Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Doctor of Philosophy

Program

Education

Supervisor

Puvirajah, A

Abstract

The Canadian federal and several provincial governments are currently collaborating to establish ‘team-based’ primary healthcare—or interprofessional collaborative practice (IPCP), which can be effectively accomplished when interprofessional education (IPE) is sustainably delivered by health and social care (HASC) professional education programs. Indeed, achieving the intended patient/client-oriented outcomes of IPE and subsequent IPCP requires deliberate and purposeful considerations of several systemic, institutional, and teaching factors. Regrettably, the analyses of the extent to which these factors have influenced effective IPCP is currently under-researched. In this integrated-article dissertation, we took a purposeful and systematic approach to explore the extent to which these multi-tiered factors influence effective IPCP in the Canadian context. First, we conducted a systematic review (Chapter 2) to familiarize ourselves with and explore when and where IPE has been implemented over the past decade (2010–2020). Next, we conducted a comparative document analysis (Chapter 3) of Canadian HASC professional accreditation standards documents, through which we evaluated the accountability of interprofessional-relevant accreditation standards―to which accrediting organizations can hold their respective academic programs accountable. These two research studies revealed three major research gaps: (1) that most IPE initiatives lacked use of theoretical/conceptual frameworks; (2) that the IPE-relevant accreditation standards overwhelmingly emphasized Students and Educational Program domains, thereby potentially compromising the sustainability of IPE; and (3) that longer IPE initiatives with greater intensity and more rigorous methodological and assessments methods are warranted. To address the first research gap, we present a conceptual paper (Chapter 4) in which we discussed the importance of curriculum and learning theories to HASC professional education processes and proposed a theoretical framework for productive engaged learning, through which IPE opportunities may be grounded. To address the second and third research gaps, we explored the integration of IPE curriculum models in the programmatic structures at four, large Canadian post-secondary institutions (Chapter 5). We further explored the enablers, barriers/challenges, limitations, and outcomes of these curriculum models, as perceived by IPE facilitators and preceptors and whether they truly lead to effective IPCP (Chapter 6). This research reinforces global and national efforts to promote sustainable IPE with aim to improve patient/client-centred care.

Summary for Lay Audience

The Canadian federal and several provincial governments are currently collaborating to establish ‘team-based’ primary healthcare—or interprofessional collaborative practice (IPCP), which is evidenced, for instance, when a physician, nurse, physical therapist, and pharmacist collaboratively apply their interprofessional knowledge, skills, and dispositions to execute personalized plans to diagnose, treat, and manage a patient’s illness or condition. Over the last few decades, this IPCP approach has increasingly become necessary to address the heavy demands on global HASC delivery systems due factors including evolving epidemiological profiles, growing ageing populations, climate change, health inequity, shifting migration (mobility) patterns, and rising healthcare costs. Optimally, HASC practitioners should be effectively trained and prepared for IPCP before they are licensed/certified to practice. As such, IPCP can be effective when students enrolled in health and social care (HASC) professional education programs are brought together to learn with, from, and about each other during interprofessional education (IPE). Indeed, achieving the intended patient/client-oriented outcomes of IPE and subsequent IPCP requires deliberate and purposeful considerations of several systemic (macro-level), institutional (meso-level), and teaching (micro-level) factors. Macro-level factors include adoption of common interprofessional language across HASC professions. Meso-level factors include fulfillment of interprofessional-relevant accreditation standards by respective HASC professional degree programs. Micro-level factors include the design, implementation, and continual evaluation of a theoretically informed and scaffolded IPE curriculum. Regrettably, the analyses of the extent to which these factors have collectively influenced effective IPCP is currently under-researched. In this dissertation, we aimed to understand the IPE milieu in Canada through an initial systematic review of IPE initiatives (Chapter 2), followed by a document analysis of Canadian HASC professional accreditation standards documents (Chapter 3), a conceptual paper that proposed a theoretical framework through which IPE initiatives may be grounded (Chapter 4), and explored the enablers, barriers/challenges, and outcomes of integrated IPE curriculum models at four post-secondary institutions in Canada (Chapters 5 and 6). This research has been prioritized by the Global Confederation for Interprofessional Education and Collaborative Practice and complements the promotion of IPE and IPCP by the World Health Organization and the Canadian federal and provincial governments with aim to improve patient/client-centred care.

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