Working together for patients is a core NHS value (Department of Health, 2015), and the public expects to receive high quality care from a well-trained, cohesive workforce. Landmark reports (Laming, 2003; Francis, 2013; Kirkup, 2015) have highlighted how poor interprofessional communication and teamwork can have devastating implications for standards of care and outcomes for service users.
The Nursing and Midwifery Council (NMC) and the Health and Care Professionals' Council (HCPC) aim to protect the public by regulating the practice of health and social care professionals in the UK. They set standards, approve programmes of study and take action when standards are not being met, thereby ensuring that registrants deliver—and service users receive—the highest standards of care. Educational institutions must provide student midwives with a variety of learning and teaching opportunities to enable them to achieve the NMC standards for pre-registration midwifery education (NMC, 2009). The standards are divided into four domains: effective midwifery practice, professional and ethical practice, developing the individual midwife and others, and achieving quality care through evaluation and research. Essential skills clusters for pre-registration midwifery education require midwives to demonstrate collaborative working with other health professionals and external agencies, and confidence in their own role in a multidisciplinary or multiagency team (NMC, 2009). There are, therefore, clear and explicit professional requirements for interprofessional education (IPE) to be included in the pre-registration midwifery curriculum.
Interprofessional education
According to the Centre for the Advancement of Interprofessional Education (CAIPE) (2019), ‘IPE enables two or more professions to learn with, from and about each other to improve collaborative practice and quality of care.’ IPE was conceived by a World Health Organization (WHO) Expert Committee on Continuing Education for Physicians in 1973 (WHO, 1973) and key messages in its Framework for Action on Interprofessional Education and Collaborative Practice (WHO, 2010:7) acknowledge that:
Successful interprofessional collaboration and teamwork have a positive impact on service user satisfaction and outcomes (Grumbach and Bodenheimer, 2004). In addition, working in an interprofessional workforce has also been shown to promote competencies (Reeves et al, 2007) and interprofessional respect, by challenging professional stereotyping (Ateah et al, 2011).
In the UK, CAIPE was established in 1987 to promote public health and social care by championing IPE. The NMC and HCPC concur that IPE is fundamental in preparing healthcare students to join a multiprofessional, multiagency workforce (HCPC, 2017; NMC, 2018). The HCPC states that programmes of study: ‘must ensure that learners are able to learn with, and from, professionals and learners in other relevant professions' (HCPC, 2017:35). The NMC state that they ‘will only approve programmes where the learning culture is ethical, open and honest, is conducive to safe and effective learning that respects the principles of equality and diversity, and where innovation, interprofessional learning and team working are embedded’ (NMC, 2018:5).
Barriers to interprofessional education
Previously, students learnt about the theory and practice of interprofessional collaboration and working as a uniprofessional activity. This is the antithesis of IPE, since it does not support professional socialisation in an educational context. IPE is challenging to organise in terms of co-ordinating multiple timetables and finding appropriate teaching spaces, and it can be perceived as an additional ‘learning burden’. It is therefore clear that an innovative, engaging and authentic strategy, where students learn with, from and about the students with whom they will actually work in the clinical setting, is key. This approach should also aim to ensure that students from across the Faculty of Health and Society at the University of Northampton to understand the relevance and importance of IPE.
Strategy
The University of Northampton's approach to learning and teaching, ‘active blended learning’, has been discussed in this column before in the context of the acquisition of clinical skills (Power and Cole, 2017). It is a student-centred approach to support the development of subject knowledge and understanding, independent learning, and digital fluency, and in line with this institutional pedagogical approach, the Faculty's IPE strategy aims to provide innovative, multidimensional learning opportunities through a scaffolded ‘collaborative curriculum’. Students will develop their knowledge, attitudes, skills and behaviours by engaging in authentic interprofessional learning activities such as workshops, group work and online activities. Tasks might include comparing roles and responsibilities; practising communication and negotiation skills; exploring the concepts of power and authority; reviewing ethics and codes of practice; and reflecting on experiences in clinical practice. Such activities aim to link theory to practice, ensuring students become practitioners who can develop effective interprofessional relationships to deliver high quality care through collaborative practice.
Just the beginning …
This is only the beginning of the new IPE ‘collaborative curriculum’ at the University of Northampton, and there will be challenges in successfully embedding IPE across the Faculty so that it is perceived by students and staff as valuable and relevant to practice. The objective is to support students to work effectively, competently and confidently in the multiprofessional team; to respect and value other health and social care professions; and make a positive impact on standards of care. The message to readers is therefore: watch this space!