Justine Silber

Interprofessional education (IPE) occurs when two or more professionals learn with, from and about each other to improve collaboration and quality of care.(1) The World Health Organisation has concluded that IPE is an important, innovative strategy to prepare a collaborative and practice-ready workforce that is responsive to local health needs.(2) Collaborative practice between doctors, nurses and other healthcare professionals strengthens the healthcare system and improves patient outcomes. 

The aims of IPE include improving teamwork and understanding the barriers to effective teamwork. This involves a deeper understanding of one’s own and others’ roles, expertise and responsibility, improved communication, critical reflection and learning, working in the best interests of patients and engaging with parents, families, and communities. IPE also aims to understand the stereotypical view of professions held by oneself and others and acknowledging that each professional’s view is equally valid and important.(3,4)

A barrier toward successful IPE is differing attitudes towards collaboration, with one study showing that  nurses show a more positive attitude towards shared education and teamwork compared to doctors.(5) While IPE is integral to postgraduate curricula, multidisciplinary teaching during training can help create more well-rounded clinicians; as learning together should improve future working relationships.(6) Most doctors work as part of a multidisciplinary team and the GMC states that doctors should be willing to work with other professionals and respect the roles and opinions of colleagues.(7) 

I have witnessed the clinical intuition of nursing staff on a paediatric assessment unit where I work as a medical assistant alongside my studies. One evening, while working with the junior doctors we were approached by a nurse who had triaged an 18-month year old with wheeze and asked for him to be reviewed urgently. While their observations were stable, the nurse recognised the child needed an urgent review as ‘something felt off’. This child was reviewed and deteriorated soon after, requiring ventilatory support before making a recovery. While the nurse could not explain why, she escalated the case appropriately to the medical team who listened and responded to her concerns. In this case, having a flat hierarchy, where there is a collaborative approach to leadership and decision-making, empowered staff to raise concerns, increasing patient safety.(8)

Clinical intuition is sometimes seen as controversial, with nurses feeling they cannot explain their actions or decisions based on ‘gut instinct’. Nursing intuition is more than this and is based on prior knowledge and clinical experience that can help to improve quality and safety of patient care.(9) The NHS health careers website describes the personal characteristics and skills needed for child nursing; the first line starts with “You’ll need to be intuitive….”(10)

This real-life example of IPE has taught me to value the opinions and ideas of other professionals as well as to trust my own gut instinct. This can be applied to many situations, including assessment of children with unexplained injuries requiring safeguarding interventions. In my own continued learning and career, I hope to engage in meaningful IPE that leads to better interprofessional working for patient benefit.

References

1. The Centre for the Advancement of Interprofessional Education (CAIPE), Hugh Barr. Interprofessional Education: Today, Yesterday and Tomorrow. 2002. 

2. World Health Organization. Framework for action on interprofessional education and collaborative practice. 2010. 

3. Teodorczuk A, Khoo TK, Morrissey S, Rogers G. Developing interprofessional education: putting theory into practice. Clin Teach. 2016 Feb;13(1):7–12. 

4. van Diggele C, Roberts C, Burgess A, Mellis C. Interprofessional education: tips for design and implementation. BMC Med Educ. 2020 Dec 3;20(S2):455. 

5. Mahboube L, Talebi E, Porouhan P, Orak R, Farahani M. Comparing the attitude of doctors and nurses toward factor of collaborative relationships. J Family Med Prim Care. 2019;8(10):3263. 

6. Thistlethwaite JE. Interprofessional education: implications and development for medical education. Educación Médica. 2015 Jan;16(1):68–73. 

7. General Medical Council. Leadership and management for all doctors: Working with colleagues. 2012. 

8. Fernandopulle N. To what extent does hierarchical leadership affect health care outcomes? Med J Islam Repub Iran. 2021 Oct 30; 

9. Melin-Johansson C, Palmqvist R, Rönnberg L. Clinical intuition in the nursing process and decision-making-A mixed-studies review. J Clin Nurs. 2017 Dec;26(23–24):3936–49. 

10. NHS Careers. Personal characteristics and skills required (child nursing). Health Careers.