Bowles L, Jones H M
Glenfield Hospital NHS Trust, Leicester, UK.
Nurse Educ Today. 1999 May;19(4):263-8.
Although there are successful examples of interdisciplinary education this generally relates to pre-registration health-care professionals. Post-registration projects are usually confined to skills workshops or social science subjects, which rarely include medical staff. This project was unusual in its attempt to combine the needs of experienced practitioners with those of medical students. There are practical issues for this form of learning such as, the organization of modules into 'systems' when health-care professionals (as part of a parallel project) indicated their interests lay in courses that related to clinical practice organized around disease processes/conditions. This case study demonstrates that concerns related to the potential mismatch of clinical expertise, maturity and scientific background are not insurmountable problems, and that clear benefits can be gained. It could be argued that until pre- and post-graduate medical staff are integrated with other disciplines, the real benefits of shared understanding, enhanced team work and mutual respect will remain illusive. It is not anticipated that this form of learning would be suitable for the majority of practitioners, whose core needs are generally met by existing opportunities. However, there is a need for a greater depth of academic understanding particularly for those in senior positions or in specific specialized areas (also identified in the parallel study) and for those whose roles are expanding. These practitioners are more likely to have the ability to apply their new knowledge to clinical practice, using reflective techniques with minimal facilitation to enhance their established clinical expertise. For them this model of learning offers the opportunity to tailor education to the individual needs of the practitioner without the costly establishment of complete new programmes of learning. This case study proved particularly successful for the participants as they enhanced understanding and confidence in the knowledge underpinning their practice. This enabled them to better anticipate patients needs, to identify complications and initiate action at an earlier stage. Their appreciation of rationale underpinning medical treatment has enabled them to support junior medical staff, and to promote the continuity of appropriate care. They are more active in the education of patients, relatives and staff, and have identified specific developments which will be informed by the knowledge they have gained. It also proved beneficial to junior medical staff with whom interdisciplinary working has improved. Each organization involved in facilitating the initiative also benefited by gaining mutual understanding and appreciation of systems, constraints and opportunities. Equally, relationships among them have been strengthened and key issues with practical solutions have been identified to inform future joint ventures. Indications suggest that there would be value in using this case study to inform a structured pilot project involving other modules of learning and potentially other disciplines. If successful it could benefit all health-care professionals, particularly those senior staff who are expanding their roles and have educational needs unmet by existing provision. In addition to providing complementary opportunities this format provides a mechanism to enhance the mutual understanding essential to effective teamwork.
尽管存在跨学科教育的成功范例，但这通常与注册前的医疗保健专业人员相关。注册后的项目通常局限于技能工作坊或社会科学科目，很少有医务人员参与其中。本项目不同寻常之处在于，它试图将经验丰富的从业者的需求与医学生的需求结合起来。这种学习形式存在一些实际问题，比如，当医疗保健专业人员（作为一个平行项目的一部分）表示他们对围绕疾病过程/病症组织的临床实践相关课程感兴趣时，如何将模块组织成“系统”。本案例研究表明，与临床专业知识、成熟度和科学背景潜在不匹配相关的问题并非无法克服，而且可以获得明显的益处。可以说，在研究生前和研究生阶段的医务人员与其他学科整合之前，共享理解、加强团队合作和相互尊重的真正益处将仍然难以实现。预计这种学习形式并不适合大多数从业者，他们的核心需求通常可通过现有机会得到满足。然而，尤其对于那些担任高级职位或处于特定专业领域的人员（平行研究中也有提及）以及那些职责正在扩大的人员而言，需要有更深入的学术理解。这些从业者更有可能有能力将新知识应用于临床实践，运用反思技巧，在最少的指导下提升他们已有的临床专业知识。对他们来说，这种学习模式提供了一个机会，可根据从业者的个人需求定制教育，而无需花费高昂成本设立全新的学习项目。本案例研究对参与者来说特别成功，因为他们增强了对实践背后知识的理解和信心。这使他们能够更好地预测患者需求，识别并发症并在更早阶段采取行动。他们对医疗治疗基本原理的理解使他们能够支持初级医务人员，并促进适当护理的连续性。他们在患者、亲属和工作人员的教育方面更加积极，并确定了将根据所获知识进行的具体发展方向。事实还证明，这对初级医务人员也有益，跨学科合作因此得到改善。每个参与推动该倡议的组织也都从中受益，增进了对系统、限制因素和机会的相互理解和认识。同样，它们之间的关系得到了加强，确定了带有实际解决方案的关键问题，为未来的合资企业提供参考。迹象表明，利用本案例研究为涉及其他学习模块以及可能其他学科的结构化试点项目提供参考是有价值的。如果成功，它将造福所有医疗保健专业人员，尤其是那些职责正在扩大且现有教育资源无法满足其教育需求的高级工作人员。除了提供补充机会外，这种形式还提供了一种机制，可增强对有效团队合作至关重要的相互理解。
