Centre for Rural Health, University of Tasmania, Launceston, Australia.
Academic Division, University of Tasmania, Hobart, Australia.
J Interprof Care. 2020 Jan-Feb;34(1):66-75. doi: 10.1080/13561820.2019.1635095. Epub 2019 Jul 22.
Interprofessional learning (IPL) is a dynamic process. It incorporates adult learning principles and requires active participation. Contemporary paramedic care typically involves collaboration with other health-care professionals. However, little is known about how paramedics work and construct meaning within this interprofessional milieu. Rural areas, where professional collaboration is well illustrated, provide an opportune setting from which to conduct the examination of IPL and paramedic care. Twenty-six participants took part in this investigation. Participants were paramedics and other professionals involved in collaboration in rural locations across the state of Tasmania, Australia. Rural Tasmania provided a diverse range of paramedic practice for investigation, including traditional (pre-hospital) care, extended care, volunteer services, and hospital-based practices. A grounded theory approach was adopted, and semi-structured interviews used to collect critical incidents in which participants described effective and less effective episodes of collaboration. Memos were kept during the research process. Analysis of data followed a process of initial and then focused coding from which the main concepts could be determined. From 75 episodes of collaboration, three main concepts emerged to create a theory of IPL and paramedic care. Relationships included reciprocity and respect, as well as professional acknowledgment. Cooperation recognized professionals as interdependent practitioners adopting open communication. Operational barriers identified contextual features under which professionals work, with constituent categories of protecting turf, and workplace culture. The findings provide new insight into IPL and paramedic care. Hierarchy, professional dominance, and gender disparity emerged as barriers to IPL. Knowledge and skills were shared between professions and this influenced how individuals interacted within interprofessional teams. A successful collaboration produced a clinical environment where patient care was informed by contributions from all team members.
跨专业学习（IPL）是一个动态的过程。它结合了成人学习原则，并需要积极参与。当代护理人员的护理工作通常涉及与其他医疗保健专业人员的合作。然而，对于护理人员在这种跨专业环境中如何工作和构建意义知之甚少。在专业合作得到充分体现的农村地区，为进行 IPL 和护理人员护理的检查提供了一个恰当的环境。共有 26 名参与者参与了这项研究。参与者是澳大利亚塔斯马尼亚州各地农村地区参与合作的护理人员和其他专业人员。塔斯马尼亚州农村地区为调查提供了多样化的护理人员实践，包括传统（院前）护理、延伸护理、志愿者服务和基于医院的实践。采用扎根理论方法，使用半结构化访谈收集参与者描述合作有效和无效的关键事件。在研究过程中保留了备忘录。数据分析遵循初始和重点编码的过程，从中可以确定主要概念。从 75 个合作事件中，出现了三个主要概念，形成了 IPL 和护理人员护理的理论。关系包括互惠和尊重，以及专业认可。合作承认专业人员是相互依存的从业者，采用开放的沟通方式。操作障碍确定了专业人员工作的上下文特征，包括保护地盘和工作场所文化的组成类别。研究结果为 IPL 和护理人员护理提供了新的见解。等级制度、专业主导地位和性别差异成为 IPL 的障碍。专业之间共享知识和技能，这影响了个人在跨专业团队中的互动方式。成功的合作产生了一个临床环境，使所有团队成员的贡献都能为患者护理提供信息。
