title: How do interprofessional student teams interact in a primary care clinic? A qualitative analysis using activity theory.
abstract: Practice based interprofessional education opportunities are proposed as a mechanism for health professionals to learn teamwork skills and gain an understanding of the roles of others. Primary care is an area of practice that offers a promising option for interprofessional student learning. In this study, we investigated what and how students from differing professions learn together. Our findings inform the design of future interprofessional education initiatives. Using activity theory, we conducted an ethnographic investigation of interprofessional education in primary care. During a 5 months period, we observed 14 clinic sessions involving mixed discipline student teams who interviewed people with chronic disease. Teams were comprised of senior medicine, nursing, occupational therapy, pharmacy and physiotherapy entry level students. Semi-structured interviews were also conducted with seven clinical educators. Data were analysed to ascertain the objectives, tools, rules and division of labour. Two integrated activity systems were identified: (1) student teams gathering information to determine patients' health care needs and (2) patients either as health consumers or student educators. Unwritten rules regarding 'shared contribution', 'patient as key information source' and 'time constraints' were identified. Both the significance of software literacy on team leadership, and a pre-determined structure of enquiry, highlighted the importance of careful consideration of the tools used in interprofessional education, and the way they can influence practice. The systems of practice identified provide evidence of differing priorities and values, and multiple perspectives of how to manage health. The work reinforced the value of the patients' voice in clinical and education processes.
authors.affiliation: HealthPEER, Monash University, Melbourne, Australia. fiona.kent@monash.edu.
authors.forename: Fiona
authors.initials: F
authors.lastname: Kent
authors.affiliation: Department of Physiotherapy, Monash University, Melbourne, Australia.
authors.forename: Alison
authors.initials: A
authors.lastname: Francis-Cracknell
authors.affiliation: Department of Occupational Therapy, Monash University, Melbourne, Australia.
authors.forename: Rachael
authors.initials: R
authors.lastname: McDonald
authors.affiliation: School of Nursing and Midwifery, Monash University, Melbourne, Australia.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Newton
authors.affiliation: Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Keating
authors.affiliation: Peninsula Clinical School, Monash University, Melbourne, Australia.|Aspendale Clinic, Melbourne, Australia.
authors.forename: Miodrag
authors.initials: M
authors.lastname: Dodic
mesh_terms: D000884:Anthropology, Cultural; D001291:Attitude of Health Personnel; D005260:Female; D006282:Health Personnel / Q000193:education*; D006801:Humans; D007400:Interprofessional Relations; D007407:Interviews as Topic; D007857:Leadership; D008297:Male; D010348:Patient Care Team / Q000458:organization & administration*; D011320:Primary Health Care; D024382:Professional Role; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012945:Social Values; D000078329:Workforce
keywords: Activity theory; Collaborative care; Interprofessional education; Primary care; Qualitative analysis