title: Healthcare students as innovative partners in the development of future healthcare services: An action research approach.
abstract: BACKGROUND
  Health care systems in Norway and the western world have experienced extensive changes due to patients living longer with complex conditions that require coordinated care. A Norwegian healthcare reform has led to significant restructuring in service delivery as a devolution of services to municipalities.
  Partners from three rural healthcare services, students from four professional programmes, and one lecturer from each of the professional programmes used a collaborative approach to obtain new knowledge through interprofessional practice. Using an action research design, the research group facilitated democratic processes through dialogues with healthcare services and students. The design is visualised as a cyclical process in which each cycle contributes to improvements, innovations, and increased understanding. A total of 32 students and 3 supervisors were interviewed before and after the clinical practice experiences. Fieldwork was conducted during three clinical periods.
  
  
  RESULTS
  Interprofessional student groups formed small healthcare teams and assessed patients with chronic and long-term conditions. Students prepared and negotiated patient follow-up. The teams' responsibilities led to reflective practices that enhanced their professional knowledge. The teams achieved a new understanding of patient situations, which influenced "second opinions" for patients with complex conditions and led to innovative practices. The change in perception of patient needs led to a changed professional approach. The students' perceptions changed as they learned from and about each other and in collaboration with the health service; this led to more coordinated care of patients with complex conditions. Interprofessional learning in community settings provided a platform to improve both healthcare education and rural healthcare services.
  
  
  CONCLUSIONS
  This research contributes to knowledge of how students' placement in interprofessional teams can enhance students learning from, with and about each other. The student teams promoted new ways of approaching and delivering complex patient treatment and care in community healthcare service. Collaborative partnerships in interprofessional learning have potential in the wider international arena as a means for practice improvement.
authors.affiliation: UiT The Arctic University of Norway, Faculty of Health Sciences, Department of Health and Care Sciences, Tromsoe, Norway. Electronic address: bente.norbye@uit.no.
authors.forename: Bente
authors.initials: B
authors.lastname: Norbye
mesh_terms: D002908:Chronic Disease / Q000628:therapy; D002982:Clinical Clerkship / Q000458:organization & administration*; D003153:Community Health Services / Q000458:organization & administration*; D003299:Cooperative Behavior; D006282:Health Personnel / Q000193:education*; D006302:Health Services Research; D006801:Humans; D007400:Interprofessional Relations; D009664:Norway; D010348:Patient Care Team / Q000458:organization & administration; D058996:Quality Improvement / Q000458:organization & administration; D019035:Rural Health Services / Q000458:organization & administration*
keywords: Action research; Community healthcare; Innovative practice; Interprofessional learning; Practice-based learning