Academic journal article Health Sociology Review

Reimagining Health Professional Socialisation: An Interactionist Study of Interprofessional Education

Academic journal article Health Sociology Review

Reimagining Health Professional Socialisation: An Interactionist Study of Interprofessional Education

Article excerpt

Introduction

The organisation of health care is changing. Medical systems are increasingly adopting interprofessional approaches, where health professionals collaborate in teams to reduce costs and improve patient and family care outcomes (Bell et al., 2009; World Health Organisation [WHO], 2010). While interprofessional practice (IPP) leads to improved patient outcomes and staff satisfaction, it can also lead to conflict within teams and increases in boundary work across professional groups (McNeil, Mitchell, & Parker, 2013).

Interprofessional education (IPE) is promoted as the solution to improving IPP (Ardnt et al., 2009; Cameron et al., 2009; Pecukonis, Doyle, & Bliss, 2008). IPE is where future health and social care professionals learn collaboratively alongside and about students in other related disciplines (Freeth, Hammick, Koppel, Reeves, & Barr, 2002), developing an appreciation for the similarities and differences in other health professionals' roles and cultures (Hamilton, 2011; Khalili, Orchard, Spence Laschinger, & Farah, 2013; Pecukonis et al., 2008). Clark (2006, p. 587) emphasises the social nature of IPE, implicating a hidden curriculum: 'Students learn as much, or more, from each other about their different professional roles, backgrounds, and training as they do from the instructor'. This statement points to the important contribution that sociology can make in understanding health professional education. Harkening back to studies conducted over 50 years ago, Merton (1957) and Becker, Geer, Hughes, and Strauss (1961) depicted medical education as a socialisation process involving both overt curricula, delivered within formal university settings, and powerful hidden curricula, enacted through interactions beyond the academy's control (see also Hafferty, 1998).

Countless studies have investigated IPE in medicine and nursing; this research goes some way towards explicating the factors (e.g. status, gender, boundary work) challenging IPE and interprofessional socialisation. Fewer studies examine IPE in allied health; those that do typically take an atheoretical intervention study design, rather than a socialisation approach (Olson & Bialocerkowski, 2014). As Khalili et al. (2013, p. 449) explain, 'To date, the focus of IPE literature has primarily been on descriptions of IPE programme development and changes in learners' attitudes, knowledge and skills following these experiences.' Thus, little is known about the social and contextual factors underpinning interprofessional socialisation in allied health. Unobtrusive research is needed to better understand not just 'what works' (d'Avray & McCrorie, 2011), but the process: what IPE mechanisms work for whom, in what contexts and why (Cameron et al., 2009; Khalili et al., 2013; Olson & Bialocerkowski, 2014)?

The aim of this research is to gain a better understanding of the overt and hidden curricula mechanisms at work as well as the social and contextual factors implicated in interprofessional socialisation. We seek to re-imagine IPE as a varied socialisation and identity confirmation process. To this end, we qualitatively analysed the experiences of pre-licensure allied health students during their first year of a university-based IPE curricula at one Australian university. To overcome the limitations of previous studies, we adopted an inductive but theory informed approach to analysis.

Background

In this section we outline social and contextual factors found to be relevant to IPE and the theories used in previous sociological investigations of IPE, demonstrating the utility of the theory used to inform our analysis: Holland, Lachicotte, Skinner, and Cain's(1998) 'identity as practice'.

Social and contextual factors

The literature on IPP and education suggests that social differences can affect relationships within teams. Social characteristics shape behaviour expectations, status, group interactions and team outcomes (Bell, Michalec, & Arenson, 2014). …

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