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Interprofessional Module 2: Interprofessional Collaboration in Practice

The following is the Essay on Interprofessional Collaboration in Practice submitted, but my sister have got only 35 marks where as the pass mark was 40 marks. I am attaching the submitted Essay with the markers comments. I here by attaching three (3) high marked essays (on Interprofessional Collaboration in Practice) for your reference and understanding, and also Key note address at the conference. At the conference we had 6 Agreed Group Sentences these sentences

also need to discuss while writing the essay (the sentences are also attached as appendix), So I need 2500 words essay in total (in two sections) without including references and appendix. Essays (detailed) criterias also attaching. This Essay needs to be referenced by using Harvard referencing system.
(This essay aims to discuss the main aspects of what I have learnt after attending the IP2 conference and my learning after the group work I undertook with students from different professions. The conference "Interprofessional Collaboration in Practice" gave me the opportunity to work with another students from different professions: adult nursing; children's nursing; midwifery; social work; physiotherapy; occupational therapy; mental health nursing; radiotherapy; learning disability nursing; diagnostic imaging; and finally medical students. After attending the conference I gained a much better understanding of these roles and, in addition I would feel more confident when interacting with them in the future (Dickinson and Carpenter, 2005).

-------------------------------------------------------------------------------------------------------------------------Overall comments (including positive aspects of work and areas which could be improved) First Marker You show that you have some knowledge and understanding of IP working and have drawn on a range of reading to explore these issues. You link your reading and the conference seminars to your team statements. You tend to present your reading by summarising key points, for example in relation to definitions of IPE and IPW, stereotyping and power. This makes your work rather descriptive and you needed to look in more detail at some of the tensions and difficulties you refer to. For example on page 2 you mention virtue and care ethics but needed to explore the difference between these and then how they relate to your discussion about surveillance and control. The team statements were interesting but you needed to say more about the process of your group working together and your contribution to this to identify what was behind some of the wording as this was not clear from your discussion.

In part 1 you needed to say more about your learning and how the team worked, for example on page 3 where you are discussing stereotyping your comments relate to Hean et als work rather

than being related to the conference. In the next paragraph you discuss power but in your discussion look at this just in relation to the medical profession rather than looking at how all professionals have power as your team statement conveys.

In part 2 you refer to the NMC Code of Practice and show that you can appreciate the importance of collaborative working. In this section you tend to present your reading rather than look in any depth at the implications for your professional practice. Also there is some repetition of your points about team working. You say there is evidence to show that IP practice contributes effectively to positive health but needed to say what the evidence for this is.

You do end with some general points about how you will take your learning into practice but these needed to be much more specific.

You have included a range of references but there are some inaccuracies and the layout of these is not consistent with the Harvard referencing guidelines.

The strength of your work is in the range of reading that you have done and your efforts to link this to the team statements. You needed to analyse the issues and how these apply to practice in much more detail to show that you understand the complexities of IP working. Second Marker: - At times the assignment reads as if an IP1 submission and you need to develop reading and understand beyond year one core issues. Further reading to develop the IP2 themes would raise understanding. Application of the IP2 themes is very weak. Knowledge & Understanding Acceptable Intellectual Skills Inadequate Transferable Skills Inadequate Professional / Practical Skills Inadequate *Please refer to your Module Handbook for the descriptors which are being assessed and the distribution of marks across them. For more detailed feedback, please refer to the marking grids in the Faculty Student Handbook. Agreed Mark: ]

Submitted Essay as follows (Above comments from the markers)

Section 1. This essay is going to discuss my learning about Interprofessional working (IPW) and Interprofessional education (IPE). Pollard et al., (2010) defined Interprofessional working as the process where members of different professions and or agencies work together to provide integrated health and or social care for the benefit of service users. The two day IP conference (2011), was a great opportunity to meet different professionals and agencies from different areas of health and social care profession and share their views and understanding on IP working and IP learning. The Centre for Advancement of Interprofessional Education (CAIPE) has defined IPE as Interprofessional Education occurs when two or more professions learn with, from and about each other to improve collaboration and the quality of care" (CAIPE, 2002). CAIPE uses the term "Interprofessional education" (IPE) to include all such learning in academic and work based settings before and after qualification, adopting an inclusive view of "professional". Based on the key themes, we discussed how Interprofessional collaboration can provide best possible care to the service users and analyse where the services are lacking. Through group discussions, key note addresses and seminars, I was able to learn about the communication issues between the health and social care professionals, contrasting professional perspectives and values, ethics within teams and stereotyping, power imbalances and team processes ( Fletcher, 2008). Improving the quality of communication is now a key priority for health and social care (DoH, 2008). Staffs at all levels are expected to work in partnership with multiprofessionals and agencies. Service users expect, and demand, greater equality in service provision. The effective communication of patient information underpins collaboration between health and social care practitioners as well as the efficient and safe delivery of care to the patients (DoH, 2008). During discussions, everyone in our group agreed that current mechanisms for information transfer are inadequate, and have largely depended on informal means of communication between professionals. Where formal mechanisms exist, communication is improved but difficulties remain

across professional and organisational boundaries. We agreed on the statement that communication is subjective for each profession but ultimately need to achieve the highest level of patient care. Fletcher (2011), suggests there are interprofessional ethical issues and challenges when practitioners from different professions work closely together in the fields of health and social care. The NMC Code (2008) states You must work co-operatively within teams and respect the skills expertise and contributions of your colleagues. Seminars from the conference on this theme emphases how to learn and work effectively within a multi-professional team. Tomorrows Doctors (GMC, 2009), explains how to understand and respect the roles and expertise of health and social care professionals in the context of working and learning as a multi-professional team and understands the contribution that effective interdisciplinary team-working makes to the delivery of safe and high-quality care. We should work with colleagues in ways that best serve the interests of patients. We also discussed issues of confidentiality and information sharing in practice and research with vulnerable people. There are challenges for teaching and learning about ethics in interprofessional settings, the potential of virtue ethics and an ethic of care for understanding and handling ethical issues in interprofessional practice and the extent to which interprofessional working may be about surveillance and control. According to Beauchamp and Childress (2001) the ethical framework has four ethical principles; respect for autonomy, beneficence, non-maleficence and justice. The need to understand and handle ethical issues in interprofessional working is contributing to the revitalisation of professional ethics as a dynamic field of study and we agreed on the statement that It is evident that there is contrast in professional values i.e. Spiritual, financial and moral etc. but perspectives can result in the downfall of Interprofessional working. Recognition of these differences will help to place the patient at the centre of care. Hean et al., (2006, p162-181) suggested that students bring with them stereotypical views of different professional groups. Health and social care (HSC) students hold

stereotypical views of other HSC professional groups is of great potential importance to team working in health care. During the course of discussion, all professionals expressed their views on stereotyping. Midwives, social workers and nurses were rated most highly on interpersonal skills and on being a team player whilst doctors were rated most highly on academic ability. Doctors, midwives and social workers were perceived as having the strongest leadership role, whilst doctors were also most highly rated on decision making. All professions were rated highly on confidence and professional competence and, with the exception of social workers, on practical skills. Pharmacists and doctors were perceived as having very similar characteristics as were social workers, midwives and nurses. However, the profiles of nurses and doctors were perceived to be very different. The implications of these similarities and differences are discussed in terms of their potential impact on interprofessional interactions, role boundaries and team working. It has been argued that stereotypes may interfere with interprofessional team working (Barnes et al., 2000); (Miller et al., 2001); (Carpenter et al., 2003). By concluding the discussion we agreed on the statement that Stereotyping in health and social care professionals do exists and certain aspects may be negative, but positive allow for a high level of care. Power and politics is no easy task as it requires and understanding and acceptance within the interprofessional settings. Fletcher (2008) states Traditional power boundaries are still present in many areas of health and social care that limit the effectiveness of IPE. Power is shared and fluctuates in accordance with whose knowledge and expertise best meets the need of the client / service user. Some may struggle with this as power has traditionally been sanctioned through and within the health and social care, has been located within the medical profession. Sharing power can be perceived as a threat to professional autonomy and joint working can engender professional rivalry and envy if those involved feel that sharing their status and unique position within health and social care practice. Our statement on this subject is, As health and social care professionals, we have power through our knowledge and procedures, this can be used for the protection and safety of the patients, but can be abused to the neglect of vulnerable persons.

Meads et al (2005) suggest values in Interprofessional education focuses on the needs of individuals, families and communities to improve their quality of care, health outcomes and wellbeing, applies equal opportunities within and between the professions and all with whom they learn and work. This relies on acknowledging, but setting aside differences in power and status between professions, respecting individuality, difference and diversity within and between the professions and all with whom they learn and work, utilising distinctive contributions to learning and practice. Maintain the identity and expertise of each profession, presenting each profession positively and distinctively. This was very evident in our conference and group discussions. We respect other professionals individuality and following on our ground rules. The IP conference helped me to improve my understanding of IPW and IPL. With regard to my experience in adult nursing it was a great opportunity for me to interact and discuss my view with other professionals and learned a lot from their perspectives. I believe effective team working can change all issues that we are presently facing in health and social care. In my future career I hope this learning experience will help me to provide best possible care to the service users. Words: 1239 Section - 2. This part of the assignment is going to look at the concept of interprofessional working (IPW) including diversities in collaborative working and how it can be implemented into my practice. I will consider what I can do in my practice as a future adult nurse to deliver and promote successful interprofessional collaboration and what challenges I need to face. By attending the IP conference, I was able to understand more about IP working and IP learning, what is team working, why it matters in health and social care sector and the importance of interprofessional working. IPW has helped to enhance my

learning to compare with real life experiences and theories. I am going to reflect on this experience to my future placements. Nursing Midwifery Council (NMC) Code of Practice (2008) implies each student carry professional responsibility for providing service in accordance with the ethics of profession and the policies of the organisation and students are expected to develop professional discipline, identification with nursing role and professional competence. To achieve this, it is essential for us to participate in collaborative working. Historically, different professionals from the private, public and voluntary sectors provided the planning and delivery of care to service users separately. Interprofessional issues were first introduced into British health and social care literature in 1977 (Barrett and Keeping, 2005). Over the past three decades, it is an approach that has been increasingly promoted as a more effective way of professionals working together and providing a better standard of care. We identified, through discussion, patient care as a complex activity which demands that health and social care professionals work together in an effective manner. Partnership working is quite literally a mater of life and death, and failure to interprofessional working can have the most serious consequences for all involved (Barrett and Keeping, 2005, p.18-31). Following the death of Victoria Climbi in 2000, a series of reforms have taken place in childrens services to promote more efficient partnerships. In the court findings there were failure at every level and by every organisation which come into contact with Victoria Climbi. Victoria needed services that worked together. Instead the report says there was confusion and conflict (DoH, 2003). The only way to break down the barriers between these services is to break down these barriers altogether. Here it is evident that the collaboration between the inter-professionals hasnt work effectively. In health and social care a professional identity influences the ways in which we care for someone (Fletcher, 2011). In nursing it is important to remember that providing holistic care often involves the use of other professionals and this concept should be encouraged in order to facilitate the provision of patient care. Interprofessional working is recognised as being paramount in provision of care and it is recommended that this

involves all agencies and disciplines. There is evidence to show that interprofessional practice is an effective contributor to the positive health outcome. Since 2001, the National Health Services (NHS) claimed that interprofessional practice education must be a core feature in the training of all health care professionals. Along with the changing of health care system around the world, interprofessional practice which can provide effective team work has the ability to improve the working environment, increase mutual respects of each team members involved in delivery care and share the knowledge between different fields (McNair, 2005) . Sellman (2010) suggests that effective IP working is dependent on three key aspects: The willingness condition to do whatever is required to contribute to effective team working. Team needs are put on a higher footing than personal needs. The trust condition the recognition that effective team working requires professionals to trust one another. The leadership condition the recognition that effective team working requires effective and appropriate leadership. We agreed, If these aspects can implement in our day today work, there really are no great secrets about team working, but different knowledge levels, skills, intuition and experiences make it a contested arena, an area that needs real commitment, investment and curiosity. Stereotypes are social categorical judgment(s) of people in terms of their group memberships (Turner, 1999). It is seen as innately socially undesirable to hold stereotypes of the members of social groups other than ones own. However, stereotyping is a natural human process Haslam et al., (2002) and one that may have both positive and negative outcomes. Positively, individuals may use their established stereotypes to guide their inter group behaviours. This is a valid mechanism whereby people make sense of their interactions with other groups. After my IP learning on stereotyping I would like to take stereotyping in a positive manner, which will enable us to provide a high standard of patient care. There really are no great secrets about team working, but different knowledge levels, skills, intuition and experiences make it a contested arena. An area that needs real

commitment, investment and curiosity. Form the conference I learned, to never underestimate the power and importance of team working. There is a tendency in health and social care settings not to prioritise team development, as care inputs are seen as more immediately important. However, team development and team working do have real implications for the quality of services delivered, particularly within interagency settings. At the same time people need to be encouraged to think about whether the task in hand really needs a team and whether there is a need for teams to tackle real issues as conflicts are draining and impact on everyone. The WHO (2010, p.14) notes that IPE is a type of long-term planning and that it can sometimes be sidelined. Another important aspect I learned through my IP group work and going to take to placement is that, there is not much time to bond well in the professional settings. Hence when collaborating in a multidisciplinary team, I have to be confident and professional to provide the best care needed for the patient. On reflecting back on work I was able to see confidence is a key and it will increase by working more in a multi professional team. We felt that it was important to challenge stereotypes and prejudices, including our own. If a person does not feel confident in working in a team they might get easily distracted and might not feel as comfortable and will not able to contribute. As a consequence when working in a health setting the patient should be the main priority and providing the best care should be the main aim. Moreover, I have to prepare and need lots of background knowledge to contribute more. Doing research and gaining more information from experienced staff could increase my background knowledge. In conclusion, the concept for IPW has been described with reference to the benefits, barriers and difficulties associated with different professional disciplines working together. Some of the significant policies, which relate to health and social care and the development of IPW, have been highlighted. The diversity in collaborative working has been analysed. Ideas have been included on how they can be accommodated. Power relations in the structuring of collaborative group work have been explained. Finally, through group work the ability to work collaboratively was reflected on using a reflective model. I am going to continue in my future placements to get as much experience as I can with different professionals and across different agencies.

Word count: 1222

Appendix I 6 Agreed Group Sentences Communication within health and social care teams 1. Communication is subjective for each profession but ultimately needs to achieve the highest level of patient care. 2. Active listening can only be effective if the whole patient is taken into account using a universal language and time to allow clarity. Contrasting professional perspectives/values within teams 1. It is evident that there is contrast in professional values i.e. spiritual, financial and moral etc. but perspectives can result in the downfall of Interprofessional working. Recognition of these differences will help to place the patient at the centre of care. 2. Recognition of these differences will help to place the patient at the centre of care. Stereotyping, power imbalances and team processes 1. As health and social care professionals we have power through our knowledge and procedures, this can be used for the protection and safety of the patients, but can be abused to the neglect of vulnerable persons. 2. Stereotyping in health and social care professionals do exists and certain aspects may be negative, but positive allow for a high level of care References: Barrett G., Keeping C. (2005). Interprofessional Working in Health and Social care: Professional Perspectives An Introductory text. Hampshire: Palgrave MacMillan, 2005, pp.18-31.

Beauchamp T., Childress J.(2001) Principles of Biomedical Ethics 5th Edition. Oxford University Press Barnes D., Carpenter J., & Dickinson C. (2000). Interprofessional Education for Community Mental Health: Attitudes to Community Care and Professional Stereotypes. Social Work Education, 19, 565 583. CAIPE. (2002) About us: Defining IPE [Online]. Available http://www.caipe.org.uk/about-us/defining-ipe/. [Accessed 7th March, 2011]. from:

Carpenter J., Barnes D., & Dickinson C. (2003). Making a Modern Mental Health Care force: Evaluation of the Birmingham University Interprofessional Training Programme in Community Mental Health 1998 2002. Durham: University of Durham. Department of Health (DoH, 2008) National Strategic Frame Work for Older People. London HMSO. Department of Health (2003), Health Committee. House of Commons. The Victoria Climbi Inquiry Report: Sixth Report of Session 20022003. The Stationery Office. 25 June 2003. Fletcher I . (2011) Ethics and Interprofessional Education. UWE Bristol, IPE Level 2 Conference Fletcher I. (2008) Power and Politics in Academy Land (a case study of 2 NHS / HEI Learning Academies. (Ed.D Thesis) UWE General Medical Council (2009) Tomorrows Doctors.(3rd Ed) GMC: London Haslam S. A., Turner J. C., Oakes P. J., Reynolds K. J., & Doosje B. (2002). Stereotypes as Explanation: The formation of Meaningful Beliefs About Social Groups. Cambridge: Cambridge University Press.
Hean, S., Macleod Clark, J., Adams, K. & Humphris, D. (2006) Will opposites attract? Similarities and differences in students perceptions of the stereotype profiles of other Health and Social Care Professional Groups Journal of Interprofessional Care 2006 20(2) 162-181

Miller C., Freeman M., & Ross N. (2001). Interprofessional Practice in Health and Social Care and Developing Common Learning: the New Generation Project Undergraduate Curriculum Model. Journal of Interprofessional Care. Meads G., Ashcroft J., Barr H., Scott R., and Wild A. (2005) The case for interprofessional collaboration in health and social care. Oxford: Blackwell publishing. McNair. (2005) cited in Learning and Teaching for Interprofessional Practice, Australia. (2009).

Nursing and Midwifery (2008) The Code: Standards of Conduct, Performance and Ethics for Nurses and Midwives. NMC: London Pollard K., Thomas J., and Miers M.(2010) Understanding Interprofessional Working in Health and Social Care, Theory and Practice. Palgrave Publishing Sellman D. (2010) Values and Ethics in Interprofessional Working In Pollard K. Thomas J (2010) Understanding Interprofessional Working in Health and Social Care: Palgrave MacMillan Turner J. C. (1999). Some current issues in Research on Social Identity and Self Categorization Theories. In N. Ellemers R. Spears, & B. Doosje (Eds.), Social Identity, Context, Commitment, Content (pp. 6 34). Oxford: Blackwell Publishers.
World Health Organisation (2010, p.14) Framework for action on Interprofessional Education and Collaborative Practice