Context / probleemstelling of aanleiding
Probleemstelling (inclusief theoretische onderbouwing en onderzoeksvraag/vragen):
Interprofessional Education (IPE) is essential for the development of a ‘collaborative practice-ready’ health workforce. To date, there is evidence that suggests mixed outcomes emerging from IPE interventions ranging from positive to no outcomes at all. Objective evidence of the contexts and mechanisms of IPE that are associated with positive outcomes in undergraduate education in health sciences is limited. With this review we seek to understand how exactly IPE in undergraduate education in health sciences and social work is executed, which components of IPE work for which specific groups, under what circumstances and why.
Methode:
We conducted a realist review, which is a theory-driven interpretive approach to evidence synthesis. We developed an initial programme theory by relying on the available literature, as well as by consulting stakeholders and drawing on the diverse expertise of our review team. The search strategy for the development of the refined programme theory focused primarily on electronic database searching (2010 – May 2022) and was complemented by, i) ‘cited by’ searching, and ii) stakeholder sessions. We included documents based on whether they contain information that can contribute to the theory building (relevance), whether there was any consideration of the context within which the intervention took place, of internal processes of the intervention, whether there was any mention of the underlying theory and whether there was any mention of facilitators of and barriers to the intervention (rigour). We collected, examined and appraised evidence of the different outcomes within the initial programme theory and we inferred how these outcomes emerge in certain contexts through various mechanisms by relying also on substantive learning theories that allowed us to better understand the function of mechanisms in specific contexts. We conducted an iterative process of collaborative thinking by a multidisciplinary project group and consultation of experts.
Resultaten (en conclusie):
Following the quality appraisal and full text screening, we analysed 58 eligible papers. We identified 3 main mechanisms facilitating students’ learning during IPE (feeling responsible, feeling enthusiastic/excited, feeling safe), and one clustered mechanism (feeling supported/competent/acknowledged and valued) that were sufficiently supported by the collected and appraised evidence. We identified a set of specific context , intervention- and facilitator modalities that trigger these mechanisms. We organized the reported learning outcomes according to the IPEC competency framework and indicated specific subcompetencies which seem to be related to the reported outcomes. Finally, we adjusted our initial programme theory according to our findings which allowed us to produce, a set of more comprehensive insights into interprofessional learning
Discussie (beschouwing resultaten en conclusie in het kader van de theorie):
Our review added insights into the mechanisms of student learning during IPE and allowed us to produce a refined and evidence-informed programme theory that is in keeping with middle range theories that aim to explain learners’ behaviour. Based on our programme theory we provide a set of recommendations for developers of IPE interventions.
