Interprofessional Outcomes: Impact of an interprofessional student interview and review on subsequent patient management

Abstract

This thesis explores the experiences and views of people involved in a pre-licensure, rural, interprofessional intervention called the rural health interprofessional immersion programme (RHIIP). The RHIIP patient interview involves patient interviews by interprofessional student groups exploring the subsequent General Practitioner (GP) management of the patient, and incorporates the perspectives of patients and participating GPs on benefits to the patient and the community. This thesis seeks to answer two questions; how do patients perceive the RHIIP patient interview and its impact on the care they receive? How do GPs perceive the RHIIP patient interview and the extent to which it contributes to their ongoing patient care? A systematic review showed that few interprofessional education (IPE) studies conducted in pre-licensure practice based settings have included patient outcomes, despite improvement of health care being an overarching aim of these studies. There was also a lack of consistent reporting on IPE goals, barriers and enablers, and sustainability of the studies. The review was followed by mixed-methods research, triangulating data from patient questionnaires (n=6), semi-structured interviews with GPs (n=4) and reports from patient/student interviews (n=8). An interpretive phenomenological approach was taken to analysis; beginning with consideration of the individual perspective and then comparing views across different groups of research participants. Four case studies are presented. Participating patients viewed the interview positively and saw engagement as a way of contributing to student learning. The case studies illustrate how multiple perspectives enhance our understanding of health care needs; inform decision making and the quality of health care. A holistic interview with a narrative approach facilitated patient-centred care through an increased understanding of the wider socio-cultural aspects of health. GP participants described the value of the RHIIP patient interview in terms of its capacity to improve patient care, service delivery, reflective practices of GPs, and growth of the rural workforce. The study identified contextual barriers and enablers for the RHIIP patient interview and for IPE more broadly. Based on the research findings, recommendations for future research are made, concerning enhancing GPpatient engagement, cultural competence in health care, and addressing barriers to implementation of IPE in the community.