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Lesley Diack is a research fellow (shared learning),
school of pharmacy,
Robert Gordon University, and School of Medicine, University of Aberdeen
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It has been nearly 50 years since shared learning and interprofessional
practice for personnel in the NHS were placed on the political agenda
by the government. Since then there have been a number of worthy, but
short-lived, initiatives to try to embed shared learning in the undergraduate
curriculum for all health and social care students.1,2 Several
factors worked against the implementation of shared learning including
inter-faculty
and inter-institutional difficulties, timetabling and curriculum problems
and the lack of adequate funding. In the past few years in England
many of these issues have been
resolved because the Department of Health has given funding to centres
to develop shared or common learning programmes. As a result, ventures
like the new generation project (where all students on health and social
care courses spend a significant part of their programme learning together)
at Southampton and Portsmouth universities have started; medical education
commentators are waiting to see how this project and other similar ones
progress.
The Scottish Executive and the NHS in Scotland has not been as forthcoming
with funding to develop shared learning projects but they have been encouraging
to any academics who try to develop and integrate shared learning practice
in the curriculum. The interest in shared learning is there, as is the
understanding that it is vital for the future of the NHS. In his foreword
to “The right medicine”, Bill Scott, the Chief Pharmaceutical
Officer for Scotland, stated: “Whole system working and improving
the patient’s experience within and across clinical and organisational
boundaries, sets a challenge to health care professionals.” This
idea follows on from “Designed to care — renewing the NHS
in Scotland”, where it is stated: “Teamwork and cohesion
are vital to the delivery of patient care.” The establishment of
an ethos of co-operative working among health care professionals must
ultimately benefit patients. Yet for this to be successful it has to
start in the undergraduate teaching curriculum. Only then can the process
become embedded in any health care system. “The belief that the
effectiveness of patient care will improve through collaboration and
teamwork within and between health care teams is providing a focus internationally
for ‘shared learning’ in health professional education.”3
During 2003 the school of pharmacy at The Robert Gordon University and
the then faculty of medicine at the University of Aberdeen jointly applied
for a grant to develop and facilitate shared learning at the undergraduate
level between the two universities. The project was funded by a grant
from NHS Education for Scotland for one year. I was appointed as the
shared learning research fellow. My remit was to research and develop
shared learning modules. These were to draw on the commonalities within
the two courses to promote common learning strategies. It was hoped that
such an approach would serve to inculcate, at the undergraduate level,
an awareness of the necessity for a multiprofessional team approach to
health care issues.
I had joint status in each university, an office in each institution
and access to the curriculum planners at each. Each institution was willing
to see the development of shared learning and that meant that there were
few problems as I tried to develop courses.
My first task was to run an ethics workshop in interprofessional practice
for final year pharmacy and medical students. This event was not compulsory
but there was an 80 per cent turn out of students (224 in total) who
obviously thought that the topic was worthwhile. These students overwhelmingly
supported the ideas of shared learning and believed that more was needed.
They also indicated in a questionnaire given to them to gauge their interest
that they would have appreciated it earlier in their studies. Several
other joint initiatives have been arranged during the year using problem-based
learning and virtual learning environments.
One of the great privileges of a shared post is access to the two institutions
with the advantages of each. There are also the disadvantages of each
to contend with, but these are perhaps not so bad when you can escape
to the other institution. I was encouraged from early in the project
to attend meetings of the curriculum steering group at the University
of Aberdeen as well as a number of year meetings and staff-student meetings.
At The Robert Gordon University I quickly became involved in a number
of faculty of health and social care initiatives and attended faculty
meetings there. This access to staff and faculty has made it easy to
set in place discussions and negotiations to take the project forward.
There is a willingness to co-operate at all levels and busy academics
are able to find time in their schedules to support the project, provided
someone else is able to do the ground work to organise the courses. The
sharing of a post of shared learning research fellow means that the development
of a common ethos is so much easier because it is synthesised through
one person and not being developed by a committee. Yet, at times, as
a shared research fellow I feel that I am perceived by some as either
a chameleon changing to suit my environment or as a double agent sent
to spy for the opposition. On bad days, I see myself as the peacemaker
and negotiator between two factions.
The development of shared learning is not a quick, simple or painless
process but it is achievable. However what is needed is adequate funding
to embed shared learning in the curriculum, a dedicated shared learning
person whose role is to develop and implement the courses, support from
the institutions at a senior management level and time to implement the
courses at all levels of the undergraduate curriculum. With the project
in Aberdeen we have all the above in place. We are currently seeking
second year funding for the project. Despite positive feedback from the
accrediting bodies of both schools, institutional and staff support,
without more funding this successful project will, as with earlier pilots,
come to nought and the efforts of a multiplicity of individuals will
have been wasted.
In summary this pilot project has been successful and has resulted in
a number of initiatives. The next stage is to extend the medicine/pharmacy
interface of shared learning across more of the curriculum while continuing
to develop and evaluate an extension of the shared learning curriculum
to other health and social care students. The journey is in its early
stages but we know where we are going.
References
1. Zwarenstein M, Reeves S, Barr H, Hammick M, Koppel I, Atkins J.
Interprofessional education: effects on professional practice and health
care outcomes
(Cochrane Review). In: The Cochrane Library, Issue 4.
2. Hammick M. Interprofessional education: evidence from the past to
guide the future. Medical Teacher 2000;22:461–7.
3. Horsburgh M, Lamdin R, Williamson E. Multiprofessional learning: the
attitudes of medical nursing and pharmacy
students to shared learning. Medical Education 2001;35:876–83. |
The
Pharmaceutical Journal