Interprofessional Learning between Pharmacy and Medicine Students

Abstract

The care of multimorbid patients requiring multiple medications is increasingly common and necessitates a collaborative working relationship between healthcare providers. Healthcare students from different professional backgrounds are often brought together under the banner of interprofessional education in an effort to improve collaborative practice. However, the traditional relationship between medicine and pharmacy professionals which is characterised by a strong power differential, can impede collaborative learning and practice, and adversely impact patient care. Overall, a more detailed understanding of what pre-licensure pharmacy and medicine students think and experience in learning with students from the other professional group in the context of the power differential between these professions, is needed. This thesis is comprised of four manuscripts based on two qualitative studies and an analysis of the research process. The first study involved an analysis of students’ reflective writing following interprofessional learning sessions. The second study explored students’ perceptions of learning with another professional group. Study participants were students from undergraduate medicine and pharmacy programs at two universities who attended interprofessional learning workshops. Paper 1 presents a reflexive account of my PhD journey and highlights the psychological dissonance inherent in my transformative learning as a qualitative researcher. Paper 2 presents a critical reflection on student participation in educational research as prompted by the challenges encountered with participant recruitment for a planned quantitative study. Papers 3 and 4 report on the qualitative research data exploring the impact of traditional roles and professional identities of pre-licensure pharmacy and medicine students on learning together. Collectively, these papers highlight that while medicine and pharmacy students valued learning with and about each other, they were less likely to engage in co-constructing and sharing new meanings. Professional hierarchy was strongly felt by the pharmacy students and although denied by medical students, was apparent in their reported behaviour and attitudes. Emerging professional identity and conceptualisation of future roles appears heavily influenced by a hierarchical relationship and poses a significant barrier to collaborative practice. However, students perceived that interprofessional learning can help them improve future practice and they were prepared to challenge traditional roles and power differentials. This thesis demonstrates that the traditional power relationship between the professions is present in the learning interactions between pre-licensure students. In order to provide a basis for meaningful collaborative practice, interprofessional education curricula need to challenge students’ fundamental assumptions, beliefs and values about other professional groups and learning with, from and about other professions. Educators need to support students to recognise the structures that perpetuate the power differential between professions and question traditional roles and power differentials. However, for sustained change, this needs to occur beyond the classroom, and include reform of the structures that perpetuate the power differential between professions, both within educational institutions, healthcare institutions and the clinical environment.