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					FDTL3 Better Together Inter-Professional Collaboration: Simulating Partnership Working in the Built Environment OCCASIONAL PAPER 3 March 2002 ______________________________________________________________

Anne Oxley (Project Manager) and Chris Glover (Project Researcher)

______________________________________________________________ This is Occasional Paper 3 in a series of 3 (as of March 2002). 1. Inter-Professional Education - a brief introduction (February 2002) 2. Inter-Professional Practice in Health: Lessons for the Built Environment? (February 2002) 3. Benefits of Inter-Professional Education: some initial reflections (March 2002) _________________________________________________________________
The background to these papers was an in-depth literature search about interprofessional education, with specific reference to initiatives within the Built Environment. However, during the course of this research, there was more evidence of work done around partnerships, collaboration and inter-professional education in disciplines than in the Built Environment. One discipline which offered an abundance of material was that of Health, and in particular, the work of Hugh Barr, and the Centre for the Advancement of Interprofessional Education (CAIPE). Consequently, much of the material referenced in the papers is not Built Environment specific. What we suggest, however, is that there are examples of good practice which transcend disciplinary barriers, and which may offer insight into some of the current issues facing us.

Introduction The Better Together project is based on the notion that inter-professional education is both a desirable and positive experience. A later project milestone report (November 2002) will discuss the barriers and solutions to achieving an inter-professional curriculum in the built environment, but there was also felt to be a need in the earlier stages of the project to carry out a cursory examination of potential positive outcomes, albeit primarily from other fields. Barlow (1999), in his description of collaborative creativity in interprofessional education in Engineering reflects that "one of the most common attitudes in organisations is 'You do your job, and I'll do mine'. The assumption is made that somehow all the parts will get integrated into an effective whole" (p10). For many working in the built environment this will strike an all-too-familiar chord. Yet evidence from the Better Together Milestone 1 report is clear that members of 1

professional bodies, employers, employees, clients, and those involved in undergraduate and postgraduate education and training all challenge the notion as portrayed by Barlow above. What is strongly emerging is the requirement to work in an interprofessional way, based on tangible, and clearly identifiable benefits for all involved. This paper lists the most frequently articulated benefits for interprofessional education in the fields of Health and Social Work, as well as of the Built Environment. Benefits of Inter-Professional Education (IPE) The Better Together project has a number of key stakeholders: built environment employers, employees, and students; professional institutes; community groups. This particular paper focuses on the benefits of inter-professional education for the first three members of this group. Issues for the other two members will be the subject of future research. Moreover, we do not suggest that the benefits to each group are distinct from those of the other groups. Any benefits for students should, for example, also impact on other stakeholders. Rance (1996), in his assessment of the extent and value of inter-professional education in the built environment, claims that IPE provides added value - it offers a "broader perspective to complement specialist professional expertise, and will ultimately make students more capable of securing employment" (p5). Employers thus recruit a higher standard of graduate, which, in turn, reflects positively on the Institution and its staff, etc. In order to present a more simplified overview of potential benefits for all, we have attempted to present each of the stakeholders separately, and to briefly examine the likely benefits. For Employers Koppel (1998) described the need for an improved quality of service (delivery), and the creation of a flexible workforce within the field of Health, as a key component here. This was succinctly articulated by an employer in our project's Milestone 1 (2001) findings: "Clients' requirements in the construction industry are continually changing, and we need graduates with the ability to adapt." Freeth, Meyer et al (1998) list the following as further benefits of IPE for employers within Healthcare:    a reduction in the occurrence of communications breakdowns an increase in morale and efficiency an avoidance of 'unhelpful protectionism'

The latter observation was one which frequently manifested itself in a variety of guises in our Milestone 1 findings, perhaps the most powerful of these guises depicted by an employer below:


"Most professionals follow their own discipline to start with, so it only after years of experience that they are exposed to other professions. This means that they get into a rut, which they then have to find their way out of again. There is a certain amount of professional snobbery about." . Barr (2000a) maintains that, rather than perpetuate the situation described above, IPE enhances personal and professional confidence, promotes mutual understanding between professions, facilitates intra- and inter-professional communication and encourages reflective practice (5:03 p19). For Universities Inter-professional education can promote creativity in teaching and research and foster inter-professional co-operation. It can also open up possibilities for practical application, for example, inter-professional project work. There is also a strength in diversity. A common thread in the literature about the positive outcomes of IPE for institutions in general was that of cost effectiveness, although the literature is clear that this was difficult to show (Creighton University 1999; Koppel 1998). 1Interprofessional education can, and should, lead to the development of the necessary skills to operate effectively in multi-disciplinary teams. This will not automatically occur, however, without "resources used in direct teaching units being transferred to teaching and learning support" (Rance 1996 p8). As Rance concludes, from evidence of such initiatives at the University of Central England, "to bring students together from different professional degrees for the sake of commonality is unlikely to produce a satisfactory educational experience without a clear sense of the interprofessional objectives of such an arrangement" (ibid p8). However, feedback from faculty staff in McCroskey and Robertson's (1999) evaluation of the University of California's inter-professional initiative indicates that there are clear benefits for individual staff members:       an exposure to new ideas an opportunity to work with different people an increased cultural sensitivity an enhanced flexibility in working with students a better sense of co-operation and networking between departments an impetus to discover more community resources.


It is interesting here that, in our own research, some students took a more cynical view. Their perception was that the creation of interdisciplinary courses or projects was more likely to be done essentially as a cost-cutting exercise by the institution. Whilst they acknowledged that such courses could lead to a more efficient use of lecturers, there was the belief that issues such as accommodation convenience were of primary concern.


For students From the perspective of Social W ork and Health, O'Neill, Wyness et al (2000) argue that meaningful inter-professional learning experiences can better prepare students for encountering the complexities of real-life inter-professional problems in the work environment. These experiences help develop a holistic approach to working, based on a common knowledge between disciplines and an awareness of diversity issues. Rance (1996), from a built environment standpoint, maintains that IPE leads the student to a recognition of overlapping professional functions, or those activities which fall between professional areas. This initiates a "breaking down of professional/demarcation roles within the development process which can lead to competition and conflict" (p2). This creates an environment in which students can develop a critical awareness of the limitations of professional roles and values (p5). Inter-professional education works to challenges stereotypes, yet allows students to strengthen their own professional identities (O'Neill, Wyness et al 2000; McCroskey and Robertson 1999). O'Neill et al further illustrate that, from preliminary evaluations of an interprofessional elective course, students gained a greater understanding of other professions' roles and skills; began to develop skills in interprofessional teamwork; gained knowledge and skills in relation to complex conditions that require intervention from a range of professionals. McCroskey & Robertson identify the learning and increasing of similar skills, and particularly identify the development of interpersonal skills, a significant element of our own findings described in the Milestone 1 report. Inter-professional education engenders a respect for, and understanding of, the role of other associated professions (McCroskey and Robertson 1999). The perceived need for a lack of professional jealousy was strong in our own research. Inter-professional teaching contributes to this by giving students the opportunity to observe good role models for collaboration, with different faculty members interacting as peers (Creighton University 1999). Concluding remarks Although it is clear that there is support for inter-professional education initiatives within higher education, and that they can bring many benefits, there were reservations about how successfully such initiatives could be developed. For example, Brian O'Neill (2000) identified several problem issues, including:     finding placements, particularly for team experiences differences among students with respect to knowledge they bring to the course, motivations for taking the course, and preferred learning styles evaluation of outcomes transferability of knowledge and skills to practice, and impact of interprofessional learning on practice.


Not all of these initiatives, where attempted, had been successful. Some respondents in our own research felt they had not benefited from interdisciplinary work as the course were "too theoretical". Where such work was successful (and this was the majority of respondents) the course included practical experience, work placements, inter-professional projects etc. Barr et al (2000b) succinctly summarise the four main benefits that interprofessional education can provide: 1. 2. 3. 4. enhances motivation to collaborate changes attitudes and perceptions cultivates interpersonal, group and organisational relations establishes common value and knowledge bases

How the project partner institutions and others have worked to develop the various positive outcomes of inter-professional education described in the previous pages will be re-visited in Better Together's Milestone 4, a later milestone report (November 2002) on the operational issues and solutions in achieving an interprofessional curriculum. We are also in the process of collecting a series of interprofessional teaching materials, examples of which are already available on the website. We hope to encourage a sharing of learning and teaching issues between academic staff from different disciplines. There are examples of interprofessional projects, modules and whole courses. These will be added to during the life of the project, and can be seen on . _________________________________________________________________ References Barlow, C. (1999). Stuart School of Business, Illinois Institute of Technology. "Issues of interprofessional education: collaborative creativity", Draft in process. Barr, H. (2000a). Interprofessional Education: 1997-2000. A Review. United Kingdom Central Council of Nursing, Midwifery and Health Visiting Barr, H., Freeth, D., Hammick, M., Koppel, I. and Reeves, S. (2000b). Evaluations of Interprofessional Education: A United Kingdom Review for Health and Social Care. Review. CAIPE/BERA Creighton University (1999). Establish required interdisciplinary programs. Omaha, Creighton University Freeth, D., Meyer, J., Reeves, S. and Spilsbury, K. (1998). Of drops in the ocean and stalactites: interprofessional education within healthcare settings. BERA, Queen's University, Belfast. 27th - 30th August. Koppel, I. (1998). Evaluation of interprofessional education: State of art: The IPE JET study. BERA, Queen's University, Belfast. 27-30th August.


McCroskey, J. and Robertson, P. J. (1999). "Challenges and Benefits of Interprofessional Education: Evaluation of the Inter-Professional Initiative at the University of Southern California." Teacher Education Quarterly (Fall 1999): 69-87 O'Neill, B., Wyness, A., McKinnon, S. and Granger, P. (2000)."Partnership, Collaboration and Course Design: An emerging model of interprofessional education". Rance B. (Ed) (1996). Proceedings of a Conference on Interprofessional Education and Large Group Teaching in the Built Environment, Faculty of the Built Environment, University of Central England, University of Central England. _________________________________________________________________ For further information on the Better Together project please contact: Anne Oxley FDTL3 Project Manager School of Environment and Development c/o Learning and Teaching Institute Sheffield Hallam University City Campus Howard Street Sheffield S1 1WB tel. 0114 225 2979 email.

This project is funded by the Higher Education Funding Council for England and the Department for Higher and Further Education, Training and Employment under the Fund for the Development of Teaching and Learning.


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