Experienced nurses learning with medical students: a case study.

Abstract

Although there are successful examples of interdisciplinary education this generally relates to pre-registration health-care professionals. Post-registration projects are usually confined to skills workshops or social science subjects, which rarely include medical staff. This project was unusual in its attempt to combine the needs of experienced practitioners with those of medical students. There are practical issues for this form of learning such as, the organization of modules into 'systems' when health-care professionals (as part of a parallel project) indicated their interests lay in courses that related to clinical practice organized around disease processes/conditions. This case study demonstrates that concerns related to the potential mismatch of clinical expertise, maturity and scientific background are not insurmountable problems, and that clear benefits can be gained. It could be argued that until pre- and post-graduate medical staff are integrated with other disciplines, the real benefits of shared understanding, enhanced team work and mutual respect will remain illusive. It is not anticipated that this form of learning would be suitable for the majority of practitioners, whose core needs are generally met by existing opportunities. However, there is a need for a greater depth of academic understanding particularly for those in senior positions or in specific specialized areas (also identified in the parallel study) and for those whose roles are expanding. These practitioners are more likely to have the ability to apply their new knowledge to clinical practice, using reflective techniques with minimal facilitation to enhance their established clinical expertise. For them this model of learning offers the opportunity to tailor education to the individual needs of the practitioner without the costly establishment of complete new programmes of learning. This case study proved particularly successful for the participants as they enhanced understanding and confidence in the knowledge underpinning their practice. This enabled them to better anticipate patients needs, to identify complications and initiate action at an earlier stage. Their appreciation of rationale underpinning medical treatment has enabled them to support junior medical staff, and to promote the continuity of appropriate care. They are more active in the education of patients, relatives and staff, and have identified specific developments which will be informed by the knowledge they have gained. It also proved beneficial to junior medical staff with whom interdisciplinary working has improved. Each organization involved in facilitating the initiative also benefited by gaining mutual understanding and appreciation of systems, constraints and opportunities. Equally, relationships among them have been strengthened and key issues with practical solutions have been identified to inform future joint ventures. Indications suggest that there would be value in using this case study to inform a structured pilot project involving other modules of learning and potentially other disciplines. If successful it could benefit all health-care professionals, particularly those senior staff who are expanding their roles and have educational needs unmet by existing provision. In addition to providing complementary opportunities this format provides a mechanism to enhance the mutual understanding essential to effective teamwork.