Planning for the new

Hugh Barr

Introduction

Accustomed though it is to challenge, the interprofessional movement is being overwhelmed by the pandemic: a challenge that knows no boundaries between professions, between institutions, between organisations and between nations; a challenge generating not only unprecedented demands but also unprecedented opportunities for collaboration on which our survival depends (Xirichis & Williams, 2020).

Interprofessional learning is the key to collaboration. It is the means by which professions join in common cause, pool their resources and engage with tasks beyond the capacity of any one of them alone, setting aside rivalries and differences. That is the process that we have been refining by trial and error for some 70 years, more rigorously, more systematically and more convincingly over time blending evidence from experience and from research.

All that was threatened in the UK when universities were ‘locked down’. Campuses were closed, teaching put online and learning materials reworked in haste. Interprofessional learning fell victim to the problems with which it was being called upon to engage. Yet colleagues assure me that it is proving to be the catalyst for a more creative, nuanced and expanded approach to working across boundaries (Gurbutt, 2020).

The challenge for interprofessional educators is to achieve more with less:
  • By strengthening the capacity of interprofessional learning to respond when and where the pandemic demands closer collaboration;
  • By compensating for constraints on face-to-face learning;
  • By exploiting advances in educational technology;
  • By capitalising on the liberalisation of learning;
  • By prioritising interprofessional learning where it promises to be most effective;
  • By marking up pointers for guidelines;
Responding to the challenge

The pandemic has generated a cocktail of problems demanding collaboration where interprofessional learning can help. To which of these should we as interprofessional educators respond: health promotion, health education, economics, employment, housing, recreation and leisure, income maintenance and welfare rights, community development, environmental protection and more? Responding to all of them if and when asked for information and advice; hesitant before inviting them to join our interprofessional learning programmes lest their inclusion dilutes, dissipates, fragments and overloads. A thousand flowers may bloom but some wither on the vine.

Arguably, our task is challenging enough building on our tried and tested track record in primary and secondary care yet interprofessional learning is spreading further and further. Where then should we draw its boundary? Around public health, I suggest, including any or all of the fields that I have listed ensuring each time that the case is made to add another that it will enrich our response to public health writ large.

Public health has long been the poor relation in the interprofessional family. Must it remain so? Or can it provide the context that embraces them all?

Compensating for constraints

Face-to-face teaching is in jeopardy, students must learn alone, at home and online, one-to-one tutorials and team-based learning is curtailed and practice placements harder to negotiate. Must standards be compromised? Some regulatory bodies are waiving their requirements for as long as the pandemic lasts with no guarantee that universities once they become accustomed to alternative styles of learning will return to them when the pandemic ends. 

Exploiting technology

Simulated learning is a timely reinforcement for face-to-face learning but not a substitute. Can researchers help us evaluate the relative impact of face-to-face and simulated learning separately and in combination? Comparative evaluations of the efficacy of learning approaches may, however, remain elusive pending advances in research methodology.  

Liberating learning

These challenges become less daunting as we discover how liberating online learning can be. Initial costs rise to restructure programmes and reorient teachers, but running costs fall freed from fees for venues, insurance cover and presenters’ and participants’ expenses for travel and overnight accommodation. Compare the virtual meetings with another being convened by my CAIPE colleagues in London where teachers and students from the Netherlands are presenting to others from Africa, Australia, Brazil, Ireland, Sri Lanka, Switzerland and Qatar during a conference attracting three times the number of participants than in previous years at conferences conventionally designed and delivered.   

Prioritising options

Incorporating interprofessional learning into pre-registration courses will continue, but webinars and workshops between experienced practitioners can impact more directly and more immediately on compelling challenges.  Research may help to determine the different effects of different interprofessional learning structures and methods.

Contributing to Guidelines

The brief that  has given of us is to help draft guidelines for interprofessional learning during the pandemic.

I volunteer the following:
  • To redefine the primary purpose of interprofessional learning to further public health
  • To exploit the liberalisation of learning to effect economies and optimise uptake
  • To set aside requirements for face-to-face learning for no more and no longer than is inescapable
  • To invoke the technologically enhancement of learning
  • To compare the effects of face-to-face and simulated learning separately and combined
Guidelines:
  • Neither regulations nor requirements?
  • By whom for whom?
  • Adapting existing guidelines or drafting from scratch?
  • Reconciling top down expectations from policy makes with the bottom up experience of interprofessional educators?
  • Moderated by educational and service managers?
  • Grounded in interprofessional values principles and methods?
  • Distinguishing between the known, the unknown and unknowable?  
Conclusion

The interprofessional movement is in the midst of its toughest challenges ever, but better prepared and equipped to cope with them at any time during its short history. Mutual support networks are firmly established backed by the WHO regions, led by ‘Interprofessional. Global’ with its a research sister organisation as a younger generation of teachers subjects their programmes to rigorous evaluation and the interprofessional literature grows exponentially peer reviewed in learned journals. All that augurs well as we see glimmers of light at the end of COVID-19 tunnel.