There is a plethora of literature available on the benefits of interprofessional learning (IPL) (Kilminster et al, 2004; Davies et al, 2011; Cunningham et al, 2015; McLeod et al, 2018), In 1987, the World Health Organization (WHO, 1988; 2020) were already advocating for a multi-professional approach to healthcare professional learning. Further, while there is a need for further research, there is a correlation between the implementation of IPL within an academic setting and improved multi-disciplinary working within clinical practice (Ketcherside et al, 2017; Reeves et al, 2017). The importance of multi-disciplinary working within contemporary prescribing practice is emphasised within the Royal Pharmaceutical Society (RPS) competency framework for all prescribers (2021). However, the literature on the use of IPL within non-medical prescriber (NMP) higher education modules is limited and has not been extensively investigated. Although some studies have explored the benefits of trainee NMPs learning with other professions (Courtenay, 2012; Hemingway et al, 2020; Stephenson et al, 2019;) these benefits have been limited by combining trainee NMPs with undergraduate students from other professions. Trainee NMPs are generally already experienced practitioners, whereas undergraduate students cannot be expected to have the same level of practical experience. Thus, the potential for interprofessional learning within a non-medical prescribing module, where participants are necessarily at similar developmental points in their careers, is an interesting concept to explore. Evolving roles, as well as recently expanded Allied Health Professional (AHP) prescribing rights (NHS England, 2016; HCPC, 2018) now mean module participants come from a wider variety of professional backgrounds, providing a clear IPL opportunity. Interestingly, Asfeth and Paterson (2017) considered the interprofessional learning which occurs between designated medical practitioner (DMP) and trainee NMP. Historically, every NMP has had to be signed off as competent by a DMP from the medical profession. The recent updates allowing independent prescribers from other professional backgrounds to take on this role as designated prescribing practitioners (DPP) could further affect the scope for interprofessional learning within these modules.
This is of prime interest to the authors, as lecturers on an independent and supplementary prescribing (ISP) module at the University of the West of Scotland. Coming from very different professional backgrounds, one an acute care advanced nurse practitioner and the other a primary care pharmacist independent prescriber, interprofessional working and, by extension, informal IPL, formed an integral part of each of the authors' clinical practices. Upon transferring into the academic setting, it became apparent that with these diverse backgrounds came different skill sets and, in some cases, differing opinions and priorities. These were embraced and used to develop an academic curriculum that reflected a wide range of prescribing roles.
‘The level of engagement with [sharing prescribing experiences] has been particularly encouraging as has the breadth and depth of the discussions, which have included profoundly honest reflections on both their own and their peers' professional and prescribing practice.’
The current COVID-19 pandemic prohibited traditional face-to-face, on campus delivery of the prescribing module; a remote, online format was therefore required (Wetzlmair et al, 2021). In moving to this delivery, it was important to prioritise relating the materials to clinical practice and making multi-disciplinary working an integral part of the module, given the strong focus on this within the RPS competency framework for all prescribers (2021) and within the Scottish Government strategy for the NHS (Scottish Government, 2017; Scottish Government 2021). Case-based discussions were incorporated into the timetable, using online break-out groups during live sessions and purposefully randomising trainee allocation to stimulate interprofessional discussion. The authors' divergent professional backgrounds within primary and secondary care were further used to deliver a joint online lecture on medicines reconciliation. This further demonstrated inter-professional working between different sectors, thus highlighting the reality of differing clinical experiences, priorities and opinions among healthcare professionals. More recently, with a new online learning platform, prescribing trainees have been able to use a community discussion feed to share their practical experiences and give peer feedback. The level of engagement with this has been particularly encouraging, as has the breadth and depth of the discussions, which have included profoundly honest reflections on both their own and their peers' professional and prescribing practice. These reflections have then been used to better inform the trainees' prospective prescribing decisions and this reflective skill is a key competency within the RPS Competency Framework for all Prescribers (2021).
Anecdotal student feedback on this new immersive, interprofessional approach has been collected through anonymous online surveys over three cohorts and this has been overwhelmingly positive. Even trainees who were initially averse to the idea of an online delivery found the interprofessional nature of the case-based discussions and the more recent addition of the community feed to be some of the principal aspects they have enjoyed and valued most within the course. In addition to trainee satisfaction, academic staff have found the implementation of IPL to be beneficial for the consolidation of the traditionally challenging concept of pharmacology. However, perhaps the most important benefit to the interprofessional approach has been the opportunity for trainees to build their own supportive, professional networks and to forge relationships with the academic team. As the inclusion of interprofessional collaboration has increased with successive cohorts, so too has trainee engagement and confidence. This has further manifested itself in increased levels of critical discussion and trainee insight into their future prescribing practices. From these limited experiences, it would appear there is sufficient scope for formal research into this area which could evidence a demonstrable link between undertaking IPL in the academic setting and multi-disciplinary working in practice.
In summary, the inclusion of IPL has been found to have wide-ranging benefits within a prescribing module where the participants are experienced practitioners. This is an area where further research is required, with the potential to include an even more diverse range of professionals, including pharmacists and doctors at similar career development points. It is recognised that IPL can ultimately improve multidisciplinary working within clinical practice (Ketcherside et al, 2017; Reeves et al, 2017). Therefore, instilling IPL during prescribing training, therefore, has the potential to contribute to multidisciplinary working which, as outlined in the RPS competency framework for all prescribers (2021), is central to contemporary prescribing practice.
CPD reflective questions
- How can interprofessional learning be practically put into place within the workplace?
- How can non-medical prescribers learn from other healthcare professions?
- What benefits to non-medical prescribers' own prescribing practice can be seen when working with other professions?
- How can non-medical prescribers use their own clinical knowledge and experience to benefit other professionals they work with?