Interprofessional education and collaboration between general practitioner trainees and practice nurses in providing chr

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RESEARCH ARTICLE

Open Access

Interprofessional education and collaboration between general practitioner trainees and practice nurses in providing chronic care; a qualitative study R. van der Gulden, N. D. Scherpbier-de Haan, C. M. Greijn, N. Looman, F. Tromp and P. W. Dielissen*

Abstract Background: Effective interprofessional collaboration (IPC) is essential for the delivery of chronic care. Interprofessional education (IPE) can help support IPC skills. This makes IPE interesting for GP practices where chronic care is delivered by GPs together with practice nurses, especially for GP trainees who have to learn to collaborate with practice nurses during their training. The aim of this study is to gain insights in how IPE and IPC occur between GP trainees and practice nurses during the delivery of chronic care in GP training practices. Methods: We conducted a qualitative research using semi structured focus groups and interviews with GP trainees, practice nurses and GP supervisors. All respondents were primed to the subject of IPE as they had followed an interprofessional training on patient-centred communication. The verbatim transcripts of the focus groups and interviews were analysed using thematic analysis. Results: Despite the overall positive attitude displayed by respondents towards IPE and IPC, the occurrence of IPE and IPC in GP training practices was limited. Possible explanations for this are impeding factors such as limited knowledge, prejudice, lack of role models and a hierarchical organisational structure. Contributing to IPE and IPC use was the integration of IPE in daily practice, e.g. via recurring scheduled meetings. Conclusion: We found a limited occurrence of IPE and IPC in GP training practices. Our results show a discrepancy between respondents enthusiasm for IPE and IPC and their actual behaviour. IPE activities have to be initiated in GP training practices, otherwise, despite good intentions, IPE and IPC will be ineffective. Keywords: Interprofessional education, Interprofessional collaboration, Chronic care, GP training practice, GP training program

Background Well attuned collaboration between professionals is key in the quality of chronic care [1]. Chronic care delivered in primary care settings - for patients with diabetes mellitus, chronic obstructive pulmonary disease, asthma, cardiovascular disease and prevention - is considered * Correspondence: [email protected] Department of Primary and Community care, Radboud university medical centre, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands

complex [2]. The high level of multimorbidity in chronic care with interactions between diseases leads to clinical complexity [3]. In addition, the fact that one patients sees many different healthcare professionals can easily lead to fragmentation of care [4, 5]. In this complexity, effective interprofessional collaboration (IPC) between general practitioner (GP) and practice nurse is essential to provide high quality care, as practice nurses are (in the Netherlands) involved in

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