Using Gibb’s reflective cycle and the Inter professional Capability Framework explain how your knowledge, skills and attitudes considered on this module will enable you to become an effective member of an inter professional team in your working environment
The National Health Service (NHS) employs more than a million employees; therefore, a system that allows the services to run in sync with the skilled and responsive workforce cannot be denied (Daly, 2004). However, does it give us the privilege to say we have overcome the barriers to collaboration and communication within NHS? Certainly not otherwise, cases like the death of Victoria Climbe and Baby Peter would have been avoided, whereby consistent failing in communication and collaborative working among various concerned professionals and agencies was unearthed (Jelphs & Dickinson, 2008).
Because of the word limitation for the essay, the essay will only seek to explore the interprofessional capabilities (i.e. knowledge, skills and attitudes) about collaborative working and communication that can enable me becoming an effective team member of an inter professional team in the future. To achieve this, I am going to exploit the first domain of the interprofessional capability (IPC) framework namely collaborative working using Gibb’s reflective cycle. The first stage of Gibb’s (1988) reflective cycle requires the description of the events (Jasper, 2003); Approximately 800 students undertook the Interprofessional education (IPE) module from various disciplines of health and social care courses.
IPE can be defined as “education that occurs when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes” (WHO, 2010 pp-7). The interprofessional group I was allocated to comprise of a mental health nurse, a midwife, two adult nurses, a physiotherapist and myself, a diagnostic radiographer. It was within the group; we had to undertake various facilitated activities as well as independent group works. The module was to offer awareness and learning about the issues of collaborative working, communication and many other topics; collaterally, it was also about demonstrating my knowledge, skills and attitudes towards these problems according to my experience as well aslearn from other team members.
By the end of the event, I was not only exposed to the notions of collaborative working and effective communication, but also to the barriers that can stop us from achieving them. The second stage of Gibb’s (1988) reflective cycle is about expression of the feelings about the event (Jasper, 2003). Initially, I was unsure about the benefits of ‘common learning’ however, it became clear as we progressed through the module (Barr, 2003). Everyone was friendly, showed respect and trusted other people’s knowledge. Moreover, a group work approach was apparent rather than an individual approach to the problems we encountered. I felt valued within the team because I could share my perception about the problems and discuss them effectively with other team members.
I also observed that although some cases were not directly related to my profession, however, the team members ensured that I was on board with what they were proposing, hence maintaining a supportive and collaborative learning environment. There was a sense of all team members wanting to work collaboratively and effectively to perform well. Nevertheless, I was little annoyed when two of the nursing students were not engaging fully with the group work. However, it was interesting to note that as soon as they apologised about their inappropriate behaviour, justified why it happened (stress about doing another essay) and agreed not to repeat it; it had a really positive effect on me, and I was easily able to let off their behaviour.
Although with hindsight, I think this may have a negative effect on the group if they had carried on repeating such behaviour (Jelphs & Dickinson, 2008). Furthermore, there was one of team members who did not attend any group works sessions in the second week, and even did not communicate with the team about her non attendance, which I thought was an unprofessional behaviour at this level. Nevertheless, the support given by the teaching team during facilitated sessions was commendable. Overall, my feeling about the whole event was quite positive. The third stage of Gibb’s (1988) reflective cycle involves evaluation of my experiences encountered during the event (Jasper, 2003). Gorman (1998) suggests that considerate amount of attention should be given to the structure of the team, the culture (interprofessional relationships) and processes as they can influence the behaviour of the team i.e. leading to collaborative working or hindrance.
This was well recognised by all members at the beginning itself and therefore time was spent on discussion about it, as a result of which the team was found to have congruity about shared commitment throughout the module. All the team members became clear about the roles of the professionals involved and their interaction with the patient-care pathway. Thus, it provided a good outline about role clarity, which was maintained throughout without any conflict (West & Markiewicz, 2006). Any challenges encountered within the group were well focused to the relevant question or working practice. Thereby, better understanding and sharing of accountability were seen. All these helped reduce the hindrance to effective collaboration.
Also shared was information about the problems experienced at the clinical placement namely incorrect filing, assumption made about illegible handwriting, acronyms and short abbreviations, etc. that can often risk the patients care and can be seen as potential source for errors. The team leader maintained a well balance about the time that was to be spent for each activity. Therefore, we were all able to share successfully our values and perceptions about the issues relating to communication and collaboration. No personality issues were encountered (Jelphs & Dickinson, 2008). There were some brilliance movement of innovation and creativity seen, e.g. during poster creating activities and rich picture activity and each member participated in one way or the other e.g. I and a physiotherapist student put forward to present it to the other groups.
Thus, overall I felt there was a good positive attitude maintained by all the team members as everyone was willing to collaborate and communicate effectively. I felt that synergy produced by contribution from everyone through interprofessional group works had far exceeded the potential of what I could have contributed individually (Jelphs & Dickinson, 2008). Although there was no absence of trust and fear of conflict among the group members however, lack of commitment was present as consistent non attendance was an issue for one of the team member, and it was felt that there was avoidance of accountability as that person did not feel it important to inform the team (Lencione, 2002). Another issue about inattention from two of the team members was resolved effectively by the team leader through good communication skills he possessed and it was a good learning example for me.
Therefore, team leaders are required to facilitate the group to stay focused and help stop getting fragmented (O’Daniel & Rosenstein, 2006). I also learned about other factors that may contribute as barriers to effective collaboration which included social conformity, risk shift, group think and diffusion of responsibility (West & Markiewicz, 2006). The stage four of the Gibb’s (1988) reflective cycle includes analysis of the event. The fact that in the UK, communication is still one of the commonest roots of problems described in complaints against the professionals should make us realise that communication should not take for granted (Health and social care information services, 2006 cited from Jelphs and Dickinson, 2008).
The Oxford dictionary (2010) defines communication as “the imparting or exchanging of information by speaking, writing, or using some other medium.” And Mehrabian (1972) suggests that non-verbal communication (body language) can contribute around 70%, when interacting. Therefore, it is vital that the healthcare professionals are not only effective in communicating verbally but also non-verbally. We all agreed and aware that every one of us had in their codes of professional conduct about clearly documenting any intervention offered or given to the patient (HPC, 2009; The Chartered Society of Physiotherapy, 2005; NMC, 2009). As a result, I felt that the team were unified on decisions made about poor documentation that were noted within the examples/cases given and videos shown.
As a group we all agreed that clear documentation can help reduce the risk of breakdown in communication and increase the likelihood of adequate sharing of information and hence quality of care. As whenever any critical information is transmitted through any medium there is always a risk of miscommunication attached to it and that is why effective communication is much more difficult to achieve in practice (O’Daniel & Rosenstein, 2006). Although this was conflicted with what the Nursing students (mental nurse and adult nurse), and physiotherapy student mentioned during the debate as they felt that there was the surplus amount of paper work to be done, which was affecting the quality of care provided to the patients, especially during handovers.
Unlike in radiography, this is not the case as we often x-ray the patients without any notes, but a request form (legal document) is required indicating the type of examination required. Nevertheless, every patient needs to be registered on the system before we can do x-rays, which can take a while. However, we have to schedule the in-patients needed to be done out of ours and therefore, have to communicate with the ward nursing staff and porters. Furthermore, during any emergency situation requiring mobile x-rays or Computerised Tomography examination effective communication with the accident and emergency (A&E) is necessary as otherwise it can delay the treatment and jeopardise patient’s well-being.
Besides, I observed that the ‘nurses’ role was quiet at the core when it came about caring patients in the hospital. Therefore, I felt that it was necessary to work collaboratively and maintain good communication with the nurses in practice as they can help me by providing crucial information about patient’s physical and psychological status that I may need to consider when taking the x-ray’s requiring some adaption of techniques (Burzotta & Noble, 2011). The group did well to work in collaboration maybe because good communication was maintained all the time between the members. Mead and Ashcroft (2005) suggest that working in collaboration is vital as it helps to avoid any misunderstandings and hence keeping it immune from barriers of interprofessional collaboration.
Nevertheless, an interprofessional team can comprise of individuals from different professional background and have a possibility of sharing same skills and knowledge, in which case clarity about their role and scope of responsibilities should get agreed as otherwise it can easily become a potential source of conflict for the teams (Thompson, Melia & Boyd, 2000). Care priorities can be affected by the codes of conduct, e.g. the main focus of doctor will be on patient’s medical condition, a physiotherapist will mainly remain concerned about the mobility issues; a social worker priority will be making available required care and support at home, nurses’ priorities to coordinate patients discharge, transport and medications to take home.
Therefore, although we see everyone wanting to work collaboratively their priorities can differ (Thompson et al, 2000). I felt there was a positive feeling until the last day between the team members, and everyone felt proud about this opportunity through which we all mutually enjoyed. I am convinced that the experience gained will certainly enhance my practice as well as attitude towards other professionals with whom I will come in contact. Overall, I have gained a profound understanding and knowledge about how individuals’ responses and behaviour can influence others and the events, the need for good communication not only with service users and their family members, but also with other team members through this experience.
I had become self-aware about my interprofessional skills and factors that contribute to communication; and feel that this experience will be a very useful to support my understanding of how to be an effective member of an interprofessional team in the future. Also, as a healthcare professional I should always try to act responsibly and try to develop stronger relationships with other team members, therefore, allowing every chance of working collaboratively and communicating adequately, which could result into better health and well-being of patients and reduce the risk of failures (Jelphs & Dickinson, 2008; DOH, 2000).
The next stage of Gibb’s (1988) reflective cycle includes discussion about the action plans. Therefore, if faced with similar scenarios or situations experienced while undertaking this module, I will ensure that the knowledge and skills acquire are well implemented to the situations and seek help from other interprofessional team members without any prejudice, but with pride (Daly, 2004). I also feel that to become more effective as a team member, continuous interprofessional development and active participation in these areas should not be neglected. Reading and reflecting through IPC framework domains can help me identify my progress as well as help me to engage and assimilate more within the interprofessional team (Interprofessional Capability framework, 2010).
To conclude, this module has really helped me get myself out of my normal area of practice and to reach out for other disciplines; learn and relate positive and negative outcomes about working in collaboration and communication. In hindsight, the module was an eye-opener for me as, despite being aware about the need for collaborative working and importance of communicating appropriately; consistency of its application in practice was seen to be lacking. Nevertheless, it will be unfair to say that we have completely failed in these areas.
I am quite convinced that although the ethos of working in collaboration can arguably be seen as a challenging aspect, however, the truth is real-life problems are always more complicated to be dealt single-handedly. Therefore, fostering of collaborative working culture through Interprofessional education can revolutionise the thinking of students as it has done mine too, thereby helping me prepare to become an effective member of future interprofessional teams, who will have collaboration and communication as one of their core parts of their practice.
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