Navigating in a landscape of practices : Healthcare students’ interprofessional collaboration and learning

Abstract: Scientific advances, along with better conditions for attaining healthy lifestyles, have had the result that more people live longer. On the flipside of this success, people are also living longer with diseases and are thus in need of more health care than before. This takes up available resources and the health care system must adapt accordingly. One solution that has been put forward for this dilemma is interprofessional collaboration. Resources can be used more efficiently by collaborating across professional boundaries, and we can benefit from each other's competencies in a way that serves both the patient and the system better. However, being able to collaborate with colleagues of different professional backgrounds is not a given. Just because you have a healthcare education does not mean that you automatically know how to collaborate with others. Interprofessional education must therefore be offered to health care students so they can learn to collaborate at an early stage.  In recent years, more research has been devoted to examining the nature of interprofessional education and what students do when they work together during different interprofessional education activities. However, since interprofessional education comes in many shapes and forms, research must continue with the endeavor to understand what students do during interprofessional learning activities. It is important to expand our collective understanding of the relation between how interprofessional education is arranged and the students’ learning. The thesis therefore focuses on the relation between how students enact interprofessional collaboration during different IPE-activities and the way the learning activities are arranged. I have paid attention to what the students do, what kind of knowledge they share with each other and how, how they negotiate tasks with each other and how they organize their interprofessional collaboration. In addition, the thesis is framed by a practice-oriented approach.  The thesis is based on four papers, all of which have been conducted with a qualitative approach. Data consist of video-recordings and ethnographic observations. Three settings are included and serve as the foundation for the thesis. In total, data collection has been conducted seven times across the three settings and been combined differently in the papers. The analysis has been supported by different theoretical concepts linked to practice theory.  Taken together, the papers show that health care students navigate in a landscape of practices. This landscape includes both profession-specific practices and practices shared among students from other study programs. As students learn, they travel through this landscape with their sights set on the goal of working in health care. To get there, they must relate to several different areas of knowledge, ways of doing things, traditions, parallel ongoing practices and much more. They need to navigate their way forward, and they get help from ongoing guidance and support. For example, supervisors help the students understand the practices, the rooms they are in, the scene for how to act, the tasks and the scenarios which show students what is in focus. Not least, students have each other. Through themselves they can connect and share knowledge in a way that enables them to also organize and enact interprofessional collaboration. However, at times they also encounter obstacles - resulting in them ending up caught in the middle of things, not sure what practice to find safety in. Collectively, this demonstrates the importance of consciously designing interprofessional education so that students benefit from all practices in the landscape.