A grounded theory of interprofessional learning and paramedic care

ABSTRACT

Interprofessional learning (IPL) is a dynamic process. It incorporates adult learning principles and requires active participation. Contemporary paramedic care typically involves collaboration with other health-care professionals. However, little is known about how paramedics work and construct meaning within this interprofessional milieu. Rural areas, where professional collaboration is well illustrated, provide an opportune setting from which to conduct the examination of IPL and paramedic care. Twenty-six participants took part in this investigation. Participants were paramedics and other professionals involved in collaboration in rural locations across the state of Tasmania, Australia. Rural Tasmania provided a diverse range of paramedic practice for investigation, including traditional (pre-hospital) care, extended care, volunteer services, and hospital-based practices. A grounded theory approach was adopted, and semi-structured interviews used to collect critical incidents in which participants described effective and less effective episodes of collaboration. Memos were kept during the research process. Analysis of data followed a process of initial and then focused coding from which the main concepts could be determined. From 75 episodes of collaboration, three main concepts emerged to create a theory of IPL and paramedic care. Relationships included reciprocity and respect, as well as professional acknowledgment. Cooperation recognized professionals as interdependent practitioners adopting open communication. Operational barriers identified contextual features under which professionals work, with constituent categories of protecting turf, and workplace culture. The findings provide new insight into IPL and paramedic care. Hierarchy, professional dominance, and gender disparity emerged as barriers to IPL. Knowledge and skills were shared between professions and this influenced how individuals interacted within interprofessional teams. A successful collaboration produced a clinical environment where patient care was informed by contributions from all team members.

KEYWORDS:

• Grounded theory
• qualitative
• collaboration
• interprofessional learning
• paramedics
• power

Acknowledgments

The authors would like to acknowledge the assistance of Ambulance Tasmania paramedics, their health-care colleagues and others who voluntarily contributed to this project. Thanks is given to Ambulance Tasmania and the Tasmanian rural medical sites that agreed to assist with this study.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the writing and content of this paper.

Additional information

Notes on contributors

Peter Mulholland

Peter Mulholland is a PhD candidate with the University of Tasmania Centre for Rural Health, and Intensive Care Paramedic with Ambulance Tasmania.

Tony Barnett

Tony Barnett is the Director of the University of Tasmania Centre for Rural Health.

Jess Woodroffe

Jess Woodroffe is a Senior Lecturer within the Academic Division if the University of Tasmania. Previously she worked for 15 years in the Faculty of Health in the areas of rural health and medical education.