An interprofessional journey: a valedictory editorial

Introduction

Colleagues often recall how their interprofessional journeys began by accident. Permit me to share mine setting aside the habit of a lifetime trying to be detached and objective. Explore with me currents and undercurrents, celebrating successes and ruing failures, winning and losing friends.

The Nottingham Experience

Within days of retiring early in 1989 as an Assistant Director of the Central Council for Education and Training in Social Work (CCETSW) Olive Stevenson invited me to attend the inaugural workshop to launch her Centre for Interprofessional Studies at the University of Nottingham.¹

It was a memorable first for those of us who had checked in overnight at the Victoria Hotel decanted into Station Street in our pajamas by a 6 am fire alarm. Seldom can an icebreaker have been so effective! The theme for the workshop may seem less remarkable – to plan discharge for older residents into the community involving a range of health and care professionals in the team – but pregnant with implications for the future of interprofessional education (IPE) and collaborative practice.

Back in London, I wrote to thank Olive. Her reply was a double whammy. John Pendleton whom she had recruited to lead the Centre had died soon after the workshop following a cardiac arrest. Would I fill his shoes? Lacking a retirement plan, I agreed. Little did I imagine the uphill struggle that lay ahead; commuting for two and half years for one to as many six days per week from my home in south London, striving to win friends across the campus and beyond for a cause whose time had not yet come. Responses differed, especially encouraging from the Head of the School of Education and the University Chaplain, tardier from nursing and medicine, slow too from colleagues in my host School of Social Policy where some volunteered support but most remained guarded.

Six months later taking a vacation in America, I invited myself to visit the Commission on Interprofessional Education and Practice at Ohio State University regarded at that time as the leading interprofessional initiative in the United States. I was bowled over by the welcome from Mike Casto and by the transformation being wrought under his leadership across the campus reaching out to revitalize disadvantaged surrounding neighborhoods (Casto & Julia, 1994).

Returning to Nottingham I urged my steering group to invite faculty across the campus to begin with them again from first principles. My fervor fell on deaf ears, colleagues reproving my lack of understanding regarding the ways of universities about which I had indeed much to learn yet convinced that I had hit upon the only way forward enjoining as equal partners in common cause.

Workshops nevertheless followed co-led with colleagues and exploratory projects with Ian Shaw commissioned by the Centre for the Advancement of Interprofessional Education (CAIPE) (Barr, 1994, Barr& Shaw, 1995, Shaw, 1995). I valued especially the opportunity to interview 50 opinion leaders including Tessa Jowell, a future cabinet minister, at the cutting edge of interprofessional thinking throughout the UK (Barr, 1994).

Under-planned and under-resourced, it was becoming painfully clear that the Centre would not fly. Others made that decision as I retreated to London where alternative interprofessional opportunities beckoned. Imagine my surprise soon after to receive an invitation from Nottingham to accept an honorary chair. Never having dreamt of such recognition, I was reluctant to turn it down. Reenergised, I renewed my partnership with Ian and others working long-arm on joint assignments from my home in Greenwich for a further six years whilst findings opportunities nearer home to assemble an interprofessional portfolio.

The Marylebone experience

Invitations from the Marylebone Centre Trust and CAIPE offered toeholds. A mere bus ride apart in North London, they were traveling much the same interprofessional road. GPs and near neighbors in Primrose Hill, their leaders, Patrick Pietroni and John Horder, knew each other well and shared the same commitment to teamwork and IPE in primary health care. There the similarities ended. Where Patrick was outgoing and provocative John was reserved and soft-spoken capitalizing on the affection that he enjoyed throughout general practice to win friends for his interprofessional cause. No man (sic) can serve two masters, but l learned much from them both.

Patrick invited me to join the Editorial Board for his Journal of Interprofessional Care and to lead a one-year team (June 1997 to May 1998) to map work-based IPE in North West London NHS trusts (Barr et al., 1998). Marilyn Miller Pietroni invited me to be an external examiner for her pioneering interprofessional master’s programme with the University of Westminster.

GP and Jungian analyst, Patrick’s use of archetypes was graphic. The doctor was the hero, the nurse the great mother, the social worker the scapegoat and the counselor the trickster (J of Interprofessional Care 13 (4) 433). Social worker turned Freudian psychotherapist, Marilyn was more prosaic grounding her experience of IPE in primary and community care (Spratley & Pietroni, 1994). The Marylebone experience reignited psychodynamic insights from my probation training; insights difficult to sustain in interprofessional circles as behavioral and sociological perspectives gained sway.

My engagement extended as the Journal gathered pace, dramatically so when Patrick summoned me to meet him for a working lunch to be told about his deal on behalf of the Trust to sell the Journal to its publisher, Taylor & Francis, including me without prior consultation in the package to succeed him as Editor-in-Chief! Sensitive though I was to the Journal’s antecedents in holistic care and Patrick’s inimical style, there was much to play for. The remaining holistic subscribers withdrew by the end of the first year as holistic copy became the exception and the Journal truly interprofessional. Coverage extended beyond primary care as perceptions of IPE and collaborative practice widened. No longer needing to solicit articles and republish ‘classics’, the Journal attracted more and more diverse copy.

My workload eased when Marilyn Hammick volunteered to help as assistant editor and Julie Clayton was recruited as an editorial administrator followed by Adam Hamilton. A major leap forward came when Madeline Schmitt agreed to become co-editor in North America. Together, we established the Journal as transatlantic and then international. Fiona Ross joined us as a co-editor when the Journal relocated to Kingston with St George’s University of London where she was Dean of Health Sciences. We were followed by Scott Reeves and later by Andreas Xyrichis.

The Westminster experience

Most of my work with Marylebone remained voluntary prompting me to sound out with Patrick whether there might be a paid post. Having negotiated a takeover for the Centre by the University of Westminster, he found funds to create a Research Coordinator for two days per week. I accepted it in the spirit intended, but hesitant whether I was competent as a research methodologist and to work mainly with complementary therapists. Other opportunities continued to engage me in interprofessional developments during the remainder of my time more off than on campus.

Complementary therapy programmes had become close knit in the University’s Centre for Health and Social Care as it then was, but mainstream medical and health professions’ programmes were conspicuous by their absence from the University precluding learning between alternative and allopathic. The University nevertheless saw fit to regularize my position by creating a part-time Professorship in Interprofessional Education. Again, opportunities blossomed off-campus but limited on campus to a handful of colleagues recruited like me by Patrick to pilot his favored projects.

The CAIPE experience

CAIPE had been founded in 1989 at much the same time as I had taken early retirement. John Horder, its chair, sounded me out to undertake assignments at Nottingham for CAIPE. My role was to describe, prescribe and sometimes proscribe. Transferring skills from previous employment in the Home Office Research Unit and CCETSW helped me to draft CAIPE documentation which interprofessional educators readily received when interprofessional literature was sparse.

My attempt to define IPE (Barr, 2007a) was checked out with colleagues and modified critiqued when presented at a conveniently timed conference. Helena Low and I drafted CAIPE’s statement of interprofessional principles (Barr2011), its first IPE guidelines (CAIPE, 2012) revised subsequently with other colleagues (CAIPE, 2016 &, 2017) and its introduction to IPE (Barr & Low 2013). As an individual CAIPE member I was elected to the Council, then as Chair and appointed long-serving President when John stood down. Invented for him, the presidency had no place in the CAIPE constitution leaving me to interpret my role with successive chairs.

At Nottingham I had returned to my profession of social work in my alma mater. At Marylebone and CAIPE I was in unfamiliar territory with neither qualifications nor experience in medicine or healthcare, relying on colleagues to help me find my bearings. I was ill prepared to understand interprofessional relations in the newly established primary care teams still less when Government launched its common learning strategy.

Relations in the teams were said to be fraught (Bruce, 1980; Dingwall, 1978; Jefferys, 1965; Thwaites, 1976) and GPs reluctant to join in IPE. That was less than fair when many were leading it in their practices, accurate where it was introduced into new universities involving nursing, allied health and sometimes social work precluding in those early days medicine with pharmacy and dentistry in the established universities. The problems eased as primary care teams became more outward looking intent on change, service improvement and patient safety, established universities joined with partnerships forged between old and new extending the range of professions that could be included.

I was overwhelmed when the incoming 1997 Labor government invoked “common learning” to generate a more responsive and more flexible workforce in health and other public services (Secretary of State for Health, 2000). Welcomed by some, common learning was feared by others. For me, it threatened distinctive roles, identities and autonomy for each profession, conflicting with the interprofessional values that CAIPE was espousing. An opportunity was engineered for me to discuss those concerns with key civil servants during a conference at the University of Southampton. My relations with them which had until then been good took a knock compounded soon after when the Department of Health devolved its responsibility for professional education to Scotland, Wales and Northern Ireland and, in England, to the regulatory bodies as the number of officials multiplied with whom to liaise. Opportunities nevertheless followed to assist Lisa Hughes leading the “Creating an Interprofessional Workforce” project (Department of Health, 2006) and mentor staff leading pilot common learning sites commissioned by the Department (CAIPE, 2007). Why the fuss when integrated care and learning are being launched today in less troubled waters? Where top-down revolution had faltered, bottom-up evolution is progressing.

The research experience

My efforts to elucidate the interprofessional message prompted commissions from the UK Central Council for Nursing, Midwifery and Health Visiting (Barr, 2000) and the Higher Education Academy (CAIPE, 2002). Self-generated reviews included a survey of IPE throughout the UK (Barr & Waterton, 1996), tracking factors driving the development of IPE in the UK between 1966 and 1997 (Barr, 2007b) and the commentary for my PhD thesis (Barr, 2007c).

More ambitious was the independent review with Marion Helme and Lynda D’Avray (Barr et al., 2014) in three phases supported by St George’s University of London and the Higher Education Academy. Phase one comprised a survey of IPE throughout the UK with Jill Thistlethwaite then at Warwick University. Phase two tackled wicked questions impeding IPE. Phase three comprised nine invited essays from IPE leaders sharing candidly their experiences. The review was adopted by the CAIPE Board and published for consultation. Richard Gray, then CAIPE’s Chair, presented it to regulatory bodies and Board members to fellow CAIPE’s members. Feedback informed the revision of CAIPE guidelines (CAIPE, 2017).

Pertinent though findings from these reviews were pressure had built up following the first ‘All Together Better Health’ (ATBH) conference in 1997 to conduct systematic reviews. The first covering IPE globally was conducted by a UK team with a protocol approved by the ‘Cochrane Collaboration’ (Zwarenstein et al., 2005). The methodology accorded with that for Cochrane reviews of clinical practice which most of us in the team soon found ill-suited to evaluate professional and interprofessional education. Reconstituted as the Interprofessional Education Joint Evaluation Team (JET), we conducted a less restrictive but no less systematic review (Barr et al., 2005; Hammick et al., 2007). The number of IPE interventions meeting the revised inclusion criteria improved but was still low. Consistent with Cochrane’s expectation the original group conducted further periodic reviews. Eligible examples increased marginally each time, but overall numbers remained disappointing. Interprofessional exponents had shot themselves in the foot. Preoccupation with assembling evidence regarding the effects of IPE has lessened as proponents have become more assertive (e.g., WHO, 2010), but evaluating IPE remains no less important.

The publishing experience

Keen to see the findings of the JET review published, we sounded out publishing houses. Blackwell was interested, reassuringly so for authoritative lower circulation texts. Three of those included reported on our findings (Barr et al., 2005; Freeth et al., 2005; Meads et al., 2005) and three more added to the series (Glasby & Dickinson, 2009; McKeown et al., 2010;; Reeves et al., 2010). All seemed set fair until Blackwell was taken over by Wiley. Expecting higher sales, it closed the series to new titles. Disappointed, we sounded out other publishers for a new series. Routledge agreed with four titles published so far (Gurbutt, 2016; Taylor & Thoburn, 2016; Reeves et al., 2019; Spicer et al., 2020).

Accustomed to working in the public sector, these were my first encounters with the commercial sector. Impressed though I was by our multitalented managing editors, CAIPE colleagues like me were frustrated by the rapidity with which they turned over and disconcerted when titles were published unbeknownst to us overlapping with the series. Why books when most outlets from CAIPE are now digital? For selected texts to ensure that they find accessible, authoritative and enduring places in the mainstream literature.

The RSM experience

It was John Horder who invited me to meet the General Practice Committee at the Royal Society of Medicine (RSM) to explore how their section could attract other primary health care workers to attend its meetings. My co-option followed. Struggling to find time for yet another commitment, I missed several meetings. Ready to resign, I was taken aback to be nominated as Section President. The first non-medic in that role, I saw yet another opportunity to break new interprofessional ground. Two years followed as President (nearer three standing in for my sick predecessor) out of ten working with the RSM.

Enjoying wide discretion in planning Section activities, I arranged joint meetings with other health and social care professions. Prepared for confrontation, I brought GPs and social workers together. My trepidation was misplaced when an older generation of medical social workers turned up eagerly recalling their partnerships with GPs in their practices in the 1960s. Remembering many of the same partnerships, retired GPs warmed to the theme.

Enthusiasm also greeted Rear Admiral James Galloway MD of the US Public Health Service (who had taken me to see healthcare on the Native American reservations). Galloway agreed to deliver the biennial John Horder lecture held jointly on that occasion by CAIPE and the RSM. Then there was the study visit to Sweden that I led, a first overseas for the RSM. Save for me, the party was all GPs whom I was able to introduce to interprofessional colleagues in Stockholm. I treated my valedictory lecture (Barr & With Lennox, 2009) as an opportunity to pay tribute to distinguished UK medics who had supported me during their own interprofessional journeys notably Sir Kenneth Calman, Sir Graeme Catto, Sir Michael Drury, Sir Denis Pereira Gray, Angela Lennox and, of course, John Horder.

Interprofessional interest strengthened in the GP Section as I forged lasting friendships though difficult to extend to other RSM sections. The greater the impact the more I became aware of covert resistance in the RSM administration. As an exclusive club admitting non-medic members was strictly circumscribed. As an educational charity mounting post-experience events the RSM ought surely to have welcomed other professions.

I was followed as President by two distinguished GP educators, Margaret Lloyd and Richard Gray dedicated to the interprofessional cause. Further interprofessional activities were generated under their leadership though undercurrents of resistance remained. My time and energy, I concluded would be better deployed working with the General Medical Council, the Royal Colleges and other well-disposed medical institutions.

Some international experiences

My collation of interprofessional developments globally is on record (CAIPE, 2015). Let me revisit some of them from a personal perspective.

Developments in Canada resonate most strongly. The Romanow Commission (Romanow, 2002) presented plans for interprofessional learning to implement its primary care strategy. Lead responsibility rested with Health Canada which disbursed federal funds to institutions. Jetlagged, I recall making my third stop during an around the world trip to attend its bilingual panel of academic experts in Ottawa responsible for recommending awards. Liaison was on-going with Canada including John Gilbert from the University of British Columbia destined to become a global interprofessional leader, and Ivy Oandasan from the University of Toronto from whom I commissioned a special Canadian Issue of the Journal of Interprofessional Care 19 (1) edited with Marilyn Hammick.

IPE development in the United States had slipped back from its peak some years before but was recovering to collaborate with Canada and the UK. Canadian and the US delegates had been convening biennial teamwork conferences for some 25 years before they were re-launched, renamed and re-energized as ‘Collaboration across Borders’. It was my privilege to represent the UK at many of those conferences delivering keynote addresses at several. A bridge was built between the UK and North America at the 1995 teamwork conference in Pittsburgh where Patrick Pietroni, Audrey Leathard and I accepted an invitation to deliver a joint keynote. From then the Journal was transatlantic.

Interprofessional developments in Latin America came later with astonishing speed spearheaded by PAHO – the Pan America Health Organization – convening successive conferences and workshops from one country to the next. I followed those developments from afar regretting that failing health prevented me from attending. Liz Anderson and Juanjo Beunza represented CAIPE at some and Andreas Xyrichis the Journal at others receiving visitors to and from the UK and Spain with a CAIPE publication translated into Spanish and Portuguese (CAIPE, 2013).

Alla El Awaisi and I met at one of the North American conferences where we explored with other delegates the feasibility of mounting a Middle Eastern interprofessional conference. Alla sounded out colleagues in Qatar and the first Middle East interprofessional conference followed. The feasibility of establishing a single interprofessional region embracing countries from Saudi and Iran to the shores of the Mediterranean with their many religious, cultural, historical and political traditions has yet to be put to the test although Qatar is volunteering a lead.

It was in Qatar that I met Salman Guraya from Saudi who invited me soon after to edit an interprofessional issue for the Taibah Medical Journal (Taibah Journal of Medical Sciences 11, 2016). Now a vice principal of a medical school in the Emirates, Salman keeps in touch as he finalizes plans to pilot the first preregistration IPE programme there.

Two proposals had been floated for Sub-Saharan networks, one originating in South Africa with Stefanus Snyman, the other universities comprising a project known to me funded by the Finnish Government. Might I be able to bring the two groups together? I made a round trip to Ndola in Zambia where leaders from both groups met and the Sub Saharan African Interprofessional Network was conceived.

Japanese universities had requested help from CAIPE to develop and support IPE for those that had received government grants. Barbara Clague and Helena Low had responded enthusiastically arranging on-going IPE study visits to and from CAIPE members. Japanese teachers relayed the interprofessional message around the Pacific while Kobe welcomed delegates to its ATBH conference. Along the way, I was learning from faculty in Gunma, Niigata, Sapporo, Tokyo Metropolitan and other Japanese universities how to combine work and pleasure enjoying the sake and the sushi.

The high spot for four of us from the UK came following the Kobe conference when we were invited overnight by Hideaki Takahashi to visit Uonoma, a city of 35,000 abutting the mountains with the most rapidly aging population even for Japan. There we observed its customs, sleeping on the floor followed by rice and seaweed for breakfast after deciphering with difficulty ‘his’ from ‘hers’ for the public baths. During the day we enjoyed the creativity of residents individualizing their rooms and corridors before getting down on the mats to join them in their exercises supervised by their gymnast.

IPE had reached Australia and New Zealand well before. CAIPE was commissioned to convene a series of capacity building workshops facilitated by Helena Low, Elizabeth Howkins and Dawn Forman and later Scott Reeves with me. From New Zealand I had welcomed an invitation to deliver two keynote addresses at a national conference in Christchurch while a visiting professor at the University of Otago. I forged a productive partnership with Margo Brewer at Curtin University in Western Australia as an adjunct professor drafting guidelines for team-based learning for interprofessional practice (Brewer & Barr, 2016). Meeting Roger Dunston during his regular family visits to England provided productive opportunities to share thinking especially that being generated by the Commonwealth-wide consultations that he was leading to construct an alliance to implement collaborative governance (Dunston, 2017).

My attention returned time and again to continental Europe where the challenge was to build a pan-European Interprofessional Network across different languages, cultures and political traditions as the last remnants of the Iron Curtain came down and the European Community rapidly expanded. Funded by the EU, Margaret Sills and Marion Helme from the UK Higher Education Academy reached out to Hungary, Poland, Slovenia and Greece inviting them to join with western European nations in the European Interprofessional Education Network (EIPEN). Appreciating that the EU was unlikely to fund yet again through the UK, leadership was passed to André Vyt in Belgium where it remains.

With CAIPE established, it was a pleasure to support Synnove Almas from Aalesund and Ester Mogensen from the Karolinska in Stockholm as they planned Nipnet – the Nordic Interprofessional Network. Other networks followed for the Netherlands, the German speaking nations and mooted for the Hispanic nations.

It is easy for those of us from the UK to exchange with Danes, Norwegians, Swedes and Finns communicating fluently in our language. My meetings with Nils Areskog from Linkoping were few but precious. I recall bumping into him just before an afternoon session at the ATBH conference in Stockholm. A lively discussion ensued joined by relays of passing delegates skipping conference presentations!

During one of those conferences three Norwegian PhD candidates – Synnove Almas (laboratory technician), Atle Odegard (clinical psychologist) and Elisabeth Willumnsen (social worker) with one Swedish licentiate candidate – Susanne Kvarnstrom (nurse) – chanced to meet. Their spontaneous teach-in encouraged them to form a self-help group (inviting me to be their mentor) to meet as often as practicable until they had all won their awards. Meetings were tacked on to conferences that the group already planned to attend. Others were held in each other’s rural retreats. Enjoying one of those, we caught sight of the Atlantic between the mountains. What better metaphor as we searched for glimpses of truth? The three Norwegian members were all awarded their PhDs and now hold chairs in Norwegian universities. After completing her licentiate, the Swede reregistered and duly obtained her PhD now holding the top training post in a Swedish Regional Council.

Meanwhile, global ATBH conferences were being convened. I led the first in London in 1997 with Patrick Pietroni and the third there in 2006 with colleagues from CAIPE and the Journal of Interprofessional Care. The second in 2004 was held in Vancouver, the fourth in 2008 in Stockholm, the fifth in 2010 in Sydney, the sixth in 2012 in Kobe, the seventh in 2014 in Pittsburgh, the eight in 2016 in Oxford and the ninth in 2018 in Auckland with the tenth rescheduled until 2021 in Qatar.

Led by John Gilbert, our first attempt to launch an international interprofessional education network (InterEd) faltered. A World Coordinating Committee followed that I convened upgraded to become ‘Interprofessional. Global’ – https://interprofessional.global/- steered by me during its formative stages then chaired by Johanna Dahlberg from Sweden extending ever more links between countries and continents (CAIPE, 2015).

The Finnish experience

My 28 visits to one institution in Finland call for explanation. I met Annikki Lamsa during a European conference at the University of Leeds when she enthused about her plans for Oulu Polytechnic where she had recently been appointed Acting Director combining schools of Business, Engineering, Health, Social Care and the Performing Arts. Her unifying mission was ‘holistic care’. She grasped instantly the significance of IPE as the means by which students from two or more of her schools could learn together in service to the community treating international relations as pivotal and welcoming teachers and students on placement.

Forty-eight hours overdue on a bleak February night, the latest party of students from Kenya arrived on the 2 am flight. The welcoming party was dispatched to the airport with thermals and snowshoes. At 8 am with my post experience students I was informed that the Kenyans would be joining us at 10 am for our final session on teamwork. Abandoning our plans, we rescued the piano from a corner of the classroom. A student volunteered to accompany traditional songs of welcome in English and Finnish before encouraging our guests to respond in Swahili. We then recalled how each of us had felt on our first day in a strange place.

I was one of an overseas party that stayed at the village hospital in Sirisia in rural west Kenya with the junior and girls’ secondary schools nearby. President Daniel Arup Moi had decreed that secondary education was for boys only. Girls from age 12 should be working on the farms and bearing families. The locals turned to the Oulu Polytechnic health professionals for help who enlisted education colleagues from Oulu University to contribute expertise and solicit Finnish funds. Bricks, stones and timber were donated by local farmers to build the classrooms and the dormitories for the girls beyond walking distance. We were greeted with a crescendo of drums and singing from the junior school children, but the high spot came later when we celebrated with her the first secondary girl to win a place at university.

Then there was the invitation to join a delegation with the Governor of Oulu Province to his counterpart in the neighboring Kyrelia Province in Russia to coordinate the management of drug trafficking. Our coach broke down just short of the border on route to Kostomuksha creating an unplanned opportunity to get to know other members of the party including the Provincial chiefs of police, customs, psychiatry, medicine, nursing and education. Arriving late, welcoming speeches were interminable. I struggled to use my allotted time to recall interactive exchanges between Russians and Americans during a previous workshop in Voronezh.

I was captivated by the northern wilderness engulfed in snow and darkness for much of the year where many of the remote communities in the forests were dying as the rising generation migrated to Oulu and beyond. Oulu grew to over a hundred thousand with two universities, a teaching hospital, shopping malls and two opera houses attracting inward investment from Japan for its high-tech industry until recession hit.

Community development engaged the social care workers, more aptly community survival as populations in many of the more remote villages shrank rendering the infant school, the doctor’s practice and other essential services no longer viable. Young people were the main export, especially newly qualified nurses fluent in English and sometimes Norwegian vowing to return one day to their roots. I recall the excitement taking teachers from Oulu to visit my local hospital in Greenwich when we found a Finnish nurse on one of the wards.

The social work experience

For better or worse, my priorities for those 30 years were mostly driven by circumstance. I missed opportunities to engage more with my own profession of social work with two exceptions. One was a review of interprofessional practice learning in social work programmes with Helena Low, a district nurse by background attuned to working with social workers (Low & Barr, 2008), the other an historic perspective on collaboration between social workers and medicine with colleagues at Westminster (Barr et al., 2007). Working down the years with social work alumni like Anne Loxley, Marilyn Miller Pietroni, Olive Stevenson, Lonica Vanclay and Marion Helme has been precious, convinced with them regarding the indispensable part that social workers must play to imbue a pervasive rationale for community-based collaborative learning and working. More still needs to be done to counter social work’s marginality in much IPE bridging the health and care divide distinguishing between social care as a field of practice and social work as a profession.

Conclusion: a fulfilling experience

An accident: a chapter of accidents, or was there another explanation? Might that be my disrupted schooling during and following the war years winning a place at university the hard way as a mature entrant on the lowest rung of the ladder? Might that explain why education was to become so important to me countering stunted ambition and poverty of thought? Why then my preoccupation with interprofessional education? Thirty years have convinced me that it can and does enhance mutual esteem, improving not only quality of care but also quality of life. How then, colleagues ask me, did you change along your interprofessional journey? Becoming more receptive and more responsive, if more exposed and more vulnerable, yet more fulfilled.

Declaration of interest

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

Acknowledgments

I am indebted to too many of you to name with whom I have learned along our interwoven ways, especially those of you who reviewed this paper critically during successive drafts.

Additional information

Notes on contributors

Hugh Barr

Professor Hugh Barr M.Phil., Ph.D., Hon. D.Sc. Emeritus Editor, the Journal of Interprofessional Care; President of the UK Centre for the Advancement of Interprofessional Education; Emeritus Professor of Interprofessional Education and Honorary Fellow, the University of Westminter, UK.

Notes

1. My friendship with Olive dated back to my days as a probation officer in Nottinghamshire followed by secondments to the Home Office Research Unit and later the voluntary sector of prison after care concurrent with part-time research studies in her department serving concurrently on the Board for the British Journal of Social Workers that she edited.