Toward a Spirit of Interprofessional Practice: A Hermeneutic Phenomenological Study

Date
2017
Authors
Flood, Brenda
Supervisor
Hocking, Clare
Smythe, Liz
Jones, Marion
Item type
Thesis
Degree name
Doctor of Health Science
Journal Title
Journal ISSN
Volume Title
Publisher
Auckland University of Technology
Abstract

Interprofessional practice is recognised as essential in the provision of patient centred, collaborative and high quality care, contributing to improvements in the patient experience and health outcomes. This way of working is expected within healthcare; however, understandings of how best to cultivate practitioners able to ‘be’ and ‘become’ interprofessional remain problematic. To advance that understanding, this study addressed the question: ‘What are health professionals’ experiences of working with people from other disciplines?’ The multifaceted and dialectical nature of interprofessional practice, and the multiple levels of meaning inherent within it, drew me to the hermeneutic phenomenological approach informed by Martin Heidegger [1889-1976] and Hans-Georg Gadamer [1900-2002], which underpins this study. This interpretive study seeks to uncover and reveal those aspects of health professionals’ everyday experience with others that point toward what it means to ‘be’ and ‘become’ an interprofessional practitioner. In dwelling with, and gaining a deeper understanding of, the nature of events as experienced in everyday life, a more thoughtful approach to the development of interprofessional learning is opened up, where the ‘being’ and ‘becoming’ can be foregrounded. In-depth, semi structured interviews with 12 health professionals from nursing, occupational therapy, physiotherapy, speech and language therapy, medicine, social work, and midwifery were undertaken, and their understandings and perspectives of interprofessional practice gathered. The interviews used a conversation style approach, and were recorded and transcribed. Immersion in the transcripts allowed stories and unifying themes of experience and meaning to emerge, many announcing themselves as important. Interpretation focused on accounts strongly linked to ways of ‘being’ interprofessional and the ways in which these were safeguarded and preserved. Writing and rewriting helped in staying connected to the meanings that emerged from the text, bringing more depth and clarity to the interpretation process. The experience of health professionals revealed things which appear to be at the ‘heart’ of interprofessional practice, illuminating ways of ‘being’ and ‘doing’ necessary in the turning toward, working in a spirit, and in the safeguarding and preserving of interprofessional practice. The findings of this research contribute to a deeper understanding of interprofessional practice as a way of being that extends beyond known and measureable skills and knowledge, to dispositions and qualities. Dispositional qualities that come from within a person and what they care about, and from experiences that shape their understandings. This study points toward interprofessional practice as being about a spirit, not a set of competencies. Who people are, what they bring and how they act is what matters.

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Keywords
Interprofessional practice , Interprofessional education , Interprofessional collaboration , Hermeneutic phenomenology , Interprofessional competencies , Ontological
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