Forord

Susanne Lindqvist, Professor of Interprofessional Practice, University of East Anglia, United Kingdom

In 2002, I joined the Centre for Interprofessional Practice (CIPP) at the University of East Anglia (UEA) with the aim of developing interprofessional learning (IPL) opportunities for healthcare students. Together with a dedicated team of students, staff, and service users, I developed IPL for a wide range of students throughout their education. In 2016-17, CIPP was responsible for the delivery of five different levels of IPL to over 3000 students, from 12 different professions.

In 2017, a decision was made that CIPP was no longer going to deliver IPL. Instead, IPL would be integrated into the different Schools of Medicine, Health Sciences and Pharmacy, with CIPP being more involved in research. Today, UEA offers one mandatory two-hour IPL session to around 1000 first-year students, and some interprofessional clinical skill initiatives are being revived after the pandemic.

For CIPP and myself personally, it was devastating to see the previous structure of IPL, built up over 15 years, being ‘lost’. However, it stimulated new thinking around other initiatives and ways that IPL can become integrated in the students’ curriculum and more resilient to changes in leadership. Furthermore, students started to notice that IPL opportunities had fallen by the wayside, and in response initiated their own interprofessional education society. This society is now well embedded and has won several awards for best society at UEA.

On writing this, the year is now 2023, and I can honestly say that I feel very excited about the future of IPL and other learning opportunities that can prepare students at UEA for a future of interprofessional collaborative practice (ICP). I recognise now that all was not ‘lost’, but that the years of learning with numerous staff, students, and service users had indeed shaped the way people think about education and that there is a real appetite to co-create IPL opportunities again, albeit in a different way.

This third issue of the book Tverrprofesjonelt samarbeid – et samfunnsoppdrag edited by Professors

Elisabeth Willumsen

and Atle Ødegård is an interesting and enlightening read, which provides an overview of theoretical perspectives, research and policy developments over many years, from a number of respected authors across the globe within the fields of interprofessional education (IPE) and collaborative practice.

The book is divided into three parts: i) the social mission, ii) the knowledge platform, and iii) strategies and models for collaboration. It reminds us about the importance of language and the fact that we still have a ways to go when it comes to a joint understanding of what different words and expressions mean. It also highlights the connectivity between the team and its network, and the attention that needs to be given to each person within an organisation and system regardless of whether they belong to a profession or not.

I appreciate the attention to social innovation and the interplay within, which will enable the change we would all like to see and that is likely to achieve the health and social care outcomes for which we strive. There are statements that I am not entirely sure I agree with, but this – to me – is a good thing, as it helps challenge convictions and standpoints. For example, I feel strongly that each of us has one identity, which is complex and shaped by people we meet, ways we learn, and places we live, work and visit. Our identity can change to some extent and some carry more than one passport, but your fingerprint will be the same in both. You are still this one individual having a number of roles in life. For our students, the uni-professional identity is important, and we must respect that. Boundaries should not be blurred, but should be kept very clear. This does not mean that they cannot change, or be moved, but they need to be clear in order to enable safe practice. As people are expected to learn and work with members of other professions in practice, students will benefit from meeting and learning with those in other disciplines so that they can practice how to communicate and work together. They also need to learn the importance of respecting differences in views, e.g., around identity, at what stage in their education students should interact, and whether they also need to develop an ‘interprofessional identity’. This book allows me to read and reflect on where I am at and thus revisit my viewpoint to see whether I may have changed my mind in light of arguments and/or evidence, be they theoretical or empirical. This iterative process of lifelong learning is crucial, particularly in this field, which has struggled to gain full recognition and priority – despite the rather apparent need for our workforce to collaborate in order to deliver safe and high-quality care.

In England, where I live, we now have 42 integrated care systems (ICSs). These are health and social care organisations within an area that need to co-ordinate their services in partnership so that the people living in this region can all live a

‘healthy and happier life’ and access services. For the ICSs to become successful, there is no other way than for stakeholders to collaborate across professions and services. For higher educational institutions, it therefore seems obvious that integration of IPL from the beginning and throughout is fundamental to prepare students for this ‘new’ type of working. Of course, there is little ‘new’ about patients/clients and service users needing professions to collaborate and services to become integrated, but what has been lacking is the commitment and drive by the government to achieve it. What has changed now is the priority and shift from the government setting up these ICSs giving IPE and ICP a renewed focus and impetus.

The pandemic taught us many lessons, including how to upskill quickly and that we can if we must! It also showed how much we need social interactions and how much these can enrich IPL. At UEA, we successfully delivered IPL for over 1000 first-year healthcare students representing ten different professions on the online platform Zoom during the first lockdown, which was exciting and great in many ways. We used this approach for two years and were pondering as to whether we would continue using the platform even when we no longer had to, as in the end it was a lot easier and cheaper. However, we decided to deliver it face-to-face, and I am so glad we did as it was a much richer learning experience. Indeed, contact is important, though not enough in itself – as I am also reminded of here.

This book discusses identity and the socialisation taking place for each student within each of their courses. Questions were raised as to whether students should develop their own professional identity before they engage in IPL, or as part of their identity development. As alluded to earlier, I am convinced of the importance of IPL facilitators/tutors in education and practice embracing the chosen approach for the investment to be worthwhile. After all these years, it is reassuring to feel confident about some things!

We still don’t know what ‘works best’: when, how often, and with whom? And I am not sure we ever will, simply because I think the circumstances will vary and therefore IPE and IPC will always need to be tailored to the local resources, opportunities and requirements. We do have some strong guidance available to us now, however, which is underpinned by empirical evidence and experiences. Like many regions in Norway, I live in a rural area – relatively speaking – in which a high percentage of inhabitants are frail, elderly people with complex health and care needs. It is also a community that sees a lot of deprivation. Many health and social care staff are burnt out after the pandemic. In parallel, we see fewer students wanting to join the health and care profession.

As stated in chapter 7, we must embrace social imagination and innovation. By fostering inclusive, altruistic leadership, and allowing space for compassion for our workers who care for patients/clients/service users, we can make this world a healthier and happier place. We will all need care at some point, and thus all depend on those who can provide such care in a safe and timely fashion. This book made me realise how important it is for us to help build this social capital so that we can recruit and retain a strong workforce. This is especially pertinent in the wake of the pandemic, where health and social care staff need to build their resilience.

Ken Schwartz was a successful American lawyer in his early 40s who died from lung cancer in the 1990s. Before he died, he wrote a piece to praise the care offered him by the Brigham and Women’s Hospital in Boston. After his death, his family set up ‘Schwartz Rounds’ as a way to support staff. The Rounds are regular meetings where hospital staff – including porters, catering staff, and others, not just doctors and nurses – can express their feelings about the care of a particular patient.

In the United Kingdom, for many years now, the Point of Care Foundation has delivered ‘Schwartz Rounds’ to health and care staff with the intention to help restore compassion by sharing emotionally charged situations with others in a facilitated and safe environment. These Rounds became more frequent after one of the greater scandals in healthcare where a national report was published requesting change, and the Rounds were mentioned as a way to help the workforce.

As we emerge from the pandemic, the physical and moral injury is real and affects us all, but especially those working on the front line. To help equip our students, we are also going to offer these Rounds and refer to them as interprofessional Schwartz Rounds, with the ‘learning’ part intentionally left out, as this is not their primary aim. Instead, they are enabling people to come together to listen to a few real experiences that help trigger reflections from the audience so emotions can be shared in a safe environment.

In a reality of practice, where the only constant is change, our students need to be appropriately equipped to look after others and themselves. Again, this book helps us appreciate the importance of co-creating, implementing, and sustaining a social capital. It is indeed about relationships, which is not always easy and requires ongoing investment. I believe in this sentiment, and that the more we connect with other people, the more we trust them – the foundation on which IPE and IPC rest.

I wholeheartedly recommend this book to everyone interested in this field. It is thought-provoking and helps consolidate the strategy going forward. I am excited about the future of IPE and ICP and the new opportunity this social mission offers! The next step at UEA is to offer interprofessional Schwartz Rounds to our health and social care students so that they can familiarise themselves with this practice as students. The first case-based round was based on ‘the patient/ client/service user I never forget’. Furthermore, as part of the development of our ICS, we will develop new interprofessional placements in our community so that we can re-connect and build our future together through ‘tverrprofesjonelt samarbeid’, which is indeed ‘et samfunnsoppdrag’.

Susanne Lindqvist