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Interprofessionellt lärande i teamarbete: Hur kontroverser, genus och erfarenhetsbaseradexpertis kan bidra till lärande i psykiatrisk vård
University West. (KAMAIL)ORCID iD: 0000-0002-4900-9570
2025 (Swedish)Doctoral thesis, comprehensive summary (Other academic)Alternative title
Interprofessional learning in teamwork : How controversies, gender and experience-based expertise can contribute to learning in psychiatric care. (English)
Abstract [sv]

Interprofessionellt lärande (IPL) är det lärande som sker mellan olika professioner när de interagerar. Forskningen har främst fokuserat på det IPL som sker genom interprofessionell utbildning (IPE). Det finns begränsad forskning om IPL i teamarbete. I interprofessionella teamarbeten är medlemmarnas professionella skillnader i perspektiv, kunskaper och värderingar både en förutsättning och en utmaning för IPL. Syftet med denna avhandling är att studera IPL i teamarbete och hur professionella skillnader har implikationer för detta lärande.

Avhandlingen granskar IPL i två olika teamarbeten i en psykiatrisk vårdkontext. Allt fler vuxna, och speciellt unga, upplever olika psykiska besvär samtidigt som det rapporteras om att vård och behandling för psykiatriska tillstånd brister. Därför behöver den psykiatriska vården genom IPL utveckla sätten att bedriva vård av god kvalitet.

I den ena delen av detta forskningsarbete undersöktes ett teams arbete med riktlinjer för psykiatrisk tvångsvård och implikationerna för IPL. Detta forskningsarbete redovisas i tre studier, som baseras på en fallbeskrivning och intervjuer. En sociokulturell lärandeteori används med inslag av idéer från genus- och kontroversstudier. Resultatet visar hur en kontrovers kring en tvångsmetod kan generera IPL i teamarbetet trots att medlemmarna använder maktstrategier för att göra anspråk på kunskapsföreträde. I hanteringen av kontroversen sker IPL dels genom en kompromiss, dels genom mediering av en lagtext. Resultatet visar även hur denna kontroversprocedur kan förstås teoretiskt. Resultatet visar hur diskussioner om könsskillnader förs i arbetet med riktlinjerna för tvångsvård. I diskussioner om kön/genus kan utbyten av professionsspecifika erfarenheter och kunskaper antas generera IPL. Lärandet begränsas dock av teamets individuella kunskaper om genus, då riktlinjerna, trots konversationer om könsskillnader i psykiatrisk vård, blir könsneutrala. I det andra forskningsarbetet undersöktes konsekvenserna för IPL i teamarbeten när erfarenhetsbaserad expertis tillfördes av peer supportrar. Peer supportrar använder sina egna erfarenheter av psykisk ohälsa för att stödja brukares/patienters återhämtning. Detta forskningsarbete redovisas i två studier. Den ena studien baseras på 23 vetenskapliga artiklar, medan den andra studien prövar en hypotes. I den senare studien används en sociokulturell lärandeteori. Resultatet visar hur befintlig kunskap mestadels har rört peer supportrars inklusion i interprofessionella team. Vidare, att IPL inte har uppmärksammats i forskning om peer supportrar i teamarbeten. Samtidigt synliggör resultatet hur peer supportrar, trots en hierarki, delar sina perspektiv och kunskaper som genererar IPL i teamarbetena. Resultatet förklarar även teoretiskt hur peer supportrar som nykomlingar, när deras erfarenhetsbaserade expertis blir bejakad i sin helhet, kan bidra till IPL i psykiatriska teamarbeten.

Därmed belyser alla studier teamarbeten där professionella skillnader både begränsade och bidrog till IPL. Denna slutsats utvecklas i diskussionsdelen. Avhandlingen bidrar med ny kunskap om utmaningar och möjligheter för IPL i teamarbeten. Vidare, hur kontroverser, genus och erfarenhetsbaserad expertis kan stärka IPL. Detta kunskapsbidrag är av nytta för en bred målgrupp inom det psykiatriska området, men också inom andra områden exempelvis i den sociala sektorn.

Abstract [en]

Background, aim, and context

Interprofessional learning (IPL) is the learning that occurs when different professions interact. Research has primarily focused on the IPL that results from interprofessional education (IPE). There is limited research on IPL in teamwork. In interprofessional teamwork, the members' professional differences in terms of perspective, knowledge and values are both a prerequisite and a challenge for IPL. This thesis investigates IPL in teamwork and how professional differences have implications for this learning. This thesis examines IPL in two different teamworks in a psychiatric care context, which is a prioritized area as mental illness is an urgent societal problem to be solved. More and more adults, and especially young people, are experiencing various mental health problems, while it is reported that care and treatment, for psychiatric conditions, is lacking. Therefore, psychiatric care needs through IPL develop ways to provide good quality care.

Empirical material, theoretical frame and results

In one part of this research work, a team's work on guidelines for psychiatric compulsory care and the implications for IPL were examined. This research work is reported in three studies, which are based on a case description and interviews. A sociocultural learning theory was applied, combined with ideas from gender studies and controversy studies. The result shows how a controversy about a coercive method can generate IPL in teamwork despite members using power strategies to claim knowledge precedence. In dealing with the controversy, the IPL takes place partly through a compromise, partly through the mediation of a legal text. This controversy is also illustrated by a model that guides how controversies can facilitate IPL in teamwork. The result also shows how in the work with the guidelines there are discussions about gender differences in psychiatric care. In discussions about sex/gender, profession-specific experiences and knowledge can be assumed to generate IPL, but when the guidelines become gender neutral, IPL is limited by individual knowledge. In the second research work, the consequences for IPL in teamwork are investigated when experience-based expertise is provided by peer support workers (PSWs). These are people who use their own experiences of mental illness to support user/patient recovery. This research work is reported in two studies. The first study is based on 23 studies, whereas the second study tests a hypothesis. In the latter study ideas from a sociocultural learning theory is applied. The result shows how existing knowledge has mostly concerned the inclusion of PSWs in interprofessional teams. Furthermore, research on PSWs in teamwork has not paid attention to the IPL. At the same time, the result makes visible how PSWs, despite a hierarchy, share their perspectives and knowledge that generate IPL in teamwork. The result also theoretically explains how by being newcomers PSWs’ experience-based expertise, when validated in its entirety, can contribute to IPL in psychiatric teamwork.

Contribution of knowledge and suggestions of future research

Thus, all studies highlight teamwork where professional differences both limited and contributed to IPL. This conclusion is developed in the discussion section. The thesis contributes new knowledge about challenges and opportunities for IPL in psychiatric teamwork. Furthermore, how controversies, gender and experience-based expertise can strengthen IPL. This knowledge contribution is useful for a wide target group in the psychiatric field, but also in other fields, for example in the social sector.

Place, publisher, year, edition, pages
Trollhättan: Högskolan Väst , 2025. , p. 157
Series
PhD Thesis: University West ; 71
Keywords [en]
Qualitative study; Interprofessional learning; Interprofessional teamwork; Professional differences; Controversy; Gender; Peer support worker; Experience-based expertise, Sociocultural theory
Keywords [sv]
Kvalitativ studie; Interprofessionellt lärande; Interprofessionellt teamarbete; Professionella skillnader; Kontrovers; Genus; Peer supporter; Erfarenhetsbaserad expertis, Sociokulturell teori.
National Category
Work Sciences Nursing
Research subject
Work Integrated Learning
Identifiers
URN: urn:nbn:se:hv:diva-22871ISBN: 978-91-89969-08-7 (electronic)ISBN: 978-91-89969-09-4 (print)OAI: oai:DiVA.org:hv-22871DiVA, id: diva2:1925953
Public defence
2025-01-31, F313, Gustava Melins gata 2, 46185, Trollhättan, 13:15 (Swedish)
Opponent
Supervisors
Note

Paper 1 is to be submitted and not included in this thesis.

Available from: 2025-01-10 Created: 2025-01-09 Last updated: 2025-01-09
List of papers
1. Interprofessional learning through discussions of troubled sex/gender in mental health care: A case study
Open this publication in new window or tab >>Interprofessional learning through discussions of troubled sex/gender in mental health care: A case study
2023 (English)In: Journal of Mental Health Training, Education and Practice, ISSN 1755-6228, E-ISSN 2042-8707, Vol. 18, no 3, p. 206-216Article in journal (Refereed) Published
Abstract [en]

Purpose

This study aims to investigate how aspects of the sex/gender were scrutinized in a team’s production of clinical guidelines for psychiatric compulsory care and what the implications were for the final guidelines and for interprofessional learning.

Design/methodology/approach

The study is a case study, where interviews were conducted and a narrative analysis was used.

Findings

The results reflected how sex/gender arose in a discussion about gender differences when using restraining belts. Furthermore, discussions are presented where profession-specific experiences and knowledge about sex/gender appeared to stimulate interprofessional learning. However, the team’s learning about the complexity of sex/gender resulted in guidelines that emphasized aspects of power and focused on the individual patient. Thus, discussions leading to analysis and learning related to gender paradoxically produced guidelines that were gender-neutral.

Originality/value

The study highlights the potential interprofessional learning in discussions of sex/gender and its complex relation in medicine.

Keywords
case study, interprofessional, interprofessional teamwork, professional differences, sex, gender, textual mediation
National Category
Psychiatry Work Sciences
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science; Work-Integrated Learning
Identifiers
urn:nbn:se:hv:diva-19776 (URN)10.1108/jmhtep-03-2021-0032 (DOI)000907202800001 ()2-s2.0-85145742287 (Scopus ID)
Note

CC BY 4.0

Available from: 2023-03-20 Created: 2023-03-20 Last updated: 2025-04-24Bibliographically approved
2. Ideas of how peer support workers facilitate interprofessional learning in mental health care teamwork: conceptual paper
Open this publication in new window or tab >>Ideas of how peer support workers facilitate interprofessional learning in mental health care teamwork: conceptual paper
2022 (English)In: Mental Health and Social Inclusion, ISSN 2042-8308, E-ISSN 2042-8316Article in journal (Refereed) Published
Abstract [en]

Purpose – The purpose of this paper is to contribute theoretical ideas of how peer support workers (PSWs) bring added value to interprofessional learning (IPL) in mental health care teamwork. The question is: How can we theoretically understand the value of PSWs’ expertise for IPL in mentalhealth care teamwork?

Design/methodology/approach – Initially, the authors formulate a hypothesis. Then, the authors describe the focus and context in IPL and PSWs, respectively, and the PSWs’ and mental health professions’ different roles, expertise and perspectives. The authors also refer to some peer provided programs related to IPL. Finally, the authors construct an outline and apply ideas from Wenger’s Communities of Practice (CoP).

Findings – Using CoP, the PSWs as newcomers can by their perspectives change mental health professions’ perspectives and stimulate IPL in teamwork.

Originality/value – The paper gives theoretical insights of how PSWs can facilitate IPL in mentalhealth care teamwork.

Keywords
Interprofessional learning, Interprofessional teamwork, Peer support workers, Mental health care, Communities of practice
National Category
Work Sciences Nursing
Research subject
Work Integrated Learning; NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-18483 (URN)10.1108/mhsi-01-2022-0004 (DOI)000799415000001 ()2-s2.0-85130989640 (Scopus ID)
Available from: 2022-06-14 Created: 2022-06-14 Last updated: 2025-01-09
3. Peer support workers´ role and expertise and interprofessional learning in mental health care:: a scoping review
Open this publication in new window or tab >>Peer support workers´ role and expertise and interprofessional learning in mental health care:: a scoping review
2022 (English)In: Journal of Interprofessional Care, ISSN 1356-1820, E-ISSN 1469-9567, Vol. 36, no 6, p. 828-838Article in journal (Refereed) Published
Abstract [en]

Interprofessional learning (IPL), which is learning arising from the interaction between representatives of two or more professions, has not been studied extensively in relation to peer support workers (PSWs) in mental health care teams. PSWs support others who face challenges with their own experience of similar challenges of mental health problems. The role of PSWs has been studied in mental health care interprofessional teams. However, researchers have not paid attention to IPL where the PSWs contribute their knowledge. This paper is a scoping review that aims to highlight existing knowledge of the PSW role and expertise in IPL in the context of mental health care. The findings show knowledge of (a) the key factors and challenges when interprofessional teams include the PSW role, (b) the legitimacy of the PSWs' role and expertise, and (c) the benefits of the PSW role. A knowledge gap was identified of teams' use of PSWs' expertise and its implications for IPL.

Place, publisher, year, edition, pages
Taylor & Francis, 2022
Keywords
Scoping review, interprofessional learning, interprofessional teamwork, peer support worker, expertise
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-18187 (URN)10.1080/13561820.2021.2014796 (DOI)000751706100001 ()35129027 (PubMedID)2-s2.0-85128230034 (Scopus ID)
Available from: 2022-03-28 Created: 2022-03-28 Last updated: 2025-01-09
4. Ideas on how educators facilitate interprofessional learning through controversies
Open this publication in new window or tab >>Ideas on how educators facilitate interprofessional learning through controversies
2024 (English)In: International Journal of Lifelong Education, ISSN 0260-1370, E-ISSN 1464-519X, Vol. 43, no 6, p. 651-663Article in journal (Refereed) Published
Abstract [en]

Constructive controversies, where team members discuss their differentopinions openly and politely, can stimulate interprofessional learning(IPL): the learning that occurs in the interactions between two or moredifferent professions. However, in science-based controversies where members compete to be the expert learning becomes complicated. This paper constructs a model for a procedure of a science-based controversyand describes the conditions for IPL in such a setting. The basis for the model is an empirical study. Firstly, we describe how constructive controversies are conceptualised in the literature. We include literature on dialogic teaching and learning. Secondly, we describe how science-basedcontroversies are conceptualised. Thirdly, we present the empirical study. Fourthly, we construct the model which focuses on mental health careprofessionals but is also applicable to other professionals. The findingssuggest a model with three contextual factors which are connected to theuse of power strategies and learning strategies. The model gives ideas foreducators on why and how to use science-based controversies to facilitateIPL in teamwork. Indirectly a theory is introduced of how to strengthen IPL through controversies. The model is relevant in teaching how controversies which often concern what is best for the users/patients can be handled constructively.

Place, publisher, year, edition, pages
Informa Healthcare, 2024
Keywords
education; controversy; interprofessional learning
National Category
Other Social Sciences not elsewhere specified Educational Sciences
Research subject
Work Integrated Learning
Identifiers
urn:nbn:se:hv:diva-22873 (URN)10.1080/02601370.2024.2384612 (DOI)001284962200001 ()2-s2.0-85200449770 (Scopus ID)
Note

CC-BY 4.0

Available from: 2025-01-09 Created: 2025-01-09 Last updated: 2025-02-18

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