Summary:



This poster showcases the emergent findings from a focused ethnographic study looking into the Inter-professional Learning culture within Adult Critical Care settings. The research is being conducted as part of doctoral study and reports early findings from 2 of the 3 critical care units researched. Partial participation observation and semi-structured interviews are being used to collect data and constant comparison analysis has thus far revealed 3 themes:  ‘Creating Space & Time for IPL’, ‘Collaborative IPL’ and ‘IPL & Humanistic Values’. The emerging theoretical framework is underpinned with social constructionism,complexity and socio-cultural learning theory

Park, Vikki

Northumbria Research Link

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Citation: Park, Vikki (2016) Interprofessional learning in adult critical care: early findings of a focused 
ethnography study. In: North of England Critical Care Annual Conference 2016, 12th October 2016, 
Durham. 
URL: 
This version was downloaded from Northumbria Research Link: http://nrl.northumbria.ac.uk/28241/
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Interprofessional Learning in Adult Critical Care:  
Early findings of a focused ethnographic study 
Vikki Park, Senior Lecturer, Northumbria University, Faculty of Health and Life Sciences: vikki2.park@northumbria.ac.uk 
Supervisors: Professor Amanda Clarke (Principal), Dr Alison Machin & Lesley Durham 
 
BACKGROUND 
Due to its complexity, critical care requires numerous 
professionals to effectively work together (Rose 2011). 
However, further exploration is needed to ascertain how 
different critical care staff working together also learn with 
and from each other in this particular environment.  
 
The critical care setting is claimed to have the potential to 
share interprofessional knowledge between staff (Wagter et 
al. 2012). However, Paradis et al. (2014) emphasise limited 
knowledge in this area at present, despite recognition that 
interprofessional collaboration in critical care units improves 
patient safety and quality of patient care. They claim that 
there needs to be increased understanding regarding the 
effects that culture or context have on shaping 
interprofessional practices and advocate ethnography as   
             an appropriate research methodology. 
METHOD 
 
The multi-site research is in fulfilment of doctoral study.  
 
Data collection:   12 months 
                              3 different NHS Hospital critical care units  
                              January 2016 – December 2016 . 
Methodology:       Focused ethnography 
Observation:        90 hours estimated 
Interviews:           12-36 hours  
Data analysis:      Constant comparison  
AIM 
To explore the culture of interprofessional learning (IPL) 
within adult critical care settings. 
 
OBJECTIVES 
To develop a rich description of the interprofessional 
learning culture in adult critical care clinical practice.  
To understand in-depth critical care practitioners’ 
perceptions & experiences of interprofessional learning 
(IPL) within adult critical care clinical practice. 
To identify which factors are perceived to promote or 
inhibit effective IPL. 
 
 
FINDINGS 
Early analysis of findings confirm that critical care staff are a rich source of knowledge and various conduits seem to facilitate effective IPL. IPL does appear to exist in adult critical care settings and this is 
explicated by numerous learning theories. Three themes are emerging from the iterative data analysis thus far: ‘Creating Space & Time for IPL’, ‘Collaborative IPL’ and ‘IPL & Humanistic Values’. An emergent 
theoretical framework is also developing which is influenced by social constructionism, socio-cultural learning theory and complexity theory. The IPL culture in critical care can be influenced by organisations 
and groups. However, variability in the IPL culture can be accounted for by the behaviour of individuals within the adult critical care setting. An early explanation for this is to theoretically consider that there 
might be a changeable holistic IPL ‘climate’ which is repeatedly influenced by the individuals in the critical care setting at any given time. The climate influences can be psychological, physical, emotional, 
spiritual, intellectual or social in origin. IPL is also not linear; it results in different levels of knowledge construction (deep and surface learning) and varying levels of learner recognition and awareness of IPL.  
Creating Space & Time for IPL 
Time: finding it, formal vs. informal, study leave 
Deadlines: HEI courses, competencies, targets 
Spatial Theory: proximity between patients & staff 
Territory: safeguarding learning zones 
Freedom: space to move, constraints 
CONCLUSION 
 
Whilst data collection remains incomplete; preliminary findings 
shed light on the intricacies and influencing factors leading to 
interprofessional learning within adult critical care. 
 
This research reveals numerous ways interprofessional 
learning takes place within adult critical care settings and the 
influential factors have been found to be multi-faceted. Critical 
care staff can be affected by both intrinsic and extrinsic 
influences therefore, individuals behaviour and engagement 
with IPL may be symptomatic of these extensive factors.  
 
3 research themes are emerging: ‘Creating Space & Time for 
IPL’, ‘Collaborative IPL’ and ‘IPL & Humanistic Values’. The  
emerging theoretical framework is underpinned with social 
constructionism,  socio-cultural learning theory and complexity. 
 
IMPLICATIONS FOR PRACTICE 
This study provides increased understanding of the components 
which facilitate effective IPL in the adult critical care setting. It 
has the potential to improve the quality of care for patients and 
to promote knowledge development of critical care staff.  
 
The research findings could optimise the environmental design 
of learning spaces in adult critical care; ‘creating space for IPL’. 
The importance of safeguarding time and opportunity for IPL 
could also be factored into daily critical care practises and 
adopting a humanistic approach to IPL and team working may 
also prove beneficial to IPL in adult critical care settings. 
 
This exploratory study invites further research into IPL in adult 
critical care settings to improve the quality of care provided. 
EMERGING KEY POINTS 
 
Interprofessional Learning (IPL) is apparent within the adult 
critical care setting and it is complex. 
 
IPL is not linear; the depth and recognition of IPL is variable. 
 
IPL is influenced by internal drivers, such as intrinsic 
motivation and an individual’s personal aspirations. 
 
It is also affected by external influences, such as extrinsic 
motivation and professional regulations.  
 
The adult critical care IPL culture can be shaped by the 
organisation and by groups, but also individuals in the setting.  
 
Variability can be accounted for theoretically by considering a 
changeable holistic IPL ‘climate’ which is repeatedly 
influenced by the individuals in the setting at any given time. 
Collaborative IPL 
Collaboration: team effort, partnership approach 
Knowledge Exchange: stories, dialogue 
Visibility: location, presence, ratios, equity 
Roles: expertise, remit, uniforms, expectations 
Responsibility: emotions & IPL accountability 
Technology: ICT, telephone, email 
REFERENCES 
 
Paradis, E., Leslie, M., Puntillo, K., Gropper, M. A., Aboumatar, A.H J., Kitto, S. & Reeves, S. (2014) “Delivering Interprofessional care in intensive care: A scoping review of ethnographic studies” American 
Journal of Critical Care, 23 (3) pp. 230-238. 
 
Rose, L. (2011) “Interprofessional collaboration in the ICU: how to define?*” Nursing in Critical Care, 16 (1) pp.5-10. 
 
Wagter, J.M., van de Bunt, G., Honing, M., Eckenhausen, M. & Scherpbier, A. (2012) “Informal interprofessional learning: Visualizing the clinical workplace” Journal of Interprofessional Care, 26 (3) pp.173-182. 
THE INDIVIDUAL &    INTRINSIC INFLUENCES     *     EMERGING THEORETICAL FRAMEWORK    *    THE ORGANISATION, GROUPS &  EXTRINSIC FACTORS 
IPL CULTURE is affected by the changeable HOLISTIC IPL CLIMATE: PSYCHOLOGICAL, PHYSICAL, EMOTIONAL, SPIRITUAL, INTELLECTUAL OR   SOCIAL  
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IPL & Humanistic Values  
Socialisation: belonging, shared identity, friendly 
Security: trust, respect, social norms 
Errors: critical incident, debrief, reflection 
Humour: coping, connecting, rapport, relations 
Motivation: interest, morale, self-esteem 
Feeling: hot, tired, overwhelmed, burnt out, fear 
Focused ethnography was chosen to develop a rich description of 
the interprofessional learning culture in adult critical care. 
Participants are being observed in clinical practice using partial 
participant observation and four staff groups (nurse, HCA, doctor 
and  physiotherapist)  are  being  interviewed   on   a   one-to-one      
                 basis   using   semi-structured  interviews. 
For the purpose of this study IPL is defined as: 
‘Learning which happens between different occupational 
groups through the collaborative sharing of expertise,  
                      knowledge and experience.’ 


Interprofessional learning in adult critical care: early findings of a focused ethnography study

Citation: Park, Vikki (2016) Interprofessional learning in adult critical care: early findings of a focused ethnography study. In: North of England Critical Care Annual Conference 2016, 12th October 2016, Durham. URL: This  version  was  downloaded  from  Northumbria  Research  Link: http://nrl.northumbria.ac.uk/28241/Northumbria University has developed Northumbria Research Link (NRL) to enable users to access the University’s research output. Copyright © and moral rights for items on NRL are retained by the individual author(s) and/or other copyright owners.  Single copies of full items can be reproduced,  displayed or  performed,  and given to  third parties in  any format  or medium for personal research or study, educational, or not-for-profit purposes without prior permission or charge, provided the authors, title and full bibliographic details are given, as well  as a hyperlink and/or URL to the original metadata page. The content must  not  be changed in any way. Full items must not be sold commercially in any format or medium without  formal  permission  of  the  copyright  holder.   The  full  policy  is  available  online: http://nrl.northumbria.ac.uk/policies.htmlThis document may differ from the final, published version of the research and has been made available online in accordance with publisher policies. To read and/or cite from the published version of the research, please visit the publisher’s website (a subscription may be required.)Interprofessional Learning in Adult Critical Care:  Early findings of a focused ethnographic study Vikki Park, Senior Lecturer, Northumbria University, Faculty of Health and Life Sciences: vikki2.park@northumbria.ac.uk Supervisors: Professor Amanda Clarke (Principal), Dr Alison Machin & Lesley Durham  BACKGROUND Due to its complexity, critical care requires numerous professionals to effectively work together (Rose 2011). However, further exploration is needed to ascertain how different critical care staff working together also learn with and from each other in this particular environment.   The critical care setting is claimed to have the potential to share interprofessional knowledge between staff (Wagter et al. 2012). However, Paradis et al. (2014) emphasise limited knowledge in this area at present, despite recognition that interprofessional collaboration in critical care units improves patient safety and quality of patient care. They claim that there needs to be increased understanding regarding the effects that culture or context have on shaping interprofessional practices and advocate ethnography as                an appropriate research methodology. METHOD  The multi-site research is in fulfilment of doctoral study.   Data collection:   12 months                               3 different NHS Hospital critical care units                                January 2016 – December 2016 . Methodology:       Focused ethnography Observation:        90 hours estimated Interviews:           12-36 hours  Data analysis:      Constant comparison  AIM To explore the culture of interprofessional learning (IPL) within adult critical care settings.  OBJECTIVES To develop a rich description of the interprofessional learning culture in adult critical care clinical practice.  To understand in-depth critical care practitioners’ perceptions & experiences of interprofessional learning (IPL) within adult critical care clinical practice. To identify which factors are perceived to promote or inhibit effective IPL.   FINDINGS Early analysis of findings confirm that critical care staff are a rich source of knowledge and various conduits seem to facilitate effective IPL. IPL does appear to exist in adult critical care settings and this is explicated by numerous learning theories. Three themes are emerging from the iterative data analysis thus far: ‘Creating Space & Time for IPL’, ‘Collaborative IPL’ and ‘IPL & Humanistic Values’. An emergent theoretical framework is also developing which is influenced by social constructionism, socio-cultural learning theory and complexity theory. The IPL culture in critical care can be influenced by organisations and groups. However, variability in the IPL culture can be accounted for by the behaviour of individuals within the adult critical care setting. An early explanation for this is to theoretically consider that there might be a changeable holistic IPL ‘climate’ which is repeatedly influenced by the individuals in the critical care setting at any given time. The climate influences can be psychological, physical, emotional, spiritual, intellectual or social in origin. IPL is also not linear; it results in different levels of knowledge construction (deep and surface learning) and varying levels of learner recognition and awareness of IPL.  Creating Space & Time for IPL Time: finding it, formal vs. informal, study leave Deadlines: HEI courses, competencies, targets Spatial Theory: proximity between patients & staff Territory: safeguarding learning zones Freedom: space to move, constraints CONCLUSION  Whilst data collection remains incomplete; preliminary findings shed light on the intricacies and influencing factors leading to interprofessional learning within adult critical care.  This research reveals numerous ways interprofessional learning takes place within adult critical care settings and the influential factors have been found to be multi-faceted. Critical care staff can be affected by both intrinsic and extrinsic influences therefore, individuals behaviour and engagement with IPL may be symptomatic of these extensive factors.   3 research themes are emerging: ‘Creating Space & Time for IPL’, ‘Collaborative IPL’ and ‘IPL & Humanistic Values’. The  emerging theoretical framework is underpinned with social constructionism,  socio-cultural learning theory and complexity.  IMPLICATIONS FOR PRACTICE This study provides increased understanding of the components which facilitate effective IPL in the adult critical care setting. It has the potential to improve the quality of care for patients and to promote knowledge development of critical care staff.   The research findings could optimise the environmental design of learning spaces in adult critical care; ‘creating space for IPL’. The importance of safeguarding time and opportunity for IPL could also be factored into daily critical care practises and adopting a humanistic approach to IPL and team working may also prove beneficial to IPL in adult critical care settings.  This exploratory study invites further research into IPL in adult critical care settings to improve the quality of care provided. EMERGING KEY POINTS  Interprofessional Learning (IPL) is apparent within the adult critical care setting and it is complex.  IPL is not linear; the depth and recognition of IPL is variable.  IPL is influenced by internal drivers, such as intrinsic motivation and an individual’s personal aspirations.  It is also affected by external influences, such as extrinsic motivation and professional regulations.   The adult critical care IPL culture can be shaped by the organisation and by groups, but also individuals in the setting.   Variability can be accounted for theoretically by considering a changeable holistic IPL ‘climate’ which is repeatedly influenced by the individuals in the setting at any given time. Collaborative IPL Collaboration: team effort, partnership approach Knowledge Exchange: stories, dialogue Visibility: location, presence, ratios, equity Roles: expertise, remit, uniforms, expectations Responsibility: emotions & IPL accountability Technology: ICT, telephone, email REFERENCES  Paradis, E., Leslie, M., Puntillo, K., Gropper, M. A., Aboumatar, A.H J., Kitto, S. & Reeves, S. (2014) “Delivering Interprofessional care in intensive care: A scoping review of ethnographic studies” American Journal of Critical Care, 23 (3) pp. 230-238.  Rose, L. (2011) “Interprofessional collaboration in the ICU: how to define?*” Nursing in Critical Care, 16 (1) pp.5-10.  Wagter, J.M., van de Bunt, G., Honing, M., Eckenhausen, M. & Scherpbier, A. (2012) “Informal interprofessional learning: Visualizing the clinical workplace” Journal of Interprofessional Care, 26 (3) pp.173-182. THE INDIVIDUAL &    INTRINSIC INFLUENCES     *     EMERGING THEORETICAL FRAMEWORK    *    THE ORGANISATION, GROUPS &  EXTRINSIC FACTORS IPL CULTURE is affected by the changeable HOLISTIC IPL CLIMATE: PSYCHOLOGICAL, PHYSICAL, EMOTIONAL, SPIRITUAL, INTELLECTUAL OR   SOCIAL  D EPTH         O F  I P L  RECOGNITION IPL & Humanistic Values  Socialisation: belonging, shared identity, friendly Security: trust, respect, social norms Errors: critical incident, debrief, reflection Humour: coping, connecting, rapport, relations Motivation: interest, morale, self-esteem Feeling: hot, tired, overwhelmed, burnt out, fear Focused ethnography was chosen to develop a rich description of the interprofessional learning culture in adult critical care. Participants are being observed in clinical practice using partial participant observation and four staff groups (nurse, HCA, doctor and  physiotherapist)  are  being  interviewed   on   a   one-to-one                       basis   using   semi-structured  interviews. For the purpose of this study IPL is defined as: ‘Learning which happens between different occupational groups through the collaborative sharing of expertise,                        knowledge and experience.’ 

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Interprofessional learning in adult critical care: early findings of a focused ethnography study

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