The paradoxical effects of workforce shortages on rural interprofessional practice
Engelsk titel: The paradoxical effects of workforce shortages on rural interprofessional practice
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Författare:
Mcneil, Karen
;
Mitchell, Rebecca
;
Parker, Vivki
Email: karen.mcneil@newcastle.edu.au
Språk: Eng
Antal referenser: 77
Dokumenttyp:
Artikel
UI-nummer: 15043615
Sammanfattning
Rationale and Aim
While interprofessional practice has been promoted as a solution to the challenges besetting rural
health services, current evidence does not offer a clear explanation as to why it is effective in some
domains and yet is not successful in others. At the same time, rural clinicians are frequently faced
with major workforce pressures and this has a significant influence on professional practice. The aim
of this study was to explore how these pressures impact on rural interprofessional practice.
Method
This study is part of a larger project investigating factors that enhance and detract from effective
interprofessional working. We utilised a modified realistic evaluation approach to analyse the
context, mechanisms and outcomes of rural interprofessional practice. Approval for this study was
granted by an accredited research ethics committee. Semi-structured interviews were conducted with
22 rural clinicians who were purposively recruited from a range of settings, roles, locations and
professions.
Findings and Discussion
We found that clinicians often invested in interprofessional practice because of the need to manage
intense workloads and this necessitated sharing of responsibilities across disciplines and blurring of
role boundaries. Paradoxically, participants noted that workload pressures hampered
interprofessional working if there were long-term skill shortages. Sharing workload and responsibility
is an important motivator for rural practitioners to engage in interprofessional practice; however, this
driver is only effective under circumstances where there are sufficient resources to facilitate
collaboration. In the context of intransient resource challenges, rural health service managers would
be best to focus on enabling IPP through facilitating role understanding and respect between
clinicians. This is most feasible via informal workplace learning and allowing time for teams to reflect
on collaborative processes. Published by arrangement with John Wiley & Sons.