Jasper m 2003 beginning reflective practice cheltenham nelson thorn

As a third year student of diagnostic imaging, I have undertaken an interprofessional education (IPE) module throughout each year study at University. During the first two years of my programme. The IPE modules introduced me to the importance of interprofessional education and also prepared me with some of the skills that are necessary for successful teamwork. The level 3 IPE module Teams in Interprofessional Practice, has built upon my prior learning and has exposed me to the actual experience of working within an interprofessional team that is focussed on the delivery of patient or service user. This learning was done using authentic of real-life scenarios where I was required to demonstrate my ability to work as part of an interprofessional care team. The essay will reflect the experience that I have gained during the ‘Team Observed Structured Professional Encounter (TOSPE)’ scenarios team work performance. Team Observed Structured Professional Encounter (TOSPE) is an adapted method of the McMaster/ Ottawa Team Observed Structured Clinical Examination (TOSCE) method of learning and can be used to assess interprofessional team performance which intends to improve collaboration and the quality of care to service users in health care setting (Lie et al, 2015). The main purpose of my essay is to demonstrate my knowledge working in interprofessional team by reflecting the experience which I had during my first TOSPE group that was conducted in week 4 and that of the summative assessment in week 10. I will follow ‘Gibbs model of reflective’ as guidance through my reflection process (Jasper, 2003). The term reflection used in healthcare professionals to describe writing that undertaken for learning from our experiences in order to develop our understanding and also to bring in our practice in to focus (Rolfe et al, 2001).

Description

I was in TOSPE group of six multidisciplinary team involving myself diagnostic imaging, two adult nurse,one child nurse,one operating department practice and physiotherapy student. I was the only man in a group of five women and the team was dominated by student nurses. In our team first TOSPE meeting, the scenario was about a woman patient who was diagnosed with multiple sclerosis. The team was concentrated on patient treatment management instead of first considering on diagnosis finding x-ray examinations. I could not understand the direction and goals of our team in the first scenario as the meeting was not structured. The summative assessment TOSPE scenario was about a 54 years-old men who has a dipetaes and prostat cancer prepared for a complete knee replacement. As a diagnostic imaging student, I delivered my role to the team from patient admission to discharge as well as the routine fellow up imaging after discharge. Every member of the team knew their task and team members were able to trust each other and I were contributed positive impact on team organisation prior to the assessment. There was a communication issue due to one member of the team being off sick at the final summative assessment. McClelland and Sands (1993) found that “a missing team member who was in a position of supplying a critical piece of information or perspective on a patient at a team meeting resulted in a negative effect on patient care”. Nevertheless, the team was well prepared, patient care plane has met; safe working environment with in the team was adhered, as a result the task completed at high standard.

Critical reflection of feelings, evaluation and analysis

I was a bit preserved in the initial TOSPE scenario, the student nurses had more positive attitude towards the scenario. The student nurses were seen to ease communication and took the lead role on the task where I from diagnostic imaging struggled to make a start. I was unsure in our team’s first meeting as I could not understand the direction of our team discussion. Equally, I was uncomfortable with our team’s meeting managing process since there were not any responsible team members who act as a leader, coordinator, and recorder. Furthermore, I felt isolate; as the team members from adult nurse profession were dominated the discussion and I was thinking that my profession was not valued. In a research finding (Goldsmith et al 2010) described that team members can be aware their own roles, their integration and value in the team. So I made known the general role of my profession to the group. Molyneux (2001) mentioned the difficulty of sharing information when somebody is unsure one’s professional identity and in (Brown et al 2011) pointed out that lack of understanding team member’s role can lead to conflict. Once, the team was understands my profession, I was able to cement my point of view on the task. I felt that I contributed well to the multidisciplinary team. Although at our first TOSPE scenario the meeting was dominated by the student nurses, I showed that I was confident on my own skills and knowledge through the process. I felt contributed more or equal as everyone which required assisting the patient management care. There was not bad experience, however on reflection I realise that I should have more involved in the discussion at first place. Reflecting on this paper made me ask that why was the communication dominated by the student nurses in our team’s first scenario meeting. Having reflecting on this paper remind me that, the student nurses were competing against each other to be heard their own opinion as a result my interaction level affected. Atwal & Caldwell (2005) suggests that members of the same profession often dominate the team meeting. Equally, it is possible that making assumption that nursing professional has more dominant role than my own profession on patient management care aspect affected my participation at first place. Another highlighted for my integration issue was gender dominance as I was the only male member in the team. There was an issue of covering for the absence of one member of the team; as a consequence the team felt pressure to cover the task which left by the individual. However having individuals from the same profession in the team had positive impact on the situation as one of our nurse members took over the responsibility. This reminds me to question to my previous statement on being the same profession dominated team. (Sarkar et al 2014) points out by stating that members from the same speciality should have arranged to cover the absent. This particular experience taught me to realise that the task was not only about my contribution; its main purpose was about improving the patient management care so I should think the positive side of having the same member of profession in my team. I was able to learn individual team member strength through the course as a result I played a big role in deciding who should be a leader, note taker, coordinator on our team’s final summative assessment. In (McNaughton et al 2013) described that individual’s approach to care on interaction with other members of the team can have positive effect on sharing the workload. Reflecting on this proves me that my contribution to the team was as good as everyone in the team.

Conclusion

To conclude my reflective paper, I have learned to look the positive side of working with people from the same profession. I should rely on my own ability instead of concerning about my profession identity on team members view. Furthermore, I have learned not to make assumptions on existing barriers such as gender, profession dominance. I realise that I should have thought professionally about planning patient care. I have also learned to listen to what members of the team discussing instead of thinking my own role. Finally, reflecting on this paper thought me that my confidence improved through the process of collaboration with members of the team which was from being participant to guidance the team direction towards the success.

Action plane

The experience working within multidisciplinary team allows me to identified area of practice to work on. Firstly, I have learned to wider my study beyond my profession and this will keep me to understand the continuity of patient care beyond my job description. I will achieve this, by taking study courses from the NHS online e-learning. Secondly, I will work on my communication skills. I will work to improve understanding of most used medical jargons in hospitals and this will allow me to communicate actively and effectively. Describing my feelings through reflection process thought me how to deal with negative assumptions and this will allow me in the future to control my body language during uncomfortable situations. Overall, I was able to maintain positive working environment throughout despite of some awkward feelings arises during the team task.

References

· Atwal, A. & Caldwell, K., 2005. Do all health and social care professionals interact equally: a study of interactions in multidisciplinary teams in the United Kingdom. Scandinavian Journal of Caring Sciences [online]. 19(3), pp. 268-273. [viewed 27 January 2015]. Available from: http://su3pq4eq3l.search.serialssolutions.com

· Brown, J., Lewis, L., Ellis, K., Stewart, M., Freeman, T.R. & Kasperski, M.J., 2011. Conflict on interprofessional primary health care teams - can it be resolved? Journal of Interprofessional Care [online]. 25(1), pp. 4-10. [viewed 30 December 201]. Available from: http://su3pq4eq3l.search.serialssolutions.com

· Goldsmith, J., Wittenberg-Lyles, E., Rodriguez, D. & Sanchez-Reilly, S., 2010. Interdisciplinary Geriatric and Palliative Care Team Narratives: Collaboration Practices and Barriers. Qualitative Health Research [online]. 20(1), pp. 93-104. [viewed 26 January 2015]. Available from: http://qhr.sagepub.com.gcu.idm.oclc.org/content/20/1/93.full.pdf+html

· Jasper, M., 2003. Beginning reflective practice. Cheltenham: Nelson Thornes

· Lie, D., May, W., Richter-Lagha, R., Forest, C., Banzali, Y. & Lohenry, K., 2015. Adapting the McMaster-Ottawa scale and developing behavioral anchors for assessing performance in an interprofessional Team Observed Structured Clinical Encounter. Medical Education Online [online]. 20, pp. 1-10. [viewed 15 December 2015]. Available from: http://search.proquest.com.gcu.idm.oclc.org/docview/1685879705?pq-origsite=summon

· MacNaughton, K., Chreim, S. & Bourgeault, I.L., 2013. Role construction and boundaries in interprofessional primary health care teams: a qualitative study. BMC health services research [online]. 13(1), pp. 486. [viewed 28 January 2015]. Available from: http://search.proquest.com.gcu.idm.oclc.org/docview/1469056247?pq-origsite=summon

· McClelland, M. & Sands, R.G., 1993. The Missing Voice in Interdisciplinary Communication. Qualitative Health Research [online]. 3(1), pp. 74-90. [viewed 27 January 2015]. Available from: http://qhr.sagepub.com.gcu.idm.oclc.org/content/3/1/74.full.pdf+html

· Molyneux, J., 2001. Interprofessional team working: what makes teams work well Journal of Interprofessional Care [online]. 15(1), pp. 29-35. [viewed 26 January 2015]. Available from: http://su3pq4eq3l.search.serialssolutions.com/?ctx_ver=Z39.88

· Rolfe, G., Freshwater, D., & Jasper, M., 2001. Critical reflection for nursing and the helping professions. New York: Palgrave.

· Sarkar, S., Arora, S., Lamb, B.W., Green, J.S., Sevdalis, N. & Darzi, A., 2014. Case review in urology multidisciplinary team meetings: What members think of its functioning. Journal of Clinical Urology [online]. 7(6), pp. 394-402. [viewed 28 January 2015]. Available from: http://uro.sagepub.com.gcu.idm.oclc.org/content/7/6/394.full.pdf+html

Scenario

. Review the artefacts as required 3. Discuss as a team the plan of action for the care of Mr White ahead of his discharge home in five days. 4. Indicate to your facilitator when you have completed the task should you complete in less than the 20 minutes allocated To do this you will be required to use the skills specific to your discipline and your skills and knowledge of interprofessional teamwork. Mr Richard White is 54 years old and has lived alone for the last 10 years since his divorce from his wife. Richard has had Type 1 Diabetes since he was 28 and has a history of poor self-management including non-attendance at clinics and poor compliance. Since the time of his divorce he has suffered from depression and this now seems to be a chronic condition. As a result of this he has been unable to maintain full employment although he ‘likes to work’. Two years ago Richard developed a small ulcer on his right foot near his heel. This grew larger in size and resulted in a short period as an in-patient in hospital during which time his Diabetic status was reassessed. Some small changes were implemented as well as helping him to understand some of the processes of self-management. Richard was referred to the Diabetes Management Clinic and to Podiatric services. Unfortunately he has attended each clinic once only. Two weeks ago Richard was readmitted to hospital with a worsening of the condition of his foot. Following successful but ongoing treatment, the condition of his foot has improved enough that he is no longer required to be in hospital. Whilst an inpatient a number of symptoms associated with prostate cancer were noted and, following investigation, he has now been diagnosed with locally invasive prostate cancer. Richard has agreed to undergo radical prostatectomy, followed by a course of external beam radiotherapy. He is to be readmitted to hospital in three weeks’ time for his surgery. At a recent case meeting a suggestion from his GP to have his care more community focussed was discussed. However, which members of the nursing and allied health care professional team would become involved was still to be agreed.

Structure

To demonstrate achievement of the above learning outcomes, you are required to undertake the following task:

Using the Gibbs’ (1988) model of reflection to structure your work, you are required to write a critically reflective essay of 1500 words. In the essay, you should identify your key learning experiences of engaging in the TOSPE interprofessional scenarios and critically reflect on how this will enable you to be a safe and effective team member in health and social care. Consideration must be given to the following:

• Your own practice relating to the delivery of safe and effective teamwork

• Cultural diversity and the need for cultural competence for safe and effective teamwork

• Psychological and sociological factors inherent in effective and non-effective teamwork

• Your ability and to give