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Challenging hierarchies and fostering collaboration: a critical discourse analysis of interprofessional education in healthcare training

Journal: Journal of Osteopathic Medicine Date: 2026/02, (online 2026/02/06):. doi: Subito , type of study: qualitative study

Full text    (https://www.degruyterbrill.com/document/doi/10.1515/jom-2024-0244/html)

Keywords:

collaboration [22]
discourse [3]
interprofessional education [11]
medical students [643]
osteopathic medicine [2013]
power dynamics [1]
qualitative study [283]
USA [1617]

Abstract:

Context Interprofessional education (IPE) in health professions training strives to create a future collaborative healthcare workforce for the betterment of patient care. One of the aims of IPE experiences is to challenge healthcare hierarchies, with a focus on fluid leadership among healthcare team members. This promotes improved patient-care experience, as well as addressing patient well-being in a more holistic manner. Objectives This study aimed to critically analyze the discourse of an interprofessional team of healthcare students following a simulated patient encounter to assess the power dynamic among the professions present. Methods Researchers critically analyzed the discourse from student Interprofessional Team Immersion (IPTI) simulation debrief sessions. Sessions were transcribed and the discourse was coded utilizing Interprofessional Education Collaborative (IPEC) core competencies. A critical discourse analysis (CDA) was employed as a methodology to identify the prevalence of utilitarian and emancipatory discourse among students in diverse health professions and how collaborative interprofessional teamwork and patient health outcomes are impacted. Results Student teams modeled emancipatory and utilitarian discourses to structure team debriefs. The first debrief session operated through utilitarian discursivity, demonstrating instances of individual insecurity, slow team growth, and less coordinated patient care. Analysis of the second debrief session demonstrated the use of emancipatory discourse through the presence of greater team cohesiveness, less focus on self, and greater collaborative focus on patient care. Furthermore, analysis suggests the presence of fluid leadership with no dominant, healthcare profession (HCP)-specific hierarchy. Conclusions Employing a critical discursive lens in healthcare education can help students challenge power imbalances and shift toward fluid leadership and increase team cohesion between HCPs. These findings highlight how IPE can lead to greater collaboration between interprofessional student team members, challenge hierarchy, and empower the healthcare team to provide improved patient care.


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