Collaborative clinical reasoning learning using an integrated care pathway in undergraduate interprofessional education: An explorative study

Abstract

Chaina Hanuma, Ardi Findyartinibc* & Diantha Soemantribca Master Program in Medical Education, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesiab Department of Medical Education, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesiac Faculty of Medicine, Medical Education Center, Indonesia Medical Education & Research Institute (IMERI), Universitas Indonesia, Jakarta, IndonesiaChaina Hanum, MD, MMedEd is a graduate from Master in Medical Education Program at Faculty of Medicine Universitas Indonesia and currently a researcher in Medical Education Cluster, Indonesia Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia.Ardi Findyartini, MD, PhD, is an Associate Professor in medical education. She is currently the Coordinator of Community Service, Department of Medical Education, Faculty of Medicine Universitas Indonesia and the Chair of Medical Education Cluster, Indonesia Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia.Diantha Soemantri, MD, MMedEd, PhD, is an Associate Professor in medical education. She is currently the Head of Master in Medical Education, Department of Medical Education, Faculty of Medicine Universitas Indonesia and the Vice Chair Education, Indonesia Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia.CONTACT Ardi Findyartini ardi.findyartini@ui.ac.id Department of Medical Education, Faculty of Medicine, Universitas Indonesia, Jakarta, IndonesiaABSTRACTCollaborative clinical reasoning (CCR) is part of interprofessional collaborative practice and aims to negotiate and manage patient problems. An integrated care pathway (ICP) can be used as a framework for developing comprehensive patient care, typically in a clinical setting. This study aims to explore the CCR process in undergraduate interprofessional teams and the use of ICP as guidance in discussing a patient’s problem and its comprehensive management. This is a qualitative study following phenomenology and was performed in an interprofessional education (IPE) program held by Health Science Cluster Universitas Indonesia. A total of four observations involving 40 students and four focus-group discussions involving 18 students from different health professions backgrounds were conducted to explore the CCR process using the ICP framework. In-depth interviews with four tutors from different health professions backgrounds and document analysis were also conducted as triangulation processes. This study shows that CCR was held in two stages – individual and group. The ICP framework could be used as a guiding tool in the CCR process to discuss the patient’s management and discharge plan. This study also demonstrates that there are several challenges in this learning process, including the clinical case used in the discussion, the need for prior knowledge and previous exposure to IPE and the ICP framework, and health professions’ dominance during the discussion. This study provides evidence on learning of CCR using the ICP framework as a guiding tool in a pre-licensure IPE program. This approach is useful for preparing students to develop an interprofessional, comprehensive, and holistic health care plan and to help them understand the roles of each profession.