In this seminar, research group, led by Dr. Nicolas Fernández and Mr. Nicolas Gulino on interprofessional collaborative practice in partnership with the patient and their family caregivers from Université de Montréal will present their work at the Institut universitaire de gériatrie de Montréal (IUGM) that translates as University Institute of Geriatrics of Montreal. They are associated with the research center (adjacent building) at the Centre de recherche de l’IUGM Both are teaching institutions affiliated with the Université de Montréal.
Home Care Manager, Dr. Jaana Nummijoki (City of Helsinki) and docent Hannele Kerosuo (Faculty of Education and Culture, Tampere University) will give their comments before a general discussion of the topic with the seminar audience.
When: Monday 4.11.2024 at 10.00-12.00
Where: Minerva Room K222b/Zoom (the link can be found at the end of this page)
Abstract
From Collective Experience to Expansive Learning: A Research-Action Project in the Co-Construction of Care Practices Among Healthcare Providers and Family Caregivers
Short-term rehabilitation care for seniors presents a complex, often stressful environment where patients, families, and healthcare providers engage in continuous negotiation and not always clear outcomes. Each patient arrives with unique short-term rehabilitation needs, often complicated by chronic conditions, comorbidities, and age-related factors. This complexity, combined with the varied circumstances and personal experiences of patients and their family caregivers, necessitates a dynamic, dialectical approach to care. Healthcare providers must continuously reassess their assumptions, diagnoses, and interventions, both within their specific disciplines and in collaboration with colleagues from other fields. This interprofessional collaboration opens new, unpredictable zones of knowledge construction and, crucially, expansive learning possibilities – learning what is not yet there – which merit further investigation.
Our research explores these dynamics of interprofessional collaboration in short-term rehabilitation care for seniors, focusing on a large geriatric hospital in Montreal. Using a Cultural-Historical Activity Theory (CHAT) framework, we investigate how healthcare providers, patients, and family caregivers navigate complex care environments and collaboratively construct knowledge. Our primary objectives are to: 1. Understand the experiential learning processes and expansive learning opportunities in complex care environments; 2. Identify the dynamics shaping interprofessional practice and the resulting avenues for action; 3. Develop strategies to strengthen professional confidence and agency for both healthcare providers and family caregivers. We have employed observations, video recording, and interviews with interprofessional teams comprising physiotherapists, nurses, occupational therapists, physicians, social workers, and pharmacists. Initial findings reveal highly collaborative environments where care discussions regularly incorporate patients and family caregivers, transcending traditional disciplinary boundaries and suggesting the forging of new learning avenues. Crucially, our findings suggest a continuous and expansive learning process, which we believe needs to be documented, valorized, and promoted.
Based on our findings, we aim to construct a continuous training strategy for healthcare professionals, family caregivers, and healthcare managers—all stakeholders in the patient’s care journey. Such a training strategy could take the form of a formative intervention such as Change Laboratory, as well as other methods yet to be developed; importantly, however, such training would be based on field research data in close, ongoing collaboration with all stakeholders. Eventually, we envision developing a dynamic (as opposed to static) academic curriculum for interprofessional collaboration that extends beyond the research site.
The challenges faced by healthcare in the context of aging populations and staff shortages demands a new lens to identify, validate and mobilize experiential and collaborative learning in an ongoing constructivist framework. Still in its infancy, our research-action project expects to leverage powerful learning potentials from those ‘in the trenches’ of care, where the complexity of care is in constant contruction, negotiation, and reconfiguration. It is here, we believe, where we have the most to learn going forward.
About the Research Group
Dr. Adriana Enriquez-Rosas, is clinical neuropsychologist at the IUGM and associate researcher of the Group.
Dr. Nicolas Fernández is the Group leader and permanent researcher at the CRIUGM. He is associate professor in the Faculty of Medicine’s Center for Applied Pedagogy in the Health Sciences (CPASS).
Mr. Nicolas Gulino is associate researcher and co-director of the Group, filmmaker, and doctoral candidate in Educational Psychology and Adult Education at the University of Montreal.
Ms. Yvonne Pelling is associate researcher of the Group, Patient and Community Engagement Lead at Passerelle https://passerelle-nte.ca/, and Master’s student in Education at the University of Calgary.