Kinnison, T; (2016) Insights from veterinary interprofessional interactions: Implications for interprofessional education (IPE) in the veterinary curricula. Doctoral thesis , UCL (University College London).

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Abstract

Historically veterinary surgeons were trained, worked and developed in isolation. However, due to increasingly complex care and public demand for quality but cost effective treatment, veterinary practices have evolved into team based organisations comprising of several occupations. Veterinary nurses are an important example and have recently undergone professionalisation in the UK. Other specialised occupations are developing in parallel including practice managers and receptionists. This research focused on veterinary interprofessional working and learning (IPW/L) utilising an overarching case study design, incorporating social network analysis (SNA) to map patterns of IPW/L and two embedded case studies to explore interactions. The embedded case studies consisted of general observations, shadowing selected individuals, interviews and artefact collection. Adaptations of theoretical frameworks including Engeström’s Cultural Historical Activity Theory and knotworking, Hutchin’s distributed cognition and SNA concepts of boundary crossing and homophily were utilised. Emergent themes from the data were confirmed in an iterative process through triangulation. Facilitators of veterinary IPW/L include trust and value, hierarchical organisation of work, formal infrastructure and different perspectives. Key people were identified as linking the team. Challenges to IPW/L include temporal and spatial nature of work, hierarchical organisation and contrasting professional motivations (care vs cure). Rich interactions are based on experience in contrast to solely professional status. Outcomes of challenges include poor communication leading to errors and blame. These findings have implications for interprofessional education alongside implications for policy and practice if teamworking is to be improved in the interests of animals and their owners. This thesis represents the first instance of researching veterinary IPW/L in practice, and by making use of novel methodologies and theories in this context, it has identified both the importance of the team dynamic and factors contributing to compromised patient care.

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