13Interprofessional Education and Practice in Social Work Field Education

Kelly Allison and Grant Charles

Most social and health issues are complex. Addressing them requires a coordinated, collaborative approach from a wide range of health professional groups (e.g., physicians, nurses, social workers) and community social service professionals (e.g., child welfare professionals, child and youth care workers, probation officers). However, this collaboration often does not happen. A major criticism of both the health and human services systems is that different professions working within them operate in silos disconnected from the work of each other (Costello et al., 2018). This individualized way of working decreases collaboration and communication between and within the systems. As a result, services users often do not get the full support that they need or deserve. There are many reasons for professions working independently of each other, but one of the key reasons is that many professionals lack the knowledge, skills, attitudes, and values for effective interaction between the professions working in the health and human service sectors (Charles et al., 2010; Salhani & Charles, 2007). This disconnection with other professions begins in the foundational training for each of the professions in post-secondary institutions and continues through field learning in practicums and, upon graduation, into practice.

In this chapter, we seek to counter siloed professional behavior and enhance interprofessional effectiveness by presenting the concepts of interprofessional education and practice. We identify the consequences of not working well together, describe the different forms of professional education and practice in our current work environments, articulate a rationale for why social workers should engage in interprofessional and collaborative practice, and describe the main concepts that define interprofessional education and practice. We hope that by understanding the rationale for, and outlining necessary skills for effective interprofessional collaborative practice, social work students entering the field will have foundational knowledge to intentionally begin to understand other professions, analyze the interprofessional practice they observe, and begin to develop competencies that will enhance their future practice.

One of the main goals of field education is to learn about the profession of social work and how social workers operate in the world (Bogo & Vayda, 1998; Bogo, 2010). While this holds true at all levels of social work education, it is particularly important in the first field placements. Field education is one of the primary methods through which social work students develop a sense of professional identity and learn to become social workers (Oliver, 2013; Maynard et al., 2015; Smith et al., 2015). Practicums provide the opportunity to apply what students have learned in the classroom about the social work profession’s values, knowledge base, and skills (Bogo & Vayda, 1998; Bogo, 2010).

This development of a professional identity is, by its nature, a time of reflection and inward focus whereby students begin to integrate what they have been learning in the classroom with the realities of practice in the real world (Wiles, 2013; Ben Shlomo et al., 2012). When social work students begin to look outward, it is not uncommon to compare themselves with other health and human service professions. They, in part, figure out who they are by trying to figure out who they are not. This comparison can lead to a better understanding of their own profession and the other health and human service professions if done with a goal of learning to work more effectively together.

Unfortunately, increased interprofessional effectiveness is often not what results from this comparison with other professions (Glaser, 2016; Mizrahi & Abramson, 2000). In an attempt to elevate their own work and their developing sense of professional identity, social work students can sometimes criticize and downplay other professions. Contributing to this negative appraisal is the fact that students often view other professions through stereotypes portrayed in media or in society. Rather than learning to work well with other professions based upon their strengths and knowledge, this lack of true understanding of others serves to create barriers to collaborating effectively with them. Other professions can also experience the same trap of stereotyping the social work profession and misunderstanding and judging social workers. This lack of genuine appreciation of each other’s roles and scope of practice creates a disconnect between what various professionals are trying to achieve with the service users with whom they are working. While each profession believes that they are doing best for the service users, poor collaboration with their professional partners can limit their effectiveness and potentially create problems.

While this may simply sound like a case of professional rivalry, there can be significant, grave consequences to service users because of this lack of collaboration and understanding between professions. It is well documented that there are significant negative service user outcomes associated with poor communication, cooperation, and understanding between the professions in the health and human services (Kohn et al., 2000). In North America, it has been estimated that thousands of people die each year through errors occurring in healthcare practice due to poor communication, coordination, and/or professional cooperation (Kohn et al., 2000; Romanow, 2002). Deaths also occur in the human service sector due to poor co-ordination and communication between professions. The Alberta Child Advocate (2022) has investigated numerous child deaths caused at least in part because professionals have failed to work effectively together. In addition to deaths, many service users have suffered injury or received ineffective or inadequate help and support because of the difficulties between the professions working together. The numbers of people being poorly served is staggering (Kohn et al., 2000). Poor service user outcomes and inadequate service continue to be problems despite an increased awareness in the health and human service systems of the benefits of interprofessional collaboration to service user safety and the quality of care provided.

To understand the reasons why health and human service professions struggle to work well together, we have identified several barriers to interprofessional collaboration and communication. Organizational structure and culture can impede professions working together when there is hierarchical decision making, a lack of time for collaboration, or when professionals are not in the same physical space, making communication more difficult (Ambrose-Miller & Ashcroft, 2016). Professions also have different values and philosophies of working (Drinka & Clark, 2000; Loxley, 1997; Miller et al., 2001), role insecurity, and a fear of their professional roles being encroached upon by other professions (Loxley, 1997; Miller et al., 2001; Hornby & Atkins, 2000). These concerns can lead to territoriality, and the need to protect professional knowledge (Geva et al., 2000; Hornby & Atkins, 2000; Miller et al., 2001). Power differences between the professions and fear of potentially losing their job can also contribute to poor collaboration (Geva et al., 2000; Hornby & Atkins, 2000). Many of these barriers to collaborative practice developed in reaction to the historical oppression by some of the professions to the others (Charles et al., 2010).

These barriers to professional collaboration are often replicated within university settings (Paul & Peterson, 2001; Charles et al., 2010): Students can be conditioned through practice stories from faculty to feel misunderstood and underappreciated by their colleagues in the health and hum services profession even before they start their placements. This can result in a suspicion of the motivations of other professionals; a devaluing of other profession’s knowledge, skills, and worldviews; and a corresponding sense of territoriality to protect one’s own turf. This makes it easy for individual professions to justify to themselves why their worldview is the best, or why another profession “doesn’t get it”. An unintended consequence of this dynamic is that it becomes difficult to accept one’s own profession’s role in the provision of ineffective or harmful services to people using the helping systems. If social work students assume their professional worldview is right and those of other professions are wrong, it becomes easier to blame other professions for systemic problems and take little or no responsibilities for the contributions of the profession of social work in these problems..

The Origins of Barriers Between the Professions

Many of the current barriers to collaborative practice can be traced back to the historical development of the health and human services professions (Charles & Alexander, 2014; Charles, Dharamsi & Alexander, 2011; Charles & Dharamsi, 2010). The way the professions were established and the early settings in which they worked still influence how they interact. Service delivery was straightforward in the later parts of the 19th century when the first health and human services began as formal professions. Many of the health professions (medicine, pharmacy, and nursing) only interacted in acute hospital settings. Their roles were hierarchical in nature, and well defined with little role overlap. There was little thought to understanding the roles or worldviews of the other professions. The healthcare system was quite simplistic in how it functioned in addressing physical health issues. However, there were major gaps in service delivery as the few existing professions did not have the expertise to meet the complex needs of service users. With the evolution of our understanding of health, the need for diverse health professions expanded necessitating interprofessional collaboration.

The motivation to meet the full range of needs of service users eventually lead to the establishment of the over sixty health and human service professions currently practicing in Canada.

The need to improve service through the proliferation of new professions has resulted in a far more complex system than had previously existed. It is increasingly uncommon for a service user to only interact with a single service provider from a single profession. Service users often interact with a team or teams of professionals who are supported behind the scenes with even more members of other professions. While this means that service users may receive more effective interventions than in the past, it also means that the opportunities for poor communication and collaboration have multiplied. The likelihood of role confusion between professions has also increased. The complexity of teams and systems and the number of professionals now needing to communicate, coordinate, and cooperate can lead to dire consequences for clients (Charles et al., 2010).

The method of training health and human service students lays the foundation for poor communication and collaboration between the professions (Charles & Alexander, 2014). The current pedagogical approaches can reinforce the barriers between the professions rather than break them down. Most professions use what can be called a modified apprenticeship model of training. This model stems from the earliest days of the professions when students did their training almost entirely in practice settings such as a hospital. Education and training eventually expanded to include classroom learning in post-secondary institutions, although the core beliefs underpinning the training did not change. Apart from skills and knowledge transfer, professional training involves the indoctrination and socialization of the students into their individual professions (Hall, 2005). This promotes pride in one’s own profession and an understanding of one’s own professional culture but does little to promote an understanding of other professions. In most professional programs, limited information is taught about the roles and scope of practice of the other professions with whom they will be working with daily. Interprofessional education and practice counters this lack of information by offering a practical framework within which the numerous health and human service professions can interact with each other to deliver the best level of care.

Why Interprofessional Practice?

The primary purpose of interprofessional practice is to improve the quality of care and service delivery for service users. Key benefits of effective interprofessional practice are reduced intervention errors that lead to poor services, less harm to patients and lower death rates (D’Amour et al., 2005). These benefits should be sufficient reasons to improve our relationships with other professions. However, improving interprofessional knowledge and collaboration also benefits individual professions.

In a study at the University of British Columbia in 2003, students from various professions took part in an intensive field learning experience where they came together to do their practicums in rural healthcare centres (Charles et al., 2011). While each of the students completed profession-specific placement requirements, they were also provided time for structured and unstructured interprofessional learning opportunities. Students from the different professions reported a significant increase in their understanding and appreciation of other professions (Charles et al., 2006; Charles et al., 2008).

There were several benefits noted by the social work students (Charles et al., 2011). The first was that they gained a deeper understanding of the scope of practice of social work by explaining to others the roles and world view of their profession. Teaching other students about their own profession helped them appreciate the unique strengths and contributions of social worker, especially in group and team settings. Their profession-specific training in group processes helped the social work students make significant contributions to resolve conflicts and mediate difficult situations in a way that benefited all team members.

This interprofessional experience allowed social work students the opportunity to educate students from other professions regarding the value of their profession in an applied way (Charles et al., 2011). By demonstrating specific skills to social work practice, articulating their systems perspective, and demonstrating their commitment to social justice, social work students were able to help the other students expand their understanding of the value of the profession of social work (Charles et al., 2011).

The social work students also became less judgemental and more informed in their critiques of the other professions (Charles et al., 2011). By working collaboratively alongside the other students and seeing the struggles these students experienced, social work students were able to better understand the complexities of those professions rather than just viewing them through stereotypes. This led to deeper dialogue and even greater understanding and appreciation of other professions.

To improve outcomes for service users, Interprofessional education and practice has been developed to counter the traditional and siloed ways professions are typically trained and practice (Kelly et al., 2020). This is not to say that all aspects of professional education should be interprofessional in nature. We need practitioners who have specialized knowledge and skills and continue to require profession-specific training approaches. However, we also need to continue to increase our ability to effectively work together across our traditional practice boundaries and barriers. Interprofessional education and practice offers a means by which students can learn to better appreciate the contributions and worldviews of the other professions. The next section of the chapter examines key interprofessional concepts and competencies.

Definitions

To help explain the rationale for interprofessional practice and education, the following definitions may be helpful.

Unidiscipline (Uniprofessional) Education and Practice

When members of a single profession work and learn together almost exclusively with other members of their own profession, this is considered unidiscipline education and practice (Charles and Alexander, 2014). Most professional education at universities take place in a unidiscipline context. While unidiscipline professionals may occasionally interact with people from other professions, their primary point of contact is with members of their own profession. For example, child protection teams in many jurisdictions are a uniprofessional practice as they tend to be solely made up of social workers.

Multidisciplinary (Multiprofessional) Education and Practice

Multidisciplinary practice occurs when two or more professions work along side each other in the same setting, often supporting the same client or patient, but their work is primarily independent of other professions (Charles & Alexander, 2014). Some outpatient clinics operate using a multidisciplinary model where professions such as social workers and occupational therapists may be co-located in the same general office space but have little professional contact with each other. Multidisciplinary education occurs when students from various professions learn together in classrooms by attending the same lectures together. In multidisciplinary education, students are not engaged in learning together, but are focused solely on mastering the course content from their own professional perspective.

Interdisciplinary Education and Practice

Interdisciplinary work and education draw upon and integrate knowledge from several disciplines (Charles & Alexander, 2014). The various professionals often come to appreciate the skills and knowledge base of the other professions in the setting, but there is no deliberate effort to understand the worldview of their colleagues. There can be role overlap and some blurred discipline boundaries in interdisciplinary practice. An example of such overlap is a mental health clinic where different professions, such as social work, psychology, nursing, and medicine, work together with both overlapping and distinct roles. Interdisciplinary courses are common at many universities. For example, a child development course might use knowledge derived from psychology, nursing, and medicine. Multidisciplinary courses incorporate knowledge from several academic disciplines or professions, although the class setting is usually either unidisciplinary (such as social work students in a social work program) or multidisciplinary.

Interprofessional Education and Practice

Interprofessional education and practice is a process whereby two or more professions interact purposefully to learn with, from, and about each other with the goal of improving, collaboration, and the quality of care (Charles & Alexander, 2014; Charles et al., 2015; Charles et al., 2010). The key component of interprofessional practice is taking the time to learn about the culture, knowledge base, and worldview of the other professions through interacting with them rather relying on any positive or negative stereotypes students may have of them. This requires active and engaged conversations with members of the other professions to understand how their histories, values, beliefs, attitudes and customs drive their professional interactions with service users and members of other professions. Ideally, this process of learning with, from, and about the other professions in the classroom would begin prior to entering field placements. By having classes on practice topics with members of other professions, it would be possible to have structured conversations about the specific differences and similarities in how different professions approach care delivery. Although scheduled interprofessional education is becoming more common in many universities through specific learning modules students participate in together, there are still limited interprofessional learning opportunities due to scheduling conflicts and expanding uniprofessional curriculum demands. Unfortunately, this means that much of the learning about other professions continues to primarily happen in field placements rather than in the classroom.

Transdisciplinary Approaches

Interprofessional practice and collaboration can move beyond the integration of professional knowledge and roles and begin to work from a transdisciplinary approach (Choi & Pak, 2006). When teams work from a transdisciplinary model, they often use a common theoretical and practice framework, such as harm reduction, that has been developed from the knowledge of multiple disciplines. As teams transcend discipline boundaries, each discipline may experience role release, where they acknowledge that others can do some of their professional roles, and role expansion, where they begin to take on roles that were, at one time, viewed as outside their scope of practice (Choi & Pak, 2006). An example of a transdisciplinary approach is the Assertive Community Treatment Team in Vancouver, BC where a psychiatric nurse might offer group therapy and a social worker may administer emergency naloxone to a client.

Core Concepts and Competencies Related to Interprofessional Practice

There is a developing body of research exploring some of the key concepts embedded in effective interprofessional collaboration. The following are some of the core ideas related to interprofessional collaboration.

Collective Ownership of Goals

A defining element of teamwork is collective action toward a common goal (D’Amour et al., 2005; Saint-Pierre et al., 2018). Collaborative practice involves several professionals analyzing problems, identifying goals, and assuming joint responsibility for actions toward meeting those goals (Hall, 2005). Iachini et al. (2018) also recognize goal evaluation as an element of effective collaboration. Frequently cited goals of professionals working together is improved services and outcomes for service users (Ambrose-Miller & Ashcroft, 2016; Philips & Walsh, 2019; Lutfiyya et al., 2019).

Shared Information and Tasks

Sharing encompasses many factors in interprofessional collaboration, including sharing information, sharing tasks and responsibilities, and sharing decision making (D’Amour et al., 2005). Information sharing can be a vital component of the continuity of care for service users. However, as confidentiality is a key ethical imperative for social workers, student should always understand their ethical and legal requirements regarding information sharing (Canadian Association of Social Workers [CASW], 2005).

Sharing also relates to how professional responsibilities and tasks are divided and distributed (D’Amour et al., 2005). There is a recognition that the scopes of practice for different professions can overlap (e.g., psychologists, nurses, and social workers can all provide emotional support for service users and families). Shared responsibilities and tasks allow professionals who work together to coordinate and allocate specific tasks to certain professionals or to recognize the contribution of several professionals to the same task (D’Amour et al., 2005; Morely & Cashell, 2017).

Finally, a key aspect of sharing is shared decision making. Collaborative practice is most effective when there is mutual input from multiple disciplines in case planning or when decision making incorporates the perspectives of several professionals (Sainte-Pierre et al., 2018).

Partnership

Partnership can describe both the quality of relationships between professionals working together and the outcomes of the relationships. Partnerships are often described as professionals having collegial relationships that are authentic, open, and constructive (D’Amour et al., 2005; Morley & Cashell, 2017). Partnerships can also encompass the idea that newly created professional activities can be the result of working together (Bronstein, 2003; Iachini et al., 2018). An example from one of the author’s own practice is the newly developed protocols or policies that resulted from emergency physicians and social workers collaborating with child protection teams in Vancouver, British Columbia (2016) regarding youth in care who came to the emergency room intoxicated. A new protocol was developed that ensured the safety of youth being discharged from hospital and was not onerous on child protection social workers.

Interdependency

When thinking about how social workers might work together with other professions, interdependency is crucial to effective collaboration (D’Amour, 2005, Iachini et al., 2018). Defined as “the state of being dependent on another” (Meriam-Webster, 2022), interdependency recognizes that social workers need to rely on other professionals to help them address complex social issues and meet the needs of the clients they serve. Interdependence requires cooperation; each discipline has an awareness of the roles and contributions of other professions and respect for and value the knowledge and skills that other professions can contribute to service delivery (D’Amour et al., 2005, Morley & Cashell, 2017).

Power

Power is related to different professionals’ influence on the behaviour of others, decision making about patient care or how service delivery unfolds in a health care setting (Nugus et al., 2010). Power struggles sometimes exist between health professionals from different hierarchical, social, and economic levels within organizations and/or across organizational boundaries when interprofessional collaborations involve more than one organization (Karam et al., 2018). Overt differences in power exist when governance models or structural issues give more decision-making power to one professional over another or when there are compensation practices that reward one profession over others (Ambrose-Miller & Ashcroft, 2016). However, power between professions can also be covert where the centrality of one profession is unspoken yet known by all. An example of this is the implicit understanding among team member’s that the doctor’s schedule takes precedence for meetings or rounds (Ambrose-Miller & Ashcroft, 2016). Power that is dominated by one profession, involves communication that is often unidirectional and where decisions involve little input from other professions is thought to be a competitive style of power (Nugus, et al, 2010).

However, power on interprofessional teams can also be intentionally distributed and collaborative allowing for the empowerment of all members of a team (Ambrose-Miller & Ashcroft, 2016; D’Amour et al., 2005). Collaborative power encourages interdependent participation of team members and input into decision making, recognizes each professions’ distinctive knowledge and encourages negotiated leadership within the team (Nugus et al., 2010). Teams exercising collaborative power tend to have less interpersonal conflict (Almost et al., 2016).

A Framework of Interdisciplinary Collaboration

As healthcare is a setting where many different professions interact and work together for the benefit of service users and families, there is a growing body of research regarding interprofessional collaboration in healthcare contexts. Several studies have identified core skills and needed for effective interprofessional collaboration and teamwork in healthcare settings, including cooperation, assertiveness, effective communication, the ability for professions to work autonomously, and the ability of team members to co-ordinate tasks and decision-making (D’Amour et al., 2005; Hall, 2005).

The Canadian Interprofessional Health Collaborative (CIHC) is a group of health organizations, educators, researchers, professionals, and students from across Canada. In 2010, a CIHC working group created an interprofessional competency framework that can help social workers and other health disciplines conceptualize the key skills and competencies necessary to collaborate. Although this framework was developed specifically for healthcare, its concepts are applicable to other social work settings where interprofessional collaboration is needed.

The framework outlines six core competencies that require the development and integration of attitudes, behaviors, values, and judgments necessary for collaborative practice (Canadian Interprofessional Health Collaborative [CIHC], 2010). The six core competencies are:

• Role clarification,
• Patient/service-user/ family/community centered care,
• Interprofessional communication,
• Team functioning,
• Interprofessional conflict resolution, and
• Collaborative leadership.

In the next section we outline the key components of this framework and expand upon them to help students think about interprofessional collaboration in other settings.

Role Clarification

Role clarification means that social workers can both describe their own role and scope of practice as well as the role and scope of practice of other professions they work with (CIHC, 2010). They understand their unique knowledge, skills, and roles and have a good understanding of how their roles interface with the knowledge, skills, and roles of other professions in contributing to the care of service users. (CIHC, 2010).

According to the CIHC (2010), role clarification can be demonstrated by:

• Being able to describe your own role and the role of others.
• Recognizing and respecting the diversity of roles, responsibilities, and competencies of other professions on the team.
• Being able to perform your own role in culturally respectful ways.
• Communicating roles, skills, and knowledge using appropriate language.
• Accessing the knowledge and skills of others through consultation.
• Considering the roles of others when determining your own professional and interprofessional role.
• Integrating roles seamlessly into models of service delivery.

Patient/Service- User/Family/Community-Centered Care

Social workers and other professionals can prioritize and value the voices and engagement of patients, service-users, families, and communities in the design or implementation of their care and service delivery (CIHC, 2010). Service users are seen as the expert in their own lives and are given access to information, knowledge, or skills in a respectful way so they can become partners in their care or service delivery. To be service user-centered, professionals listen carefully to the expressed wishes, needs, and goals of service users; this information is central to care or service delivery plans (CIHC, 2010).

The Institute for Patient and Family Centered Care (1992) identifies four key concepts of service user and family centered care.

1. Dignity and respect: listening and honoring service user and family perspectives and choices. Service user and family knowledge, values, beliefs, and cultural backgrounds are incorporated into the planning and delivery of care.
2. Information sharing: communicating and sharing complete, timely and unbiased information with service users and families in ways that are affirming and useful. Service users and families are given accurate information to effectively participate and make decisions in their own care.
3. Participation: encouraging and supporting service users and families to participate in care and decision-making at the level they choose.
4. Collaboration: working with service users and families in designing policy, developing, implementing, and evaluating programs, designing facilities and professional education.

Interprofessional Communication

Effective communication skills are central to social work practice and essential for professionals working collaboratively (Ambrose-Miller & Ashcroft, 2016; Hall, 2005; Richards et al., 2005). This competency means that professionals prioritize respectful, authentic, and trusting relationships with their colleagues (CIHC, 2010). They can actively listen to one another, using verbal and nonverbal communication skills, and confirm their understanding with the speaker. Good communication requires transparency and communication technology that enhances shared decision making and collaboration (CIHC, 2010).

Team Functioning

Sometimes collaborative practice takes place within loosely defined networks, while other times it takes place in organized interprofessional teams. Groups of professionals working together in teams need to have some understanding of group dynamics and team development processes (CIHC, 2010). Social workers have training in group processes that can be beneficial to teamwork. Guidelines for ensuring respectful and ethical discussions, shared decision-making processes that consider confidentiality, and interprofessional ethics are important for aspects of effective team functioning.

Interprofessional Conflict Resolution

Conflict is a natural and expected aspect of professionals working together. In fact, disagreements can be valuable in teams helping professionals working together to make better decisions (Almost et al., 2016). Although expected, conflict needs to be addressed respectfully and constructively for effective collaborative practice (CIHC, 2010). Conflict needs to be differentiated from other behavior such as bullying, harassment, ostracism, or violence where there is intent to intimidate, threaten, insult, humiliate, exclude, or harm another (Almost et al., 2016). Whereas conflict can have positive outcomes, the previous types of behaviours always have negative outcomes and should be formally reported.

Role ambiguity, power hierarchies and differences in goals between professionals can be potential sources for disagreements and conflict (Ambrose Miller & Ashcroft, 2016; CIHC, 2010; D’Amour et al., 2005). All team members need to ensure that they create environments that are safe for diverse opinions to be expressed. All professionals should be provided space to share their perspective, even if that perspective is in opposition to others. Teams and groups should have processes and strategies in place to address conflict as it arises, analyze the source of conflict, and take steps to find solutions. Communication is essential to effective interprofessional conflict resolution.

Collaborative Leadership

When professionals work on structured teams, collaborative leadership means that the team applies leadership principles that are both task and relationship oriented (CIHC, 2010). Collaborative leadership means that leadership can be shared amongst members and that the group uses the expertise of their members at various times for different tasks. Individual members take accountability for their actions, responsibilities, and roles. Collaborative leadership requires a climate for collaboration and attending to the relationships among members so there are effective processes for discussion, negotiation, and decision making (CIHC, 2010).

Understanding Other Professions

It takes time to learn about other professions — it does not simply involve having one or two conversations with others. Understanding the complexities of the culture and worldviews of others and how this translates into practice, beliefs, and actions is a dynamic and ongoing process that requires reflection. The University of British Columbia’s model of interprofessional education reflects the belief that there are optimal learning times for health and human services students and practitioners to incorporate the key concepts of interprofessional education and practice (Charles et al., 2010). These optimal points of learning are dependent upon peoples’ stage of professional identity development and their readiness to learn and develop new perspectives on professional interaction. The UBC model of interprofessional education outlines three stages involved in this process (Charles et al., 2010):

Stage 1 – Exposure: Exposure lays the foundation for an advanced understanding and integration of the key concepts and competencies (role clarification, patient/service user/family/community-centered care, interprofessional communication, team functioning, interprofessional conflict resolution, collaborative leadership) of interprofessional practice. While students primarily focus on the development of their own professional identity, they are also provided with the opportunity to learn about the worldviews and roles of other health and human service professions: students learn that there can be multiple perspectives on any number of practice issues. These different perspectives are not right or wrong but are simply reflective of the world and practice views of the other professions. This exposure primarily occurs within the classroom setting prior to or during the first practicum. This is often a parallel learning experience where students take classes with members of other professions or are in field placement with them.

The Second Stage: Immersion. This stage of learning is collaborative, rather than parallel, where students learn from other professions. At this stage, students need to be able to maintain their own foundational professional identity while simultaneously be open to accepting that there are other valid worldviews, values and beliefs as they begin to learn about other professions. Students can gain an interprofessional worldview within which the student incorporates and understands the multiple perspectives of other professions, as well as the role and contributions they make to service user care. This is achieved through the provision of opportunities for ongoing structured and unstructured interactions with people from other professions. These interactions help students learn about the strengths and challenges of other professions and to contribute to other students better understanding social work. This requires thoughtful reflection on the dynamics of these moments of learning with members of other professions.

The Third Stage: Mastery. The mastery stage often occurs at advanced levels of training and education. In the mastery stage, students or practitioners incorporate the key concepts of interprofessional practice into their everyday professional lives. Mastery occurs when one has a well-developed sense of who they are as members of their own profession and of the role of social work within the helping systems. This usually only happens when students or practitioners have had significant practice experience and advanced professional training to interact from a place of competency with members of other professions. The goal of the mastery stage is to develop advanced-level critical thinking skills and a high degree of self-reflection that allows a deeper understanding of the contribution of one’s own and the other professions within the health and human service delivery systems. Advanced learning experiences available through graduate programs and senior level placements or considerable experience in practice are often required to achieve mastery.

Conclusion

It is imperative that communication and collaboration between health and human service professions is improved to increase the likelihood that service users will get the care and support they need (Charles, 2011). Social work students and practitioners need to purposefully take the time to learn about and appreciate the contribution and struggles of the other professions. The first step in this process is to begin to see other professions as allies and not enemies. This requires that individual professions move away from their own positions of arrogance of believing and maintaining that their own profession’s worldview is the only valid one. Social workers need to learn to see the practice world through multiple perspectives as well as their own.

Social work students and practitioners can develop competencies that will enable them to interact and work more effectively with other professions. Being able to articulate their own role and scope of practice as well as understand the role of others is essential. Learning effective communication skills, group development processes, and conflict resolution skills can enhance interprofessional collaboration. Finally, learning how to prioritize the service user’s voice in their own care and service delivery, as well as developing leadership skills that are both task and relationship oriented will help social workers collaborate with other professions more effectively. Current service systems are far too complex; they will only change for the better if professionals change the way we interact with each other (Rubin et al., 2018). The best way to improve our levels of effectiveness and collaboration is to learn with intentionally and actively, from, and about the other professions.

Discussion Questions

1. What stereotypes, assumptions or biases do we have about other professions we work with? What stereotypes, assumptions or biases might other professions have about social workers? How might these stereotypes impede interprofessional collaboration?
2. What core competencies for interprofessional collaboration might social work students and social workers have that is unique to our professional training? How might social workers use these skills for enhancing collaboration with others?
3. Where do you see barriers to interprofessional practice in your practicum setting? What key concepts of interprofessional collaboration are evident in practice? Where do you see opportunities for social work students in practicums to enhance their knowledge and understanding of other professions?
4. Read the following case example and answer the questions below.

References

Almost, J., Wolff, A. C., Stewart-Pyne, A., McCormick, L. G., Strachan D., & D’Souza, C. (2016). Managing and mitigating conflict in healthcare teams: An integrative review. Journal of Advanced Nursing, 72(7), 1490–505. https://doi.org/10.1111/jan.12903

Ambrose-Miller, W., & Ashcroft, R. (2016). Challenges faced by social workers as members of interprofessional collaborative health care teams. Health & Social Work, 41(2), 101–109. https://doi.org/10.1093/hsw/hlw006

Ben Shlomo, S., Levy, D., & Itzhaky, H. (2012) Development of professional identity among social work students: Contributing factors. The Clinical Supervisor, 31(2), 240–255. https://doi.org/10.1080/07325223.2013.733305

Bogo, M. (2010). Achieving competence in social work. University of Toronto Press.

Bogo, M., & Vayda, E. J. (1998). The practice of field instruction in social work (2nd ed.). University of Toronto Press.

Bronstein, L. R. (2003). A model for interdisciplinary collaboration. Social Work, 48(3), 297–306. https://doi.org/10.1093/sw/48.3.297

Canadian Association of Social Workers. (2005). CASW Code of Ethics and Scope of Practice. https://casw-acts.ca/en/Code-of-Ethics

Canadian Interprofessional Health Collaborative. (2010). A national interprofessional competency framework. University of British Columbia. https://drive.google.com/file/d/1Des_mznc7Rr8stsEhHxl8XMjgiYWzRIn/view

Charles, G. (2011). Reflective response: Interdisciplinary and interprofessional collaboration: Essential for the doctoral advanced practice nurse. In M. Dreher and M. E. Smith Glasgow (Eds.), Role development for doctoral advanced nursing practice (pp. 351–356). Springer.

Charles, G., Bainbridge, L., Copeman-Stewart, K., Tiffin, S., & Kassam, P. (2006). The Interprofessional rural program of British Columbia (IRPbc). Journal of Interprofessional Care, 20(1), 40–50. https://doi.org/10.1080/13561820500498154

Charles, G., Bainbridge, L., Copeman-Stewart, K., & Kassam, R. (2008). The impact of an interprofessional rural healthcare practice education experience on students and communities. Journal of Allied Health, 37, 127–131.

Charles, G., Bainbridge, L., & Gilbert, J. (2010). The University of British Columbia model of interprofessional education. Journal of Interprofessional Care, 24(1), 8–18. https://doi.org/10.3109/13561820903294549

Charles, G., & Dharamsi, S. (2010). Service learning, interprofessional education and the social work placement: The case for combining the best of all worlds. In E. Ralph, K. Walker and R. Wimmer (Eds.), The practicum in professional education: Canadian perspectives (pp. 69–88). Detselig Press.

Charles, G., Dharamsi, S., & Alexander, C. (2011). Interprofessional field education: Reciprocal learning for collaborative practice. In J. Drolet, N. Clark, and H. Allen (Eds.), Shifting sites of practice: Field experience in Canada (pp. 253–263).

Charles, G., Birring, V., & Lake, S. (2011). What’s in it for us?: Making the case for interprofessional field education experiences in social work. Journal of Teaching in Social Work, 31(5), 579–593. https://doi.org/10.1080/08841233.2011.615265

Charles, G., & Alexander, C. (2014). An introduction to interprofessional practice in social and health care settings. Relational Child and Youth Care Practice, 27(3), 51–55.

Charles, G., Alexander, C., & Oliver, C. (2015). Overcoming isolation: Making the case for the development of blended service learning and social work interprofessional field education experiences to improve university-community engagement. Currents: Scholarship in the Human Services, 13(1), 1–17. https://cjc-rcc.ucalgary.ca/index.php/currents/article/view/15949

Choi, B., & Pak, A. (2006). Multidisciplinarity, interdisciplinarity and transdisciplinarity in health research, services, education, and policy: 1. Definitions, objectives, and evidence of effectiveness. Clinical and Investigative Medicine, 29(6), 351–364.

Costello, M., Prelack, K., Faller, J., Huddleston, J., Adly, S., & Doolin, J. (2018). Student experiences of interprofessional simulation: Findings from a qualitative study. Journal of Interprofessional Care, 32, 95–97. https://doi.org/10.1080/13561820.2017.1356810

D’Amour, D., Ferrada-Videla, M., San Martin Rodriguez, L., & Beaulieu, M. D. (2005). The conceptual basis for interprofessional collaboration: core concepts and theoretical frameworks. Journal of Interprofessional Care, 19(sup1), 116–131. https://doi.org/10.1080/13561820500082529

Drinka, T. J. K., & Clark, P. G. (2000). Health care teamwork: Interdisciplinary practice and teaching. Auburn House.

Geva, E., Barsky, A., & Westernoff, F. (2000). Developing a framework for interprofessional and diversity informed practice. In E. Geva, A. Barsky, and F. Westernoff (Eds.), Interprofessional practice with diverse populations: Cases in point (pp. 1–28). Auburn House.

Glaser, B. (2016). Interprofessional collaboration and integration as experienced by social workers in health care. Social Work in Health Care, 55(5), 395–408. https://doi.org/10.1080/00981389.2015.1116483

Hall, P. (2005). Interprofessional teamwork: Professional cultures as barriers. Journal of Interprofessional Care, 19(sup1), 188–196. https://doi.org/10.1080/13561820500081745

Hornby, S., & Atkins, J. (2000). Collaborative care: Interprofessional, interagency and interpersonal (2nd ed.). Blackwell.

Iachini, A. L., Bronstein, L. R., & Mellin, E. (2018). A guide for interprofessional collaboration. Council on Social Work Education Press.

Institute for Patient and Family Centered Care: Transforming health care through partnerships. (n.d.). Patient and family centered care. https://www.ipfcc.org/about/pfcc.html

Karam, M., Brault, I., Van Durme, T., & Macq, J. (2018). Comparing interprofessional and interorganizational collaboration in healthcare: a systematic review of the qualitative research. International Journal of Nursing Studies, 79, 70–83. https://doi.org/10.1016/j.ijnurstu.2017.11.002

Kelly, P. L., Heyman, J. C, Tice-Brown, D., & White-Ryan, L. (2020). Interprofessional practice: Social work students’ perspectives on collaboration. Social Work in Health Care, 59(2), 108–112. https://doi.org/10.1080/00981389.2020.1719565

Kohn, L. T., Corrigan. J. M., & Donaldson, M. S. (2000). To err is human: Building a safer health system. Institute of Medicine, Committee on Quality of Health Care in America.

Loxley, A. (1997). Collaboration in health and welfare: Working with difference. Kingsley.

Lutfiyya, M., Chang, L., McGrath, C., Dana, C., & Lipsky, M. (2019). The state of the science of interprofessional collaborative practice: A scoping review of the patient health-related outcomes based on literature published between 2010 and 2018. PLoS One, 14(6), 1–18. https://doi.org/10.1371/journal.pone.0218578

Maynard, S. P., Mertz, L. K. P., & Fortune, A. E. (2015). Off-site supervision in social work education: What makes it work? Journal of Social Work Education, 51(3), 519–534. https://doi.org/10.1080/10437797.2015.1043201.

Merriam-Webster. (n.d.). Interdependence. In Merriam-Webster.com dictionary. https://www.merriam-webster.com/dictionary/interdependence

Miller, C., Freeman, M., & Ross, N. (2001). Interprofessional practice in health and social care: Challenging the shared learning agenda. Arnold.

Mizrahi, T., & Abramson, J. (2000). Collaboration between social workers and physicians: Perspectives on a shared case. Social Work in Health Care, 31(3), 1–24. https://doi.org/10.1300/J010v31n03_01

Morley, L., & Cashell, A. (2017). Collaboration in health care. Journal of Medical Imaging and Radiation Sciences, 48(2), 207–216. https://doi.org/10.1016/j.jmir.2017.02.071

Nugus, P., Greenfield, D., Travaglia, J., Westbrook, J., & Braithwaite, J. (2010). How and where clinicians exercise power: Interprofessional relations in health care. Social Science & Medicine, 71(5), 898–909. https://doi.org/10.1016/j.socscimed.2010.05.029

Office of the Child and Youth Advocate Alberta. (2022). Mandatory reviews into child death: April 1, 2021 – September 30, 2021. https://www.ocya.alberta.ca/adult/publications/investigative-review/

Oliver, C. (2013). Social workers as boundary spanners: Reframing our professional identity for interprofessional practice. Social Work Education, 32(6), 773–784. https://doi.org/10.1080/02615479.2013.765401

Paul, S., & Peterson, C. Q. (2001). Interprofessional collaboration: Issues for practice and research. Occupational Therapy in Health Care, 15, 1–15. https://doi.org/10.1080/J003v15n03_01

Phillips, J. D., & Walsh, M. A. (2019). Teaming up in child welfare: The perspective of guardians ad litem on the components of interprofessional collaboration. Children and Youth Services Review, 96, 17–26. https://doi.org/10.1016/j.childyouth.2018.11.016

Providence Health Care Vancouver. (2016, April 26). Patient and family centered care at PHC. [Video]. YouTube. https://www.youtube.com/watch?v=lqfcfuwtj4g

Richards, S., Ruch, G., & Trevithick, P. (2005). Communication skills training for practice: the ethical dilemma for social work education. Social Work Education, 24(4), 409–422. https://doi.org/10.1080/02615470500096928

Romanow, R. J. (2002). Building our values: The future of health care in Canada—Final report. Commission on the Future of Health Care in Canada. https://publications.gc.ca/collections/Collection/CP32-85-2002E.pdf

Rubin, M., Cohen Konrad, S., Nimmagadda, J., Scheyett, A., & Dunn, K. (2018). Social work and interprofessional education: integration, intersectionality, and institutional leadership. Social Work Education, 37(1), 17–33. https://doi.org/10.1080/02615479.2017.1363174

Saint-Pierre, C., Herskovic, V., & Sepúlveda, M. (2018). Multidisciplinary collaboration in primary care: a systematic review. Family Practice, 35(2), 132–141. https://doi.org/10.1093/fampra/cmx085

Salhani, D., & Charles, G. (2007). The dynamics of an interprofessional team: The interplay of child and youth care with other professions within a residential milieu. Relational Child and Youth Care Practice, 20(4), 12–20. https://www.researchgate.net/publication/273694211_The_dynamics_of_an_interprofessional_team_The_interplay_of_child_and_youth_care_with_other_professions_within_a_residential_treatment_milieu

Smith, D., Cleak, H., &d Vreugdenhil, A. (2015). “What are they really doing?” An exploration of student learning activities in field placement. Australian Social Work, 68(4), 515–531. https://doi.org/10.1080/0312407X.2014.960433

Wiles, F. (2013) “Not easily put into a box”: Constructing professional identity. Social Work Education, 32(7), 854–866. https://doi.org/10.1080/02615479.2012.705273