Foundations and Essentials for the Doctor of Nursing Practice

International Journal of Teaching and Learning in Higher Education 2018, Volume 30, Number 3, 560-570 http://www.isetl.org/ijtlhe/ ISSN 1812-9129

Teaching and Learning about Interprofessional Collaboration Through Student-

Designed Case Study and Analysis

Beverley Henry

and Brandon Male Northern Illinois University

Catherine Garner Walden University

Ann Guernon Marianjoy Rehabilitation Hospital

Learning activities to develop interprofessional collaboration align with goals for professional preparation to improve health outcomes. A problem-based case study approach can offer formal and

informal learning interactions that promote information exchange and collaborative practice. The

purpose of this instructional article was to describe a five-stage student-designed case study and analysis activity to accomplish student learning outcomes for developing knowledge and skills in

evidence-based case analysis through interprofessional collaboration. Four main learning outcomes

included gaining knowledge of other professions, planning and reviewing care interventions, evaluating outcomes of other practitioners, and facilitating inter-professional case conferences and

team working. An example case scenario and lessons learned are presented. This paper offers key

learning points for educators and students related to the literature in problem-based learning and

interprofessional education. The results confirm the feasibility of student-designed case studies as a

problem-based experiential learning activity. Potential benefits for students include increased

knowledge of, and appreciation for, other disciplines gained through practicing and reflecting on peer feedback. Information exchange between the students allowed interprofessional learning to

occur. Students from different disciplines collaborated in the development of strategies for planning, implementing, monitoring, and evaluating a health program.

The World Health Organization advocates for

interprofessional education (IPE) that occurs “when

students from two or more professions learn about, from,

and with each other to enable effective collaborative

practice and improve health outcomes” (WHO, 2010). In

2011, the Interprofessional Collaborative Practice (IPEC)

panel report proposed interactive learning and

competencies for health students from different

disciplines to prepare for “deliberatively working

together” to improve community and population health

systems (IPEC, 2011). Interprofessional collaboration

was defined in the Canadian Interprofessional Health

Collaborative (CIHC) national competency

recommendations as “[a] partnership between a team of

health providers and a client in a participatory,

collaborative and coordinated approach to shared

decision-making around health and social issues” (CIHC,

2010). In 2016, the IPEC panel of experts expanded from

6 to 15 professional organizations. Their updated

guidelines placed interprofessional collaboration as a

central domain in IPE (IPEC, 2016). This signified a

growing priority for educators in health professions to

develop formal and informal learning activities that

advance students’ abilities with interprofessional

collaboration (CIHC, 2010; Gambescia, 2017; IOM,

2013; WHO, 2010;). Related to these national efforts, the

Global Forum on Innovation in Health Professional

Education requested that an Institute of Medicine (IOM)

consensus committee examine the evidence on the

impact of IPE. This IOM committee proposed that

knowledge and skills with interprofessional collaboration

occur during prelicensure and graduate education in

professional programs. Their report included a

framework wherein development of these collaborative

competencies happens while students develop

profession-specific skills rather than outside the standard

curriculum (IOM, 2015). Collectively, these

organizations described the relevance and timing of IPE

for improving health systems.

Guidelines for the development of teaching and

learning activities to integrate IPE into professional

education can be drawn from the literature on the socio-

cultural learning theory, competency-based learning,

and problem-based learning. The socio-cultural learning

theory, within the context of constructivist approaches

introduced by Vygotsky, has been applied in the field of

medical education among others (Nalliah & Idris, 2014;

Salomon & Perkins, 1998). It highlights the important

influence of students working together and learning

from each other to reach the next area of potential

development (e.g., active experimentation, scaffolding,

the Zone of Proximal Development) (Chaiklin 2003;

Nalliah & Idris, 2014; Vgotsky, 1978). As others have

identified, the constructivist framework can lend itself

to IPE as an interactive and socialization process

(Casmiro, MacDonal, Thompson, & Stodel, 2009;

Olenick, Allen, & Smego, 2010).

Barr’s model for competency-based interprofessional

education described key abilities relevant to various stages

on the learning continuum (Barr, 1998). These include: (1)

recognize and respect the roles of other professionals, (2)

jointly plan and review care interventions, (3) evaluate the

outcomes of another practitioner’s work, and (4) facilitate

interprofessional case conferences and teamwork. Olenick

and colleagues (2010) conducted a concept analysis of IPE

and noted that the processes conducive to interprofessional

Henry, Garner, Guernon, and Male Interprofessional Collaboration 561

learning included problem-solving and critical thinking.

The interprofessional learning continuum model, designed

to guide assessment of IPE from education-to-practice,

included collaborative behavior, as well as knowledge and

skills, attitudes, and perceptions of other professionals as

learning outcomes (Hammick, Freeth, Copperman &

Goodsman, 2009; IOM, 2015). Within the list of learning

methods for IPE, exchange-based learning, such as case

studies, allowed students to compare views and

experiences (Barr, 2002).

Problem-based learning (PBL) as an instructional

approach permits students to activate their existing

knowledge and present arguments on solving

multifaceted problems in a wide variety of fields to gain

a stronger understanding of the scientific process

(Loyens, Jones, Mikkers & Van Gog, 2015). In

addition, Dolmans and collegeaus described PBL as “a

student-centered approach in which problems are the

stimulus for learning. It is characterized by: (1) learning

through problems, (2) small group sessions, (3) group

learning facilitated by a teacher, and (4) learning

through self-study” (Dolmans, Michaelsen, Van

merrienboer, & van der Vleuten, 2015, p. 355,).

The work of Engeström and Sennino (2010)

described how students gain mastery toward an objective

with the aid of a mediating tool. For the IPE project

reported here, the object to be achieved was collaborative

practice through a mediating step of case design. By

asking students to concentrate on case design, we

considered that the scope of learning could include a

focus on the process of learning. In other words, by

collaborating on case design, students would consider the

impact of the collaborative process, as well as the results

of fact-finding and problem-solving, thereby, drawing

from the socio-constructivist perspective by which

“learners create meaning from experience through

interactions with other learners and with their learning

environment” (Casmiro et al., 2009, p. 396). Also, this

process seemed true to the “with, from and about”

definition of IPE in socio-cultural learning is key to an

understanding of interprofessional learning (Freeth,

Hammick, Koppel, Reeves, & Barr, 2002).

The purpose of the IPE learning activity

described in this article was to apply a problem-

based case study approach to promote collaborative

practice and information exchange between students

of varying disciplines. In this instructional article we

described the development and implementation of

this learning activity with an example student-

designed case scenario. The resulting learning

outcomes were identified through informal

discussions with students. Evidence from the

literature was considered with the “lessons learned”

from this effort to help students become practice-

ready to problem-solve and research complex

problems in collaboration with other professions.

Method

To ensure that the case study learning activity

provided a platform for students from different

disciplines to recognize different perspectives through

interaction and collaboration, key aims were identified,

the setting was selected, and course development and

implementation followed. To meet the primary aim for

interprofessional collaboration, students from different

disciplinary backgrounds worked together in the design

of a case scenario. Through their combined efforts, a

case scenario that exemplified a complex problem and

multiple perspectives would be incorporated in the

content of the case itself. The premise of this step was

that students could benefit more if tasked with

collaborating to design a unique case scenario that

reflected problem(s) within their own fields than they

would if assigned a case scenario.

In addition, this IPE learning process was intended

to meet students’ own professional competencies, as well

as inter-professional collaborative practice, through

shared discovery of an empirical and theoretical basis for

case analysis. Thus, knowledge translation became a

secondary, and complementary, aim of this learning

activity. Knowledge translation was selected because it

had the potential to offer students a near-authentic

opportunity to develop experience with case-based

problem-solving (Bhogal et al., 2011). As defined by

Graham and colleagues (2006), through the process of

knowledge translation students can identify gaps between

desired and actual care, identify needed practice changes;

and evaluate outcomes, causes, and solutions.

The setting for this innovative student-designed

case activity was an inter-professional health sciences

doctoral program at a large university in the

Midwestern U.S.A. The doctoral program, housed in

the College of Health and Human Sciences at Northern

Illinois University (NIU), offers full- and part-time

program options for place-bound students through

blended course delivery. In the NIU program, course

planning faculty envisioned the term “inter-

professional” as ascribed to Hall and Weaver (2001).

The NIU doctoral program promotes individuals from

different disciplines working and communicating with

each other. It encompasses an inter-professional

learning environment in which each member provides

his/her knowledge, skills, and attitudes to augment and

support the contributions of others.

Most students in this program seek a research-

based terminal degree to advance in academia or as

principle investigators for a health agency, professional

organization, or academic medical center. This

instructional activity was implemented to meet program

goals in a class of seven students: three males and four

females. The students participating in this course were

working adults of varied educational backgrounds and

Henry, Garner, Guernon, and Male Interprofessional Collaboration 562

Figure 1

Criteria for case study peer review

work experiences that included an associate director for

rural health professions, a biology instructor, a chiropractor,

a clinical research coordinator, an epidemiologist, a medical

laboratory scientist, and a public health advisor.

Course Development

We began with the end in mind in the manner of

backward design (Wiggins & McTighe, 2005). From a

review of curricular resources in the public domain and

related literature, we highlighted the knowledge and skills

for interprofessional collaboration and evidence-based

case analysis. For this activity we determined the main

learning outcomes to be that students would be able to:

 Collaborate to design a case scenario of an

overarching research problem

 Evaluate current solutions through teamwork

with people in other professional roles

 Disseminate results of an evidence-based case

analysis through oral and written presentations

 Engage classmates in discussion about an

overarching problem and adequacy of the evidence

 Critique case presentations in a respectful

manner with an interprofessional focus

To devise evaluation criteria applicable across

disciplines, we reviewed rubrics such as those from the

Association for the Assessment of Learning in Higher

Education. We selected a three-point rating scale, with

descriptors for “met,” “partially met,” and “not met”

status to offer discrete categories for peer review. The

case study review criteria were drawn from examples in

the public domain (see Figure 1). Lastly, we developed

the learning experiences, written directions, and

corresponding forms for the case study assignment that

resulted in a five-stage process.

Implementation

The IPE activity was delivered through an online

platform for information sharing, discussions,

presentations, and feedback. Students in the class were

encouraged to share their disciplinary perspectives,

literature sources, health measurement tools, and outcomes

through collegial exchange.

Henry, Garner, Guernon, and Male Interprofessional Collaboration 563

Stage one: Group case discussion. Students reviewed

a presentation about the purpose, scope, and evaluation of

case studies through an audio-recorded module. They also

participated in analysis of a case study based on the article,

“Managing Everyday Ethics in Assisted Living”

(Messikomer & Cirka, 2008). The template for this activity

served as the format for the final case study design project.

The goal of this stage was to provide students with the

opportunity to practice case analysis of a healthcare issue

related to aging adults. This activity encompassed a shared

interest for multiple disciplines and levels of experience.

Students were instructed to write a short case

analysis and post this in the online classroom

discussion section responding to the following

questions: (1) What immediate steps should the

executive director take to manage the situation? (2)

What actions or policy changes are needed over the

long term? (3) What health measurements could be

used to achieve goals related to these issues, such as

public resources Vital Signs, Human Development

Index, and Health Outcomes Core Health Outcomes

Library? and (4) Provide a case

Figure 2

Example of student-designed case study and analysis

Henry, Garner, Guernon, and Male Interprofessional Collaboration 564

synopsis with your recommendations and how they

reflect an interprofessional focus. Students engaged in

dialogue about the case from different disciplinary

perspectives through the online discussion forum.

Faculty provided feedback using the same rubric and

criteria that would be used for the final project in order

to allow students to become familiar with the case study

process. This activity allowed students to observe how

their classmates with different backgrounds in health

approached a uniform case.

Stage two: Inter-professional collaboration in case

analysis. In the following week, students practiced inter-

professional collaboration to improve health care systems

through case study review in partnership with a classmate

from a different discipline. Students chose a case study from

the Institute for Healthcare Improvement (IHI) and took the

role of leader/champion for IPE and collaborative practice.

The case studies provided opportunities to improve care

across a continuum of health issues ranging from extended

care to confidentiality to international issues of health care

systems. The students identified the key coordinating

elements required to address this case. They also provided

rationale for an interprofessional approach to addressing real

world issues in the delivery of quality health care. Through

interprofessional collaboration, each group came to a

consensus about key elements and solutions identified for

the case they chose to analyze.

Stage three: Case study design. In this stage,

students were tasked with designing a case scenario to

exemplify overarching problem(s) in a health or

community setting through collaboration with one or

more individuals from different disciplines. Students

matched up themselves into small groups. Each small

group developed a case-based analysis including a

comprehensive description of the context, significant

issues for different disciplines, stakeholder perspectives,

and credible measurements. In addition, the context of

the case incorporated current industry standards and

regulations, as well as relevant individual, familial,

organizational, and societal issues. Regardless of the

group size, the students were required to consider at least

three different stakeholder perspectives in their case

analysis. Finally, each small group provided empirically-

based recommendations for problem solving with

targeted solutions and evaluation. As an example, one

pair of students combined their research interests in law

enforcement and concussion-related injuries in the design

of their case study (see Figure 2).

Stage four: Case presentation and review.

Student groups presented their case studies using a

PowerPointTM format in a synchronous web-based

platform. Each of the other students was asked to

critique their peer’s presentation in a constructive

manner using the Case Study Analysis Criteria for Peer

Review (see Figure 1). This allowed the student groups

to experience feedback from their peers, who often

represented other disciplines. This exercise aimed to

reinforce the concepts that interprofessional work is a

collaborative effort and that interaction across different

professional cultures and languages results in the

construction of common ground (Klein, 2014). The two

faculty members also provided feedback.

Stage five: Written case study. To meet student

learning outcomes, student groups reflected on their case

presentation and utilized feedback to revise their case

study and analysis to develop a final written case study

for faculty review and grading. At this stage, faculty

primarily assessed how well student groups incorporated

feedback from the instructors and peers to enhance their

overall case study and analysis. Table 1 provides

information from the example case with peer-review

comments and application to the final written case study.

Results

Completion of the student-designed case study

activity provided students with an opportunity to

examine several facets of IPE with realistic problem

solving. The results of this learning activity are

presented in the framework from Barr’s model of key

competencies for IPE (Barr, 1998). These findings were

summarized from comments from students in the class,

the review by the two co-facilitators, and the example

student-designed case (Figure 2).

Recognize and Respect the Roles of Other

Professions

Working closely with others from disciplines

outside of their own allowed students to learn more

about problems that spanned multiple fields and

occupations. In the example case, students with

backgrounds in kinesiology and speech language

pathology discovered a shared interest in the awareness

of diagnosis, treatment, and recovery from concussion.

Though this topic exists as a health promotion priority,

examining a case from different perspectives helped

illustrate the wide scope of underlying issues within one

case scenario. The students additionally identified

concerns crossing several disciplines that included

health care professionals, members of administration

within the law enforcement community, and human

resource representatives in order to meet the medical

and employment concerns of the patient and his wife.

Issues that surfaced included interpersonal

communication and the individual mental or

psychological beliefs regarding concussion as a

traumatic brain injury. The education that occurred with

the law enforcement personnel led to an internal policy

review and additional training for officers. Students

Henry, Garner, Guernon, and Male Interprofessional Collaboration 565

Table 1

Select Feedback and Group Response on the Example Case and Analysis

Review Criteria

Self-assessment of 1st

Case Presentation: Oral Peer-Review Feedback

Student Use of Feedback for

Case Presentation: Final Paper

Identify Problem

and Underlying

Issues

 Presented problematic

issues from ED staff,

PCP and patient

perspective

 Clear, realistic

description of case

 Difficult to keep track

of stakeholders

 Need more focus on

conceptual background

 Maintained realism of case

 Expanded focus to

organizational

infrastructure and

leadership issues

 Elaborated on conceptual

framework

Inference of Data

for Decision-

making

 Evidence related to

healthcare only

 Clear, empirical

supporting evidence

 Need more examples

of proposed solutions

from the literature

 Expanded solutions to

utilize communication

methods from aviation and

the Navy

Use of Health

Measurements to

Achieve Goals

 Proposed follow-up 48

hours after discharge

from ED

 Focused measurement

on staff level

communication and

hand-off issues

 Need recommendations

and evidence to be

more integrated

 Need to apply current

models and trainings to

case

 Consider care pathway

in ED instead of

follow-up 48 hours

after visit

 Consider culture

changes rather than

individual changes

 Incorporated additional

training and expanded

explanations of models

 Modified recommendation

from follow-up to care

pathway development

 Focused development of

solutions at the

organizational/leadership

level and staff level

Interprofessional

Focus of Case

Analysis

 Case spanned 3

different settings:

emergency department,

primary care and word

setting

 Great diversity of

stakeholders

 Consider expanding

individual patient view

of interprofessional care

 Appreciated conclusions

targeting several

disciplines

 Expanded the

interprofessional focus

through creation of

working group comprised

of organizational

leadership, staff and PCP

representatives

reported understanding the differences between multiple

disciplinary perspectives more clearly, even though those

differences may be nuanced and not explicit. They

emphasized the importance of respectful communication

and environments that valued collaboration.

Jointly Plan and Review Care Interventions

Many over-arching problems facing society today

compel investigators to examine data from multiple

disciplines to make effective decisions. In this project,

the shared process of examining scholarly literature

exposed students to new types and sources of data,

including theoretical and empirical research. This

provided students with a different foundation to draw

upon when developing recommendations for their

analysis. As such, collaborative practice may assist with

reviewing care processes. For instance, in the example

case students identified potential benefits from

improving communication through standardized

reporting mechanisms. A lack of structured

communication strategies could have cumulative effects

on professionals outside of their immediate setting and

impact outcomes. The case analysis included planning

Henry, Garner, Guernon, and Male Interprofessional Collaboration 566

to enhance communication by outlining action steps

based on literature and existing practices.

Evaluate the Outcomes of Another Practitioner’s

Work

Commonly, a first step was to develop consensus

on the focus of their desired outcomes and

measurement goals. In the example case, the students

prioritized four domains in the case for measurement:

inter-professional collaboration, communication,

transition in care, and patient satisfaction. They selected

assessment tools for each domain noting explanations

and critique of these choices in their case presentation

and final written report. The list of evaluation measures

students proposed reflected a wider range of tools than

expected from a narrower scope of discussion. During

the presentation, other student colleagues shared their

own findings from the review of the literature from

different professions.

Facilitation of Inter-professional Case Conferences

and Team-working

During case development the students incorporated

perspectives from different disciplines by describing the

actions of several individuals in the case. One benefit

from working in small groups to create this case analysis

was the combining of perspectives and experiences to

describe a multitude of stakeholders in the case, as well

as the possibilities for inter-professional collaboration

within the care plan. Blending their knowledge and

experiences opened the door to identifying potential

shortcomings or strengths of treatment approaches

illustrated in the case. In the example case, students

applied their knowledge gains about inter-professional

approaches to health promotion and exemplified the need

for collaboration between professionals from diverse

fields to solve complex problems. Though this case

highlighted health care provided to a single person, the

students also realized health promotion efforts using

interprofessional approaches might show significant

benefits with broader impact.

Lessons Learned

Through this activity, student experiences can be

tied to the literature of teaching and learning.

Use case study design to promote inter-

professional interaction in a new way. For this project,

the object achieved was collaborative practice through a

mediating step of case design. We raised the level of

expectations by requiring that students work in small

groups to design a case for the primary goal of gaining

knowledge of other disciplines, communication skills,

and appreciation for interprofessional collaboration.

Reeves and colleagues suggested that scheduling time for

interaction was a responsibility of the IPE planner

(Reeves, Goldman & Oandasan, 2007). Consistent with a

constructivist approach to teaching and learning, student

interaction through informal exchanges was a significant

component of the learning process as they developed

real-world problem-solving skills (Dirkx, 2001; Mann,

2004). As a benefit of social learning, the planning for

this case-based activity aimed for the groups to achieve

more by working together than they could have in

individual efforts (Salomon & Perkins, 1998).

Prepare students to think critically. Two important

considerations for future application of this activity include:

(1) building a framework that promotes student exchange,

application, and refinement of knowledge; and (2) balancing

opportunities for student engagement within a set timeline

(Bhogal et al., 2011). In addition to cognitive benefits,

improved social dimensions of learning, such as

communication and interpersonal skills, were observed.

These skills may support collaborative discussions for

effective application of empirical evidence to cases (Koh,

Khoo, Wong, & Koh, 2008). A practical example of how

we applied this was in grading the final written report. We

sought evidence that students considered the peer-review

feedback as an indicator of their responsiveness to areas that

needed further elaboration and clarification in their revised

paper. This was a significant component of their grade.

Make the case for inter-professional

collaboration, challenges and opportunities. When

beginning this activity, we provided students with

general descriptions about inter-professional

collaboration and asked them to discuss the challenges

and opportunities they experienced when multiple

disciplines shared knowledge and perspectives to solve

problems. Several students commented on inhibitors,

such as those reported by Reeves and colleagues

(2007), from gaps in supervisor comfort with IPE to

organizational structures and external factors. The

processes of developing professional identity and

cultures could influence attitudes about IPE (Hall,

2005; Mitchell, Parker & Giles, 2011). Peer feedback

indicated that the case studies showed interprofessional

practice and education as a complex and valuable

strategy to improving health outcomes.

See problems through the eyes of another. As

students collaborated on case design, differences in

their professional preparation and perspectives

emerged. Preformed stereotypes about professional

identity could signal a need for consensus-building to

describe a case scenario that seems realistic to different

disciplines. Also, students discovered the development

of their scenario could quickly snowball, and they faced

the challenge of leaving out discipline-related teaching

points to keep the case scope manageable (WHO,

2010). A critical skill for PBL is defining the problem

and working with students of other disciplines, thus

Henry, Garner, Guernon, and Male Interprofessional Collaboration 567

requiring students to transfer their problem-solving

strategies in new ways (Hmelo-Silver, 2004).

We also learned that we needed specifically to

encourage students to do crosschecks on their

communication, such as jargon use and assumptions

about the meanings of conversations (Casimiro et al.,

2009). As noted by Pippa Hall in her paper on inter-

professional teamwork and professional culture, it is

important to ask, “[D]o you see what I see?” (2005, p.

190). Students commented positively about the process

of becoming open to forming a shared understanding of

issues and considering different strengths and

limitations of potential solutions. A benefit of the

knowledge translation process is the focus on seeing

gaps in care as others see them in order to identify

effective practice changes (Graham et al., 2006).

Question assumptions about how to measure

outcomes. While the students could easily agree on

goals to resolve their case problem, this instructional

activity required more attention to identifying and

justifying measurement tools than they anticipated.

Selection of measurement tools provided a meaningful

avenue for collaboration to devise a plan for assessment

and decision-making (Barr, 1998). Students needed to

infer the nature of the data required to develop multiple

solutions and evaluate the potential pros and cons based

on evidence. However, students may be more

comfortable when asked to apply deductive reasoning

in a guided experience to resolve an assigned case

problem. By accepting different disciplinary

perspectives from the start, students may take additional

steps to develop a flexible knowledge base and

effective problem-solving skills (Hmelo-Silvers, 2004).

Secondly, students needed to develop a process for

evaluating measurements found in the literature and

public domain to narrow down a list of appropriate

tools. Students received information about

measurement selection through lecture, course readings,

and discussion that they drew upon to select the health

measurements that fit their case studies. Student

development of skills with collaborative decision

making to measure outcomes can contribute to positive

health and system outcomes to meet the objectives of

IPE (IOM, 2015).

Third, students needed to develop their priority

measures and maintain a realistic measurement set to

apply in a real-world situation. Peer feedback and class

discussions helped students develop plans for

monitoring and evaluation. For the case example

illustrated here, students appreciated issues from a

system/administration level and then focused on

shortcomings in policy that may lead to improved

collaborative practice. These factors reinforced that

professionals should collaborate in the evaluation of

variables to measure outcomes for complex problems in

a practice setting.

Share perspective through constructive feedback.

Providing peer review represented a quandary for the

students. On one hand, students struggled with giving

classmates constructive comments. On the other hand,

students really wanted the feedback their peers provided.

Another option would be to use a blind process. As noted

in a study of a doctoral nursing program by Sethares and

Morris (2016), students typically lack experience with peer

review and struggle to give constructive comments.

However, students recognized that constructive criticism

and negotiating of opinion led to informed discussion and

important reflection given the complexities of

interprofessional practice (Kuziemsky & Varpio, 2011).

Discussion

The structure of this learning activity successfully

aligned with IPE guidelines from the WHO to allow

students from a variety of disciplines to learn with each

other to develop collaborative practices and improve

health outcomes (WHO, 2010). Students demonstrated

the intended learning outcomes as they collaborated on

describing, researching, evaluating, and making

recommendations to solve complex problems. They

exchanged information from their own disciplines

within their groups and presented information for

classmates’ peer review.

The framework of the assignment provided an

opportunity to “deliberatively work together” to improve

community and population health care systems (IPEC,

2016). Also, this student-designed case activity incorporated

students’ active engagement to enhance knowledge, skills,

and attitudes about interprofessional collaboration in a

manner that may support practice improvements (Bhogal et

al., 2011; Loyens et al., 2015). Efforts by the Canadian

Interprofessional Health Collaborative emphasizes

knowledge transfer as a key component of interprofessional

education and collaborative practice to improve health

systems (CIHC, 2009).

Combining students from different professions in

the student-designed case study process supported a

structured opportunity for socio-cultural learning,

which is considered key to interprofessional learning

(Freeth et al., 2002). Since students self-selected their

group members, they freely combined forces and

infused individual interest areas into the case without

instructor influence. There was no indication that the

combination of disciplines participating and potentially

benefitting from this learning activity is limited to

predetermined options. The tenets of expansive learning

may be applied to this learning activity, also. By

students needing to design and make recommendations

to solve a problem with awareness of the perspective of

other fields, they began questioning disciplinary

wisdom and could move from abstract to concrete

learning actions (Engeström & Sannino, 2010). These

Henry, Garner, Guernon, and Male Interprofessional Collaboration 568

processes may enable students to continue efforts to

meet IPE goals to cross-disciplinary boundaries and

build more effective networks.

As noted by Choi and Pak, the objective of

interdisciplinary approaches is to resolve real world or

complex problems using the different perspectives of

various disciplines (2006). The literature on “learning

transfer” highlights benefits from students working

through multiple cases and instructor cueing (Speicher,

Bell, Kehrhahn, & Casa, 2014). As students actively

engaged in critiquing other cases and responded to

instructor and peer feedback in the iterative process of

this IPE case study activity, they may have become

more proficient at problem solving. Another

consideration is the complex concept theory as

described by Szostak (2014). Our case study activity

encourages students to explore complex problems from

different perspectives. This process of analyzing

complex problems may be similar to breaking down

complex concepts into combinations of more basic

concepts (Szostak, 2014).

With this case study we aimed to provide

opportunities for students to develop real-world

problem-solving skills as described in the literature

(Dirkx, 2001; Mann, 2004). As we implemented

exchange-based learning through case study and

problem solving, these students learned about both

similarities and differences in others’ roles (Barr,

1996). Our findings are limited to short-term results and

limited application of this course assignment at NIU.

We encourage other instructors to consider the

challenge of leaving the case design up to the students

and support an interprofessional learning environment.

Implications

Through the development and analysis of a case

study, educators can apply a problem-based learning

approach with instructor guidance and peer feedback

that may be well received by the students. While the

assignment’s five-stage process allowed for progressive

building of skill levels, others could apply the premise

with shortened stages in another setting or with revised

student learning outcomes. The student-designed case

study promoted collaborative practice between students

through formal and informal interactions. As identified

by others, the constructivist framework lends itself to

IPE as an interactive and socialization process (Casmiro

et al., 2009; Olenick et al., 2010).

Key features to consider include the dialogue,

planning, and critique among classmates. First,

collaboration occurs in the small groups in order to

design a case and to allow inter-professional

perspectives to emerge. In addition, the collaboration

allows for the exploration of problems, measuring tools,

and solutions from different disciplinary views to

enhance the graduate students’ application of research

to practice. The practice of giving and receiving

feedback from other disciplines can add another

dimension to understanding the dynamics of inter-

professional collaboration. The learning process for this

activity could contribute to the development of real-

world problem-solving skills.

Conclusion

This student-designed case study activity allowed

students to develop collaborative competencies and to

practice application of research and theory to a complex

problem. Reflection on Barr’s model of competency-

based interprofessional education, the social-

participatory learning process, and the IPE literature

provided guidance for course planning. Such problem-

based learning activities may support students working

together and learning from each other to reach the next

area of potential development that extends beyond

disciplinary formation. Through interprofessional

collaboration, small groups of students from different

disciplines developed strategies for planning,

implementing, monitoring, and evaluating a health

program. Increasing student confidence with solving

complex problems through collaboration in case design

may enhance later skills with collaborative practice to

improve health outcomes.

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DR. BEVERLY W HENRY is the Associate Dean for

Academic Affairs, College of Health and Human

Sciences at Northern Illinois University. Dr. Henry’s

background includes clinical management of pediatric

nutrition programs and a doctoral degree in Higher

Education. Her research interests include person-

centered care, improving community health programs,

and assessment of teaching and learning for staff,

clients, and students. She mentored graduate students at

the masters’ level and now in the NIU doctoral program

in Health Sciences for which she currently teaches.

DR. CATHERINE GARNER serves as doctoral

faculty at Walden University. Previously, she served

as Executive Director for Nursing Practice and

Academics at the Greenville Health System, an

academic seven hospital system in northwest South

Carolina. Prior nursing experience includes senior

administration in ambulatory care, home care, and

managed care. Dr. Garner holds a Doctorate in

Public Health Policy and Administration from the

University of North Carolina-Chapel Hill, where she

was a HRSA Leadership Fellow. She is a Fellow in

the American Academy of Nursing and the Robert

Wood Johnson Executive Nurse Fellowship and

completed a Harvard-Macy Foundation fellowship in

Educational Innovation.

MS. ANN GUERNON is a Clinical Research

Coordinator/Manager at Marianjoy Rehabilitation

Hospital/Northwestern Medicine in Wheaton, Illinois

and the Hines VA Hospital in Hines, IL. She is an

adjunct instructor at Northern Illinois University in the

College of Health and Human Sciences where she is

pursuing her doctoral degree in health sciences. She

has a clinical background in speech language pathology

focused on adults with cognitive impairments following

neurological injury. Her research experience is related

to neurobehavioral measurement and treatment for

persons following traumatic brain injury. Ms. Guernon

has several peer reviewed publications in the area of

traumatic brain injury.

MR. BRANDON MALE is currently a full-time

member of the Kinesiology and Physical Education

Faculty at Northern Illinois University where he

delivers instruction in Applied Exercise Physiology,

High Performance Resistance Training, and Sports

Performance Development. Additionally, he is in

pursuit of his doctoral degree in health sciences at

Northern Illinois University. As a researcher, his

primary areas of interest include: Stress response and

alterations to fine motor control, sports nutrition,

biomechanical concepts of elite level human

performance, and physiological adaptations to high

force/velocity muscular performance.

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