Interprofessional collaboration on an internal medicine ward: role perceptions and expectations among nurses and residents

PLoS One. 2013;8(2):e57570. doi: 10.1371/journal.pone.0057570. Epub 2013 Feb 28.

Abstract

Background: Effective interprofessional collaboration requires that team members share common perceptions and expectations of each other's roles.

Objective: Describe and compare residents' and nurses' perceptions and expectations of their own and each other's professional roles in the context of an Internal Medicine ward.

Methods: A convenience sample of 14 residents and 14 nurses volunteers from the General Internal Medicine Division at the University Hospitals of Geneva, Switzerland, were interviewed to explore their perceptions and expectations of residents' and nurses' professional roles, for their own and the other profession. Interviews were analysed using thematic content analysis. The same respondents also filled a questionnaire asking their own intended actions and the expected actions from the other professional in response to 11 clinical scenarios.

Results: Three main themes emerged from the interviews: patient management, clinical reasoning and decision-making processes, and roles in the team. Nurses and residents shared general perceptions about patient management. However, there was a lack of shared perceptions and expectations regarding nurses' autonomy in patient management, nurses' participation in the decision-making process, professional interdependence, and residents' implication in teamwork. Results from the clinical scenarios showed that nurses' intended actions differed from residents' expectations mainly regarding autonomy in patient management. Correlation between residents' expectations and nurses' intended actions was 0.56 (p=0.08), while correlation between nurses' expectations and residents' intended actions was 0.80 (p<0.001).

Conclusions: There are discordant perceptions and unmet expectations among nurses and residents about each other's roles, including several aspects related to the decision-making process. Interprofessional education should foster a shared vision of each other's roles and clarify the boundaries of autonomy of each profession.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cooperative Behavior*
  • Hospital Units*
  • Humans
  • Internship and Residency*
  • Interprofessional Relations*
  • Medical Staff, Hospital*
  • Nursing Staff, Hospital*
  • Professional Role*

Grants and funding

The study was funded by the “Fondation Ernst et Lucie Schmidheiny” (ME 8676) and the “Projet de Recherche et de Développement, Direction médicale, Hôpitaux Universitaires de Genève” (PRD 2010-II-5). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.