Towards Continuing Interprofessional Education: Interaction patterns of health professionals in a resource-limited setting

There are challenges related to collaboration among health professionals in resource-limited settings. Continuing Interprofessional Education initiatives grounded on workplace dynamics, structure and the prevailing attitudes and biases of targeted health professionals may be a vehicle to develop collaboration among health professionals. Workplace dynamics are revealed as health professionals interact. We argue that insights into the interaction patterns of health professionals in the workplace could provide guidance for improving the design and value of CIPE initiative. The study was conducted through rapid ethnography and data were collected from non-participant observations. The data were transcribed and analysed through an inductive iterative process. Appropriate ethical principles were applied throughout the study. Three themes emerged namely “Formed professional identities influencing interprofessional interaction”, “Diversity in communication networks and approaches” and “Professional practice and care in resource limited contexts”. This study revealed poor interaction patterns among health professionals within the workplace. These poor interaction patterns were catalyzed by the pervasive professional hierarchy, the protracted health professional shortages, limited understanding of professional roles and the lack of a common language of communication among the health professionals. Several recommendations were made regarding the design and development of Continuing Interprofessional Education initiatives for resource-limited settings.


Introduction
Problem formulation -Description and significance of the problem/phenomenon studied; review of relevant theory and empirical work; problem statement Purpose or research question -Purpose of the study and specific objectives or questions

Methods
Qualitative approach and research paradigm -Qualitative approach (e.g., ethnography, grounded theory, case study, phenomenology, narrative research) and guiding theory if appropriate; identifying the research paradigm (e.g., postpositivist, constructivist/ interpretivist) is also recommended; rationale** Researcher characteristics and reflexivity -Researchers' characteristics that may influence the research, including personal attributes, qualifications/experience, relationship with participants, assumptions, and/or presuppositions; potential or actual interaction between researchers' characteristics and the research questions, approach, methods, results, and/or transferability Context -Setting/site and salient contextual factors; rationale** Sampling strategy -How and why research participants, documents, or events were selected; criteria for deciding when no further sampling was necessary (e.g., sampling saturation); rationale** Ethical issues pertaining to human subjects -Documentation of approval by an appropriate ethics review board and participant consent, or explanation for lack thereof; other confidentiality and data security issues Data collection methods -Types of data collected; details of data collection procedures including (as appropriate) start and stop dates of data collection and analysis, iterative process, triangulation of sources/methods, and modification of procedures in response to evolving study findings; rationale** Data collection instruments and technologies -Description of instruments (e.g., interview guides, questionnaires) and devices (e.g., audio recorders) used for data collection; if/how the instrument(s) changed over the course of the study Units of study -Number and relevant characteristics of participants, documents, or events included in the study; level of participation (could be reported in results) Data processing -Methods for processing data prior to and during analysis, including transcription, data entry, data management and security, verification of data integrity, data coding, and anonymization/de-identification of excerpts Data analysis -Process by which inferences, themes, etc., were identified and developed, including the researchers involved in data analysis; usually references a specific paradigm or approach; rationale** Techniques to enhance trustworthiness -Techniques to enhance trustworthiness and credibility of data analysis (e.g., member checking, audit trail, triangulation); rationale**

Results/findings
Synthesis and interpretation -Main findings (e.g., interpretations, inferences, and themes); might include development of a theory or model, or integration with prior research or theory Links to empirical data -Evidence (e.g., quotes, field notes, text excerpts, photographs) to substantiate analytic findings

Discussion
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Other
Conflicts of interest -Potential sources of influence or perceived influence on study conduct and conclusions; how these were managed Funding -Sources of funding and other support; role of funders in data collection, interpretation, and reporting *The authors created the SRQR by searching the literature to identify guidelines, reporting standards, and critical appraisal criteria for qualitative research; reviewing the reference lists of retrieved sources; and contacting experts to gain feedback. The SRQR aims to improve the transparency of all aspects of qualitative research by providing clear standards for reporting qualitative research. **The rationale should briefly discuss the justification for choosing that theory, approach, method, or technique rather than other options available, the assumptions and limitations implicit in those choices, and how those choices influence study conclusions and transferability. As appropriate, the rationale for several items might be discussed together.