Making the Key Elements of Palliative Care Practice Visible to Inform for the Development of Interprofessional Scenario-Based Simulations in Undergraduate Health Professions Education

Abstract

Current undergraduate skills lab programmes in health professions education demonstrate an absence of interprofessional training, particularly with regard to comprehensive patient care and collaboration between primary and specialist care. The ACTIVATE project addresses this issue by developing interprofessional simulation scenarios for home and palliative care. The project aims to provide students with the opportunity to engage socially and intellectually with students from other profession. It should enable them to experiment with challenges that require the application of general knowledge and social and communication skills in a safe environment. Post-event debriefings should focus less on instrumental, direct solutions and more on “problematizing” and “sensemaking”, unlike traditional skills training debriefings. Cultural-Historical Activity Theory (CHAT) was used as a lens to identify data of interest for the design of simulation-based scenarios and for debriefing conversations. The six elements of an activity system—“Subject”, “Object”, “Community”, “Tools”, “Rules” and “Division of labour”—were used as overarching codes to identify and label critical incident reports of palliative care cases, as well as academic papers that used qualitative research methods to describe interprofessional collaboration in palliative care. Qualitative data analysis using a combination of deductive and inductive coding revealed 172 codes representing the elements of an activity system. The coding scheme’s structure and the collection of related, authentic data emphasised aspects of interprofessional collaboration that could be incorporated into palliative care simulations and discussed during subsequent debriefing sessions. In the ACTIVATE project, the codes and their associated texts were useful for communicating with the team responsible for developing interprofessional skills training. Such training provides an overview of complex, collaborative and dynamic systems, establishing a foundation for crossing professional boundaries.