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Getting outside the box: exploring role fluidity in interprofessional student groups through the lens of activity theory

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Abstract

Health professionals’ roles and scopes often overlap, creating a need for role clarity in interprofessional teamwork. Yet, such clarity does not mean roles are fixed within teams and some literature suggests role flexibility can enhance team functioning. Interprofessional practice competencies and learning activities often emphasize knowledge and definition of roles, but rarely attend to the dynamic nature of roles and influential contextual factors. This study explores role fluidity in interprofessional student groups using an activity theory framework. Using a collective instrumental case study approach, the authors examine the fluidity of one physical therapy (PT) student’s role within 3 different interprofessional (medical, pharmacy, PT) student groups completing nursing home patient care plans. Field notes, group debriefing interviews, and care plans were collected and coded from all care planning sessions. Codes mapped to group-specific activity systems that compared role-influencing interactions and tensions. The PT student’s role fluidity varied in each group’s activity system, influenced primarily by system tensions from implicit rules (e.g., encouraging questions), division of labor (e.g., rigid profession-based task assignment), and tool use (e.g., computers). Attention to modifiable system elements, such as tool use and explicit rules of inclusivity, could foster role fluidity and improve interprofessional teamwork and learning environments.

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Acknowledgements

We thank Dr. Judith Bowen for her expert critique and review of this manuscript. We also thank Rachel Campbell, PharmD and Jessica Larson, DPT for their assistance in student care plans review as well as their support as student preceptors.

Funding

This project was funded in part by a 2016 AAMC Western Group on Educational Affairs Mini-Grant.

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Correspondence to Laura K. Byerly.

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The authors report no conflict of interest. The authors alone are responsible for the content and writing of this article.

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Byerly, L.K., Floren, L.C., Yukawa, M. et al. Getting outside the box: exploring role fluidity in interprofessional student groups through the lens of activity theory. Adv in Health Sci Educ 26, 253–275 (2021). https://doi.org/10.1007/s10459-020-09983-w

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  • DOI: https://doi.org/10.1007/s10459-020-09983-w

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