Luminary Learning Gastrointestinal Disorder- Issue 1

60  • LUMINARY LEARNING: GASTROINTESTINAL DISORDERS interprofessional collaboration and learning (Hammick, Olckers, and Campion-Smith, 2009) and safe patient care. Communication breakdowns involve verbal, non-verbal, and written commu- nication during patient handoffs, communication with patients, and failures to speak up with concerns (Sutcliffe, Lewton, and Rosenthal, 2004). Interprofessional education (IPE), enacted “when members (or students) of two or more health and/or social care professions engage in interactive learning activities to improve collabo- ration and/or the delivery of care” (p. xiv) (Reeves, Lewin, Espin, and Zwarenstein, 2010), is one potential antidote to collective incompetence. But it is, at best, a partial solution. IPE, continuing education, and workplace learning intersect (Kitto, Goldman, Schmitt, and Olson, 2014) as do quality improvement, patient safety, and continuing education (Kitto et al., 2015). In contrast to uni-professional, off-the-job education, work is the primary medium for learning interprofes- sional collaboration and communication. The next section explores how physicians and other healthcare professionals can enhance their clinical practice by the way they work, talk, and learn together around the central task of giving patients high quality care. Section III: AligningWorkplace Learning, CPD, and Improved Care Quality We now envision a world in which workplace learning plays a central role in certified CPD, and enhances practice through quality improvement. We focus on three examples of fundamental structural changes, which support collective team learning and enhance communicative practice. Each example exemplifies Teunissen’s (2015) ETR framework by representing concrete experi- ences and trajectories of activities, shared between individuals and groups over time. Each struc- tural change focuses on a mechanism for steering the talk of practice through reifications, which promote collective learning and are inextricably linked to patient care. In each instance, learning also benefited patients. These examples include: (a) interdisciplinary and family-centred rounds (b) patient handoffs in a children’s hospital, and (c) use of checklists in surgery and for central venous catheter insertion. Improving Patient Care Through Enhanced Interdisciplinary Collaboration onWard Rounds When patients are admitted to hospital, a team of physicians, nurses, and other allied health pro- fessionals cares for them. Each day, physicians review patients’ status and responses to treatment, and modify care plans during what is known as a ‘ward round’. It is in this setting that medical learners give oral presentations about their patients in order to inform the team about patients’ status and contribute to plan care. Given the sheer number of providers involved, there is great potential for miscommunication. Indeed, doctors and nurses may not communicate clearly with each other or even agree about the care plan (O’Leary, Thompson, et al., 2010). In response to these findings, O’Leary and colleagues re-engineered ward rounds into structured interdiscipli- nary rounds (SIDR) on both units with medical trainees (O’Leary et al., 2010) and those units