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Balancing health care education and patient care in the UK workplace: a realist synthesis

Sholl, Sarah, Ajjawi, Rola, Allbutt, Helen, Butler, Jane, Jindal-Snape, Divya, Morrison, Jill and Rees, Charlotte 2017, Balancing health care education and patient care in the UK workplace: a realist synthesis, Medical education, vol. 51, no. 8, pp. 787-801, doi: 10.1111/medu.13290.

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Title Balancing health care education and patient care in the UK workplace: a realist synthesis
Author(s) Sholl, Sarah
Ajjawi, RolaORCID iD for Ajjawi, Rola orcid.org/0000-0003-0651-3870
Allbutt, Helen
Butler, Jane
Jindal-Snape, Divya
Morrison, Jill
Rees, Charlotte
Journal name Medical education
Volume number 51
Issue number 8
Start page 787
End page 801
Total pages 15
Publisher Wiley
Place of publication London, Eng.
Publication date 2017-08
ISSN 1365-2923
Summary Context
Patient care activity has recently increased without a proportionate rise in workforce numbers, impacting negatively on health care workplace learning. Health care professionals are prepared in part by spending time in clinical practice, and for medical staff this constitutes a contribution to service. Although stakeholders have identified the balance between health care professional education and patient care as a key priority for medical education research, there have been very few reviews to date on this important topic.

Methods
We conducted a realist synthesis of the UK literature from 1998 to answer two research questions. (1) What are the key workplace interventions designed to help achieve a balance between health care professional education and patient care delivery? (2) In what ways do interventions enable or inhibit this balance within the health care workplace, for whom and in what contexts? We followed Pawson's five stages of realist review: clarifying scope, searching for evidence, assessment of quality, data extraction and data synthesis.

Results

The most common interventions identified for balancing health care professional education and patient care delivery were ward round teaching, protected learning time and continuous professional development. The most common positive outcomes were simultaneous improvements in learning and patient care or improved learning or improved patient care. The most common contexts in which interventions were effective were primary care, postgraduate trainee, nurse and allied health professional contexts. By far the most common mechanisms through which interventions worked were organisational funding, workload management and support.

Conclusion

Our novel findings extend existing literature in this emerging area of health care education research. We provide recommendations for the development of educational policy and practice at the individual, interpersonal and organisational levels and call for more research using realist approaches to evaluate the increasing range of complex interventions to help balance health care professional education and patient care delivery.
Language eng
DOI 10.1111/medu.13290
Field of Research 13 Education
11 Medical And Health Sciences
17 Psychology And Cognitive Sciences
Copyright notice ©2017, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution non-commercial licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30096197

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.