Collaborative Practice Reflective Essay. Using the Gibbs mode to analyse my TOSPE sessions.

by liliankamotoyahoocouk (student)

University Degree Subjects allied to Medicine

The Gibbs model of reflection (1988) has been used to reflect on my performance in the first formative and summative Team Observed Structured Professional Encounters (TOSPE) sessions. All discussions within the team were to reflect good inter-professional collaboration, conflict management and resolution skills, good communication skills, interproffessional roles and responsibilities and good team functioning with awareness of human factors

I engaged in (TOSPE) sessions with other students from other professions and my group comprised of four adult student nurses and two physiotherapy student nurses. During the TOSPE we were each required to use knowledge from our respective professional background to contribute towards the development of a care plan for the given client.

During the formative TOSPE, I felt that we were all nice to each other and we set team objectives, values and also defined and agreed to each other’s roles. However, as the TOSPE went on, I became nervous as there was no effective communication within the team. Some members were talking over others something that undermines respect for each other’s’ opinions and views. This led to poor time management and potential poor patient outcomes as we were not able to exhaust every one’s contribution towards the patient’s care plan in the given time. The Canadian Interprofessional Health collaborative (CIHC) (2010) states that a team cannot function well if they lack competencies like interprofessional communication, role clarification, collaborative leadership and interprofessional team functioning. However, we realised this at the end of the formative TOSPE, because we questioned each other’s values as people and student professionals and also gave each other constructive feedback. This made me feel more relaxed and outspoken about my professional values but most importantly it gave me an insight into other members' professional values and the need to respect them. This was very beneficial for the summative TOSPE because I felt that we listened to each other better, had mutual respect for each other and our communication improved greatly.

I also felt that we were able to achieve effective collaboration in the summative TOSPE because all team members were able to apply the attributes of an effective health care. Reeves etal, (2010) states that using good communication skills, understanding the values, knowledge and skills of team members, maintaining professional relationships and setting and agreeing to ground rules is the key to effective team functioning. This is supported by Thistlethwalte (2012) by stressing that effective collaboration can only be achieved if there is effective interprofessional communication.

The TOSPE Scenarios have been a great learning experience and grounding background towards my development of safe and effective collaborative practice which is an essential factor for effective team working in health and social care. Thiestlethwalte (2012) describes collaborative practice as a situation when different healthcare workers from various professional backgrounds work together to achieve the highest quality of care. The World Health Organisation (WHO) (2010) considers interprofessional collaboration a priority for health care service delivery.

It is bad that we lacked structure in our formative TOSPE but it was good that we gave each other feedback at the ...

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It is bad that we lacked structure in our formative TOSPE but it was good that we gave each other feedback at the end because I was able to reflect on my practice and my professional values as a nursing student. Arnold & Boggs (2011) stress that a nurse should always use effective communication and interpersonal skills to build good working relationships with other members of the MDT, patients, carers and their families. Having such knowledge allowed me to listen and respect other team members' opinions, give feedback in a sensitive and constructive manner in order to resolve team differences. I was also able to ensure that other team members were aware of my role by giving accurate evidence based information, communicating fairly and inclusively while acknowledging and taking into account other members views and opinions.

Day (2013) states that conflict can be a productive aspect in team functioning if differences are openly discussed and there are ground rules in place to ensure respect for everyone’s opinions and views. Essen, Freshwater & Cahill (2015) support this and explain that conflict can arise if there is a lack of trust among team members. This is usually due to a lack of understanding of other member’s professional role and competency. Furthermore, Hewitt, Sims & Harris (2014) stress that if in doubt, it is important that team members ask for clarity and should ensure that all members are committed towards achieving a common goal once the conflict is resolved. During the summative TOSPE, the team was able to achieve effective team work and collaboration because we resolved our professional differences, set goals to be achieved where each team member was given a specific role. This gave me and others a better understanding of each other’s roles and responsibilities and hence allowed the team to improve on our working relationships by communicating effectively and recognising personal roles and responsibilities. As a result, we were able to work effectively as a team to meet our objectives of coming up with a good care plan for the patient in the given time.

Giving and receiving feedback allowed me to reflect on how well I was working within the team, record and implement any agreed changes and also resolve any issues. London (2014) suggests that feedback given in a sensitive manner allows individuals to focus on the task at hand. Lewin & Reeves (2011) assert that it is very crucial for health care professionals to have an understanding of working with diversity and its challenges and developing capabilities to work effectively to resolve them. Challenges can arise when team members don’t realise the impact of prejudices and biases that could stem from stereotyping other professionals (Thistlethwalte, 2012). Individuals are different for instance their culture, gender, race, age, ethnicity, sexuality, religion or different cognitive and physical capabilities. Thistlethwalte, (2012) explains that stereotypes develop from having pre conceived ideas and expectations of other professional members which may be based on un-confirmed stories from the media or friends.

By giving and receiving feedback we were able to overcome such challenges as a team by avoiding and resolving any misconceptions about each other. Each team member was given the opportunity to discuss their own professional values as well as knowledge and skills they would bring to the team. This allowed me to evaluate my own contribution, accept constructive criticism, recognise the contribution of each team member, identify and encourage good team practice while respecting other's opinions and views. Other team members also appreciated and acted on their own feedback thus creating an environment where every one’s views and opinions were taken into account. As such we had minimal disagreements and hence a safe and effective team by the summative TOSPE. This gave us an opportunity to ensure that the expertise and experience of each team member was used to the full benefit when drawing up the client’s care plan.

All in all, despite the team’s failure to function well in the formative TOSPE, we were able to achieve a safe and effective team by the summative TOSPE. Effective collaborative practice has been highlighted by the WHO (2010) as an essential approach to improving patient care, minimising and eliminating errors and improving safety in health care service delivery. As a student nurse, I will always strive towards building good interproffessional working relationships. Reaves etal (2013) agrees with this and stresses that good interprofessional collaboration requires all members to share similar values, skills and resources to allow them solve patient problems quicker and deliver high quality person centred health care services.

WHO (2010) recognises that successful interproffessional collaborative practice can be hard to achieve but when it is achieved, it can result in efficient teams where members maximise the value of shared expertise. This in return results in better clinical practice where health care services are delivered quicker and efficiently and patient satisfaction enhanced. Therefore, if I was to work within a team of other student professionals again, I would always strive to ensure that we achieve a safe and effective team by doing the following below;

Use effective communication skills when dealing with other professionals, where I am patient when listening and keep an open body posture.
Understand and respect the skills, values and knowledge of each team member.
Maintain professional relationships where I recognise and respect other members’ contributions.
Use evidence based knowledge to contribute and recognise other members' contributions towards the planning and achieving of a good quality care plan.
Review team effectiveness by giving feedback and accepting constructive criticisms.
Understand diversity, its challenges and how to overcome them.

It is essential that I acquire all the required support and knowledge to achieve an effective interprofessional team. Dowson etal, (2007) note that health professionals who work in inefficient teams report high levels of stress and burn out due to lack of job satisfaction. This can result in a greater likelihood of causing patient safety issues and contradict the Nursing and Midwifery Council (NMC) (2015) code that requires nurses to always safeguard the well-being of their patients.

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