The benefits of interprofessional learning and teamwork in primary care ambulatory training settings

Background: New skills for assembling, working effectively in, and leading teams are needed to prepare the next generation of health professionals who work in outpatient settings. Purpose: To report on a qualitative analysis conducted with 27 residency primary care training programs that included multiple health professional learners. Methods: Twenty-seven focus groups were conducted with family medicine, general internal medicine and general pediatrics faculty, clinic staff, and diverse groups of learners to identify benefits of learning together in ambulatory primary care practices. Independent and consensus open and axial coding techniques applied to focus group field notes with consensus meetings identified emergent themes. Discussion: Four themes were beneficial: Development of Personal Relationships, Improved Education, Improved Patient Care and Improved Job Satisfaction. Enablers to realizing benefits involved leadership support, co-location of learners and having adequate space for team huddles, which allowed health professionals to collaborate and learn together. Barriers to achieving benefits included top-down leadership approaches, poor communication, and lack of knowledge of roles and professions. Inadequate staffing, space constraints, scheduling challenges and clinic productivity pressures made interprofessional learning difficult. Conclusions: Clinic culture, structures and operations both enable or create barriers to interprofessional learning.