Enablers and barriers to interprofessional education and collaborative practice in rural healthcare settings: a mixed methods systematic review

Enablers and barriers to interprofessional education and collaborative practice in rural healthcare settings: a mixed methods systematic review

Background Interprofessional Education and Collaborative Practice (IPECP) occurs when multiple healthcare workers from varying professional backgrounds work with each other, and consumers to deliver more appropriate healthcare. Adherence to interprofessional care can enhance positive health outcomes compared to non-collaborative alternatives. The COVID-19 pandemic caused great pressures on health service delivery, especially in resource-constrained rural areas, thereby pushing practices back towards siloed care. Objectives This systematic review synthesised the current literature on the experiences and perspectives of healthcare workers and students in developing, implementing, and evaluating IPECP initiatives in rural healthcare settings. Reported enablers and barriers that facilitate or hinder healthcare worker participation in IPECP in rural healthcare settings were identified. Methods This systematic review followed the JBI methodological guidance and will be reported following the PRISMA guidelines. Databases searched included PubMed, Scopus, Embase, and Web Of Science for relevant articles published in the last 10 years. Grey literature sources such as Google and ProQuest Dissertations and Theses Global were searched. Results Forty three articles met inclusion criteria and were included in the review. Extracted data were synthesised using a narrative synthesis approach. Findings indicated that enablers of IPECP in rural healthcare settings consisted of 1) student factors 2) supervisor/ clinician factors and 3) community factors. Students that had a rural interest or background, were in their senior years of study, and from professions other than medicine made most of the IPECP opportunity. Supervisors that were inclusive and modelled collaborative practice were enablers of IPECP. Communities that were close-knit, where members participated in student learning through role play scenarios and took students on placement ‘under their wings’ enabled IPECP. Barriers to IPECP mirrored barriers well-known in resource-constrained settings, namely funding constraints that impacted sustainability of initiatives, lack of trained IPECP facilitators that were stable in their roles, and IPECP opportunities lacking structure and clarity. These barriers also impacted evaluation and research of IPECP initiatives in rural areas. Conclusions Our findings on factors that enable or hinder IPECP in rural healthcare settings can inform policy and practice to revitalise IPECP initiatives in rural healthcare settings to benefit students, staff and patients.

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