Volume 3 (2016): Issue 1 (June 2016)

There are some significant differences between the health systems in German speaking Europe and Sweden: In Sweden, the number of hospitals is small, caregiving services in the hospital and ambulatory sector are integrated, health professionals with university degrees are granted extended competencies and rights incl. first line consultation and limited prescription. Education is designed to prepare for these functions and responsibilities. It started more than 30 years ago when Linköping implemented the OECD-model of Health Universities. Interprofessional teaching, common learning of the various tracks and training on real patients are constitutive elements of this novel approach. Karolinska University in Stockholm adopted the model in 1998 and gave way to a nationwide reform. A recommendation of the German Science Council regarding training of health professionals, published 2012, drew the attention of educators to this approach. The paper explains the circumstances of the consolidation of this concept. It is important to realize that overarching governance principles and measures deriving from health and education policy are of crucial importance. They evolve from evaluations of needs carried out by the regional health agencies which lead to conditional mandates and financial incentives to the education sector. Moreover, decisions taken by the national board for accreditation and quality assurance take also in account the goals set and the outcomes in education and caregiving. Outside Sweden they would be considered an inappropriate limitation of academic freedom.The paper ends with a reflection of impressions collected during a study trip and shows some lessons to be learnt from the Swedish education and practice.

The University Osnabrück and the University of Applied Sciences Osnabrück and regional partners recently signed a Memorandum of Understanding to establish a Healthcare Campus. The aim of the Healthcare Campus is to develop innovative concepts for delivering patient care in the Osnabrück region. It brings together academia, networks, enterprises, healthcare providers and local authorities. Financed by the State of Lower Saxony, the project „The Learning Healthcare System in the Region Osnabrück Emsland (ROSE)” is a central activity within the Healthcare Campus. This project makes use of the learning paradigm. Providing feedback is the driving mechanism to achieve progress. Research provides the feedback to the healthcare providers and local authorities, in order to optimise the current practice in urban and rural areas of the region. The feedback mechanism is based on data from practice, which play the central role in turning evidence-based-practice into practice-based-evidence and putting translation at the start, not at the end of the project. Both universities coordinate their activities within the ROSE project to attain the goals of the Healthcare Campus Osnabrück. The model with five measures for the implementation is presented. It builds upon the wealth of existing bachelor and masters programs in healthcare and unites research, PhD programs and translation of scientific results into practice.

The academization of health professions is a complex process, whose progress is denoted by the parallelism of different processes. These include for example the setup of scientific disciplines as well as the development of higher education concepts. Meanwhile, entering interprofessional teaching and work processes is demanded. This requirement is a chance and often a concern of specialist development. In this article, interprofessionalism is defined as a social construct and distinct object of research that is a crucial requirement for the academisation of health professions. The engagement with other professions and disciplines as outlined with exemplary processes is relevant for the development of specialist profiles and should be supported.

Studies indicate positive effects of interprofessional collaboration on the quality of health care. Interprofessional academic education of health care professionals is crucial for successful cooperation, although Terizakis & Gehring (2014, p. 24) state «a genuine understanding of interprofessional teaching […] hasn't developed yet.» The undefined usage of terminology and coexisting interprofessional study programs are only one part of the problem. Further consented interprofessional learning concepts and systematic knowledge regarding competencies and teaching experiences are lacking. The WHO (2010, pp. 27 f) recommends lecturers to generate a common understanding of interprofessionality. At Hamburg University of Applied Sciences a part-time study program in interprofessional health care and management started in September 2015. It was designed as a continuing education program for occupational-, physio-, and speech therapists, nurses and midwives. As a preparation for the program focus group discussions with staff members of the department „Pfege & Management» were conducted. The aim was to investigate their understanding of interprofessionality, learning and teaching. The results indicated a contextual understanding of interprofessionality, although the usage of the terminology remains blurred. The tension of a congruent interprofessional learning concept is to enhance scientific reflection of disciplines, as well as strengthening interprofessional aspects. Regarding the change in demands of the health care system, interprofessional collaboration is seen as a major resource. The research gap on disciplinary orientations in terms of enhancing professional identity on the one and interprofessionality as innovative construct on the other hand has to be filled.

After five years of experience in interprofessional education (IPE) in the Bachelor programs occupational therapy, midwifery, nursing, speech therapy, and physiotherapy at the University of Applied Sciences in Bochum (Germany), we have systematically evaluated and substantially revised our IPE concept in 2014/15. The structural and curricular embedding of IPE throughout the course of the five Bachelor programs requires the development and ongoing evolution of a binding concept for the interprofessional competence development. This concept needs to be based on a systematic reflection of current practice and sound scientific knowledge concerning interprofessional topics. Furthermore, it needs to address the promotion of competencies to act inter- and transprofessionally to enable a high quality of care (Wissenschaftsrat, 2012; Walkenhorst, 2012). Results of narrative literature reviews, structured internal discussions, interviews of experts and various internal and external evaluations have been incorporated into a new conceptual framework for IPE. It has been shown that a revision of the structure, the temporal sequences of modules and the framework to facilitate interprofessional practice are essential steps for continuous development of interprofessional education. In addition, barriers and challenges are identified and discussed. Overall, the process of development has been coordinated and accompanied continuously and successfully by an IPE committee involving different groups of representative members from the Department of Applied Health Sciences.

The health care sector is facing many aspects of transformation. One aspect amongst others herein is an alteration of qualification profiles. Universities have to focus on both aspects determining future qualification profiles and increasing permeability between educational systems in a sense of optimally intermeshing competences that have been acquired at universities and those that have been acquired outside of them. This leads to the question how to create university certificate programs that offers two aspects: academic qualification on the one hand and on the other hand a possibility to identify, evaluate and certify non-formally and informally acquired competences of participating students. The ultimate goal is to identify and evaluate a person´s overall competence in a clearly defined thematic context, whereat competences that have been acquired outside universities will play an important role. Competences that have been certified by these academic programs may be used later for crediting purposes. In this report an initial prototype is being presented. It defines itself mainly as additional novel way of discussing crediting concepts.

With the academization of practical health professions universities as well as universities of applied sciences are facing the challenge to qualify nurses and therapists for a field of profession which is not defined yet. Science has to answer the questions about the exact contents and the boundary of academic health professions to other professions, which are established in fields of activities within patient care for a long time. Furthermore, science has to show prospective developments. At this point the need of labour research in academic, practical professions of health care arises.

The concept of this contribution combines the further qualification with labour research in the professional field and aims to design modules of further education, which combine systematically the practical field of work with the contents of the module. The base is a didactical approach of a relation between theoretical and practical parts, known from dual study programs. A reflective oriented case study is the central instrument of the further education in every module. The participants have to use the theoretical contents of the module to reflect their practical field of work with a professional perspective. In doing so the participants become researcher in their own practice and at the same time the further education is used for a scientific reflection of their field of work which generates inputs for the development of the practice.