Introduction Healthcare service delivery is revolutionising from the


Healthcare service
delivery is revolutionising from the medical model of treatment to a biopsychosocial
interprofessional client centred approach (MacArthur et al., 2016) (Fisher et
al., 2017) (Sweet et al., 2017). Globally, we are moving into an era of an
aging society, where the increase of chronic disease and illness is on the rise.
Therefore the presence of an interprofessional team to counter these effects
will be beneficial moving forward.

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“Interprofessional education occurs when students from two or more
professions learn about, from and with each other to enable effective collaboration
and improve health outcomes” (World Health Organisation, 2010). From my experience
in practice education, health service delivery is adapting to this change.
Offices are laid out in the NHS were multiple health professionals work within
the same room, encouraging interprofessional collaboration. Interprofessional healthcare
systems work collaboratively to increase patient safety, reduce healthcare
costs and result in efficient patient care (Fisher et al., 2017) (Dunlap &
Dunlap, 2017) (Hardin et al., 2017).

My learning has been in line with literature where
reflective writing has allowed me develop knowledge and skills, link theory and
practice and allows continuation of learning through professional practice as a
result working competently and safely in practice (Moon 1999). This will be
evidenced in this essay as I use the Rolfe et al., Reflective framework (2001)
on my experience of interprofessional group working. The basis of the framework
is on “What, So What and Now What” which Rolfe et al., (2001) developed from
Borton (1970). Borton, a school teacher in America, developed the idea on
experimentation with students. From there, Rolfe et al., (2001) critised
Bortons model as being a simplified format for reflection that can be used from
novice to advanced professionals. Rolfe et al., (2001) critically analysed this
framework as he found that it would be more beneficial to steer reflection
through apply questions to use in each sections to further breakdown

I will use this framework to reflect on communication
and role acknowledgement as working as part of an interprofessional team. I
selected these two areas to reflect on these had the most positive outcomes for
me. Communication and role acknowledgement are among the most important factors
for successful interprofessional work (Bzowsyckyj, 2017) (Nancarrow et al.,
2013). This supports my reasoning for reflection.  Following this I will develop a plan to
positively impact my future going forward in health and social care
professional practice. 

Rolfe et al., Framework (2001)

framework is broken down into three components; what, so what and now what.
“What” is the descriptive component. It looks at the “what” questions involved
in the reflective experience. This component forms a basis to format the
process of reflection. Rolfe et al., (2001) suggested to further format the
“what” component by posing questions such as: positives and negatives of the
experience, feelings, individual role, action, action response and achievement
in actions. The second component is the “so what”. This builds from the
descriptive format of the first stage a level of reflection based on theory and
knowledge. “So what” questions include: so what does this tell me, teach me,
implicate,  is my thought process upon
action, did I base my actions on, other knowledge can I bring, should I have done
to make it better, is my new understanding and are broader issues. The final reflexive
phase is “now what”. It is action orientated based on the description and
deeper reflection of the experience. Now what questions could include; now what
do I do in the future to make things better, stop being stuck, resolve
difficult situations, feel better consideration of future issues and looking at
the consequences of these actions should I put these considerations into
action. Rolfe et al., (2001) depicts this model as being a cyclical process where
“now what” reflects back into “what” and begins the process of reflection
again. This shows that reflection is continual at all stages. The Rolfe et al.,
Framework (2001) is not individualistic therefore a review of these questions
may be necessary to steer specific direction of health professionals that may
use the framework for the future.



the day of presentation group allocations, our group discussed our preferred
method of communication. I felt discussion was essential ensuring engagement
outside of group meetings. We decided to use facebook. It allowed an effective
and accessible forum for communication. I felt ease in consulting the group when
working on individual sections of the presentation. I could discuss informally
and get clarity in discussions through our facebook group within a short space
of time. It allowed me to express what I thought about different topics brought
up by others in the group and also actively listen others in response to my
questions. I was engaged and felt I had a role in engaging participation of
others through active communication. It also allowed me to familiarise with the
group members outside of a professional context which I feel supported the work
we carried out in between.

So what?

This has taught me that it is important to create a
means of communication with others, not only written but verbal where I can
actively engage and listen to others. It taught me that clarity of writing when
communicating is key to ensure that others are aware that you are listening but
also that you are making your point clear. It taught me that various forms of
communication are applicable in various settings. It made me think of how I may
be entering into practice in the future using other forms of communication that
I may not be familiar with. As a student, encouraging this may be more
applicable for future use when in practice. Students are motivated when they
engage in health related communication (MacArthur et al., 2016). Therefore
using professional communication tools in study could be beneficial for future
application as a health professional. There is an importance for informal
communication within interprofessional teams where healthcare members often
engage in informal discussions to exchange organisational information and team
issues (MacArthur et al., 2016). This can be applied in future health
professional practices through the use of information and communication
technology. There has been a rapid development of information and communication
technology which can be beneficial to access vulnerable populations who have
limited access to care (Graves et al., 2017). Building a therapeutic
relationship, operating such technologies and understanding the value of using
information and communications technologies interprofessional can serve as
benefits and challenges for future health service delivery (Graves et al.,
2017). Using facebook was relevant to our group as it was readily accessible to
us and available at all times. Future practice in healthcare could involve the
creation of a means of communication that is more readily accessible than
emails. However in creating this, healthcare systems must consider privacy and
safety of patient information which could serve as a stumbling block to future
improvement of health related information communications technology.




Role acknowledgement
was developed from the first day of meeting together. I felt that this was
beneficial as it helped create a plan: selecting what we would work on
individually and having continual meeting reviews. We created a client centred
approach to interprofessional service delivery. We used a case study to provide
a basis for the work we carried out and framed our interprofessional approach
around this. I worked on patient goals. These served as indicators to
professional’s role individually and collaboratively for the patient’s needs. I
had conversations with each professional team member and discussed what their
role would entail if they encountered this patient in practice. On discussions
with other students in my group it was interesting to note how much
collaboration occurs when dealing with one patient. It made me think about the
variance of health work associated with one patient.

So What

The creation of roles
within interprofessional collaboration during our presentation could be
applicable to that of interprofessional working in practice in the future. In
creating a plan at the start, I could base my actions on my role as set out
collectively. My role in the group presentation assisted in my understanding of
each professional serving as a link to the chain of interprofessional practice.
It conjured my thought into each individual’s role in the group being similar
to that of health professional’s roles in an interprofessional team. I felt
that our group functioned well together because each individual knew what their
role was in creating our presentation. Interprofessional education can help
understand roles of various health professionals, increased positive assessment
of individual role within team work, increase familiarity across discipline’s and
increase confidence during interactions with other health professionals
(Peterson & Bromelsiek, 2017)(Sweet et al., 2017). Knowing your role also
involves knowing where your role finishes and where others should carry equal
work. I think this is important in moving forward in interprofessional working.
Interchangeable roles could help lessen workload of interprofessional team
members, however this comes with power struggles as professions become less
differentiated (MacNaughton et al., 2013). Fortunately I feel that this was not
the case for our group as clarity in roles ensured no cross over of work and
wasting of time. Rather than this, interprofessional working should capture,
embrace and understand the intricacies of working with a team (Matthieu et al.,
2008). I feel that ensuring value of knowledge and skills amongst group members
was imperative for successful interprofessional work. This is supported by
MacArthur et al., (2016) when results from a survey of physicians reported that
professional identity was impacted most significantly by mutual support.


Action Plan


final “now what” stage involves future planning based on reflection experience.
For the purpose of this section of the essay I will develop a future action
plan based on my learning for professional development. I will:

Invest in a reflective
journal and reflect on practice as much as possible to enhance learning.

Take opportunities to
collaborate with health staff to engage more and further understand various

Encourage confidence in
portrayal of occupational therapy and ensure through practice, other health
professionals value occupational therapists contribution as part of an
interdisciplinary team.

Take into account individualistic
characteristics that may be barriers to communication. Examples Include:
culture, ethnicity, generational differences, personal values, expectations,
gender, hierarchy, differences in language, jargon across professions and
professional routines (O’Daniel & Rosenstein, 2008). I will apply these
ensuring clarity and sensitivity in communicating with professionals and

Make conscious efforts to
observe interprofessional working. I will apply observable traits that are
beneficial to interprofessional working in practice.

Take part in
opportunities for interprofessional training and development.

is not an exhaustive plan. In the future, should other plans be beneficial for
development, I would adapt the plan and apply when in practice.



collaboration with students is beneficial as a foundation for future
collaboration as professionals. In using an interprofessional approach each
health professional should be able to recognise their role and the role of
other health professionals. Once establishing this, a clear pathway of
communication is necessary to ensure that each health professional can engage
in discussions, work with each other and use each other’s skills and knowledge.
This will ensure that health care professionals provide a client centred
approach to healthcare. As communicative technologies are advancing rapidly,
healthcare systems can use these to improve accessibility to health services
increasing the level of patient care and reducing long term costs. Healthcare
is also moving from a medical model towards a biopsychosocial model, which views
healthcare provision beyond treatment and encourages a holistic view of a
patient. Therefore as health professionals advance in their career it is
important to be reflective in practice. The Rolfe et al., Reflexive Framework
(2001) provides a simplistic and guided method which can be applied in future
practice. In carrying out interprofessional reflective work, I can acknowledge
strengths that I can bring, adopt beneficial skills observed by others and
highlight areas of weaknesses to build on for future practice.