An activity theory perspective on interprofessional teamwork in long-term care

Authors

  • Nicolas Fernandez Université de Montréal
  • Nicolas Gulino Université de Montréal

DOI:

https://doi.org/10.36834/cmej.77484

Abstract

Background: Teamwork in healthcare is shaped by reciprocal interactions among individual team members and their clinical context. Cultural Historical Activity Theory (CHAT) provides a framework to study teamwork from a developmental perspective. We observed interactions between members of an Interprofessional Healthcare Team (IHT) to identify practical guidelines for educators. 

Method: Three Health Care Providers (HCPs) with more than 22-years’ experience in a semi-urban LTC facility participated. We video-recorded two regular IHT meetings and selected excerpts for subsequent video-recall interviews. The excerpts were shown and discussed first with each team member, then with members in pairs and finally with all members reunited. We prompted participants to explain what was happening on the videos. All interviews were recorded, transcribed, and analyzed using CHAT’s unit of analysis based on Activity Systems.

Findings: We observed contradictions within the Activity Systems involving diverging views on outcomes of enhancing or maintaining quality of life; using non-traditional tools and spaces to sustain resident mobility; safeguarding community and patient safety despite time constraints and job titles, and unease for being paid to perform unconventional interventions. The contradictions have been grouped into three themes reflecting the Activity Systems: 1) enhancing versus maintaining quality of life; 2) improvising to achieve care goals; and 3) role fluidity.

Discussion: Our findings show that practical goal-oriented and contextual adaptations rely heavily on improvisation and dialogue. Educating HCPs for interprofessional teamwork should focus on developing situational awareness to foster continuous adaptation of disciplinary interventions.

Author Biographies

Nicolas Fernandez, Université de Montréal

Fernandez, Nicolas, PhD, is Assistant Professor in the Department of Specialized Education and Training at the Université du Québec à Montréal, Canada. 

Nicolas Gulino, Université de Montréal

PhD Candidate in Educational Sciences. 

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Published

2024-08-12

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1.
Fernandez N, Gulino N. An activity theory perspective on interprofessional teamwork in long-term care . Can. Med. Ed. J [Internet]. 2024 Aug. 12 [cited 2024 Dec. 23];15(4):28-39. Available from: https://journalhosting.ucalgary.ca/index.php/cmej/article/view/77484

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