Implications of early workplace experiences on continuing interprofessional education for physicians and nurses.

Formative experiences, identities and collaborative strategies of nurses and physicians need to be appreciated to develop transformative interprofessional education for them. This article develops the collaborative profiles of recently graduated physicians and nurses based on a phenomenological study conducted at tertiary training hospitals in Canada and the United Kingdom. Recent nursing and medical graduates were interviewed to study the impact of undergraduate professional education on their ability to practice collaboratively in the workplace. The impact of undergraduate professional education on teamwork was found to be diluted by internal contradictions and overshadowed by the demands and contingencies of the workplace reported here. Initiation into the workplace was frequently precipitous and for residents the workplace environment was fluid and repeatedly new, as they rotated through various disciplines in the hospital. In busy wards, interdependent but competing priorities led to the development of adversarial uniprofessional identities and derogatory stereotyping of the other. Both groups were overwhelmed by high workload, unpreparedness and responsibility. Cross generational and gender based interactions also provoked resentment. Over time collaborative attitudes became blunted and interprofessional identities were renegotiated. Continuing interprofessional education, for recent graduates that prioritises problem areas, alongside appropriate structural changes could potentially transform the prevalent culture and impact teamwork downstream.