Barriers to Preceptorship in Interprofessional Education: An Integrative Review
Interprofessional Student Poster Description: Interprofessional education (IPE) delivered in practice settings is potent for the development of collaborative competencies. The preceptor is the professional linked to the health service that approaches the students to the reality of services for the development of professional, clinical, ethical, and collaborative competencies. There are factors at the micro, meso, and macro levels of the educational and professional systems that are part of the daily work of preceptors and that can influence the effectiveness of IPE. We propose to identify the barriers related to preceptorship in IPE.
Integrative review with question-based on the PICo acronym: what are the barriers of preceptors in IPE? We included quantitative, qualitative, and mixed-methods peer-reviewed studies published in any time and language. Comprehensive search strategies were constructed and the search was performed in Scielo, LILACS, BDENF, Medline/PUBMED, Web of Science, Scopus, Embase, and CINAHL databases. The selection was peer-reviewed and blinded. The data extraction instrument was validated and the data were analyzed by data reduction, data display, data comparison, conclusion drawing, and verification.
Eighteen studies were identified. At the macro level, the barriers are related to the predominance of medical-centered, fragmented health focused on individual and curative care, accompanied by the predominance of uniprofessional education in health; power differences between professions; and instability in the financing of proposals for IPE. At the meso level, barriers were identified in the health services, educational institutions, and the articulation between both, such as low institutional support and devaluation of the preceptorship, overload, and precarious work, the difficulty of articulation and a common agenda between the activities of teaching and health services. In the micro is highlighted the lack of training for IPE, little availability and resistance of professionals for collaborative practice, and dissatisfaction of preceptors.
To strengthen the preceptorship in IPE, it will be necessary to access different levels of power. The barriers organized into levels are articulated and interdependent. Therefore, health care and training at the macro level influence the devaluation of the preceptorship in the IPE and little opportunity for interprofessional experiences in health services, identified as barriers at the meso level. In this sense, changes at one level will have repercussions and articulate with the others.
The barriers reflect the complexity of the preceptorship role related to educational, institutional, and interactional systems. The results can promote discussion among stakeholders of each level in order to enable strategies across levels to advance IPE.