Healthcare improvement depends not only on new systems and technologies but also on how teams learn together across professional and organisational boundaries. An editorial in BMJ Quality & Safety identifies interprofessional learning as a potential mechanism for safer care and quality improvement. It centres on a pilot training programme for remote general practice in the UK, where clinical, administrative and managerial staff examined realistic patient safety scenarios together. The programme created structured opportunities to compare everyday practices, question assumptions and consider local changes. Its value lay in collective reflection on how care is actually delivered rather than in transferring information to individuals.
Realistic Cases Reveal Everyday Safety Work
The programme drew on a qualitative longitudinal investigation of organisational challenges in remote and hybrid general practice. Seven patient safety vignettes were co-produced with NHS Resolution and the Health Services Safety Investigations Body, then used in facilitated sessions involving whole teams from six UK general practices. Sixty-seven staff took part across clinical, administrative and managerial roles.
The scenarios focused on decisions that depend on several parts of a practice rather than on one professional alone. Judgements about whether a patient needs urgent or in-person assessment or can be managed remotely, rely on triage, escalation and communication across reception, nursing and clinical roles. Bringing these groups together allowed teams to examine how those linked decisions unfold in everyday work.
Participants found the vignette format engaging and reported meaningful reflection across the whole team. The sessions brought informal safety practices into view, exposed differences in assumptions and workflows between roles and prompted consideration of changes to local systems. They also revealed aspects of care that can remain hidden in formal descriptions of how work is expected to happen. The programme therefore created more than a discussion of individual cases. It supported collective sense-making across role boundaries and made it possible for staff to compare how work is imagined with how it is actually carried out. The format also made informal adaptations and role-specific differences visible to colleagues who might not otherwise see them.
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Learning Across Roles Builds Shared Understanding
Interprofessional education involves people from two or more professions learning with, from and about one another to improve collaboration and care quality. This differs from shared learning, where different groups receive the same information but have little opportunity to interact. Shared learning may increase knowledge, while interprofessional learning creates space for dialogue, role negotiation and a common understanding of complex work.
The pilot programme included several conditions associated with effective team learning: authentic problems, facilitated interaction, discussion across professions and roles, psychological safety and opportunities to build shared understanding. Facilitators observed that staff were able to ask questions and challenge assumptions regardless of role. That openness matters because collective learning depends on people being able to examine differences in practice without professional position preventing discussion.
Patient safety problems often arise through interactions among roles, workflows, technologies and organisational systems rather than through shortcomings in one person’s knowledge or skill. Teams therefore need the capacity to understand work across boundaries, identify how tasks are connected and adapt together. Treating the team as the main unit of learning places education within improvement activity rather than separating it as an individual training exercise. Whole-team participation can help staff surface risks, recognise role-specific perspectives and develop a shared account of how care is delivered under everyday conditions. This form of learning also supports dialogue about uncertainty, escalation and the practical consequences of role boundaries.
Scaling Whole-Team Training Requires Careful Evaluation
Whole-team learning also creates practical demands. Sessions must be coordinated across busy and differently organised rotas, staff need to be released from clinical duties and skilled interprofessional facilitators must be available. These requirements involve investment, although the pilot indicates that facilitated team learning can be feasible and acceptable. Participants reported learning and intended changes to practice, but further evaluation is needed before wider implementation.
A cluster-randomised trial at team or practice level could test the training as it expands while accounting for differences between practice contexts. A linked process evaluation would be needed to clarify how change occurs, which conditions support success and how benefits might be sustained. Evaluation would therefore need to consider both outcomes and the mechanisms operating within complex organisational systems.
Existing interprofessional learning approaches offer several starting points. Skilled facilitation can support psychological safety, while authentic scenarios allow participants to recognise their own practice and contribute knowledge that other roles cannot provide alone. Such scenarios can reveal tacit assumptions, adaptive behaviour, workarounds and perspectives that otherwise remain hidden. Qualitative and ethnographic methods can help develop learning materials grounded in everyday care. Feeding observations of real practice back to teams may stimulate critical reflection, collective sense-making and local improvement by keeping educational design closely connected to how work is actually done.
The central message is that how teams learn together may matter as much as the content they receive. Whole-team participation, authentic cases, skilled facilitation, psychological safety and collective reflection can create conditions for identifying risk and developing shared understanding across roles. Team learning is therefore positioned not simply as a way to distribute information but as a possible mechanism within quality improvement itself. The next step is to establish whether these approaches generate measurable change, how their effects arise and whether benefits can be maintained across different organisational settings.
Source: BMJ Quality & Safety
Image Credit: iStock
References:
Xyrichis A & Zwarenstein M (2026) Interprofessional learning as a mechanism for quality improvement and patient safety. BMJ Qual Saf: Online first.
