Limitations of the study

The generalisability of the findings from this study is subject to a number of limitations. For instance, there were limitations related to the use of the two pre-validated tools which were used to measure attitudes to IPW and IPPL. Firstly, although these survey tools were used in other similar studies, previous studies did not focus on practice mentors’ attitudes to IPPL. In discussing and interpreting the survey results, it was, therefore, difficult to draw comparisons against the findings of other studies.

171 Secondly, the multi group measurement tool which was used to measure attitudes to IPW was valued for the ‘round robin’ design and ability for multiple professions to rate other professions. However, with the large number of different professions involved in this study, it was not possible to ensure that the wording of each item relevant to all professions involved in this study. As a result, some professions were unable to rate other professions that they may normally have worked regularly with. Figure 5 in Chapter 4 illustrates this point by showing that doctors and nurses were not given the opportunity to rate pharmacists in the online survey. Thirdly, the 4-point Likert scale did not provide participants with the option to provide a neutral response to the survey items, an issue which was raised by some participants the free text comments areas of the online survey. Therefore, these results do not provide a clear indication of those participants who were uncertain if they agreed or disagreed with some of the items in the online survey.

Although the combination of quantitative and qualitative methods enabled attitudes to be measured and perspectives to be explored, both methods required participants to self-report their attitudes and perspectives. With self-reporting methods, there is a risk of social desirability bias (Cohen et al., 2011) and the possibility that participants provided responses based on their perceptions of the norm in relation to IPW and IPPL. Further research would need to include observations of groups of professions to verify if what was reported, matched with what was observed.

Due to the smaller numbers of social workers and pharmacists in this study’s sample, and the smaller number of participants working across both community and acute care settings, it was not possible to include their data during the statistical analysis. Although these professions reported generally positive attitudes to IPW, and IPPL for students, it was not possible to determine whether their attitudes significantly differed from other professions.

Prior experience of IPE as an educator or as a learner was a variable of interest in the statistical analysis of quantitative data. As discussed in Chapter 6, the results of the analysis showed that prior experience did not affect attitudes. However, these findings may be limited. In analysing the demographic data generated in the online survey, it was evident that the majority of survey participants reported that they had prior experience of IPE. However, on interviewing participants, it was evident that

172 some of the experiences that participants described were more multiprofessional, rather than interprofessional. Further inquiry into the nature of participants prior IPE experience may have therefore have enabled a more reliable analysis of the effect of this variable on attitudes to IPW, and IPPL for students.

It was evident that there was limited representation of some professions and contexts of care in this study, a research gap that was highlighted in the review of previous literature. Midwifery as a professional group governed by the NMC was under- represented, as were some professional groups within the AHPs, such as podiatrists, paramedics and orthotists. In relation to underrepresentation of care contexts, this study did not include practice mentors working within the care home and residential care setting. Care homes and residential care settings are important contexts to consider, particularly in relation to the impact of enablers and barriers of IPW between health and social care professions working within these settings. Although professions from these settings were targeted in the recruitment phase of the study, future studies would possibly need to consider other recruitment strategies and appropriate methods of data generation, to encourage participation from these professions.

The mean scores from the survey that was used to measure practice mentors’ attitudes to IPW, and IPPL for students and demonstrated that attitudes were generally positive for both. Unlike other studies, professional background and previous IPE experience were not found to significantly affect attitudes to IPW or IPPL. These differences in findings may be due to the differing countries and their cultures, and the differing organisational structures in which the studies took place. Therefore, there may be other variables that have not been accounted for in this current study.

As a single case study, these limitations may add to the scepticism around case studies and concerns regarding the generalisability of its findings (Yin, 2014). However, in relation to IPW, these findings contribute to existing knowledge and offer new evidence during a time in health and social care where major changes require professions within these services to change the way that they work together. In relation to IPPL, given that there are few other studies that have investigated practice mentors’ attitudes to IPPL for students, these findings contribute to the understanding

173 of how IPPL is valued. This knowledge can help with identifying strategies for improving the continuum of IPE from academic settings to practice settings.