Working collaboratively in health care contexts: the influence of bioscientific knowledge on patient outcomes

This paper explores work-based learning and collaborative working in health care by drawing on the findings of a completed study about the influence of nursing knowledge on patient outcomes [Prowse, M.A., 2001. The development of effective bioscience-based knowledge in the Post-Anaesthesia Care Unit (PACU). Unpublished PhD Thesis. University of Wales College of Medicine, Cardiff]. A qualitative research approach was used to explore the experiences of nurses in critical care settings. Interviews and analysis produced a descriptive and interpretive account of everyday working and learning for these specialist nurses. Findings showed that nursing knowledge influenced patient outcomes in a number of ways. Nurses draw on bioscientific knowledge and experience in order to achieve patient outcomes. Moreover, they collaborated with other health professionals in everyday working and learning. The study findings are explored with reference to the literature about situated knowledge, clinical problem solving and work-based learning. The significance of the findings is that the kind of 'collaborative competence' identified here contributes to the achievement of the aims of the NHS plan and ' Working Together, Learning Together' [Department of Health, 2001. Working Together, Learning Together. Department of Health, London]. Despite the centrality of team working and the trend for more work-based learning in NHS contexts, there is a limited evidence base to date about the influence of team working or work-based learning on patient outcomes. The analysis and discussion in this paper adds to this body of knowledge.