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Article

How Can Interprofessional Skills Be Taught during University Studies? Student Teachers, and Social Work and Law Students Solving Complex Student Welfare Cases

1
Faculty of Education, University of Lapland, 96300 Rovaniemi, Finland
2
Faculty of Social Sciences, University of Lapland, 96300 Rovaniemi, Finland
*
Author to whom correspondence should be addressed.
Educ. Sci. 2023, 13(8), 806; https://doi.org/10.3390/educsci13080806
Submission received: 10 July 2023 / Revised: 25 July 2023 / Accepted: 1 August 2023 / Published: 5 August 2023
(This article belongs to the Special Issue Innovative Approaches to Enhance Inclusive Education)

Abstract

:
This study focused on the learning of interprofessional skills through an interdisciplinary university course provided to student teachers, and social work and law students. This study explored the development of the course, the aim of which was to raise the student’s understanding of interprofessional work to a more conscious level. The key research question was as follows: what kind of assignments and arrangements can be used to promote the interprofessional skills of students and their ability to solve complex student welfare cases? In this practice-oriented case study, we analyzed our own development process for the course, as well as the student’s reflective essays. Through our analysis, we identified four central themes of an interdisciplinary course that can enhance interprofessional skills in students: (1) identifying discipline-specific expertise as a part of a multi-professional network; (2) gaining an understanding of interprofessional working processes; (3) realizing the complexity of student welfare cases; and (4) orienting towards working life. Our research demonstrates that building an interdisciplinary university course based on flipped learning principles, which incorporates collaborative and reflective assignments supported by various course materials and literature, can promote the learning of interprofessional skills and processes by students.

1. Introduction

In this study, we investigated how to teach students to understand the nature of interprofessional processes and the professional–scientific foundation of teamwork based on complicated student welfare cases in an educational context. In particular, this paper is based on researching the development process for an interdisciplinary university course, which aims to introduce the interdisciplinary nature of student welfare work to student teachers and social work and law students. The university students explored student cases that included morally charged and complex child welfare issues requiring the expertise of different professionals. The students dealt with the cases in interdisciplinary teams and shared dialogue on how they can enhance the child’s rights and participation in the student case.
Inclusive education is currently an international educational goal, which aims to create education that is more attentive to the individual needs of all students, regardless of their differences in personal competence or socio-economic/family background, in order to provide students with equal opportunities for success [1]. In schools, there has been an increasing emphasis on the intersection of supporting student well-being and providing learning support. To plan support for diverse students, inclusive pedagogy requires forums for negotiation, collegial and interprofessional co-operation [2], and collaboration with the families of students [3].
Children and young people have diverse academic, social, and behavioral needs. The guidelines in many countries require that special education and student welfare services in schools be provided by interprofessional teams [4]. The school’s student welfare work encompasses the school management, teachers, counsellors, school psychologists, and social workers, all of whom have obligations based on the law and professional ethical principles to ensure the well-being of the students and their families. Multi-professional support for schools would be the best response to the complex problems faced by children and young people [5]. However, future social workers, teachers, and legal experts typically receive their education through separate education programs. For example, Anderson [6] documented a study in which early childhood education and social work students engaged in interprofessional and collaborative activities as part of their studies. The findings revealed that their discipline-specific understanding hindered effective communication. Additionally, other researchers have stated that the context of a student’s own discipline orients their interpretations and responses to the problems they encounter in their work [7,8].
International efforts towards inclusive education [9] require schools to restructure their professional work in novel ways. For example, preventive student welfare work and interprofessional work are emphasized in school social work. Social workers need to collaborate more closely with other professionals at school, necessitating that they articulate their expertise outwardly in relation to the interprofessional operating environment [10]. However, professionals involved with student welfare issues may find it challenging to work interprofessionally [11]. Björn et al. [12] have asserted that teachers frequently struggle to detect early indications of well-being issues in students and possess limited expertise and abilities to co-operate with student welfare professionals and families. Overall, the push towards inclusive education demands increased collaboration among school professionals and sectors, with the hope of facilitating educational support for all students within inclusive environments [2].

1.1. The Framework of Collaborative Work

We use the term interdisciplinary when we refer to the structure and starting point of our university course in which the students from three disciplines are given a joint goal: they are expected to analyze and harmonize the student cases from different disciplinary perspectives. In the research literature, multi-professional and interprofessional work are distinguished from each other. However, the differences between the concepts are not always clearly defined. In this study, we use the concept multi-professional teamwork, when the team members have a joint problem, for example a student case; however, the members may not necessarily work closely together, and each is responsible for their own field-specific tasks. In contrast, we use the term interprofessional work, when emphasis is placed on the interactions between team members. Interprofessional work recognizes the tensions that arise from working at the boundary spaces of different professions, as well as the importance of commitment to a shared goal and negotiating one’s role in advancing that goal [7,13]. In other words, interprofessional work takes one step further than multi-professional teamwork, building boundary practices between different types of expertise and creating a new kind of relational expertise [14].
Finding joint goals is necessary in interprofessional teamwork when facing multi-faceted child welfare problems. To achieve these goals successfully, the team needs to realize children’s rights and their best interests, while maintaining a capability to consider alternative ways of acting with respect to each professional [15]. The need to work in boundary spaces between different types of expertise may challenge the professionalism of individuals [7]; for example, prioritizing the overall burdensome situation of a student’s family over their academic goals can be challenging for a teacher. Interprofessional work requires a relational mindset, which emphasizes the willingness to learn from others, the ability to articulate and share one’s own expertise for the purpose of solving common problems, and the creation of shared knowledge [16,17].
Many barriers may be encountered in interprofessional work, especially those related to developing and coordinating collective goals [14]. When various experts start working on a joint problem, they may detect differences between the values and perspectives, professional vocabulary, and working culture of the team members which, in turn, may cause feelings of insecurity [13,18]. The team members need to be able to detect their role as promoters of collaboration and negotiators of new goals in boundary spaces [7]. In interactions, these boundaries may concern institutional, cultural, or professional boundaries and manifest as power issues [17]. Therefore, the team members need to find a power balance between their roles and be able to support each other as a team [13,14].

1.2. Elements for Learning in an Interdisciplinary Study Course

There is an evident need to develop the interprofessional skills of various professionals, even as early as during their university studies. The inclusion of interdisciplinary courses into university degree programs has increased during the last two decades [8,15,19]. When interprofessional skills are taught in university studies, they need to be conducted systematically, giving opportunities for students to observe and develop their interprofessional competencies [20]. In an interdisciplinary course, the diverse viewpoints of participants may cause conflicts and feelings of uncertainty [14], which may remain at a subconscious, non-rational level and cause withdrawal from the learning situation if they are not identified as a part of the process [13,21]. Therefore, the students need to develop tools for negotiating and reflecting on the given assignments in interdisciplinary learning situations.
The interdisciplinary course in this research can be characterized as flipped learning or flipped classroom, placing the student at the core of learning activities with the goal of constructing knowledge that can be applied in various contexts. The aim of the course is to encourage active and constructive learning and promote self-regulation through interactive and collaborative experiences [22]. Flipped learning can be utilized to engage learners and promote understanding and metacognition of the subject matter being taught [23]. The flipped approach distinguishes itself by adopting different sequencing of activities and instruction both before and during in-person class sessions, in contrast to conventional courses [24].
The pedagogical principles of the course also reflect our own teaching philosophy. Kreber et al. [25] talk about “authenticity in teaching”, characterized, among other aspects, by consistency between values and actions, as well as an interest in engaging both the students and the teachers with the subject around ideas that matter. As educators, we have come together with the observation that one discipline alone cannot provide students with the reflective, interdisciplinary perspectives they need, and thus, we have exposed ourselves to critical discussions that working in boundary spaces entails.
It has been found that the collective dimensions of professional expertise do not develop without concrete possibilities for interdisciplinary learning and clear assignments that require collaboration in teamwork processes focused on complex problems [26,27]. The promotion of interprofessional work has been emphasized in various fields, but is often focused on collaboration within the social and healthcare fields [28] or, for example, social work and law students [8,29]. There are very few studies in which student teachers are also involved in learning interprofessional work [28,30]. In our study course, students from the three disciplines—education, social work, and law—who all have a stake in handling student welfare cases have the opportunity to learn how to perform interprofessional work. These professions have various points of intersection where interdisciplinary education would significantly benefit the future working life skills of the students, in terms of co-operating with other professionals [8,15].
This paper explores how to teach interprofessional skills during university studies by analyzing the reflective essays of students, as well as the development process of the course by the teachers. The research question was: What kind of assignments and arrangements can be used to promote the interprofessional skills of students and their ability to solve complex student welfare cases? We argue that an interdisciplinary university course can enhance both the discipline-specific and interdisciplinary professional skills of students; that is, through such a course, the students will be able to better locate both the responsibilities of their own professional field and understand what relational expertise can mean in their professional field when acting in a multi-professional network [16].

2. The Interdisciplinary Course: “Children’s Rights and Position in Multi-Professional Networks”

2.1. Background of the Course

The practical scene of the research is an interdisciplinary course that was established in 2015 based on development work for joint content areas of teacher education and social work education. In connection with this, a case study was carried out [13], in which the participants reflected on their experience of participating in a shared practicum at a primary school. One of the concrete outcomes was identifying the need for and establishing the joint course for interprofessional work as part of teacher education and social work programs for Master’s students in 2015.
Before and after the course, the teachers met annually, assessed the student feedback, and made changes to the course such as scheduling the tasks, amending the student cases, clarifying the instructions of the assignments, and updating the literature. In 2018, the discipline of law joined the course. The course materials were broadened to concern education, social work, and related legislation. Additionally, according to requests for flexible studying by the students, the course has been implemented online on the Moodle platform since 2018. This course is obligatory for student teachers and elective for social work and law students. At present, six teachers from three faculties are involved in the course.
The university where the teaching takes place is one of the Finnish universities. They/The Finnish universities are primarily funded by the Finnish government. Scientifically, the universities are autonomous. The structure of university degrees is standardized, but there is room for individual choices in the content of the curriculum and in the pedagogical implementation.

2.2. Description of the Course

The online course is scheduled into four modules, each varying between 1 and 4 weeks, and lasts approximately two and half months in total (see Table 1).
At first, the students meet the teachers in the kick-off seminar for the introduction to the course and watch three 30 min videos in which three of the teachers lecture on the important aspects of child’s rights and position from the perspective of their own discipline and professional action. Then, the students are divided into small groups of their own profession, in so-called expert teams. Each team meets online and the members introduce themselves and tell which article of the Convention on the Rights of the Child [31] they have chosen and why they consider it important.
Second, based on the lecture recordings and course literature, the expert teams explore their professional roles in a multi-professional network in terms of the interests, voice, and participation of the child/youth, as well as how the professionals can ensure that they are realized in the helping process. Discipline-specific materials, such as literature lists, lectures, and videos, are made available to all students. All students are familiarized with the Finnish ethical guidelines and good practice for each profession. The expert teams produce a research-based, structured output on their professional roles. In addition, the expert teams familiarize themselves with three student cases—named Minna, Minttu, and Pekka—and discuss them from the viewpoint of their own professional roles and responsibilities. The student cases are short narratives about an imaginary student, their difficulties, and their family background. The cases include many complex and sensitive issues, including children experiencing school bullying due to their ethnic background, eating disorder, juvenile delinquency, parent’s conflicted separation, child abuse and neglect, and suspicion of child sexual abuse.
Third, the students start the interdisciplinary teamwork on one student case. The course includes a lecture regarding the information flow between social work and education, as well as a lecture about interprofessional work. Moreover, a school social worker and school psychologist visit and speak about their experiences of multi-professional and interprofessional collaborations. When working with the case, the students utilize a conceptual assessment framework that covers the children in need and their family [32] and share their insights and expertise regarding the case. They proceed—with the support of recorded and online lectures held by diverse experts and the course literature—to make an action plan on how to support the child/youth and their family. As an interdisciplinary team, they produce a seven-minute video presentation, in which they structure their plan(s) on the student case, referring to research literature and relevant legislation. The teachers assess the videos together and give feedback to each team.
In the final seminar, some of the videos are shown as examples, and further discussions and reflections are made by all the teachers and students together. Finally, the students produce a personal reflective essay (3–5 pages) on their chosen set of questions in relation to the rights and position of the child in a multi-professional network. The students can freely choose a question that is important to them and related to the issues discussed in the course, justifying their arguments based on research literature. The teachers assess the essays of the students in their discipline.

2.3. Addressing the Challenges in the Course

Despite utilizing the yearly feedback of students and making amendments to the course, the teachers noticed the constant problem of some students not engaging in the interdisciplinary teamwork. Every year, the students reported that some students were not committed to the mutual assignments and did not take responsibility in doing them. According to the student feedback, the collaboration in some teams was not very constructive, considering certain members of the teams.
In autumn of 2022, part of the teacher team (i.e., three teachers from the faculties of social sciences and education) decided to initiate a research-based development work to address the problems that consistently arose in the yearly student feedback. The aim was to raise the interprofessional collaboration skills of students to a conscious level, focusing on interprofessional work to build boundary practices [7,13,14]. The three teachers started meeting regularly, negotiating and studying previous research on interprofessional work and, based on this, they decided to add two new reflective assignments to the course. Through these reflective tasks, the teachers aimed to obtain more accurate information on how the collaboration between the students progresses and how joint outcomes are formed.
The first new assignment was added as a part of interdisciplinary collaboration. To support this assignment, a new lecture on interprofessional work and its dilemmas—mainly based on the theoretical analysis of Rose and Norwich [14]—was added to the course. After watching and listening to this lecture, and before finalizing their action plan for the student case, the students were instructed to reflect first by themselves and, after that, gather together to reflect on their professional roles and responsibilities in their interdisciplinary team. They were given a list of questions to facilitate their discussion and reflection.
The other new assignment was added to the final essay, which now consisted of two parts, extending the length of the new essay (4–7 pages). In addition to writing about the children’s rights and position in a multi-professional network, as before, the students were additionally instructed to ponder their experiences as a member of an interdisciplinary team in terms of their own engagement and contribution, as well as their inter-relations and actions as a team. The teachers asked permission from the students to use these reflective outputs as research material.

3. Materials and Methods

3.1. Research Design and Data

This study is a practice-oriented action research using a Master’s-level university course as a case [33] in exploring how to enhance accuracy and depth in learning interprofessional work during university studies. We—the three teachers, as researchers—embarked on a cyclical process involving investigation, introspection, and strategic thinking to modify the current interdisciplinary course in preparation for its development [34]. In this sense, the research strategy resembles a collaborative action research process in which the epistemological starting point is the knowledge constructed by the people involved [35]. The final outcomes of the research are not solely the result of our work as researchers but, rather, a collective effort involving the contributions of all participants. We were not objective observers, but were actively involved as teachers in interpreting the understanding of students and contributing their perspectives [36].
The data were derived from both our own reflective process as teachers and the reflective essays of the students. The materials used in our reflective process comprised 10 meetings (each lasting about 2 h) and their memos (11 pages altogether). In the meetings, we pondered how to confront the identified problems regarding learning interprofessional work and how to develop the course.
All of the students (86) participating in the course in 2022 wrote a reflective essay. As a new assignment, the essay was converted into a two-part essay in which the students were additionally instructed to ponder their experiences as a member of an interdisciplinary team. The students were informed that the course was being researched, and that their experiences with the group work would help in the course development. They were asked to indicate at the beginning of their essay if their output concerning the second part of the essay could be used as research data. The consent letter included relevant information about the research goals, the ways of reporting the findings, and the possibility of withdrawing from the research at any point, without affecting one’s studies [33]. Sixty-four students gave permission to use their essays as research material. Table 2 shows the number of students and essays, as well as the extent of the data.

3.2. Data Analysis

We conducted a qualitative content analysis, including elements of both inductive and theory-driven analyses [37,38] on the student essays and our memos as teacher researchers. At first, we shared the student’s essays with each other and carefully read them to individually perform a preliminary analysis to reduce the data [36]. We looked at how the students experienced the process of solving the student welfare cases and the aim to create an implementation plan for the case. We also investigated the descriptions of the interprofessional work process between the students and related dilemmas [14]. Next, we held a meeting to discuss the preliminary themes emerging from the data. The student experiences were interpreted in relation to the objectives and teaching methods of the course, as well as our own experiences of making amendments to the course. We divided the themes and read the literature based on those themes, in order to capture the relevant conceptual terminology, and started writing about the themes [38]. Then, we met again and refined the analysis through combination and reduction. We identified the following central themes of an interdisciplinary course that can enhance the interprofessional skills of students: (1) identifying discipline-specific expertise as a part of a multi-professional network; (2) gaining an understanding of an interprofessional working processes; (3) realizing the complexity of student welfare cases; and (4) orienting towards working life.
Next, the themes were described using data extracted from the student essays and teacher memos. We indexed the data according to discipline and by giving a number to each student (see Table 3).

4. Learning Interprofessional Working Skills during the University Course

4.1. Identifying Discipline-Specific Expertise as a Part of a Multi-Professional Network

An essential aspect in preparing students for interprofessional teamwork and solving the case study was that they worked first in their discipline-specific expert teams, then in interdisciplinary teams. Familiarizing themselves with the student case, identifying the reasons for concern and the child’s needs in the case, and determining the possible supportive means and interventions together with students from the same discipline created a safe ground for the students and encouraged them to share ideas in an interdisciplinary team:
“I pondered whether I could adequately represent the perspective of my field and how students from other disciplines would perceive the social work viewpoint. However, (…) the support from [discipline-specific] expert teams proved immensely helpful in this regard. Reflecting on the case within an expert team provided confidence and facilitated a broader understanding of the social work perspective.”
(SW8)
“Working with the student case initially caused a lot of uncertainty, as reading the case and forming an interpretation felt very challenging. (…) However, through the process (…), the responsibilities and significance of the school teacher’s role within interprofessional work became much more apparent.”
(TS4)
We, as teacher researchers, supported the teamwork by providing as clear a framework and assignment as possible [39]. Still, within the given structure, the students could decide how to conduct the assignment; for example, which technical devices and software they want to use and how many meetings they will have while carrying out the assignment. The interprofessional work was instructed to start by sharing views from all disciplines regarding the student case at the first meeting. In this way, we aimed to ensure that the teamwork started and proceeded in a balanced manner. In the following, the students describe the activities conducted as a team:
“The problem-solving process in Minna’s case progressed smoothly, with each professional team representative’s perspective being heard. (…) The initial meeting highlighted the importance of bringing together different professional teams’ thoughts and perspectives. Despite the varying viewpoints, each statement emphasized a common goal: the child’s best interest, development, and growth.”
(TS15)
Combining the expertise of students enabled the teams to evaluate alternative ways to support the child of the case and develop an implementation plan to realize the child’s rights and best interest. According to the essays, in order to reach a successful solution for the student case, the expertise of all team members should be considered as widely as possible:
“The shared discussion (…) revealed alternative courses of action that could be taken. I believe that one of the benefits of interprofessional work is that professionals, with their expertise, can yield different support options that they can offer to the child. (…) Through collaboration, each professional’s expertise can be utilized to develop a well-designed plan for further actions concerning the child’s case.”
(SW13)
“By collaborating with professionals from different fields, even a lawyer can solve their tasks in a more comprehensive and high-quality manner.”
(LS3)
The essays indicated that the students learned new perspectives from other students. This was possible when the students familiarized themselves with the professional expertise of their fellow students through the course material and discussions with other students. They described how interprofessional work produced necessary openings for students from other disciplines:
“In my opinion, the best thing about interprofessional work is the joy of gaining new perspectives. When you (…) rely solely on your professional expertise, you may overlook small yet significant details or potential solutions. The “aha” moment and the expansion of professional perspectives are the highlights of interprofessional work!”
(SW7)
“It was thought-provoking to hear students’ thoughts on the case from different fields, as they approached it from slightly different angles than mine. In our team discussions, we extensively deliberated on the role of a classroom teacher, social worker, and lawyer in an interprofessional team, which opened up my thinking in a new way.”
(TS1)
Recognizing the similarities and differences in their perspectives induced critical and reflective discussions between students to solve the case. The different perspectives either reinforced one another or provided an opportunity to test the aspects and knowledge that each possessed, which led to learning to argue one’s point of view to other students and the possible critical elements of interprofessional aspirations [14]:
“I noticed interesting differences in perspectives among our team members. The teacher student, and I shared the view that there were significant concerns in the case, and we believed that something was happening at Minttu’s home (with her father) that she was afraid to talk about. On the other hand, other team members seemed to perceive that the child had low self-esteem and would benefit from a conversation with a school social worker. Our perspectives also diverged on whether to consult child protection or social welfare authorities and make a child protection report. After an active and relatively intense discussion, we arrived at the approach of considering the case from the standpoint that the child’s father had done something that the child couldn’t articulate. We also concluded that it would be advisable to at least consult a social worker regarding the matter and, if necessary, make a child protection report.”
(SW3)
“Professionals from different fields possess slightly different knowledge and interpret matters and situations from their own professional standpoint. It’s easy to encounter situations where another professional’s views or expertise are not valued, which leads to the underutilization of the benefits and opportunities of interprofessional collaboration. Consequently, the entire collaboration process and its efficiency suffer as a result.”
(TS35)
The data demonstrated that students were able to strengthen their own expertise and learn the expertise of other students through working both in discipline-specific and interdisciplinary teams. Working in these teams augmented their sociocultural knowledge and understanding of the considered child’s life situation [19]. The interdisciplinary collaboration during the course enabled students to develop their relational expertise, as they were engaged with the knowledge of their specialist practice and expertise, as well as a capacity to recognize and respond to the contributions of various actors [16].

4.2. Gaining Understanding of an Interprofessional Working Processes

One crucial notion we held, as teacher researchers, was that the students did not reflect much on their behavior during the course. As action without reflection does not necessarily lead to learning [21], we decided to develop assignments to raise their awareness of the necessity of reflecting on one’s thoughts and actions as a part of the course learning goals regarding interprofessional teamwork [38]. We realized that the course implementation was too general, and decided to change the instructions during the interdisciplinary teamwork. The students were instructed to meet and ponder some central concepts during their interdisciplinary teamwork process, including their feelings of insecurity and conflicts (Memo 12, August 2022).
Indeed, according to the essays, the students were able to express their critical opinions regarding the interprofessional work and related feelings. They could analyze the development of their collaboration. Some had prejudices against interprofessional teamwork, or felt unsure and nervous about the flow of the interprofessional work before the co-operation started:
“At first, I felt nervous about working in a team and doubted whether my professional expertise would be sufficient to solve the case example. However, as our team became familiar with each other and engaged in open discussions, working in the team became a safe space, and my professional uncertainties disappeared.”
(SW12)
“Regarding interdisciplinary collaboration, we discussed the importance of actively listening to the thoughts and opinions of all professional backgrounds in the team. It was emphasized that no team member should have pre-determined decisions on how to proceed or what solution to reach before engaging in discussions. This allows for genuine collaboration and the exchange of ideas to take place.”
(LS6)
In most of the essays, the students stated that they engaged in teamwork and collectively committed to share the goal for solving the case example [14]. In many ways, the course provided an ideal environment for learning and training interprofessional work, as the students had considerably more time to solve the cases, reflect, and collaborate than later in their working life [40]. The positive experience of interprofessional practice may even give an overly optimistic image, as collaboration between different professionals often poses challenges. The students reflected on their positive experiences, but also critically assessed their ideal learning experience for interprofessional work.
“My experience with multi-professional collaboration in the work life varies greatly. During the course, our interdisciplinary collaboration was of high quality and efficient. We accomplished the task at hand, thanks to a seamless exchange of information among the different actors facilitated by weekly meetings.”
(SW10)
“While my initial experience with interprofessional work is quite positive, I am left pondering its authenticity: Will future workplaces allocate the necessary time and resources to address a single Minttu’s situation as diligently as in this exercise? And what about when there are three, five, or eight different Minttu cases simultaneously?”
(TS37)
The students found excellent interactions as facilitators of collaboration. Listening, giving space to others, taking responsibility, and being active in team-supported collaboration led to successful resolution of the cases. Good interaction made it possible to strengthen one’s professional self-efficacy, and the place and value of each team member and their competence were determined by how fellow students listened to and showed appreciation for each other. The student reflections emphasized the role of social emotions, which can directly affect student engagement [41] and serve as a pre-requisite for successful teamwork.
“Our team had a good and respectful atmosphere where expressing one’s perspective felt easy and natural. Team members listened to each other and were willing to learn from different viewpoints.”
(SW2)
“In my team, respect was primarily demonstrated through the commitment to collaborative work. Everyone was present at meetings on time and prepared, allocated sufficient time for the meetings, actively participated in discussions, and completed their assigned tasks or conducted the necessary research as agreed upon.”
(LS10)
“Our team members were very active and committed to the task (…) [and] I also want to highlight the inclusive atmosphere that allowed space for everyone’s opinions and contributions, despite some individuals being more vocal than others.”
(TS37)
Although the students emphasized the importance of equal distribution of work in solving the case, some brought forth the importance of sharing and taking roles when working in a team. As teachers, we randomly nominated two students to take responsibility for convening the interdisciplinary team and to create a platform from which the students could start planning how to organize the team meetings. Although some students found these pre-named chair roles unfair, others found it an excellent experience to learn co-ordination skills. In some teams, a student could start to take responsibility based on their previous working experience and expectations related to the professional role in solving the student’s case.
“The interaction worked excellently. It was evident that someone in the team took on a sort of leadership role and ensured that things were taken care of. Others then complemented, and the discussion flowed very naturally.”
(TS14)
“I noticed early on that my role seemed to shape up as the team leader. However, at the same time, I aimed not to be the team leader because my primary goal was to learn more about interdisciplinary collaboration. (…) Social workers typically have a strong role in multi-professional networks, and, on the other hand, social workers are usually expected to take on leadership responsibilities.”
(SW1)
The student essays indicated that the assignments and teamwork arrangements enabled students to achieve a social level of learning [19], through which they gained an understanding of interprofessional work as a shared working process. In most of the teams, the students were able to carry out a collaborative process where they shared a team goal and carried out a motivational process to solve the case example [14].

4.3. Realizing the Complexity of Student Welfare Cases

The cases to be solved in interdisciplinary teams were constructed to represent concrete, complex, and open student welfare cases. The aim was that they persuaded the students to participate in multi-vocal discussions. The cases included triggers for knowledge formation and opened up dialogue between the students and discussion of possible differing and even conflicting aspects regarding the case [42]. The students reflected in their essays on the process of solving the case:
“Regarding the different solution options, we reviewed the opinions and views of representatives from different professional fields. We aimed to choose a solution path that everyone considered the most ideal in that case.”
(LS5)
“We resolved the situation through case-specific judgment, where we tried to consider all possible scenarios and selected an approach that we assessed would cause the least harm.”
(LS11)
“The task was structured in a way that did not involve many conflicting or overlapping perspectives. The teachers and social workers mainly presented similar observations and remarks. Legal studies brought more new and interesting observations supporting the teachers and social work.”
(SW2)
Every year, some students brought forth that they found the open nature of the student case descriptions difficult and the information of the cases too unclear, written too generally, or the case was missing some relevant information. The students found that the vagueness of the cases hindered drawing conclusions regarding what could have happened in the student cases. They felt that this prevented the drafting of the implementation plan, increased the taboo nature of the phenomenon, and discouraged addressing the issue in real life.
“In our team, we discussed Minttu’s case, which had relatively vague and incomplete background information available. Based on the available information, it was not straightforward for our workteam to determine the division of labor among different stakeholders without making radical assumptions and inferences about the underlying factors of the case. To some extent, this steered the collaboration towards a more hypothetical rather than realistic direction.”
(TS13)
We, as teachers, found it important that the cases are open and represent real life. The students need to utilize the relevant information that is already known in the case, clarify the possibly contradictory information, and search for new information regarding the child’s case to fill in the incomplete knowledge (Memo 25, October 2022). Thus, the open nature of the cases enabled the students to engage in interprofessional discussion, negotiation, and interpretation. This can lead to shared knowledge formation in solving the case, a pre-requisite for successful interprofessional work and developing interventions that support the child’s best interest [16]. Furthermore, the open nature of the cases enabled students to experience an interprofessional process in which the right actions and interventions are not clear-cut, and there is no unequivocal solution [40]. Achieving a shared understanding of the child’s situation and how the child could be helped requires arguing one’s perspective and the reasons behind the decision.
“We also engaged in discussions and reflections on why it might not be advisable to prioritize a certain action in the child’s situation, and we provided each other with justifications regarding the considerations for the follow-up plan. We were able to justify our perspectives to one another. I consider this to be one of the requirements of interprofessional work. Members must be able to interact and justify their positions to other members who may not know each other’s expertise.”
(SW13)
The student teachers and social work students often found the cases relevant to their professional expertise. However, some law students found determining their professional role in the child’s matter challenging. This may be because the educational approaches for law students differ from those for social work and student teachers, who learn more practical skills in real-world settings during their studies [8]. The law students reflected on their approach to the cases and differences between the disciplines:
“However, I noticed that law was more abstract while other fields were very practical. By this, I mean that the role of law in the task was not as present in everyday life and not as seamlessly integrated with other fields, so I had to try to bring my perspective to work.”
(LS2)
“I didn’t feel that I could identify common practices in, for example, communication between the student and the teacher, and I didn’t necessarily understand the child’s individual developmental and age-related characteristics, which significantly impact the decision-making process.”
(LS8)
The experiences of the law students aligned with the notions of previous studies regarding interdisciplinary learning. For example, Kekoni et al. [19] pointed out the different approaches and attitudes between social work and law, where the perspective of legal experts is in the client’s wishes while social work considers the client’s interests as a whole and their effects on the wider surrounding community. Although some students had difficulties finding their expertise in the case, most of them comprehended the value of interprofessional collaboration. However, one student also critically reflected the work with students from other disciplines, regarding their own learning.
“It is difficult to say whether the interdisciplinary nature of the teamwork had any significance for my own learning. It was meaningful to have different strengths and perspectives within the team. Still, from my own learning process perspective, I don’t necessarily feel that the interdisciplinary team added a tremendous amount of value to it.”
(SW5)
The student essays and teacher reflections on the course indicated that complex and open student welfare cases can induce multi-vocal dialogue between students from different disciplines. Moreover, in drafting the cases, it is important that the students from different disciplines can identify their expertise in the case and the points of intersection where an interdisciplinary approach can promote the better realization of child’s rights and best interest [8].

4.4. Orienting toward Working Life

The student experiences of the high working-life relevance of the course were very consistent. Both solving the student welfare case and working in an interdisciplinary team oriented the students toward their future working life. None of the students gave feedback describing case-based teamwork as a poor assignment or, for example, a preference for the literature essay that emphasizes theoretical contents. In terms of future careers and working life, the students saw the many benefits of the course.
The course generally strengthened the students ability to act in real-life situations, and the relevance to working life seemed to increase their motivation for learning. Students often mentioned how their studies lack connection to the real working-life context. For example, student teachers rarely practice communication between home and school or work in interdisciplinary teams during university studies. In this course, the feedback was the opposite, as described in the following excerpts:
“Although I have worked as a substitute teacher in various positions, I have never had the opportunity to be part of an interprofessional meeting. That is why the assignment for this course was good practice for my future professional life. I noticed that speaking up and expressing my opinions or thoughts is worthwhile, as they can develop into good solutions within the team for the problem.”
(TS5)
“Overall, I found the interdisciplinary cooperation in the course to be rewarding and highly relevant for all participants, as the course closely resembled the context of working life.”
(SW10)
The benefits of interprofessional work and its practical arrangements were particularly emphasized in the student essays: the students wanted to be ready to solve complex cases after graduation through well-functioning interprofessional work. The casework opened up mainly positive perspectives on their thoughts on their future working life, emphasizing the benefits of interprofessional work. However, a few students also woke up to the demands of working life, and even felt anxious about the many things that cannot be learned during their studies:
“Overall, my experience working in the team has been positive. Integrating the thoughts of professionals from different fields into a coherent whole is something I will continue to practice in my future career. As a law student, the opportunity to work in this team provided by this course felt valuable to me.”
(LS7)
“As an aspiring class teacher, I’m somewhat nervous about the idea that my knowledge as a member of an interprofessional team is solely based on this course. Although this course is comprehensive and well-executed, it feels like only a glimpse of what interprofessional work will be like in the actual work environment.”
(TS19)
The team assignment allowed the students to learn various collaborative skills for working life, such as problem-solving and taking responsibility for a shared group work [27]. On the other hand, the students were aware of the possible challenges of interprofessional collaboration in working life [14]. The students considered many practical issues related to collaboration, such as scheduling meetings and working with different kinds of people, which are relevant issues in working life.
“Our teamwork went fairly smoothly; fortunately, we could easily organize our schedules. However, I wondered how the meetings would have worked out when we are all in the actual work environment and have families and our own busy schedules. (…) It would be interesting to know how such situations are handled in the real work life.”
(TS14)
“The collaboration was partly complicated by one member of our team who was mostly quiet during the meetings and had a unique approach to teamwork. This experience could very well reflect the nature of working in multi-professional teams in the actual work environment.”
(SW4)
Some of the students had already worked in their field and, thus, had experiences of multi-professional collaboration or working with real-life child welfare cases similar to the course. These students reflected on the knowledge transfer between the university course and working life experiences.
“Working in an interdisciplinary team helped me better understand the differences in perspectives across various fields, and I believe it will also benefit my future career. While working in child protection, I have sometimes wondered why a teacher has acted in a certain way. This collaboration provided me with different perspectives on that matter.”
(SW8)
The data indicated that the students could see the course’s connection to the real working-life context and perceived the working-life relevance as very valuable. When the students had working-life experiences, they could often make connections between the formal and informal learning contexts and transfer knowledge and skills from one context to another [43].

5. Discussion

School is an environment where children and young people come together every day. In inclusive education, recognizing and removing barriers to learning are seen as important aspects [44]. Various factors, such as student well-being and the supportiveness of their family background, influence the academic success of students and their engagement in school [45]. To effectively support students from diverse backgrounds and in different life situations, inclusive education requires the ability to establish practices that encourage open discussions, collaborative teamwork, and co-operation among various professionals and the families of students [3]. The heterogeneity of an inclusive school poses new demands on the working culture of professionals. One profession’s expertise alone is often insufficient to identify all the needs for student support, and interprofessional work is necessary [2]. However, there exists few university programs in which interdisciplinary work is included, and few studies describing how to teach interprofessional skills at the university level [46].
In our university course, through teaching interprofessional skills in the context of complex student welfare cases, we gave the students an interdisciplinary perspective that combined different fields of knowledge (children’s rights) and a collectively solvable “problem” (i.e., the student cases) that professionals of a single discipline could not solve alone. To enhance the ability of the students to work with complex student welfare cases, we found that it was important that they experienced real interactions with fellow students from other disciplines [8,15,24] in order to actively construct knowledge and understanding of the interprofessional working processes [22,23].
The principles of flipped learning [24] helped us to structure the course. Learning interprofessional skills can be achieved by having individual and group assignments where the students consciously reflect on their own role and identity in relation to the interdisciplinary team, as well as the roles of the other members and the possible challenges related to collaboration [14] at the emotional, rational, and behavioral levels [21,41].
After we made the amendments to the course to promote reflection on the interprofessional work by the students to a more conscious level, they reported mostly positive experiences of working in an interdisciplinary team in the course. While it is apparent that students will encounter challenges in interprofessional work within their professional careers, a favorable experience gained from their studies can serve as a guiding example [14] for understanding the key factors that contribute to success in resolving complex cases within multi-professional environments. Our study shows that, through paying particular attention to creating reflective assignments and collaborative course arrangements, students can have a successful experience of working in professional boundary spaces and develop their relational expertise during their university studies [14,16].
Furthermore, to achieve the desired learning outcomes, the teacher-researchers from the three disciplines were required to collaborate as an interdisciplinary team [34]. The joint meetings and running the course together served to develop our own understanding of ourselves as authentic teachers [25], and how to teach interprofessional work at the university level, as well as in the context of student welfare work. One crucial element that helped us to succeed with the course was the fact that we managed to overcome administrative barriers to include the study course as an official part of the curriculum of the faculties [46].
Our role as teachers may limit the results of our research. As our research included features of action research, we, as teacher-researchers, tightly interacted with the participating students and the research phenomenon [35,47]. It is important to acknowledge that the power relationships between us teachers and the students are inevitably imbalanced. We were able to emphasize the teacher’s role and deduce important matters relevant to teaching and learning. However, the students may have tried to demonstrate their competence to us, without questioning the things that may have bothered them. In order to avoid this, we highlighted the reflective nature of the student welfare work and the need for continuous professional development. We persuaded the students that their honest opinions and experiences are essential for the development of the course [47].

Author Contributions

All authors contributed to the design, data collection, data analysis and writing of the article. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Ethical review and approval of an institutional board were waived for this study, due to reason that the research procedures and practices followed All European Federation of Academies of Sciences and Humanities’ instructions. Furthermore, the study did not contain elements that, according to the Finnish National Board on Research Integrity, would require ethical pre-evaluation.

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

The data presented in this study are available on request from the corresponding author.

Acknowledgments

We wish to thank the other members of our teacher team, Merja Laitinen, Tuija Turunen and Mirva Lohiniva-Kerkelä. We are grateful to the students who participated in our research and made their experiences available to us.

Conflicts of Interest

The authors declare no conflict of interest.

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Table 1. The modules of the course.
Table 1. The modules of the course.
Module 1Orientation to child’s rights and introduction in small discipline-specific teams (the so-called expert team)
Module 2Discipline-specific professional expertise as part of a multi-professional network
Module 3Working in an interdisciplinary team with one student case, creating an interprofessional implementation plan
Module 4Final seminar on student cases and an individual reflective essay
Table 2. Students’ research data.
Table 2. Students’ research data.
DisciplineNumber of Essays:
Permission to Use as Data
(No Permission)
Extent of Data (Times New Roman; Font 12; Line 1.5)
Student teacher37 (19)44 pages
Social work student17 (1)21 pages
Law student11 (2)16 pages
Ʃ64 (22)81 pages
Table 3. Reference codes for the research data.
Table 3. Reference codes for the research data.
Student teacherTS1–37
Social work studentSWS1–16
Law studentLS1–11
Teacher memosMemo, date
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Lakkala, S.; Nikupeteri, A.; Lantela, L. How Can Interprofessional Skills Be Taught during University Studies? Student Teachers, and Social Work and Law Students Solving Complex Student Welfare Cases. Educ. Sci. 2023, 13, 806. https://doi.org/10.3390/educsci13080806

AMA Style

Lakkala S, Nikupeteri A, Lantela L. How Can Interprofessional Skills Be Taught during University Studies? Student Teachers, and Social Work and Law Students Solving Complex Student Welfare Cases. Education Sciences. 2023; 13(8):806. https://doi.org/10.3390/educsci13080806

Chicago/Turabian Style

Lakkala, Suvi, Anna Nikupeteri, and Lauri Lantela. 2023. "How Can Interprofessional Skills Be Taught during University Studies? Student Teachers, and Social Work and Law Students Solving Complex Student Welfare Cases" Education Sciences 13, no. 8: 806. https://doi.org/10.3390/educsci13080806

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