It is of my opinion, that working together is an important component of working in healthcare. Team work has often been studied with results often pointing towards its importance for high quality of care of the patient (2,3,4). As many patients have complex needs, they need multiple disciplinary care - as some of their needs fall outside the scope of practice of physiotherapists (practice safely and effectively within own scope of practice)- such as swallow difficulties. Therefore, integration in healthcare is vitally important to put the patient at the center of practice but to also follow the HCPC (5) and CSP (6) standards of working within your own scope of practice. The values of this domain are also echoed by the CSP standard to work effectively with others and the HCPC standard to be able to work appropriately with others.

 These standards are put in place in order for the patient to receive quality care and so that staff  work effectively with others to meet the  responsibility of professional practice. Over the course of 2 years in the MSc Course I have been able to improve my ability to work with others - particularly other physiotherapists. An area I could develop further is actively seeking out other professions within the wider MDT for assistance. This has not been done on a regular basis throughout my placements - due to confidence and not being fully aware of the scope of practice of other professions. 

Team working is a concept I am familiar with having spent much of my younger years playing team sports while also finding employment in team jobs. This has enabled me to participate and develop professional networks to encourage collaboration over the course of this two-year masters degree. As student physiotherapist - and student member of the CSP I have joined a number of networks within the ICSP to foster collaboration, share information and ideas and enhance practice. I have included a screenshot of my networks as evidence, presented here as 'iCSP Networks' and a screenshot replying to a question in a student forum, presented as 'student forum'. I have also included a screenshot of myself asking a question to a speaker at a CPD event to demonstrate my participation in professional networks. This is presented as 'webinar screenshot'. Being a part of these types of groups and networks is important for physiotherapy. It allows us to gain the perspective and ideas of other clinicians, which we may then implement into our own practice and improve the quality of the service. This has helped me to be able to understand some of the key concepts of the knowledge base and respect and support individuals' autonomy. I must admit, this is an area I have only began to get in depth exposure in the last 6 months. While I always would watch certain speakers in webinars I would not routinely get involved in the discussion. Lately, I have been occasionally commenting my views and joining networks of interest, to gain the views of others, engage in debate and in general improve my scope of practice. Prior to this, I would very rarely comment on anything physio related. I feel this is because I was still adjusting to the environment of being a student physiotherapist and felt I did not have the knowledge to offer a worthwhile opinion. However, now as my confidence is on the rise and I begin to be surer of myself as a physiotherapist, I aim to interact more with networks to build relationships and my own knowledge base.

During my first year studying MSc Physiotherapy I got the opportunity to participate in a cross-discipline module which involved collaborating with occupational therapists and speech and language therapists to create a poster and write a reflective assignment on the processes we engaged it. This was not something I was accustomed to at the time, and I was surprised at how other professions viewed physiotherapy. I did not know much about the other professions either at this time. Understanding what other professions can offer is an important part of MDT working, as if you are fully aware of their role, you can liaise with them to work with a patient. I found working with different professions difficult at first and I worried it would not become easier. I think this was perhaps down to differing professional language and inexperience of not working with multidisciplinary teams before. However, we all worked together and communicated effectively to create a comprehensive poster ('IPL Poster') - much like it takes multiple disciples to come together to bring comprehensive care to the patient. This process taught me the basics of working effectively with others to meet the responsibility of professional practice. As part of this module. I then had to write a reflective assignment on the process while taking a close look at interdisciplinary communication, 'IPL Reflection'. This demonstrates evidence of reflecting on experience of collaborative working.

This process of being aware of other professions scope of practice is important. With the emergence of physiotherapists working in primary care as first contact practitioners, it may be necessary to educate other professionals to their job role. This may be important so that first contact practitioners receive appropriate referrals, as in other countries, the roles of physiotherapists in primary care have sometimes been misunderstood (7).

I believe I have come on a journey, learning about and participating in activities listed in this domain. I believe, sometimes I could integrate more with teams and collaborate more. In my opinion my own confidence is the issue which holds me back and I am sometimes tentative approaching members of MDT for support or to collaborate. Over the course of my placements, I feel that this has improved and I now engage much better with the MDT but can still be tentative at times. This is presented here as 'skills journal example' and 'placement feedback'. How I aim to combat this is by getting more experience in teams and pushing my-self to get involved in more communication and team projects to boost my confidence. I also aim to keep learning more about other professions within the team and taking the time to ask questions of them - so the patient receives the most comprehensive experience of care.

The emergence of COVID-19 has changed things for definite within this domain. Collaboration and integration for new starters can be hampered by the need to social distance. Sometimes there are a limit on numbers of people in certain rooms and with facemasks and PPE sometimes the communication is interrupted- as facial expressions are somewhat lost for example. All of this just means that each individual has to try a bit harder to collaborate. Whether it be finding a less crowded area to discuss a patient or by having meetings virtually.  One positive outcome from the pandemic however is the growth of webinars, which means there are more opportunities for continual professional development from the comfort of your home.