Peters, Henry B.
The subject of health policy and its influence on patients and providers is explored with an emphasis on an interprofessional consortium, devoted to representing the consumer constituency. Expanded involvement and expenditures by the federal government in the health care field are discussed and the need for regulatory reform is described.…
This paper reports from the first phase of a study of the inter-professional work of hospital play specialists (HPSs). In this phase, the author aimed to test the utility of Edwards' concept of "relational agency" in inter-professional work in hospital settings. Individual HPSs in two London hospitals were observed for half-day periods,…
Goldman, Joanne; Reeves, Scott; Wu, Robert; Silver, Ivan; MacMillan, Kathleen; Kitto, Simon
Patient discharge is a key concern in hospitals, particularly in acute care, given the multifaceted and challenging nature of patients' healthcare needs. Policies on discharge have identified the importance of interprofessional collaboration, yet research has described its limitations in this clinical context. This study aimed to extend our understanding of interprofessional interactions related to discharge in a general internal medicine setting by using sociological theories to illuminate the existence of, and interplay between, structural factors and microlevel practices. An ethnographic approach was employed to obtain an in-depth insight into healthcare providers' perspectives, behaviours, and interactions regarding discharge. Data collection involved observations, interviews, and document analysis. Approximately 65 hours of observations were undertaken, 23 interviews were conducted with healthcare providers, and government and hospital discharge documents were collected. Data were analysed using a directed content approach. The findings indicate the existence of a medically dominated division of healthcare labour in patient discharge with opportunities for some interprofessional negotiations; the role of organizational routines in facilitating and challenging interprofessional negotiations in patient discharge; and tensions in organizational priorities that impact an interprofessional approach to discharge. The findings provide insight into the various levels at which interventions can be targeted to improve interprofessional collaboration in discharge while recognizing the organizational tensions that challenge an interprofessional approach.
Miller, Karen-Lee; Kontos, Pia C
To report a study of the negotiation practices of neurorehabilitation nurses with one another and with allied health professionals to understand nursing relations. Negotiated order theory offers a promising theoretical lens with which to explore negotiation between nurses and other professionals. This study is the first to apply the perspective to nurse-nurse and nurse-allied health professional relations. The study is a secondary analysis of findings from a multi-site arts-based intervention to improve patient-centred neurorehabilitation practice. Interviews and ethnographic observations were conducted (2008-2011) in two neurorehabilitation units in Ontario, Canada. Participants (n = 31) included registered and practical nurses, nurse leaders, and allied health professionals from physical, occupational, and recreational therapy, speech language pathology, and social work. Neurorehabilitation nursing is characterized by heavy workload, high patient acuity, and poor interprofessional collaboration. This practice context was negotiated by nurses through two strategies: (1) intraprofessional collegialism, accomplished through tactics including task and knowledge sharing, emotional support, coercive threats, and suppression of dissension; and (2) vying for an autonomous essential nursing role in interprofessional practice, accomplished by claiming unique nursing knowledge based on 24/7 nursing proximity, the expansion of the division of professional labour with allied health professionals and modifying physical therapy care plans. The intraprofessional context and negotiations therein were linked in significant ways to interprofessional negotiations. Understanding this complexity has important implications for improving patient safety and interprofessional practice interventions. © 2012 Blackwell Publishing Ltd.
Fox, Ann; Reeves, Scott
There has been sustained international interest from health care policy makers, practitioners, and researchers in developing interprofessional approaches to delivering patient-centred care. In this paper, we offer a critical exploration of a selection of professional discourses related to these practice paradigms, including interprofessional collaboration, patient-centred care, and the combination of the two. We argue that for some groups of patients, inequalities between different health and social care professions and between professionals and patients challenge the successful realization of the positive aims associated with these discourses. Specifically, we argue that interprofessional and professional-patient hierarchies raise a number of key questions about the nature of professions, their relationships with one another as well as their relationship with patients. We explore how the focus on interprofessional collaboration and patient-centred care have the potential to reinforce a patient compliance model by shifting responsibility to patients to do the "right thing" and by extending the reach of medical power across other groups of professionals. Our goal is to stimulate debate that leads to enhanced practice opportunities for health professionals and improved care for patients.
Lee, Charlotte T
Coordination is a vital component in healthcare provision and teamwork. Relational coordination (RC) represents a type of informal coordination reinforced by communication and supportive relationships. It is an important concept in the study of interprofessional team performance and is associated with improved patient care outcomes. However, little is known about the specific relational characteristics that contribute to higher levels of RC. This study examined the association between social capital (resources embedded within relationships) and RC in outpatient clinics. RC was hypothesized to be predicted by social capital. In addition, social capital was hypothesized to be predicted by team tenure, and RC was hypothesized to be predicted by formal coordination mechanisms. A cross-sectional design was used to survey a random sample of 342 physicians and nurses from outpatient clinics. Study variables were measured using previously validated instruments with acceptable levels of reliability and validity. Structural equation modeling was used for hypothesis testing. Final analysis revealed a good fit of data to the hypothesized model (comparative fit index = 0.966; standardized root mean square residual = 0.0316). Results suggested that social capital predicted both factors of RC (b = 0.70 and 0.81, p < 0.001) and team tenure predicted social capital (b = 0.13, p < 0.05). Also, the association between team tenure and RC (b = 0.09, p < 0.05) was found to be partially mediated by social capital. Findings of this study suggest that characteristics within relational ties are predictive of informal coordination. The strength and pattern of these associations provide a better understanding in how relationships may facilitate interprofessional teamwork.
Bell, Sigall K; Pascucci, Robert; Fancy, Kristina; Coleman, Kelliann; Zurakowski, David; Meyer, Elaine C
To assess the educational value of improvisational actors in difficult conversation simulations to teach communication and relational skills to interprofessional learners. Surveys of 192 interprofessional health care professionals, and 33 teaching faculty, and semi-structured interviews of 10 actors. Descriptive statistics, Fisher's exact test and chi-square test were used for quantitative analyses, and the Crabtree and Miller approach was used for qualitative analyses. 191/192 (99.5%) interprofessional learners (L), and 31/33 (94%) teaching faculty (F) responded to surveys. All 10/10 actors completed interviews. Nearly all participants found the actors realistic (98%L, 96%F), and valuable to the learning (97%L, 100%F). Most felt that role-play with another clinician would not have been as valuable as learning with actors (80%L, 97%F). There were no statistically significant differences in perceived value between learners who participated in the simulations (47%) versus those who observed (53%), or between doctors, nurses, or psychosocial professionals. Qualitative assessment yielded five actor value themes: Realism, Actor Feedback, Layperson Perspective, Depth of Emotion, and Role of Improvisation in Education. Actors independently identified similar themes as goals of their work. The value attributed to actors was nearly universal among interprofessional learners and faculty, and independent of enactment participation versus observation. Authenticity, feedback from actors, patient/family perspectives, emotion, and improvisation were key educational elements. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Ren, ZhengJia; Wang, HongTao; Zhang, Wei
The purpose of this study was to begin to generate an exploratory model of the disaster-related mental health education process associated with the training experiences of psychological relief workers active during the Sichuan earthquake in China. The data consisted of semi-structured interviews with 20 psychological relief workers from four different professions (social workers, psychiatric nurses, psychiatrists, and counsellors) regarding their experiences in training and ideas for improvement. The model explains the need to use a people-centred community interprofessional education approach, which focuses on role-modelling of the trainer, caring for relief workers, paying attention to the needs of the trainee, and building systematic interprofessional education strategies. The proposed model identifies areas for the comprehensive training of relief workers and aims to address the importance of people-centred mental health service provisions, ensure intentional and strategic training of relief workers using interprofessional concepts and strategies, and use culturally attuned and community-informed strategies in mental health training practices.
Scaria, Minimol Kulakkottu
Cohesive interprofessional teamwork is essential to successful healthcare services. Interprofessional teamwork is the means by which different healthcare professionals - with diverse knowledge, skills and talents - collaborate to achieve a common goal. Several interventions are available to improve teamwork in the healthcare setting. This article explores the role of care pathways in improving interprofessional teamwork. Care pathways enhance teamwork by promoting coordination, collaboration, communication and decision making to achieve optimal healthcare outcomes. They result in improved staff knowledge, communication, documentation and interprofessional relations. Care pathways also contribute to patient-centred care and increase patient satisfaction.
Donovan, Anne L; Aldrich, J Matthew; Gross, A Kendall; Barchas, Denise M; Thornton, Kevin C; Schell-Chaple, Hildy M; Gropper, Michael A; Lipshutz, Angela K M
We describe the importance of interprofessional care in modern critical care medicine. This review highlights the essential roles played by specific members of the interprofessional care team, including patients and family members, and discusses quality improvement initiatives that require interprofessional collaboration for success. Studies were identified through MEDLINE search using a variety of search phrases related to interprofessional care, critical care provider types, and quality improvement initiatives. Additional articles were identified through a review of the reference lists of identified articles. Original articles, review articles, and systematic reviews were considered. Manuscripts were selected for inclusion based on expert opinion of well-designed or key studies and review articles. "Interprofessional care" refers to care provided by a team of healthcare professionals with overlapping expertise and an appreciation for the unique contribution of other team members as partners in achieving a common goal. A robust body of data supports improvement in patient-level outcomes when care is provided by an interprofessional team. Critical care nurses, advanced practice providers, pharmacists, respiratory care practitioners, rehabilitation specialists, dieticians, social workers, case managers, spiritual care providers, intensivists, and nonintensivist physicians each provide unique expertise and perspectives to patient care, and therefore play an important role in a team that must address the diverse needs of patients and families in the ICU. Engaging patients and families as partners in their healthcare is also critical. Many important ICU quality improvement initiatives require an interprofessional approach, including Awakening and Breathing Coordination, Delirium, Early Exercise/Mobility, and Family Empowerment bundle implementation, interprofessional rounding practices, unit-based quality improvement initiatives, Patient and Family Advisory Councils
Azar, Jose M.; Johnson, Cynthia S.; Frame, Amie M.; Perkins, Susan M.; Cottingham, Ann H.; Litzelman, Debra K.
This pilot study was designed to measure teamwork and the relationship of teamwork to patient perceptions of care among sixty-three members of twelve oncology teams at a Cancer Center in the Midwest. Lack of teamwork in cancer care can result in serious clinical errors, fragmentation of care, and poor quality of care. Many oncology team members, highly skilled in clinical care, are not trained to work effectively as members of a care team. The research team administered the Relational Coordination survey to core oncology team members--medical oncologists, nurse coordinators, and clinical secretaries--to measure seven dimensions of team skills (four relating to communication [frequency, timeliness, accuracy, and problem solving] and three relating to relationship [shared goals, shared knowledge and mutual respect]) averaged to create a Relational Coordination Index. Results indicated that among the team member roles, nurse coordinator relational coordination indices were the strongest and most positively correlated with patient perception of care. Statistically significant correlations were intra-nurse coordinator relational coordination indices and two patient perception of care factors (information and education and patient’s preferences). All other nurse coordinator intra-role as well as inter-role correlations were also positively correlated, although not statistically significant. PMID:27936991
Azar, Jose M; Johnson, Cynthia S; Frame, Amie M; Perkins, Susan M; Cottingham, Ann H; Litzelman, Debra K
This pilot study was designed to measure teamwork and the relationship of teamwork to patient perceptions of care among 63 members of 12 oncology teams at a Cancer Centre in the Midwest. Lack of teamwork in cancer care can result in serious clinical errors, fragmentation of care, and poor quality of care. Many oncology team members, highly skilled in clinical care, are not trained to work effectively as members of a care team. The research team administered the Relational Coordination survey to core oncology team members-medical oncologists, nurse coordinators, and clinical secretaries-to measure seven dimensions of team skills (four relating to communication [frequency, timeliness, accuracy, and problem solving] and three relating to relationship [shared goals, shared knowledge, and mutual respect]) averaged to create a Relational Coordination Index. The results indicated that among the team member roles, nurse coordinator relational coordination indices were the strongest and most positively correlated with patient perception of care. Statistically significant correlations were intra-nurse coordinator relational coordination indices and two patient perception of care factors (information and education and patient's preferences). All other nurse coordinator intra-role as well as inter-role correlations were also positively correlated, although not statistically significant.
Kailee Burdick DNP, RN
Full Text Available Background: Bedside interprofessional rounding is gaining ground as a means to improve collaboration and patient outcomes, yet little is known regarding patients’ perceptions of the practice. Methods: This descriptive study used individual patient interviews to elicit views on interprofessional rounding from 35 patients at a large, urban hospital. Results: The findings identified three major categories: 1 about the rounding process; 2 clinical information; and 3 the impact/value of bedside inter-professional rounding. Discussion: Intentionally eliciting and responding to our patients’ views of interprofessional rounding may help us design methods that are patient centered and effective.
Aase, Ingunn; Aase, Karina; Dieckmann, Peter
of interprofessional teamwork in all nursing and medical education in Norway. The study programs issued by the 32 educational institutions were subject to content analysis, distilling the ambitions and goals for teaching interprofessional teamwork. Study program coordinators were approached and asked to what degree...... interprofessional teamwork was actually introduced in lecturing and clinical training. Results indicate that the medical and nursing schools clearly aspire to teach interprofessional teamwork and that this has largely been achieved when it comes to theoretical teaching. Although three of the four medical programs...... have integrated interprofessional teamwork into their clinical training, there is a gap in the nursing programs where introduction of interprofessional teamwork in clinical training has been limited. Current challenges are related to organizational issues (e.g. lack of institutional collaboration...
Lee, Chia-Lun; Hung, Chich-Hsiu
Inter-professional practice (IPP), necessary in today's healthcare environment, should be guided and practiced through inter-professional education (IPE). Within the context of an effective IPE program, collaborative medical professionals must be cognizant of the demands of patients' integrated care, organize a collaborative inter-professional team, and achieve the objectives of patient-centered care. However, the many challenges of IPE include insufficient understanding of inter-professional care, occupational culture-related boundary issues, lack of a college education, and insufficient support from academic and medical institutions. This article suggests adopting effective strategies to promote inter-professional recognition, create a harmonious medical culture, eliminate barriers to education, and enhance support for academic and medical institutions. Inter-professional collaboration between academic and clinical institutions must provide resources and substantive professional training. Effectively implementing IPE and IPP is expected to elicit trust, respect, and efficient communication from team members.
Leila Safabakhsh; Alireza Irajpour; Nikoo Yamani
Background: Traditional continuing education (CE) approaches have limited impact on patient management and outcomes. Continuing interprofessional education is an innovated educational approach that can improve patient care and outcomes related to health care. There is a need to provide guidance to continuing education professionals in the development, implementation, and evaluation of continuing interprofessional education activities. Objectives: This study attempted to identity effective ele...
Background. A collaborative interprofessional research project that involved community members was beneficial to community development. Objective. To draw upon the experiences of academics relating to their involvement in an interprofessional community-based participatory research (CBPR) project. Methods. A Delphi ...
Jakobsen, Flemming; Morcke, Anne Mette; Hansen, Torben Baek
who worked in an interprofessional outpatient orthopaedic clinic from March 2015 to January 2016. The interviews were transcribed and analysed using systematic text condensation. The students’ self-reported learning experience in this outpatient clinic was characterised by direct patient contact...... we ensure that this shift maximises learning. The purpose of this article is to understand the authentic learning experience in an interprofessional outpatient clinic setting. We performed an exploratory case study with interviews of four nursing students, 13 medical students, and six staff members...... and by authentic, interprofessional, task-based learning, and a preference for indirect supervision when conducting uncomplicated patient consultations. The supervisors intended to create this interprofessional outpatient clinic experience by having a clear teaching approach based on adult learning principles...
Hall, Pippa; Weaver, Lynda; Grassau, Pamela Anne
In this article, we illustrate the application of a number of theoretical frameworks we have used to guide our work in interprofessional education (IPE) and collaborative interprofessional care (IPC). Although we do not claim to be experts in any one of these theories, each has offered important insights that have broadened our understanding of the complexities of interprofessional learning and practice. We have gained an appreciation for an increasing number of theories relevant to IPE and IPC, and, as a result, we have woven together more key principles from different theories to develop activities for all levels of interprofessional learners and clinicians. We pay particular attention to relational competencies, knotworking/idea dominance, targeted tension and situational awareness. We are now drawing on the arts and humanities and complexity theory to foster relationship-building learning. Evaluation of our endeavors will eventually follow these latter theories for methods that better match the human and social experiences that underpin learning. Our "theoretical toolbox" therefore may be of value to educators who develop and implement creative interprofessional learning activities, as well as clinicians interested in moving toward more effective collaboration.
Milburn, Peter C.; Colyer, Hazel
Interprofessional education (IPE) is well-established in the professional discipline of radiography and other health and social care professions, driven by central government policies promoting interprofessional, collaborative working. The development of an appropriate knowledge base for interprofessional work is therefore important and, as a starting point, the article investigates the concept and significance of professional knowledge as a means to unravel and shed light on the potential emergence of a new body of knowledge, 'interprofessional knowledge'. The paper discusses whether the term 'interprofessional knowledge' (IPK) is meaningful and its utility for interprofessional practice, arguing that such knowledge is located within the discourse of interprofessional learning and practice. As such it is fluid and contextualised. The implications of this for all health and social care professionals, including radiographers, are elaborated to assist in future curriculum development and enhance understanding of the knowledge that underpins effective, collaborative, interprofessional practice. The paper concludes by suggesting there are a number of key implications for professional practice namely, IPE cannot teach interprofessional knowledge, rather it should facilitate interprofessional practice, through which such knowledge is construed, and person-centred care can be more effectively achieved. Second, interprofessional practice is highly contextualised by practice setting and point of service delivery. Any attempt to decontextualise it for the purpose of curriculum development would be illogical; interprofessional knowledge is in a symbiotic relationship with its prior professional knowledge. Third, the organisation of IPE would be better driven by alliances of complementary professions in order to maximise its potential effectiveness and credibility with practitioners
Hean, Sarah; Craddock, Deborah; Hammick, Marilyn
This article argues for the need for theory in the practice of interprofessional education. It highlights the range of theories available to interprofessional educators and promotes the practical application of these to interprofessional learning and teaching. It summarises the AMEE Guides in Medical Education publication entitled Theoretical Insights into Interprofessional Education: AMEE Guide No. 62, where the practical application of three theories, social capital, social constructivism and a sociological perspective of interprofessional education are discussed in-depth through the lens of a case study. The key conclusions of these discussions are presented in this article.
Hamming, Anders; Nielsen, Anette
Denmark has a tradition of interprofessional collaboration between the health, social work and teaching professions in many settings, dating back to the early 1960’s. Collaboration has been enshrined in law, mostly in order to prevent the exclusion of people with social, physical or other...... disabilities and to improve the efficiency of service delivery. Interprofessional education (IPE) has been required by law since 2001 for entrants to the health professions (including nurses, midwifes, physiotherapists and occupational therapists), since 2002 to social work and since 2007 for school teaching...... and social education...
Gary L. Beck Dallaghan
Full Text Available Background: Interprofessional education (IPE is an important component to training health care professionals. Research is limited in exploring the attitudes that faculty hold regarding IPE and what barriers they perceive to participating in IPE. The purpose of this study was to identify faculty attitudes about IPE and to identify barriers to participating in campus-wide IPE activities. Methods: A locally used questionnaire called the Nebraska Interprofessional Education Attitudes Scale (NIPEAS was used to assess attitudes related to interprofessional collaboration. Questions regarding perceived barriers were included at the end of the questionnaire. Descriptive and non-parametric statistics were used to analyze the results in aggregate as well as by college. In addition, open-ended questions were analyzed using an immersion/crystallization framework to identify themes. Results: The results showed that faculty had positive attitudes of IPE, indicating that is not a barrier to participating in IPE activities. Most common barriers to participation were scheduling conflicts (x24,285=19.17, p=0.001, lack of department support (4,285=10.09, p=0.039, and lack of awareness of events (x24,285=26.38, p=0.000. Narrative comments corroborated that scheduling conflicts are an issue because of other priorities. Those who commented also added to the list of barriers, including relevance of the activities, location, and prior negative experiences. Discussion: With faculty attitudes being positive, the exploration of faculty's perceived barriers to IPE was considered even more important. Identifying these barriers will allow us to modify our IPE activities from large, campus-wide events to smaller activities that are longitudinal in nature, embedded within current curriculum and involving more authentic experiences.
McMurtry, Angus; Rohse, Shanta; Kilgour, Kelly N
Interprofessional teamwork and collaboration have become important parts of health care practice and education. Most of the literature on interprofessional learning, however, assumes that learning is something acquired by individuals and readily transferred to other contexts. This assumption severely limits the ways in which interprofessional educators and researchers can conceptualise and support learning related to collaborative interprofessional health care. Socio-material theories provide an alternative to individualistic, acquisition-oriented notions by reconceiving learning in terms of collective dynamics, participation in social communities and active engagement with material contexts. Socio-material literature and theories were reviewed to identify concepts relevant to interprofessional learning. After briefly summarising the origins and key principles of socio-material approaches, the authors draw upon specific socio-material theories--including complexity theory, cultural-historical activity theory and actor-network theory--in order to reconceive how learning happens in interprofessional contexts. This reframing of interprofessional learning focuses less on individuals and more on collective dynamics and the actual social and material relations involved in practice. The paper proposes five ways in which learning may be enacted in interprofessional teamwork and collaboration from a socio-material perspective: (i) diverse contributions; (ii) social interactions and relationships; (iii) synthesis of professional ideas; (iv) integration of material elements, and (v) connections to large-scale organisations. For each of these categories, the paper provides practical illustrations to assist educators and researchers who wish to identify and assess this learning. Although more exploratory than comprehensive, this paper articulates many key aspects of socio-material learning theories and offers practical guidance for those who wish to employ and assess them in
Full Text Available Interprofessional care within many clinical and community mental health teams in Australia require staff to work collaboratively and outside their traditional scope. Whilst shared decision making and interprofessional collaboration are important approaches in supporting an individual’s recovery journey, working interprofessionally can create issues within teams when determining and defining ways to respond, care and support people with mental illness. The aim of this report is to examine workforce perspectives regarding an interprofessional postgraduate learning approach in mental health practice. Semi-structured in-depth interviews were conducted with eight mental health stakeholders. Findings indicate that practitioner learning needs are dependent on practice setting (i.e. hospital/clinical vs. community and professional background (i.e. social work, nursing. Learning needs were related to the application of practice frameworks (therapeutic relationship, recovery and professional identity and the workforce issues for employers (qualifications and skills. Overall interprofessional understanding and collaboration were seen as an essential requirement in ensuring an evidence based response to improve quality of life and economic and social participation for consumers. Tension between professional identities and the need for mental health practitioners to operate successfully within interprofessional contexts provides a challenge for postgraduate higher education providers. Keywords: Inter-professional; multidisciplinary; mental health; postgraduate; higher education
Nisbet, Gillian; Dunn, Stewart; Lincoln, Michelle
This study explores the potential for workplace interprofessional learning, specifically the learning that occurs between health professionals as part of their attendance at their regular interprofessional team meetings. While most interprofessional learning research to date has focused on formal structured education programs, this study adds to our understanding of the complexities of the learning processes occurring between health professionals as part of everyday practice. Through observations of team meetings and semi-structured interviews, we found that the interprofessional team meeting provided a practical, time-efficient, and relevant means for interprofessional learning, resulting in perceived benefits to individuals, teams, and patients. The learning process, however, was influenced by members' conceptions of learning, participation within the meeting, and medical presence. This study provides a basis for further research to assist health professionals capitalize on informal learning opportunities within the interprofessional meeting.
Hernández-Marrero, Pablo; Pereira, Sandra Martins; Carvalho, Ana Sofia
Ethical decisions are part of contemporary practices in palliative care. The need of making such decisions is associated to higher burnout levels and other work related problems among healthcare professionals. As part of the project entitled "Decisions in End-of-Life Care in Spain and Portugal" (DELiCaSP), this study aims to (i) identify the most common ethical decisions made by Portuguese palliative care teams and (ii) understand how the making of such decisions relates to burnout. A mixed methods study was conducted with 9 palliative care teams, using (i) questionnaires of socio-demographic and professional variables, work-related experiences, (ii) the Maslach Burnout Inventory, (iii) interviews and (iv) observations. These teams were geographically dispersed across the country, covering the North, Centrum and South regions, and heterogeneous: Five palliative care units for inpatients; three home care teams; and one hospital support team. A total of 20 interviews and 240 hours of observations were completed until reaching saturation. The most common ethical decisions were related to communication issues (information disclosure of the diagnosis and prognosis), forgoing treatment and sedation. Although perceived as stressful, emotionally demanding and challenging, ethical decisions were not significantly associated with burnout. Making ethical decisions is not associated with higher burnout levels among professionals working in Portuguese palliative care teams. This can be explained by the interprofessional decision-making process followed by these teams, which promotes a sense of shared-decision and team-based empowerment; and by the advanced level of interdisciplinary education in palliative care that these professionals have. © The Author(s) 2015.
Milburn, Peter C. [Canterbury Christ Church University, Undergraduate Interprofessional Studies, North Holmes Road, Canterbury, Kent, CT1 1QU (United Kingdom)], E-mail: firstname.lastname@example.org; Colyer, Hazel [Faculty of Health and Social Care, Canterbury Christ Church University, Canterbury, Kent, CT1 1QU (United Kingdom)
Interprofessional education (IPE) is well-established in the professional discipline of radiography and other health and social care professions, driven by central government policies promoting interprofessional, collaborative working. The development of an appropriate knowledge base for interprofessional work is therefore important and, as a starting point, the article investigates the concept and significance of professional knowledge as a means to unravel and shed light on the potential emergence of a new body of knowledge, 'interprofessional knowledge'. The paper discusses whether the term 'interprofessional knowledge' (IPK) is meaningful and its utility for interprofessional practice, arguing that such knowledge is located within the discourse of interprofessional learning and practice. As such it is fluid and contextualised. The implications of this for all health and social care professionals, including radiographers, are elaborated to assist in future curriculum development and enhance understanding of the knowledge that underpins effective, collaborative, interprofessional practice. The paper concludes by suggesting there are a number of key implications for professional practice namely, IPE cannot teach interprofessional knowledge, rather it should facilitate interprofessional practice, through which such knowledge is construed, and person-centred care can be more effectively achieved. Second, interprofessional practice is highly contextualised by practice setting and point of service delivery. Any attempt to decontextualise it for the purpose of curriculum development would be illogical; interprofessional knowledge is in a symbiotic relationship with its prior professional knowledge. Third, the organisation of IPE would be better driven by alliances of complementary professions in order to maximise its potential effectiveness and credibility with practitioners.
Diane R. Bridges
Full Text Available Interprofessional education is a collaborative approach to develop healthcare students as future interprofessional team members and a recommendation suggested by the Institute of Medicine. Complex medical issues can be best addressed by interprofessional teams. Training future healthcare providers to work in such teams will help facilitate this model resulting in improved healthcare outcomes for patients. In this paper, three universities, the Rosalind Franklin University of Medicine and Science, the University of Florida and the University of Washington describe their training curricula models of collaborative and interprofessional education.The models represent a didactic program, a community-based experience and an interprofessional-simulation experience. The didactic program emphasizes interprofessional team building skills, knowledge of professions, patient centered care, service learning, the impact of culture on healthcare delivery and an interprofessional clinical component. The community-based experience demonstrates how interprofessional collaborations provide service to patients and how the environment and availability of resources impact one's health status. The interprofessional-simulation experience describes clinical team skills training in both formative and summative simulations used to develop skills in communication and leadership.One common theme leading to a successful experience among these three interprofessional models included helping students to understand their own professional identity while gaining an understanding of other professional's roles on the health care team. Commitment from departments and colleges, diverse calendar agreements, curricular mapping, mentor and faculty training, a sense of community, adequate physical space, technology, and community relationships were all identified as critical resources for a successful program. Summary recommendations for best practices included the need for administrative
Full Text Available Twenty-three of 26 participants, mainly women from six local agencies involved in the reception of refugees, completed a university course titled “Refugee-related stress and mental health—local cooperation”, which was spread over seven days in 2011. The course was based on evidence and clinical experience and was commissioned to serve as competency training by Stockholm County Council and Södertälje Municipality. It received funding from the Swedish National Board of Health and Welfare. It was a continuation of an earlier one-week full-time university course from 2010 with the same title. As a result of a new law relating to refugee reception, which led to organizational change, the participants requested a continuation of the original course. The learning objectives were met (5.4 on a 6-point scale; 1 = strongly disagree, 6 = strongly agree. The general assessment of the course as a whole by the participants was 5.7 (on a 6-point scale, 1 = very unsatisfied, 6 = very satisfied. The participants thought that their skills had increased, and their perception was that they had significantly better control of their work situation following completion of the course. The most important findings were that participants from different agencies at the local level: (1 perceived that they had developed the sense that there was a local inter-cultural and inter-professional inter-agency collaboration in the reception of newly arrived refugees and (2 will continue efforts to stabilize and develop this together. This method of teaching, in terms of skills training, is not a “quick fix.” It is a process, and it needs support from those in power in order to continue.
No wonder two movements described in such similar terms are so often confused. One strives to knit services together, the other to cultivate collaborative practice amongst their workers. Dedicated though both of them are to the improvement of health and social care, integrated care falters without engaging the workforce actively as partners in change whilst interprofessional care falters without organisational support. Neither stands alone. Each depends on the other. PMID:23593049
Full Text Available No wonder two movements described in such similar terms are so often confused. One strives to knit services together, the other to cultivate collaborative practice amongst their workers. Dedicated though both of them are to the improvement of health and social care, integrated care falters without engaging the workforce actively as partners in change whilst interprofessional care falters without organisational support. Neither stands alone. Each depends on the other.
Hendricks, Susan; LaMothe, Virginia Julie; Kara, Areeba; Miller, Joan
The purpose of this qualitative study was to describe the barriers and facilitators for interprofessional patient-centered rounding across 4 acute care units in a large urban hospital. A qualitative descriptive method that included data gathered over an 18-month period was used. Three data sources were included: participant observation of rounding activities, focused meetings related to interprofessional practice, and exit interviews with key informants representing multiple professions and roles. The data were analyzed, and the findings were developed through an extensive transcription, coding, and discussion process. The facilitators and barriers related to the team included high versus low turnover of team membership, structured versus unstructured rounding, valuing versus skepticism about interprofessional practice, and confidence versus hesitancy about skills. Facilitator/barrier pairs related to the environment included rounding aligned versus mismatched with hospital's mission, time for rounding versus competing demands, geographically cohorted versus distributed teams, and readiness for change and innovation versus saturation. Factors associated with the members of the interprofessional team were important in successful implementation of interprofessional rounding. The organizational context and structure were also important. Leaders who anticipate implementing interprofessional rounding may incorporate knowledge of these facilitators and barriers into their planning process.
Edwards, Scott; Molina, Patricia E; McDonough, Kathleen H; Mercante, Donald E; Gunaldo, Tina P
To obtain physician assistant (PA) student perceptions about an interprofessional education (IPE) training experience embedded in a multidisciplinary science course. An IPE training experience was integrated into a graduate human physiology course offered to PA, physical therapy, and graduate studies students. The focus of the activity related to the Interprofessional Education Collaborative (IPEC) competency domains of (1) roles and responsibilities and (2) teams and teamwork. Effectiveness was assessed in pretraining and posttraining surveys, which included questions addressing student self-perceptions of IPEC competency domains, student assessment of the learning activity, and student reflection. We observed a statistically significant positive change in PA student perceptions of IPEC competency domains. Students also provided a positive evaluation of the IPE activity and communicated personal improvements in IPE perspectives. Incorporating planned IPE experiences into multidisciplinary health science courses represents an appropriate venue for PA students to learn and apply interprofessional competencies, which may benefit future interprofessional practice.
Interprofessional education, continuing interprofessional education, interprofessional collaboration, and interprofessional care are moving to the forefront of approaches with the potential to reorganize the delivery of health professions education and health care practice. This article discusses 7 key trends in the scholarship and practice of…
Heale, Roberta; Dickieson, Patti; Carter, Lorraine; Wenghofer, Elizabeth F
To determine the perceptions of nurse practitioners (NPs) about the level of functioning of their interprofessional teams. Interprofessional teams are a global trend, and nurses play leadership roles in their management. Little is known about the impact of specific barriers to team functioning and the role of the nurse manager on team functioning. Ninety-eight NPs at a conference completed the Interprofessional Team Functioning Survey (ITFS). The survey items with the lowest mean scores were related to organisational systems. These items included workplace policies that support interprofessional teamwork, in particular, orientation to the interprofessional team. Items that generated lower mean scores were adequate time to work as a member of the interprofessional team, team dynamics, collaboration among team members and the sharing of responsibility. Organisational and team relational issues can be addressed through organisational management strategies. Nurse managers have an important role in facilitating high functioning interprofessional teams. Strategies for managers to support interprofessional team functioning emerged. These strategies include ensuring that there are appropriate policies, orientation of new members, allocation of time to support interprofessional teamwork, leadership to enhance team collaboration and clear delineation of responsibilities of each member. © 2013 John Wiley & Sons Ltd.
Penwell-Waines, Lauren; Wilson, Christina K; Macapagal, Kathryn R; Valvano, Abbey K; Waller, Jennifer L; West, Lindsey M; Stepleman, Lara M
Interprofessional collaboration requires that health professionals think holistically about presenting concerns, particularly for multimodal problems like sexual dysfunction. However, health professions students appear to receive relatively little sexual health education, and generally none is offered on an interprofessional basis. To assess current degree of interprofessional thinking in sexual health care, 472 health professions students in Georgia, United States, were presented with a sexual dysfunction vignette and asked to rate the relevance of, and their familiarity with, interventions offered by several professionals. They also were asked to identify the most likely cause of the sexual dysfunction. Students rated relevance and familiarity with interventions as highest for physicians and lowest for dentists, with higher ratings of nurses by nursing students. More advanced students reported greater familiarity with mental health, physician, and physical therapy interventions. Finally, nursing students were less likely to attribute the dysfunction to a physical cause. These findings indicate that students may prioritize biomedical approaches in their initial assessment and may need additional supports to consider the spectrum of biopsychosocial factors contributing to sexual functioning. To encourage interprofessional critical thinking and prepare students for interprofessional care, sexual health curricula may be improved with the inclusion of interprofessional training. Specific recommendations for curriculum development are offered.
Hansen, Britt Blaabjerg; Højholdt, Andy; Arndal, Lars Stubbe
circles (Persson, 2007). The design development was theory oriented, with our introducing theories about the different aspects of professional collaboration, co-creation and social innovation (Conger, S. 2002, Edwall et. al. 2008)).In accordance with the processes of design-based research (iteration...... required to work with these students. This paper describes the challenges [education/school] professionals (teachers and child and youth educators) face in striving to develop inclusive school practice, and how these challenges relate to differences in skills and competencies between the professions....... The knowledge for the paper was generated in a research project entitled “Interprofessional development in inclusive schools”. The project worked from a basic understanding that we need to develop preventive educational strategies for children and young people with learning difficulties and in social risk...
dr Ed de Jonge
Thesis: Ethics work (Banks 2012, 2016) is a stimulating concept for the ethical improvement of inter-professional cooperation. Outline: Starting point: ideal-typical professionalism Introduction to ethics work Professionalism requires inter-professional cooperation Inter-professional expansion
Fox, Lanae; Onders, Robert; Hermansen-Kobulnicky, Carol J; Nguyen, Thanh-Nga; Myran, Leena; Linn, Becky; Hornecker, Jaime
An expanding body of literature is examining interprofessional teamwork and its effect in healthcare. To produce capable healthcare professionals prepared to participate in interprofessional roles, teamwork training must begin early in health professional students' training. The focus of this scoping review was to explore interprofessional education (IPE) studies designed to teach and/or assess interprofessional teamwork skills to students from two or more different health professions, to find and describe effective pedagogy and assessment strategies. Using a scoping review methodology, 1,106 abstracts were reviewed by three teams of investigators. Eligibility criteria were inclusion of students in interprofessional teams, an intervention to improve interprofessional teamwork skills and assessment of outcomes related to teamwork. Thirty-three studies met the criteria for inclusion. The literature was varied in terms of study design, teaching methods and assessment measures for interprofessional teamwork. The lack of rigorous, comparable studies in this area makes recommending one teaching method or assessment measure over another difficult. Regardless of teaching method, it appears that most learning activities where interprofessional teams interact result in positive changes in student perceptions and attitudes towards IPE and practice. As health education programs seek to incorporate more interprofessional activities into their respective programs, it is important to review methods and measures that would best fit their individual program. This review highlights the importance of standardising the reporting of methods and outcomes for those who wish to incorporate the studied methods into their curricula.
D'Amour, Danielle; Oandasan, Ivy
This paper proposes a new concept and a frame of reference that should permit the development of a better understanding of a phenomenon that is the development of a cohesive and integrated health care practice among professionals in response to clients' needs. The concept is named "interprofessionality" and aims to draw a clear distinction with another concept, that of interdisciplinarity. The utilization of the concept of interdisciplinarity, which originally concerns the development of integrated knowledge in response to fragmented disciplinary knowledge, has caused some confusion. We need a concept that will specifically concern the development of a cohesive practice among different professionals from the same organization or from different organizations and the factors influencing it. There is no concept that focuses clearly on this field. Interprofessionality concerns the processes and determinants that influence interprofessional education initiatives as well as determinants and processes inherent to interprofessional collaboration. Interprofessionality also involves analysis of the linkages between these two spheres of activity. An attempt to bridge the gap between interprofessional education and interprofessional practice is long overdue; the two fields of inquiry need a common basis for analysis. To this end, we propose a frame of reference, an interprofessional education for collaborative patient-centred practice framework. The framework establishes linkages between the determinants and processes of collaboration at several levels, including links among learners, teachers and professionals (micro level), links at the organizational level between teaching and health organizations (meso level) and links among systems such as political, socio-economic and cultural systems (macro level). Research must play a key role in the development of interprofessionality in order to document these linkages and the results of initiatives as they are proposed and
Susan C. Sommerfeldt
Full Text Available The aim of this study was to explore dimensions of relational work in interprofessional health care teams. Practitioners from a variety of disciplines came together to examine teamwork and cocreate knowledge about interprofessionalism using forum theater. Interviews held prior to the workshop to explore teamwork were foundational to structuring the workshop. The forum theater processes offered participants the opportunity to enact and challenge behaviors and attitudes they experienced in health care teams. Throughout the workshop, aspects of professional identity, power, trust, communication, system structures, and motivation were explored. The activities of the workshop were analyzed using Pickering’s theory, identifying three mangle strands found in being a team: organizational influences, accomplishing tasks, and an orientation to care. Performativity was identified as having a bearing on how teams perform and how teamwork is enacted. Practice components were seen as strands within a mangling of human and nonhuman forces that shape team performativity.
Lin, Yu-Chih; Chan, Te-Fu; Lai, Chung-Sheng; Chin, Chi-Chun; Chou, Fan-Hao; Lin, Hui-Ju
Clinical ethic situations in modern multiprofessional healthcare systems may involve different healthcare professions who work together for patient care. The undergraduate interprofessional education of clinical ethics would help to incubate healthcare students' ability of interprofessional collaboration in solving ethical problems. However, the impact from an interprofessional educational model on student's attitudes and confidence of interprofessional collaboration should be carefully evaluated during the process of curricular development. This study aimed to conduct a pilot interprofessional PBL curriculum of clinical ethics and evaluate the curricular impact on interprofessional students' attitude and confidence of collaborative teamwork. Thirty-six medical and nursing students volunteered to participate in this study and were divided into three groups (medical group, nursing group, and mixed group). Tutors were recruited from the Medical School and the College of Nursing. The pilot curriculum included one lecture of clinical ethics, one PBL case study with two tutorial sessions, and one session of group discussion and feedback. A narrative story with multiple story lines and a multiperspective problem analysis tool were used in the PBL tutorials. The students' self-evaluation of learning questionnaire was used to evaluate students' learning of clinical ethics and interprofessional collaborative skills and attitude. The internal consistency of the questionnaire was measured by Cronbach α, and the criterion-related validity of the questionnaire was evaluated through associations between the dimension scores with the student group by one-way analysis of variance test (ANOVA) test and Tukey-Kramer honestly significant difference (HSD) comparison. There was significant difference among different groups in students' ability and attitudes about "interprofessional communication and collaboration" (p = 0.0184). The scores in the mixed group (37.58 ± 3.26) were higher
Kishimoto, Miyako; Noda, Mitsuhiko
Diabetes is a multifactorial disease and its nature means that interprofessional teamwork is essential for its treatment. However, in general, interprofessional teamwork has certain problems that impede its function. To clarify these problems in relation to diabetes care, a questionnaire survey was conducted. The participants who were involved in diabetes-related educational seminars, and medical personnel who were engaged in diabetes care from the National Center for Global Health and Medicine, were asked to complete the questionnaire about perceptions of, and satisfaction with, interprofessional teamwork across multiple health care providers, who were actually involved in diabetes care. From 456 people who were asked to take the questionnaire, 275 people answered. The percentages of the respondents according to profession who considered multidisciplinary teamwork sufficient were as follows: physicians, 20.5%; nurses, 12.7%; registered dietitians, 29.6%; pharmacists, 21.9%; physiotherapists, 18.2%; and clinical laboratory technicians 15.4%. Insufficient interprofessional communication and inconsistency in motivation levels among staff were frequently cited as causes of insufficient teamwork. All professions considered interprofessional meetings or conferences necessary and essential for teamwork. The survey revealed that interprofessional teamwork in diabetes care is currently insufficient. Continuous efforts to change each profession's perceptions about interprofessional teamwork and efforts to improve the quality of interprofessional meetings are necessary.
Kishimoto, Miyako; Noda, Mitsuhiko
Background Diabetes is a multifactorial disease and its nature means that interprofessional teamwork is essential for its treatment. However, in general, interprofessional teamwork has certain problems that impede its function. To clarify these problems in relation to diabetes care, a questionnaire survey was conducted. Methods The participants who were involved in diabetes-related educational seminars, and medical personnel who were engaged in diabetes care from the National Center for Global Health and Medicine, were asked to complete the questionnaire about perceptions of, and satisfaction with, interprofessional teamwork across multiple health care providers, who were actually involved in diabetes care. Results From 456 people who were asked to take the questionnaire, 275 people answered. The percentages of the respondents according to profession who considered multidisciplinary teamwork sufficient were as follows: physicians, 20.5%; nurses, 12.7%; registered dietitians, 29.6%; pharmacists, 21.9%; physiotherapists, 18.2%; and clinical laboratory technicians 15.4%. Insufficient interprofessional communication and inconsistency in motivation levels among staff were frequently cited as causes of insufficient teamwork. All professions considered interprofessional meetings or conferences necessary and essential for teamwork. Conclusion The survey revealed that interprofessional teamwork in diabetes care is currently insufficient. Continuous efforts to change each profession’s perceptions about interprofessional teamwork and efforts to improve the quality of interprofessional meetings are necessary. PMID:25120370
Curran, Vernon R; Sharpe, Dennis; Forristall, Jennifer; Flynn, Kate
The small group, case-based learning approach is believed to be a useful strategy for facilitating interprofessional learning and interaction factors are said to have a significant effect on student interest, learning and satisfaction with such approaches. The purpose of our study was twofold: assess students' satisfaction with a blended approach to interprofessional learning which combined computer-mediated and face-to-face, case-based learning; and examine the relationship between student satisfaction and perceptions of the collaborative learning process. We introduced six interprofessional learning modules to approximately 520 undergraduate health professional students from medicine (61), nursing (351), pharmacy (20), and social work (89). All students were invited to complete an evaluation survey which assessed student satisfaction with the interprofessional learning experience and students' perceptions of the small group learning process. Students' satisfaction with interprofessional education was related to professional background. Students from across professions reported greater satisfaction with face-to-face, case-based learning when compared with other learning methods. A more positive perception of face-to-face, case-based learning was related to greater satisfaction with interprofessional learning. The findings support the case-based method in facilitating interprofessional learning and highlight the importance of effective facilitation of small-group collaborative learning to enhance student satisfaction with interprofessional learning experiences.
Full Text Available In this commentary, the beneficial value of the relational aspects of interprofessional collaboration is emphasized to demonstrate that conflict of interests arising in self-referrals are more complex than presented in classic cases of conflicts of interest. A dialog involving health professionals and ethicists is recommended to better understand the relational aspects that are essential to patient wellness and autonomy, in relation to the various care and organizational contexts across private and public sectors. The goal is to inform policy making on management of conflicts of interests associated with self-referrals.
VanderWielen, Lynn M; Vanderbilt, Allison A; Dumke, Erika K; Do, Elizabeth K; Isringhausen, Kim T; Wright, Marcie S; Enurah, Alexander S; Mayer, Sallie D; Bradner, Melissa
In the US, health care professionals are trained predominantly in uniprofessional settings independent of interprofessional education and collaboration. Yet, these professionals are tasked to work collaboratively as part of an interprofessional team in the practice environment to provide comprehensive care to complex patient populations. Although many advantages of interprofessional education have been cited in the literature, interprofessional education and collaboration present unique barriers that have challenged educators and practitioners for years. In spite of these impediments, one student-led organization has successfully implemented interprofessional education and cross-disciplinary collaboration. The purpose of this paper is to provide a conceptual framework for successful implementation of interprofessional education and collaboration for other student organizations, as well as for faculty and administrators. Each member of the interprofessional team brings discipline-specific expertise, allowing for a diverse team to attend to the multidimensional health needs of individual patients. The interprofessional team must organize around a common goal and work collaboratively to optimize patient outcomes. Successful interdisciplinary endeavors must address issues related to role clarity and skills regarding teamwork, communication, and conflict resolution. This conceptual framework can serve as a guide for student and health care organizations, in addition to academic institutions to produce health care professionals equipped with interdisciplinary teamwork skills to meet the changing health care demands of the 21st century. PMID:24550677
Vanderwielen, Lynn M; Vanderbilt, Allison A; Dumke, Erika K; Do, Elizabeth K; Isringhausen, Kim T; Wright, Marcie S; Enurah, Alexander S; Mayer, Sallie D; Bradner, Melissa
In the US, health care professionals are trained predominantly in uniprofessional settings independent of interprofessional education and collaboration. Yet, these professionals are tasked to work collaboratively as part of an interprofessional team in the practice environment to provide comprehensive care to complex patient populations. Although many advantages of interprofessional education have been cited in the literature, interprofessional education and collaboration present unique barriers that have challenged educators and practitioners for years. In spite of these impediments, one student-led organization has successfully implemented interprofessional education and cross-disciplinary collaboration. The purpose of this paper is to provide a conceptual framework for successful implementation of interprofessional education and collaboration for other student organizations, as well as for faculty and administrators. Each member of the interprofessional team brings discipline-specific expertise, allowing for a diverse team to attend to the multidimensional health needs of individual patients. The interprofessional team must organize around a common goal and work collaboratively to optimize patient outcomes. Successful interdisciplinary endeavors must address issues related to role clarity and skills regarding teamwork, communication, and conflict resolution. This conceptual framework can serve as a guide for student and health care organizations, in addition to academic institutions to produce health care professionals equipped with interdisciplinary teamwork skills to meet the changing health care demands of the 21st century.
Aase, Ingunn; Aase, Karina; Dieckmann, Peter
The notions of interprofessional education and interprofessional teamwork have attained widespread acceptance, partly because lack of teamwork has been tentatively linked to adverse incidents in healthcare. By analyzing data from 32 educational institutions, this study identifies the status of interprofessional teamwork in all nursing and medical education in Norway. The study programs issued by the 32 educational institutions were subject to content analysis, distilling the ambitions and goals for teaching interprofessional teamwork. Study program coordinators were approached and asked to what degree interprofessional teamwork was actually introduced in lecturing and clinical training. Results indicate that the medical and nursing schools clearly aspire to teach interprofessional teamwork and that this has largely been achieved when it comes to theoretical teaching. Although three of the four medical programs have integrated interprofessional teamwork into their clinical training, there is a gap in the nursing programs where introduction of interprofessional teamwork in clinical training has been limited. Current challenges are related to organizational issues (e.g. lack of institutional collaboration), practical difficulties (e.g. finding time to bring students of various professions together) and possibly managerial issues (e.g. lack of strategic perspective and change management).
Luke, Robert; Solomon, Patty; Baptiste, Sue; Hall, Pippa; Orchard, Carole; Rukholm, Ellen; Carter, Lorraine
Online learning (e-learning) has a nascent but established history. Its application to interprofessional education (IPE), however, is relatively new. Over the past 2 decades the Internet has been used increasingly to mediate education. We have come past the point of "should we use the Internet for education" to "how should we use the Internet for education." Research has begun on the optimal development of online learning environments to support IPE. Developing online IPE should follow best practices in e-learning generally, though there are some special considerations for acknowledging the interprofessional context and clinical environments that online IPE is designed to support. The design, development, and deployment of effective online IPE must therefore pay special attention to the particular constraints of the health care worker educational matrix, both pre- and postlicensure. In this article we outline the design of online, interprofessional health sciences education. Our work has involved 4 educational and 4 clinical service institutions. We establish the context in which we situate our development activities that created learning modules designed to support IPE and its transfer into new interprofessional health care practices. We illustrate some best practices for the design of effective online IPE, and show how this design can create effective learning for IPE. Challenges exist regarding the full implementation of interprofessional clinical practice that are beginning to be met by coordinated efforts of multiple health care education silos.
Bachchu Kailash Kaini
Interprofessional care is an essential part of the health service delivery system. It helps to achieve improved care and to deliver the optimal and desired health outcomes by working together, sharing and learning skills. Health care organisation is a collective sum of many leaders and followers. Successful delivery of interprofessional care relies on the contribution of interprofessional care team leaders and health care professionals from all groups. The role of the interprofessional care t...
Edelbring, Samuel; Dahlgren, Madeleine Abrandt; Wiegleb Edström, Desiree
Interprofessional learning activities are included in many curricula but are difficult to assess. For languages that are not widely spoken such as Swedish, few validated questionnaires exist that relate to interprofessional outcomes. Therefore, the aim was to examine two such questionnaires in relation to interprofessional competence domains. Psychometric characteristics, such as homogeneity of items and internal consistency, were assessed for the Swedish versions of the Jefferson Scale of Attitudes Towards Physician-Nurse Collaboration (JSAPNC) and the Readiness for Interprofessional Learning Scale (RIPLS). The questionnaires were distributed directly following IPL activities. Mokken scale analysis based on Loevinger's coefficient for homogeneity and Cronbach's alpha were used to evaluate the scales. Two expert panels performed a qualitative analysis of items in relation to four internationally defined interprofessional competences. In total, 88 and 84 responded to the JSAPNC and RIPLS questionnaires, respectively. Estimates of homogeneity were low for both the JSAPNC (H = 0.16) and the RIPLS (H = 0.21). Reliabilities were weak (0.62 and 0.66, respectively) for the total scales. The expert panels categorised 68% of items into similar competence domains. However, their discussion revealed ambiguous wordings and imbalances in the two questionnaires in relation to domains. Interprofessional competence domains are defined but few validated tools exist to assess them. Examined tools relating to interprofessional learning in Swedish do not qualify for assessing overarching IPL outcomes, and summed scores from these tools should be used with caution.
Strudwick, Ruth M.; Day, Jane
This paper considers interprofessional working within one diagnostic imaging department. The literature is still divided about the long-term impact of interprofessional learning in pre-registration health and social care education, and its impact on the quality of care provided. When reading the literature about interprofessional working the main topics considered by other authors are team working, communication between professionals, stereotyping and tribalism. The results presented are from an ethnographic study in one department with participant observation and semi-structured interviews. The three main aspects discussed in this paper are; tribalism and culture within the diagnostic radiography profession, communication between different professional groups, and a lack of understanding of the roles of other professional groups. It was evident from the results of this study that tribalism and culture, and a lack of understanding were significant barriers to interprofessional working. It was felt by the authors that pre-registration and post-registration interprofessional education could be significant in changing the culture of the NHS in the future as more professionals learn from and about one another
Bentley, Michael; Freeman, Toby; Baum, Fran; Javanparast, Sara
This article draws on data from a 5-year project that examined the effectiveness of Comprehensive primary healthcare (CPHC) in local communities. A hallmark of CPHC services is interprofessional teamwork. Drawing from this study, our article presents factors that enabled, or hindered, healthcare teams working interprofessionally in Australian primary healthcare (PHC) services. The article reports on the experiences of teams working in six Australian PHC services (four managed by state governments, one non-government sexual health organisation, and one Aboriginal community-controlled health service) during a time of significant health sector restructure. Findings are drawn from two key methods: an online survey of practitioners and managers (n = 154), and interviews with managers and practitioners (n = 60) from the six study sites. The majority of survey respondents worked with other health professionals in their service to provide interprofessional care to clients. Processes included formal team meetings, case conferencing, referring clients to other health professionals if needed, informal communication with other health professionals about clients, and team-based delivery of care. A range of interrelated factors affected interprofessional work at the services, from contextual, organisational, processual, and relational domains. Funding cuts and policy changes that saw a reorientation and re-medicalisation of South Australian services undermined interprofessional work, while a shared CPHC culture and commitment among some staff was helpful in resisting some of these effects. The co-location of services was a factor in PHC teams working interprofessionally and not only enabled some PHC teams to work more interprofessionally but also created barriers to interprofessional teamwork through disruption resulting from restructuring of services. Our study indicates the importance of decision makers taking into account the potential effects of policy and structural
Kaini, B K
Interprofessional care is an essential part of the health service delivery system. It helps to achieve improved care and to deliver the optimal and desired health outcomes by working together, sharing and learning skills. Health care organisation is a collective sum of many leaders and followers. Successful delivery of interprofessional care relies on the contribution of interprofessional care team leaders and health care professionals from all groups. The role of the interprofessional care team leader is vital to ensuring continuity and consistency of care and to mobilise and motivate health care professionals for the effective delivery of health services. Medical professionals usually lead interprofessional care teams. Interprofessional care leaders require various skills and competencies for the successful delivery of interprofessional care.
To discuss immune checkpoint inhibitor therapy and identify opportunities for interprofessional collaboration in the management of toxicities in the areas of gastroenterology, endocrinology, and neurology. Published research and education articles in oncology, nursing, and various specialties. The use of immune checkpoint inhibitors is expanding; timely management of toxicity is critical for positive patient outcomes. There are many opportunities for interprofessional collaboration in the diagnosis and treatment of immune-related adverse events. Nurses play key roles in recognizing immune-related adverse events, providing patient education, and helping to facilitate interprofessional collaboration. Copyright © 2017 Elsevier Inc. All rights reserved.
Schapmire, Tara J; Head, Barbara A; Nash, Whitney A; Yankeelov, Pamela A; Furman, Christian D; Wright, R Brent; Gopalraj, Rangaraj; Gordon, Barbara; Black, Karen P; Jones, Carol; Hall-Faul, Madri; Faul, Anna C
A fragmented workforce consisting of multiple disciplines with varying levels of training and limited ability to work as a team often provides care to older adults. Interprofessional education (IPE) is essential for preparing practitioners for the effective teamwork required for community-based, holistic, person-centered care of the older adults. Despite numerous programs and offerings to advance education and interdisciplinary patient care, there is an unmet need for geriatric IPE, especially as it relates to community-dwelling older adults and caregivers in medically underserved areas. A core group of university faculty from multiple disciplines received funding from the Health Resources and Services Administration Geriatric Workforce Enhancement Program to collaborate with community-based providers from several Area Agencies on Aging in the creation and implementation of the Interprofessional Curriculum for the Care of Older Adults (iCCOA). This geriatric curriculum is interprofessional, comprehensive, and community-based. Learners include third-year nursing students, nurse practitioner students, third-year medical students, internal medicine and family medicine residents, master's level social work students, third-year pharmacy students, pharmacy residents, third-year dental students, dental hygiene students, community-based organization professionals, practicing community organizers, and community health navigators. This article describes the efforts, successes, and challenges experienced with this endeavor, including securing funding, ensuring equal representation of the disciplines, adding new components to already crowded curricula, building curriculum on best practices, improving faculty expertise in IPE, managing logistics, and ensuring comprehensive evaluation. The results summarize the iCCOA components, as well as the interprofessional domains, knowledge, and competencies.
Bonello, Marjorie; Wright, Jon; Morris, Jane; Sadlo, Gaynor
Interprofessional education (IPE) is perceived to be one strategy to reduce professional compartmentalisation and improve collaborative practices. The unequal power relations existing between the various professions who need to collaborate for IPE remains largely unexamined and it is only in recent years that sociological theories have been…
Full Text Available Aim: Interprofessional education (IPE is taking on increasing importance in our complex healthcare system and receiving ever greater attention in the teaching of health science. The majority of concepts and methods employed in this area are based on normative ideas about interprofessional cooperation and only seldom based on empirical research. This paper is an initial attempt to augment this deductive approach with an inductive perspective for the purpose of subsequently providing empirical support for IPE teaching methods.Method: Drawing on the qualitative approach to linguistic conversation analysis, language-based professional markers are identified on the basis of recorded classroom simulations with nursing and midwifery students; it is assumed that these markers are significant in relevant interprofessional communication processes and, as a result, influence actual collaboration between the health professions. These markers are classified and commented on, and their importance to teaching and practical implementation in interprofessional interaction is emphasized.Results: Students routinely use various professional markers in simulations. However, these occur much less frequently than initially expected, except when marking difference in relation to physicians. At the same time, all the interactions are shaped by pronounced self-presentation among the students, and this comprises a large aspect of the interactions observed here. Profession-specific communication and differentiation processes also appear to be slow in establishing themselves in terms of students delegating tasks or voicing expectations. In addition, the role of “student” has a function that should not be underestimated in these interactions.Conclusion: Professional markers are an essential component of interprofessional communication and are based on numerous, observable linguistic phenomena, of which only a few are presented here. This empirical approach has not yet
Drummond, Neil; Abbott, Karen; Williamson, Tyler; Somji, Behnaz
To explore the status and processes of interprofessional work environments and the implications for interprofessional education in a sample of family medicine teaching clinics. Focus group interviews using a purposive sampling procedure. Four academic family medicine clinics in Alberta. Seven family physicians, 9 registered nurses, 5 licensed practical nurses, 2 residents, 1 psychologist, 1 informatics specialist, 1 pharmacist, 1 dietitian, 1 nurse practitioner, 1 receptionist, and 1 respiratory therapist. Assessment of clinic status and performance in relation to established principles of interprofessional work and education was explored using semistructured focus group interviews. Our data supported the D'Amour and Oandasan model of successful interprofessional collaborative practice in terms of the model's main "factors" (ie, shared goals and vision, sense of belonging, governance, and the structuring of clinical care) and their constituent "elements." It is reasonable to conclude that the extent to which these factors and elements are both present and positively oriented in academic clinic settings is an important contributory factor to the establishment of interprofessional collaborative practice in primary care. Using this model, 2 of the 4 clinics were rated as expressing substantial progress in relation to interprofessional work, while the other 2 clinics were rated as less successful on that dimension. None of the clinics was identified as having a clear and explicit focus on providing interprofessional education. The key factor in relation to the implementation of interprofessional work in primary care appears to be the existence of clear and explicit leadership in that direction. Substantial scope exists for improvement in the organization, conduct, and promotion of interprofessional education for Canadian primary care.
Schug, Vicki; Finch-Guthrie, Patricia; Benz, Janet
This article describes team-based pedagogical strategies for a hybrid, four-credit research methods course with students from nursing, exercise, and nutrition science. The research problem of concussion in football, a socially relevant and controversial topic, was used to explore interprofessional perspectives and develop shared problem solving. The course was designed using permanent teams, readiness assurance, application exercises, and peer evaluation to facilitate student achievement of competencies related to interprofessional collaboration and research application. Feedback from students, faculty, and the Readiness for Interprofessional Learning Scale was used to evaluate the learning innovation.
VanderWielen, Lynn M; Halder, Gabriela E; Enurah, Alexander S; Pearson, Catherine; Stevens, Michael P; Crossman, Steven H
Short-term service trips from the USA annually spend over $250 million dollars to provide healthcare to individuals in developing nations. These trips often uniquely define goals as related to changes in the host population and overlook the valuable benefits potentially incurred by the trip volunteers. The Honduras Outreach Medical Brigada Relief Effort utilizes an interprofessional team approach to develop the dual goals of improving health and quality of life in host communities and improving interprofessional teamwork values and skills among participants. This article outlines details of this program, describes on-going evaluation work and discusses the interprofessional implications from this project.
Full Text Available Miyako Kishimoto,1,2 Mitsuhiko Noda2,3 1Department of Diabetes, Endocrinology, and Metabolism, Center Hospital, National Center for Global Health and Medicine, Tokyo, Japan; 2Diabetes and Metabolism Information Center, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan; 3Department of Diabetes Research, Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan Background: Diabetes is a multifactorial disease and its nature means that interprofessional teamwork is essential for its treatment. However, in general, interprofessional teamwork has certain problems that impede its function. To clarify these problems in relation to diabetes care, a questionnaire survey was conducted. Methods: The participants who were involved in diabetes-related educational seminars, and medical personnel who were engaged in diabetes care from the National Center for Global Health and Medicine, were asked to complete the questionnaire about perceptions of, and satisfaction with, interprofessional teamwork across multiple health care providers, who were actually involved in diabetes care. Results: From 456 people who were asked to take the questionnaire, 275 people answered. The percentages of the respondents according to profession who considered multidisciplinary teamwork sufficient were as follows: physicians, 20.5%; nurses, 12.7%; registered dietitians, 29.6%; pharmacists, 21.9%; physiotherapists, 18.2%; and clinical laboratory technicians 15.4%. Insufficient interprofessional communication and inconsistency in motivation levels among staff were frequently cited as causes of insufficient teamwork. All professions considered interprofessional meetings or conferences necessary and essential for teamwork. Conclusion: The survey revealed that interprofessional teamwork in diabetes care is currently insufficient. Continuous efforts to change each profession
Croker, Anne; Smith, Tony; Fisher, Karin; Littlejohns, Sonja
Similar to other professions, pharmacy educators use workplace learning opportunities to prepare students for collaborative practice. Thus, collaborative relationships between educators of different professions are important for planning, implementing and evaluating interprofessional learning strategies and role modelling interprofessional collaboration within and across university and workplace settings. However, there is a paucity of research exploring educators' interprofessional relationships. Using collaborative dialogical inquiry we explored the nature of educators' interprofessional relationships in a co-located setting. Data from interprofessional focus groups and semi-structured interviews were interpreted to identify themes that transcended the participants' professional affiliations. Educators' interprofessional collaborative relationships involved the development and interweaving of five interpersonal behaviours: being inclusive of other professions; developing interpersonal connections with colleagues from other professions; bringing a sense of own profession in relation to other professions; giving and receiving respect to other professions; and being learner-centred for students' collaborative practice . Pharmacy educators, like other educators, need to ensure that interprofessional relationships are founded on positive experiences rather than vested in professional interests.
Inter-professional teams are typical in health care, and inter-professional education has thus become more common. This empirical study explores the instruction-related challenges when students of dentistry and oral hygiene collaborate during their internship in caring for the oral health of patients. The conceptual framework of the study stems…
Gotlib Conn, Lesley; Reeves, Scott; Dainty, Katie; Kenaszchuk, Chris; Zwarenstein, Merrick
Studies in General Internal Medicine [GIM] settings have shown that optimizing interprofessional communication is important, yet complex and challenging. While the physician is integral to interprofessional work in GIM there are often communication barriers in place that impact perceptions and experiences with the quality and quantity of their communication with other team members. This study aims to understand how team members' perceptions and experiences with the communication styles and strategies of either hospitalist or consultant physicians in their units influence the quality and effectiveness of interprofessional relations and work. A multiple case study methodology was used. Thirty-one semi-structured interviews were conducted with physicians, nurses and other health care providers [e.g. physiotherapist, social worker, etc.] working across 5 interprofessional GIM programs. Questions explored participants' experiences with communication with all other health care providers in their units, probing for barriers and enablers to effective interprofessional work, as well as the use of communication tools or strategies. Observations in GIM wards were also conducted. Three main themes emerged from the data:  availability for interprofessional communication,  relationship-building for effective communication, and  physician vs. team-based approaches. Findings suggest a significant contrast in participants' experiences with the quantity and quality of interprofessional relationships and work when comparing the communication styles and strategies of hospitalist and consultant physicians. Hospitalist staffed GIM units were believed to have more frequent and higher caliber interprofessional communication and collaboration, resulting in more positive experiences among all health care providers in a given unit. This study helps to improve our understanding of the collaborative environment in GIM, comparing the communication styles and strategies of hospitalist
Butler, Jeffrey I; Fox, Mary T
Older people present with complex health issues on admission to hospital and are at high risk for functional decline and related complications. Thus, they require the services of diverse health-care professionals working in concert to support their functioning. Despite nurses' central role in caring for this patient population, and evidence indicating that interprofessional communication is a persistent challenge for nurses in acute-care settings, little is known about nurses' views on interprofessional communication in care preserving functioning in acutely admitted older people. To fill this knowledge gap, we gathered acute-care staff nurses' perspectives on interprofessional communication in a function-focused, interprofessional approach to hospital care for older adults. Thirteen focus groups were conducted with a purposeful, criterion-based sample of 57 nurses working in acute-care hospitals. Thematic analysis revealed two overarching themes capturing nurses' perspectives on key factors shaping interprofessional communication in a function-focused interprofessional approach to care (1) context of direct communication and (2) context of indirect communication. The first theme demonstrates that nurses preferred synchronous modes of communication, but some ascribed greater importance to unstructured forms of direct information-sharing, while others stressed structured direct communication, particularly interprofessional rounds. The second theme also documents divergence in nurses' views on asynchronous communication, with some emphasizing information technology and others analog tools. Perceptions of some modes of interprofessional communication were found to vary by practice setting. Theoretical and pragmatic conclusions are drawn that can be used to optimize interprofessional communication processes supporting hospitalized older people's functioning.
Wilcock, Peter M.; Janes, Gillian; Chambers, Alison
Health care improvement and continuing professional education must be better understood if we are to promote continuous service improvement through interprofessional learning in the workplace. We propose that situating interprofessional working, interprofessional learning, work-based learning, and service improvement within a framework of social…
Jonge, de, Ed
Thesis: Ethics work (Banks 2012, 2016) is a stimulating concept for the ethical improvement of inter-professional cooperation. Outline: Starting point: ideal-typical professionalism Introduction to ethics work Professionalism requires inter-professional cooperation Inter-professional expansion of ethics work Final remarks and further challenges
Robins, Lynne; Murphy, Nanci; Belza, Basia; Brock, Doug; Gallagher, Thomas H.; Lindhorst, Taryn; Morton, Tom; Schaad, Doug; Mitchell, Pamela
Pharmacists must collaborate with other health professionals to promote the optimal use of medications, relying on coordinated, interprofessional communication and care to do so. In 2003, the Institute of Medicine (IOM) recommended “all health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics.”2 At the University of Washington, the Center for Health Sciences Interprofessional Education (CHSIE) was established in 1997 to promote interprofessional curricular and clinical innovation in education, faculty development, and student activities, and to conduct evaluative research regarding the impact of interprofessional innovations. In this manuscript, we will describe the Center for Health Sciences Interprofessional Education, and highlight key projects that serve as examples of pharmacy involvement in interprofessional education, research, and service. PMID:19657496
Evans, Sherryn Maree; Ward, Catherine; Reeves, Scott
The use of online media to deliver interprofessional education (IPE) is becoming more prevalent across health professions education settings. Facilitation of IPE activities is known to be critical to the effective delivery of IPE, however, specifics about the nature of online IPE facilitation remains unclear. To explore the health professions education literature to understand the extent, range and nature of research on online IPE facilitation. Scoping review methodology was used to guide a search of four electronic databases for relevant papers. Of the 2095 abstracts initially identified, after screening of both abstracts and full-text papers, 10 studies were selected for inclusion in this review. Following abstraction of key information from each study, a thematic analysis was undertaken. Three key themes emerged to describe the nature of the IPE facilitation literature: (1) types of online IPE facilitation contributions, (2) the experience of online IPE facilitation and (3) personal outcomes of online IPE facilitation. These IPE facilitation themes were particularly focused on facilitation of interprofessional student teams on an asynchronous basis. While the included studies provide some insight into the nature of online IPE facilitation, future research is needed to better understand facilitator contributions, and the facilitation experience and associated outcomes, both relating to synchronous and asynchronous online environments.
Meyer, Jakob J; Obmann, Markus M; Gießler, Marianne; Schuldis, Dominik; Brückner, Ann-Kathrin; Strohm, Peter C; Sandeck, Florian; Spittau, Björn
Profound knowledge in functional and clinical anatomy is a prerequisite for efficient diagnosis in medical practice. However, anatomy teaching does not always consider functional and clinical aspects. Here we introduce a new interprofessional approach to effectively teach the anatomy of the knee joint. The presented teaching approach involves anatomists, orthopaedists and physical therapists to teach anatomy of the knee joint in small groups under functional and clinical aspects. The knee joint courses were implemented during early stages of the medical curriculum and medical students were grouped with students of physical therapy to sensitize students to the importance of interprofessional work. Evaluation results clearly demonstrate that medical students and physical therapy students appreciated this teaching approach. First evaluations of following curricular anatomy exams suggest a benefit of course participants in knee-related multiple choice questions. Together, the interprofessional approach presented here proves to be a suitable approach to teach functional and clinical anatomy of the knee joint and further trains interprofessional work between prospective physicians and physical therapists as a basis for successful healthcare management. Copyright © 2016 The Authors. Published by Elsevier GmbH.. All rights reserved.
Rozmus, Cathy L; Carlin, Nathan; Polczynski, Angela; Spike, Jeffrey; Buday, Richard
One of the barriers to interprofessional ethics education is a lack of resources that actively engage students in reflection on living an ethical professional life. This project implemented and evaluated an innovative resource for interprofessional ethics education. The objective of this project was to create and evaluate an interprofessional learning activity on professionalism, clinical ethics, and research ethics. The Brewsters is a choose-your-own-adventure novel that addresses professionalism, clinical ethics, and research ethics. For the pilot of the book, a pre-test/post-test design was used. Once implemented across campus, a post-test was used to evaluate student learning in addition to a student satisfaction survey. A total of 755 students in six academic schools in a health science center completed the activity as part of orientation or in coursework. The project was approved as exempt by the university's Committee for the Protection of Human Subjects. The pilot study with 112 students demonstrated a significant increase in student knowledge. The 755 students who participated in the project had relatively high knowledge scores on the post-test and evaluated the activity positively. Students who read The Brewsters scored well on the post-test and had the highest scores on clinical ethics. Clinical ethics scores may indicate issues encountered in mass media. The Brewsters is an innovative resource for teaching interprofessional ethics and professionalism. Further work is needed to determine whether actual and long-term behavior is affected by the activity. © The Author(s) 2014.
Bluteau, Patricia; Clouder, Lynn; Cureton, Debra
This article relates the findings of a discourse analysis of an online asynchronous interprofessional learning initiative involving two UK universities. The impact of the initiative is traced over three intensive periods of online interaction, each of several-weeks duration occurring over a three-year period, through an analysis of a random sample of discussion forum threads. The corpus of rich data drawn from the forums is interpreted using ecological systems theory, which highlights the complexity of interaction of individual, social and cultural elements. Ecological systems theory adopts a life course approach to understand how development occurs through processes of progressively more complex reciprocal interaction between people and their environment. This lens provides a novel approach for analysis and interpretation of findings with respect to the impact of pre-registration interprofessional education and the interaction between the individual and their social and cultural contexts as they progress through 3/4 years of their programmes. Development is mapped over time (the chronosystem) to highlight the complexity of interaction across microsystems (individual), mesosystems (curriculum and institutional/care settings), exosystems (community/wider local context), and macrosystems (national context and culture). This article illustrates the intricacies of students' interprofessional development over time and the interactive effects of social ecological components in terms of professional knowledge and understanding, wider appreciation of health and social care culture and identity work. The implications for contemporary pre-registration interprofessional education and the usefulness and applicability of ecological systems theory for future research and development are considered.
Rousseau, Cécile; Pontbriand, Annie; Nadeau, Lucie; Johnson-Lafleur, Janique
Interprofessional collaboration is a cornerstone of youth mental health collaborative care models. This article presents quantitative results from a mixed-methods study. It analyses the organizational predictors of the perception of interprofessional collaboration of professionals comparing two models of services within recently constituted youth mental health collaborative care teams. Professionals (n=104) belonging to six health and social services institutions completed an online survey measuring their perceptions of interprofessional collaboration through a validated questionnaire, the PINCOM-Q. Results suggest that the integrated model of collaborative care in which specialized resources are co-located with the primary care teams is the main significant predictor of positive perception of interprofessional collaborations in the youth mental health team. More research on the relation between service delivery models and interprofessional relations could help support the successful implementation of collaborative care in youth mental health.
Lapkin, Samuel; Levett-Jones, Tracy; Gilligan, Conor
Background: A key responsibility of universities is to prepare health professional graduates for their roles as effective members of the health care team. Currently, most university-based health professional education is delivered in a traditional, discipline specific way. This approach is limited in its ability to equip graduates with the necessary knowledge, skills and attitudes for effective interprofessional collaboration and for working as part of a complex health care team. Interprofessional education occurs when learners from two or more professional groups learn about, from and with each other. The fundamental premise of interprofessional education is that if health professional students learn together they will be better prepared for interprofessional collaboration ultimately leading to improved patient outcomes.Objective -The objective of this systematic review was to identify the best available evidence for the effectiveness of university-based interprofessional education.Inclusion criteria -The review included all randomised controlled trials and quasi-experimental studies that assessed the effectiveness of interprofessional education in university-based health professional programs. All studies that included two or more undergraduate or post-graduate health professional groups engaged in interprofessional education were considered. Outcome measures included objectively measured or self-reported educational outcomes and/or professional competencies related to interprofessional education as assessed by validated instruments such as the Readiness for Interprofessional Learning Scale and the Interdisciplinary Education Perception Scale. A three-stage comprehensive search strategy was utilised to search across ten electronic databases. English language studies published between January 2000 and February 2011 were considered for inclusion.Methodological quality: Two independent reviewers assessed the methodological quality of each study selected for
For many health programmes, developing interprofessional education (IPE) has been a challenge. Evidence on the best method for design and implementation of IPE has been slow to emerge, with little research on how to best incorporate IPE in the asynchronous online learning environment. This leaves online programmes with no clear guidance when embarking upon an initiative to integrate IPE into the curriculum. One tool that can be effective at guiding the incorporation of IPE across all learning platforms is the Interprofessional Education Collaborative (IPEC) competencies. A project was designed to integrate the nationally defined IPEC competencies throughout an asynchronous, online baccalaureate nursing completion programme. A programme-wide review led to targeted revision of course and unit-level objectives, learning experiences, and assessments based on the IPEC framework. As a result of this effort, the programme curriculum now provides interprofessional learning activities across all courses. This report provides a method for using the IPEC competencies to incorporate IPE within various asynchronous learning assessments, assuring students learn about, with, and from other professions.
Full Text Available Clinical ethic situations in modern multiprofessional healthcare systems may involve different healthcare professions who work together for patient care. The undergraduate interprofessional education of clinical ethics would help to incubate healthcare students' ability of interprofessional collaboration in solving ethical problems. However, the impact from an interprofessional educational model on student's attitudes and confidence of interprofessional collaboration should be carefully evaluated during the process of curricular development. This study aimed to conduct a pilot interprofessional PBL curriculum of clinical ethics and evaluate the curricular impact on interprofessional students' attitude and confidence of collaborative teamwork. Thirty-six medical and nursing students volunteered to participate in this study and were divided into three groups (medical group, nursing group, and mixed group. Tutors were recruited from the Medical School and the College of Nursing. The pilot curriculum included one lecture of clinical ethics, one PBL case study with two tutorial sessions, and one session of group discussion and feedback. A narrative story with multiple story lines and a multiperspective problem analysis tool were used in the PBL tutorials. The students' self-evaluation of learning questionnaire was used to evaluate students' learning of clinical ethics and interprofessional collaborative skills and attitude. The internal consistency of the questionnaire was measured by Cronbach α, and the criterion-related validity of the questionnaire was evaluated through associations between the dimension scores with the student group by one-way analysis of variance test (ANOVA test and Tukey-Kramer honestly significant difference (HSD comparison. There was significant difference among different groups in students' ability and attitudes about “interprofessional communication and collaboration” (p = 0.0184. The scores in the mixed group (37
Liston, Beth W.; Wagner, Janet; Miller, Jackie
Background: Interprofessional teamwork is a crucial competency in health professions education which improves patient care. However, interprofessional education is not a widespread practice in medical schools. To address this need, we developed an educational pilot utilizing a standardized patient simulation to teach interprofessional…
Continuing interprofessional education is the means by which experienced health, social care, and other practitioners learn with, from, and about each other, formally and informally, to improve their collective practice and to cultivate closer collaboration. It applies principles of interprofessional education through media commonly employed in…
Facilitating community-based interprofessional education and collaborative practice in a health sciences faculty: Student perceptions and experiences. ... It became apparent that students need to be prepared to work in interprofessional groups. The overall intervention was perceived positively, allowing students to become ...
Kallio, Sonja; Kumpusalo-Vauhkonen, Anne; Järvensivu, Timo; Mäntylä, Antti; Pohjanoksa-Mäntylä, Marika; Airaksinen, Marja
related problems of the aged. Challenges in the implementation of interprofessional collaboration in medication management appear in legislation, information systems, operational models and individuals' attitudes. Optimising medications requires better interprofessional networking and new systemic solutions within and between macro, meso and micro levels.
Full Text Available Steffy EA Stans, JG Anita Stevens, Anna JHM Beurskens Research Center of Autonomy and Participation for Persons with a Chronic Illness, Zuyd University of Applied Sciences, Heerlen, The Netherlands Purpose: This study investigated the improvement of interprofessional practice in primary care by performing the first three steps of the implementation model described by Grol et al. This article describes the targets for improvement in a setting for children with complex care needs (step 1, the identification of barriers and facilitators influencing interprofessional practice (step 2, and the development of a tailored interprofessional process model (step 3. Methods: In step 2, thirteen qualitative semistructured interviews were held with several stakeholders, including parents of children, an occupational therapist, a speech and language therapist, a physical therapist, the manager of the team, two general practitioners, a psychologist, and a primary school teacher. The data were analyzed using directed content analysis and using the domains of the Chronic Care Model as a framework. In step 3, a project group was formed to develop helpful strategies, including the development of an interprofessional process through process mapping. Results: In step 2, it was found that the most important barriers to implementing interprofessional practice related to the lack of structure in the care process. A process model for interprofessional primary care was developed for the target group. Conclusion: The lack of a shared view of what is involved in the process of interprofessional practice was the most important barrier to its successful implementation. It is suggested that the tailored process developed, supported with the appropriate tools, may provide both professional staff and their clients, in this setting but also in other areas of primary care, with insight to the care process and a clear representation of "who should do what, when, and how." Keywords
Curran, Vernon R; Sharpe, Dennis; Forristall, Jennifer
Faculty attitudes are believed to be a barrier to successful implementation of interprofessional education (IPE) initiatives within academic health sciences settings. The purpose of this study was to examine specific attributes of faculty members, which might relate to attitudes towards IPE and interprofessional teamwork. A survey was distributed to all faculty members in the medicine, nursing, pharmacy and social work programmes at our institution. Respondents were asked to rate their attitudes towards interprofessional health care teams, IPE and interprofessional learning in an academic setting using scales adopted from the peer-reviewed literature. Information on the characteristics of the respondents was also collected, including data on gender, prior experience with IPE, age and years of practice experience. A total response rate of 63.0% was achieved. Medicine faculty members reported significantly lower mean scores (P nursing faculty on attitudes towards IPE, interprofessional teams and interprofessional learning in the academic setting. Female faculty and faculty who reported prior experience in IPE reported significantly higher mean scores (P teamwork. The findings have implications for both the advancement of IPE within academic institutions and strategies to promote faculty development initiatives. In terms of IPE evaluation, the findings also highlight the importance of measuring baseline attitudinal constructs as part of systematic evaluative activities when introducing new IPE initiatives within academic settings.
Franklin, Catherine M; Bernhardt, Jean M; Lopez, Ruth Palan; Long-Middleton, Ellen R; Davis, Sheila
Community Health Workers (CHWs) serve as a means of improving outcomes for underserved populations. However, their relationship within health care teams is not well studied. The purpose of this integrative review was to examine published research reports that demonstrated positive health outcomes as a result of CHW intervention to identify interprofessional teamwork and collaboration between CHWs and health care teams. A total of 47 studies spanning 33 years were reviewed using an integrative literature review methodology for evidence to support the following assumptions of effective interprofessional teamwork between CHWs and health care teams: (1) shared understanding of roles, norms, values, and goals of the team; (2) egalitarianism; (3) cooperation; (4) interdependence; and(5) synergy. Of the 47 studies, 12 reported at least one assumption of effective interprofessional teamwork. Four studies demonstrated all 5 assumptions of interprofessional teamwork. Four studies identified in this integrative review serve as exemplars for effective interprofessional teamwork between CHWs and health care teams. Further study is needed to describe the nature of interprofessional teamwork and collaboration in relation to patient health outcomes.
Bernhardt, Jean M.; Lopez, Ruth Palan; Long-Middleton, Ellen R.; Davis, Sheila
Objectives: Community Health Workers (CHWs) serve as a means of improving outcomes for underserved populations. However, their relationship within health care teams is not well studied. The purpose of this integrative review was to examine published research reports that demonstrated positive health outcomes as a result of CHW intervention to identify interprofessional teamwork and collaboration between CHWs and health care teams. Methods: A total of 47 studies spanning 33 years were reviewed using an integrative literature review methodology for evidence to support the following assumptions of effective interprofessional teamwork between CHWs and health care teams: (1) shared understanding of roles, norms, values, and goals of the team; (2) egalitarianism; (3) cooperation; (4) interdependence; and(5) synergy. Results: Of the 47 studies, 12 reported at least one assumption of effective interprofessional teamwork. Four studies demonstrated all 5 assumptions of interprofessional teamwork. Conclusions: Four studies identified in this integrative review serve as exemplars for effective interprofessional teamwork between CHWs and health care teams. Further study is needed to describe the nature of interprofessional teamwork and collaboration in relation to patient health outcomes. PMID:28462254
Kendall-Gallagher, Deborah; Reeves, Scott; Alexanian, Janet A; Kitto, Simon
This article presents a secondary analysis of nurse interviews from a 2-year comparative ethnographic study exploring cultures of collaboration across intensive care units (ICU). Critically ill patients rely on their interprofessional health care team to communicate and problem-solve quickly to give patients the best outcome available. Critical care nurses function at the hub of patient care giving them a distinct perspective of how interprofessional interactions impact collaborative practice. Secondary analysis of a subset of primary qualitative data is appropriate when analysis extends rather than exceeds the primary study aim. Primary ethnographic data included 178 semistructured interviews of ICU professionals from 8 medical-surgical ICUs in North America; purposeful maximum variation sampling was used to represent each profession accurately. Fifteen anonymized ICU nurse interview transcripts were coded iteratively to identify emerging themes impacting interprofessional collaborative practice. Findings suggest that quality of interprofessional collaboration is a product of a multitude of factors occurring at multiple levels within the organization. Managerial and organizational factors related to ICU nurse training and staffing may impede development of nurses' interprofessional skills. Deliberative development of ICU nurses' interprofessional skills is essential if nursing is to move from primary coordinator to active collaborator in patient management. Copyright © 2016 Elsevier Inc. All rights reserved.
Full Text Available Tara J Schapmire,1,2 Barbara A Head,1,2 Whitney A Nash,3 Pamela A Yankeelov,2,4 Christian D Furman,1,4,5 R Brent Wright,5 Rangaraj Gopalraj,5 Barbara Gordon,6 Karen P Black,3 Carol Jones,1 Madri Hall-Faul,6 Anna C Faul2,4,7 1Division of General Internal Medicine, Palliative Care and Medical Education, University of Louisville School of Medicine, 2Kent School of Social Work, 3School of Nursing, 4The Institute for Sustainable Health & Optimal Aging, University of Louisville, 5Division of Geriatric Medicine, University of Louisville School of Medicine, 6Kentuckiana Regional Planning & Development Agency, Louisville, KY, USA; 7Department of Social Work, University of the Free State, Bloemfontein, South Africa Abstract: A fragmented workforce consisting of multiple disciplines with varying levels of training and limited ability to work as a team often provides care to older adults. Interprofessional education (IPE is essential for preparing practitioners for the effective teamwork required for community-based, holistic, person-centered care of the older adults. Despite numerous programs and offerings to advance education and interdisciplinary patient care, there is an unmet need for geriatric IPE, especially as it relates to community-dwelling older adults and caregivers in medically underserved areas. A core group of university faculty from multiple disciplines received funding from the Health Resources and Services Administration Geriatric Workforce Enhancement Program to collaborate with community-based providers from several Area Agencies on Aging in the creation and implementation of the Interprofessional Curriculum for the Care of Older Adults (iCCOA. This geriatric curriculum is interprofessional, comprehensive, and community-based. Learners include third-year nursing students, nurse practitioner students, third-year medical students, internal medicine and family medicine residents, master’s level social work students, third-year pharmacy
Granheim, Benedikte M; Shaw, Julie M; Mansah, Martha
To identify how simulation and interprofessional learning are used together in undergraduate nursing programs and undertaken in schools of nursing to address interprofessional communication and collaboration. An integrative literature review. The databases CINAHL, ProQuest, PubMed, Scopus, PsycInfo and Science Direct were searched to identify articles from 2006 to 2016 that reported on the use of IPL and simulation together in undergraduate nursing education. Whittemore and Knafl's five step process was used to guide the integrative review of quantitative and qualitative literature. Only peer reviewed articles written in English that addressed undergraduate nursing studies, were included in the review. Articles that did not aim to improve communication and collaboration were excluded. All articles selected were examined to determine their contribution to interprofessional learning and simulation in undergraduate nursing knowledge. The faculties of nursing used interprofessional learning and simulation in undergraduate nursing programs that in some cases were connected to a specific course. A total of nine articles, eight research papers and one narrative report, that focused on collaboration and communication were selected for this review. Studies predominantly used nursing and medical student participants. None of the included studies identified prior student experience with interprofessional learning and simulation. Four key themes were identified: communication, collaboration/teamwork, learning in practice and understanding of roles, and communication. This review highlights the identified research relating to the combined teaching strategy of interprofessional learning and simulation that addressed communication and collaboration in undergraduate nursing programs. Further research into the implementation of interprofessional learning and simulation may benefit the emergent challenges. Information drawn from this review can be used in informing education and
Catharina Dwiana Wijayanti; Kristina Lisum
Background and Purpose: Collaboration among health care profession is required to create synergism in delivering health care at various clinical setting. This collaboration should be initiated at the academic setting through interprofessional learning. The Purpose of this research was to identify the influence of interprofessional attitudes to readiness of health care professions students for interprofessional learning. Method: Research method used quantitative with descriptive comparati...
Shrader, Sarah; Kostoff, Matthew; Shin, Tiffany; Heble, Annie; Kempin, Brian; Miller, Astyn; Patykiewicz, Nick
To determine the impact of simulations using an alternative method of communication on students' satisfaction, attitudes, confidence, and performance related to interprofessional communication. One hundred sixty-three pharmacy students participated in a required applications-based capstone course. Students were randomly assigned to one of three interprofessional education (IPE) simulations with other health professions students using communication methods such as telephone, e-mail, and video conferencing. Pharmacy students completed a validated survey instrument, Attitude Toward Healthcare Teams Scale (ATHCTS) prior to and after course participation. Significant positive changes occurred for 5 out of 20 items. Written reflection papers and student satisfaction surveys completed after participation showed positive themes and satisfaction. Course instructors evaluated student performance using rubrics for formative feedback. Implementation of IPE simulations using various methods of communication technology is an effective way for pharmacy schools to incorporate IPE into their curriculum.
van Soeren, Mary; Devlin-Cop, Sandra; Macmillan, Kathleen; Baker, Lindsay; Egan-Lee, Eileen; Reeves, Scott
Simulated learning activities are increasingly being used in health professions and interprofessional education (IPE). Specifically, IPE programs are frequently adopting role-play simulations as a key learning approach. Despite this widespread adoption, there is little empirical evidence exploring the teaching and learning processes embedded within this type of simulation. This exploratory study provides insight into the nature of these processes through the use of qualitative methods. A total of 152 clinicians, 101 students and 9 facilitators representing a range of health professions, participated in video-recorded role-plays and debrief sessions. Videotapes were analyzed to explore emerging issues and themes related to teaching and learning processes related to this type of interprofessional simulated learning experience. In addition, three focus groups were conducted with a subset of participants to explore perceptions of their educational experiences. Five key themes emerged from the data analysis: enthusiasm and motivation, professional role assignment, scenario realism, facilitator style and background and team facilitation. Our findings suggest that program developers need to be mindful of these five themes when using role-plays in an interprofessional context and point to the importance of deliberate and skilled facilitation in meeting desired learning outcomes.
Full Text Available The authors explore the training and expertise of occupational therapists and the cost benefit of the strategic use of occupational therapists as members of the interprofessional primary care (PC team. PC practices can optimize successful and cost-effective patient care delivery, outcomes, and access to care by using interprofessional care teams and allowing physicians to off-load patients whose issues relate to routines and habits and do not require diagnostic or prescriptive intervention. This, and the occupational therapist’s ability to obtain reimbursement for his or her services, demonstrates that this professional can be an invaluable addition to the integrated PC team. The authors review the educational background, core competencies, and skill set of this group of professionals. Occupational therapists have a comprehensive education and are well equipped to address patient issues related to general health and chronic illness management, behavioral health, rehabilitation, and habilitation. Their ability to treat health issues that affect quality of life and overall function ensures that they are an asset to the interprofessional team. They can improve patient care and assist practices in their goal to achieve the triple aim. The authors encourage PC practices to include occupational therapists as value-added members of integrated PC teams.
van Dongen, Jerôme Jean Jacques; van Bokhoven, Marloes Amantia; Daniëls, Ramon; van der Weijden, Trudy; Emonts, Wencke Wilhelmina Gerarda Petronella; Beurskens, Anna
The number of people suffering from one or more chronic conditions is rising, resulting in an increase in patients with complex health care demands. Interprofessional collaboration and the use of shared care plans support the management of complex health care demands of patients with chronic illnesses. This study aims to get an overview of the scientific literature on developing interprofessional shared care plans. We conducted a scoping review of the scientific literature regarding the development of interprofessional shared care plans. A systematic database search resulted in 45 articles being included, 5 of which were empirical studies concentrating purely on the care plan. Findings were synthesised using directed content analysis. This review revealed three themes. The first theme was the format of the shared care plan, with the following elements: patient's current state; goals and concerns; actions and interventions; and evaluation. The second theme concerned the development of shared care plans, and can be categorised as interpersonal, organisational and patient-related factors. The third theme covered tools, whose main function is to support professionals in sharing patient information without personal contact. Such tools relate to documentation of and communication about patient information. Care plan development is not a free-standing concept, but should be seen as the result of an underlying process of interprofessional collaboration between team members, including the patient. To integrate the patients' perspectives into the care plans, their needs and values need careful consideration. This review indicates a need for new empirical studies examining the development and use of shared care plans and evaluating their effects.
Cannistraci, Patricia; Kehm, Bonny; Pieper, Barbara B; Speerschneider, Kim; Farber, Stacey L; Storandt, Barbara C
This study investigated the effect of interprofessional educational (IPE) in a distance education setting on students' self-efficacy around the Interprofessional Collaborative Practice (IPEC) constructs. Senior RN-to-Bachelor of Science nursing students, students from health sciences, and dietetic intern students participated in the IPE learning experience. A pre- postsurvey design measured the change in student self-efficacy in relation to the IPEC constructs of values and ethics, roles and responsibilities, interprofessional communication, and teams and teamwork. In total, 92 students participated and 46 completed the pre-postsurvey. There were statistically significant changes in student self-efficacy across all constructs. Qualitative comments revealed themes of collaboration strengthening care, the value of exposure to different perspectives, and desire for commonly shared goals among the team. Research on IPE in distance education lags behind IPE in traditional settings. This study revealed that IPE is attainable in distance education, with significant changes in student's self-efficacy. Self-efficacy is a key indicator of future behavior. [J Nurs Educ. 2018;57(4):225-228.]. Copyright 2018, SLACK Incorporated.
Beaird, Genevieve; Dent, John M; Keim-Malpass, Jessica; Muller, Abigail Guo Jian; Nelson, Nicole; Brashers, Valentina
Patient perceptions of teamwork have been a relatively undiscovered domain. Our study investigated the use of the Patients' Insights and Views of Teamwork (PIVOT) survey on an acute cardiology unit in an academic teaching hospital with patients receiving Rounding with Heart, an interprofessional bedside rounding initiative, and others receiving traditional rounding processes. Sixty-three subjects were surveyed during their hospital stay. We found a significant difference (p = .006) in PIVOT scores between those receiving interprofessional rounding and those not receiving this rounding structure. In an item-by-item analysis, four specific items were found to be significant which were supported by analysis of qualitative data. Observations of the structured interprofessional rounding process by our research team reveal themes that emerged from observations: (1) openness/inclusivity, (2) patient-centeredness, (3) attending role/shared leadership, (4) nonconfrontational learning, (5) efficacy, and (6) team at bedside. Our results indicate that patients may be able to recognize the teamwork in the structured bedside rounding process and that interfacing with the team may be an important component to patients. We conclude that patient perceptions of teamwork are a valuable informant to modeling collaborative practices, and there are key observable components to the structured rounding model that may foster collaboration among different disciplines.
Matziou, Vasiliki; Vlahioti, Efrosyni; Perdikaris, Pantelis; Matziou, Theodora; Megapanou, Efstathia; Petsios, Konstantinos
The aim of the study was to investigate the physician and nursing perceptions regarding communication and collaboration as well as the factors that may influence these activities. A self-administered questionnaire survey was sent to a random sample of 93 physicians and 197 nurses based in two large public hospitals in Athens, Greece. Descriptive statistics, t-test and chi square test were performed with the SPSS 19.0 statistical package. Years of experience, the size of the clinic, the university degree and the postgraduate studies were found to be significant factors according to nurses' view (p nursing staff significantly (p nurses and physicians do not share the same views concerning the effectiveness of their communication and nurses' role in the decision-making process of the patients' care. The most important barrier for the establishment of good relations between these professions, according to the physicians, was that they did not recognize the nurses' professional role. The study also indicated that the absence of interprofessional collaboration may result in a higher possibility of errors and omissions in patients' care. Therefore, in everyday practice, both nurses and physicians should acknowledge the importance of their effective communication and they should develop and implement interprofessional teamwork interventions to improve collaboration. Moreover, nurses have to constantly consolidate their role in the decision process and patients' care, especially in countries with limited interprofessional collaboration culture. In addition, factors that improve physicians' attitudes toward collaboration and effective communication should be further explored.
Jutte, Lisa S.; Browne, Fredrick R.; Reynolds, Marie
Context: Interprofessional education (IPE) is encouraged in health care education in the hope that it will improve communication among future health care professionals. In response, health professional education programs are developing IPE curricula. Objective: To determine if a multicourse interprofessional (IP) project impacted students'…
Dow, Alan W.; DiazGranados, Deborah; Mazmanian, Paul E.; Retchin, Sheldon M.
Linking the outcomes from interprofessional education to improvements in patient care has been hampered by educational assessments that primarily measure the short-term benefits of specific curricular interventions. Competencies, recently published by the Interprofessional Education Collaborative (IPEC), elaborate overarching goals for interprofessional education by specifying desired outcomes for graduating health professions students. The competencies define a transition point between the prescribed and structured educational experience of a professional degree program and the more self-directed, patient-oriented learning associated with professional practice. Drawing on the IPEC competencies for validity, we created a 42-item questionnaire to assess outcomes related to collaborative practice at the degree program level. To establish the usability and psychometric properties of the questionnaire, it was administered to all the students on a health science campus at a large urban university in the mid-Atlantic of the United States. The student responses (n = 481) defined four components aligned in part with the four domains of the IPEC competencies. In addition, the results demonstrated differences in scores by domain that can be used to structure future curricula. These findings suggest a questionnaire based on the IPEC competencies might provide a measure to assess programmatic outcomes related to interprofessional education. We discuss directions for future research, such as a comparison of results within and between institutions, and how these results could provide valuable insights about the effect of different curricular approaches to interprofessional education and the success of various educational programs at preparing students for collaborative practice. PMID:24593327
Mortensen, Hanne Franciska
: Based on the qualitative evaluation of the course Metropolitan University College is now developing and implementing new learning activities: An educational game, forum theatre, reflective tools, collaboration with NGOs, use of WIKIs and simulation. Experiences with these learning activities......Abstract 7th International Nurse Education Conference, Banff, CANADA, May 2018 Theme: Curriculum innovation & development. Preferred presentation form: Poster Title: Educating the Interprofessionals of tomorrow Author: Mortensen, Hanne Franciska, Senior Lecturer, Metropolitan University College, DK...... courses since 2015 to develop students’ Common competencies, Complementary competencies and Collaborative competencies (Barr, 1998). The course is a 10-week program where up to 1.200 students and 150 lecturers from 12 different welfare educations participate. The students select and follow one of 12...
Nielsen, Cathrine Sand
is a movement between the political macro-level, the institutional meso-level and the practical micro-levels. These movements between different levels of importance influence the critical optics as well as the theoretical approaches. Theoretically, the project ranges from organisational learning to health...... project are collected in a report (9). Research questions: This Industrial PhD Project will explore the embedded assumptions and challenges in InterTværs and examine how InterTværs influences the professional learning. The project focuses on how students develop interprofessional competencies and (inter...... (11, 13). The aim of the project is to investigate the function of InterTværs as an educational concept and the influence this concept has on the health professional learning. The empirical phase is scheduled from May 2014 to May 2015. The first empirical studies will be conducted with one month...
Madsen, Kirsten Halskov; Henriksen, Jette; Meldgaard, Anette
-professional level of palliative care’ – has been increasing for many years where palliative care has conventionally and primarily been associated with specialist training. As the authors show – based on a mapping out of existing educational initiatives in a region of Denmark, a reading of the curriculum......Chapter 11 by Kirsten Halskov Madsen, Anette Meldgaard and Jette Henriksen deals with the development of palliative care programmes aimed at the basic level of palliative care practice. The need to develop educational opportunities at particularly this level – described as ‘the basic inter...... and a description of the organization of palliative care – there is a need for such inter-professional palliative care that raises the level of competences at the basic level and the sharing of knowledge as well as securing the continuous qualifying of healthcare staff working with palliative care....
van Dongen, Jerôme Jean Jacques; Lenzen, Stephanie Anna; van Bokhoven, Marloes Amantia; Daniëls, Ramon; van der Weijden, Trudy; Beurskens, Anna
The number of people with multiple chronic conditions demanding primary care services is increasing. To deal with the complex health care demands of these people, professionals from different disciplines collaborate. This study aims to explore influential factors regarding interprofessional collaboration related to care plan development in primary care. A qualitative study, including four semi-structured focus group interviews (n = 4). In total, a heterogeneous group of experts (n = 16) and health care professionals (n = 15) participated. Participants discussed viewpoints, barriers, and facilitators regarding interprofessional collaboration related to care plan development. The data were analysed by means of inductive content analysis. The findings show a variety of factors influencing the interprofessional collaboration in developing a care plan. Factors can be divided into 5 key categories: (1) patient-related factors: active role, self-management, goals and wishes, membership of the team; (2) professional-related factors: individual competences, domain thinking, motivation; (3) interpersonal factors: language differences, knowing each other, trust and respect, and motivation; (4) organisational factors: structure, composition, time, shared vision, leadership and administrative support; and (5) external factors: education, culture, hierarchy, domain thinking, law and regulations, finance, technology and ICT. Improving interprofessional collaboration regarding care plan development calls for an integral approach including patient- and professional related factors, interpersonal, organisational, and external factors. Further, the leader of the team seems to play a key role in watching the patient perspective, organising and coordinating interprofessional collaborations, and guiding the team through developments. The results of this study can be used as input for developing tools and interventions targeted at executing and improving interprofessional
Conclusion: It seems that inter-professional education can improve the quality of health care to some extent through influencing knowledge and collaborative performance of health care teams. It also can make the health-related messages provided to the covered population more consistent in addition to enhancing self-confidence of the personnel.
This paper describes a model for interprofessional and transcultural learning established by the author and supported by the University of New England and Ghana Health Mission, Inc. The model for interprofessional immersion in cultural settings represents a guiding framework predicated on a conceptual "brick and mortar" process for building cultural proficiency among individuals and within teams. It encompasses social, clinical and behavioral components (brick) and personal desire, cultural humility and values (mortar). The ``bounty'' aspect of the model is achieved by way of successful student learning outcomes, positive interprofessional and community-based collaborations, and finally, and to be measured over time, favorable patient and population (programmatic) outcomes. In partnership with the Ghana Health Mission, Inc and local community health workers, students and faculty from a range of health professions took part in a cultural-clinical experience known as Transcultural Immersion in Healthcare. The goal of the experience was to advance cultural proficiency and knowledge through intensive cultural immersion. An urban setting in Ghana, located in West Africa served as the setting for this unique experience. The transcultural immersion in healthcare experience achieved its ``bounty'' as seen in the enhanced cultural proficiency of students and faculty, seamless interprofessional communication and collaboration, and provision of primary care and related services to patients and the Ghanaian community. Future research is in development to test the Model for Interprofessional Immersion in Cultural Settings (MIICS) in a variety of other settings and with a cross section of health disciplines.
Anderson, Elizabeth Susan; Thorpe, Lucy
the paper reports on the first 100 students who completed ward-based interprofessional learning using the Leicester Model of Interprofessional Education. Pre-registration health and social care students were placed in small groups (n = 2-5) to learn together on a care of the elderly ward. The students cared for one in-patient to analyse the care package and the contributions of all members of the ward clinical team. At the end of the week the student team presented their patient case to the ward team offering solutions to problems in an interactive feedback session. a multi-method evaluation aimed to assess the impact of the learning. Tutors completed a post-course questionnaire. the results confirmed that the learning was worthwhile. Students learned about related policy, patient involvement in discharge, the roles and responsibilities of team members in care delivery, the importance of effective communication, the complexity of teamworking and team decisions on discharge. They highlighted the added benefit of learning interprofessionally. All tutors saw the value of the interprofessional learning and welcomed student feedback which could be used to improve patient care. Clinicians had to balance clinical work and teaching. interprofessional learning in clinical areas requires effective models which engage students and ward teams. The Leicester Model can be applied in hospital settings to establish student team learning that is experiential, reflective and contributes to improving the quality of patient care. Blackwell Publishing Ltd 2010.
Moore Ainsley E
Full Text Available Abstract The World Health Organization has recently added Interprofessional Education (IPE to its global health agenda recognizing it as a necessary component of all health professionals' education. We suggest mandatory interprofessional shadowing experiences as a mechanism to be used by chiropractic institutions to address this agenda. IPE initiatives of other professions (pharmacy and medicine are described along with chiropractic. This relative comparison of professions local to our jurisdiction in Ontario, Canada is made so that the chiropractic profession may take note that they are behind other health care providers in implementing IPE. Interprofessional shadowing experiences would likely take place in a multi-disciplinary clinical setting. We offer an example of how two separate professions within a Family Health Team (FHT can work together in such a setting to enhance both student learning and patient care. For adult learners, using interprofessional shadowing experiences with learner-derived and active objectives across diverse health professional groups may help to improve the educational experience. Mandatory interprofessional shadowing experiences for chiropractors during their training can enhance future collaborative practice and provide success in reaching a goal common to each profession - improved patient care.
Washington, Tiffany R; Ward, Trina Salm; Young, Henry N; Orpinas, Pamela; Cornelius, Llewellyn J
Interprofessional education (IPE) is one strategy for addressing health inequities; however, little attention has been paid to continuing IPE for practicing social work and healthcare professionals. This article offers guidance to faculty in social work and health-related academic units on offering continuing IPE on the topic of minority health. An interprofessional group of faculty offered a day-long conference on minority health, ethics, and social justice. The conference goal was to promote interprofessional communication in a co-learning environment and promote dialogue on social determinants of health and health equity in the state. Data were obtained from surveys and analysis of work plans developed during the conference. Workshop participants were majority White (62%), social workers (79%), and practiced for 14 years on average. The most useful topics were dementia and polypharmacy. Takeaway strategies included interprofessional work, being mindful of access to resources, and engagement in continuing education. Lessons learned include plan in advance for all professions; recruit faculty and students from multiple departments to increase interprofessional diversity; offer strategies and incentives to increase student participation; be strategic about conference location and format; and identify a strategic format and theme. IPE is a means of preparing learners for working together in their future careers to provide high-quality patient-centred care and reduce health disparities. Professional development can provide an opportunity to enhance skills to address health disparities, and learning can be significantly enhanced when participants connect with colleagues from different professions, discuss diverse opinions, and share successful practices.
Alexanian, Janet A; Kitto, Simon; Rak, Kim J; Reeves, Scott
To examine the ways in which healthcare professionals work together in the ICU setting, through a consideration of the contextual, organizational, processual, and relational factors that impact their interprofessional collaboration. Data from over 350 hours of ethnographic observation and 35 semistructured interviews with clinicians in two ICUs were collected by two medical anthropologists over a period of 6 months. Medical surgical ICUs in two urban research hospitals in Canada and the United States. Although the concept of teamwork is often central to interventions to improve patient safety in the ICU, our observations suggest that this concept does not fully describe how interprofessional work actually occurs in this setting. With the exception of crisis situations, most interprofessional interactions in the two ICUs we studied could be better described as forms of interprofessional work other than teamwork, which include collaboration, coordination, and networking. A singular notion of team is too reductive to account for the ways in which work happens in the ICU and therefore cannot be taken for granted in quality improvement initiatives or among healthcare professionals in this setting. Adapting interventions to the complex nature of interprofessional work and each ICUs unique local context is an important and necessary step to ensure the delivery of safe and effective patient care.
Gotlib Conn Lesley
Full Text Available Abstract Background Studies in General Internal Medicine [GIM] settings have shown that optimizing interprofessional communication is important, yet complex and challenging. While the physician is integral to interprofessional work in GIM there are often communication barriers in place that impact perceptions and experiences with the quality and quantity of their communication with other team members. This study aims to understand how team members’ perceptions and experiences with the communication styles and strategies of either hospitalist or consultant physicians in their units influence the quality and effectiveness of interprofessional relations and work. Methods A multiple case study methodology was used. Thirty-one semi-structured interviews were conducted with physicians, nurses and other health care providers [e.g. physiotherapist, social worker, etc.] working across 5 interprofessional GIM programs. Questions explored participants’ experiences with communication with all other health care providers in their units, probing for barriers and enablers to effective interprofessional work, as well as the use of communication tools or strategies. Observations in GIM wards were also conducted. Results Three main themes emerged from the data:  availability for interprofessional communication,  relationship-building for effective communication, and  physician vs. team-based approaches. Findings suggest a significant contrast in participants’ experiences with the quantity and quality of interprofessional relationships and work when comparing the communication styles and strategies of hospitalist and consultant physicians. Hospitalist staffed GIM units were believed to have more frequent and higher caliber interprofessional communication and collaboration, resulting in more positive experiences among all health care providers in a given unit. Conclusions This study helps to improve our understanding of the collaborative environment
issues related to role clarity and skills regarding teamwork, communication, and conflict resolution. This conceptual framework can serve as a guide for student and health care organizations, in addition to academic institutions to produce health care professionals equipped with interdisciplinary teamwork skills to meet the changing health care demands of the 21st century.Keywords: interprofessional education, conceptual framework, student organization, health care teams
Aase, Ingunn; Hansen, Britt Sætre; Aase, Karina; Reeves, Scott
This article presents an explorative case study focusing on interprofessional training for medical and nursing students in Norway. Based on interviews with, and observations of, multiple stakeholder groups--students, university faculty, and hospital staff--content analysis was applied to investigate their perspectives regarding the design of such educational training. The findings revealed a positive perspective amongst stakeholders while voicing some concerns related to how communication issues, collaboration, workflow, and professional role patterns should be reflected in such training. Based on our data analysis we derive three themes that must be considered for successful interprofessional training of nursing and medical students: clinical professionalism, team performance, and patient-centered perspective. These themes must be balanced contingent on the students' background and the learning objectives of future interprofessional training efforts.
Jane Murray Cramm
Full Text Available Introduction: The quality of integrated stroke care depends on smooth team functioning but professionals may not always work well together. Professionals' perspectives on the factors that influence stroke team functioning remain largely unexamined. Understanding their experiences is critical to indentifying measures to improve team functioning. The aim of this study was to identify the factors that contributed to the success of interprofessional stroke teams as perceived by team members. Methods: We distributed questionnaires to professionals within 34 integrated stroke care teams at various health care facilities in 9 Dutch regions. 558 respondents (response rate: 39% completed the questionnaire. To account for the hierarchical structure of the study design we fitted a hierarchical random-effects model. The hierarchical structure comprised 558 stroke team members (level 1 nested in 34 teams (level 2. Results: Analyses showed that personal development, social well-being, interprofessional education, communication, and role understanding significantly contributed to stroke team functioning. Team-level constructs affecting interprofessional stroke team functioning were communication and role understanding. No significant relationships were found with individual-level personal autonomy and team-level cohesion. Discussion and conclusion: Our findings suggest that interventions to improve team members' social well-being, communication, and role understanding will improve teams' performance. To further advance interprofessional team functioning, healthcare organizations should pay attention to developing professionals' interpersonal skills and interprofessional education.
Jane Murray Cramm
Full Text Available Introduction: The quality of integrated stroke care depends on smooth team functioning but professionals may not always work well together. Professionals' perspectives on the factors that influence stroke team functioning remain largely unexamined. Understanding their experiences is critical to indentifying measures to improve team functioning. The aim of this study was to identify the factors that contributed to the success of interprofessional stroke teams as perceived by team members. Methods: We distributed questionnaires to professionals within 34 integrated stroke care teams at various health care facilities in 9 Dutch regions. 558 respondents (response rate: 39% completed the questionnaire. To account for the hierarchical structure of the study design we fitted a hierarchical random-effects model. The hierarchical structure comprised 558 stroke team members (level 1 nested in 34 teams (level 2. Results: Analyses showed that personal development, social well-being, interprofessional education, communication, and role understanding significantly contributed to stroke team functioning. Team-level constructs affecting interprofessional stroke team functioning were communication and role understanding. No significant relationships were found with individual-level personal autonomy and team-level cohesion. Discussion and conclusion: Our findings suggest that interventions to improve team members' social well-being, communication, and role understanding will improve teams' performance. To further advance interprofessional team functioning, healthcare organizations should pay attention to developing professionals' interpersonal skills and interprofessional education.
There is increasing agreement that graduates who finish tertiary education with the full complement of skills and knowledge required for their designated profession are not 'work-ready' unless they also acquire interpersonal, collaborative practice and team-working capabilities. Health workers are unable to contribute to organisational culture in a positive way unless they too attain these capabilities. These capabilities have been shown to improve health care in terms of patient safety, worker satisfaction and health service efficiency. Given the importance of interprofessional learning (IPL) which seeks to address these capabilities, why is IPL not consistently embedded into the education of undergraduates, postgraduates and vocationally qualified personnel through formal assessment? This paper offers an argument for the formal assessment of IPL. It illustrates how the interests of the many stakeholders in IPL can benefit from, and contribute to, the integration of IPL into mainstream professional development and tertiary education. It offers practical examples of assessment in IPL which could drive learning and offer authentic, contextual teaching and learning experiences to undergraduates and health workers alike. Assessment drives learning and without formal assessment IPL will continue to be viewed as an optional topic of little relative importance for learners. In order to make the next step forward, IPL needs to be recognised and endorsed through formal assessment, both at the tertiary education level and within the workplace environment. This is supported by workforce initiatives and tertiary education policy which can be used to specify the capabilities or generic skills necessary for effective teamwork and collaborative practice.
Riotte, Clare O; Kukora, Stephanie K; Keefer, Patricia M; Firn, Janice I
Despite the number of interprofessional team members caring for children at the end of life, little evidence exists on how institutions can support their staff in providing care in these situations. We sought to evaluate which aspects of the hospital work environment were most helpful for multidisciplinary team members who care for patients at the end of life and identify areas for improvement to better address staff needs. Qualitative thematic analysis was completed of free-text comments from a survey distributed to interprofessional staff members involved in the care of a recently deceased pediatric patient. A total of 2701 surveys were sent; 890 completed. Free-text responses were provided by 306 interprofessional team members. Interprofessional team members involved in the care of a child who died at a 348 bed academic children's hospital in the Midwestern United States. Realist thematic analysis of free-text responses was completed in Dedoose using a deductive and inductive approach with line-by-line coding. Descriptive statistics of demographic information was completed using Excel. Thematic analysis of the 306 free-text responses identified three main support-related themes. Interprofessional team members desire to have (1) support through educational efforts such as workshops, (2) support from colleagues, and (3) support through institutional practices. Providers who participate in end-of-life work benefit from ongoing support through education, interpersonal relationships, and institutional practices. Addressing these areas from an interprofessional perspective enables staff to provide the optimal care for patients, patients' families, and themselves.
This article presents a discussion of emerging non-medical roles in emergency care against the current policy context and the issues of role substitution and interprofessional working. Non-medical roles in emergency care have grown internationally in response to an increasing demand for emergency care services and to address the growing importance of the quality healthcare agenda. The blurring of role boundaries between professional groups has become more common. Data sources. Searches were made of three electronic databases; CINAHL, Medline and EMBASE. The literature relating to interprofessional healthcare roles, and new roles in emergency care was searched from 1980 to 2010 and underpinned the discussion. A theoretical framework that has emerged from the literature is that task, role substitution and interprofessional working lie on a spectrum and evolving non-medical roles can be plotted on the spectrum, usually starting at one end of the spectrum under task substitution and then potentially moving in time towards true interprofessional working. There is still a great deal of progress to be made until non-medical roles in emergency care can truly be encompassed under the umbrella of interprofessional working and that a more robust critical mass of evidence is required to substantiate the theory that interprofessional working within teams contributes to effective, cost-effective care and better patient outcomes. It is essential to understand the underlying motivation, policy context and key drivers for the development of new nursing and non-medical roles. This allows services to be established successfully, by understanding and addressing the key predicable barriers to implementation and change. © 2011 Blackwell Publishing Ltd.
Redley, Bernice; Botti, Mari; Wood, Beverley; Bucknall, Tracey
Poor interprofessional communication poses a risk to patient safety at change-of-shift in emergency departments (EDs). The purpose of this study was to identify and describe patterns and processes of interprofessional communication impacting quality of ED change-of-shift handovers. Observation of 66 change-of-shift handovers at two acute hospital EDs in Victoria, Australia. Focus groups with 34 nurse participants complemented the observations. Qualitative data analysis involved content and thematic methods. Four structural components of ED handover processes emerged represented by (ABCD): (1) Antecedents; (2) Behaviours and interactions; (3) Content; and (4) Delegation of ongoing care. Infrequent and ad hoc interprofessional communication and discipline-specific handover content and processes emerged as specific risks to patient safety at change-of-shift handovers. Three themes related to risky and effective practices to support interprofessional communications across the four stages of ED handovers emerged: 1) standard processes and practices, 2) teamwork and interactions and 3) communication activities and practices. Unreliable interprofessional communication can impact the quality of change-of-shift handovers in EDs and poses risk to patient safety. Structured reflective analysis of existing practices can identify opportunities for standardisation, enhanced team practices and effective communication across four stages of the handover process to support clinicians to enhance local handover practices. Future research should test and refine models to support analysis of practice, and identify and test strategies to enhance ED interprofessional communication to support clinical handovers. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.
Kinnison, Tierney; May, Stephen A; Guile, David
Animal health care is being delivered by an increasing number of professions and occupations. This article takes an inward look at the veterinary team, focusing on the day-to-day life of veterinarians and those with whom they work, such as veterinary technicians/nurses, physical therapists, and farriers. The evolution of the work of the veterinarian should be explored alongside the evolution of closely related occupations, as the current working practice of veterinarians is affected by the practice of these other occupations. An example is given of UK veterinary nurses (similar to veterinary technicians in North America) who are currently undergoing professionalization. Seminal implementations have included a register (2007), disciplinary procedures (2011), a declaration of professional responsibilities (2012), and required continuing professional development for registered veterinary nurses (RVNs). These implementations result in veterinary nurses who are now accountable for their actions. There are many potential benefits to good inter-professional practice for the practice itself, individual team members, clients, and patients, including better results produced by the whole team rather than the sum of the parts, financial benefits to using individuals in lower-paid occupations for shared roles, and greater client satisfaction regarding increased options for treatment. There are, however, many challenges to inter-professional working that center on the interlinked themes of hierarchy (power, status, and the understanding/appreciation of professional roles) and communication (lack of/poor). Inter-professional education (IPE) is suggested as a potential means to overcome these challenges; however, research into IPE exclusively related to the veterinary team is lacking.
The paper analyses a form of interprofessional working and learning (IPWL)--the fleeting spatial and temporal constitution of project teams with little prior history of working together--that is an increasing feature of work in the global economy. The paper argues firstly: (i) this form of working and learning is relatively under-researched in…
Xyrichis, Andreas; Reeves, Scott; Zwarenstein, Merrick
The practice of, and research on interprofessional working in healthcare, commonly referred to as teamwork, has been growing rapidly. This has attracted international policy support flowing from the growing belief that patient safety and quality of care can only be achieved through the collective effort of the multiple professionals caring for a given patient. Despite the increasing policy support, the evidence for effectiveness lags behind: while there are supporting analytic epidemiological studies, few reliable intervention studies have been published and so we have yet to confirm a causal link. We argue that this lag in evidence development may be because interprofessional terms (e.g. teamwork, collaboration) remain conceptually unclear, with no common terminology or definitions, making it difficult to distinguish interventions from each other. In this paper, we examine published studies from the last decade in order to elicit current usage of terms related to interprofessional working; and, in so doing, undertake an initial empirical validation of an existing conceptual framework by mapping its four categories (teamwork, collaboration, coordination and networking) against the descriptions of interprofessional interventions in the included studies. We searched Medline and Embase for papers describing interprofessional interventions using a standard approach. We independently screened papers and classified these under set categories following a thematic approach. Disagreements were resolved through consensus. Twenty papers met our inclusion criteria. Identified interprofessional work interventions fall into a range, from looser to tighter links between members. Definitions are inconsistently and inadequately applied. We found the framework to be a helpful and practical tool for classifying such interventions more consistently. Our analysis enabled us to scrutinise the original dimensions of the framework, confirm their usefulness and consistency, and reveal new
Kallio, Sonja; Kumpusalo-Vauhkonen, Anne; Järvensivu, Timo; Mäntylä, Antti; Pohjanoksa-Mäntylä, Marika; Airaksinen, Marja
care system and lack of coordinated patient care are reasons for medication related problems of the aged.Challenges in the implementation of interprofessional collaboration in medication management appear in legislation, information systems, operational models and individuals’ attitudes.Optimising medications requires better interprofessional networking and new systemic solutions within and between macro, meso and micro levels. PMID:27822968
Harriet Rosanne Etheredge
Full Text Available Background. Communication is essential to the transplant process, but it is challenging in South Africa (SA because of the complexity of the country and the health system, the nature of transplantation as a technical procedure with inherent psychological considerations, and the large number of professionals involved. Transplant communication has not been explored in SA, and this study was the first to use health communication methods to generate empirical evidence relating to it. Objective. To explore communication in transplant settings in Gauteng Province, SA. Methods. Qualitative methods were used to collect data across six hospitals and transplant centres in Gauteng. State and private institutions were equally represented. Health professionals and transplant co-ordinators participated. Thematic analysis of data was undertaken. Results. Facilitators of interprofessional transplant communication included appreciation of its importance to good practice and cohesive individual transplant teams. Barriers to interprofessional communication were observed when individual teams had to come together in a multi-team, interdisciplinary environment, when interchange became aggressive, and when information was not passed on to other health professionals timeously. These barriers had implications for continuity of care and ethics, which could lead to moral distress. Conclusion. Transplantation in Gauteng is characterised by aspects of good teamwork, and the importance of effective communication is acknowledged. Transplantation also faces some challenges in terms of interprofessional communication. Recommendations for mitigating some of the gaps include integrating a health communication specialist into the transplant process, ‘knotworking’, the use of apology, and an advance warning text-message system for transplant professionals.
Activities related to interprofessional education (IPE) vary between countries according to local and national health needs and systems. The International Pharmaceutical Federation (FIP) Education Initiative endeavors to provide a global vision in IPE by the sharing of experiences and gathering of evidence collaboratively to facilitate country-level initiatives. The purpose of this paper is to contribute to the further development of IPE activities in pharmacy in Japan through sharing global perspectives and activities related to IPE. FIP Education Initiative published the Interprofessional Education in a Pharmacy Context: Global Report in September 2015, which marked a milestone in the growing recognition of IPE in pharmacy globally. The paper shared global and regional perspectives and experiences in IPE in pharmacy, both from the report and FIP activities. This paper can be seen as a snapshot of IPE-related international activities, which enables gaps and challenges in implementing IPE activities in Japan to be identified. This paper provides an opportunity to explore global trends and initiatives regarding IPE, and to consider how to form and implement IPE specifically based on Japanese health needs and systems.
McCally, Michael; And Others
A survey of the interprofessional education activities included in 54 physician's assistant and 60 nurse practitioner programs is reported. A variety of methods are being used to achieve the objectives of effective team delivery of primary health care, including the mixing of students in both classroom and clinical settings. (LBH)
Breitbach, Anthony P.; Richardson, Russ
Professional preparation in athletic training has grown from modest roots based in physical education in the 1960s to its emergence as a recognized health profession today. The profession has long embraced interprofessional practice (IPP), but many times has not been included in discussions held at the institutional, governmental, and…
Sargeant, Joan; MacLeod, Tanya; Murray, Anne
Introduction: Recent research suggests that effective interprofessional communication and collaboration can positively influence patient satisfaction and outcomes. Health professional communication skills do not necessarily improve over time but can improve with formal communication skills training (CST). This article describes the development,…
Conclusion. Transplantation in Gauteng is characterised by aspects of good teamwork, and the importance of effective communication is acknowledged. Transplantation also faces some challenges in terms of interprofessional communication. Recommendations for mitigating some of the gaps include integrating a health ...
Leeman, Yvonne; van Koeven, Erna; Schaafsma, Frank
This article describes an example of inter-professional action research conducted by teachers and university-based researchers/teacher educators in a vocational college in the Netherlands. The research was aimed at the professional learning of the teachers on their pedagogical approach to a new curriculum initiative. Despite a difficult context in…
... financial constraints, administrative support, logistical issues and resistance to change. The designing and implementing of new modules were intense and time consuming, and required commitment. The development of the modules was an excellent example of interprofessional teamwork that needs to be transferred to ...
Meyer, Brittney A; Seefeldt, Teresa M; Ngorsuraches, Surachat; Hendrickx, Lori D; Lubeck, Paula M; Farver, Debra K; Heins, Jodi R
This study examined the feasibility of an interprofessional high-fidelity pharmacology simulation and its impact on pharmacy and nursing students' perceptions of interprofessionalism and pharmacology knowledge. Pharmacy and nursing students participated in a pharmacology simulation using a high-fidelity patient simulator. Faculty-facilitated debriefing included discussion of the case and collaboration. To determine the impact of the activity on students' perceptions of interprofessionalism and their ability to apply pharmacology knowledge, surveys were administered to students before and after the simulation. Attitudes Toward Health Care Teams scale (ATHCT) scores improved from 4.55 to 4.72 on a scale of 1-6 (p = 0.005). Almost all (over 90%) of the students stated their pharmacology knowledge and their ability to apply that knowledge improved following the simulation. A simulation in pharmacology is feasible and favorably affected students' interprofessionalism and pharmacology knowledge perceptions. Pharmacology is a core science course required by multiple health professions in early program curricula, making it favorable for incorporation of interprofessional learning experiences. However, reports of high-fidelity interprofessional simulation in pharmacology courses are limited. This manuscript contributes to the literature in the field of interprofessional education by demonstrating that an interprofessional simulation in pharmacology is feasible and can favorably affect students' perceptions of interprofessionalism. This manuscript provides an example of a pharmacology interprofessional simulation that faculty in other programs can use to build similar educational activities. Copyright © 2017 Elsevier Inc. All rights reserved.
Gonzalo, Jed D; Wolpaw, Daniel R; Lehman, Erik; Chuang, Cynthia H
Medical care delivered in hospital-based medicine units requires interprofessional collaborative care (IPCC) to improve quality. However, models such as bedside interprofessional rounds, or encounters that include the team of physician and nurse providers discussing medical care at the patient's bedside, are not well studied. To examine the incidence of and time spent in bedside interprofessional rounds on internal medicine teaching services in one academic medical center. Observational descriptive study of internal medicine faculty serving as inpatient medicine attending physicians. Participants completed a daily electronic survey following team rounding sessions to assess rounding characteristics (November 2012-June 2013); variables such as resident level-of-training, attending physician years' of experience, house staff call day and clinic schedule were obtained from administrative data. Descriptive, Kruskal-Wallis, and multivariable logistic regression statistics were used to evaluate the study objectives. Primary outcomes were: (1) incidence of bedside interprofessional rounds, (2) time spent with patients during bedside interprofessional rounding encounters, and, (3) factors associated with increased occurrence of and time spent with patients during bedside interprofessional rounds. Covariates included resident level-of-training, attending physician years' of experience, census size, and call day. Of 549 rounding sessions, 412 surveys were collected (75 % response) from 25 attending physicians. Bedside interprofessional rounds occurred with 64 % of patients (median 8.0 min/encounter), differing by unit (intermediate care 81 %, general medicine 63 %, non-medicine 57 %, p interprofessional rounds were senior resident (OR 2.67, CI 1.75-4.06, PGY-3/PGY-4 vs. PGY-2), weekdays (OR 1.74, CI 1.13-2.69), team census size ≤ 11 (OR 2.36, CI 1.37-4.06), and attending physicians with ≤ 4 years' experience (OR 2.15, CI 1.31-3.55). Factors independently associated with
Imafuku, Rintaro; Kataoka, Ryuta; Ogura, Hiroshi; Suzuki, Hisayoshi; Enokida, Megumi; Osakabe, Keitaro
Interprofessional collaboration is an essential approach to comprehensive patient care. As previous studies have argued, interprofessional education (IPE) must be integrated in a stepwise, systematic manner in undergraduate health profession education programmes. Given this perspective, first-year IPE is a critical opportunity for building the foundation of interprofessional collaborative practice. This study aims to explore the first-year students' learning processes and the longitudinal changes in their perceptions of learning in a year-long IPE programme. Data were collected at a Japanese medical university, in which different pedagogical approaches are adopted in the IPE programme. Some of these approaches include interprofessional problem-based learning, early exposure, and interactive lecture-based teaching. The students are required to submit written reflections as a formative assessment. This study conducted an inductive thematic analysis of 104 written reflections from a series of e-portfolios of 26 first-year students. The themes related to learning outcomes from student perspectives included communication (e.g., active listening and intelligible explanation), teams and teamwork (e.g., mutual engagement and leadership), roles/responsibilities as a group member (e.g., self-directed learning and information literacy), and roles/responsibilities as a health professional (e.g., understanding of the student's own professional and mutual respect in an interprofessional team). The study also indicated three perspectives of students' learning process at different stages of the IPE, i.e., processes by which students became active and responsible learners, emphasised the enhancement of teamwork, and developed their own interprofessional identities. This study revealed the first-year students' learning processes in the year-long IPE programme and clarified the role of the first-year IPE programme within the overall curriculum. The findings suggest that the students
Multiple events are calling for greater interprofessional collaboration and communication, including initiatives aimed at enhancing patient safety and preventing medical errors. Education is 1 way to increase collaboration and communication, and is an explicit goal of interprofessional education (IPE). Yet health professionals to date are largely educated in isolation. IPE differs from most traditional continuing education in that knowledge is largely socially created through interactions with others and involves unique collaborative skills and attitudes. It requires thinking differently about what constitutes teaching and learning. The article draws upon a small number of social and learning theories to explain the rationale for IPE needing a new way of thinking, and proposes approaches to guide development and implementation of IP continuing education. Social psychology and complexity theory explain the influence of the dynamism and interaction of internal (cognitive) and external (environmental) factors upon learning and set the stage for IPE. Theories related to professionalism and stereotyping, communities of practice, reflective learning, and transformative learning appear central to IPE and guide specific educational interventions. In sum, IPE requires CE to adopt new content, recognize new knowledge, and use new approaches for learning; we are now in a different place.
Liu, Min; Poirier, Therese; Butler, Lakesha; Comrie, Rhonda; Pailden, Junvie
The 2013 National Standards for Culturally and Linguistically Appropriate Services (CLAS) call for healthcare professionals to provide quality care and services that are responsive to diverse cultural health beliefs and practices. Accreditation organizations for health professional programs require their curriculum to adequately prepare future practitioners for serving culturally and linguistically diverse populations. Another common curricular need of health professional programs is interprofessional education (IPE). This study presents data that evaluates two IPE culturally competent communication sessions designed for pharmacy and nursing students. Teams of nursing and pharmacy students (n = 160) engaged in case studies focused on developing cross-cultural communication skills, using the LEARN model. Quantitative survey data collected pre-test and post-test measured cultural competency (including subscales of perceived skills, perceived knowledge, confidence in encounter, and attitude) and knowledge related to culturally competent communication. Univariate ANOVA results indicate that actual knowledge as measured by the test and all four Clinical Cultural Competency Questionnaire (CCCQ) subscales significantly increased after the IPE sessions. Pharmacy students scored higher than nursing students on the knowledge pre-test, and nursing students had a more positive attitude at pre-test. The IPE sessions effectively addressed all learning outcomes and will continue in future course offerings. Using cross-cultural communication as a thematic area for IPE program development resulted in educational benefits for the students. To further strengthen nursing and pharmacy students' interprofessional practice, additional IPE opportunities are to be explored.
Solomon, Patricia; Baptiste, Sue; Hall, Pippa; Luke, Robert; Orchard, Carole; Rukholm, Ellen; Carter, Lorraine; King, Susanne; Damiani-Taraba, Gissele
Asynchronous e-learning is an appealing option for interprofessional education (IPE) as it addresses the geographic and timetabling barriers often encountered when organizing activities across educational programs. This study examined the extent to which pre-licensure students were able to learn with, from, and about each other through completion of innovative online IPE learning modules. Seventy-seven students completed e-learning modules developed through a consortium of educational institutions. Evaluation was primarily qualitative through focus groups, interviews, analyses on off-line discussions and an online feedback form. Qualitative analyses of the discussion fora revealed that students were able to solve problems collaboratively, clarify their professional roles, and provide information from their professional perspective. Focus groups and interviews reinforced that students recognized the importance of working together and implicate clinical education as an important venue to reinforce learning about collaborative practice. Analyses of the online feedback form suggest the need for clear processes related to group assignments and deadlines. Students learned about each other's role, solved problems together and had positive perceptions of the online modules as a venue for interprofessional learning. Results are encouraging to those interested in using e-learning in IPE as part of an overall curriculum.
Smith, Denise Colter
Since the passage of the Affordable Care Act, collaborative practice has been cited as one method of increasing access to care, decreasing costs, and improving efficiency. How and under what conditions might these goals be achieved? Midwives and physicians have built effective collaborative practice models over a period of 30 years. Empirical study of interprofessional collaboration between midwives and physicians could be useful in guiding professional education, regulation, and health policy in women's health and maternity care. Construction of a conceptual framework for interprofessional collaboration between midwives and physicians was guided by a review of the literature. A theory derivation strategy was used to define dimensions, concepts, and statements of the framework. Midwife-physician interprofessional collaboration can be defined by 4 dimensions (organizational, procedural, relational, and contextual) and 12 concepts (trust, shared power, synergy, commitment, and respect, among others). The constructed framework provides the foundation for further empirical study of the interprofessional collaborative process. The experiences of midwife-physician collaborations provide solid support for a conceptual framework of the collaborative process. A conceptual framework provides a point from which further research can increase knowledge and understanding about how successful outcomes are achieved in collaborative health care practices. Construction of a measurement scale and validation of the model are important next steps. © 2014 by the American College of Nurse-Midwives.
Burau, Viola; Carstensen, Kathrine; Lou, Stina; Kuhlmann, Ellen
Patient-centred care based on needs has been gaining momentum in health policy and the workforce. This creates new demand for interprofessional teams and redefining roles and tasks of professionals, yet little is known on how to implement new health policies more effectively. Our aim was to analyse the role and capacity of health professions in driving organisational change in interprofessional working and patient-centred care. A case study of the introduction of interprofessional, early discharge teams in stroke rehabilitation in Denmark was conducted with focus on day-to-day coordination of care tasks and the professional groups' interests and strategies. The study included 5 stroke teams and 17 interviews with different health professionals conducted in 2015. Professional groups expressed highly positive professional interest in reorganised stroke rehabilitation concerning patients, professional practice and intersectoral relations; individual professional and collective interprofessional interests strongly coincided. The corresponding strategies were driven by a shared goal of providing needs-based care for patients. Individual professionals worked independently and on behalf of the team. There was also a degree of skills transfer as individual team members screened patients on behalf of other professional groups. The study identified supportive factors and contexts of patient-centred care. This highlights capacity to improve health workforce governance through professional participation, which should be explored more systematically in a wider range of healthcare services.
Matthews, Lynda R; Pockett, Rosalie B; Nisbet, Gillian; Thistlethwaite, Jill E; Dunston, Roger; Lee, Alison; White, Jill F
A substantial literature engaging with the directions and experiences of stakeholders involved in interprofessional health education exists at the international level, yet almost nothing has been published that documents and analyses the Australian experience. Accordingly, this study aimed to scope the experiences of key stakeholders in health and higher education in relation to the development of interprofessional practice capabilities in health graduates in Australia. Twenty-seven semi-structured interviews and two focus groups of key stakeholders involved in the development and delivery of interprofessional health education in Australian higher education were undertaken. Interview data were coded to identify categories that were organised into key themes, according to principles of thematic analysis. Three themes were identified: the need for common ground between health and higher education, constraints and enablers in current practice, and the need for research to establish an evidence base. Five directions for national development were also identified. The study identified a range of interconnected changes that will be required to successfully mainstream interprofessional education within Australia, in particular, the importance of addressing issues of culture change and the need for a nationally coordinated and research informed approach. These findings reiterate those found in the international literature.
Cino, Kathleen; Austin, Rita; Casa, Cristina; Nebocat, Christine; Spencer, Adele
To prepare for the modern collaborative healthcare system, health science academia is charged with educating future professionals to be competent members of the interprofessional team. The purpose of this pilot study was to assess self-efficacy for interprofessional education (IPE) in medical laboratory technology, dental hygiene, and nursing students before and after an IPE session. The specific topic of ethics was the focus of the session. The interprofessional seminar was designed to compare the codes of ethics from each programme through discussion and a case-based approach. The Self-Efficacy for Interprofessional Experiential Learning scale was used to collect quantitative data. A total of 75 participants rated self-efficacy for IPE before and after the educational offering. A paired sample t-test was used to analyse data. Significant results were found in students' pre- and post-test scores that indicated increased levels of self-efficacy related to working as a collaborative team for the benefit of the patient. Overall, there was an increase in participants' self-efficacy after collaborating with students from different health professions programmes. Healthcare students that learn together are more confident in their abilities to implement a team-structured approach, and understand that doing so will foster optimal patient wellbeing.
O'Leary, Denise Fiona
It has been previously demonstrated that interactions within interprofessional teams are characterised by effective communication, shared decision-making, and knowledge sharing. This article outlines aspects of an action research study examining the emergence of these characteristics within change management teams made up of nurses, general practitioners, physiotherapists, care assistants, a health and safety officer, and a client at two residential care facilities for older people in Ireland. The theoretical concept of team psychological safety (TPS) is utilised in presenting these characteristics. TPS has been defined as an atmosphere within a team where individuals feel comfortable engaging in discussion and reflection without fear of censure. Study results suggest that TPS was an important catalyst in enhancing understanding and power sharing across professional boundaries and thus in the development of interprofessional teamwork. There were differences between the teams. In one facility, the team developed many characteristics of interprofessional teamwork while at the other there was only a limited shift. Stability in team membership and organisational norms relating to shared decision-making emerged as particularly important in accounting for differences in the development of TPS and interprofessional teamwork.
Van den Bulcke, Bo; Vyt, Andre; Vanheule, Stijn; Hoste, Eric; Decruyenaere, Johan; Benoit, Dominique
This article describes a study that evaluated the quality of teamwork in a surgical intensive care unit and assessed whether teamwork could be improved significantly through a tailor-made intervention. The quality of teamwork prior to and after the intervention was assessed using the Interprofessional Practice and Education Quality Scales (IPEQS) using the PROSE online diagnostics and documenting system, which assesses three domains of teamwork: organisational factors, care processes, and team members' attitudes and beliefs. Furthermore, team members evaluated strengths and weaknesses of the teamwork through open-ended questions. Information gathered by means of the open questions was used to design a tailor-made 12-week intervention consisting of (1) optimising the existing weekly interdisciplinary meetings with collaborative decision-making and clear communication of goal-oriented actions, including the psychosocial aspects of care; and (2) organising and supporting the effective exchange of information over time between all professions involved. It was found that the intervention had a significant impact on organisational factors and care processes related to interprofessional teamwork for the total group and within all subgroups, despite baseline differences between the subgroups in interprofessional teamwork. In conclusion, teamwork, and more particularly the organisational aspects of interprofessional collaboration and processes of care, can be improved by a tailor-made intervention that takes into account the professional needs of healthcare workers.
Swenty, Constance L; Schaar, Gina L; Butler, Ryan M
Veterans are challenged with multiple unique healthcare issues related to their military service environment. Likewise, health care providers must understand the special concerns associated with military conflict and recognize how the veteran's care can be optimized by interprofessional care delivery. Little is taught didactically or clinically that supports nursing students in addressing the unique issues of the veteran or the student's need to work collaboratively with allied health team members to enhance the veteran's care. Because of limited exposure to the veteran's special conditions, nursing students who may seek a career with the veteran population often face challenges in rendering appropriate care. The VA offers an invaluable opportunity for health profession students to collaborate with VA interprofessional Patient Aligned Care Teams (PACT) ultimately optimizing veteran health outcomes. This academic partnership, that implements an interprofessional model, will prepare students to better embrace the veteran population. This article describes the immersion of health profession students in interprofessional collaborative practice (IPCP) using PACT team principles which ultimately promotes the students' ability to link theory content to patient care delivery. Copyright © 2016 Elsevier Ltd. All rights reserved.
Bordeleau, Lyne; Leblanc, Jeannette
Child and adolescent intervention in child psychiatric clinics generates a high risk of therapeutic impasses for clinicians. Among the factors that contribute to this situation are the increasing severity of the problems of young people who are referred to psychiatric clinics and the obligation for professionals to collaborate with various actors surrounding the patient. This literature review explores the possibility that an intervention targeting indicators of interprofessional collaboration can help resolved the therapeutic impasses encountered by professionals working in child psychiatry. The article begins with a description of the impasse in therapeutic clinical child psychiatry. It then introduces a broad look at research about interprofessional collaboration and its effects on mental health service delivery. Finally, it examines the structuring model of the interprofessional collaboration process of D'Amour et al. in order to highlight the indicators that may be related to the resolution of clinical therapeutic impasses in child psychiatry. This review examines the possible interventions that could be done when targeting indicators of D'Amour et al.'s interprofessional collaboration model in order to improve therapeutic impasses resolution. A promising direction for future research which could contribute to therapeutic impasses resolution in child psychiatry is proposed.
Tamuz, Michal; Giardina, Traber Davis; Thomas, Eric J.; Menon, Shailaja; Singh, Hardeep
Background Inadequate supervision is a significant contributing factor to medical errors involving trainees but supervision in high-risk settings such as the Intensive Care Unit (ICU) is not well studied. Objective We explored how residents in the ICU experienced supervision related to medication safety not only from supervising physicians but also from other professionals. Design, Setting, Measurements Using qualitative methods, we examined in-depth interviews with 17 residents working in ICUs of three tertiary-care hospitals. We analyzed residents' perspectives on receiving and initiating supervision from physicians within the traditional medical hierarchy and from other professionals, including nurses, staff pharmacists and clinical pharmacists (“interprofessional supervision”). Results While initiating their own supervision within the traditional hierarchy, residents believed in seeking assistance from fellows and attendings and articulated rules of thumb for doing so; however, they also experienced difficulties. Some residents were concerned that their questions would reflect poorly on them; others were embarrassed by their mistaken decisions. Conversely, residents described receiving interprofessional supervision from nurses and pharmacists, who proactively monitored, intervened in, and guided residents' decisions. Residents relied on nurses and pharmacists for non-judgmental answers to their queries, especially after-hours. To enhance both types of supervision, residents emphasized the importance of improving interpersonal communication skills. Conclusions Residents depended on interprofessional supervision when making decisions regarding medications in the ICU. Improving interprofessional supervision, which thus far has been under-recognized and underemphasized in graduate medical education, can potentially improve medication safety in high-risk settings. PMID:21990173
Full Text Available There are significant limitations among the few prior studies that have examined the development and implementation of interprofessional education (IPE experiences to accommodate a high volume of students from several disciplines and from different institutions. The present study addressed these gaps by seeking to determine the extent to which a single, large, inter-institutional, and IPE simulation event improves student perceptions of the importance and relevance of IPE and simulation as a learning modality, whether there is a difference in students’ perceptions among disciplines, and whether the results are reproducible. A total of 290 medical, nursing, pharmacy, and physical therapy students participated in one of two large, inter-institutional, IPE simulation events. Measurements included student perceptions about their simulation experience using the Attitude Towards Teamwork in Training Undergoing Designed Educational Simulation (ATTITUDES Questionnaire and open-ended questions related to teamwork and communication. Results demonstrated a statistically significant improvement across all ATTITUDES subscales, while time management, role confusion, collaboration, and mutual support emerged as significant themes. Results of the present study indicate that a single IPE simulation event can reproducibly result in significant and educationally meaningful improvements in student perceptions towards teamwork, IPE, and simulation as a learning modality.
Bambini, Deborah; Emery, Matthew; de Voest, Margaret; Meny, Lisa; Shoemaker, Michael J
There are significant limitations among the few prior studies that have examined the development and implementation of interprofessional education (IPE) experiences to accommodate a high volume of students from several disciplines and from different institutions. The present study addressed these gaps by seeking to determine the extent to which a single, large, inter-institutional, and IPE simulation event improves student perceptions of the importance and relevance of IPE and simulation as a learning modality, whether there is a difference in students' perceptions among disciplines, and whether the results are reproducible. A total of 290 medical, nursing, pharmacy, and physical therapy students participated in one of two large, inter-institutional, IPE simulation events. Measurements included student perceptions about their simulation experience using the Attitude Towards Teamwork in Training Undergoing Designed Educational Simulation (ATTITUDES) Questionnaire and open-ended questions related to teamwork and communication. Results demonstrated a statistically significant improvement across all ATTITUDES subscales, while time management, role confusion, collaboration, and mutual support emerged as significant themes. Results of the present study indicate that a single IPE simulation event can reproducibly result in significant and educationally meaningful improvements in student perceptions towards teamwork, IPE, and simulation as a learning modality.
Pabian, Patrick S; Oliveira, Leonardo; Tucker, Jennifer; Beato, Morris; Gual, Carlos
Due to the high incidence of sports concussion, various health and medical providers are likely to encounter athletes who have sustained such an injury. Management of concussion necessitates coordinated care by the members of the sports medicine team due to its pathophysiology and complexity of management during recovery. All members of the sports medicine team must possess contemporary knowledge of concussion management as well as strong interprofessional communication skills to ensure effective care and safe return to sports participation. Therefore, the aim of this manuscript is to review the current best practices in interdisciplinary management of sports concussion with a special emphasis on the required interprofessional communication among the sports medicine team. Copyright © 2016 Elsevier Ltd. All rights reserved.
Varga-Atkins, Tünde; Cooper, Helen
An evidence-based, interprofessional educational course involving first-year undergraduate students studying medicine, nursing, physiotherapy and occupational therapy has been piloted at the University of Liverpool. Part of the content was developed in an online format. To capture the development process and the e-learning writing experience, a focus group was arranged for the content writers. The session was audio-recorded and tapes were transcribed. All the data were subjected to thematic analysis. Twenty-three sub-themes were identified in the 72 comments. These were grouped under six themes, corresponding to the developmental stages of e-learning. The highest number of comments fell under the theme of preparation, followed by content development, evaluation, general design and structure, and finally delivery. Team working contributed to the success of the writing process, reflecting the theme of working inter-professionally.
Joseph, Sundari; Diack, Lesley
This report explores the relevance of gaming in IPE curriculum design with the use of the Interprofessional Education Game (iPEG) as an activity aimed to achieve positive interprofessional learning outcomes for students. It was designed to enable the understanding of professional roles and responsibilities in patient/client care settings. We provide a description of its implementation and evaluation with first year student cohorts (900+ per cohort) over a 3-year period within an established interprofessional education (IPE) programme. The game encapsulates fun and memorable learning styles to explore professional stereotypes and team approaches to care delivery. It can be a valuable teaching tool for those designing IPE curriculum. Evaluation data from students and staff were mainly positive. We discuss the use of the game and its potential to be adapted in flexible and creative ways to assist educators in consider incorporating gaming within their own IPE programmes.
Kent, Fiona; Hayes, Jacinta; Glass, Sharon; Rees, Charlotte E
The inclusion of interprofessional education opportunities in clinical placements for pre-registration learners has recently been proposed as a strategy to enhance graduates' skills in collaborative practice. A realist review was undertaken to ascertain the contexts, mechanisms and outcomes of formal interprofessional clinical workplace learning. Initial scoping was carried out, after which Ovid MEDLINE, CINAHL and EMBASE were searched from 2005 to April 2016 to identify formal interprofessional workplace educational interventions involving pre-registration learners. Papers reporting studies conducted in dedicated training wards were excluded, leaving a total of 30 papers to be included in the review. Several educational formats that combined students from medicine, nursing, pharmacy and allied health professions were identified. These included: the use of engagement by student teams with a real patient through interview as the basis for discussion and reflection; the use of case studies through which student teams work to promote discussion; structured workshops; ward rounds, and shadowing. Meaningful interprofessional student discussion and reflection comprised the mechanism by which the outcome of learners acquiring knowledge of the roles of other professions and teamwork skills was achieved. The mechanism of dialogue during an interaction with a real patient allowed the patient to provide his or her perspective and contributed to an awareness of the patient's perspective in health care practice. Medication- or safety-focused interprofessional tasks contributed to improved safety awareness. In the absence of trained facilitators or in the context of negative role-modelling, programmes were less successful. In the design of workplace education initiatives, curriculum decisions should take into consideration the contexts of the initiatives and the mechanisms for achieving the education-related outcomes of interest. © 2017 John Wiley & Sons Ltd and The Association
Starks, Helene; Coats, Heather; Paganelli, Tia; Mauksch, Larry; van Schaik, Eileen; Lindhorst, Taryn; Hurd, Caroline; Doorenbos, Ardith
The National Consensus Project for Quality Palliative Care Clinical Practice Guidelines recommend that palliative care clinicians work together as interprofessional teams. We created and piloted a 9-month curriculum that focused on 3 related domains: (1) patient-centered, narrative communication skills; (2) interprofessional team practice; and (3) metrics and systems integration. The multifaceted curriculum was delivered through 16 webinars, 8 online modules, 4 in-person workshops, reflective skill practice, written reflections, and small group online discussions. Report evaluations of the course content and skill self-assessments from 24 interprofessional palliative care clinicians. Participants rated each learning activity and completed a retrospective pre-post test skill assessment. Learning gains were measured as the difference in the percentage of participants reporting "strong" or "highly competent" skill levels at baseline and the end of the course. Participants also provided examples of how they used the skills in practice. Participants achieved an average learning gain of 50% across all domains, and in each domain communication (54%), interprofessional team practice (52%), and metrics and systems integration (34%). They also gave high ratings for the curriculum content (overall mean [standard deviation] rating of 5.5 (0.7) out of 6). Examples of practice impacts included improved skills in responding to emotions, understanding the equal importance of all professions on their team and incorporating different perspectives into their practice, and learning about outcome measurement in palliative care. This curriculum demonstrated success in increasing perceived skills for interprofessional palliative care clinicians in advanced communication, team practice, and metrics and system integration.
Price, Sheri; Doucet, Shelley; Hall, Linda McGillis
For almost half a century, research has identified that effective teamwork is essential in order to enhance care provision and health outcomes for patients. Although the value of teamwork is well-recognized in healthcare, the historically rooted dynamics of workplace relationships create a myriad of challenges to creating collaborative teams. Understanding the history of interpersonal dynamics between health professionals can provide direction for future interprofessional education and collaboration strategies. The aim of this paper is to provide a historical overview of the social positioning of nursing and medicine in the context of interprofessional collaboration. Few professions work as closely as nursing and medicine. Despite the well-recognized benefits of interprofessional collaboration, these two professions are often socially positioned in opposition to one another and depicted as adversarial. This analysis will seek to advance our understanding of the historical roots between these two professions and their relationships with and among each other in relation to career choice, early socialization and patient care delivery. An exploration of the historical social positioning of nursing and medicine can provide an enhanced understanding of the barriers to interprofessional collaboration and inform future successes in interprofessional education and practice among all health and social care professions.
Full Text Available Maria Olenick,1 Lois Ryan Allen2 1College of Nursing and Health Science, Florida International University, Miami, FL, USA; 2School of Nursing, Widener University, Chester, PA, USA Background: This descriptive correlational and comparative study explored health-care faculty (HCF attitudes toward interprofessional education (IPE and interprofessional health-care teams, HCF perceptions of subjective norms, the influence of subjective norms on HCF intent to engage in IPE, and HCF intent to engage in IPE. In addition, differences among seven disciplines of HCF were explored. Methods: Nursing, medicine, pharmacy, physical therapy, occupational therapy, physician assistants, and social work faculty were identified. Stratified random sampling was used to ensure that the population surveyed was representative of the target population. The total sample for this study included 439 HCF from the seven identified health-care professions in the US. Data collection included measures of attitudes toward IPE and attitudes toward interprofessional health-care teams. Subjective norms were measured using two 7-point rating scales. Intent to engage in IPE was measured using a 10-point rating scale. Results: There were no significant differences among HCF groups regarding attitudes toward IPE or interprofessional health-care teams. Administrative faculty reported greater intent to engage in IPE than teaching faculty. HCF who were currently in or had previously engaged in IPE reported greater intent to engage in or continue to engage, and had higher attitude and subjective norm scores than faculty without IPE experience. The combination of perceived pressure from school administrators and attitudes toward IPE was the best predictor of intent to engage in IPE. Conclusion: IPE has the potential to influence patient quality of care and lead to better working relationships between health-care providers. HCF are more likely to engage in IPE when they believe their school
Olenick, Maria; Allen, Lois Ryan
This descriptive correlational and comparative study explored health-care faculty (HCF) attitudes toward interprofessional education (IPE) and interprofessional health-care teams, HCF perceptions of subjective norms, the influence of subjective norms on HCF intent to engage in IPE, and HCF intent to engage in IPE. In addition, differences among seven disciplines of HCF were explored. Nursing, medicine, pharmacy, physical therapy, occupational therapy, physician assistants, and social work faculty were identified. Stratified random sampling was used to ensure that the population surveyed was representative of the target population. The total sample for this study included 439 HCF from the seven identified health-care professions in the US. Data collection included measures of attitudes toward IPE and attitudes toward interprofessional health-care teams. Subjective norms were measured using two 7-point rating scales. Intent to engage in IPE was measured using a 10-point rating scale. There were no significant differences among HCF groups regarding attitudes toward IPE or interprofessional health-care teams. Administrative faculty reported greater intent to engage in IPE than teaching faculty. HCF who were currently in or had previously engaged in IPE reported greater intent to engage in or continue to engage, and had higher attitude and subjective norm scores than faculty without IPE experience. The combination of perceived pressure from school administrators and attitudes toward IPE was the best predictor of intent to engage in IPE. IPE has the potential to influence patient quality of care and lead to better working relationships between health-care providers. HCF are more likely to engage in IPE when they believe their school's administrators think they should engage in IPE and when they have positive attitudes toward IPE.
Full Text Available Christine Patterson,1 Heather Arthur,1,2 Gladys Peachey,1 Julie Vohra,1 David Price,3 Dave Pearson,4 Rob Mariani51School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; 2Heart and Stroke Foundation of Ontario/Michael G DeGroote Endowed Chair in Cardiovascular Nursing Research, McMaster University, Hamilton, ON, Canada; 3Department of Family Medicine, McMaster University, Hamilton, ON, Canada; 4Central West Local Health Integration Network, Brampton, ON, Canada; 5Ascentum Consulting, Ottawa, ON, CanadaImportance: Resources to support change are needed for solo practitioners who are transitioning to family health teams (FHTs which involve multiple health disciplines working together to provide team-based care.Objective: The purpose of this project was: (1 to explore the use of an online resource, the Interprofessional Resource Centre (IRC, when planning for interprofessional change and; (2 to explore the experience of planning interprofessional change.Design and setting: Six FHTs organized under the structure of one Local Health Integrated Network (LHIN in Ontario, Canada.Intervention: Participants in six FHTs were directed to the IRC to support planning interprofessional change. In addition, two of the six FHTs participated in pilot site meetings with investigators where they received in-person support to apply the information from the IRC to an interprofessional activity.Results: Pilot site participants reported the IRC was useful for planning, but they cited lack of time to use it as a key barrier. When planning for interprofessional change, providers experienced challenges with physician buy-in and team dynamics. As a strategy for change, providers would like to learn from other FHTs who have experienced success with interprofessional change; at the LHIN level, they saw a need for more educational opportunities. Participation was found to be low among those only receiving online support.Conclusion and
Arthur, Nancy; Russell-Mayhew, Shelly
Interprofessional collaboration is emerging as a best practice in health care. For counsellors to work effectively alongside professionals from other disciplines, they need to be educated about the value of collaborative practice and the roles, responsibilities, and expertise that they bring to interprofessional teams. Supervision practices in…
Parker, Ramona Ann; Gottlieb, Helmut; Dominguez, Daniel G.; Sanchez-Diaz, Patricia C.; Jones, Mary Elaine
In 2012, a private University in South Texas sought to prepare eight cohorts of 25 nursing, optometry, pharmacy, physical therapy, and health care administration students with an interprofessional education activity as a model for collaborative learning. The two semester interprofessional activity used a blended model (Blackboard Learn®,…
DiazGranados, Deborah; Dow, Alan W; Appelbaum, Nital; Mazmanian, Paul E; Retchin, Sheldon M
Increasing interprofessional practice is seen as a path to improved quality, decreased cost, and enhanced patient experience. However, little is known about how context shapes interprofessional work and how interventions should be crafted to account for a specific setting of interprofessional practice. To better understand, how the work of interprofessional practice differs across patient care settings we sought to understand the social processes found in varying work contexts to better understand how care is provided. A case study design was used in this study to yield a picture of patient care across three different settings. Qualitative analysis of teams from three healthcare settings (rehabilitation, acute care, and code team) was conducted, through the use of ten in-depth semi-structured interviews. Interview data from each participant were analyzed via an inductive content analysis approach based upon theories of work and teams from organisational science, a framework for interprofessional practice, and competencies for interprofessional education. The work processes of interprofessional practice varied across settings. Information exchange was more physician-centric and decision-making was more physician dominant in the non-rehabilitation settings. Work was described as concurrent only for the code team. Goal setting varied by setting and interpersonal relationships were only mentioned as important in the rehabilitation setting. The differences observed across settings identify some insights into how context shapes the process of interprofessional collaboration and some research questions that need further study.
Boland, Daubney; White, Traci; Adams, Eve
Interprofessional education is essential in that it helps healthcare disciplines better utilize each other and provide team-based collaboration that improves patient care. Many pharmacy training programs struggle to implement interprofessional education. This purpose of the study was to examine the effect of a 30-h interprofessional training that included pharmacy students to determine if the training helped these students build valuable knowledge and skills while working alongside other health care professions. The interprofessional training included graduate-level trainees from pharmacy, behavioral health, nursing, and family medicine programs where the trainees worked within teams to build interprofessional education competencies based on the Interprofessional Education Collaborative core competencies. Sixteen pharmacy trainees participated in the training and completed pre- and post-test measures. Data were collected over a two-year period with participants completing the Team Skills Scale and the Interprofessional Attitudes Scale. Paired sample t -tests indicated that, after this training, pharmacy trainees showed significant increases in feeling better able to work in healthcare teams and valuing interprofessional practice.
Full Text Available Interprofessional education is essential in that it helps healthcare disciplines better utilize each other and provide team-based collaboration that improves patient care. Many pharmacy training programs struggle to implement interprofessional education. This purpose of the study was to examine the effect of a 30-h interprofessional training that included pharmacy students to determine if the training helped these students build valuable knowledge and skills while working alongside other health care professions. The interprofessional training included graduate-level trainees from pharmacy, behavioral health, nursing, and family medicine programs where the trainees worked within teams to build interprofessional education competencies based on the Interprofessional Education Collaborative core competencies. Sixteen pharmacy trainees participated in the training and completed pre- and post-test measures. Data were collected over a two-year period with participants completing the Team Skills Scale and the Interprofessional Attitudes Scale. Paired sample t-tests indicated that, after this training, pharmacy trainees showed significant increases in feeling better able to work in healthcare teams and valuing interprofessional practice.
Ross, Cory; Alexander, Kathleen; Gritsyuk, Renata; Morrin, Arleen; Tan, Jackie
George Brown College is among the leaders in the interprofessional health-care education movement in Canada. Interprofessional Education (IPE) and Collaborative Practice occur "when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes." According to the…
The ICF care plan and the CBR matrix were used to conduct a retrospective document analysis. The documents were completed by interprofessional groups of students who were involved in an interprofessional community-based intervention. Data were captured on a sheet and analysed descriptively using the domains of ...
Full Text Available Introduction Preventable mistakes occur frequently and can lead to patient harm and death. The emergency department (ED is notoriously prone to such errors, and evidence suggests that improving teamwork is a key aspect to reduce the rate of error in acute care settings. Only a few strategies are in place to train team skills and communication in interprofessional situations. Our goal was to conceptualize, implement, and evaluate a training module for students of three professions involved in emergency care. The objective was to sensitize participants to barriers for their team skills and communication across professional borders. Methods We developed a longitudinal simulation-enhanced training format for interprofessional teams, consisting of final-year medical students, advanced trainees of emergency nursing and student paramedics. The training format consisted of several one-day training modules, which took place twice in 2016 and 2017. Each training module started with an introduction to share one’s roles, professional self-concepts, common misconceptions, and communication barriers. Next, we conducted different simulated cases. Each case consisted of a prehospital section (for paramedics and medical students, a handover (everyone, and an ED section (medical students and emergency nurses. After each training module, we assessed participants’ “Commitment to Change.” In this questionnaire, students were anonymously asked to state up to three changes that they wished to implement as a result of the course, as well as the strength of their commitment to these changes. Results In total, 64 of 80 participants (80.0% made at least one commitment to change after participating in the training modules. The total of 123 commitments was evenly distributed over four emerging categories: communication, behavior, knowledge and attitude. Roughly one third of behavior- and attitude-related commitments were directly related to interprofessional topics
Eisenmann, Dorothea; Stroben, Fabian; Gerken, Jan D; Exadaktylos, Aristomenis K; Machner, Mareen; Hautz, Wolf E
Preventable mistakes occur frequently and can lead to patient harm and death. The emergency department (ED) is notoriously prone to such errors, and evidence suggests that improving teamwork is a key aspect to reduce the rate of error in acute care settings. Only a few strategies are in place to train team skills and communication in interprofessional situations. Our goal was to conceptualize, implement, and evaluate a training module for students of three professions involved in emergency care. The objective was to sensitize participants to barriers for their team skills and communication across professional borders. We developed a longitudinal simulation-enhanced training format for interprofessional teams, consisting of final-year medical students, advanced trainees of emergency nursing and student paramedics. The training format consisted of several one-day training modules, which took place twice in 2016 and 2017. Each training module started with an introduction to share one's roles, professional self-concepts, common misconceptions, and communication barriers. Next, we conducted different simulated cases. Each case consisted of a prehospital section (for paramedics and medical students), a handover (everyone), and an ED section (medical students and emergency nurses). After each training module, we assessed participants' "Commitment to Change." In this questionnaire, students were anonymously asked to state up to three changes that they wished to implement as a result of the course, as well as the strength of their commitment to these changes. In total, 64 of 80 participants (80.0%) made at least one commitment to change after participating in the training modules. The total of 123 commitments was evenly distributed over four emerging categories: communication , behavior , knowledge and attitude . Roughly one third of behavior- and attitude-related commitments were directly related to interprofessional topics (e.g., "acknowledge other professions' work
Cartwright, Jade; Franklin, Diane; Forman, Dawn; Freegard, Heather
This study aimed to develop, implement and evaluate an online interprofessional education (IPE) dementia case study for health science students. The IPE initiative aimed to develop collaborative interprofessional capabilities and client-centred mindsets that underpin high-quality dementia care. A mixed methods research design was used to assess students' values, attitudes and learning outcomes using an interprofessional socialization and valuing scale (ISVS) completed pre and post the online case study and via thematic analysis of free text responses. Students' ISVS scores improved significantly following online participation, and the qualitative results support a shift towards interprofessional collaboration and client-centred care. This online IPE case study was successful in developing the collaborative mindsets and interprofessional capabilities required by a future workforce to meet the complex, client-centred needs of people living with dementia. © 2013 ACOTA.
Arnett, Kelly; Sudore, Rebecca L; Nowels, David; Feng, Cindy X; Levy, Cari R; Lum, Hillary D
Interprofessional health care team members consider advance care planning (ACP) to be important, yet gaps remain in systematic clinical routines to support ACP. A clearer understanding of the interprofessional team members' perspectives on ACP clinical routines in diverse settings is needed. One hundred eighteen health care team members from community-based clinics, long-term care facilities, academic clinics, federally qualified health centers, and hospitals participated in a 35-question, cross-sectional online survey to assess clinical routines, workflow processes, and policies relating to ACP. Respondents were 53% physicians, 18% advanced practice nurses, 11% nurses, and 18% other interprofessional team members including administrators, chaplains, social workers, and others. Regarding clinical routines, respondents reported that several interprofessional team members play a role in facilitating ACP (ie, physician, social worker, nurse, others). Most (62%) settings did not have, or did not know of, policies related to ACP documentation. Only 14% of settings had a patient education program. Two-thirds of the respondents said that addressing ACP is a high priority and 85% felt that nonphysicians could have ACP conversations with appropriate training. The clinical resources needed to improve clinical routines included training for providers and staff, dedicated staff to facilitate ACP, and availability of patient/family educational materials. Although interprofessional health care team members consider ACP a priority and several team members may be involved, clinical settings lack systematic clinical routines to support ACP. Patient educational materials, interprofessional team training, and policies to support ACP clinical workflows that do not rely solely on physicians could improve ACP across diverse clinical settings.
Yamani, Nikoo; Asgarimoqadam, Marzieh; Haghani, Fariba; Alavijeh, Abbas Qari
The increase in life expectancy and changes in lifestyle have led to prevalence of non-communicable diseases including diabetes whose treatment and care requires effective teamwork. This study was conducted to examine the effect of inter-professional education on performance and diabetes care knowledge of health care teams. This quasi-experimental study was performed as an inter-professional education on 6 healthcare teams (34 people) based on Kolb's Learning Cycle and consisted of a set of training activities to improve individual, group, and inter-professional capabilities of members of the health care team. The pre- and post-tests included Team Climate Inventory (TCI) and a knowledge assessment tool performed before the workshop and 3 months later. Mean scores for knowledge of health care team before intervention and 3 months later were 7.06 ± 1.04 and 7.97 ± 0.97 out of 10, respectively, that showed a significant difference (P teams. It also can make the health-related messages provided to the covered population more consistent in addition to enhancing self-confidence of the personnel.
Fragemann, K; Meyer, N; Graf, B M; Wiese, C H R
The care of patients, suffering from acute, chronic, or malignant pain, requires systematic and interprofessional collaboration between all team members to ensure a holistic approach to pain management. In doing so, the different professions are often in a competitive, tense, or dependent relationship resulting from a lack of precise definitions and concepts regarding their responsibilities in the wide field of pain management. Considering pain management as a whole, we can define numerous interfaces concerning competencies and tasks which may open up some new perspectives on concepts of interprofessional education (IPE). Internationally, there have been many attempts to establish concepts of interprofessional education, and it is considered a great challenge to improve continuing medical education. However, interdisciplinary subjects like pain management may benefit from it. Apart from enhancing specialized knowledge, interprofessional education aims to consider the different roles, skills, and responsibilities as well as interprofessional strategies of decision-making. In Germany, only a few efforts have been made with regard to interprofessional pain education. In the following paper, different challenges, tasks, and roles within the field of pain management are discussed in the sense of potential areas of collaboration in the context of interprofessional education. Against this background, the Regensburg model for interprofessional pain management education is described as one national program to enhance the effectiveness of pain management.
Roberto Nuño Solinís
Full Text Available Introduction: This article explores the impact of the creation of a new integrated delivery organisation on the evolution of interprofessional collaboration between primary and secondary care levels. In particular, the case of the Bidasoa Integrated Healthcare Organisation is analysed. Theory and methods: The evolution of interprofessional collaboration is measured through a validated Spanish questionnaire, with 10 items and a 5-point Likert scale, based on the D’Amour’s model of collaboration . The final sample included 146 observations (doctors and nurses. Results: The questionnaire identified a significant improvement on the mean scores for interprofessional collaboration of 0.57 points before and after the intervention. A significant improvement was also found in the two dimensions of the measure of interprofessional collaboration used, with the size of the change being higher for the dimension related to the organisational setting (0.63 than for interpersonal relationships (0.47. Conclusions: Before and after the creation of the Bidasoa Integrated Healthcare Organisation, an improvement in the perceived degree of interprofessional collaboration between primary and secondary care levels was observed. This finding supports the benefit of a multilevel and multidimensional approach to integration, as in the described Bidasoa case. Discussion: Results on the two dimensions of the measure of interprofessional collaboration used, seem to point to the longer time required for interpersonal relationships to change, compared to the organisational setting.
Roberto Nuño Solinís
Full Text Available Introduction: This article explores the impact of the creation of a new integrated delivery organisation on the evolution of interprofessional collaboration between primary and secondary care levels. In particular, the case of the Bidasoa Integrated Healthcare Organisation is analysed.Theory and methods: The evolution of interprofessional collaboration is measured through a validated Spanish questionnaire, with 10 items and a 5-point Likert scale, based on the D’Amour’s model of collaboration . The final sample included 146 observations (doctors and nurses. Results: The questionnaire identified a significant improvement on the mean scores for interprofessional collaboration of 0.57 points before and after the intervention. A significant improvement was also found in the two dimensions of the measure of interprofessional collaboration used, with the size of the change being higher for the dimension related to the organisational setting (0.63 than for interpersonal relationships (0.47.Conclusions: Before and after the creation of the Bidasoa Integrated Healthcare Organisation, an improvement in the perceived degree of interprofessional collaboration between primary and secondary care levels was observed. This finding supports the benefit of a multilevel and multidimensional approach to integration, as in the described Bidasoa case.Discussion: Results on the two dimensions of the measure of interprofessional collaboration used, seem to point to the longer time required for interpersonal relationships to change, compared to the organisational setting.
Bentley, Regina; Engelhardt, Joan A; Watzak, Bree
Interprofessional collaborative practice is the key to safe, high-quality, accessible, patient-centered care. Achieving this requires the development of interprofessional competencies by health professions students as part of the learning process so that they enter the workforce ready to practice effective team-based care. The authors describe how the immersion process of an international short-term medical mission experience can intensify interprofessional learning by addressing selected Interprofessional Education Collaborative (IPEC), 2011, Core Interprofessional Education Competencies.
Pechak, Celia; Gonzalez, Eugenia; Summers, Connie; Capshaw, Stephanie
Various models of interprofessional education, including service-learning, are used to teach students how to be effective members of healthcare teams. The purpose of this study was to examine pilot data related to the impact of an elective one-credit global health course with an international service-learning experience (ISL) on the student participants. An interdisciplinary team of 3 faculty accompanied 4 students representing occupational therapy, physical therapy, and speech-language pathology programs for an 8-day ISL experience. Students responded to faculty-developed reflection questions pre-travel, during travel, and 2-weeks and 4-months post travel. Content analysis was used to analyze themes that emerged from the students' written reflections. Three major themes emerged: collaboration, satisfaction, and self-discovery. The most prominent theme was related to interprofessional collaboration.
Fried, Jacquelyn L
A collaborative practice model related to Human Papilloma Virus (HPV) associated oropharyngeal cancer highlights the role of the dental hygienist in addressing this condition. The incidence of HPV associated head and neck cancer is rising. Multiple professionals including the dental hygienist can work collaboratively to confront this growing public health concern. A critical review applies the growth and utilization of interprofessional education (IPE) and interprofessional collaboration (IPC) to multi-disciplinary models addressing the human papilloma virus and oropharyngeal cancers. A model related to HPV associated oropharyngeal cancer addresses an oral systemic condition that supports the inclusion of a dental hygienist on collaborative teams addressing prevention, detection, treatment and cure of OPC. Copyright © 2014 Elsevier Inc. All rights reserved.
Duffy, Pamela Ann; Ronnebaum, Julie A; Stumbo, Teri A; Smith, Kari Nies; Reimer, Rachel A
Interprofessional education (IPE) creates dynamic experiential learning that can address social determinants of health that influence health outcomes. To examine the effects of including public health students on IPE teams on the interprofessional practice domain constructs (values/ethics, roles/responsibilities, interprofessional communication, and teams and teamwork). This single-case, mixed-methods study was performed using a grounded theory approach. Students from 8 graduate health sciences programs participated in an asynchronous, 6-week, online IPE learning activity. Three of the 4 interprofessional practice domain constructs were examined as outcome variables: participants' biomedical vs biopsychosocial patient approach (values/ethics); reported change in attitudes, beliefs, or values about other health professions (roles/responsibilities); and anticipated changes in future professional behaviors/interactions/approaches (teams and teamwork). Predictor variables were having an MPH participant on the IPE team, participants' enrollment in a clinical or nonclinical program, and student perception of the online format (interprofessional communication). Three hundred nineteen students were included, 261 from clinical and 58 from nonclinical programs. A significant association was found between having an MPH participant on the IPE teams and participants' awareness of the influence of social determinants of health (OR, 2.04; 95% CI, 1.13-3.66; Pimportance of social determinants of health in the care plan (OR, 3.68; 95% CI, 1.38-9.84; P<.01). Participants were significantly less likely to report future behavior change if they were in clinical programs (OR, 0.44; 95% CI, 0.23-0.86; P<.05) or if they disliked the online format (OR, 0.25; 95% CI, 0.14-0.42; P<.01). The model fit the data well (χ23=30.80; P<.001). Inclusion of MPH students on IPE teams has the potential to increase clinical participants' awareness of the influence of social determinants of health and
Zijlstra, Elza; Lo Fo Wong, Sylvie; Teerling, Anne; Hutschemaekers, Giel; Lagro-Janssen, Antoine
Sexual and family violence are problems that affect many women and men, and the negative health consequences of violence are numerous. As adequate acute interprofessional care can prevent negative health consequences and improve forensic medical examination, a Centre for Sexual and Family Violence was set up. We aimed to improve our understanding of the challenges in interprofessional collaboration in a newly set-up centre for sexual and family violence. We conducted a qualitative study with semi-structured interviews about the experiences with interprofessional collaboration of 16 stakeholders involved in the Centre for Sexual and Family Violence Nijmegen. Participants were selected by purposive sampling. Participants found that the interprofessional collaboration had improved communication and competences. However, there were challenges too. Firstly, the interprofessional collaboration had brought parties closer together, but the collaboration also forced professionals to strongly define their boundaries. Mutual trust and understanding needed to be built up. Secondly, a balance had to be struck between pursuing the shared vision - which was to improve quality of care for victims - and giving space to organizations' and professionals' own interest. Thirdly, care for victims of sexual and family violence could be demanding on healthcare providers in an emotional sense, which might jeopardize professional's initial motivation for joining the Centre for Sexual and Family Violence Nijmegen. The interprofessional collaboration in an assault centre improves quality of care for victims, but there are also challenges. The tasks of an assault centre are to create opportunities to discuss professional roles and professional interests, to build up good interpersonal relations in which trust and understanding can grow, to formulate a strong and shared victim-centred vision and to support care providers with training, feedback and supervision. © 2017 Nordic College of Caring
Goldman, Joanne; Meuser, Jamie; Lawrie, Lynne; Rogers, Jess; Reeves, Scott
Primary care reform involving interprofessional team-based care is a global phenomenon. In Ontario, Canada, 150 Family Health Teams (FHTs) have been approved in the past few years. The transition to a FHT is complex involving many changes and the processes for collaborative teamwork are not clearly delineated. To support the transition to team-based care in FHTs, a project was undertaken to develop and implement a series of interprofessional protocols in four clinical areas. These interprofessional protocols would contain relevant and evidence-based resources to support both a team and evidence-based approach to care. This paper reports on a qualitative study to examine the process of interprofessional protocol development and pilot implementation. Adopting an exploratory case study approach (Robson, 2002 ), 36 interviews were conducted with health professionals and community group members who participated in the creation and piloting of the protocols, and with project managers. In addition, observational and documentary data were gathered on the protocol development and implementation processes. The findings from the protocol development stage demonstrate the value of the focus on evidence and team, the process of assessing and targeting FHT needs, inter-organizational and interprofessional sharing, the importance of facilitation and support, and expectations for implementation. The findings from the pilot implementation stage report on the importance of champions and leaders, the implementation strategies used, FHT and organizational factors affecting implementation, and outcomes achieved. Findings are discussed in relation to the knowledge translation and interprofessional literature. Research is ongoing to examine the effectiveness of dissemination of the protocols to FHTs across the province of Ontario and its impact on health care outcomes.
Bailey, Christopher; Agreli, Heloise F.; Peduzzi, Marina
Relational and organisational factors are key elements of interprofessional collaboration (IPC) and team climate. Few studies have explored the relationship between IPC and team climate. This article presents a study that 10 aimed to explore IPC in primary healthcare teams and understand how the assessment of team climate may provide insights into IPC. A mixed methods study design was adopted. In Stage 1 of the study, team climate was assessed using the Team Climate Inventory with 159 profess...
Tamayo, M; Besoaín-Saldaña, A; Aguirre, M; Leiva, J
Determine the perception of university students regarding interprofessional and interdependent work between team members in their inclusion in primary care. Analytical cross-sectional study. The sampling had a probabilistic, stratified random type with 95% confidence and 5% margin of error. Seven-hundred and four students of Public Universities in Santiago (Chile) answered self-administered questionnaire. Ninety-seven point eight of students say that interprofessional work is important; 27.1% of them declare that their university did not seem to show that their study plans were important. The professionals listed as most important in teams are physicians and nurses. Spaces for development and institutional support are key elements to promote interprofessional work. If this competence can involve each academic unit in their different formative spaces there will be a significant contribution to said promotion. Teamwork is a pending task. Determinar la percepción de estudiantes universitarios respecto al trabajo interprofesional e interdependencia entre los miembros del equipo en su inserción en la atención primaria. Estudio de tipo analítico y transversal. El muestreo fue de tipo aleatorio, probabilístico estratificado con un 95% de confianza y un 5% de margen de error. Se utilizó un cuestionario auto-administrado en 704 estudiantes de Universidades del Estado en Santiago de Chile. Un 97,8% de los estudiantes opinan que el trabajo interprofesional es importante; un 27,1% de ellos declara que su universidad no le ha entregado importancia en sus planes de estudios. Los profesionales mencionados como más importantes en el equipo son los médicos y enfermeras. Espacios de desarrollo y respaldo institucional son elementos claves para promover el trabajo interprofesional. Que esta competencia logre involucrar a cada unidad académica en sus diferentes espacios formativos será un aporte significativo en aquello. Trabajo en equipo es una tarea pendiente.
Epiney, M; Vial, Y
In the field of perinatality, development of prenatal diagnosis and neonatal management have been impressive. But these were also associated with the emergence of the increasingly important emotional dimension for parents and professionals. Obstetricians dealing with the difficult breaking of bad news, the uncertainties of prenatal diagnosis and the complex somatic, psychological and social follow-up have to work in a multidisciplinary approach. The securing role of a coherent teamwork is recognised by parents as well as health care providers This article discusses interprofessional relationship as an obstetrical goal and give some landmarks in order to improve the management and the collaboration with parents.
Castillo-Parra, Silvana; Oyarzo Torres, Sandra; Espinoza Barrios, Mónica; Rojas-Serey, Ana María; Maya, Juan Diego; Sabaj Diez, Valeria; Aliaga Castillo, Verónica; Castillo Niño, Manuel; Romero Romero, Luis; Foster, Jennifer; Hawes Barrios, Gustavo
Multiple interprofessional integrated modules (MIIM) 1 and 2 are two required, cross-curricular courses developed by a team of health professions faculty, as well as experts in education, within the Faculty of Medicine of the University of Chile. MIIM 1 focused on virtual cases requiring team decision-making in real time. MIIM 2 focused on a team-based community project. The evaluation of MIIM included student, teacher, and coordinator perspectives. To explore the perceptions of this interprofessional experience quantitative data in the form of standardised course evaluations regarding teaching methodology, interpersonal relations and the course organisation and logistics were gathered. In addition, qualitative perceptions were collected from student focus groups and meetings with tutors and coordinators. Between 2010 and 2014, 881 students enrolled in MIIM. Their evaluation scores rated interpersonal relations most highly, followed by organisation and logistics, and then teaching methodology. A key result was the learning related to interprofessional team work by the teaching coordinators, as well as the participating faculty. The strengths of this experience included student integration and construction of new knowledge, skill development in making decisions, and collective self-learning. Challenges included additional time management and tutors' role. This work requires valuation of an alternative way of learning, which is critical for the performance of future health professionals.
Arain, Mubashir; Suter, Esther; Mallinson, Sara; Hepp, Shelanne L; Deutschlander, Siegrid; Nanayakkara, Shyama Dilani; Harrison, Elizabeth Louise; Mickelson, Grace; Bainbridge, Lesley; Grymonpre, Ruby E
Objective The objective of this environmental scan was to identify Western Canadian interprofessional education (IPE) resources that currently exist for internationally educated health professionals (IEHPs). Methodology A web-based search was conducted to identify learning resources meeting defined inclusion criteria with a particular focus on the resources available in the Western Canadian provinces. Information was extracted using a standardized template, and we contacted IEHP programs for additional information if necessary. Members of the research team reviewed preliminary findings, identified missing information from their respective provinces, and contacted organizations to fill in any gaps. Results The scan identified 26 learning resources for IEHPs in Western Canadian provinces and 15 in other provinces focused on support for IEHPs to meet their profession-specific licensing requirements and to acquire knowledge and competencies relevant to working in the Canadian health care system. Most learning resources, such as those found in bridging programs for IEHPs, included an orientation to the Canadian health care system, components of cultural competence, and at least one aspect of interprofessional competence (eg, communication skills). None of the 41 learning resources provided comprehensive training for IEHPs to cover the six interprofessional competency domains defined in the Canadian Interprofessional Health Collaborative (CIHC) National Interprofessional Competency Framework. Conclusion The IEHPs learning resources in Western Canada do not cover all of the interprofessional competencies. This review points to the value of developing a comprehensive IPE curriculum, based on the six domains identified in the CIHC National Interprofessional Competency Framework. PMID:28424551
Sevin, Alexa M; Hale, Kenneth M; Brown, Nicole V; McAuley, James W
Objective. To investigate the effect of an interprofessional service-learning course on health professions students' self-assessment of Interprofessional Education Collaborative (IPEC) competencies. Design. The semester-long elective course consisted of two components: a service component where students provided patient care in an interprofessional student-run free clinic and bi-weekly workshops in which students reflected on their experiences and discussed roles, team dynamics, communication skills, and challenges with underserved patient populations. Assessment. All fifteen students enrolled in the course completed a validated 42-question survey in a retrospective post-then-pre design. The survey instrument assessed IPEC competencies in four domains: Values and Ethics, Roles and Responsibilities, Interprofessional Communication, and Teams and Teamwork. Students' self-assessment of IPEC competencies significantly improved in all four domains after completion of the course. Conclusion. Completing an interprofessional service-learning course had a positive effect on students' self-assessment of interprofessional competencies, suggesting service-learning is an effective pedagogical platform for interprofessional education.
Rachma Sari, Vika; Hariyati, Rr Tutik Sri; Syuhaimie Hamid, Achir Yani
This study aimed to identify the association between stereotyping and professional intercollaborative practice. This study used a cross-sectional analytical study involving physicians, nurses, pharmacists, and dietitians in a hospital in Jakarta, Indonesia, who were selected using the stratified random sampling method. Data was collected using the Student Stereotypes Rating Questionnaire (SSRQ) and the Assessment of Interprofessional Team Collaboration Scale (AITCS). The stereotyping level was analyzed based on a nine-point SSRQ, while interprofessional collaborative practice was scored based on partnership/shared decision-making, cooperation, and coordination. Stereotyping was shown to significantly correlate with interprofessional collaborative practice as measured by the SSRQ and AITCS. Poor interprofessional collaborative practice in subscale partnership/decision-making was dominant. Also, low-rating stereotyping was shown to be dominant with poor interprofessional collaborative practice. The research recommends that health care providers improve partnership/ decision-making skills for better interprofessional collaboration. For further research, it's recommended to explore another barrier of interprofessional collaborative practice. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.
Milutinović, Dragana; Lovrić, Robert; Simin, Dragana
There is an implicit expectation for medical sciences students to work together effectively as members of health-care team, and interprofessional education is therefore widely accepted. Students' attitudes, which are affected by various factors, have been recognized as the most important predictors of successful implementation of interprofessional education with the aim of developing collaborative practice. The Readiness for Interprofessional Learning Scale has often been used in studies to measure these perspectives. To describe the psychometric properties of the Serbian cross-culturally adapted version of the original Readiness for Interprofessional Learning Scale, to assess the attitudes of undergraduate health science students towards interprofessional education and to evaluate whether a professional group and student characteristics have influence on attitudes towards collaborative practice and shared learning. A descriptive/analytical and comparative cross-sectional study. Faculty of Medicine in Serbia. Nursing and medical students after completed first clinical rotations (n = 257). The Readiness for Interprofessional Learning Scale for assessing attitudes among students towards interprofessional learning, Professional Identity Questionnaire for Nursing Students for assessing professional identity in nursing students, Professional Nursing Image Survey for assessing attitudes of medical students towards the nursing profession, as well as a socio-demographic questionnaire were the instruments used in this research study. The data were analysed using descriptive and inferential statistics. Exploratory factor analysis on 19 items revealed two-factors accounting for 51.1% of the total variance with the internal reliability α = 0.90. The mean total score of the Readiness for Interprofessional Learning Scale was 73.5 (SD = 11.5) indicating that students are ready for interprofessional learning. Nursing students, female students; students in their first
Casimiro, Lynn; MacDonald, Colla J; Thompson, Terrie Lynn; Stodel, Emma J
Interprofessional care (IPC) is a prerequisite for enhanced communication between healthcare team members, improved quality of care, and better outcomes for patients. A move to an IPC model requires changing the learning experiences of healthcare providers during and after their qualification program. With the rapid growth of online and blended approaches to learning, an educational framework that explains how to construct quality learning events to provide IPC is pressing. Such a framework would offer a quality standard to help educators design, develop, deliver, and evaluate online interprofessional education (IPE) programs. IPE is an extremely delicate process due to issues related to knowledge, status, power, accountability, personality traits, and culture that surround IPC. In this paper, a review of the pertinent literature that would inform the development of such a framework is presented. The review covers IPC, IPE, learning theories, and eLearning in healthcare.
Bateman, Hilarie; Bailey, Peter; McLellan, Hilary
A new interprofessional primary care team was established in a greenfield site. Using anethnographic approach, significant experiences in the formation of the team were documented and specific problem areas were defined and addressed using action research principles. The nature of the problems experienced and the processes used in their resolution are described and related to current policy recommendations and to existing literature on the theory and practice of team development. Problems include: the potentially varied expectations and managerial requirements of collaborating partners, the lack of clarity over professional roles and associated essential competencies, and the appropriate management and development of specialist professional roles. Conclusions drawn concern the complexity of the issues raised by interprofessional team working, and the value of existing techniques and models in this setting, such as the viable systems model, 360 degree appraisal and action research.
Hean, Sarah; Craddock, Deborah; Hammick, Marilyn; Hammick, Marilyn
In this Guide, we support the need for theory in the practice of interprofessional education and highlight a range of theories that can be applied to interprofessional education. We specifically discuss the application of theories that support the social dimensions of interprofessional learning and teaching, choosing by way of illustration the theory of social capital, adult learning theory and a sociological perspective of interprofessional education. We introduce some of the key ideas behind each theory and then apply these to a case study about the development and delivery of interprofessional education for pre-registration healthcare sciences students. We suggest a model that assists with the management of the numerous theories potentially available to the interprofessional educator. In this model, context is central and a range of dimensions are presented for the reader to decide which, when, why and how to use a theory. We also present some practical guidelines of how theories may be translated into tangible curriculum opportunities. Using social capital theory, we show how theory can be used to defend and present the benefits of learning in an interprofessional group. We also show how this theory can guide thinking as to how interprofessional learning networks can best be constructed to achieve these benefits. Using adult learning theories, we explore the rationale and importance of problem solving, facilitation and scaffolding in the design of interprofessional curricula. Finally, from a sociological perspective, using Bernstein's concepts of regions and terrains, we explore the concepts of socialisation as a means of understanding the resistance to interprofessional education sometimes experienced by curriculum developers. We advocate for new, parallel ways of viewing professional knowledge and the development of an interprofessional knowledge terrain that is understood and is contributed to by all practitioners and, importantly, is centred on the needs of
Lachmann, Hanna; Ponzer, Sari; Johansson, Unn-Britt; Benson, Lina; Karlgren, Klas
An important goal for interprofessional education (IPE) in clinical settings is to support healthcare students in collaboratively developing their understanding of interprofessional teamwork. The aim of this study was to investigate students' learning experiences and academic emotions as they occur in actual context in relation to collaborative and trialogical activities during a clinical IPE course. The contextual activity sampling system methodology was used to collect data via mobile phones. Thirty-seven healthcare students (medical, nursing, physiotherapy and occupational therapy) reported their experiences, learning activities and academic emotions several times a day via their mobile phones during their 2-week course at an interprofessional training ward (IPTW). The results provided understanding of the students' experiences of their academic emotions and how they created new knowledge collaboratively. These collaborative knowledge creation activities occurred mostly when students from different professions were collaborating as a team (e.g. discussing patient care or participating in a ward round) and were also significantly related to optimal experiences, i.e. "flow" (high challenge in combination with high competence). In conclusion, these results emphasize the importance of collaboration among students during IPTW courses. Our results might help to optimize the design of IPE learning activities in clinical healthcare contexts.
Manspeaker, Sarah A; Donoso Brown, Elena V; Wallace, Sarah E; DiBartola, Leesa; Morgan, Allison
Interprofessional education (IPE) is a vital component of healthcare education yet challenges to implementation persist. This study aimed to evaluate the perceived impact of an ethics-based IPE workshop designed for professional phase healthcare students enrolled in athletic training, health management systems, occupational therapy, physical therapy, physician assistant studies, and speech-language pathology programmes at one university. A pre/post-test cohort study was conducted to evaluate the impact of the workshop on interprofessional values and teamwork. Findings from the 61 students who completed both pre- and post-programme evaluation surveys suggest that the ethics-based workshop was successful in improving perceived confidence as related to the workshop objectives and strengthened positive perceptions of IPE as evaluated by the Student Perceptions of Interprofessional Clinical Education-Revised (SPICE-R). Analysis of responses to open-ended reflection questions after the workshop suggest that student participants perceived changes in understanding related to multiple areas of IPE. These results suggest that an ethics-based workshop using case-based collaborative pedagogy may be an effective mechanism for delivery of IPE-oriented information resulting in greater student confidence and understanding of IPE competencies.
Salhani, Daniel; Coulter, Ian
This study of interprofessional work relations in a Canadian mental health team examines how nursing deployed different forms of power in order to alter the mental health division of labour, to gain administrative, organizational and content control over its own work, expand its jurisdictional boundaries by expropriating the work of other professionals, and exclude others from encroaching on its old and newly acquired jurisdictions. This is set against the context of nursing's long-standing professional project to consolidate and expand its professional jurisdiction. Using an ethnographic study of a single interprofessional mental health team in a psychiatric hospital in Canada, the paper attempts to understand the politics and paradoxes involved in realizing nursing's professional project and how the politics of professional autonomy and professional dominance are actually conducted through micro-political struggles. The data demonstrates the effects of the political struggles at the organizational and work process levels, particularly in the forms of collaboration that result. Nurses gained substantial autonomy from medical domination and secured practical dominion over the work of non-medical professionals. New forms of interprofessional collaboration were accomplished through both simultaneous and sequential micro-political struggles with psychiatrists and non-medical professionals, and the formation of political alliances and informal agreements. Nursing solidarity at the elite level and substantial effort by the elite nurses and their committed colleagues to mobilize their less enthused members were fundamental to their success. The nurses deployed political (power) strategies and tactics to organize and reorganize themselves and other professionals on multiple levels (politically, organizationally, ideologically, socially and culturally). This study reveals the complexity and robustness of micro-political dynamics in the constitution of professional and
Lyons, Kevin J; Giordano, Carolyn
It's been 12 years since the Journal published its last special themed issue (see Winter 1998, volume 27, no. 1), focused on the World Congress held in Telford, UK, in July 1997. Since that time, there have been a number of subjects that probably warranted special attention, but were not addressed. For that, you can blame one of the Editors of this special issue, who served as Journal Editor during that 10-year period. The topic of interprofessional education (IPE) and care (IPC) is one such theme that warrants our attention at this time. Interprofessional approaches by now have received not only increased attention in the United States, but attention from across the globe. This makes the task of putting together this issue both easy but, at the same time, a bit daunting. Easy in the sense that there is no lack of reports, programs, and efforts at implementing both IPE and IPC from which to choose. Daunting for the same reason: Which are the ones that deserve special attention? What major initiative have we missed?
Simko, Lynn Coletta; Rhodes, Diane C; McGinnis, Kathleen A; Fiedor, Jaclyn
Objective. To evaluate changes in pharmacy and nursing student perspectives before and after completion of an interprofessional education (IPE) course. Methods. A pre- and post-perception scale descriptive prospective study design utilizing Interdisciplinary Education Perception Scale (IEPS) and Collaboration and Satisfaction about Care Decisions (CSACD) with self-reported statements of knowledge and importance of professional roles was used. Results. Significant improvement was shown for IEPS and CSACD overall and for both pharmacy and nursing students. Post-scores improved from 2013 to 2014, with significant improvements for IEPS. Pharmacy student findings show an increase in knowledge and importance of their roles and those of nursing students. Nursing students grew significantly in their knowledge of the pharmacist's role only. Conclusion. An IPE course for nursing and pharmacy students, taught by diverse health professionals with a care plan and simulation assignments, fosters the Interprofessional Education Collaborative panel's competencies for IPE.
Payler, Jane; Meyer, Edgar; Humphris, Debra
This study outlines the development of a conceptual framework to guide the evaluation of the impact of the pedagogy employed in continuing professional development for professionals in education, health and social care. The work is developed as part of the Centre for Excellence in Teaching and Learning: Interprofessional Learning across the Public Sector (CETL: IPPS) at the University of Southampton. The study briefly outlines the field for pedagogic research and comments on the underpinning ...
Goldman, Joanne; Reeves, Scott; Wu, Robert; Silver, Ivan; MacMillan, Kathleen; Kitto, Simon
Interprofessional collaboration is an important aspect of patient discharge from a general internal medicine (GIM) unit. However, there has been minimal empirical or theoretical research that has examined interactions that occur between medical residents and other healthcare professionals in the discharge process. This study provides insight into the social processes that shape and characterize such interactions. To explore factors that shape interactions between medical residents and other healthcare professionals in relation to patient discharge, and to examine the opportunities for negotiations about discharge between these professional groups. A qualitative ethnographic approach using observations, interviews and documentary analysis. Healthcare professionals working in a GIM unit in Canada. Sixty-five hours of observations were undertaken in a range of settings (e.g. interprofessional rounds, medical and nursing rounds, nursing station) in the unit over a 17-month period. A maximum variation sampling approach was used to identify healthcare professionals working in the unit. Twenty-three interviews were completed, recorded and transcribed verbatim. A directed content approach using theories of medical dominance and negotiated order was used to analyze the data. The organization of clinical work in combination with clinical teaching influenced interprofessional interactions and the quality of discharge in this GIM unit. While organizational activities (orientation and rounds) and individual activities (e.g. role modeling, teaching) supported negotiations between medical residents and other healthcare professionals around discharge, participants had varied perspectives about their effectiveness. This study illuminates social factors and processes that require attention in order to address challenges with interprofessional collaboration and discharge in GIM. These findings have implications for medical education, workplace learning, patient safety and quality
Sadideen, Hazim; Wilson, David; Moiemen, Naiem; Kneebone, Roger
Educational theory highlights the importance of contextualized simulation for effective learning. The authors recently published the concept of "The Burns Suite" (TBS) as a novel tool to advance the delivery of burns education for residents/clinicians. Effectively, TBS represents a low-cost, high-fidelity, portable, immersive simulation environment. Recently, simulation-based team training (SBTT) has been advocated as a means to improve interprofessional practice. The authors aimed to explore the role of TBS in SBTT. A realistic pediatric burn resuscitation scenario was designed based on "advanced trauma and life support" and "emergency management of severe burns" principles, refined utilizing expert opinion through cognitive task analysis. The focus of this analysis was on nontechnical and interpersonal skills of clinicians and nurses within the scenario, mirroring what happens in real life. Five-point Likert-type questionnaires were developed for face and content validity. Cronbach's alpha was calculated for scale reliability. Semistructured interviews captured responses for qualitative thematic analysis allowing for data triangulation. Twenty-two participants completed TBS resuscitation scenario. Mean face and content validity ratings were high (4.4 and 4.7 respectively; range 4-5). The internal consistency of questions was high. Qualitative data analysis revealed two new themes. Participants reported that the experience felt particularly authentic because the simulation had high psychological and social fidelity, and there was a demand for such a facility to be made available to improve nontechnical skills and interprofessional relations. TBS provides a realistic, novel tool for SBTT, addressing both nontechnical and interprofessional team skills. Recreating clinical challenge is crucial to optimize SBTT. With a better understanding of the theories underpinning simulation and interprofessional education, future simulation scenarios can be designed to provide
McElfish, Pearl Anna; Moore, Ramey; Buron, Bill; Hudson, Jonell; Long, Christopher R; Purvis, Rachel S; Schulz, Thomas K; Rowland, Brett; Warmack, T Scott
Many U.S. medical schools have accreditation requirements for interprofessional education and training in cultural competency, yet few programs have developed programs to meet both of these requirements simultaneously. Furthermore, most training programs to address these requirements are broad in nature and do not focus on addressing health disparities. The lack of integration may reduce the students' ability to apply the knowledge learned. Innovative programs that combine these two learning objectives and focus on disenfranchised communities are needed to train the next generation of health professionals. A unique interprofessional education program was developed at the University of Arkansas for Medical Sciences Northwest. The program includes experiential learning, cultural exposure, and competence-building activities for interprofessional teams of medicine, nursing, and pharmacy students. The activities include (a) educational seminars, (b) clinical experiential learning in a student-led clinic, and (c) community-based service-learning through health assessments and survey research events. The program focuses on interprofessional collaboration to address the health disparities experienced by the Marshallese community in northwest Arkansas. The Marshallese are Pacific Islanders who suffer from significant health disparities related to chronic and infectious diseases. Comparison tests revealed statistically significant changes in participants' retrospectively reported pre/posttest scores for Subscales 1 and 2 of the Readiness for Interpersonal Learning Scale and for the Caffrey Cultural Competence in Healthcare Scale. However, no significant change was found for Subscale 3 of the Readiness for Interpersonal Learning Scale. Qualitative findings demonstrated a change in students' knowledge, attitudes, and behavior toward working with other professions and the underserved population. The program had to be flexible enough to meet the educational requirements and
Toiviainen, Hanna; Kira, Mari
In interprofessional service networks, employees cross professional boundaries to collaborate with colleagues and clients with expertise and values different from their own. It can be a struggle to adopt shared work practices and deal with "multivoicedness." At the same time, networks allow members to engage in meaningful service provision, gain a broader understanding of the service provided, and obtain social support. Intertwined network struggles and resource gains have received limited attention in the interprofessional care literature to date. The aim of the study was to investigate the learning potential of the co-existing struggles and resource gains. This article reports findings from two interprofessional networks. Interviews were conducted with 19 employees and thematically analysed. Three types of struggles and six types of resource gains of networking were identified. The struggles relate, first, to the assumptions of networking following similar practices to those in a home organisation; second, to the challenges of dealing with the multivoicedness of networking; and, third, to the experienced gap between the networking ideals and the reality of cooperation. At the same time, the network members experience gains in emotional resources (e.g., stronger sense of meaningfulness at work), cognitive resources (e.g., understanding the customer needs from alternative perspectives), and social resources (e.g., being able to rely on other professionals' competence). Learning potential emerged from the dynamics between coexisting struggles and resource gains.
Ignjatovic, Milka; Langlois, Sylvia; Dematteo, Dale; DiProspero, Lisa; Wagner, Susan; Reeves, Scott
Objective To implement and evaluate the effectiveness and short-term impact of an interprofessional education (IPE) session in the first year for health sciences students representing 9 health professions. Design An interprofessional faculty committee created a 2½ hour introductory interprofessional education session focusing on a single patient case and 2 possible discharge scenarios. A mixed method pretest/posttest research design was used to examine changes in students' perceptions of and attitudes toward IPE. Six follow-up focus groups also were held with students from the participating professions. Assessment Of 1197 health professions students enrolled, 914 students (76%) attended the IPE session. Two hundred thirty-two of 240 pharmacy students (97%) attended. Forty-three (18.5%) pharmacy students responded to the open-ended questions on the survey instrument. The most frequently reported gains from attending the session were recognition of teamwork importance to benefit the patient (30%) and understanding of other professionals' roles (29%). Shortfalls reported by students related to the content/style of presentation (26%) and technical/organizational (23%) aspects of the session. Pharmacy students who participated in one of the focus groups stated the session demonstrated the benefits as well as facilitators and barriers to collaborative care. Conclusion The session served as an effective introduction to IPE; debriefing and integration with uniprofessional curricula should occur. Students need additional small group interaction with other health professional students, and can contribute as members of the planning committee. PMID:19657495
Lax, Leila; Watt-Watson, Judy; Lui, Michelle; Dubrowski, Adam; McGillion, Michael; Hunter, Judith; Maclennan, Cameron; Knickle, Kerry; Robb, Anja; Lapeyre, Jaime
The present article describes educational innovation processes and design of a web-based pain interprofessional resource for prelicensure health science students in universities across Canada. Operationalization of educational theory in design coupled with formative evaluation of design are discussed, along with strategies that support collaborative innovation. Educational design was driven by content, theory and evaluation. Pain misbeliefs and teaching points along the continuum from acute to persistent pain were identified. Knowledge-building theory, situated learning, reflection and novel designs for cognitive scaffolding were then employed. Design research principles were incorporated to inform iterative and ongoing design. An authentic patient case was constructed, situated in interprofessional complex care to highlight learning objectives related to pre-operative, postoperative and treatment up to one year, for a surgical cancer patient. Pain mechanisms, assessment and management framed content creation. Knowledge building scaffolds were used, which included video simulations, embedded resources, concurrent feedback, practice-based reflective exercises and commentaries. Scaffolds were refined to specifically support knowledge translation. Illustrative commentaries were designed to explicate pain misbeliefs and best practices. Architecture of the resource was mapped; a multimedia, interactive prototype was created. This pain education resource was developed primarily for individual use, with extensions for interprofessional collective discourse. Translation of curricular content scripts into representation maps supported the collaborative design process by establishing a common visual language. The web-based prototype will be formatively and summatively evaluated to assess pedagogic design, knowledge-translation scaffolds, pain knowledge gains, relevance, feasibility and fidelity of this educational innovation.
Agreli, Heloise F; Peduzzi, Marina; Bailey, Christopher
Relational and organisational factors are key elements of interprofessional collaboration (IPC) and team climate. Few studies have explored the relationship between IPC and team climate. This article presents a study that aimed to explore IPC in primary healthcare teams and understand how the assessment of team climate may provide insights into IPC. A mixed methods study design was adopted. In Stage 1 of the study, team climate was assessed using the Team Climate Inventory with 159 professionals in 18 interprofessional teams based in São Paulo, Brazil. In Stage 2, data were collected through in-depth interviews with a sample of team members who participated in the first stage of the study. Results from Stage 1 provided an overview of factors relevant to teamwork, which in turn informed our exploration of the relationship between team climate and IPC. Preliminary findings from Stage 2 indicated that teams with a more positive team climate (in particular, greater participative safety) also reported more effective communication and mutual support. In conclusion, team climate provided insights into IPC, especially regarding aspects of communication and interaction in teams. Further research will provide a better understanding of differences and areas of overlap between team climate and IPC. It will potentially contribute for an innovative theoretical approach to explore interprofessional work in primary care settings.
Bilodeau, Karine; Dubois, Sylvie; Pepin, Jacinthe
Studies on interprofessional practice usually report professionals' viewpoints and document organizational, procedural and relational factors influencing that practice. Considering the importance of interprofessional patient-centred (IPPC) practice, it seems necessary to describe it in detail in an actual context of care, from the perspective of patients, their families and health-care professionals. The goal of this study was to describe IPPC practice throughout the continuum of cancer care. A qualitative multiple case study was completed with two interprofessional teams from a Canadian teaching hospital. Interviews were conducted with patients, their families and professionals, and observation was carried out. Three themes were illustrated by current team practice: welcoming the person as a unique individual, but still requiring the patient to comply; the paradoxical coexistence of patient-centred discourse and professional-centred practice; and triggering team collaboration with the culmination of the patient's situation. Several influential factors were described, including the way the team works; the physical environment; professionals' and patients'/family members' stance on the collaboration; professionals' stance on patients and their families; and patients' stance on professionals. Finally, themes describing the desired IPPC practice reflect the wish of most participants to be more involved. They were: providing support in line with the patient's experience and involvement; respecting patients by not imposing professionals' values and goals; and consistency and regularity in the collaboration of all members.
Clark, Phillip G
Health and social care professionals increasingly use narrative approaches to focus on the patient and to communicate with each other. Both effective interprofessional education (IPE) and practice (IPP) require recognizing the various values and voices of different professions, how they relate to the patient's life story, and how they interact with each other at the level of the healthcare team. This article analyzes and integrates the literature on narrative to explore: self-narrative as an expression of one's professional identity; the co-creation of the patient's narrative by the professional and the patient; and the interprofessional multi-vocal narrative discourse as co-constructed by members of the healthcare team. Using a narrative approach to thinking about professional identity, provider-patient communication, and interprofessional teamwork expands our thinking about both IPE and IPP by providing new insights into the nature of professional practice based on relationships to oneself, the patient, and others on the team. How professionals define themselves, gather and present information from the patient, and communicate as members of a clinical team all have important dimensions that can be revealed by a narrative approach. Implications and conclusions for the further development of the narrative approach in IPE and IPP are offered.
Ragucci, Kelly R; Kern, Donna H; Shrader, Sarah P
Objective. To evaluate the impact of an Interprofessional Communication Skills Workshop on pharmacy student confidence and proficiency in disclosing medical errors to patients. Pharmacy student behavior was also compared to that of other health professions' students on the team. Design. Students from up to four different health professions participated in a simulation as part of an interprofessional team. Teams were evaluated with a validated rubric postsimulation on how well they handled the disclosure of an error to the patient. Individually, each student provided anonymous feedback and self-reflected on their abilities via a Likert-scale evaluation tool. A comparison of pharmacy students who completed the workshop (active group) vs all others who did not (control group) was completed and analyzed. Assessment. The majority of students felt they had adequate training related to communication issues that cause medication errors. However, fewer students believed that they knew how to report such an error to a patient or within a health system. Pharmacy students who completed the workshop were significantly more comfortable explicitly stating the error disclosure to a patient and/or caregiver and were more likely to apologize and respond to questions forthrightly ( p medical errors and how to report these errors. Educators should be encouraged to incorporate such training within interprofessional education curricula.
McCaffrey, Ruth; Tappen, Ruth M; Lichtstein, Daniel M; Friedland, Michael
As the population ages and understanding of Alzheimer's disease (AD) improves, the number of older adults diagnosed and treated for AD and related dementias is projected to increase. Dementia diagnosis, treatment and patient and family education are complex processes best done through collaboration among healthcare professions. The educational program described in this article aimed to create an interprofessional team approach to the diagnosis and treatment of dementia involving medical and family nurse practitioner students. A two-group treatment/control pretest posttest design was used to measure changes in knowledge, attitudes and appreciation for an interprofessional team approach to patient care. Findings from this interprofessional program demonstrated that nurse practitioner students gained higher levels of knowledge regarding AD, and medical students gained more positive attitudes toward these patients and their caregivers. Comments from students indicated that both medical and nursing students found the experience valuable. Understanding the roles that various providers play will help healthcare professional meet the challenge of caring for the increasing number of patients with memory loss and for their families.
Wright, Anna; Hawkes, Gillian; Baker, Becky; Lindqvist, Susanne Marie
This paper reports work from a Centre for Interprofessional Practice in a higher education institution in the UK that offers four levels of interprofessional learning (IPL) to all healthcare students. The second level (IPL2) integrates professional practice into the learning process, requiring students to shadow a qualified healthcare professional (from a different profession) for half a day. Students complete a reflective statement upon their learning experience on their return. A study was undertaken to analyse students' reflective statements in depth to see their observations and reflections on the shadowing visit. Using frame analysis, 160 reflective statements were analyzed, identifying common words and phrases used by students, which were then grouped together under six themes. Three of these related directly to the assignment: communication styles and techniques; communication between healthcare professionals and comparison of students' own and other healthcare professionals' roles. Three themes emerged from student's own interpretation of observations and reflections made during the shadowing of a different professional: attitudes toward other professions; power structures between professionals and patients and between professionals and impact of communication on patient care. Interprofessional shadowing gives students an opportunity to observe communication between healthcare professionals and patients and to reflect on broader issues surrounding collaborative working.
Atack, Lynda; Parker, Kathryn; Rocchi, Marie; Maher, Janet; Dryden, Trish
A recent national assessment of emergency planning in Canada suggests that health care professionals are not properly prepared for disasters. In response to this gap, an interprofessional course in disaster management was developed, implemented and evaluated in Toronto, Canada from 2007 to 2008. Undergraduate students from five educational institutions in nursing, medicine, paramedicine, police, media and health administration programs took an eight-week online course. The course was highly interactive and included video, a discussion forum, an online board game and opportunity to participate in a high fidelity disaster simulation with professional staff. Curriculum developers set interprofessional competency as a major course outcome and this concept guided every aspect of content and activity development. A study was conducted to examine change in students' perceptions of disaster management competency and interprofessional attitudes after the course was completed. Results indicate that the course helped students master basic disaster management content and raised their awareness of, and appreciation for, other members of the interdisciplinary team. The undergraduate curriculum must support the development of collaborative competencies and ensure learners are prepared to work in collaborative practice.
Kent, Fiona; Lai, Francis; Beovich, Bronwyn; Dodic, Miodrag
The aim of this study was to determine the usefulness of student-led interprofessional consultations within residential aged care in augmenting patient care and enhancing student education. Volunteer fourth and final year health-care students conducted interprofessional consultations. In a mixed methods design, residents' health-care changes and perspectives were collected prospectively, and student and educator perceptions were measured by survey and interview. Sixteen aged care residents were consulted by interprofessional teams. Students identified two new health issues and proposed 17 recommendations for referrals and five changes to medication management. At six-weeks follow-up, two recommendations had been acted upon clinically, and two medication changes had been implemented. Reasons for the low uptake of recommendations were determined. Residents, students and educators reported high levels of satisfaction. Residential care facilities offer a useful interprofessional learning environment. Student consultations are positively regarded by patients, students and educators and may augment existing health services. © 2016 AJA Inc.
Knoop, Teresa; Wujcik, Debra; Wujcik, Kari
To present emerging models for oncology health professionals to consider when coordinating cancer care among professionals, beginning as early as initial professional education and training and continuing along the cancer continuum to include cancer treatment and psychosocial support. Journal articles indexed on the National Library of Medicine database and personal communications with oncology colleagues. Interprofessional collaboration is becoming increasingly important in the specialty of oncology. The complexity of new therapies and their associated side-effect profiles benefit from a collaborative, interprofessional approach to the care of the patient with cancer. Additionally, oncology patients can benefit from interprofessional collaboration across the complexities of the care continuum. Oncology nurses are often in roles that can facilitate interprofessional collaboration, optimizing the care of patients with cancer. Copyright © 2017 Elsevier Inc. All rights reserved.
W Hutchison, Robert
Community Health Centers that provide diabetic care for underserved patients have unique challenges. This study describes how interprofessional care improves outcomes and results in cost savings. Interprofessional diabetes education and structured team building are discussed. The team consisted of a physician, nurse practitioner, clinical pharmacist, and a number of pre-medicinal, nursing, and pharmacy students. The outcomes were measured at one year intervals for a total of three years. During the two year period with the interprofessional care team, the diabetic patients in this study achieved a 10% improvement in HgA1c, and 9% improvement in systolic blood pressure, a 5% improvement in diastolic blood pressure, and a 62.6% reduction in triglycerides. These findings suggest that this interprofessional care model in a free clinic significantly improved the HgA1c, triglycerides, and blood pressure.
Arenson, Christine; Rose, Molly; Lyons, Kevin
Thomas Jefferson University initiated the Jefferson InterProfessional Education Center in early 2007. The Center facilitates many diverse student and faculty projects on interprofessional education yearly. Faculty development programs include, most recently, the second Jefferson Interprofessional Education conference, IPE scholarly lecture series, an IPE and care practicum, and multiple lecture/discussions to select faculty/administrative groups. At present, there is no external funding for any of the programs. The Health Mentor Program is one of the major student programs. It is a required two-year longitudinal interprofessional chronic illness program for all medical, nursing, occupational therapy, physical therapy, pharmacy and couples and family therapy students. It began in the fall of 2007 and is integrated into existing coursework in each of the participating disciplines.
Timmermans, Olaf; Callewaert, Nadine; Verhoeven, Veronique; Lopez-Hartmann, Maja; Truijen, Steven; Meulemans, Herman; Van Royen, Paul
Background: Geriatric care increasingly needs more multidisciplinary health care services to deliver the necessary complex and continuous care. The aim of this study is to summarize indicators of effective interprofessional outcomes for this population. Method: A systematic review is performed in the Cochrane Library, Pubmed (Medline), Embase, Cinahl and Psychinfo with a search until June 2014. Results: Overall, 689 references were identified of which 29 studies met the inclusion criteria. All outcome indicators were summarized in three categories: collaboration, patient level outcome and costs. Seventeen out of 24 outcome indicators within the category of ‘collaboration’ reached significant difference in advantage of the intervention group. On ‘patient outcome level’ only 15 out of 32 outcome parameters met statistical significance. In the category of ‘costs’ only one study reached statistical significance. Discussion and conclusion: The overall effects of interprofessional interventions for elderly are positive, but based on heterogeneous outcomes. Outcome indicators of interprofessional collaboration for elderly with a significant effect can be summarized in three main categories: ‘collaboration’, patient level’ and ‘costs’. For ‘collaboration’ the outcome indicators are key elements of collaboration, involved disciplines, professional and patient satisfaction and quality of care. On ‘patient level’ the outcome indicators are pain, fall incidence, quality of life, independence for daily life activities, depression and agitated behaviour, transitions, length of stay in hospital, mortality and period of rehabilitation. ‘Costs’ of interprofessional interventions on short- and long-term for elderly need further investigation. When organizing interprofessional collaboration or interprofessional education these outcome indicators can be considered as important topics to be addressed. Overall more research is needed to gain insight in
Full Text Available Background: Geriatric care increasingly needs more multidisciplinary health care services to deliver the necessary complex and continuous care. The aim of this study is to summarize indicators of effective interprofessional outcomes for this population. Method: A systematic review is performed in the Cochrane Library, Pubmed (Medline, Embase, Cinahl and Psychinfo with a search until June 2014. Results: Overall, 689 references were identified of which 29 studies met the inclusion criteria. All outcome indicators were summarized in three categories: collaboration, patient level outcome and costs. Seventeen out of 24 outcome indicators within the category of ‘collaboration’ reached significant difference in advantage of the intervention group. On ‘patient outcome level’ only 15 out of 32 outcome parameters met statistical significance. In the category of ‘costs’ only one study reached statistical significance. Discussion and conclusion: The overall effects of interprofessional interventions for elderly are positive, but based on heterogeneous outcomes. Outcome indicators of interprofessional collaboration for elderly with a significant effect can be summarized in three main categories: ‘collaboration’, patient level’ and ‘costs’. For ‘collaboration’ the outcome indicators are key elements of collaboration, involved disciplines, professional and patient satisfaction and quality of care. On ‘patient level’ the outcome indicators are pain, fall incidence, quality of life, independence for daily life activities, depression and agitated behaviour, transitions, length of stay in hospital, mortality and period of rehabilitation. ‘Costs’ of interprofessional interventions on short- and long-term for elderly need further investigation. When organizing interprofessional collaboration or interprofessional education these outcome indicators can be considered as important topics to be addressed. Overall more research is
Nicely, Stephanie; Farra, Sharon
This article presents a unique strategy for improving didactic learning and clinical skill while simultaneously fostering interprofessional collaboration and communication. Senior-level nursing students collaborated with students enrolled in the Department of Interactive Media Studies to design a virtual reality simulation based upon disaster management and triage techniques. Collaborative creation of the simulation proved to be a strategy for enhancing students' knowledge of and skill in disaster management and triage while impacting attitudes about interprofessional communication and teamwork.
Andvig, Ellen; Syse, Jonn; Severinsson, Elisabeth
The aim of this study was to describe and interpret interprofessional collaboration between healthcare professionals (HCPs) working at the district psychiatric centre (DPC) and employed in community mental health care (CMHC) using a dialogue-oriented co-operative approach. Data were collected by means of multistage focus groups and qualitative content analysis was performed. The main theme “development of interprofessional collaboration by means of organisational strategies and interactional ...
The intensive care unit (ICU) is a dynamic, complex and, at times, highly stressful work environment that involves ongoing exposure to the complexities of interprofessional team functioning. Failures of communication, considered examples of poor collaboration among health care professionals, are the leading cause of inadvertent harm across all health care settings. Evidence suggests effective interprofessional collaboration results in improved outcomes for critically ill patients. One recent study demonstrated a link between low standardized mortality ratios and self-identified levels of collaboration. The aim of this paper is to discuss determinants and complexities of interprofessional collaboration, the evidence supporting its impact on outcomes in the ICU, and interventions designed to foster better interprofessional team functioning. Elements of effective interprofessional collaboration include shared goals and partnerships including explicit, complementary and interdependent roles; mutual respect; and power sharing. In the ICU setting, teams continually alter due to large staff numbers, shift work and staff rotations through the institution. Therefore, the ideal 'unified' team working together to provide better care and improve patient outcomes may be difficult to sustain. Power sharing is one of the most complex aspects of interprofessional collaboration. Ownership of specialized knowledge, technical skills, clinical territory, or even the patient, may produce interprofessional conflict when ownership is not acknowledged. Collaboration by definition implies interdependency as opposed to autonomy. Yet, much nursing literature focuses on achievement of autonomy in clinical decision-making, cited to improve job satisfaction, retention and patient outcomes. Autonomy of health care professionals may be an inappropriate goal when striving to foster interprofessional collaboration. Tools such as checklists, guidelines and protocols are advocated, by some, as ways
Hansen, Britt Blaabjerg; Højholdt, Andy; Arndal, Lars Stubbe
practices/the need to establish collaborative practices between the different groups of professionals working at a school (Downes 2011, Anderson-Butcher 2004). To ensure all students succeed at school, teachers and child and youth educators need to collaborate more effectively, particularly when it comes...... educators, both initiatives of which support the subject-oriented education at school. These changes have challenged the way [education/school] professionals work and how they see their own and each other's roles in the school system (EVA 2013). The changes have also increased the need for collaborative...... required to work with these students. This paper describes the challenges [education/school] professionals (teachers and child and youth educators) face in striving to develop inclusive school practice, and how these challenges relate to differences in skills and competencies between the professions...
Konrad, Thomas R; Fletcher, Grant S; Carey, Timothy S
Despite the fact that chiropractic physicians (DCs) are growing in number and legitimacy in the community of health care professionals, little recent research describes how their relationships with medical doctors (MDs) affect their job and career perceptions. This study explores interprofessional relations by identifying factors associated with variations in how DCs evaluate their interaction with MDs. It also adapts a previously validated multifaceted measure of MD job satisfaction for use with DCs. Cross-sectional survey of 311 DC physicians in North Carolina. The hypothesized multifaceted nature of DC job satisfaction was confirmed. Four distinct job facets and global career satisfaction were measured effectively in DCs. DCs' career satisfaction is related to satisfaction with compensation, intrinsic motivation of relating to patients, and having positive relationships with DC colleagues. DCs report referring patients to MDs more often than they report MDs referring patients to them. Satisfaction with relationships between DCs and MDs is relatively low and is strongly linked to the quantity of referrals from MDs and the perception that MDs practice collaboratively with DCs. However, DCs' global career satisfaction is unrelated to their relationships with MDs. Global career satisfaction of DCs is relatively high and unaffected by the low level of satisfaction DCs report having with their relationships with MDs. These findings suggest that despite increasing interaction and interdependence, DCs' relationship with MDs is of minor importance in their professional self-image.
Mavronicolas, Heather A; Laraque, Fabienne; Shankar, Arti; Campbell, Claudia
Care coordination programmes are an important aspect of HIV management whose success depends largely on HIV primary care provider (PCP) and case manager collaboration. Factors influencing collaboration among HIV PCPs and case managers remain to be studied. The study objective was to test an existing theoretical model of interprofessional collaborative practice and determine which factors play the most important role in facilitating collaboration. A self-administered, anonymous mail survey was sent to HIV PCPs and case managers in New York City. An adapted survey instrument elicited information on demographic, contextual, and perceived social exchange (trustworthiness, role specification, and relationship initiation) characteristics. The dependent variable, perceived interprofessional practice, was constructed from a validated scale. A sequential block wise regression model specifying variable entry order examined the relative importance of each group of factors and of individual variables. The analysis showed that social exchange factors were the dominant drivers of collaboration. Relationship initiation was the most important predictor of interprofessional collaboration. Additional influential factors included organisational leadership support of collaboration, practice settings, and frequency of interprofessional meetings. Addressing factors influencing collaboration among providers will help public health programmes optimally design their structural, hiring, and training strategies to foster effective social exchanges and promote collaborative working relationships.
Doherty, Regina F; Knab, Mary; Cahn, Peter S
A primary goal of interprofessional education is to produce clinicians who practice collaboratively to provide patient-centered care. This exploratory study evaluated whether students' attitudes about a literary account of an illness experience endured after a year of professional and clinical education and if students applied lessons learned from a common reading to the delivery of patient centered care. Six focus groups were completed with health professions students and five main themes emerged from the focus group data. Themes include: Seeing family members as stakeholders; Establishing common ground with peers and the larger reason for graduate school; Applying lessons to clinical practice that see the patient as a person; Experiencing an emotional connection with a story and its characters; and Taking alternative perspectives/stepping into the shoes of the patient. Study results are discussed in relation to the interprofessional education literature, with implications for educators and interprofessional curricula also presented. We conclude that a common reading program may provide an effective means for developing health professions students' knowledge and attitudes in the tenets of patient-centered collaborative care. It has the potential to build community through shared intellectual experience, facilitating meaningful reflection and perspective-taking in interprofessional learners.
Fung, Lillia; Boet, Sylvain; Bould, M Dylan; Qosa, Haytham; Perrier, Laure; Tricco, Andrea; Tavares, Walter; Reeves, Scott
Crisis resource management (CRM) abilities are important for different healthcare providers to effectively manage critical clinical events. This study aims to review the effectiveness of simulation-based CRM training for interprofessional and interdisciplinary teams compared to other instructional methods (e.g., didactics). Interprofessional teams are composed of several professions (e.g., nurse, physician, midwife) while interdisciplinary teams are composed of several disciplines from the same profession (e.g., cardiologist, anaesthesiologist, orthopaedist). Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were searched using terms related to CRM, crisis management, crew resource management, teamwork, and simulation. Trials comparing simulation-based CRM team training versus any other methods of education were included. The educational interventions involved interprofessional or interdisciplinary healthcare teams. The initial search identified 7456 publications; 12 studies were included. Simulation-based CRM team training was associated with significant improvements in CRM skill acquisition in all but two studies when compared to didactic case-based CRM training or simulation without CRM training. Of the 12 included studies, one showed significant improvements in team behaviours in the workplace, while two studies demonstrated sustained reductions in adverse patient outcomes after a single simulation-based CRM team intervention. In conclusion, CRM simulation-based training for interprofessional and interdisciplinary teams show promise in teaching CRM in the simulator when compared to didactic case-based CRM education or simulation without CRM teaching. More research, however, is required to demonstrate transfer of learning to workplaces and potential impact on patient outcomes.
Bode, Sebastian Felix Nepomuk; Giesler, Marianne; Heinzmann, Andrea; Krüger, Marcus; Straub, Christine
Interprofessional education (IPE) is the basis for interprofessional collaboration (IPC) in health care systems. It has beneficial effects for both patients and health care professionals. IPC is paramount for adequate care of patients and their families, especially in pediatrics. To determine the attitudes of medical doctors (n=121), nurses (n=15), psychologists (n=14), and social workers (n=19) toward IPE and IPC in a tertiary pediatric university teaching hospital, as well as the inpatient and outpatient settings in pediatrics, we developed a questionnaire with 21 items in four categories based on established questionnaires. All participants worked as part of interprofessional teams, and the overwhelming majority valued IPC highly. Most competencies important for IPC were acquired on the job. There was a substantial lack of interprofessional education, especially for medical doctors and psychologists. IPE still needs to be established as part of the undergraduate curriculum at German universities.
Clarke, Pamela N; Hassmiller, Susan
The column presents a scholarly dialogue about nursing's role in interprofessional education, practice, and collaboration. Susan Hassmiller, PhD, RN, FAAN, is the Robert Wood Johnson Foundation (RWJF) senior adviser for nursing. In this role, she shapes and leads the foundation's strategies to address nurse and nurse faculty shortages and ensures that RWJF's commitments in nursing have a broad and lasting national impact. In partnership with AARP, Hassmiller directs the foundation's Future of Nursing: Campaign for Action. This effort, active in 50 states plus the District of Columbia, strives to implement the recommendations of the Institute of Medicine's 2011 report, The Future of Nursing: Leading Change, Advancing Health, for which Hassmiller served as the study director.
Lewin, Simon; Reeves, Scott
Interprofessional teamwork is widely advocated in health and social care policies. However, the theoretical literature is rarely employed to help understand the nature of collaborative relations in action or to critique normative discourses of teamworking. This paper draws upon Goffman's (1963) theory of impression management, modified by Sinclair (1997), to explore how professionals 'present' themselves when interacting on hospital wards and also how they employ front stage and backstage settings in their collaborative work. The study was undertaken in the general medicine directorate of a large NHS teaching hospital in England. An ethnographic approach was used, including interviews with 49 different health and social care staff and participant observation of ward-based work. These observations focused on both verbal and non-verbal interprofessional interactions. Thematic analysis of the data was undertaken. The study findings suggest that doctor-nurse relationships were characterised by 'parallel working', with limited information sharing or effective joint working. Interprofessional working was based less on planned, 'front stage' activities, such as wards rounds, than on ad hoc backstage opportunistic strategies. These backstage interactions, including corridor conversations, allowed the appearance of collaborative 'teamwork' to be maintained as a form of impression management. These interactions also helped to overcome the limitations of planned front stage work. Our data also highlight the shifting 'ownership' of space by different professional groups and the ways in which front and backstage activities are structured by physical space. We argue that the use of Sinclair's model helps to illuminate the nature of collaborative interprofessional relations within an acute care setting. In such settings, the notion of teamwork, as a form of regular interaction and with a shared team identity, appears to have little relevance. This suggests that interventions to
Sargeant, Joan; MacLeod, Tanya; Murray, Anne
Recent research suggests that effective interprofessional communication and collaboration can positively influence patient satisfaction and outcomes. Health professional communication skills do not necessarily improve over time but can improve with formal communication skills training (CST). This article describes the development, evaluation, and lessons learned for a novel theater-based role-play CST program designed to improve community cancer care for patients and families by enhancing health care professionals' communication skills. Four 2-hour interprofessional communication skills workshops for Nova Scotia health professionals were developed. Topics were (1) Essential Communication Skills, (2) Delivering Difficult News and Providing Support, (3) When Patients and Families Are Angry, and (4) Managing Conflict in the Workplace. Strategies for enhancing communication skills based on the science (evidence-based practice and teaching) and the art (interactive theater) of communication skills were included. Facilitators included professional actors, communication skills facilitators, and trained health professionals. We used a mixed-methods evaluation design assessing 4 levels of educational outcomes at 3 points: pre- and post-workshop and follow-up. Five hundred eighteen professionals representing over 20 health professions attended 17 workshops. Data showed the workshops were well received, despite some discomfort with role-playing. Pre/post paired t-tests of self-reported communication skills showed significant improvement after all workshops (p ≤ 0.05); 92% indicated intended changes to their communication practice immediately following the workshops. Of 68 respondents to the follow-up, 59 (87%) reported positive changes in the responses of their patients. Both positive and negative lessons learned are described. Copyright © 2011 The Alliance for Continuing Medical Education, the Society for Academic Continuing Medical Education, and the Council on CME
Ward, Wendy; Zagoloff, Alexandra; Rieck, Cortney; Robiner, William
This manuscript is an outgrowth of an invited panel presentation at the national Association for Psychologists in Academic Health Centers Conference in 2017 on Interprofessional Education (IPE). IPE is a structured and transformative educational strategy designed to provide active learning experiences where trainees from diverse healthcare professions gain shared content knowledge plus collaboration skills as they learn about, from, and with each other. Collaboration skills include understanding professional role distinctions and overlap, effective team-based communication, shared values/ethics and respect for each other's expertise, and teamwork dynamics. It is increasingly important to expand training beyond the intraprofessional activities in which psychology trainees engage to prepare them to participate in interprofessional collaborative care. As healthcare systems move to team-based collaborative practice and value-based reimbursement models, the profession of psychology needs leaders at every academic health center to facilitate the design and/or implementation of IPE activities. The panel of psychologists presented roles that psychologists play in IPE institutional program design and implementation, graduate training programs, and the perspectives of an early career psychologist and psychology trainee. Opportunities and challenges are highlighted, culminating in a call to action. Psychologists must embrace their identity as health professionals and engage their learners in IPE so that the emerging cognitive schemata of healthcare that is developed includes the profession of psychology. Otherwise, healthcare teams and health professionals will not understand the value, roles, or potential contributions of psychologists in enhancing patient care outcomes, ultimately jeopardizing psychologists' referrals, involvement in healthcare delivery, and career opportunities.
Marloes Amantia van Bokhoven; Jerôme Jean Jacques van Dongen; Anneke van Dijk-de Vries
The significance of effective interprofessional teamwork to improve the quality of care has been widely recognised. Effective interprofessional teamwork calls on good collaboration between professionals and patients, coordination between professionals, and the development of teamwork over time.
Verhaegh, Kim J.; Seller-Boersma, Annamarike; Simons, Robert; Steenbruggen, Jeanet; Geerlings, Suzanne E.; de Rooij, Sophia E.; Buurman, Bianca M.
Interprofessional communication and collaboration during hospitalisation is critically important to provide safe and effective care. Clinical rounds are an essential interprofessional process in which the clinical problems of patients are discussed on a daily basis. The objective of this exploratory
Verhaegh, Kim J.; Seller-Boersma, Annamarike; Simons, Robert; Steenbruggen, Jeanet; Geerlings, Suzanne E.; de Rooij, Sophia E.; Buurman, Bianca M.
Interprofessional communication and collaboration during hospitalisation is critically important to provide safe and effective care. Clinical rounds are an essential interprofessional process in which the clinical problems of patients are discussed on a daily basis. The objective of this exploratory
Molin, Jenny; Graneheim, Ulla Hällgren; Ringnér, Anders; Lindgren, Britt-Marie
WHAT IS KNOWN ON THE SUBJECT?: Psychiatric inpatient care has been described by both ward staff and patients as being demanding and disorganized, lacking opportunities for quality interactions in everyday life through joint activities. Qualitative research on interprofessional teams' perspectives on everyday life processes in psychiatric inpatient care is lacking. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Staff have ideals about care and collaboration, but the obstacles they face in everyday life, such as a poor environment, power asymmetry, lacking structure and the demands of managing chaos, mean that they appear to resign and shift focus from the patients' best interests to self-survival. Different professions in general describe the same obstacles in everyday life on the wards but there are also profession-specific perspectives on distancing and feelings of abandonment. To our knowledge, these findings have not been reported in the international evidence. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Given these findings we suggest interventions such as Protected Engagement Time as well as reflective dialogues within interprofessional teams. This would help staff to resume their caring role in everyday life in psychiatric inpatient care and put their ideals into practice. Introduction Patients and ward staff describe psychiatric inpatient care as demanding, characterized by unpredictable events, yet research on interprofessional teams perspectives of everyday life processes in psychiatric inpatient care lacks. Aim This study aims to explore everyday life processes in psychiatric inpatient care, as reported by staff in interprofessional teams. Method A grounded theory design was used and 36 participants were interviewed. Results The analysis resulted in a process-oriented core category From ideals to resignation. Related to this core category were three further categories: Knowing where to go, Walking a path of obstacles and Shifting focus from the patient's best
Full Text Available Over the past seven years, the Department of Pediatric Dentistry at New York University College of Dentistry (NYUCD and the Advanced Practice: Pediatrics and the Pediatric Nurse Practitioner (PNP program at New York University College of Nursing (NYUCN have engaged in a program of formal educational activities with the specific goals of advancing interprofessional education, evidence-based practice, and interprofessional strategies to improve the oral-systemic health of infants and young children. Mentoring interprofessional students in all health care professions to collaboratively assess, analyze, and care-manage patients demands that faculty reflect on current practices and determine ways to enhance the curriculum to include evidence-based scholarly activities, opportunities for interprofessional education and practice, and interprofessional socialization. Through the processes of interprofessional education and practice, the pediatric nursing and dental faculty identified interprofessional performance and affective oral health core competencies for all dental and pediatric primary care providers. Students demonstrated achievement of interprofessional core competencies, after completing the interprofessional educational clinical practice activities at Head Start programs that included interprofessional evidence-based collaborative practice, case analyses, and presentations with scholarly discussions that explored ways to improve the oral health of diverse pediatric populations. The goal of improving the oral health of all children begins with interprofessional education that lays the foundations for interprofessional practice.
Goldberg, Lynette R.
Interprofessional education (IPE) is recognized as a critical component in preparing students for effective interprofessional practice in health care. IPE is supported by the American Speech-Language-Hearing Association and students' competence in interprofessional practice is expected by clinical supervisors for effective work in any…
Mahler, Cornelia; Gutmann, Thomas; Karstens, Sven; Joos, Stefanie
Interprofessional collaboration leads to an improvement in health care. This call for increased interprofessional collaboration has led to national and international recommendations for interprofessional learning and education. The GMA has taken up this challenge and has implemented a working group on "interprofessional education in the health professions" to address this topic. The terminology used to describe collaboration among the health professions seems to vary and does not reflect any clear consensus. The aim of this paper is to identify the different terms used to describe collaboration between health professions and to analyse their use in German journals. The terms frequently used to describe collaboration between health professionals were identified and defined. German medical journals were then pragmatically analyzed regarding the use of the terms interprof* and interdiszip*. The German terms for interprofessional and interdisciplinary were not used consistently in the journals reviewed. There seems to be no agreement on the use of terms to describe the collaboration between health professions. Consistent terminology should be used as a basis for promoting collaboration and improving understanding among the parties involved.
Chipchase, Lucy; Allen, Shelley; Eley, Diann; McAllister, Lindy; Strong, Jenny
Our understanding of the qualities and value of clinical supervision is based on uniprofessional clinical education models. There is little research regarding the role and qualities needed in the supervisor role for supporting interprofessional placements. This paper reports the views and perceptions of medical and allied heath students and supervisors on the characteristics of clinical supervision in an interprofessional, international context. A qualitative case study was used involving semi-structured interviews of eight health professional students and four clinical supervisors before and after an interprofessional, international clinical placement. Our findings suggest that supervision from educators whose profession differs from that of the students can be a beneficial and rewarding experience leading to the use of alternative learning strategies. Although all participants valued interprofessional supervision, there was agreement that profession-specific supervision was required throughout the placement. Further research is required to understand this view as interprofessional education aims to prepare graduates for collaborative practice where they may work in teams supervised by staff whose profession may differ from their own.
Körner, Mirjam; Ehrhardt, Heike; Steger, Anne-Kathrin
For implementation of patient-centered treatment in interprofessional health care units, such as rehabilitation teams, external participation (interaction between patient and health care professionals) and internal participation (communication, coordination and cooperation in the interprofessional team) need to be considered. The aim of this study is to identify the preferences of patients and health care professionals concerning internal and external participation in rehabilitation clinics, in order to develop an interprofessional shared decision-making (SDM) training program for health care professionals to enhance both types of participation. Therefore, a cross-sectional mixed-methods study was implemented in four rehabilitation clinics. The study consists of two parts: focus groups with patients and a survey of experts (senior health care professionals from medicine, psychotherapy, physical therapy and nursing). More time, more respect from the health care professionals and the desire for more participation in decision-making processes were mentioned most frequently by patients (n = 36) in the focus groups. The health care professionals (n = 32) saw most deficits in internal participation, e.g. management of feedback, talking with difficult team members and moderate conflict discussion. The results of both assessments have been used to develop an interprofessional SDM training program for implementing internal and external participation in interprofessional teams in medical rehabilitation.
Ekmekci, Ozgur; Sheingold, Brenda; Plack, Margaret; LeLacheur, Susan; Halvaksz, Jennifer; Lewis, Karen; Schlumpf, Karen; Greenberg, Larrie
Teamwork has become an integral part of health care delivery. Such emphasis on teamwork has generated the need to systematically measure and improve the learning and performance of health care teams. The purpose of this study was to develop a comprehensive assessment instrument, the Interprofessional Education and Practice Inventory (IPEPI), to evaluate learning and performance in interprofessional health care teams. The 12-month study commenced in three 4-month phases: (1) a panel of 25 national and international experts participated in the Delphi process to identify factors influencing team learning and team performance; (2) the research team analyzed the findings from the two Delphi rounds to develop the IPEPI; and (3) a cohort of 27 students at the university engaged in clinical simulations to test and refine the IPEPI. Findings suggest key factors that significantly influence team learning and performance include whether the group is able to foster a climate of mutual respect, adopt effective communication strategies, develop a sense of trust, and invite contributions from others. Additionally, in assessing organizational factors, participants indicated those factors that significantly influence team learning and performance include whether the organization is patient-centered, creates a culture of safety (not blame), and supports individual and team learning. These findings highlight the critical role assessment plays in enhancing not just interprofessional education or interprofessional practice, but in essence advancing interprofessional education and practice--which requires an integrated examination of how health care professionals learn and perform in teams.
Simin, Dragana; Milutinović, Dragana; Brestovacki, Branislava; Andrijević, Ilija; Cigić, Tomislav
Collaboration, within and between healthcare teams, facilitates effective healthcare. Internationally, the development of interprofessional education, as a means to facilitate more effective teamwork in health care, has been recognized for over forty years. The aim of this paper is to evaluate students' attitudes toward the influence of interprofessional education on improvement of collaboration and teamwork. The research was conducted by interviewing students at the Medical Faculty in Novi Sad in the form of cross-sectional study. The study sample included students from two undergraduate programmes: School of Nursing (n=52) and Integrated Studies of Medicine (n=53). Students admitted to the research had to be exposed to clinical experience. The instrument used in this study was the Readiness for Interprofessional Learning Scale (RIPLS). As many as 93.3% of students indicated that basics of teamwork skills should be obtained prior to graduation, whereas 96.2% considered that interprofessional education would enable them to improve mutual trust and respect. The majority of interviewees indicated that patients would ultimately benefit if healthcare students worked together to solve patient problems. Multivariate procedures MANOVA p attitudes toward teamwork and collaboration showed significant differences between the students of medicine and nursing. The students of the Integrated Studies of Medicine and School of Nursing had a positive attitude toward the influence of interprofessional education on the improvement of collaboration and teamwork.
Full Text Available Introduction. Collaboration, within and between healthcare teams, facilitates effective healthcare. Internationally, the development of interprofessional education, as a means to facilitate more effective teamwork in health care, has been recognized for over forty years. Objective. The aim of this paper is to evaluate students' attitudes toward the influence of interprofessional education on improvement of collaboration and teamwork. Methods. The research was conducted by interviewing students at the Medical Faculty in Novi Sad in the form of cross-sectional study. The study sample included students from two undergraduate programmes: School of Nursing (n=52 and Integrated Studies of Medicine (n=53. Students admitted to the research had to be exposed to clinical experience. The instrument used in this study was the Readiness for Interprofessional Learning Scale (RIPLS. Results. As many as 93.3% of students indicated that basics of teamwork skills should be obtained prior to graduation, whereas 96.2% considered that interprofessional education would enable them to improve mutual trust and respect. The majority of interviewees indicated that patients would ultimately benefit if healthcare students worked together to solve patient problems. Multivariate procedures MANOVA p<0.05 and discriminative analysis p<0.05 of students' attitudes toward teamwork and collaboration showed significant differences between the students of medicine and nursing. Conclusion. The students of the Integrated Studies of Medicine and School of Nursing had a positive attitude toward the influence of interprofessional education on the improvement of collaboration and teamwork.
Anderson, Elizabeth; Smith, Roger; Hammick, Marilyn
This paper retrospectively reports on an evaluation framework applied to a local interprofessional education (IPE) curriculum design. The theoretically informed IPE curriculum spans the undergraduate health and social care programmes of over 10 professions as a curriculum theme. The teaching design and its impact were informed by psycho-social and learning theories. This meta-analysis is presented to share the importance of longitudinal IPE, whole curriculum evaluation for comparisons and to advance our understandings of what works and why. The meta-analysis used the Presage, Process and Product conceptual framework outlined by Biggs in 1993, and the Kirkpatrick in 1996, evaluation outcome model. Data are shared on the final overall learning from evaluating the teaching and the outcomes from students, teachers, practitioners, patients and carers. The evaluation highlighted cyclical issues relating to students experiences, facilitators abilities and highlights the challenges of learning in practice which was highly praised by students. The problems and challenges were solved through the application of theory to illuminate our understandings. We lament at missed opportunities for the application of theoretically informed research questions that still require to be addressed. However, we share this framework as having offered a complete and comprehensive evaluation process.
O'Carroll, Veronica; McSwiggan, Linda; Campbell, Martin
The healthcare setting is a rich learning environment for students to experience interprofessional working (IPW) and interprofessional education (IPE). However, opportunities for IPE are limited, and student experiences of effective IPW are varied. This raises the question of how IPW and IPE are valued by health or social care professionals. A search of the literature was carried out to identify studies of health and social care staff attitudes to IPW and IPE. This review provides a summary of the main factors found to influence attitudes and the strengths and limitations of these studies. Professional background and prior IPE experience were identified as the influencing factors for which there is most evidence. The main limitations of the studies accessed included a focus on the value of IPE for staff, as opposed to students, and a limited number of studies considering the relationship between attitudes to IPW and the value placed on IPE. It is important that health and social care professionals lead by example by working collaboratively and providing students with opportunities for IPE. Identifying the variables influencing attitudes to IPW and IPE may assist in improving IPW and experiences of IPE for students learning in the healthcare setting.
Ong, Sik Yin; Tan, Nigel C K; Knab, Mary S; Farrell, Susan E; Lim, Wee Shiong
The increasing complexity of healthcare needs underlines the growing importance of interprofessional education and collaborative practice (IPECP) in enhancing quality of patient care. In particular, clinician educators play an influential role in advocating IPECP. The primary goal of our exploratory pilot study is to explore 34 clinician educators' attitudes towards IPECP by using the adapted 14-item Attitudes Toward Health Care Teams Scale (ATHCTS) and 15-item Readiness for Interprofessional Learning Scale (RIPLS). Mean scores of ATHCTS and RIPLS were 3.81 (SD = 0.90) and 4.02 (SD = 0.79), respectively. Using exploratory factor analysis, we identified four factors: team value (ATHCTS), team efficiency (ATHCTS), teamwork and collaboration (RIPLS), and professional socialisation (RIPLS). The "team efficiency" factor on the ATHCTS scored lowest (factor mean = 3.49) compared with other factors (factor means = 3.87-4.08). Correlation analyses revealed that the "team efficiency" factor had small correlations with other factors (r = -0.05-0.37). Our clinician educators valued IPECP in promoting teamwork and professional socialisation but they perceived IPECP to compromise efficiency. The issue of perceived inefficiency by clinician educators merits attention in order to promote wider implementation of IPECP.
Prast, Jean; Herlache-Pretzer, Ellen; Frederick, Andrea; Gafni-Lachter, Liat
Interprofessional collaboration is vital for the provision of quality patient care. Thoughtfully designed educational programs can help students of health professions develop interprofessional competencies and capacities, including values and ethics, roles and responsibilities, interprofessional communication, and teamwork (Interprofessional Education Collaborative Expert Panel, 2011). The authors were involved in developing Interprofessional Education (IPE) activities and simulations to be infused into the curriculums of the various health professions programs in their College. A review of the IPE experiences revealed students greatly benefited from involvement in a diverse set of IPE activities and simulations.
Full Text Available To shift health professions regulation from traditional to ‘collaborative’ self-regulation, Nova Scotia has adopted legislation which will: make all self-regulating health professions members of the Regulated Health Professions Network; mandate the Network to facilitate voluntary collaboration among its members; and enable regulators to work together on investigations of patient complaints, to adjust scopes of practice on an ongoing basis and to adjudicate appeals of unsuccessful applicants for registration. The goals are to give health professions regulation the capacity to enable and support the functioning of interprofessional teams. The legislation was adopted primarily for two reasons: collaborative development and unanimous support by all of the province’s self-regulating professions; and alignment with the government’s health care reform agenda and its emphasis on collaborative team-based care. Contrary to the approach of several other provinces, the legislation will enable but not require regulators to collaborate on the premise that consensual collaboration is more likely to happen, to be meaningful and to yield tangible benefits. Support for this approach can be taken from the impressive collaborative work on which the legislation is based. Evaluation will be critical, and the five-year review required by the legislation will give Nova Scotia the opportunity to test not only the legislation but the ideas on which it is based. The extent of the legislation’s reliance on voluntary process will prove to be either its greatest strength or its greatest weakness.
Bachchu Kailash Kaini
Full Text Available Interprofessional care is joint working between health care professionals by pooling their skills, knowledge and expertise, to make joint decisions and learn from each other for the benefits of service users and healthcare professionals. Service users involvement is considered as one of the important aspects of planning, management and decision making process in the delivery of health care to service users. Service users’ involvement is not the same as public involvement and partnership arrangements in health care. The active involvement and engagement of service users in health care positively contributes to improve quality of care, to promote better health and to shape the future of health services. Service users are always at the centre of health care professionals’ values, work ethics and roles. Moreover, service users centred interprofessional team collaboration is very important to deliver effective health services. Keywords: interprofessional; service users; health care; benefits; collaboration. | PubMed
Full Text Available Daniel R Tuite,1 David Healy,1 Thomas S MacKinnon2 1Faculty of Medicine, Brighton and Sussex Medical School, Brighton, 2School of Medicine, Imperial College London, London, UKWe read with great interest the paper by Henkin et al,1 demonstrating that the use of interprofessional bedside rounding (IBR significantly improved nurse–physician teamwork, particularly from the nurses’ point of view. This finding is relevant when one takes into account the importance of interdisciplinary teamwork; a review conducted by Epstein concluded that effective interprofessional teamwork both maximizes patient safety and increases job satisfaction and efficiency.2 We, as medical students, believe that inadequate emphasis is placed on interprofessional collaboration at the prequalification phase, and therefore, we suggest that implementing IBR at the university level could represent a method to improve teamwork between the nurses and doctors of the future. View the original paper by Henkin et al.
Engel, Joyce; Prentice, Dawn; Taplay, Karyn
The purpose of this supplementary analysis of a hermeneutic phenomenological study of the experience of interprofessional collaboration for nursing and medical students was to explore the experience of power that was threaded throughout the original study. Seventeen students participated in guided, face-to-face conversations in the original study (Prentice, Engel, Taplay, & Stobbe, 2014). Through the processes of deductive analysis and inductive reasoning, 2 themes of power emerged from these research conversations: (a) complicated knowledge is power and (b) the power and silence of intimidation. These themes suggest that power and power differentials are significant factors in student interactions in interprofessional learning and have the potential to adversely affect these interactions. Students' perceptions of power need to be taken into account and addressed when planning and implementing interprofessional education events. Copyright © 2016 Elsevier Inc. All rights reserved.
Schwind, Jasna K; McCay, Elizabeth; Metersky, Kateryna; Martin, Jennifer
Interprofessional education and practice have been gaining recognition during the past decade. However, little has been written on person-centered care (PCC) within interprofessional practice and how it could be taught to interprofessional learners. A key element of PCC is therapeutic communication. Consequently, a group of interprofessional faculty innovated a graduate-level elective course on advanced therapeutic communication where interprofessional learners together explore PCC within interprofessional care. The course curriculum is underpinned by mindfulness in education, nonviolent communication, and reflective writing. Various teaching- learning strategies, including creative self-expression, are also used. The created competencies and conceptual framework may be used by other educators in creating a similar interprofessional course. Interprofessional learners gained a deeper and broader understanding of PCC in interprofessional care. On the basis of this undertaking, the faculty gained a deeper appreciation for interprofessional collaboration in the development of innovative educational methodologies that advance interprofessional teamwork in education and professional practice. [J Nurs Educ. 2016;55(10):592-597.]. Copyright 2016, SLACK Incorporated.
Nisbet, Gillian; Jorm, Christine; Roberts, Chris; Gordon, Christopher J; Chen, Timothy F
Large scale models of interprofessional learning (IPL) where outcomes are assessed are rare within health professional curricula. To date, there is sparse research describing robust assessment strategies to support such activities. We describe the development of an IPL assessment task based on peer rating of a student generated video evidencing collaborative interprofessional practice. We provide content validation evidence of an assessment rubric in the context of large scale IPL. Two established approaches to scale development in an educational setting were combined. A literature review was undertaken to develop a conceptual model of the relevant domains and issues pertaining to assessment of student generated videos within IPL. Starting with a prototype rubric developed from the literature, a series of staff and student workshops were undertaken to integrate expert opinion and user perspectives. Participants assessed five-minute videos produced in a prior pilot IPL activity. Outcomes from each workshop informed the next version of the rubric until agreement was reached on anchoring statements and criteria. At this point the rubric was declared fit to be used in the upcoming mandatory large scale IPL activity. The assessment rubric consisted of four domains: patient issues, interprofessional negotiation; interprofessional management plan in action; and effective use of video medium to engage audience. The first three domains reflected topic content relevant to the underlying construct of interprofessional collaborative practice. The fourth domain was consistent with the broader video assessment literature calling for greater emphasis on creativity in education. We have provided evidence for the content validity of a video-based peer assessment task portraying interprofessional collaborative practice in the context of large-scale IPL activities for healthcare professional students. Further research is needed to establish the reliability of such a scale.
Shilpa Hegde, MD
Full Text Available With current global healthcare trends, there is a growing need for interprofessional education (IPE and interprofessional practice (IPP in collaborative care of persons with chronic medical conditions. Tools and models for IPE and IPP are now available, but they are not yet in widespread use. Developmental-behavioural paediatrics is a medical discipline that is characterized by IPP with an encouraging emergence of this speciality in India and other developing countries. This article provides an overview of IPE and IPP, followed by a precise account of an Indian institution, which provides services to children suffering from neurodevelopmental disorders utilizing an IPP approach and implementing IPE to its trainees.
Klaasen, Kathleen; Bowman, Susan; Komenda, Paul
This project developed an evaluation platform aimed at diagnosing team functioning using evidence-informed, measurable indicators to provide an actionable roadmap to guide teams in improving their interprofessional collaborative team performance. A scoping literature review, stakeholder consultation, survey and focus groups were conducted to inform both the final selection of eight indicators of effective, high-performing teams and the process to assess and evaluate teams against these indicators. The program was piloted with two interprofessional teams in the Winnipeg Health Region. Focus groups and questionnaires were used to evaluate the program.
Greer, Annette Grady; Clay, Maria C
This article describes the creation, development, and peer review of an instrument for the assessment and improvement of interprofessional health educational programs in public and private health educational institutions nationally and internationally. The self-assessment is constructed with consideration of the following domains: educational venues, educational evaluation, programmatic participation, institutional support, and faculty incentives. The interprofessional education assessment and planning instrument for academic institutions can be a major aide in helping national and international leaders promoting IPE as the method to prepare future health professionals.
Annear, Michael; Walker, Kim; Lucas, Peter; Lo, Amanda; Robinson, Andrew
This article examines the reflective discourses of medical, nursing, and paramedic students participating in interprofessional education (IPE) activities in the context of aged-care clinical placements. The intent of the research is to explore how students engage with their interprofessional colleagues in an IPE assessment and care planning activity and elucidate how students configure their role as learners within the context of a non-traditional aged-care training environment. Research participants included cohorts of volunteer medical (n = 61), nursing (n = 46), and paramedic (n = 20) students who were on clinical placements at two large teaching aged-care facilities in Tasmania, Australia, over a period of 18 months. A total of 39 facilitated focus group discussions were undertaken with cohorts of undergraduate student volunteers from three health professions between February 2013 and October 2014. Thematic analysis of focus group transcripts was assisted by NVIVO software and verified through secondary coding and member checking procedures. With an acceptable level of agreement across two independent coders, four themes were identified from student focus group transcripts that described the IPE relations and perceptions of the aged-care environment. Emergent themes included reinforcement of professional hierarchies, IPE in aged care perceived as mundane and extraneous, opportunities for reciprocal teaching and learning, and understanding interprofessional roles. While not all students can be engaged with IPE activities in aged care, our evidence suggests that within 1 week of clinical placements there is a possibility to develop reciprocal professional relations, affirm a positive identity within a collaborative healthcare team, and support the health of vulnerable older adults with complex care needs. These important clinical learnings support aged-care-based IPE as a potentially powerful context for undergraduate learning in the 21st Century.
Weissenborn, Marina; Haefeli, Walter E; Peters-Klimm, Frank; Seidling, Hanna M
Background While collaboration between community pharmacists (CPs) and general practitioners (GPs) is essential to provide comprehensive patient care, their communication often is scarce and hampered by multiple barriers. Objective We aimed to assess both professions' perceptions of interprofessional communication with regard to content and methods of communication as a basis to subsequently develop best-practice recommendations for information exchange. Setting Ambulatory care setting in Germany. Method CPs and GPs shared their experience in focus groups and in-depth interviews which were conducted using a semi-structured interview guideline. Transcribed recordings were assessed using qualitative content analysis according to Mayring. Main outcome measure Specification of existing barriers, CPs'/GPs' general perceptions of interprofessional communication and similarities and differences regarding prioritization of specific information items and how to best communicate with each other. Results Four focus groups and fourteen interviews were conducted. Seven internal (e.g. professions were not personally known to one another) and nine external barriers (e.g. mutual accessibility) were identified. Ten organizational, eight medication-related, and four patient-related information items were identified requiring interprofessional communication. Their relevance varied between the professions, e.g. CPs rated organizational issues higher than GPs. Both professions indicated communication via phone to be the most frequently used method of communication. Conclusion CPs and GPs opinions often differ. However, communication between CPs and GPs is perceived as crucial suggesting that a future concept has to offer standardized recommendations, while leaving CPs and GPs room to adjust it to their individual needs.
Powell, Rhea E; Doty, Amanda; Casten, Robin J; Rovner, Barry W; Rising, Kristin L
Healthcare systems increasingly engage interprofessional healthcare team members such as case managers, social workers, and community health workers to work directly with patients and improve population health. This study elicited perspectives of interprofessional healthcare team members regarding patient barriers to health and suggestions to address these barriers. This is a qualitative study employing focus groups and semi-structured interviews with 39 interprofessional healthcare team members in Philadelphia to elicit perceptions of patients' needs and experiences with the health system, and suggestions for positioning health care systems to better serve patients. Themes were identified using a content analysis approach. Three focus groups and 21 interviews were conducted with 26 hospital-based and 13 ambulatory-based participants. Three domains emerged to characterize barriers to care: social determinants, health system factors, and patient trust in the health system. Social determinants included insurance and financial shortcomings, mental health and substance abuse issues, housing and transportation-related limitations, and unpredictability associated with living in poverty. Suggestions for addressing these barriers included increased financial assistance from the health system, and building a workforce to address these determinants directly. Health care system factors included poor care coordination, inadequate communication of hospital discharge instructions, and difficulty navigating complex systems. Suggestions for addressing these barriers included enhanced communication between care sites, patient-centered scheduling, and improved patient education especially in discharge planning. Finally, factors related to patient trust of the health system emerged. Participants reported that patients are often intimidated by the health system, mistrusting of physicians, and fearful of receiving a serious diagnosis or prognosis. A suggestion for mitigating these
Sabus, Carla; Sabata, Dory; Antonacci, David
Technology has become a ubiquitous part of our society and is largely embedded in today's educational system. 3D virtual reality technology can be used to simulate environments and activities and may be used as an instructional technology. The purpose of this research was to better understand the utility of a web-based virtual environment as a teaching tool to represent clinical assessment and interventions in the home environment. Specifically, students' learning outcomes related to interprofessional collaboration, patient-centered decision-making, and appreciation of the environmental and social context of functional mobility and occupational performance will be described through descriptive analysis. Thirty-four physical therapist students and 35 occupational therapist students participated in an instructor-guided virtual assessment of a client's function in a home environment utilizing a virtual environment, Second Life®. Teams formulated task-specific, functional client goals and home modification recommendations. Students revisited a solution virtual environment to view and evaluate recommendations in a follow-up instructor-guided tour. Students completed a web-based survey capturing student perception of the experience. Team assignments were analyzed based on a rubric representing learning objectives. Descriptive analysis was conducted on the survey. Assignment analysis revealed contextual and client-centered recommendations. Student surveys revealed that students found the virtual environment supportive of learning. Student surveys and reflection statements were supportive of the interprofessional collaboration. Use of a virtual environment in instruction allows an authentic means of representing interprofessional home assessment. The virtual environment allowed a temporal depiction of home environment issues and solutions providing the unique opportunity for students to evaluate home recommendations.
Allen, Emily; Jackson, Debra; Elliott, Doug
To describe the development of a proposed case study protocol investigating interprofessional relationships in a rapid response system (RRS) in a socioculturally complex clinical environment. Suboptimal care of deteriorating ward patients remains a concern for many acute healthcare organisations. Despite the advent of RRSs, emergency response teams are not always used to their full potential. How and why interprofessional relationships influence practices associated with the care and management of ward patients at risk of clinical deterioration requires investigation. Theoretical and empirical literature describing case study research and RRSs. Review methods An integrative review approach of the literature, focusing on key terms relating to 'case study research' and 'rapid response system', provided context and informed development of the study protocol. A single-site mixed-method instrumental case study protocol was developed using methodological triangulation and a multi-level model to examine interprofessional relationships between a broad range of stakeholders. Concurrent data collection and analysis will occur using document review of clinical scenarios, non-participant observations and semi-structured interviews. Case study research is an effective method for investigating socioculturally complex clinical environments. A strength of this approach is the flexibility in the choice of methods, which allows the researcher to build the design most suitable for the subjects or phenomena being investigated. Although this flexibility may be considered a potential weakness, rigour can be achieved by application of the strategies described. Findings from this research will provide rich descriptive insights into RRS relationships and healthcare professional practices during day-to-day management of acute ward patients at risk of or experiencing clinical deterioration. Description of this structured case study research approach will also inform other researchers.
Evaluation of interprofessional education: lessons learned through the development and implementation of an interprofessional seminar on team communication for undergraduate health care students in Heidelberg - a project report.
Berger, Sarah; Mahler, Cornelia; Krug, Katja; Szecsenyi, Joachim; Schultz, Jobst-Hendrik
This project report describes the development, "piloting" and evaluation of an interprofessional seminar on team communication bringing together medical students and Interprofessional Health Care B.Sc. students at the Medical Faculty of Heidelberg University, Germany. A five-member interprofessional team collaborated together on this project. Kolb's experiential learning concept formed the theoretical foundation for the seminar, which explored three interprofessional competency areas: team work, communication and values/ethics. Evaluation for the purposes of quality assurance and future curricula development was conducted using two quantitative measures: descriptive analysis of a standardized course evaluation tool (EvaSys) ANOVA analysis of the German translation of the University of the West of England Interprofessional Questionnaire (UWE-IP-D). The key finding from the standardized course evaluation was that the interprofessional seminars were rated more positively [M=2.11 (1 most positive and 5 most negative), SD=1, n=27] than the monoprofessional seminars [M=2.55, SD=0.98, n=90]. The key finding from the UWE-IP-D survey, comparing pre and post scores of the interprofessional (IP) (n=40) and monoprofessional (MP) groups (n=34), was that significant positive changes in mean scores for both groups towards communication, teamwork and interprofessional learning occurred. Lessons learnt included: a) recognising the benefit of being pragmatic when introducing interprofessional education initiatives, which enabled various logistical and attitudinal barriers to be overcome; b) quantitative evaluation of learning outcomes alone could not explain positive responses or potential influences of interprofessional aspects, which highlighted the need for a mixed methods approach, including qualitative methods, to enrich judgment formation on interprofessional educational outcomes.
Little, Meg M; St Hill, Catherine A; Ware, Kenric B; Swanoski, Michael T; Chapman, Scott A; Lutfiyya, M Nawal; Cerra, Frank B
The National Institute of Health's concept of team science is a means of addressing complex clinical problems by applying conceptual and methodological approaches from multiple disciplines and health professions. The ultimate goal is the improved quality of care of patients with an emphasis on better population health outcomes. Collaborative research practice occurs when researchers from >1 health-related profession engage in scientific inquiry to jointly create and disseminate new knowledge to clinical and research health professionals in order to provide the highest quality of patient care to improve population health outcomes. Training of clinicians and researchers is necessary to produce clinically relevant evidence upon which to base patient care for disease management and empirically guided team-based patient care. In this study, we hypothesized that team science is an example of effective and impactful interprofessional collaborative research practice. To assess this hypothesis, we examined the contemporary literature on the science of team science (SciTS) produced in the past 10 years (2005–2015) and related the SciTS to the overall field of interprofessional collaborative practice, of which collaborative research practice is a subset. A modified preferred reporting items for systematic reviews and meta-analyses (PRISMA) approach was employed to analyze the SciTS literature in light of the general question: Is team science an example of interprofessional collaborative research practice? After completing a systematic review of the SciTS literature, the posed hypothesis was accepted, concluding that team science is a dimension of interprofessional collaborative practice. PMID:27619555
Little, Meg M; St Hill, Catherine A; Ware, Kenric B; Swanoski, Michael T; Chapman, Scott A; Lutfiyya, M Nawal; Cerra, Frank B
The National Institute of Health's concept of team science is a means of addressing complex clinical problems by applying conceptual and methodological approaches from multiple disciplines and health professions. The ultimate goal is the improved quality of care of patients with an emphasis on better population health outcomes. Collaborative research practice occurs when researchers from >1 health-related profession engage in scientific inquiry to jointly create and disseminate new knowledge to clinical and research health professionals in order to provide the highest quality of patient care to improve population health outcomes. Training of clinicians and researchers is necessary to produce clinically relevant evidence upon which to base patient care for disease management and empirically guided team-based patient care. In this study, we hypothesized that team science is an example of effective and impactful interprofessional collaborative research practice. To assess this hypothesis, we examined the contemporary literature on the science of team science (SciTS) produced in the past 10 years (2005-2015) and related the SciTS to the overall field of interprofessional collaborative practice, of which collaborative research practice is a subset. A modified preferred reporting items for systematic reviews and meta-analyses (PRISMA) approach was employed to analyze the SciTS literature in light of the general question: Is team science an example of interprofessional collaborative research practice? After completing a systematic review of the SciTS literature, the posed hypothesis was accepted, concluding that team science is a dimension of interprofessional collaborative practice. Copyright © 2016 American Federation for Medical Research.
Karsten, Kathleen; McMillan Coddington, Deborah; Lehman, Regina M.; Pierce, Cynthia; Tom, May; Gallo-Silver, Les
Each member of the healthcare team has been trained with specific knowledge and skills. Quality patient care is dependent on the collaboration of the various healthcare professionals and their ability to work as a team. In order to be effective, interprofessional collaboration should be included in the academic preparation of each of the various…
Ramon Daniëls; Trudy van der Weijden; Wencke Emonts; Anna Beurskens; Marloes Amantia van Bokhoven; Jerôme Jean Jacques van Dongen
Background: The number of people suffering from one or more chronic conditions is rising, resulting in an increase in patients with complex health care demands. Interprofessional collaboration and the use of shared care plans support the management of complex health care demands of patients with
The historical transition of modern medicine from an autonomous profession to a team-based interprofessional practice can be described in terms of space rather than time, with "place" as the unit of analysis. Imagining modern medicine spatially was instigated by Foucault, who described medical dominance as a territorializing of both individual body spaces and public spaces--the former through the diagnostic medical gaze, the latter in a gaze of health surveillance. However, much has happened since Foucault's (1963) analysis. The diagnostic gaze has been dispersed to develop a collaborative gaze including patients and healthcare professionals; political interests have appropriated the public health gaze; and the medical profession is subject to democratic processes of accountability. Medicine has lost its territorial imperative as new "liquid" and "nomadic" work practices emerge, making space for interprofessional care. Such dislocation of medical dominance and its multiple relocations are poorly theorised. Deleuze and Guattari distinguish between "striated" and "smooth" spaces. Striated space is associated with hierarchies and boundaries, where smooth space includes boundary crossing and democratic collaboration. Smooth or liminal spaces in hospitals, such as corridors, can paradoxically act as catalysts for collaboration or assembly democracy, affording opportunities for improvised interprofessional encounters. Such encounters can act as an antidote to planned protocols or imperatives for interprofessional collaboration.
Students' experiences of inter-professional education through International Classification of Functioning-based activities at a community-based rehabilitation centre. ... To ultimately strengthen the health system, training has to respond to new health challenges, health science developments and societal needs. The Bishop ...
Tivener, Kristin Ann; Gloe, Donna Sue
Context: While multidisciplinary team approaches to education and practice have been promoted for decades, literature on collaborative efforts in athletic training and nursing remains sparse. Objective: The goal of this article is to provide an example of an interprofessional teaching collaboration in which a simulation scenario was developed…
San Martin-Rodriguez, Leticia; D'Amour, Danielle; Leduc, Nicole
This study aims to evaluate the effect of the intensity of interprofessional collaboration on hospitalized cancer patients. We conducted a cross-sectional study of 312 patients to examine the effects of intensity of interprofessional collaboration (low vs high intensity collaboration) on patient satisfaction, uncertainty, pain management, and length of stay. Data on the intensity of interprofessional collaboration, patient satisfaction, and uncertainty were collected from professionals and patients using valid and reliable instruments. Administrative and clinical records were used to calculate the index of pain management and length of hospital stay. The analysis revealed the existence of significant differences between patients who are cared for by teams operating with a high intensity of collaboration and those who are cared for by teams operating with a low intensity of collaboration, as measured by the mean satisfaction (P management (P = .047). The analysis also found no significant difference (P = .217) in their length of hospital stay. The findings suggest that intensity of interprofessional collaboration has a positive effect on patient satisfaction, reduces uncertainty, and improves pain management, yet they also suggest that the degree of collaboration does not influence the length of hospital stay.
This paper discusses 10 key elements for the design and implementation of interprofessional education (IPE) in a skills centre. The elements are based on published literature as well as on the experience of an IPE initiative, simulating the management of a multiple-traumatised patient in the acute and rehabilitation phases, ...
Estrada, Amara H; Behar-Horenstein, Linda; Estrada, Daniel J; Black, Erik; Kwiatkowski, Alison; Bzoch, Annie; Blue, Amy
Inter-professional education (IPE) is identified as an important component of health profession training and is listed in the accreditation requirements for many fields, including veterinary medicine. The goals of IPE are to develop inter-professional skills and to improve patient-oriented care and community health outcomes. To meet these goals, IPE relies on enhanced teamwork, a high level of communication, mutual planning, collective decision making, and shared responsibilities. One Health initiatives have also become integral parts of core competencies for veterinary curricular development. While the overall objectives of an IPE program are similar to those of a One Health initiative, they are not identical. There are unique differences in expectations and outcomes for an IPE program. The purpose of this study was to explore veterinary medical students' perceptions of their interprofessional experiences following participation in a required IPE course that brought together beginning health profession students from the colleges of medicine, dentistry, nursing, pharmacy, nutrition, public health and health professions, and veterinary medicine. Using qualitative research methods, we found that there is powerful experiential learning that occurs for both the veterinary students and the other health profession students when they work together at the beginning of their curriculum as an inter-professional team.
Guyton, Brad; LeBeau, Jan; Sorci, Rebecca; Doneen, Amy
An innovative interprofessional model is described for the delivery of dental care in the year 2026 to optimize efficiency and profitability while enhancing quality of care. The dental practice of tomorrow may look different than today. Although not broken, the current system can be improved in efficiency and effectiveness. Although traditional private practices will continue to exist and many will thrive over the next decades, they may not present the optimal model for dental practice. To manage complex patient needs, a more collaborative model of multidisciplinary, interprofessional clinical teams capable of treating patients comprehensively has been suggested by the authors. They explore an alternative model of practice that may be possible in the next 10 years to better serve patients and improve outcomes while honoring the role of practitioners. Landmark publications and reviews are used to examine evidence showing the potential benefits of an innovative interprofessional approach to the delivery of care in the oral health care setting. By examining key studies, the authors provide commentary on the potential for enhanced efficiency, profitability, and quality of care in the oral health care setting through a collaborative model of multidisciplinary, interprofessional clinical teams capable of treating patients comprehensively. Copyright © 2016 Elsevier Inc. All rights reserved.
Zucchero, Reneé A.
Healthcare providers, including psychologists who work as health service providers and with older adults, must be able to work effectively with professionals from other disciplines. Interprofessional education (IPE) engages students from two or more professions to learn collaboratively. To date, only a few studies have examined psychology student…
Lessard, Sylvie; Bareil, Céline; Lalonde, Lyne; Duhamel, Fabie; Hudon, Eveline; Goudreau, Johanne; Lévesque, Lise
Facilitation is a powerful approach to support practice change. The purpose of this study is to better understand the facilitation roles exercised by both external facilitators and interprofessional facilitation teams to foster the implementation of change. Building on Dogherty et al.'s taxonomy of facilitation activities, this study uses an organizational development lens to identify and analyze facilitation roles. It includes a concise definition of what interprofessional facilitation teams actually do, thus expanding our limited knowledge of teams that act as change agents. We also investigate the facilitation dynamics between change actors. We carried out a qualitative analysis of a 1-year process of practice change implementation. We studied four family medicine groups, in which we constituted interprofessional facilitation teams. Each team was supported by one external facilitator and included at least one family physician, one case manager nurse, and health professionals located on or off the family medicine group's site (one pharmacist, plus at least one nutritionist, kinesiologist, or psychologist). We collected our data through focus group interviews with the four teams, individual interviews with the two external facilitators, and case audit documentation. We analyzed both predetermined (as per Dogherty et al., 2012) and emerging facilitation roles, as well as facilitation dynamics. A non-linear framework of facilitation roles emerged from our data, based on four fields of expertise: change management, project management, meeting management, and group/interpersonal dynamics. We identified 72 facilitation roles, grouped into two categories: "implementation-oriented" and "support-oriented." Each category was subdivided into themes (n = 6; n = 5) for clearer understanding (e.g., legitimation of change/project, management of effective meetings). Finally, an examination of facilitation dynamics revealed eight relational ties occurring within and/or between
Full Text Available Mubashir Arain,1 Esther Suter,1 Sara Mallinson,1 Shelanne L Hepp,1 Siegrid Deutschlander,1 Shyama Dilani Nanayakkara,2 Elizabeth Louise Harrison,3 Grace Mickelson,4 Lesley Bainbridge,5 Ruby E Grymonpre2 1Workforce Research & Evaluation, Alberta Health Services, Edmonton, AB, 2College of Pharmacy, University of Manitoba, Winnipeg, MB, 3School of Physical Therapy, College of Medicine, University of Saskatchewan, Saskatoon, SK, 4Provincial Health Services Authority, Vancouver, BC, 5Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada Objective: The objective of this environmental scan was to identify Western Canadian interprofessional education (IPE resources that currently exist for internationally educated health professionals (IEHPs. Methodology: A web-based search was conducted to identify learning resources meeting defined inclusion criteria with a particular focus on the resources available in the Western Canadian provinces. Information was extracted using a standardized template, and we contacted IEHP programs for additional information if necessary. Members of the research team reviewed preliminary findings, identified missing information from their respective provinces, and contacted organizations to fill in any gaps. Results: The scan identified 26 learning resources for IEHPs in Western Canadian provinces and 15 in other provinces focused on support for IEHPs to meet their profession-specific licensing requirements and to acquire knowledge and competencies relevant to working in the Canadian health care system. Most learning resources, such as those found in bridging programs for IEHPs, included an orientation to the Canadian health care system, components of cultural competence, and at least one aspect of interprofessional competence (eg, communication skills. None of the 41 learning resources provided comprehensive training for IEHPs to cover the six interprofessional competency
Meleis, Afaf I
Effective, quality care to achieve the newly developed sustainable development goals requires the development of collaborative teams and is predicated on implementing transformative interprofessional education and on team members who are equally empowered. This is a report on The Lancet commission on transformative education for health professionals and the National Academy of Medicine's dialogues on developing and implementing innovations to enhance collaborations and to facilitate the effectiveness of healthcare teams. Using postcolonial feminist theory for critical analysis and integrations of findings from both reports, as well as for identification of barriers to achieving equity in team functioning. The global Lancet commission and the National Academy of Medicine/Institute of Medicine forum developed frameworks that could be used to educate the next generation of professionals based on identifying the local needs of communities within a global context. Recommendations included breaking down silos that exists between schools and using an equity and justice framework in developing educational programs; utilizing contemporary innovations in teaching that correspond with innovations in healthcare systems; and insuring investments in time, energy, and resources in interprofessional education. However, without addressing the silos created through professional identities and power differentials, goals of interprofessional education and collaborative practice may not be achieved. While a great deal has been written about interprofessional education, it is imperative for faculty in the different professional schools and for members of healthcare teams to engage in dialogues that address the fundamental and most obstinate barriers to forming equitable teams, which is the consistent narrative of medical privilege and centrism. The dialogues about medical privilege and physician centrism in education and health care could drive the development of programmatic approaches
King, Gillian; Orchard, Carole; Khalili, Hossein; Avery, Lisa
Measures of interprofessional (IP) socialization are needed to capture the role of interprofessional education in preparing students and health practitioners to function as part of IP health care teams. The aims of this study were to refine a previously published version of the Interprofessional Socialization and Valuing Scale (the ISVS-24) and create two shorter equivalent forms to be used in pre-post studies. A graded response model was used to identify ISVS items in a practitioner data set (n = 345), with validation (measure invariance) conducted using a separate student sample (n = 341). Analyses indicated a unidimensional 21-item version with excellent measurement properties, Cronbach alpha of 0.988, 95% confidence interval (CI) 0.985-0.991. There was evidence of measure invariance, as there was excellent agreement of the factor scores for the practitioner and student data, intraclass correlation coefficient = 0.993, 95% CI 0.991-0.994. This indicates that the ISVS-21 measures IP socialization consistently across groups. Two 9-item equivalent versions for pre-post use were developed, with excellent agreement between the two forms. The student score agreement for the two item sets was excellent: intraclass correlation coefficient = 0.970, 95% CI 0.963-0.976. The ISVS-21 is a refined measure to assess existing levels of IP socialization in practitioners and students, and relate IP socialization to other important constructs such as IP collaboration and the development of an IP identity. The equivalent versions can be used to assess change in IP socialization as a result of interprofessional education.
Egenberg, Signe; Øian, Pål; Eggebø, Torbjørn Moe; Arsenovic, Mirjana Grujic; Bru, Lars Edvin
To examine whether interprofessional simulation training on management of postpartum haemorrhage enhances self-efficacy and collective efficacy and reduces the blood transfusion rate after birth. Postpartum haemorrhage is a leading cause of maternal morbidity and mortality worldwide, although it is preventable in most cases. Interprofessional simulation training might help improve the competence of health professionals dealing with postpartum haemorrhage, and more information is needed to determine its potential. Multimethod, quasi-experimental, pre-post intervention design. Interprofessional simulation training on postpartum haemorrhage was implemented for midwives, obstetricians and auxiliary nurses in a university hospital. Training included realistic scenarios and debriefing, and a measurement scale for perceived postpartum haemorrhage-specific self-efficacy, and collective efficacy was developed and implemented. Red blood cell transfusion was used as the dependent variable for improved patient outcome pre-post intervention. Self-efficacy and collective efficacy levels were significantly increased after training. The overall red blood cell transfusion rate did not change, but there was a significant reduction in the use of ≥5 units of blood products related to severe bleeding after birth. The study contributes to new knowledge on how simulation training through mastery and vicarious experiences, verbal persuasion and psychophysiological state might enhance postpartum haemorrhage-specific self-efficacy and collective efficacy levels and thereby predict team performance. The significant reduction in severe postpartum haemorrhage after training, indicated by reduction in ≥5 units of blood transfusions, corresponds well with the improvement in collective efficacy, and might reflect the emphasis on collective efforts to counteract severe cases of postpartum haemorrhage. Interprofessional simulation training in teams may contribute to enhanced prevention and
Full Text Available Background: In the recent decades, Inter-Professional Team Objective Structured Clinical Examination (ITOSCE has been considered as an efficient tool in evaluating the teamwork and the Inter-professional competences. The aim of this study was to review the literature related ITOSCE as educational tool. Method: This narrative review study was conducted in 2015. Relevant literature was found by searching the databases such as: PubMed, Medline, CINAHL, Google Scholar, Science Direct, EBSCO, ProQuest. Title searching was performed in full English texts without time limitation using keywords including; Team, Inter professional Team, Group, Inter-disciplinary, Objective Structured Clinical Examination (TOSCE, ITOSCE, GOSCE. Results: 19 studies met the inclusion criteria and were included in the analyses. In 13 studies, ITOSCE was used as an assessment tool, and in 6 studies as a learning tool. ITOSCE had been used in several fields such as: obstetrics, gynecology, emergency, palliative care with participating of a variety of disciplines, including: medicine, pharmacy, several trends of nursing, physiotherapy, occupational therapy and Social working. Conclusion: Eventually, it can be noted that ITOSCE plays significant role as an educational and evaluation tool to improve inter-professional teamwork competences among the students. Further studies are needed to develop to examine the psychometric criteria of ITOSCE.
Pettignano, Robert; Bliss, Lisa; McLaren, Susan; Caley, Sylvia
Screening tools exist to help identify patient issues related to social determinants of health (SDH), but solutions to many of these problems remain elusive to health care providers as they require legal solutions. Interprofessional medical-legal education is essential to optimizing health care delivery. In 2011, the authors implemented a four-session didactic interprofessional curriculum on medical-legal practice for third-year medical students at Morehouse School of Medicine. This program, also attended by law students, focused on interprofessional collaboration to address client/patient SDH issues and health-harming legal needs. In 2011-2014, the medical students participated in pre- and postintervention surveys designed to determine their awareness of SDH's impact on health as well as their attitudes toward screening for SDH issues and incorporating resources, including a legal resource, to address them. Mean ratings were compared between pre- and postintervention respondent cohorts using independent-sample t tests. Of the 222 medical students who participated in the program, 102 (46%) completed the preintervention survey and 100 (45%) completed the postintervention survey. Postintervention survey results indicated that students self-reported an increased likelihood to screen patients for SDH issues and an increased likelihood to refer patients to a legal resource (P education into undergraduate medical education may result in an increased likelihood to screen patients for SDH and to refer patients with legal needs to a legal resource. In the future, an additional evaluation to assess the curriculum's long-term impact will be administered prior to graduation.
Derbyshire, Julie A; Machin, Alison I; Crozier, Suzanne
The provision of inter professional learning (IPL) within undergraduate programmes is now well established within many Higher Education Institutions (HEIs). IPL aims to better equip nurses and other health professionals with effective collaborative working skills and knowledge to improve the quality of patient care. Although there is still ambiguity in relation to the optimum timing and method for delivering IPL, effective facilitation is seen as essential. This paper reports on a grounded theory study of university educators' perceptions of the knowledge and skills needed for their role adequacy as IPL facilitators. Data was collected using semi structured interviews with nine participants who were theoretically sampled from a range of professional backgrounds, with varied experiences of education and involvement in facilitating IPL. Constant comparative analysis was used to generate four data categories: creating and sustaining an IPL group culture through transformational IPL leadership (core category), readiness for IPL facilitation, drawing on past interprofessional learning and working experiences and role modelling an interprofessional approach. The grounded theory generated from this study, although propositional, suggests that role adequacy for IPL facilitation is dependent on facilitator engagement in a process of 'transformational interprofessional learning leadership' to create and sustain a group culture. Copyright © 2014 Elsevier Ltd. All rights reserved.
Joynes, Viktoria C T
This paper is concerned with exploring the relationship between perceptions of professional identities, interprofessional education (IPE) and collaborative practice. It seeks to introduce the concept of interprofessional responsibility as both a shift in the way in which to conceptualise the professional identity of Health and Social Care (H&SC) staff and as a new set of practices that help to inform the way in which students are prepared for collaborative working. The presented research, undertaken as part of a Ph.D. study, is based upon semi-structured interviews (n = 33) with H&SC staff who were recruited from both the United Kingdom (UK) Health Service and UK universities. Drawing upon thematic analysis of the data, the results of the research identified that previous conceptualisations of professional identity aligned to a whole profession do not relate to the way in which professionals perceive their identities. Senior professionals claimed to be more comfortable with their own professional identity, and with working across professional boundaries, than junior colleagues. Academic staff also identified that much IPE currently taught in universities serves the purpose of box-ticking rather than being delivered in meaningful way. It is proposed that the findings have implications for the way in which IPE is currently taught, and that adoption of the proposed concept of 'interprofessional responsibility' may help address some of the concerns these findings raise.
Chan, Engle Angela; Lam, Winsome; Lam Yeung, Syrine Kit-Sum
Being a professional in today's health care system carries with it an expectation of becoming interprofessional. This study was designed to explore the perceived development of the participants' interprofessional competence through interprofessional seminars and collaborative community practice. Data were collected from social work and nursing undergraduates through two interprofessional seminar discussions, followed by focus group interviews after the completion of 2 weeks of practice experience. Study findings included: (a) role clarification and enhancement, (b) evolving role emphasis, (c) understanding the importance of and various communications in teamwork, and (d) being more responsive to the meaning of teamwork and the understanding of collaborative interdependence. Through interprofessional collaborative practice, students developed an insight into teamwork, where they witnessed the merits of collaboration and gained an understanding of each other's lack of holistic approach. In addition, not only the particular practice settings but also the role variations involved revealed various dimensions of interprofessional learning. Copyright 2013, SLACK Incorporated.
Long, Theodore; Dann, Sarah; Wolff, Marissa Lynn; Brienza, Rebecca S
As the United States faces an impending shortage in the primary care workforce, interprofessional teamwork training to improve clinic efficiency and health outcomes is becoming increasingly important. Currently there is limited integration of interprofessional training in educational models for health professionals. The implementation of Patient Aligned Care Teams at the Department of Veterans Affairs (VA) has provided an opportunity for interprofessional collaboration among trainee and faculty providers within the VA system. However, integration of interprofessional education is also necessary to train future providers in order to provide effective team-based care. We describe a transportable educational model for health professional collaboration from our experience as a VA Center of Excellence in Primary Care Education, including a complementary novel one-year post-Master's adult nurse practitioner interprofessional clinical fellowship. With growing recognition that interprofessional care can improve efficiency and outcomes, there is an increasing need for programs that train future providers in collaboration and team-based care.
Pahor, Majda; Rasmussen, Birgit H
Research shows slow improvement of the care of dying persons and their significant others. One of the reasons for that is the lack of palliative care education as an integral part of health professionals' undergraduate education. The paper discusses an attempt to develop innovative forms of palliative care education: an international, interprofessional and IT-supported undergraduate course for Swedish and Slovenian students of nursing, medicine, occupational therapy, physiotherapy, psychology and social work, which has been developed jointly by the two authors. One of the aims of the course has been to address differences in professional and national cultures relevant to quality in palliative care. The development and pilot implementation phases of the course were analysed qualitatively, using evaluation materials from students and teachers and from an external evaluation study. The results show that the interprofessional approach in the course enabled students to get to know other professions, as well as enabling them to work together as a team and resolve conflicts. Cultural differences between Sweden and Slovenia were not very pronounced, yet they came to the fore regarding teamwork and relationships between professions, as well as in respect of the "right thing" to do in relation to patient' problems.
Martinussen, Monica; Adolfsen, Frode; Lauritzen, Camilla; Richardsen, Astrid Marie
The main purpose of this study was, firstly, to evaluate the effect of an intervention aimed at improving interprofessional collaboration and service quality, and secondly, to examine if collaboration could predict burnout, engagement and service quality among human service professionals working with children and adolescents. The intervention included the establishment of local interprofessional teams and offering courses. The sample was recruited from six different small municipalities in Northern Norway (N = 93) and a comparison group from four similar municipalities (N = 58). Participation in the project increased the level of collaboration in the intervention group significantly (Hedges' g = 0.36), but not the perceived level of service quality. Hierarchical regression analyses were used to test a model for predicting burnout, engagement and perceived service quality using work-related factors, including collaboration as predictors. Both burnout and engagement were predicted by job demands and resources after controlling for demographic variables and participation in the project. Service quality was mostly predicted by collaboration. Increasing collaboration seems possible by introducing practice-based changes; however, this intervention did not have the desired effect on perceived service quality.
Price, Sheri; McGillis Hall, Linda; Angus, Jan; Peter, Elizabeth
Health human resource and workforce planning is a global priority. Given the critical nursing shortage, and the fact that nurses are the largest group of healthcare providers, health workforce planning must focus on strategies to enhance both recruitment and retention of nurses. Understanding early socialization to career choice can provide insight into professional perceptions and expectations that have implications for recruitment, retention and interprofessional collaboration. This interpretive narrative inquiry utilized Polkinghorne's theory of narrative emplotment to understand the career choice experiences of 12 millennial nurses (born between 1980 and 2000) in Eastern Canada. Participants were interviewed twice, face-to-face, 4 to 6 weeks apart prior to commencing their nursing program. The narratives present career choice as a complex consideration of social positioning. The findings provide insight into how nursing is perceived to be positioned in relation to medicine and how the participants struggled to locate themselves within this social hierarchy. Implications of this research highlight the need to ensure that recruitment messaging and organizational policies promote interprofessional collaboration from the onset of choosing a career in the health professions. Early professional socialization strategies during recruitment and education can enhance future collaboration between the health professions.
Uden-Holman, Tanya M; Curry, Susan J; Benz, Loretta; Aquilino, Mary Lober
Although interprofessional education (IPE) has existed in various formats for several decades, the need for IPE recently has taken on renewed interest and momentum. Public health has a critical role to play in furthering IPE, yet schools of public health are often underrepresented in IPE initiatives. The University of Iowa College of Public Health is serving as a catalyst for IPE activities on our health sciences campus, which includes colleges of dentistry, medicine, nursing, pharmacy, and public health. IPE-related activities have included campus visit by IPE leaders, administration of the Survey of Critical Elements for Implementing IPE, administration of the Interprofessional Learning Opportunities Inventory survey, the development of a comprehensive strategic plan, and the pilot of an IPE course for all first-year prelicensure students and Master of Health Administration students. Although more work is needed to more fully integrate IPE into the curriculum, success to date of the University of Iowa IPE initiative demonstrates that public health can play a critical role as a convener and catalyst for IPE curricular innovations on a health sciences campus.
Full Text Available The terminology which has been used up until now within interprofessional healthcare has been characterised by a certain definitional weakness, which, among other factors, has been caused by an uncritical adoption of language conventions and a lack of theoretical reflection. However, as terminological clarity plays a significant role in the development and profiling of a discipline, the clarification and definition of commonly-used terminology has manifested itself as a considerable objective for the interprofessional research community. One of the most important journals for research in the area of interprofessional education and care, the Journal of Interprofessional Care, has expanded its author guidelines relating to terminology, modeled after the conceptual considerations of the research group around Barr et. al and Reeves et al. A German translation of the suggested terms therein has been presented in this contribution, and discussed in light of the challenges to a possible adaptation for the German-speaking world. The objective is to assist communication in practice and research in becoming clearer, while promoting an increasing awareness to and the transparency of determined definitions and terminologies.
Mitzkat, Anika; Berger, Sarah; Reeves, Scott; Mahler, Cornelia
The terminology which has been used up until now within interprofessional healthcare has been characterised by a certain definitional weakness, which, among other factors, has been caused by an uncritical adoption of language conventions and a lack of theoretical reflection. However, as terminological clarity plays a significant role in the development and profiling of a discipline, the clarification and definition of commonly-used terminology has manifested itself as a considerable objective for the interprofessional research community. One of the most important journals for research in the area of interprofessional education and care, the Journal of Interprofessional Care, has expanded its author guidelines relating to terminology, modeled after the conceptual considerations of the research group around Barr et. al and Reeves et al. A German translation of the suggested terms therein has been presented in this contribution, and discussed in light of the challenges to a possible adaptation for the German-speaking world. The objective is to assist communication in practice and research in becoming clearer, while promoting an increasing awareness to and the transparency of determined definitions and terminologies.
Zook, Sharon Strang; Hulton, Linda J; Dudding, Carol C; Stewart, Anne L; Graham, Amy C
Fragmentation of health care negatively impacts quality; one of the contributing factors may be ineffective collaboration among health care professionals. This article describes the implementation of an interprofessional education curriculum for graduate students enrolled in nursing, psychology, and speech-language pathology programs. Over 3 semesters, students engaged in interprofessional collaboration modules, unfolding case studies, virtual simulation, and shared case planning experiences. The curriculum's impact on students' attitudes and values toward interprofessional collaborative practice was measured.
Kunz, Aline; Pohlmann, Sabrina; Heinze, Oliver; Brandner, Antje; Reiß, Christina; Kamradt, Martina; Szecsenyi, Joachim; Ose, Dominik
The importance of information and communication technology for healthcare is steadily growing. Newly developed tools are addressing different user groups: physicians, other health care professionals, social workers, patients, and family members. Since often many different actors with different expertise and perspectives are involved in the development process it can be a challenge to integrate the user-reported requirements of those heterogeneous user groups. Nevertheless, the understanding and consideration of user requirements is the prerequisite of building a feasible technical solution. In the course of the presented project it proved to be difficult to gain clear action steps and priorities for the development process out of the primary requirements compilation. Even if a regular exchange between involved teams took place there was a lack of a common language. The objective of this paper is to show how the already existing requirements catalog was subdivided into specific, prioritized, and coherent working packages and the cooperation of multiple interprofessional teams within one development project was reorganized at the same time. In the case presented, the manner of cooperation was reorganized and a new instrument called an Action Sheet was implemented. This paper introduces the newly developed methodology which was meant to smooth the development of a user-centered software product and to restructure interprofessional cooperation. There were 10 focus groups in which views of patients with colorectal cancer, physicians, and other health care professionals were collected in order to create a requirements catalog for developing a personal electronic health record. Data were audio- and videotaped, transcribed verbatim, and thematically analyzed. Afterwards, the requirements catalog was reorganized in the form of Action Sheets which supported the interprofessional cooperation referring to the development process of a personal electronic health record for the
Giles, Eileen M; Parange, Nayana; Knight, Bronwyn
The literature surrounding interprofessional education claims that students who learn with, from, and about one another in well-designed interprofessional programs will practice together collaboratively upon graduation, given the skills to do so. The objective of this study was to examine attitudes to interprofessional practice before and after an interprofessional learning (IPL) activity. A total of 35 postgraduate medical imaging students attended a week-long mammography workshop. The sessions provided a range of didactic sessions related to diagnosis and management of breast cancer. An IPL session was incorporated on completion of the workshop to consolidate learning. Props and authentic resources were used to increase the fidelity of the simulation. Participants completed pre- and post-workshop questionnaires comprising an interprofessional education and collaboration scale and a quiz to gauge knowledge of specific content related to professional roles. Responses to each statement in the scale and quiz score, pre or post workshop, were compared, whereas responses to open-ended questions in post-workshop survey were thematically analyzed. Seventeen paired surveys were received. There was a significant total improvement of 10.66% (P = .036). After simulation, there was a statistically significant improvement in participants' understanding (P < .05) that IPL offers holistic care to the patient and that teamwork is useful for reducing errors in patient care. Simulation helped participants develop more awareness of their role within the profession, improve their understanding of other professionals, and gain more realistic expectations of team members. This pilot study confirmed learning within an IPL simulation improved attitudes toward shared learning, teamwork, and communication. Simulation provides opportunities for learning in a safe environment, and technology can be used in diverse ways to provide authentic learning. Copyright © 2017 The Association
Stilos, Kalli; Daines, Patricia; Moore, Jennifer
Interprofessional education in health care and in palliative care has been the focus of increasing attention in recent years. For health professionals to provide and deliver high-quality palliative care, collaboration and teamwork is required. Palliative care is the ideal service to introduce interprofessional teamwork to medical learners early on in their training. During a 1-month palliative care rotation in Ontario, Canada, medical learners completed a questionnaire seeking their feedback on the interprofessional team model. This article will highlight the results of the questionnaire, how the team promotes a culture of interprofessional collaborative practice, and the supportive structures that foster collaboration among professionals.
Brandt, Barbara F.
Using adult learning principles, health professions educators are well positioned to create interprofessional learning systems for collaborative, team-based practice in the transforming health-care system.
Full Text Available The aim of this study was to describe and interpret interprofessional collaboration between healthcare professionals (HCPs working at the district psychiatric centre (DPC and employed in community mental health care (CMHC using a dialogue-oriented co-operative approach. Data were collected by means of multistage focus groups and qualitative content analysis was performed. The main theme “development of interprofessional collaboration by means of organisational strategies and interactional styles” encompassed the following categories: “improved communication skills,” “developing structures for coordination and responsibility” and “ increased professional insight into the values and conditions necessary for decision-making.” In conclusion, more attention should be paid to leadership in terms of coordination and feedback. The HCPs must be acknowledged, understood and strengthened in their work to improve the quality of CMHC. Finally, we recommend that a range of organisational and administrative models of care be used in order to support improvement work.
Andvig, Ellen; Syse, Jonn; Severinsson, Elisabeth
The aim of this study was to describe and interpret interprofessional collaboration between healthcare professionals (HCPs) working at the district psychiatric centre (DPC) and employed in community mental health care (CMHC) using a dialogue-oriented co-operative approach. Data were collected by means of multistage focus groups and qualitative content analysis was performed. The main theme "development of interprofessional collaboration by means of organisational strategies and interactional styles" encompassed the following categories: "improved communication skills," "developing structures for coordination and responsibility" and " increased professional insight into the values and conditions necessary for decision-making." In conclusion, more attention should be paid to leadership in terms of coordination and feedback. The HCPs must be acknowledged, understood and strengthened in their work to improve the quality of CMHC. Finally, we recommend that a range of organisational and administrative models of care be used in order to support improvement work.
Gary, Jodie C; Gosselin, Kevin; Bentley, Regina
The attitudes of faculty towards interprofessional education (IPE) and teamwork impact the education of health professions education (HPE) students. This paper reports on a study evaluating attitudes from health professions educators towards IPE and teamwork at one academic health science center (HSC) where modest IPE initiatives have commenced. Drawing from the results of a previous investigation, this study was conducted to examine current attitudes of the faculty responsible for the training of future healthcare professionals. Survey data were collected to evaluate attitudes from HSC faculty, dentistry, nursing, medicine, pharmacy and public health. In general, positive HSC faculty attitudes towards interprofessional learning, education, and teamwork were significantly predicted by those affiliated with the component of nursing. Faculty development aimed at changing attitudes and increasing understanding of IPE and teamwork are critical. Results of this study serve as an underpinning to leverage strengths and evaluate weakness in initiating IPE.
Levesque, Jean-Frederic; Harris, Mark F; Scott, Cathie; Crabtree, Benjamin; Miller, William; Halma, Lisa M; Hogg, William E; Weenink, Jan-Willem; Advocat, Jenny R; Gunn, Jane; Russell, Grant
Inter-professional teamwork in primary care settings offers potential benefits for responding to the increasing complexity of patients' needs. While it is a central element in many reforms to primary care delivery, implementing inter-professional teamwork has proven to be more challenging than anticipated. The objective of this study was to better understand the dimensions and intensity of teamwork and the developmental process involved in creating fully integrated teams. Secondary analyses of qualitative and quantitative data from completed studies conducted in Australia, Canada and USA. Case studies and matrices were used, along with face-to-face group retreats, using a Collaborative Reflexive Deliberative Approach. Four dimensions of teamwork were identified. The structural dimension relates to human resources and mechanisms implemented to create the foundations for teamwork. The operational dimension relates to the activities and programs conducted as part of the team's production of services. The relational dimension relates to the relationships and interactions occurring in the team. Finally, the functional dimension relates to definitions of roles and responsibilities aimed at coordinating the team's activities as well as to the shared vision, objectives and developmental activities aimed at ensuring the long-term cohesion of the team. There was a high degree of variation in the way the dimensions were addressed by reforms across the national contexts. The framework enables a clearer understanding of the incremental and iterative aspects that relate to higher achievement of teamwork. Future reforms of primary care need to address higher-level dimensions of teamwork to achieve its expected outcomes. © The Author 2017. Published by Oxford University Press.
Anders, Patrick L; Scherer, Yvonne Krall; Hatton, Michael; Antonson, Donald; Austin-Ketch, Tammy; Campbell-Heider, Nancy
The aims of this study were to develop, implement, and evaluate a novel interprofessional standardized patient exercise (ISPE) with oral-systemic and interprofessional collaborative practice (IPCP) components. Dental students and doctor of nursing practice (DNP) students at one U.S. university participated in the simulation, which was primarily designed to test their teamwork skills. In spring 2014, DNP students worked in the dental clinics with dental students under the supervision of nursing and dental faculty members. To test the teamwork outcomes for both groups of students, a standardized patient (SP) scenario was designed to include multiple chronic medical diagnoses and an oral-systemic component. The exercise was filmed for later review. Outcomes measures included SP and student self-evaluations and faculty evaluation of student documentation. The primary outcome of interest from a dental standpoint was faculty evaluation of IPCP competencies derived from the Core Competencies of Interprofessional Collaborative Practice and were deemed to be observable by faculty when viewing the videotaped scenario. Eight teams of students participated with an SP trained in the scenario. Each team consisted of a DNP student, a fourth-year dental student, and a second-year dental student. All eligible students in the DNP class (n=20) and eight students from each dental class (approximately 110 each) participated. The results showed that the teams scored highest on the role/responsibilities subscale, indicating students were respectful of each other's roles and expertise and effectively engaged each other to develop strategies to meet the patient's needs. Scores on the three other subscales (values/ethics, interprofessional communication, and teams/teamwork) were also high. These findings appeared to support IPCP as a method to foster knowledge and respect for other roles and responsibilities, improve appreciation of teamwork, and encourage better communication among health
Zarezadeh, Yadolah; Pearson, Pauline; Dickinson, Clair
Both Reflective Practice and Interprofessional Education (IPE) have gained a considerable attention in the past three decades. Although a plethora of literature exists on either topic, few articles address the issue of using reflective techniques to enhance IPE (King &Ross, 2003; Ross et al, 2005; Goosey & Barr, 2002; Craddock, O'Halloran, Borthwick, & McPherson, 2006) and fewer provide a model to achieve this. The aim of this article is to propose a simple model for employing reflection in t...
Stone, Teresa; Hua, Susan; Turale, Sue
International and interprofessional collaborations are increasingly becoming a core requirement for health professionals in our globalized world. The aim of this study was to evaluate the effectiveness of the Asia Pacific Alliance of Health Leaders (APAHL) Forum to enhance the development of international perspectives and leadership among students and faculty in the discipline of health. This pilot study used a student-designed questionnaire to evaluate the views of students and faculty members about the effectiveness of APAHL in meeting its goals. Quantitative data from the scaled items on the questionnaire were analyzed by aggregating the data. Qualitative data were analyzed using a qualitative descriptive approach. Study participants comprised of 22 health science (nursing and laboratory science) students and 15 faculty members. Both faculty and students agreed that APAHL was effective in leadership development of students, as well as in advancing internationalization, interprofessional collaboration, and cultural awareness among students. A clear theme among the students was acknowledgement of the importance of communication, in particular being proficient in English. Difficulties in communication were an issue for both students and faculty members. This pilot study has shown the benefits of a student-focused international forum in developing cross-cultural awareness, and will provide the groundwork for evaluating the effectiveness of cross-cultural and interprofessional leadership forums aimed particularly at students of health. Copyright © 2016 Elsevier Ltd. All rights reserved.
West, Courtney; Veronin, Michael; Landry, Karen; Kurz, Terri; Watzak, Bree; Quiram, Barbara; Graham, Lori
Integrating interprofessional education (IPE) activities and curricular components in health professions education has been emphasized recently by the inclusion of accreditation standards across disciplines. The Interprofessional Education Collaborative (IPEC) established IPE competencies in 2009, but evaluating how activities link to competencies has not been investigated in depth. The purpose of this project is to investigate how well two IPE activities align with IPEC competencies. To evaluate how our IPE activities met IPEC competencies, we developed a checklist and an observation instrument. A brief description of each is included as well as the outcomes. We analyzed Disaster Day, a simulation exercise that includes participants from Nursing, Medicine, and Pharmacy, and Interprofessional Healthcare Ethics (IPHCE), a course that introduced medical, nursing, and pharmacy students to ethical issues using didactic sessions and case discussions. While both activities appeared to facilitate the development of IPE competencies, Disaster Day aligned more with IPEC competencies than the IPHCE course and appears to be a more comprehensive way of addressing IPEC competencies. However, offering one IPE activity or curricular element is not sufficient. Having several IPE options available, utilizing the tools we developed to map the IPE curriculum and evaluating competency coverage is recommended.
Paré, Line; Maziade, Jean; Pelletier, Francine; Houle, Nathalie; Iloko-Fundi, Maximilien
A number of agencies that accredit university health sciences programs recently added standards for the acquisition of knowledge and skills with respect to interprofessional collaboration. Within primary care settings there are no practical training programs that allow students from different disciplines to develop competencies in this area. The training program was developed within family medicine units affiliated with Université Laval in Quebec for family medicine residents and trainees from various disciplines to develop competencies in patient-centred, interprofessional collaborative practice in primary care. Based on adult learning theories, the program was divided into 3 phases--preparing family medicine unit professionals, training preceptors, and training the residents and trainees. The program's pedagogic strategies allowed participants to learn with, from, and about one another while preparing them to engage in contemporary primary care practices. A combination of quantitative and qualitative methods was used to evaluate the implementation process and the immediate results of the training program. The training program had a positive effect on both the clinical settings and the students. Preparation of clinical settings is an important issue that must be considered when planning practical interprofessional training.
Ernawati, Desak Ketut; Lee, Ya Ping; Hughes, Jeffery
Interprofessional learning activities, such as workshops allow students to learn from, with and about each other. This study assessed the impact on Indonesian health students' attitudes towards interprofessional education (IPE) from participating in a workshop on medication safety. The students attended a two-day IPE workshop on medication safety. Thirty-five (48.6%) students completed pre-/post-workshop surveys using a modified Readiness for Interprofessional Learning Scale (RIPLS) survey. The post-workshop survey also had a series of open-ended questions. Students' responses to each RIPLS statement pre-/post-workshop were compared, whilst their responses to open-ended questions in post-workshop survey were thematically analysed. Students reported positive attitudinal changes on statements of shared learning and teamwork sub-scale (Wilcoxon p value importance of teamwork and communication skills. This study found that learning with other health students through an IPE workshop improved medical, nursing and pharmacy students' attitudes towards the importance of shared learning, teamwork and communication in healthcare service.
Blue, Amy V; Chesluk, Benjamin J; Conforti, Lisa N; Holmboe, Eric S
The practice of interprofessional education (IPE) is expanding rapidly in the United States and globally. The publication of competencies from the Interprofessional Education Collaborative (IPEC) was a significant step forward to recognize the importance of health professions collaboration and to guide institutions for educational program development. However, there remains substantial difficulty in implementation, as well as considerable variability in assessment of learners' interprofessional collaborative knowledge and skills and evaluation of IPE programs. We conducted a multi-methods project which included 20 key informant interviews, a literature review, and a meeting of an expert panel. Our goals were 1) explore the current field of IPE, 2) identify and disseminate best practices to institutions wishing to implement/augment IPE assessment and evaluation processes, 3) uncover gaps in current IPE assessment and evaluation practices, and 4) recommend next steps for the field. A small and growing literature indicates evidence of the effectiveness of IPE. A diverse collection of methods and tools are used to assess and evaluate IPE learners and programs; these are often used without an explicit program-evaluation framework. For the field to advance and to align with the demands of changing clinical care systems, robust assessment and evaluation methods, standardized use of common tools, and longitudinal assessment from diverse data streams are needed for IPE.
Grace, Sandra; Coutts, Rosanne
Effective interprofessional learning (IPL) in multisectoral collaborations such as those linking health services within communities can provide an authentic experience for students and also appears to be the most effective way to achieve health changes in targeted population groups. The aim of this study was to facilitate the IPL of students at a rural university in a multisectoral health assessment programme and to promote health in players of rural amateur sport. Two rural rugby league teams took part in three pre-season health assessments conducted by general medical practitioners, practice nurses, and nursing, osteopathy, and exercise science students. The Readiness for Interprofessional Learning Scale questionnaire and a series of focus groups were used to evaluate participants' experiences of the programme. Results indicated that students saw the benefits for patients and 93% valued the opportunity to improve interprofessional communication, problem-solving and team skills. Some students felt they needed to learn more about their own professional role before learning about others, and instances of stereotyping were identified. The programme also enabled early detection of potential health risks and referral for medical care, management of musculoskeletal conditions, and health promotion. These health assessments would be readily transferred to other multisectoral sporting settings.
Full Text Available Integrating interprofessional education (IPE activities and curricular components in health professions education has been emphasized recently by the inclusion of accreditation standards across disciplines. The Interprofessional Education Collaborative (IPEC established IPE competencies in 2009, but evaluating how activities link to competencies has not been investigated in depth. The purpose of this project is to investigate how well two IPE activities align with IPEC competencies. To evaluate how our IPE activities met IPEC competencies, we developed a checklist and an observation instrument. A brief description of each is included as well as the outcomes. We analyzed Disaster Day, a simulation exercise that includes participants from Nursing, Medicine, and Pharmacy, and Interprofessional Healthcare Ethics (IPHCE, a course that introduced medical, nursing, and pharmacy students to ethical issues using didactic sessions and case discussions. While both activities appeared to facilitate the development of IPE competencies, Disaster Day aligned more with IPEC competencies than the IPHCE course and appears to be a more comprehensive way of addressing IPEC competencies. However, offering one IPE activity or curricular element is not sufficient. Having several IPE options available, utilizing the tools we developed to map the IPE curriculum and evaluating competency coverage is recommended.
Solomon, Patricia; Risdon, Cathy
The home care setting is ideal for medical students to learn about the importance of interprofessional collaboration in the community. This project examined the impact of a unique program designed to facilitate medical students' knowledge and awareness of the challenges of interprofessional care in the home. In pairs, medical students participated in two community visits with preceptors from different professions. Students completed a structured personal reflection after their first visit. Students and preceptors participated in focus groups or interviews to identify strengths and challenges of the experiences. The structured reflections and the focus group and interview transcripts were analyzed qualitatively. 164 medical students and 36 preceptors participated in 326 visits. There were high ratings of satisfaction from students and preceptors. Students developed unexpected insights into peoples' lives, developed a greater understanding of the patient's perspective and determinants of health, learned about others' scope of practice, and developed an appreciation of the limitations of their own scope of practice. Preceptors had high expectations for student performance and engagement and enjoyed the opportunity to impart their knowledge to future physicians. Although organizationally complex, the program evaluation suggestions that students and preceptors benefit from interprofessional experiences in the home.
Cleveland, Benjamin; Kvan, Thomas
This article explores connections between interprofessional education (IPE) models and the design of learning spaces for undergraduate and graduate education in the anatomical sciences and other professional preparation. The authors argue that for IPE models to be successful and sustained they must be embodied in the environment in which interprofessional learning occurs. To elaborate these arguments, two exemplar tertiary education facilities are discussed: the Charles Perkins Centre at the University of Sydney for science education and research, and Victoria University's Interprofessional Clinic in Wyndham for undergraduate IPE in health care. Backed by well-conceived curriculum and pedagogical models, the architectures of these facilities embody the educational visions, methods, and practices they were designed to support. Subsequently, the article discusses the spatial implications of curriculum and pedagogical change in the teaching of the anatomical sciences and explores how architecture might further the development of IPE models in the field. In conclusion, it is argued that learning spaces should be designed and developed (socially) with the expressed intention of supporting collaborative IPE models in health education settings, including those in the anatomical sciences. © 2015 American Association of Anatomists.
Michael D. Lehrer
Full Text Available Background: The role of peer teachers in interprofessional education has not been extensively studied. This study is designed to determine if peer-teacher-led problem-based seminars can influence medical and pharmacy students’ perceptions of interprofessional education. Methods: Undergraduate medical and pharmacy students participated in one-hour problem-based learning seminars held over the course of 16 weeks. A case–control study design was used to compare perceptions of interprofessional education between students who participated in seminars and students who did not participate in seminars. The validated Interdisciplinary Education Perception Scale (IEPS was used to assess perceptions of interprofessional education and was distributed to medical and pharmacy students at the conclusion of 16 weeks of seminars. A two-tailed t-test was used to determine significance between groups. A survey was also distributed to all students regarding perceived barriers to involvement in interprofessional education training. Results: In total, 97 students responded to IEPS (62 medical, 35 pharmacy. Data showed significantly higher perception of professional cooperation among medical students (p=0.006 and pharmacy students (p=0.02 who attended interprofessional seminars compared to those who did not attend. One hundred and nine students responded to the survey regarding perceived barriers to interprofessional education, with the two most common barriers being: ‘I am not aware of interprofessional education opportunities’ (61.5% and ‘I do not have time to participate’ (52.3%. Conclusion: Based on this data we believe peer-teacher-led problem-based interprofessional seminars can be used to increase medical and pharmacy students’ perceived need for professional cooperation. Currently, major barriers to interprofessional education involvement are awareness and time commitment. Undergraduate health professions education can incorporate student
Lehrer, Michael D; Murray, Samuel; Benzar, Ruth; Stormont, Ryan; Lightfoot, Megan; Hafertepe, Michael; Welch, Gabrielle; Peters, Nicholas; Maio, Anna
The role of peer teachers in interprofessional education has not been extensively studied. This study is designed to determine if peer-teacher-led problem-based seminars can influence medical and pharmacy students' perceptions of interprofessional education. Undergraduate medical and pharmacy students participated in one-hour problem-based learning seminars held over the course of 16 weeks. A case-control study design was used to compare perceptions of interprofessional education between students who participated in seminars and students who did not participate in seminars. The validated Interdisciplinary Education Perception Scale (IEPS) was used to assess perceptions of interprofessional education and was distributed to medical and pharmacy students at the conclusion of 16 weeks of seminars. A two-tailed t-test was used to determine significance between groups. A survey was also distributed to all students regarding perceived barriers to involvement in interprofessional education training. In total, 97 students responded to IEPS (62 medical, 35 pharmacy). Data showed significantly higher perception of professional cooperation among medical students (p=0.006) and pharmacy students (p=0.02) who attended interprofessional seminars compared to those who did not attend. One hundred and nine students responded to the survey regarding perceived barriers to interprofessional education, with the two most common barriers being: 'I am not aware of interprofessional education opportunities' (61.5%) and 'I do not have time to participate' (52.3%). Based on this data we believe peer-teacher-led problem-based interprofessional seminars can be used to increase medical and pharmacy students' perceived need for professional cooperation. Currently, major barriers to interprofessional education involvement are awareness and time commitment. Undergraduate health professions education can incorporate student-led seminars to improve interprofessional education.
Czarnecki, Gail A; Kloostra, Stephanie J; Boynton, James R; Inglehart, Marita R
Interprofessional education (IPE) has received increasingly more attention over recent years. The objectives of this study were to assess 1) how nursing students' considerations concerning their own oral health and oral health-related knowledge changed from before to after experiencing IPE; 2) how nursing students', dental students', and pediatric dentistry residents' IPE-related attitudes and Readiness for Interprofessional Learning Scale (RIPLS) scores changed after experiencing an IPE rotation; and 3) how these groups' attitudes and RIPLS scores were related. Data were collected from three groups who participated in an IPE rotation: thirty-eight of forty third-year dental students (95 percent response rate), all thirty-three nursing students (100 percent), and all six pediatric dentistry residents (100 percent) prior to the rotation, and 100 percent of each group after the rotation. As a control group, data were also collected at the beginning of the winter term from first-year dental students (104 out of 105; 99 percent response rate) and second-year dental students (102 out of 116; 88 percent); the same groups were surveyed at the end of term, with response rates of 98 percent for first-year students and 89 percent for second-year students. After the rotation, the nursing students' tooth brushing frequency increased, and their comfort level with dental visits and oral health-related knowledge improved. The dental students rated the importance of nurses' having oral health-related knowledge and skills lower than did the nursing students and pediatric dentistry residents. The groups' RIPLS scores correlated with these importance ratings. Overall, while the nursing students showed positive responses to IPE, the dental students' attitudes and RIPLS scores did not change as a result of the IPE experience. Future research should explore the conditions under which dental students are impacted by IPE.
Abrahamsen, Charlotte; Nørgaard, Birgitte; Draborg, Eva
aspects; those voiced by the nursing staff related to work strain and the interests of their professional group whereas the physicians’ reservations concentrated on the planning of the change. The exploration of readiness for organizational change among health care professionals offers managers......Professionals´ readiness for change is a precursor to successful implementation of organizational changes. An assessment of readiness for change can set the stage for the implementation by providing information regarding staff members’ beliefs and attitudes prior to an organizational change. We...... conducted a cross-sectional survey to assess readiness for change (N=223 employees) in a hospital on the verge of implementing an interprofessional, co-managed, orthogeriatric unit. Staff members from three departments with tasks related to orthogeriatric patients were invited to answer a web...
El-Awaisi, Alla; Joseph, Sundari; El Hajj, Maguy Saffouh; Diack, Lesley
Pharmacists are key professionals in the collaborative working process and are integral members of the healthcare team. However, there is paucity of information regarding their perspectives towards interprofessional education (IPE) and collaborative practice. The aim of this systematic review is to synthesise, summarise and evaluate the quality of the quantitative and qualitative literature related to the perspectives of pharmacy students, pharmacy faculty and practising pharmacists toward IPE and collaborative practice. The perspectives included their views, experiences and attitudes with a special focus on their perceived benefits and challenges in relation to IPE and collaborative practice. An integrated mixed method systematic review was conducted. Four electronic databases were searched for articles published in English between 2000 and 2015. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the studies. Twenty-nine articles were identified meeting the selection criteria from the first initial search of 8512 articles. Seventeen articles (59%) targeted pharmacy students, 11 articles (38%) focused on practising pharmacists and 1 study (3%) was related to pharmacy faculty. The majority of studies were conducted in the United States (n = 13), were published in the last five years (83%, n = 24) and employed quantitative methods (52%, n = 15). The two commonly used survey instruments to measure the perspectives were: different versions of the RIPLS (35%, n = 6) and the IEPS scale (35%, n = 6). Fourteen of the 29 studies were rated as low quality (MMAT = 25%), eight studies were rated as average quality (MMAT = 50%), four were rated as high quality (MMAT 75%) and three were rated as very poor quality (MMAT 0%). No studies were rated with 100% MMAT quality. Overall, the findings suggest that pharmacy students, practicing pharmacists and faculty valued interprofessional education and collaborative practice and had positive
Hunter, Judith P; Stinson, Jennifer; Campbell, Fiona; Stevens, Bonnie; Wagner, Susan J; Simmons, Brian; White, Meghan; van Wyk, Margaret
BACKGROUND: Health care trainees/students lack knowledge and skills for the comprehensive clinical assessment and management of pain. Moreover, most teaching has been limited to classroom settings within each profession. OBJECTIVES: To develop and evaluate the feasibility and preliminary outcomes of the ‘Pain-Interprofessional Education (IPE) Placement’, a five-week pain IPE implemented in the clinical setting. The utility (content validity, readability, internal consistency and practical considerations) of the outcome measures was also evaluated. METHODS: A convenience sample of 21 trainees from eight professions was recruited over three Pain-IPE Placement cycles. Pre- and postcurriculum assessment included: pain knowledge (Pediatric Pain Knowledge and Attitudes Survey), IPE attitudes (Interdisciplinary Education Perception Scale [IEPS]) and IPE competencies (Interprofessional Care Core Competencies Global Rating Scales [IPC-GRS]), and qualitative feedback on process/acceptability. RESULTS: Recruitment and retention met expectations. Qualitative feedback was excellent. IPE measures (IEPS and IPC-GRS) exhibited satisfactory utility. Postcurriculum scores improved significantly: IEPS, Pinterprofessional competencies. The present study represents a first step at defining and assessing change in interprofessional competencies gained from Pain-IPE. PMID:25144859
McKee, Nora; D'Eon, Marcel; Trinder, Krista
The objective of this article was to analyze the theory and pedagogical basis of the use of problem-based learning (PBL) for inter-professional education (IPE) in undergraduate health science education and present evidence from a palliative care iPBL (inter-professional PBL) module that confirms the importance of the two methodologies being used together. More than 1000 student surveys collected over 4 years were analyzed for components of usefulness, enjoyment and facilitator effectiveness. A retrospective self-assessment of learning was used for both content knowledge of palliative care and knowledge of the other professions participating in the module. Statistically significant gains in knowledge were recorded in both areas assessed. Medical students reported lower gains in knowledge than those in other programs. On a scale of 0 to 6, mean scores were moderately high for usefulness (4.37) and facilitator effectiveness (5.19). Mean scores for enjoyment of the iPBL module were very high at 5.25. There is strong theoretical and empirical evidence that PBL is a useful method to deliver IPE for palliative care education. With the evidence presented from the palliative care iPBL it is our contention that PBL inter-professional cases should be utilized more often, incorporated into IPE programs generally, and researched more rigorously.
Full Text Available Introduction: The objective of this article was to analyze the theory and pedagogical basis of the use of problem-based learning (PBL for inter-professional education (IPE in undergraduate health science education and present evidence from a palliative care iPBL (inter-professional PBL module that confirms the importance of the two methodologies being used together. Methods: More than 1000 student surveys collected over 4 years were analyzed for components of usefulness, enjoyment and facilitator effectiveness. A retrospective self-assessment of learning was used for both content knowledge of palliative care and knowledge of the other professions participating in the module. Results: Statistically significant gains in knowledge were recorded in both areas assessed. Medical students reported lower gains in knowledge than those in other programs. Scores were moderately high for usefulness and facilitator effectiveness. Scores for enjoyment were very high at 5.19 out of a total score of 6.0. Conclusion: There is strong theoretical and empirical evidence that PBL is a useful method to deliver IPE for palliative care education. With the evidence presented from the palliative care iPBL it is our contention that PBL inter-professional cases should be utilized more often, incorporated into IPE programs generally, and researched more rigorously.
Lee, Linda; Weston, W. Wayne; Hillier, Loretta M.
Introduction: Primary care is challenged to meet the needs of patients with dementia. A training program was developed to increase capacity for dementia care through the development of Family Health Team (FHT)-based interprofessional memory clinics. The interprofessional training program consisted of a 2-day workshop, 1-day observership, and 2-day…
Welsch, Lauren A.; Rutledge, Carolyn; Hoch, Johanna M.
Context: Athletic trainers are encouraged to work collaboratively with other health care professionals to improve patient outcomes. Interprofessional education (IPE) experiences for practicing clinicians should be developed to improve interprofessional collaborative practice postcertification. An outcome measure, such as the modified Readiness for…
King, Judy; Beanlands, Sarah; Fiset, Valerie; Chartrand, Louise; Clarke, Shelley; Findlay, Tarra; Morley, Michelle; Summers, Ian
Within the care of people living with respiratory conditions, nursing, physiotherapy, and respiratory therapy healthcare professionals routinely work in interprofessional teams. To help students prepare for their future professional roles, there is a need for them to be involved in interprofessional education. The purpose of this project was to compare two different methods of patient simulation in improving interprofessional competencies for students in nursing, physiotherapy, and respiratory therapy programmes. The Canadian Interprofessional Health Collaborative competencies of communication, collaboration, conflict resolution patient/family-centred care, roles and responsibilities, and team functioning were measured. Using a quasi-experimental pre-post intervention approach two different interprofessional workshops were compared: the combination of standardised and simulated patients, and exclusively standardised patients. Students from nursing, physiotherapy, and respiratory therapy programmes worked together in these simulation-based activities to plan and implement care for a patient with a respiratory condition. Key results were that participants in both years improved in their self-reported interprofessional competencies as measured by the Interprofessional Collaborative Competencies Attainment Survey (ICCAS). Participants indicated that they found their interprofessional teams did well with communication and collaboration. But the participants felt they could have better involved the patients and their family members in the patient's care. Regardless of method of patient simulation used, mannequin or standardised patients, students found the experience beneficial and appreciated the opportunity to better understand the roles of other healthcare professionals in working together to help patients living with respiratory conditions.
Donato, Emily; Lightfoot, Nancy; Carter, Lorraine; MacEwan, Leigh
In 2010, the Canadian Association of Schools of Nursing, the accrediting body for nursing programs in Canada, became part of the Accreditation of Interprofessional Health Education initiative. In turn, interprofessional education (IPE) is now a requirement in nursing curricula. Although the requirement is formally in place, how it is achieved…
Curran, Vernon; Sargeant, Joan; Hollett, Ann
Introduction: Interest in collaborative care approaches and in interprofessional education (IPE) to prepare providers for interprofessional collaboration is increasing and particularly so in the field of primary health care. Although evidence for the effectiveness of IPE is mixed, Barr et al. (2005) have proposed a useful framework for evaluating…
Meekins, Eva M.
Teamwork and communication are essential concepts for new graduate registered nurses working as members of the interprofessional team. Studies have shown the efficacy of applying these interprofessional education concepts by allowing student nurses to round with health teams before graduation. The innovative practice of rounding significantly…
Legare, F.; Stacey, D.; Pouliot, S.; Gauvin, F.P.; Desroches, S.; Kryworuchko, J.; Dunn, S.; Elwyn, G.; Frosch, D.; Gagnon, M.P.; Harrison, M.B.; Pluye, P.; Graham, I.D.
Most shared decision-making (SDM) models within healthcare have been limited to the patient-physician dyad. As a first step towards promoting an interprofessional approach to SDM in primary care, this article reports how an interprofessional and interdisciplinary group developed and achieved
Jones, Barbara; Phillips, Farya
A report from the Interprofessional Education Collaborative and another from the Institute of Medicine cite working as part of interdisciplinary teams as a core proficiency area for improving health care. This article discusses the core competencies of interprofessional education and the essential role for social workers as leaders and…
Collin, Kaija; Paloniemi, Susanna; Herranen, Sanna
This paper summarises the findings of a research project on interprofessional collaboration in the emergency unit of a major Finnish hospital. The findings are discussed through a broad conceptual framework which involves work process knowledge and interprofessional collaboration. The project, carried out from 2010-2012, investigated different…
Williams, Brett; Lewis, Belinda; Boyle, Malcolm; Brown, Ted
The aim of this study was to identify if wireless keypads could facilitate interprofessional interaction among undergraduate paramedic, nursing, occupational therapy, physiotherapy, health science, social work and midwifery students. Secondary research aims included the examination of students' perceptions of interprofessional education and how…
Cahn, Peter S
Although international reports have called for making interprofessional education an integral part of health professions education, most interprofessional learning activities remain voluntary and occur a single time. Barriers to implementing comprehensive interprofessional education come from forces both internal and external to institutions. Understanding the historical context for how one graduate health professions school attempted to overcome these barriers will provide a longitudinal perspective that may assist other institutions with their interprofessional education efforts. The case of the Massachusetts General Hospital Institute of Health Professions shows that, despite being founded with a mission to educate students from different professions together, interprofessional education does not emerge naturally. An analysis of archival documents, academic catalogs and oral history interviews revealed that early attempts focused on requiring students to take common courses. Later, the faculty created voluntary interprofessional learning activities. Neither approach achieved its intended goals until the Institute developed deliberate strategies to counter the internal and external barriers to integrating interprofessional education. This historical case study suggests that sustainable interprofessional education initiatives require both an organizational home and a permanent place in the curriculum.
Coats, Heather; Paganelli, Tia; Starks, Helene; Lindhorst, Taryn; Starks Acosta, Anne; Mauksch, Larry; Doorenbos, Ardith
There is a known shortage of trained palliative care professionals, and an even greater shortage of professionals who have been trained through interprofessional curricula. As part of an institutional Palliative Care Training Center grant, a core team of interprofessional palliative care academic faculty and staff completed a state-wide palliative care educational assessment to determine the needs for an interprofessional palliative care training program. The purpose of this article is to describe the process and results of our community needs assessment of interprofessional palliative care educational needs in Washington state. We approached the needs assessment through a cross-sectional descriptive design by using mixed-method inquiry. Each phase incorporated a variety of settings and subjects. The assessment incorporated multiple phases with diverse methodological approaches: a preparatory phase-identifying key informants; Phase I-key informant interviews; Phase II-survey; and Phase III-steering committee endorsement. The multiple phases of the needs assessment helped create a conceptual framework for the Palliative Care Training Center and developed an interprofessional palliative care curriculum. The input from key informants at multiple phases also allowed us to define priority needs and to refine an interprofessional palliative care curriculum. This curriculum will provide an interprofessional palliative care educational program that crosses disciplinary boundaries to integrate knowledge that is beneficial for all palliative care clinicians. The input from a range of palliative care clinicians and professionals at every phase of the needs assessment was critical for creating an interprofessional palliative care curriculum.
Interprofessional learning is identified as one of the most innovative ways to encourage students of different disciplines to communicate with each other in interprofessional teams. A review of existing studies identified that inter-professional learning with nursing and midwifery students learning together had not previously been reported. This qualitative study sought to explore perceptions and experiences of midwifery students from interprofessional learning with nursing students. This study was an exploratory qualitative study employing focus groups. Participants were 30 female students in the fourth year Bachelor of Midwifery at one university in Iran who undertook the surgical training course in midwifery in their seventh semester by inter-professional learning based on problem solving. Data were analysed according to the six steps of the concurrent thematic analysis method. One main theme of challenging approach in learning emerged and two sub-themes 1) being challenged in a simulated clinical situation and 2) demonstrating professional knowledge. Interprofessional learning by challenging students of various professions during shared interprofessional learning can be followed by positive outcomes such as improved critical thinking, interprofessional communication, teaching-learning motivation and independent learning. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
Moradi, Kamran; Najarkolai, Atena Rahmati; Keshmiri, Fatemeh
HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Interprofessional Teamwork Education: Moving Toward the Patient-Centered Approach," found on pages 449-460, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until September 30, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Explain the recommended framework in teaching and implementing interprofessional competencies. Identify
Goodier, Robyn; Uppal, Shiv; Ashcroft, Harriet
Supporting homeless people to recovery requires interprofessional collaborative responses. In North America interprofessional student groups have supported traditional services to address the needs of homeless populations. We report on the first two years of designing and developing an interprofessional student-led response to support homeless people in the UK. The project began with working in partnership with local statutory and voluntary services; and was affirmed through interviews with local homeless people. The findings identified that many avoided going to the services provided and 90% would welcome clinical services from interprofessional groups of students. The results have led to the launch of project LIGHT (Leicester Initiative Good Health Team) and today interprofessional student groups run health promotion activities for this population.
Blacker, Susan; Head, Barbara A; Jones, Barbara L; Remke, Stacy S; Supiano, Katherine
The importance of interprofessional collaboration in achieving high quality outcomes, improving patient quality of life, and decreasing costs has been growing significantly in health care. Palliative care has been viewed as an exemplary model of interprofessional care delivery, yet best practices in both interprofessional education (IPE) and interprofessional practice (IPP) in the field are still developing. So, too, is the leadership of hospice and palliative care social workers within IPE and IPP. Generating evidence regarding best practices that can prepare social work professionals for collaborative practice is essential. Lessons learned from practice experiences of social workers working in hospice and palliative care can inform educational efforts of all professionals. The emergence of interprofessional education and competencies is a development that is relevant to social work practice in this field. Opportunities for hospice and palliative social workers to demonstrate leadership in IPE and IPP are presented in this article.
Murphy, Judy I; Nimmagadda, Jayashree
Learning to effectively communicate and work with other professionals requires skill, yet interprofessional education is often not included in the undergraduate healthcare provider curriculum. Simulation is an effective pedagogy to bring students from multiple professions together for learning. This article describes a pilot study where nursing and social work students learned together in a simulated learning activity, which was evaluated to by the Readiness for Interprofessional Learning Scale (RIPLS). The RIPLS was used before and after the simulated activity to determine if this form of education impacted students' perceptions of readiness to learn together. Students from both professions improved in their RIPLS scores. Students were also asked to identify their interprofessional strengths and challenges before and after the simulation. Changes were identified in qualitative data where reports of strengths and challenges indicated learning and growth had occurred. In conclusion, this pilot study suggests that interprofessional simulation can be an effective method to integrate Interprofessional Education Collaborative core competencies into the curriculum.
Vyas, Deepti; McCulloh, Russell; Dyer, Carla; Gregory, Gretchen; Higbee, Dena
To assess the effectiveness of human patient simulation to teach patient safety, team-building skills, and the value of interprofessional collaboration to pharmacy students. Five scenarios simulating semi-urgent situations that required interprofessional collaboration were developed. Groups of 10 to 12 health professions students that included 1 to 2 pharmacy students evaluated patients while addressing patient safety hazards. Pharmacy students' scores on 8 of 30 items on a post-simulation survey of knowledge, skills, and attitudes improved over pre-simulation scores. Students' scores on 3 of 10 items on a team building and interprofessional communications survey also improved after participating in the simulation exercise. Over 90% of students reported that simulation increased their understanding of professional roles and the importance of interprofessional communication. Simulation training provided an opportunity to improve pharmacy students' ability to recognize and react to patient safety concerns and enhanced their interprofessional collaboration and communication skills.
McNaughton, Susan Maree
Implementing an interprofessional teamwork project for first-year students presents pedagogical and practical challenges. While transferable skills and attributes are important, engagement of students with limited professional experience in teamwork depends on relevance to current learning needs. This report outlines principles learned from planning and implementing a teamwork project for an interprofessional health administration and service development course. Practising interprofessional teamwork as leaders and teachers, aligning with previous, current and future teamwork content and processes and responding to student feedback and achievement have been the key factors in shaping the project over three semesters. Face-to-face and online interprofessional teamwork learning has necessitated developing resources that support self-direction, using familiar technology and providing enabling physical environments. Implications for first-year interprofessional teamwork are that structured well-resourced processes, responsiveness and alignment of learning all improve student outcomes.
van Dongen, Jerôme Jean Jacques; Habets, Iris Gerarda Josephine; Beurskens, Anna; van Bokhoven, Marloes Amantia
The number of people with multiple chronic conditions increases as a result of ageing. To deal with the complex health-care needs of these patients, it is important that health-care professionals collaborate in interprofessional teams. To deliver patient-centred care, it is often recommended to include the patient as a member of the team. To gain more insight into how health-care professionals and patients, who are used to participate in interprofessional team meetings, experience and organize patient participation in the team meetings. A qualitative study including observations of meetings (n=8), followed by semi-structured interviews with participating health-care professionals (n=8), patients and/or relatives (n=11). Professionals and patients were asked about their experiences of patient participation immediately after the team meetings. Results from both observations and interviews were analysed using content analysis. The findings show a variety of influencing factors related to patient participation that can be divided into five categories: (i) structure and task distribution, (ii) group composition, (iii) relationship between professionals and patients or relatives, (iv) patients' characteristics and (v) the purpose of the meeting. Patient participation during team meetings was appreciated by professionals and patients. A tailored approach to patient involvement during team meetings is preferable. When considering the presence of patients in team meetings, it is recommended to pay attention to patients' willingness and ability to participate, and the necessary information shared before the meeting. Participating patients seem to appreciate support and preparation for the meeting. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.
Full Text Available Goal: The aim of the course “interprofessional communication and nursing” is to reflect medical students’ experiences from the nursing internship. The content of the course focuses on barriers and support of interprofessional communication as a foundation for teamwork between nursing professionals and physicians. The nursing internship is for most medical students the first contact with nursing professionals and can lead to perceptions about the other group that might hinder interprofessional teamwork and consequently harm patients. To meet the demographic challenges ahead it is important to emphasize interprofessional education in the study of medicine and better prepare future physicians for interprofessional collaboration. Method: The design of the course includes an assessment of a change in the students’ perceptions about nursing and interprofessional communication. The first class meeting presents the starting point of the assessment and visualizes students’ perceptions of nursing and medicine. The content of the following class meetings serve to enhance the students’ knowledge about nursing as a profession with its own theories, science and scholarship. In addition, all students have to write a research paper that entails to interview one nursing professional and one physician about their ideas of interprofessional communication and to compare the interviews with their own experiences from the nursing internship. To access what students learned during the course a reflective discussion takes place at the last meeting combined with an analysis of the students’ research papers. Results: The assessment of the students’ perceptions about the nursing profession and the importance of successful interprofessional communication showed a new and deeper understanding of the topic. They were able to identify barriers and support measures of interprofessional communication and their own responsibilities as part of a team
Eich-Krohm, Astrid; Kaufmann, Alexandra; Winkler-Stuck, Kirstin; Werwick, Katrin; Spura, Anke; Robra, Bernt-Peter
The aim of the course "interprofessional communication and nursing" is to reflect medical students' experiences from the nursing internship. The content of the course focuses on barriers and support of interprofessional communication as a foundation for teamwork between nursing professionals and physicians. The nursing internship is for most medical students the first contact with nursing professionals and can lead to perceptions about the other group that might hinder interprofessional teamwork and consequently harm patients. To meet the demographic challenges ahead it is important to emphasize interprofessional education in the study of medicine and better prepare future physicians for interprofessional collaboration. The design of the course includes an assessment of a change in the students' perceptions about nursing and interprofessional communication. The first class meeting presents the starting point of the assessment and visualizes students' perceptions of nursing and medicine. The content of the following class meetings serve to enhance the students' knowledge about nursing as a profession with its own theories, science and scholarship. In addition, all students have to write a research paper that entails to interview one nursing professional and one physician about their ideas of interprofessional communication and to compare the interviews with their own experiences from the nursing internship. To access what students learned during the course a reflective discussion takes place at the last meeting combined with an analysis of the students' research papers. The assessment of the students' perceptions about the nursing profession and the importance of successful interprofessional communication showed a new and deeper understanding of the topic. They were able to identify barriers and support measures of interprofessional communication and their own responsibilities as part of a team. Interprofessional education is an important part of medical education
Gooding, Holly C; Ziniel, Sonja; Touloumtzis, Currie; Pitts, Sarah; Goncalves, Adrianne; Emans, Jean; Burke, Pam
Adolescent health providers increasingly work in interprofessional environments. There is a lack of evidence regarding best educational practices for preparing the adolescent health care workforce of the future. We developed, implemented, and evaluated an interprofessional longitudinal case-based curriculum for postgraduate trainees in adolescent health. Faculty in an academic adolescent medicine division worked collaboratively with recent trainees to develop six teaching cases illustrative of interprofessional care of adolescents. During the 2013-2014 academic year, seven trainees (two social workers, two physicians, one nurse practitioner, one psychologist, and one dietician) completed the six month-long case modules while simultaneously working together in an interprofessional clinic. Trainees completed four-item pre- and post-case questionnaires that assessed confidence with assessment and diagnosis, comfort with counseling skills, ability to devise a treatment plan, and understanding of their colleagues' role for each of the six cases. Participants completed the 19-item Readiness for Interprofessional Learning Scale and the 12-item Interdisciplinary Education Perception Scale at three time points during the academic year and a 15-minute interview after their final session. Confidence with assessment/diagnosis, comfort counseling adolescents, and the ability to devise treatment plans increased for most case topics, as did understanding of the role of others on the interprofessional team. Mean Readiness for Interprofessional Learning Scale and Interdisciplinary Education Perception Scale scores were high at baseline and similar at all three time points. Interviews highlighted the value of role clarity, communication, and learning within interprofessional teams along with modeling from interprofessional faculty. Case-based learning in conjunction with collaborative practice provided a successful teaching strategy for interprofessionals in adolescent health
Jensen, Didde Cramer; Nørgaard, Birgitte; Draborg, Eva
This article presents results from an organizational evaluation of an interprofessional clinical study unit (ICS) in Denmark. The aim of this study was to test whether the ICS was based on a durable organizational concept and to identify the prerequisites for the unit to be successful....... The evaluation framework was "theory-based evaluation". A program theory was developed based on the concepts and expectations of the steering committee which initiated and designed the ICS. The program theory was tested for conflicts of interest among the stakeholders related to the ICS regarding prerequisites...... for the study unit to function organizationally. Further analysis examined whether these conditions had been present during the project period and whether all elements had been correctly implemented. The results suggested that although the ICS had taken into account stakeholders' requests, it was not possible...
LeGros, Theresa A; Amerongen, Helen M; Cooley, Janet H; Schloss, Ernest P
Despite the increasing need for faculty and preceptors skilled in interprofessional facilitation (IPF), the relative novelty of the field poses a challenge to the development and evaluation of IPF programs. We use learning theory and IPF competencies with associated behavioral indicators to develop and evaluate six key messages in IPF training and experience. Our mixed methods approach included two phases: quantitative data collection with embedded qualitative data, followed by qualitative data collection in explanatory sequential fashion. This enabled triangulated analyses of both data types and of facilitation behaviors from facilitator and student perspectives. Results indicate the competency-based training was effective. Facilitators felt comfortable performing behaviors associated with IPF competencies; student observations of those behaviors supported facilitator self-reported performance. Overall, students perceived more facilitation opportunities than facilitators. Findings corroborate the importance of recruiting seasoned facilitators and establishing IPF guidelines that acknowledge variable team dynamics and help facilitators recognize teachable moments.
Reuterswärd, Marina; Hylander, Ingrid
The Swedish Education Act (2011) mandated a new combination of services to boost students' physical health, their mental health and special education through interprofessional pupil health and well-being (PH) teams. For Swedish school nurses, providing these services presents new challenges. To describe how Swedish school nurses experience their work and collaboration within the interprofessional PH teams. Twenty-five school nurses (SNs) were interviewed in five focus groups. Content analysis was used to examine the data and to explore SNs' workplace characteristics by using the components of the sense of coherence (SOC) framework. SNs' experiences of work and collaboration within PH teams can be described using three domains: the expectations of others regarding SNs' roles, SNs' contributions to pupils' health and well-being, and collaboration among SNs within PH teams. The results indicate a discrepancy between SNs' own experiences of their contribution and their experiences of other professionals' expectations regarding those contributions. Some duties were perceived as expected, comprehensible, manageable and meaningful, while other duties - though expected - were perceived as less meaningful, taking time away from school-related matters. Other duties that were not explicitly expected - promoting general health and creating safety zones for pupils, teachers and parents, for example - were nonetheless perceived as meaningful. Collaboration within PH teams was considered meaningful, comprehensible and manageable only if the objectives of the team meetings were clear, if other professionals were available and if professional roles on the team were clearly communicated. The SNs reported a lack of clarity regarding their role in PH and its implementation in schools, indicating that professionals in PH teams need to discuss collaboration so as to find their niche given the new conditions. SOC theory emerged as a useful framework for discussing concrete work-related
Boland, Daubney Harper; Scott, Mary Alice; Kim, Helen; White, Traci; Adams, Eve
While supported by the Affordable Care Act, in the United States, interprofessional training often takes place after healthcare providers graduate and are practicing in the field. This article describes the implementation and evaluation of an interprofessional training for graduate-level healthcare trainees. A group of interprofessional healthcare faculty provided a weeklong interprofessional immersion for doctoral-level healthcare trainees (n = 24) in Pharmacy, Counselling Psychology, Nursing, and Family Medicine residents. Healthcare faculty and staff from each profession worked side-by-side to provide integrated training utilising the Interprofessional Education Collaborative core competency domains. Trainees were placed into small teams with representatives from each profession; each team observed, learned, and practiced working within teams to provide quality patient care. Qualitative and quantitative data were collected to identify the effect of the training on trainees' self-reported team skills, as well as the extent to which the trainees learned and utilised the competencies. The results suggest that after completing the training, trainees felt more confident in their ability to work within an interprofessional team and more likely to utilise a team-based approach in the future.
Wilbur, Kerry; Kelly, Isabelle
Medical care is increasingly complex and must draw upon the distinct, yet complementary skills of various health disciplines. Healthcare student integration through interprofessional education (IPE) activity is considered one way to promote early, and subsequently sustain, the principles of teamwork. However, It has been demonstrated that each profession has distinct profession-based subcultures, or common attitudes, beliefs and values, even among undergraduate students before commencing their training. We sought to evaluate if undergraduate pharmacy and nursing student in the Middle East had similarly formed attitudes and perceptions of each others' roles. Focus group and semi-structured interviews were conducted with undergraduate pharmacy and nursing students enrolled at Qatar University College of Pharmacy and University of Calgary - Qatar Nursing programs. An eight-question topic guide was developed following comprehensive literature review of reports of other interdisciplinary assessments (either quantitative and qualitative). Working theories were drawn by the two primary investigators based on relevant topic characteristics such as expressed roles and purposes for interacting with one other, patients, and physicians, to develop explanatory constructs for the findings and identify patterns in the data. Qualitative analysis of interviews were supported by NVivo10 (©) (QSR International 2013) software. One shared themes across both health professional groups evolved during data analysis: perceptions of collaborative roles. Discipline specific themes included pharmacist knowledge and visibility (nursing students) and nurses as informants and roles in total patient care (pharmacy students). As expected, students with little or no curricular-based structured experiential training yet largely drew upon personal experiences, whereas senior students, who did have some amount of professional context, often mirrored those that have been found in other studies
Kinnison, Tierney; Lumbis, Rachel; Orpet, Hilary; Welsh, Perdi; Gregory, Sue; Baillie, Sarah
Interprofessional education (IPE) has received little attention in veterinary education even though members of the veterinary and nursing professions work closely together. The present study investigates veterinary and veterinary nursing students' and practitioners' experiences with interprofessional issues and the potential benefits of IPE. Based on stakeholder consultations, two teaching interventions were modified or developed for use with veterinary and veterinary nursing students: Talking Walls, which aimed to increase individuals' understanding of each other's roles, and an Emergency-Case Role-Play Scenario, which aimed to improve teamwork. These interventions were piloted with volunteer veterinary and veterinary nursing students who were recruited through convenience sampling. A questionnaire (the Readiness for Interprofessional Learning Scale [RIPLS]) was modified for use in veterinary education and used to investigate changes in attitudes toward IPE over time (pre-intervention, immediately post-intervention, and four to five months afterward). The results showed an immediate and significant positive change in attitude after the intervention, highlighting the students' willingness to learn collaboratively, their ability to recognize the benefits of IPE, a decreased sense of professional isolation, and reduced hierarchical views. Although nearly half of the students felt concerned about learning with students from another profession before the intervention, the majority (97%) enjoyed learning together. However, the positive change in attitude was not evident four to five months after the intervention, though attitudes remained above pre-intervention levels. The results of the pilot study were encouraging and emphasize the relevance and importance of veterinary IPE as well as the need for further investigation to explore methods of sustaining a change in attitude over time.
Glassman, Paul; Harrington, Maureen; Namakian, Maysa; Subar, Paul
People with complex medical, physical, and psychological conditions are among the most underserved groups in receiving dental care and consequently have the most significant oral health disparities of any group. The traditional dental care delivery system is not able to deliver adequate services to these people with "special needs" for a variety of reasons. New systems of care are evolving that better serve the needs of these groups by using interprofessional teams to reach these individuals and integrate oral health services into social, educational, and general health systems. Copyright © 2016 Elsevier Inc. All rights reserved.
Myers, Christine Teeters; O'Brien, Shirley Peganoff
Interdisciplinary courses among students in occupational therapy, physical therapy, and speech-language pathology are important for addressing teamwork, communication, and understanding of professional roles, especially in pre-service training for early intervention and school-based practice where collaboration is essential. Although interprofessional education (IPE) as a part of higher education in the health sciences has been strongly encouraged, IPE courses are difficult to schedule and implement. This article discusses the challenges of developing and delivering two IPE courses in an online format, specifically the innovation that addresses logistics, time factors, and social presence for the IPE courses across two institutions.
Full Text Available Christian Cable,1,2 Mary Knab,3,4 Kum Ying Tham,5,6 Deborah D Navedo,3 Elizabeth Armstrong3,7,81Scott and White Healthcare, Temple, 2Texas A&M University Health Science Center, TAMHSC College of Medicine, Bryan, TX, 3MGH Institute of Health Professions, 4Physical and Occupational Therapy Services Department, Massachusetts General Hospital, Boston, MA, USA; 5Emergency Department, Tan Tock Seng Hospital, 6Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; 7Harvard Macy Institute, 8Department of Pediatrics, Harvard Medical School, Boston, MA, USAAbstract: Little is known about the nature of faculty development that is needed to meet calls for a focus on quality and safety with particular attention to the power of interprofessional collaborative practice. Through grounded-theory methodology, the authors describe the motivation and needs of 20 educator/clinicians in multiple disciplines who chose to enroll in an explicitly interprofessional master's program in health profession education. The results, derived from axial coding described by Strauss and Corbin, revealed that faculty pursue such postprofessional master's degrees out of a desire to be better prepared for their roles as educators. A hybrid-delivery model on campus and online provided access to graduate degrees while protecting the ability of participants to remain in current positions. The added benefit of a community of practice related to evidence-based and innovative models of education was valued by participants. Authentic, project-based learning and assessment supported their advancement in home institutions and systems. The experience was described by participants as a disruptive innovation that helped them attain their goal of leadership in health profession education.Keywords: health education
Gordon, Morris; Fell, Christopher W R; Box, Helen; Farrell, Michael; Stewart, Alison
Healthcare increasingly recognises and focusses on the phenomena of 'safe practice' and 'patient safety.' Success with non-technical skills (NTS) training in other industries has led to widespread transposition to healthcare education, with communication and teamwork skills central to NTS frameworks. This study set out to identify how the context of interprofessional simulation learning influences NTS acquisition and development of 'safety' amongst learners. Participants receiving a non-technical skills (NTS) safety focussed training package were invited to take part in a focus group interview which set out to explore communication, teamwork, and the phenomenon of safety in the context of the learning experiences they had within the training programme. The analysis was aligned with a constructivist paradigm and took an interactive methodological approach. The analysis proceeded through three stages, consisting of open, axial, and selective coding, with constant comparisons taking place throughout each phase. Each stage provided categories that could be used to explore the themes of the data. Additionally, to ensure thematic saturation, transcripts of observed simulated learning encounters were then analysed. Six themes were established at the axial coding level, i.e., analytical skills, personal behaviours, communication, teamwork, context, and pedagogy. Underlying these themes, two principal concepts emerged, namely: intergroup contact anxiety - as both a result of and determinant of communication - and teamwork, both of which must be considered in relation to context. These concepts have subsequently been used to propose a framework for NTS learning. This study highlights the role of intergroup contact anxiety and teamwork as factors in NTS behaviour and its dissipation through interprofessional simulation learning. Therefore, this should be a key consideration in NTS education. Future research is needed to consider the role of the affective non
Pullon, Susan Sue; Wilson, Christine; Gallagher, Peter; Skinner, Margot; McKinlay, Eileen; Gray, Lesley; McHugh, Patrick
The transition from student to health practitioner at entry-to-practice is complex, requiring critical acquisition of collaborative practice skills. In rural communities where health need is multidimensional, there is potential for multiple intentional collaborative learning objectives to be met concurrently. A five-week, rurally-located, clinically-based interprofessional programme was introduced as a transition-to-practice rotation for final-year, pre-registration health professional students in the professions of dentistry, dietetics, medicine, nursing, pharmacy and physiotherapy. The programme integrated learning objectives in four related domains: interprofessional practice; hauora Māori (Māori health); rural health; long-term condition management. This study investigated student learning experiences over the first two complete years of the programme, comparing responses from participating students with those from a cohort of non-participating peers. Using a pre and post quasi-experimental design, respondents from two successive student year cohorts completed questionnaires at the start and end of their final year. Additional survey data were collected from participating students at the end of each rotation. 131 students participated in the programme during 2013-2014. Participating student respondents (55/131;42 %) reported being significantly better prepared than a cohort of 56 non-participating colleagues in many aspects of their understanding of and knowledge about each of four key learning domains. 94 % (123/131) of programme participants completed end-of-rotation questionnaires. Positive from the outset (mean 5-point Likert scale scores between 3 and 5; 5 = most positive), student satisfaction further increased across all domains in the second year (mean 5-point Likert scale scores between 4 and 5). At entry-to-practice level, multiple learning objectives, including indigenous health learning, can be met simultaneously in the clinical context
Fowler, Terri O; Wise, Holly H; Mauldin, Mary P; Ragucci, Kelly R; Scheurer, Danielle B; Su, Zemin; Mauldin, Patrick D; Bailey, Jennifer R; Borckardt, Jeffrey J
Assessment of interprofessional education (IPE) frequently focuses on students' learning outcomes including changes in knowledge, skills, and/or attitudes. While a foundational education in the values and information of their chosen profession is critical, interprofessional learning follows a continuum from formal education to practice. The continuum increases in significance and complexity as learning becomes more relationship based and dependent upon the ability to navigate complex interactions with patients, families, communities, co-workers, and others. Integrating IPE into collaborative practice is critical to enhancing students' experiential learning, developing teamwork competencies, and understanding the complexity of teams. This article describes a project that linked students with a hospital-based quality-improvement effort to focus on the acquisition and practice of teamwork skills and to determine the impact of teamwork on patient and quality outcome measures. A hospital unit was identified with an opportunity for improvement related to quality care, patient satisfaction, employee engagement, and team behaviours. One hundred and thirty-seven students from six health profession colleges at the Medical University of South Carolina underwent TeamSTEPPS® training and demonstrated proficiency of their teamwork-rating skills with the TeamSTEPPS® Team Performance Observation Tool (T-TPO). Students observed real-time team behaviours of unit staff before and after staff attended formal TeamSTEPPS® training. The students collected a total of 778 observations using the T-TPO. Teamwork performance on the unit improved significantly across all T-TPO domains (team structure, communication, leadership, situation monitoring, and mutual support). Significant improvement in each domain continued post-intervention and at 15-month follow-up, improvement remained significant compared to baseline. Student engagement in TeamSTEPPS® training and demonstration of their
Lawlis, Tanya; Wicks, Alison; Jamieson, Maggie; Haughey, Amy; Grealish, Laurie
Health professional clinical education is commonly conducted in single discipline modes, thus limiting student collaboration skills. Aged care residential facilities, due to the chronic and complex health care needs of residents, provide an ideal placement to provide a collaborative experience. Interprofessional education is widely acknowledged as the pedagogical framework through which to facilitate collaboration. The aim of the evaluation was to assess student attitudes towards collaboration after active involvement in an interprofessional education program. Students studying nursing, occupational therapy, and aged care were invited to complete a version of the Readiness for Interprofessional Learning Scale before and after participating in a three-week pilot interprofessional program. A positive change in student attitudes towards other health professionals and the importance of working in interprofessional teams was reported with significant differences between two statements indicated: Learning with health-care students before qualifications would improve relationships after qualifications; and I learned a lot from the students from the other disciplines. The innovative pilot project was found to enhance student learning in interprofessional teams and the aged care environment. Further development of this and similar interprofessional programs is required to develop sustainable student projects that have health benefits for residents in aged care residential facilities. Copyright © 2015 Elsevier Ltd. All rights reserved.
Tomizawa, Ryoko; Shigeta, Masahiro; Reeves, Scott
In mental health settings, interprofessional practice is regarded as a comprehensive approach to prevent relapse and manage chronic conditions with practice of various teamwork interventions. To reinforce the potential of interprofessional teamwork, it is recommended that theories or conceptual frameworks be employed. There continues, however, to be a limited use of such approaches that assess the quality of interprofessional teamwork in mental health settings. This article aimed to present a new conceptual framework for the assessment of interprofessional teamwork based on the findings of a scoping review of the literature. This review was undertaken to identify conceptual frameworks utilised in interprofessional teamwork in mental health settings. After reviewing 952 articles, the methodological characteristics extracted from 12 articles were considered. The included studies were synthesised into the Donabedian structure-process-outcome model. The findings revealed that structural issues comprised three elements: professional characteristics, client-care characteristics, and contextual characteristics in organisations. Process issues comprised two elements: team mechanisms and community-oriented services. Finally, outcome issues comprised the following elements: clients' outcomes and professionals' outcomes. The review findings suggested possibilities for further development of how to assess the quality of interprofessional teamwork and provided information about what specific approach is required to improve interprofessional teamwork. Future research should utilise various areas and cultures to clarify the adaptation potential.
van Dijk-de Vries, Anneke; van Dongen, Jerôme Jean Jacques; van Bokhoven, Marloes Amantia
The significance of effective interprofessional teamwork to improve the quality of care has been widely recognised. Effective interprofessional teamwork calls on good collaboration between professionals and patients, coordination between professionals, and the development of teamwork over time. Effective development of teams also requires support from the wider organisational context. In a Dutch village, healthcare professionals work closely together, and mutual consultations as well as interprofessional meetings take place on a regular basis. The network was created as a precondition for sustainable interprofessional teamwork in elderly care. However, several external barriers were experienced regarding the supportive structure and cooperative attitude of the healthcare insurer and municipality. The aim of the article is to examine these experience-based issues regarding internal organisation, perspective, and definition of effective teamwork. Complicating factors refer to finding the right key figures, and the different perspectives on team development and team effectiveness. Our conclusion is that the organisation of healthcare insurance companies needs to implement fundamental changes to facilitate an interprofessional care approach. Furthermore, municipalities should work on their vision of the needs and benefits of a fruitful collaboration with interprofessional healthcare teams. The challenge for healthcare teams is to learn to speak the language of external partners. To support the development of interprofessional teams, external parties need to recognise and trust in a shared aim to provide quality of care in an efficient and effective way.
Morris, Diane; Matthews, June
Health care professionals are expected to work collaboratively across diverse settings. In rural hospitals, these professionals face different challenges from their urban colleagues; however, little is known about interprofessional practice in these settings. Eleven health care professionals from 2 rural interprofessional teams were interviewed about collaborative practice. The data were analyzed using a constant comparative method. Common themes included communication, respect, leadership, benefits of interprofessional teams, and the assets and challenges of working in small or rural hospitals. Differences between the cases were apparent in how the members conceptualized their teams, models of which were then compared with an "Ideal Interprofessional Team". These results suggest that many experienced health care professionals function well in interprofessional teams; yet, they did not likely receive much education about interprofessional practice in their training. Providing interprofessional education to new practitioners may help them to establish this approach early in their careers and build on it with additional experience. Finally, these findings can be applied to address concerns that have arisen from other reports by exploring innovative ways to attract health professionals to communities in rural, remote, and northern areas, as there is a constant need for dietitians and other health care professionals in these practice settings.
Wong, Arkers Kwan Ching; Wong, Frances Kam Yuet; Chan, Lap Ki; Chan, Namkiu; Ganotice, Fraide A; Ho, Jacqueline
Although interprofessional education has received attention in recent years as a means of providing opportunities for health-care professionals to learn with, from and about other disciplines and enhance the quality of patient care, evidence of its effectiveness is limited. Interprofessional team-based learning was introduced to make it possible for students in different healthcare disciplines to interact with each other, and to prepare them to function effectively within a team in their future career. To examine the effects of interprofessional team-based learning for undergraduate nursing students in terms of knowledge level, readiness for interprofessional learning, attitude towards various aspects of team learning, and perceived collective efficacy. The study employed a one-group pretest-posttest quasi-experimental design. An interprofessional education program was given to students from two universities in Hong Kong who were in different healthcare disciplines including medicine, nursing, pharmacy, biomedical science, and Chinese medicine programs. The program was based on four phases of student learning- individual readiness assessment test, ice breaking session, team readiness assessment test, and application exercise. Nursing students involved in the program were invited to complete anonymous questionnaires to evaluate their interprofessional team experience. A total of 40 nursing students (9 male, 31 female) participated in the study. A statistically significant improvement was identified in their knowledge level (pattitude towards readiness for interprofessional learning, team learning, and perceived collective efficacy (plearning can enhance cross-disciplinary learning and outcomes resulting from team efforts. Copyright © 2017 Elsevier Ltd. All rights reserved.
Singer, Zachary; Fung, Kevin; Lillie, Elaine; McLeod, Jennifer; Scott, Grace; You, Peng; Helleman, Krista
Interprofessional health care teams have been shown to improve patient safety and reduce medical errors, among other benefits. Introducing interprofessional concepts to students in full day events is an established model that allows students to learn together. Our group developed an academic day for first-year students devoted to an introductory interprofessional education (IPE) experience, 'IPE Day'. In total, 438 students representing medicine, dentistry, pharmacy and optometry gathered together, along with 25 facilitators, for IPE Day. Following the day's program, students completed the evaluation consisting of the Interprofessional Collaborative Competencies Attainment Survey and open-ended questions. Narrative responses were analyzed for content and coded using the Canadian Interprofessional Health Collaborative competency domains. Three hundred and eight evaluations were completed. Students reported increased self-ratings of competency across all 20 items (p < 0.05). Their comments were organized into the six domains: interprofessional communication, collaborative leadership, role clarification, patient-centred care, conflict resolution, and team functioning. Based on these findings, we suggest that this IPE activity may be useful for improving learner perceptions about their interprofessional collaborative practice competence.
Full Text Available Introduction: Ward rounds are an essential activity for interprofessional teams in hospital settings and represent complex tasks requiring not only medical knowledge but also communication skills, clinical technical skills, patient management skills and team-work skills. The present study aimed to analyse final year students’, nurses’ as well as physiotherapists’ views on a simulation-based interprofessional ward round training.Methods: In two successive passes a total number of 29 final year students, nursing students and physiotherapy students (16 in the first run, 13 in the second volunteered to participate in two standardized patient ward round scenarios: (1 patient with myocardial infarction, and (2 patient with poorly controlled diabetes. Views on the interprofessional ward round training were assessed using focus groups.Results: Focus group based feedback contained two main categories (A ward round training benefits and (B difficulties. Positive aspects enfolded course preparation, setting of the training, the involvement of the participants during training and the positive learning atmosphere. Difficulties were seen in the flawed atmosphere and realization of ward rounds in the daily clinical setting with respect to inter-professional aspects, and course benefit for the different professional groups.Conclusion: The presented inter-professional ward round training represents a well received and valuable model of interprofessional learning. Further research should assess its effectiveness, processes of interprofessional interplay and transfer into clinical practice.
Wong, Ambrose Hon-Wai; Gang, Maureen; Szyld, Demian; Mahoney, Heather
Health care providers must effectively function in highly skilled teams in a collaborative manner, but there are few interprofessional training strategies in place. Interprofessional education (IPE) using simulation technology has gained popularity to address this need because of its inherent ability to impact learners' cognitive frames and promote peer-to-peer dialog. Provider attitudes toward teamwork have been directly linked to the quality of patient care. Investigators implemented a simulation-enhanced IPE intervention to improve staff attitudes toward teamwork and interprofessional communication in the emergency department setting. The 3-hour course consisted of a didactic session highlighting teamwork and communication strategies, 2 simulation scenarios on septic shock and cardiac arrest, and structured debriefing directed at impacting participant attitudes to teamwork and communication. This was a survey-based observational study. We used the TeamSTEPPS Teamwork Attitudes Questionnaire immediately before and after the session as a measurement of attitude change as well as the Hospital Survey on Patient Safety Culture before the session and 1 year after the intervention for program impact at the behavior level. Seventy-two emergency department nurses and resident physicians participated in the course from July to September 2012. Of the 5 constructs in TeamSTEPPS Teamwork Attitudes Questionnaire, 4 had a significant improvement in scores-6.4%, 2.8%, 4.0%, and 4.0% for team structure, leadership, situation monitoring, and mutual support, respectively (P teamwork and communication showed a significant improvement-20.6%, 20.5%, and 23.9%, for frequency of event reporting, teamwork within hospital units, and hospital handoffs and transitions, respectively (P = 0.028, P = 0.035, and P = 0.024, respectively). A simulation-enhanced IPE curriculum was successful in improving participant attitudes toward teamwork and components of patient safety culture related to
Development of health inter-professional telemedicine practice through simulation scenario training with students of physiotherapy-, occupational therapy-, medical laboratory technology-, and nursing education
Nortvig, Anne-Mette; Vestergaard*, Kitt
technology-, and nursing education. •to motivate and retain male students by the use of simulation training that involves technology. Methodology: The project was settled as a cross-professional telemedicine course on health educations. Nursing students (N=20) and physiotherapy students (N=34) participated...... must take place in an inter-professional context. Aims: The purpose of the project was •to develop practice oriented competences related to telemedicine in an inter-professional and a cross-sectoral context among health professional students of physiotherapy-, occupational therapy-, medical laboratory...... and motivation. Results: Evaluations and follow-up research showed that students developed competences equivalent to novice level through simulation training (3). The project gave rise to wide project on Occupational Therapy education and medical laboratory technology education too. Follow-up research concludes...
Stocker, Martin; Pilgrim, Sina B; Burmester, Margarita; Allen, Meredith L; Gijselaers, Wim H
Aiming for and ensuring effective patient safety is a major priority in the management and culture of every health care organization. The pediatric intensive care unit (PICU) has become a workplace with a high diversity of multidisciplinary physicians and professionals. Therefore, delivery of high-quality care with optimal patient safety in a PICU is dependent on effective interprofessional team management. Nevertheless, ineffective interprofessional teamwork remains ubiquitous. We based our review on the framework for interprofessional teamwork recently published in association with the UK Centre for Advancement of Interprofessional Education. Articles were selected to achieve better understanding and to include and translate new ideas and concepts. The barrier between autonomous nurses and doctors in the PICU within their silos of specialization, the failure of shared mental models, a culture of disrespect, and the lack of empowering parents as team members preclude interprofessional team management and patient safety. A mindset of individual responsibility and accountability embedded in a network of equivalent partners, including the patient and their family members, is required to achieve optimal interprofessional care. Second, working competently as an interprofessional team is a learning process. Working declared as a learning process, psychological safety, and speaking up are pivotal factors to learning in daily practice. Finally, changes in small steps at the level of the microlevel unit are the bases to improve interprofessional team management and patient safety. Once small things with potential impact can be changed in one's own unit, engagement of health care professionals occurs and projects become accepted. Bottom-up patient safety initiatives encouraging participation of every single care provider by learning effective interprofessional team management within daily practice may be an effective way of fostering patient safety.
Evaluation of interprofessional education: lessons learned through the development and implementation of an interprofessional seminar on team communication for undergraduate health care students in Heidelberg – a project report
Full Text Available Introduction: This project report describes the development, “piloting” and evaluation of an interprofessional seminar on team communication bringing together medical students and Interprofessional Health Care B.Sc. students at the Medical Faculty of Heidelberg University, Germany.Project Description: A five-member interprofessional team collaborated together on this project. Kolb’s concept formed the theoretical foundation for the seminar, which explored three interprofessional competency areas: team work, communication and values/ethics. Evaluation for the purposes of quality assurance and future curricula development was conducted using two quantitative measures: Results: The key finding from the standardized course evaluation was that the interprofessional seminars were rated more positively [M=2.11 (1 most positive and 5 most negative, SD=1, n=27] than the monoprofessional seminars [M=2.55, SD=0.98, n=90]. The key finding from the UWE-IP-D survey, comparing pre and post scores of the interprofessional (IP (n=40 and monoprofessional (MP groups (n=34, was that significant positive changes in mean scores for both groups towards communication, teamwork and interprofessional learning occurred. Conclusions: Lessons learnt included: a recognising the benefit of being pragmatic when introducing interprofessional education initiatives, which enabled various logistical and attitudinal barriers to be overcome; b quantitative evaluation of learning outcomes alone could not explain positive responses or potential influences of interprofessional aspects, which highlighted the need for a mixed methods approach, including qualitative methods, to enrich judgment formation on interprofessional educational outcomes.
Poghosyan, Lusine; Norful, Allison A; Martsolf, Grant R
Developing team-based care models and expanding nurse practitioner (NP) workforce in primary care are recommended by policy makers to meet demand. Little is known how to promote interprofessional teamwork. Using a mixed-methods design, we analyzed qualitative interview and quantitative survey data from primary care NPs to explore practice characteristics important for teamwork. The Interprofessional Teamwork for Health and Social Care Framework guided the study. We identified NP-physician and NP-administration relationships; organizational support and governance; time and space for teamwork; and regulations and economic impact as important. Practice and policy change addressing these factors is needed for effective interprofessional teamwork.
Gilardi, Silvia; Guglielmetti, Chiara; Pravettoni, Gabriella
In Emergency Departments, fragmentation and breakdown in information exchange can be important factors leading to adverse events. This article aims to consider the critical aspects of collaborative teamwork in Emergency Departments that may have an impact on the information flow. On the basis of Distributed Cognition Theory, we have assumed that cognitive outcomes in critical-care settings are not confined to the thoughts of isolated individuals; rather, they are better understood as properties of a distributed cognitive system across the minds of the clinical team members and across the technological artefacts. We report on an exploratory ethnographic study of two Emergency Departments. Data were collected over a period of four months in 2008 via observation and interviews. The results highlight a specific distribution of cognitive work between physicians and nurses. The nurse's roles as information highlighter, memory keeper and process organizer helped to ensure the information flow and to overcome some of the problems identified with the computer-assisted communication process. Such distribution of cognitive work improved care quality, but it crossed established professional boundaries. As cross-boundary distribution of cognitive work in Emergency Departments can be perceived as role substitution, building an interprofessional working system is needed to avoid information breakdown in fast-moving contexts. To realize an interprofessional working system, practice-based training is required, aimed at developing a deep understanding of team cognition. © 2013 John Wiley & Sons Ltd.
Full Text Available Interprofessional education (IPE is becoming a common practice among most allied health professions as a part of entry level training. IPE is intended to promote greater professional collaboration in routine clinical practice. The prerequisites for this type of educational process include gaining an understanding of one’s own and other professions while developing mutual respect, trust, and communication skills. The Idaho State University (ISU Interdisciplinary Evaluation Team (IET course delivery model is one such vehicle which fosters IPE across numerous disciplines while providing significant clinical support to the local community. This study presents the ISU IET course process, which combines clinical care of community pediatric clients via student/clinician partnership, which reflect on the process of interprofessional care. Occupational therapy student perceptions of the IET course consistently trended in favorable directions. All participants desired more opportunities for IPE combined with direct client interaction as a part of their other course work. Occupational therapy educational programs are well suited and positioned to host and/or to establish key roles in IPE to support student clinical training and meet the health and needs of their local communities.
Dauenhauer, Jason A; Glose, Susan; Watt, Celia
This article describes the development, delivery, and outcomes from an interprofessional evidence-based falls management course for undergraduate and graduate students. The 3-credit elective course was developed by a gerontological social work and nursing faculty member in partnership with community-based housing and case management organizations. Creation of the course was in response to a mandate by the Health Resources and Services Administration, funding source for federal Geriatric Education Centers, to train interprofessional students using an evidence-based approach while tying the outcomes to improved health measures in the target population. Therefore, this article describes student competencies pre- and postcourse completion and outcomes of community-dwelling older adults completing a Matter of Balance (MOB) program delivered by these students. A total of 16 students completed the course which included delivery of the MOB program to 41 older adults. Results indicate statistically significant improvements in student outcomes from a pre/post falls knowledge test. For older adult participants, many screened positively for fall risk factors pre-post MOB participation showed statistically significant improvements in falls efficacy, control, management, and overall mobility. Opportunities and challenges associated with course delivery are also described.
Steinemann, Susan; Kurosawa, Gene; Wei, Alexander; Ho, Nina; Lim, Eunjung; Suares, Gregory; Bhatt, Ajay; Berg, Benjamin
Trauma care requires coordinating an interprofessional team, with formative feedback on teamwork skills. We hypothesized nurses and surgeons have different perceptions regarding roles during resuscitation; that nurses' teamwork self-assessment differs from experts', and that video debriefing might improve accuracy of self-assessment. Trauma nurses and surgeons were surveyed regarding resuscitation responsibilities. Subsequently, nurses joined interprofessional teams in simulated trauma resuscitations. After each resuscitation, nurses and teamwork experts independently scored teamwork (T-NOTECHS). After video debriefing, nurses repeated T-NOTECHS self-assessment. Nurses and surgeons assumed significantly more responsibility by their own profession for 71% of resuscitation tasks. Nurses' overall T-NOTECHS ratings were slightly higher than experts'. This was evident in all T-NOTECHS subdomains except "leadership," but despite statistical significance the difference was small and clinically irrelevant. Video debriefing did not improve the accuracy of self-assessment. Nurses and physicians demonstrated discordant perceptions of responsibilities. Nurses' self-assessment of teamwork was statistically, but not clinically significantly, higher than experts' in all domains except physician leadership. Copyright © 2016 Elsevier Inc. All rights reserved.
Beebe, Lora Humphrey; Roman, Marian; Skolits, Gary; Raynor, Hollie; Thompson, Dixie; Franks, Andrea
A faculty team developed the 4-week Recovery-Based Interprofessional Distance Education (RIDE) rotation for graduate students in their disciplines. The evaluation team identified the Team Development Measure (TDM) as a potential alternative to reflect team development during the RIDE rotation. The TDM, completed anonymously online, was piloted on the second student cohort (N = 18) to complete the RIDE rotation. The overall pretest mean was 60.73 points (SD = 11.85) of a possible 100 points, indicating that students anticipated their RIDE team would function at a moderately high level during the 4-week rotation. The overall posttest mean, indicating student perceptions of actual team functioning, was 72.71 points (SD = 23.31), an average increase of 11.98 points. Although not statistically significant, Cohen's effect size (d = 0.43) indicates an observed difference of large magnitude. No other published work has used the TDM as a pre-/posttest measure of team development. The authors believe the TDM has several advantages as a measure of student response to interprofessional education offerings, particularly in graduate students with prior experience on health care teams. Further work is needed to validate and extend the findings of this pilot study. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.]. Copyright 2018, SLACK Incorporated.
Barr, Hugh; Ross, Fiona
Interprofessional education (IPE) is being built into the mainstream of professional education for all health and social care professions throughout the United Kingdom (UK) driven by the Labour Government elected in 1997, coincidentally the year that this Journal hosted the first All Together Better Health conference in London. The incoming government prioritized pre-qualifying IPE to be provided in partnership by universities and service agencies supported regionally by workforce development confederations, later absorbed into strategic health authorities (SHAs), and centrally by educational, professional and regulatory bodies. Ambitious agenda for pre-qualifying IPE set by government are being tempered by realistic assessment of current outcomes borne of experience and corroborated by evidence. This paper suggests some ways to ease constraints and improve outcomes, but emphasizes the need to generate continuing interprofessional learning opportunities that build on the basics. It argues that accumulating experience and evidence must be brought to bear in formulating criteria for the approval and review of IPE within regulatory systems for professional education. Can IPE be sustained within mainstream professional education once initial enthusiasm ebbs and earmarked funds run dry? That is the issue.
Begley, Cecily M
Teamwork and collaboration between all health professionals results in high quality clinical care, and increased job satisfaction for staff. Encouraging inter-professional learning (IPL) may be advantageous in developing more effective teams. There is little rigorous research in this area, but many small uncontrolled studies do demonstrate positive results. IPL involves structured learning opportunities that enhance problem-solving abilities and conflict resolution. It should be clearly differentiated from shared teaching (or multidisciplinary/multiprofessional learning), where common content is taught to many professions without any intention to develop interaction. To counteract the sometimes negative attitudes in both students and staff, educators need to commence IPL early in the programme, base it in both theoretical and clinical placements and ensure that it is valued and assessed. Difficulties with timetabling and accommodation need to be solved prior to commencement. A facilitator should be employed, and a team of committed lecturers developed, with an emphasis on teamwork and the discouragement of individualism. Opportunities for student interaction and ways of improving group dynamics within non-threatening learning environments should to be sought, and instances of conflict embraced and resolved. Future IPL programmes should be rigorously evaluated and may demonstrate enhanced inter-professional relationships and improved quality of patient/client care.
Full Text Available Abstract Background Safe drug prescribing and administration are essential elements within undergraduate healthcare curricula, but medication errors, especially in paediatric practice, continue to compromise patient safety. In this area of clinical care, collective responsibility, team working and communication between health professionals have been identified as key elements in safe clinical practice. To date, there is limited research evidence as to how best to deliver teaching and learning of these competencies to practitioners of the future. Methods An interprofessional workshop to facilitate learning of knowledge, core competencies, communication and team working skills in paediatric drug prescribing and administration at undergraduate level was developed and evaluated. The practical, ward-based workshop was delivered to 4th year medical and 3rd year nursing students and evaluated using a pre and post workshop questionnaire with open-ended response questions. Results Following the workshop, students reported an increase in their knowledge and awareness of paediatric medication safety and the causes of medication errors (p Conclusion This study has helped bridge the knowledge-skills gap, demonstrating how an interprofessional approach to drug prescribing and administration has the potential to improve quality and safety within healthcare.
Boehm, Leanne M; Vasilevskis, Eduard E; Mion, Lorraine C
The ABCDE bundle is a multifaceted, interprofessional intervention that is associated with reduced ventilator and delirium days as well as increased likelihood of mobility in intensive care. The aim of this study is to describe organizational domains that contribute to variation in ABCDE bundle implementation as reported by intensive care unit providers and to examine the capability of a conceptual framework for identifying variation in ABCDE bundle implementation. We conducted 2 separate focus groups that included nurses, respiratory therapists, occupational and physical therapists (N = 16) from the surgical and medical intensive care units at 1 academic medical center. All participants had experience performing ABCDE bundle activities. Variation in how the ABCDE bundle was interpreted and executed within and across disciplines was noted. Organizational facets, the physical environment, labor quantity and quality, task burden, provider attitudes, and patient characteristics were noted to influence ABCDE bundle execution. The difficulty coordinating and implementing early mobility was emphasized. The number of disciplines required to perform an activity and individual component complexity was reported to influence ABCDE bundle implementation. Nurses repeatedly described challenges with coordinating care across disciplines. Small tests of change, adequate staffing, interprofessional training and protocol development efforts, and role modeling may be effective methods for successful ABCDE bundle implementation.
Vachon, Brigitte; Désorcy, Bruno; Camirand, Michel; Rodrigue, Jean; Quesnel, Louise; Guimond, Claude; Labelle, Martin; Fournier, Johanne; Grimshaw, Jeremy
The scientific literature continues to advocate interprofessional collaboration (IPC) as a key component of primary care. It is recommended that primary care groups be created and configured to meet the healthcare needs of the patient population, as defined by patient demographics and other data analyses related to the health of the population being served. It is further recommended that the improvement of primary care services be supported by the delivery of feedback and performance measurements. This paper describes the theory underlying an interprofessional educational intervention developed in Quebec's Montérégie region (Canada) for the purpose of improving chronic disease management in primary care. The objectives of this study were to explain explicitly the theory underlying this intervention, to describe its components in detail and to assess the intervention's feasibility and acceptability. A program impact theory-driven evaluation approach was used. Multiple sources of information were examined to make explicit the theory underlying the education intervention: 1) a literature review and a review of documents describing the program's development; 2) regular attendance at the project's committee meetings; 3) direct observation of the workshops; 4) interviews of workshop participants; and 5) focus groups with workshop facilitators. Qualitative data collected were analysed using thematic analysis. The theoretical basis of the interprofessional education intervention was found to be work motivation theory and reflective learning. Five themes describing the workshop objectives emerged from the qualitative analysis of the interviews conducted with the workshop participants. These five themes were the importance of: 1) adopting a regional perspective, 2) reflecting, 3) recognizing gaps between practice and guidelines, 4) collaborating, and 5) identifying possible practice improvements. The team experienced few challenges implementing the intervention. However
McLoughlin, Clodagh; Patel, Kunal D; O'Callaghan, Tom; Reeves, Scott
The recent growth in online technology has led to a rapid increase in the sharing of health related information globally. Health and social care professionals are now using a wide range of virtual communities of practice (VCoPs) for learning, support, continuing professional education, knowledge management and information sharing. In this article, we report the findings from a review of the literature that explored the use of VCoPs by health and social care professionals to determine their potential for interprofessional education and collaboration. We employed integrated review methods to search and identify relevant VCoP articles. We undertook searches of PubMed and Google Scholar from 2000, which after screening, resulted in the inclusion of 19 articles. A thematic analysis generated the following key issues related to the use of VCoPs: 'definitions and approaches', 'technological infrastructure', 'reported benefits', 'participation issues', 'trust and privacy and 'technical ability'. Based on the findings from this review, there is some evidence that VCoPs can offer an informal method of professional and interprofessional development for clinicians, and can decrease social and professional isolation. However, for VCoPs to be successful, issues of privacy, trust, encouragement and technology need to be addressed.
Omura, Mieko; Levett-Jones, Tracy; Stone, Teresa Elizabeth; Maguire, Jane; Lapkin, Samuel
Interprofessional communication and teamwork are essential for medication safety; however, limited educational opportunities for health professionals and students to develop these skills exist in Japan. This study evaluated the impact of an interprofessional multimedia learning resource on registered nurses' and nursing students' intention to practice in a manner promoting medication safety. Using a quasi-experimental design, Japanese registered nurses and nursing students (n = 203) were allocated to an experimental (n = 109) or control group (n = 94). Behavioral intentions of medication safety and the predictor variables of attitudes, perceived behavioral control, and subjective norms were measured using a Japanese version of the Theory of Planned Behavior Medication Safety Questionnaire. Registered nurses in the experimental group demonstrated a greater intention to collaborate and practice in a manner that enhanced medication safety, evidenced by higher scores than the control group on all predictor variables. The results demonstrate the potential for interprofessional multimedia learning resources to positively impact the behaviors of Japanese registered nurses in relation to safe medication practices. Further research in other contexts and with other cohorts is warranted. © 2015 Wiley Publishing Asia Pty Ltd.
Osamah M. Alfayez
The results suggest that involvement of pharmacists in direct patient care as members of interprofessional team in our specialty ambulatory care clinic is associated with a positive impact on the glycemic control in patients with diabetes.
Driessen, Julia; Bellon, Johanna E; Stevans, Joel; James, A Everette; Minnier, Tami; Reynolds, Benjamin R; Zhang, Yuting
The enactment of the Affordable Care Act expands coverage to millions of uninsured Americans and creates a new workforce landscape. Interprofessional Collaborative Practice (ICP) is no longer a choice but a necessity. In this paper, we describe four innovative approaches to interprofessional practice at the University of Pittsburgh Medical Center. These models demonstrate innovative applications of ICP to inpatient and outpatient care, relying on non-physician providers, training programs, and technology to deliver more appropriate care to specific patient groups. We also discuss the ongoing evaluation plans to assess the effects of these interprofessional practices on patient health, quality of care, and healthcare costs. We conclude that successful implementation of interprofessional teams involves more than just a reassignment of tasks, but also depends on structuring the environment and workflow in a way that facilitates team-based care.
Irons, Brian; Evans, Lance; Bogschutz, Renee; Panasci, Kathryn; Sun, Grace
Interprofessional education (IPE) is an important component of healthcare professional curriculum in order to optimally prepare students for their roles as part of the healthcare team. Integrating IPE activities into direct patient care in the primary care clinic setting can help improve perceptions and student understanding of other healthcare professionals' responsibilities in this ever-evolving practice setting. This report describes the implementation of an interprofessional clinic including a variety of healthcare professionals and students in the context of the Medicare Annual Wellness Visits (AWV). Design of the clinic and general roles of the professionals in optimising preventive care are described. Student perceptions of IPE and their knowledge of other healthcare professionals were also surveyed. Student knowledge of other professionals mildly improved. Student perception of actual cooperation and interprofessional interaction statistically improved, while perception of interprofessional learning slightly worsened. Utilising Medicare AWVs can be a way for various professionals to improve IPE in the primary care setting.
Peluso, Michael J; Hafler, Janet P; Sipsma, Heather; Cherlin, Emily
While global health (GH) opportunities have expanded at schools of medicine, nursing, and public health, few examples of interprofessional approaches to GH education have been described. The elective GH program at our university serves as an important opportunity for high-quality interprofessional education. We undertook a qualitative study to examine the experience of student, faculty and administrative leaders of the program. We used content analysis to code responses and analyze data. Among the leadership, key themes fell within the categories of interprofessional education, student-faculty collaboration, professional development, and practical considerations for the development of such programs. The principles described could be considered by institutions seeking to develop meaningful partnerships in an effort to develop or refine interprofessional global health education programs.
Zorek, Joseph A.; MacLaughlin, Anitra A.; Samiuddin, Mohammed; Young, Rodney B.; MacLaughlin, Eric J.
Objectives. To describe the development and validation of an instrument designed to assess student perceptions of physician-pharmacist interprofessional clinical education (SPICE). Methods. Faculty members from pharmacy and medical schools developed items for the instrument, and 179 medical and pharmacy students completed the scale. Psychometric properties, including reliability and construct validity, were assessed using confirmatory factor analysis. Results. The final instrument consisted of 10 items with 3 subscales measuring student perceptions of interprofessional teamwork and team-based practice, roles/responsibilities for collaborative practice, and patient outcomes from collaborative practice. Validity and reliability of the instrument were demonstrated. Conclusion. The SPICE instrument demonstrated promise as a valid and reliable measure of pharmacy and medical student perceptions of interprofessional clinical education. SPICE may serve as a useful instrument for educational researchers in assessing the impact of interprofessional educational experiences. PMID:24249852
King, Sharla; Greidanus, Elaine; Carbonaro, Michael; Drummond, Jane; Patterson, Steven
This study describes the redesign of an interprofessional team development course for health science students. A theoretical model is hypothesized as a framework for the redesign process, consisting of two themes: 1) the increasing trend among post-secondary students to participate in social networking (e.g., Facebook, Second Life) and 2) the need for healthcare educators to provide interprofessional training that results in effective communities of practice and better patient care. The redesign focused on increasing the relevance of the course through the integration of custom-designed technology to facilitate social networking during their interprofessional education. Results suggest that students in an educationally structured social networking environment can be guided to join learning communities quickly and access course materials. More research and implementation work is required to effectively develop interprofessional health sciences communities in a combined face-to-face and on-line social networking context.
Ward, Wendy L; Shaffer, Laura A; Testa, Elizabeth Getzoff
Health Care reform calls for collaborative team-based care; psychologists must therefore strengthen their competencies for work in interprofessional clinical care settings. Toward that end, a group of psychologists participated with physicians, dieticians, physical activity specialists, nurses, and others in a national interprofessional workgroup focused on pediatric obesity. The interprofessional group was designed to identify areas in need of national advocacy, key assessment and treatment concerns, and gaps in internal policies and procedures in children's hospitals. This article provides a case report of psychologists' roles and experience in this workgroup, and focuses on factors that underlie successful collaboration among diverse health professionals, as well as potential barriers to success. The participating psychologists developed a working model for collaboration with other disciplines. Additionally, they formed a Psychology Subcommittee to identify and address discipline-specific issues regarding collaborative practice in pediatric psychology. Lessons learned in this interprofessional collaborative undertaking have relevance for future collaborative endeavors.
Aiguier, Grégory; Poirette, Sabine; Pélissier, Marie-France
Comprehensive care for patients in hospital requires a collective practice of care. Interprofessional collaboration becomes a major issue for organizations of care but also for health schools. This text questions the pedagogical practices that promote an effective interprofessional collaboration of actors in caregiving situation. Theoretical reflection will lead to consider interprofessionality education as a collective learning process actors and organizations. Therefore, this learning must necessarily supported by an inter-institutional project (the care and training institutions) making this a common learning problems and requiring a reflective governance. The presentation of an inter-institutional learning project currently experienced and dedicated to interprofessional collaboration in the geriatric field will illustrate the point. It will present the activities of educational intervention and research-intervention performed by a group of actors (caregivers, health trainers and researchers in health ethics and pedagogy) responsible for ensuring the reflective control.
Jones, Aled; Jones, Delyth
This study explored the perceptions of staff in an interprofessional team based on a medical rehabilitation ward for older people, following the introduction of a service improvement programme designed to promote better teamworking. The study aimed to address a lack of in-depth qualitative research that could explain the day-to-day realities of interprofessional teamworking in healthcare. All members of the team participated, (e.g. nurses, doctors, physiotherapists, social worker, occupational therapists), and findings suggest that interprofessional teamworking improved over the 12-month period. Four themes emerged from the data offering insights into the development and effects of better interprofessional teamworking: the emergence of collegial trust within the team, the importance of team meetings and participative safety, the role of shared objectives in conflict management and the value of autonomy within the team. Reductions in staff sickness/absence levels and catastrophic/major patient safety incidents were also detected following the introduction of the service improvement programme.
Dahlke, Sherry; Meherali, Salima; Chambers, Thane; Freund-Heritage, Rosalie; Steil, Kim; Wagg, Adrian
We conducted a scoping study to examine how interprofessional health care teams improve the outcomes of older adults experiencing cognitive challenges. We searched Ovid, Medline 1946, and MEDLINE In-Process and other non-indexed citations, using the concepts multi or interdisciplinary care teams, confusion or cognitive impairment, and elderly adults. Of 4,554 articles the review yielded, 34 relevant to our inquiry, using Arksey and O'Malley's methodological framework. Twenty-nine per cent of authors reported on the processes interprofessional teams use to achieve positive outcomes for older adults. They highlighted the importance of communication, staff strategies, and education interventions in achieving outcomes with older adults and in supporting interprofessional collaboration. The review revealed knowledge gaps about the processes teams use to collaborate in caring for older adults experiencing cognitive challenges, and how to best incorporate older adults and their families' perspectives in team decisions. More research to understand processes interprofessional teams use is needed.
Conclusion: Interprofessional inner city health educational programs are beneficial for students to learn about poverty intervention and resources, and may represent a strategy to address a gap in the healthcare professional curriculum.
Lennon-Dearing, Robin; Lowry, Lois W; Ross, Calvin W; Dyer, Allen R
Future health professionals are often educated with other students of their same discipline when, in practice, they will be working with professionals from other backgrounds to provide care for the patient. Complex issues of ethical concern are common to health professionals due to modern technology. This paper describes the evolution of an interprofessional bioethics course that had a unique combination of students and faculty. Innovative teaching methods were utilized and continuously refined based on student evaluations. Students commonly cited the interprofessional interactions as the most enjoyable part of the learning experience. Establishing a patient-centered focus and an appreciation of the contributions of other disciplines, students learned how to apply ethical decision-making to real cases. At the conclusion of the course, students reported improved attitudes toward interprofessional teamwork. This course format and teaching techniques may be applied at other universities looking for linkages to encourage consistent interprofessional collaboration across disciplines.
Morgan, Sonya; Pullon, Susan; McKinlay, Eileen
Interprofessional collaboration improves patient care, especially for those patients with complex and/or chronic conditions. Many studies examining collaborative practice in primary care settings have been undertaken, yet identification of essential elements of effective interprofessional collaboration in primary care settings remains obscure. To examine the nature of interprofessional collaboration (including interprofessional collaborative practice) and the key influences that lead to successful models of interprofessional practice in primary care teams, as reported in studies using direct observation methods. Integrative review using Whittemore and Knafl's (2005) five stage framework: problem identification, literature search, data evaluation, data analysis and presentation. Data sources and review method: Primary research studies meeting the search criteria were accessed from MEDLINE, PsycINFO, Scopus, King's Fund and Informit Health Collection databases, and by hand-searching reference lists. From 2005 to 2013, 105 studies closely examining elements of interprofessional collaboration were identified. Of these, 11 studies were identified which incorporated a range of 'real time' direct observation methods where the collaborative practice of health professionals was closely observed. Constant opportunity for effective, frequent, informal shared communication emerged as the overarching theme and most critical factor in achieving and sustaining effective interprofessional collaboration and interprofessional collaborative practice in this review. Multiple channels for repeated (often brief) informal shared communication were necessary for shared knowledge creation, development of shared goals, and shared clinical decision making. Favourable physical space configuration and 'having frequent brief time in common' were key facilitators. This review highlights the need to look critically at the body of research purported to investigate interprofessional collaboration
Stephanie L Pott
Full Text Available Healthcare practice is continuing to shift toward interprofessional team-based care to improve the patient experience and the health of populations as well as to reduce the per capita cost of healthcare (National Center for Interprofessional Practice & Education, 2013. In particular, high-risk pregnancy is a uniquely complex healthcare challenge, which makes team- and partnership-based care in this specialty essential (American College of Obstetricians and Gynecologists’ Task Force on Collaborative Practice, 2016. Despite healthcare leaders in the United States recognizing the need for collaborative care models and team-based care, the training of healthcare professions students in the skills needed to collaborate effectively as part of an interprofessional team have lagged dramatically behind the changes in current healthcare practices (Interprofessional Education Collaborative [IPEC] Expert Panel, 2011; National Center for Interprofessional Practice & Education, 2015b. A Doctorate of Nursing Practice (DNP Student and a Women’s Health DNP Program faculty identified that there was an opportunity to implement interprofessional practice-focused immersion experiences for advanced practice registered nursing (APRN students at an academic Maternal-Fetal Medicine Center. The faculty and student partnership allowed for the project interventions to be integrated directly into an existing APRN practicum course. This project’s implementation provided an opportunity for the Maternal-Fetal Medicine Center to integrate APRN students into their clinical team, and demonstrated that interprofessional practice-focused immersion experiences are beneficial for students’ learning of how to collaborate effectively as part of an interprofessional team, which is congruent with the research. The Maternal-Fetal Medicine Center embodied many of the components of the domains of interprofessional practice and qualities of a partnership-based system, making it an
Savage, Grant T; Duncan, W Jack; Knowles, Kathy L; Nelson, Kathleen; Rogers, David A; Kennedy, Karen N
The study describes the genesis of the University of Alabama at Birmingham's Healthcare Leadership Academy (HLA), highlights the HLA's outcomes, discloses how the HLA has changed, and delineates future directions for academic health center (AHC) interprofessional leadership training. While interprofessional training is recognized as an important component of the professional education for health professionals, AHCs have not focused on interprofessional leadership training to prepare future AHC leaders. As professional bureaucracies, AHCs require leadership distributed across different professions; these leaders not only should be technical experts, but also skilled at interprofessional teamwork and collaborative governance. The HLA is examined using the case method, which is supplemented with a descriptive analysis of program evaluation data and outcomes. The HLA has created a networked community of AHC leaders; the HLA's interprofessional team projects foster innovative problem solving. Interprofessional leadership training expands individuals' networks and has multiple organizational benefits. © 2014.
Balogun, S A; Rose, K; Thomas, S; Owen, J; Brashers, V
Interprofessional education (IPE) is crucial in fostering effective collaboration and optimal team-based patient care, all of which improve patient care and outcomes. Appropriate interprofessional communication is especially important in geriatrics where patients are vulnerable to adverse effects across the care continuum. Transitions in geriatric care are complex, involving several disciplines and requiring careful coordination. As part of the University of Virginia's initiative on IPE, we developed and implemented an interprofessional geriatric education workshop for nursing and medical students with a focus on transitions in care. A total of 254 students (144 medical students, 107 nursing students and 3 unknown) participated in a 90-min interactive, case-based workshop. Nursing and medical faculty facilitated the monthly workshops with small groups of medical and nursing students over 1 year. Self-perceived competencies in IPE skills and attitudes toward interprofessional teamwork were measured through post-workshop surveys. Data were analyzed using descriptive and nonparametric statistics, excluding the three unknown students. Over 90% of students were better able to describe the necessary interprofessional communication needed to develop a patient-centered care plan in transitioning patients between clinical sites. Four out of five students reported an enhanced appreciation of interprofessional teamwork. They were also able to identify legal, financial and social implications in transitions of care (75%). Nursing students consistently rated the workshop more highly than medical students across most domains (P interprofessional communication and teamwork skills required in transitions of geriatric care. Introducing these concepts in medical and nursing training may help in fostering effective interprofessional communication and collaboration. © The Author 2014. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved
Burau, Viola; Carstensen, Kathrine; Lou, Stina; Kuhlmann, Ellen
Background Patient-centred care based on needs has been gaining momentum in health policy and the workforce. This creates new demand for interprofessional teams and redefining roles and tasks of professionals, yet little is known on how to implement new health policies more effectively. Our aim was to analyse the role and capacity of health professions in driving organisational change in interprofessional working and patient-centred care. Methods A case study of the introduction of interprofe...
Nørgaard, Birgitte; Draborg, Eva; Vestergaard, Poul Erik
Background: Interprofessional collaboration potentially enhances patient safety and satisfaction, and reduces tensions and conflicts among health professionals. However, health professionals often lack sufficient knowledge of other professional roles and competences to engage in interprofessional...... study (ICS) unit including students from nursing, medicine, physiotherapy, occupational therapy, laboratory technology and radiography. Data on students' perceived self-efficacy were collected through web-based questionnaires. Aspects of self-efficacy measured were: (1) collaboration with other...
Poghosyan, Lusine; Norful, Allison A.; Martsolf, Grant R.
Developing team-based care models and expanding nurse practitioner (NP) workforce in primary care are recommended by policy makers to meet demand. Little is known how to promote interprofessional teamwork. Using a mixed-methods design, we analyzed qualitative interview and quantitative survey data from primary care NPs to explore practice characteristics important for teamwork. The Interprofessional Teamwork for Health and Social Care Framework guided the study. We identified NP-physician and...
Torbjörnsson, Eva; Olivecrona, Charlotta; Sonden, Anders
Every semester, the operating room (OR) ward receives students from different educational programmes. Although interprofessional knowledge is essential for OR teamwork, students have traditionally been prepared in an uniprofessional manner, with no focus on interprofessional learning outcomes. This report describes the work process of an interprofessional initiative undertaken to create a common learning resource aimed at preparing students for OR practice. With a focus on interprofessional learning, shared and profession-specific learning outcomes, which are needed to prepare for practice, were identified by an interprofessional faculty. To avoid timetabling and geographic barriers, learning outcomes and constructed learning activities were packaged into an e-module and delivered on-line as an adjunct to existing lectures and workshops. A survey was administered to 4th year medical (n = 42) and 1st year OR nurse students (n = 4) to evaluate their perceptions of the e-module. We found that most learning outcomes from the different syllabuses were common for all professions. The overall response rate of the survey was 59% (27 of 46 students). Eighteen of the 27 responding students had used the learning resource, of which 15 students considered it to be of 'high' or 'very high' value. In summary, this interprofessional initiative resulted in a new common learning resource for the OR, which was used and perceived valuable by a majority of the students. The learning outcomes needed to prepare students from different educational programmes for OR practice are, to a great extent, generic and interprofessional and we thus argue that the interprofessional nature of the faculty was essential for the success of the initiative.
Williams, Brett; Beovich, Bronwyn; Ross, Linda; Wright, Caroline; Ilic, Dragan
Self-efficacy is an individual's perception of their ability to be successful in a given endeavour and it has been shown to have an important role in successful university education and clinical performance of healthcare workers. This article examines the self-efficacy beliefs of undergraduate healthcare students (n = 388) for the skills required for interprofessional education and interprofessional collaboration. The students were enrolled at an Australian university from the disciplines of public health, social work, and paramedic practice. The Self-Efficacy for Interprofessional Experiential Learning (SEIEL) scale, which is a valid and reliable scale, was used to determine the self-reported perceptions of self-efficacy in this cohort. The 16-item scale was developed for use with medicine and other healthcare professional undergraduate students. Student t-tests were used to compare scores between males and females, with one-way ANOVAs used to explore SEIEL scores across disciplines and year level. A significant difference was found between genders for the scores on SEIEL subscale 2 "Interprofessional evaluation and feedback" (p = 0.01) with the male mean being 2.65 units higher (Cohen's d = 0.29). There was also a significant gender difference for the overall SEIEL scale (p = 0.029) with the male mean being 4.1 units higher (Cohen's d = 0.238). No significant gender differences were demonstrated for the subscale "Interprofessional interaction." Neither subscale demonstrated significant differences between healthcare disciplines or course year. Further investigation is required to explore the reasons for the outcomes of this study. With the increasing importance of interprofessional education and practice within healthcare, it would also appear reasonable to consider further research into the development and support of student self-efficacy for the skills required for interprofessional education and interprofessional collaboration within healthcare
Straub, Christine; Krüger, Marcus; Bode, Sebastian
Interprofessional collaboration between different professional groups in the health care system is essential to efficient and effective patient care. Especially in pediatrics, in the field of child protection, and family services it is mandatory to involve experts from different health-care professions to optimize support for children and their families. Interprofessional education in medical schools and specifically in pediatrics is rare in Germany, but is called for by the German National Competence Based Catalogue of Learning Objectives for Undergraduate Medical Education (NKLM). We developed an interprofessional course aimed at bringing medical students together with students of psychology, social work, clinical education, and educational science to learn from, about and with each other in the context of child protection and family services. This offers opportunities for all participants to understand profession-specific competencies, roles, attitudes, and limits of their professional roles. The course is led by an interprofessional teaching tandem (social scientist & physician); further input is provided by other health and social care professionals. After the students get a brief overview about the requirements for a successful interprofessional cooperation they solve case studies in interprofessional teams with online support by the teaching tandem. We assess the feasibility and acceptability of this interprofessional course and describe challenges encountered when conducting this kind of learning concept for health care professions. All conducted courses over five consecutive terms were evaluated with an arithmetic mean of AM=1.32 on a 6-point scale (1="excellent", 6="insufficient"), the teaching tandem was evaluated with AM=1.1. All participants (N=85 complete evaluations) voted for the course to be continued in the following terms. Especially the opportunity to discuss cases with students from different degree programs was highly valued as were
Full Text Available Shelley B Bhattacharya,1–3 Michelle I Rossi,1,2 Jennifer M Mentz11Geriatric Research Education and Clinical Center (GRECC, Veteran's Affairs Pittsburgh Healthcare System, 2University of Pittsburgh Medical Center, Pittsburgh, PA, USA; 3Albert Schweitzer Fellowship Program, Pittsburgh, PA, USAIntroduction: Interprofessional patient care is a well-recognized path that health care systems are striving toward. The Veteran's Affairs (VA system initiated interprofessional practice (IPP models with their Geriatric Evaluation and Management (GEM programs. GEM programs incorporate a range of specialties, including but not limited to, medicine, nursing, social work, physical therapy and pharmacy, to collaboratively evaluate veterans. Despite being a valuable resource, they are now faced with significant cut-backs, including closures. The primary goal of this project was to assess how the GEM model could be optimized at the Pittsburgh, Pennsylvania VA to allow for the sustainability of this important IPP assessment. Part 1 of the study evaluated the IPP process using program, patient, and family surveys. Part 2 examined how well the geriatrician matched patients to specialists in the GEM model. This paper describes Part 1 of our study.Methods: Three strategies were used: 1 a national GEM program survey; 2 a veteran/family satisfaction survey; and 3 an absentee assessment.Results: Twenty-six of 92 programs responded to the GEM IPP survey. Six strategies were shared to optimize IPP models throughout the country. Of the 34 satisfaction surveys, 80% stated the GEM clinic was beneficial, 79% stated their concerns were addressed, and 100% would recommend GEM to their friends. Of the 24 absentee assessments, the top three reasons for missing the appointments were transportation, medical illnesses, and not knowing/remembering about the appointment. Absentee rate diminished from 41% to 19% after instituting a reminder phone call policy.Discussion: Maintaining the
Full Text Available Stanislav Henkin,1 Tony Y Chon,2 Marie L Christopherson,3 Andrew J Halvorsen,1,4 Lindsey M Worden,3 John T Ratelle51Department of Medicine, Mayo Clinic, 2Division of General Internal Medicine, Mayo Clinic, 3Department of Nursing, Mayo Clinic, 4Department of Medicine, Internal Medicine Residency Office of Educational Innovations, Mayo Clinic, 5Division of Hospital Medicine, Mayo Clinic, Rochester, MN, USA Background: Teamwork between physicians and nurses has a positive association with patient satisfaction and outcomes, but perceptions of physician–nurse teamwork are often suboptimal.Objective: To improve nurse–physician teamwork in a general medicine inpatient teaching unit by increasing face-to-face communication through interprofessional bedside rounds.Intervention: From July 2013 through October 2013, physicians (attendings and residents and nurses from four general medicine teams in a single nursing unit participated in bedside rounding, which involved the inclusion of nurses in morning rounds with the medicine teams at the patients’ bedside. Based on stakeholder analysis and feedback, a checklist for key patient care issues was created and utilized during bedside rounds.Assessment: To assess the effect of bedside rounding on nurse–physician teamwork, a survey of selected items from the Safety Attitudes Questionnaire (SAQ was administered to participants before and after the implementation of bedside rounds. The number of pages to the general medicine teams was also measured as a marker of physician–nurse communication.Results: Participation rate in bedside rounds across the four medicine teams was 58%. SAQ response rates for attendings, residents, and nurses were 36/36 (100%, 73/73 (100%, and 32/73 (44% prior to implementation of bedside rounding and 36 attendings (100%, 72 residents (100%, and 14 (19% nurses after the implementation of bedside rounding, respectively. Prior to bedside rounding, nurses provided lower
Lutfiyya, May Nawal; Brandt, Barbara; Delaney, Connie; Pechacek, Judith; Cerra, Frank
ABSTRACT Interprofessional education (IPE) and collaborative practice (CP) have been prolific areas of inquiry exploring research questions mostly concerned with local program and project assessment. The actual sphere of influence of this research has been limited. Often discussed separately, this article places IPE and CP in the same conceptual space. The interface of these form a nexus where new knowledge creation may be facilitated. Rigorous research on IPE in relation to CP that is relevant to and framed by health system reform in the U.S. is the ultimate research goal of the National Center for Interprofessional Practice and Education at the University of Minnesota. This paper describes the direction and scope for a focused and purposive IPECP research agenda linked to improvement in health outcomes, contextualized by health care reform in the U.S. that has provided a revitalizing energy for this area of inquiry. A research agenda articulates a focus, meaningful and robust questions, and a theory of change within which intervention outcomes are examined. Further, a research agenda identifies the practices the area of inquiry is interested in informing, and the types of study designs and analytic approaches amenable to carrying out the proposed work. PMID:26230379
Hark, Lisa A; Deen, Darwin
It is the position of the Academy of Nutrition and Dietetics that registered dietitian nutritionists (RDNs) should play a significant role in educating medical students, residents, fellows, and physicians in practice. The more physicians learn about the effectiveness of nutrition for the prevention and treatment of noncommunicable diseases, the more likely they are to consult with RDNs and refer patients for medical nutrition therapy. The more interprofessional education that occurs between medical students, other health professional students, and RDNs, the more likely all health care professionals will understand and value the role of the RDN in improving the quality of care provided to patients. The training and experience of RDNs make them uniquely qualified for the role of educating medical students about nutrition as it relates to health and disease. This position paper provides RDNs with the tools and language to emphasize to medical educators, course directors, curriculum committees, medical school deans, residency and fellowship directors, physicians, and other health professionals in training and practice how ongoing nutrition counseling and management, conducted by an RDN, can benefit their patients. Specific teaching settings and examples for RDNs to take a leadership role (paid and unpaid positions) in ensuring that future physicians discuss nutrition, healthy lifestyle, and physical activity with their patients, consult with RDNs, and refer patients for medical nutrition therapy are presented. This position paper supports interprofessional education in nutrition as an essential component of medical education. Copyright © 2017 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Hojat, Mohammadreza; Ward, Julia; Spandorfer, John; Arenson, Christine; Van Winkle, Lon J; Williams, Brett
This study was designed to develop a psychometrically sound instrument to measure attitudes toward interprofessional collaboration in health profession students and practitioners regardless of their professions and areas of practice. Based on a review of the literature a list of 27 items was generated, 12 faculty judged the face validity of the items, and 124 health profession faculty examined the content validity of the items. The preliminary version of the instrument was administered to 1976 health profession students in three universities (Thomas Jefferson University, n = 510; Midwestern University, n = 392; and Monash University, n = 1074). Twenty items that survived the psychometric scrutiny were included in the Jefferson Scale of Attitudes Toward Interprofessional Collaboration (JeffSATIC). Two constructs of "working relationships" and "accountability" emerged from factor analysis of the JeffSATIC. Cronbach's α coefficients for the JeffSATIC ranged from 0.84 to 0.90 in the three samples. Women obtained significantly higher JeffSATIC mean scores than men. Medical students obtained lower mean score on the JeffSATIC than most other health profession students at the same university. Psychometric support from a relatively large sample size of students in a variety of health profession programs in this multi-institutional study is encouraging which adds to the credibility of the JeffSATIC.
Ogbonnaya, L U; Ogbonnaya, C E; Adeoye-Sunday, I M
Interprofessional conflict in university teaching hospitals in Nigeria is on the increase. This study was aimed at assessing the health professions' perception of factors responsible forconflict. A cross-sectional descriptive survey among six health professions. The perceived causes of conflict include differential salary between doctors and others, physician intimidation and discrimination of other professions, "inordinate ambition" of the other professions to lead the health team, and envy of the doctor by the other professions. Doctors differed significantly from the other professions on the role of each of these in causing conflict. Mutual respect for each other's competence, proper remuneration and clear delineation of duties for all, and other groups appreciating the salary differential between them and doctors were perceived as means of resolving the conflict. While all accepted mutual respect and proper remuneration as effective, other health workers differed significantly from doctors on the effectiveness of appreciating salary differential between them and doctors in resolving the conflict. Differential salary between the doctor and the other health workers is the main factor perceived to cause interprofessional conflict. The government and all health professions should accept, and maintain the relativity in salary differential between doctors and other health professions.
Miller, Ryan; Winterton, Tessa; Hoffman, Wendell W
Throughout the last decade, there has been a significant move toward integrating patient safety and quality improvement concepts into health professions education, essentially building a whole new mind in terms of medical knowledge. While existing literature has suggested possible means of implementation, little research has described outcomes and specific examples of integration. The Institute for Healthcare Improvement (IHI) Open School offers a curriculum that could be incorporated in most health professions training. This project serves to study implementation of Open School courses, garner student feedback and guide the implementation of quality and safety curricula across health disciplines in South Dakota. First-year medical and allied health students at the University of South Dakota completed surveys before and after having one introductory lecture and finishing two of the Open School courses in interprofessional teams within an existing health professions course. Medical student means showed significant differences in 16 of 16 (p=0.05) primary teaching points related to Open School course objectives, while allied health students showed significant differences in 13 of 16 (p=0.05) points. Students valued an introductory lecture and thought their educational experience was enhanced by the addition of the Open School courses. Our results demonstrate that the Open School courses chosen for this sample of interprofessional students provide a simple, inexpensive and effective method to implement quality and patient safety concepts within existing health professions curricula.
Clark, Phillip G; Weeks, Lori E; van Den Bergh, Graziella; Doucet, Shelley
The need for interprofessional teamwork and the global challenges for health care systems of dramatically increasing numbers of older adults have received increased recognition in gerontological and geriatrics education. The authors report on the pilot development of a hybrid course on aging and health for graduate-level health professions students from Norway, Canada, and the United States. International faculty from partnering universities developed, taught, and evaluated the course. Course assignments included online forum postings, reflections, and a problem-based learning group assignment and presentation. Directed readings and discussion included topics related to health care systems and services in the three participating countries, teamwork, and patient-centered care. To evaluate the course, quantitative and qualitative data were collected and analyzed. Results indicate a significant impact on student learning outcomes, including understanding of issues in international aging and health, attitudes and skills in teamwork, and application to clinical practice. This course clearly established the importance of developing innovative interprofessional educational experiences that respond to the increasingly universal impacts of aging populations on health and social care systems around the world.
DiMaria-Ghalili, Rose Ann; Mirtallo, Jay M; Tobin, Brian W; Hark, Lisa; Van Horn, Linda; Palmer, Carole A
Understanding and applying nutrition knowledge and skills to all aspects of health care are extremely important, and all health care professions need basic training to effectively assess dietary intake and provide appropriate guidance, counseling, and treatment to their patients. With obesity rates at an all-time high and the increasing prevalence of diabetes projected to cost the Federal government billions of dollars, the need for interprofessional nutrition education is paramount. Physicians, physician assistants, nurses, nurse practitioners, pharmacists, dentists, dental hygienists, occupational therapists, physical therapists, speech and language pathologists, and others can positively affect patient care by synchronizing and reinforcing the importance of nutrition across all specialty areas. Although nutrition is a critical component of acute and chronic disease management, as well as health and wellness across the health care professions, each profession must reevaluate its individual nutrition-related professional competencies before the establishment of meaningful interprofessional collaborative nutrition competencies. This article discusses gaps in nutrition education and training within individual health professions (ie, nursing, pharmacy, dentistry, and dietetics) and offers suggestions for educators, clinicians, researchers, and key stakeholders on how to build further capacity within the individual professions for basic and applied nutrition education. This “gaps methodology” can be applied to all health professions, including physician assistants, physical therapists, speech and language pathologists, and occupational therapists. PMID:24646823
DiMaria-Ghalili, Rose Ann; Mirtallo, Jay M; Tobin, Brian W; Hark, Lisa; Van Horn, Linda; Palmer, Carole A
Understanding and applying nutrition knowledge and skills to all aspects of health care are extremely important, and all health care professions need basic training to effectively assess dietary intake and provide appropriate guidance, counseling, and treatment to their patients. With obesity rates at an all-time high and the increasing prevalence of diabetes projected to cost the Federal government billions of dollars, the need for interprofessional nutrition education is paramount. Physicians, physician assistants, nurses, nurse practitioners, pharmacists, dentists, dental hygienists, occupational therapists, physical therapists, speech and language pathologists, and others can positively affect patient care by synchronizing and reinforcing the importance of nutrition across all specialty areas. Although nutrition is a critical component of acute and chronic disease management, as well as health and wellness across the health care professions, each profession must reevaluate its individual nutrition-related professional competencies before the establishment of meaningful interprofessional collaborative nutrition competencies. This article discusses gaps in nutrition education and training within individual health professions (ie, nursing, pharmacy, dentistry, and dietetics) and offers suggestions for educators, clinicians, researchers, and key stakeholders on how to build further capacity within the individual professions for basic and applied nutrition education. This "gaps methodology" can be applied to all health professions, including physician assistants, physical therapists, speech and language pathologists, and occupational therapists.
MacKenzie, Diane; Creaser, Gail; Sponagle, Kim; Gubitz, Gordon; MacDougall, Peter; Blacquiere, Dylan; Miller, Stephen; Sarty, Gordon
Interprofessional practice (IPP) is the accepted standard of care for clients following a stroke. A brief, embedded and evidence-based IPP team simulation was designed to address stroke care knowledge and IPP competencies for students within limited curriculum space. Each team was required to construct a collaborative care plan for their patient during the simulation and submit the care plan for evaluation of best practice stroke care knowledge and implementation with evidence of interprofessional collaboration (IPC). A total of 302 students (274 on-site, 28 by distance technology) representing four professions comprised of 55 teams took part in this experience. Post-simulation, voluntary and anonymous programme evaluations were completed using the standardised interprofessional collaborative competency assessment scale (ICCAS) and open-ended free-text responses to five questions. There was a significant improvement for all pre-post ratings on the ICCAS regardless of profession or previous interprofessional experience. Additionally, the open-ended responses indicated perceived changes to role clarification, communication, and teamwork. The combined interpretation of the programme evaluation results supports interprofessional team simulation as an effective and efficient learning experience for students regardless of previous interprofessional experience, and demonstrated positive changes in stroke best-practice knowledge and IPC competencies.
Interprofessional education (IPE) continues to grow as a field internationally, and therefore has become a key activity which numerous institutions have implemented around the world. A number of learner characteristics have been suggested as being important for the success of interprofessional interventions, including prior experiences, expectations, and motivations. This study sought to explore medical student engagement with IPE and the factors that affect this. Twelve final and penultimate year students took part in two focus groups to discuss previous IPE and the factors which they felt led to successful interprofessional experiences. Thematic analysis was used to interpret the data. Students were found to be receptive to the idea of IPE, but had some reservations about its current form. Students were enthusiastic about clinically relevant IPE experiences, but were put off by generic teambuilding exercises, especially those with a poor mix of professional groups. They also reported being aware of interprofessional tensions and communication issues, which they felt might be alleviated through frequent interprofessional contact at the undergraduate level. This study suggests that medical students desire realistic, clinically relevant, interprofessional experiences, with a good mix of professionals, through which they can gain more awareness of their own role and that of other professionals.
Brewer, Margo L; Flavell, Helen Louise; Jordon, Joanne
Interprofessional education in practice settings typically requires greater resource investment than in the classroom or online. Increased interest in return on investment means research on the outcomes of practice-based interprofessional education is needed. In this article, we report findings from a qualitative study involving a series of focus groups with health sciences' students during their interprofessional placements in three community health settings in Western Australia. An exploratory case study approach was adopted to determine students' perceptions of the placement and their learning. The presage-process-product (3P) model of learning and teaching was employed to illuminate to the nature of this interprofessional education experience. Verbatim transcripts were analysed by two researchers using an inductive approach to derive key themes. Findings illuminate a number of factors that strongly influenced student perceptions of their learning in interprofessional practice-based placements including a dedicated space to collaborate and learn; exposure to a wide range of professions in practice settings; the approach of the facilitators; and students' previous clinical experience, year level and the timing of the placement. Students reported that the placement enhanced their knowledge, professional communication, leadership, understanding of other health professions and collaboration. This study provides contemporary insight into key factors that influence student learning during practice-based interprofessional placements.
Mann, K V; Mcfetridge-Durdle, J; Martin-Misener, R; Clovis, J; Rowe, R; Beanlands, H; Sarria, M
"Seamless Care" was one of 21 grants awarded by Health Canada to inform policymakers of the effectiveness of interprofessional education in promoting collaborative patient-centred practice among health professionals. The "Seamless Care" model of interprofessional education was designed with input from three Faculties at Dalhousie University (Medicine, Dentistry and Health Professions). The design was grounded in relevant learning theories--Social Cognitive Theory, Self-efficacy, Situated Learning theory and Constructivism. The intervention was informed by principles of active learning, problem-based learning, reflection and role modeling. The primary goal of Seamless Care was to develop students' interprofessional patient-centred collaborative skills through experiential learning. Fourteen student teams, each including one student from medicine, nursing, pharmacy, dentistry and dental hygiene, learned with, from and about each other while they were mentored in the collaborative care of patients transitioning from acute care to the community. Student teams providing collaborative care assisted patients experiencing a chronic illness to become more active in managing their health through development of self-management and decision-making skills. This paper describes the Seamless Care model of interprofessional education and discusses the theoretical underpinnings of this experiential model of interprofessional education designed to extend classroom-based interprofessional education to the clinical setting.
Kwon, Jae Yung; Bulk, Laura Yvonne; Giannone, Zarina; Liva, Sarah; Chakraborty, Bubli; Brown, Helen
Despite numerous studies on formal interprofessional education programes, less attention has been focused on informal interprofessional learning opportunities. To provide such an opportunity, a collaborative peer review process (CPRP) was created as part of a peer-reviewed journal. Replacing the traditional peer review process wherein two or more reviewers review the manuscript separately, the CPRP brings together students from different professions to collaboratively review a manuscript. The aim of this study was to assess whether the CPRP can be used as an informal interprofessional learning tool using an exploratory qualitative approach. Eight students from Counselling Psychology, Occupational and Physical Therapy, Nursing, and Rehabilitation Sciences were invited to participate in interprofessional focus groups. Data were analysed inductively using thematic analysis. Two key themes emerged, revealing that the CPRP created new opportunities for interprofessional learning and gave practice in negotiating feedback. The results reveal that the CPRP has the potential to be a valuable interprofessional learning tool that can also enhance reviewing and constructive feedback skills.
Keshtkaran, Zahra; Sharif, Farkhondeh; Rambod, Masoume
Inter-professional education is a critical pedagogical approach aiming at preparing healthcare students for providing patient care in a collaborative team atmosphere. To investigate the readiness for and perception of inter-professional learning and their relationship among healthcare students. It was a correlational, cross-sectional study. Two hundred and fifty undergraduate medical, B.Sc. nursing, and B.Sc. science in surgical technology students participated in this study. The samples were selected from the colleges affiliated to Shiraz University of Medical Sciences using stratified random sampling. The Readiness for Inter-Professional Learning Scale (RIPLS) and Interdisciplinary Education Perception Scale (IEPS) were used to measure the readiness for and perception of inter-professional leaning. The data were analyzed using One-way Analysis of Variance (ANOVA) and independent sample T-test. The total mean scores of readiness for and perception of inter-professional learning were 82.40 (SD=23.16) and 74.04 (SD=14.26), respectively. Besides, the medical students' total mean score of readiness was significantly lower than that of the nursing and science in surgical technology students (F=76.73, Pstudents had the lowest RIPLS. In addition, the nursing students reported the lowest IEPS; therefore, this group's curriculum is suggested to be revised. For evidence based practice, other studies are recommended to improve inter-professional learning. Copyright © 2013 Elsevier Ltd. All rights reserved.
Piers, Ruth D; Versluys, Karen J J; Devoghel, Johan; Lambrecht, Sophie; Vyt, André; Van Den Noortgate, Nele J
To explore the quality of interprofessional teamwork in acute geriatric care and to build a model of team types. Cross-sectional multicenter study. Acute geriatric units in Belgium. Team members of different professional backgrounds. Perceptions of interprofessional teamwork among team members of 55 acute geriatric units in Belgium were measured using a survey covering collaborative practice and experience, managerial coaching and open team culture, shared reflection and decision-making, patient files facilitating teamwork, members' belief in the power of teamwork, and members' comfort in reporting incidents. Cluster analysis was used to determine types of interprofessional teamwork. Professions and clusters were compared using analysis of variance. The overall response rate was 60%. Of the 890 respondents, 71% were nursing professionals, 20% other allied health professionals, 5% physicians, and 4% logistic and administrative staff. More than 70% of respondents scored highly on interprofessional teamwork competencies, consultation, experiences, meetings, management, and results. Fewer than 55% scored highly on items about shared reflection and decision-making, reporting incidents from a colleague, and patient files facilitating interprofessional teamwork. Nurses in this study rated shared reflection and decision-making lower than physicians on the same acute geriatric units (P teamwork in acute geriatric units is satisfactory, but shared reflection and decision-making needs improvement. Four types of interprofessional teamwork are identified and can be used to benchmark the teamwork of individual teams. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.
Lavender, Charlotte, E-mail: email@example.com; Miller, Seth; Church, Jessica; Chen, Ronald C.; Muresan, Petronella A.; Adams, Robert D.
A less-studied aspect of radiation therapy and medical dosimetry education is experiential learning through attendance at interprofessional conferences. University of North Carolina radiation therapy and medical dosimetry students regularly attended morning conferences and daily pretreatment peer review, including approximately 145 hours of direct interaction with medical attending physicians and residents, medical physicists, and other faculty. We herein assessed the effect of their participation in these interprofessional conferences on knowledge and communication. The students who graduated from our radiation therapy and medical dosimetry programs who were exposed to the interprofessional education initiative were compared with those who graduated in the previous years. The groups were compared with regard to their knowledge (as assessed by grades on end-of-training examinations) and team communication (assessed via survey). The results for the 2 groups were compared via exact tests. There was a trend for the examination scores for the 2012 cohort to be higher than for the 2007 to 2011 groups. Survey results suggested that students who attended the interprofessional education sessions were more comfortable speaking with attending physicians, residents, physicists, and faculty compared with earlier students who did not attend these educational sessions. Interprofessional education, particularly vertical integration, appears to provide an enhanced educational experience both in regard to knowledge (per the examination scores) and in building a sense of communication (via the survey results). Integration of interprofessional education into radiation therapy and medical dosimetry educational programs may represent an opportunity to enrich the learning experience in multiple ways and merits further study.
Lavender, Charlotte; Miller, Seth; Church, Jessica; Chen, Ronald C.; Muresan, Petronella A.; Adams, Robert D.
A less-studied aspect of radiation therapy and medical dosimetry education is experiential learning through attendance at interprofessional conferences. University of North Carolina radiation therapy and medical dosimetry students regularly attended morning conferences and daily pretreatment peer review, including approximately 145 hours of direct interaction with medical attending physicians and residents, medical physicists, and other faculty. We herein assessed the effect of their participation in these interprofessional conferences on knowledge and communication. The students who graduated from our radiation therapy and medical dosimetry programs who were exposed to the interprofessional education initiative were compared with those who graduated in the previous years. The groups were compared with regard to their knowledge (as assessed by grades on end-of-training examinations) and team communication (assessed via survey). The results for the 2 groups were compared via exact tests. There was a trend for the examination scores for the 2012 cohort to be higher than for the 2007 to 2011 groups. Survey results suggested that students who attended the interprofessional education sessions were more comfortable speaking with attending physicians, residents, physicists, and faculty compared with earlier students who did not attend these educational sessions. Interprofessional education, particularly vertical integration, appears to provide an enhanced educational experience both in regard to knowledge (per the examination scores) and in building a sense of communication (via the survey results). Integration of interprofessional education into radiation therapy and medical dosimetry educational programs may represent an opportunity to enrich the learning experience in multiple ways and merits further study
Jeffs, Lianne; Abramovich, Ilona Alex; Hayes, Chris; Smith, Orla; Tregunno, Deborah; Chan, Wai-Hin; Reeves, Scott
Effective teamwork and interprofessional collaboration are vital for healthcare quality and safety; however, challenges persist in creating interprofessional teamwork and resilient professional teams. A study was undertaken to delineate perceptions of individuals involved with the implementation of an interprofessional patient safety competency-based intervention and intervention participants. The study employed a qualitative study design that triangulated data from interviews with six steering committee members and five members of the project team who developed and monitored the intervention and six focus groups with clinical team members who participated in the intervention and implemented local patient safety projects within a large teaching hospital in Canada. Our study findings reveal that healthcare professionals and support staff acquired patient safety competencies in an interprofessional context that can result in improved patient and work flow processes. However, key challenges exist including managing projects amidst competing priorities, lacking physician engagement and sustaining projects. Our findings point to leaders to provide opportunities for healthcare teams to engage in interprofessional teamwork and patient safety projects to improve quality of patient care. Further research efforts should examine the sustainability of interprofessional safety projects and how leaders can more fully engage the participation of all professions, specifically physicians.
Maharajan, Mari Kannan; Rajiah, Kingston; Khoo, Suan Phaik; Chellappan, Dinesh Kumar; De Alwis, Ranjit; Chui, Hui Cing; Tan, Lui Lee; Tan, Yee Ning; Lau, Shin Yee
To evaluate the attitudes and readiness of students of healthcare professions towards interprofessional learning. A cross-sectional study design was used. Two different scales were used to measure the readiness for and perception of interprofessional learning; these were the 'Readiness for Interprofessional Learning Scale' and the 'Interdisciplinary Education Perception Scale'. A convenience sampling method was employed. The sample was drawn from undergraduate students enrolled in years 1 to 5 of medical, dental, pharmacy and health sciences programme. Descriptive and inferential statistics were used to analyse the data. The overall response rate was 83%. The students mentioned that shared learning with other healthcare professional students will increase their ability to understand clinical problems. The students also mentioned that such shared learning will help them to communicate better with patients and other professionals. The students preferred to work with individuals from their own profession. Participants from medical, dental, pharmacy, and health sciences had a difference in opinion about 'negative professional identity', a domain of the Readiness for Interprofessional Learning Scale. Based on the different year of study of the students, 'team work and collaboration', 'negative professional identity' and 'roles and responsibility' were the Interdisciplinary Education Perception Scale domains where students had a difference in opinion. Attitudes and readiness towards interprofessional learning showed significant differences among students of various healthcare professions; these differences also depended on the students' year of study. Interprofessional learning should be incorporated in the curriculum of all healthcare professional programs, which may foster students to become competent healthcare providers and understand each profession's role.
Rajamani, Sripriya; Westra, Bonnie L; Monsen, Karen A; LaVenture, Martin; Gatewood, Laël Cranmer
Team-based healthcare delivery models, which emphasize care coordination, patient engagement, and utilization of health information technology, are emerging. To achieve these models, expertise in interprofessional education, collaborative practice across professions, and informatics is essential. This case study from informatics programs in the Academic Health Center (AHC) at the University of Minnesota and the Office of Health Information Technology (OHIT) at the Minnesota Department of Health presents an academic-practice partnership, which focuses on both interprofessionalism and informatics. Outcomes include the Minnesota Framework for Interprofessional Biomedical Health Informatics, comprising collaborative curriculum development, teaching and research, practicums to promote competencies, service to advance biomedical health informatics, and collaborative environments to facilitate a learning health system. Details on these Framework categories are presented. Partnership success is due to interprofessional connections created with emphasis on informatics and to committed leadership across partners. A limitation of this collaboration is the need for formal agreements outlining resources and roles, which are vital for sustainability. This partnership addresses a recommendation on the future of interprofessionalism: that both education and practice sectors be attuned to each other's expectations and evolving trends. Success strategies and lessons learned from collaborations, such as that of the AHC-OHIT that promote both interprofessionalism and informatics, need to be shared.
Witt Sherman, Deborah; Maitra, Kinsuk; Gordon, Yhovana; Simon, Sharon; Olenick, Maria; Barbara, Salvatore; Doherty-Restrepo, Jennifer; Hough, Monica; Randolph, Marilys; Singh, Arvindar
A basic tenet of palliative care is interprofessional collaboration. Palliative care educators and practitioners lead the way in responding to the Institute of Medicine's (2003) challenge to transform educational and health care systems through interprofessional collaboration. Through exemplary commitment to interprofessional collaboration, a college's academic and palliative care leader, in collaboration with Department Chairs and Directors of nursing and allied health professions, can illustrate and analyze the processes of interprofessional collaboration through the development of a simulated case study of a combat veteran with traumatic brain injury. Methodologic components: (1) interprofessional development of a palliative care case study and (2) debriefing interviews regarding the experience of collaboration of interprofessional team members. The results provide the identification of steps of the interprofessional process and the shared and unique disciplinary competencies in determining a comprehensive health history, physical examination, identifying and prioritizing diagnoses, and determining collaborative discipline-specific interventions. Content analysis of debriefing team interviews provides a description of group composition, structure, process, development, and performance, as well as team member's perceptions of what fosters and challenges collaboration, benefits, and drawbacks, and what could have been done differently in developing an interprofessional initiative. Transformative change in healthcare education and clinical practice involves interprofessional collaboration of colleagues within, across, and beyond universities/colleges and healthcare systems and agencies. Advocating for teamwork has to go beyond talking about being a team player or not to having the language and behaviors we need to observe and measure. This article not only provides key processes in interprofessional collaboration but also identifies key attitudes and behaviors
Hurlock-Chorostecki, Christina; van Soeren, Mary; MacMillan, Kathleen; Sidani, Souraya; Donald, Faith; Reeves, Scott
Objective: Interprofessional care, an aim of institutional healthcare settings globally, promotes safe, cost-effective, quality care. How professionals act to enable interprofessional care has not been described. The nurse practitioner role, with its expertise in both medicine and nursing, is known to enhance collaboration and promote interprofessional care delivery. The objective of this study was to identify, from the healthcare professionals' perspective, nurse practitioner strategies used...
Cahn, Peter S; Bzowyckyj, Andrew; Collins, Lauren; Dow, Alan; Goodell, Kristen; Johnson, Alex F; Klocko, David; Knab, Mary; Parker, Kathryn; Reeves, Scott; Zierler, Brenda K
The complex challenge of evaluating the impact of interprofessional education (IPE) on patient and community health outcomes is well documented. Recently, at the Radcliffe Institute for Advanced Study in the United States, leaders in health professions education met to help generate a direction for future IPE evaluation research. Participants followed the stages of design thinking, a process for human-centred problem solving, to reach consensus on recommendations. The group concluded that future studies should focus on measuring an intermediate step between learning activities and patient outcomes. Specifically, knowing how IPE-prepared students and preceptors influence the organisational culture of a clinical site as well as how the culture of clinical sites influences learners' attitudes about collaborative practice will demonstrate the value of educational interventions. With a mixed methods approach and an appreciation for context, researchers will be able to identify the factors that foster effective collaborative practice and, by extension, promote patient-centred care.
It is critical to prepare nurses for future practice to work in teams by engaging students in interprofessional education (IPE) that fosters positive attitudes toward teamwork. The purpose of this study was to examine the effects of computer-supported IPE on students’ attitudes and perceptions toward health care teamwork and team performance. A hybrid approach to IPE was used to provide students with an educational experience that combined the benefits of traditional face-to-face communication methodology with a computer-mediated platform that focused on reflection and team building. A statistically significant difference was found in students’ perceptions of team performance after engaging in computer-supported IPE. No statistically significant difference in students’ pretest–posttest composite attitude toward teamwork scores was noted; however, there was a positive trend toward improved scores.
Smith, Denise C
Healthcare delivered by teams is becoming more common, and an estimated 50% of obstetricians in the United States (US) work with or employ nurse practitioners or nurse-midwives. The number of midwife-attended births in the United States is also growing. Interprofessional collaboration between midwives and physicians can increase access to safe, quality maternity care for women in the United States. A review of the literature indicates that successful collaborative practice includes effective communication, trust, and respect between providers. A review of concepts and theoretical frameworks offers a foundation for scholarly inquiry, suggests a research agenda for future study, and provides suggestions for organizational leaders to translate current knowledge into the clinical setting. Midwifery, through increasing collaborative practices, has the potential to change care delivery in the years to come.
Thurston, Maria Miller; Harris, Elaine C.; Ryan, Gina J.
Objective. To assess and compare interprofessional education (IPE) naive pharmacy and nursing student stereotypes prior to completion of an IPE activity. Methods. Three hundred and twenty-three pharmacy students and 275 nursing students at Mercer University completed the Student Stereotypes Rating Questionnaire. Responses from pharmacy and nursing students were compared, and responses from different level learners within the same profession also were compared. Results. Three hundred and fifty-six (59.5%) students completed the survey. Pharmacy students viewed pharmacists more favorably than nursing students viewed pharmacists for all attributes except the ability to work independently. Additionally, nursing students viewed nurses less favorably than pharmacy students viewed nurses for academic ability and practical skills. There was some variability in stereotypes between professional years. Conclusion. This study confirms the existence of professional stereotypes, although overall student perceptions of their own profession and the other were generally positive. PMID:28720912
The literature on team and inter-professional care practice describes numerous barriers to the institutionalization of inter-professional healthcare. Responses to slow institutionalization of inter-professional healthcare practice have failed to describe change variables and to identify change agents relevant to inter-professional healthcare practice. The purpose of this paper is to (1) describe individual and organizational level barriers to collaborative practice in healthcare; (2) identify change variables relevant to the institutionalization of inter-professional practice at individual and organizational levels of analysis; and (3) identify human resource professionals as change agents and describe how the strategic use of the human resource function could transform individual and organizational level change variables and therefore facilitate the healthcare system's shift toward inter-professional practice. A proposed program of institutionalization includes the following components: a strategic plan to align human resource functions with organizational level inter-professional healthcare strategies, activities to enhance professional competencies and the organizational position of human resource personnel, activities to integrate inter-professional healthcare practices into the daily routines of institutional and individual providers, activities to stand up health provider champions as permanent leaders of inter-professional teams with human resource professionals as consultants and activities to bring all key players to the table including health providers. Copyright © 2012 John Wiley & Sons, Ltd.
Collins, Sarah; Klinkenberg-Ramirez, Stephanie; Tsivkin, Kira; Mar, Perry L; Iskhakova, Dina; Nandigam, Hari; Samal, Lipika; Rocha, Roberto A
Develop a prototype of an interprofessional terminology and information model infrastructure that can enable care planning applications to facilitate patient-centered care, learn care plan linkages and associations, provide decision support, and enable automated, prospective analytics. The study steps included a 3 step approach: (1) Process model and clinical scenario development, and (2) Requirements analysis, and (3) Development and validation of information and terminology models. Components of the terminology model include: Health Concerns, Goals, Decisions, Interventions, Assessments, and Evaluations. A terminology infrastructure should: (A) Include discrete care plan concepts; (B) Include sets of profession-specific concerns, decisions, and interventions; (C) Communicate rationales, anticipatory guidance, and guidelines that inform decisions among the care team; (D) Define semantic linkages across clinical events and professions; (E) Define sets of shared patient goals and sub-goals, including patient stated goals; (F) Capture evaluation toward achievement of goals. These requirements were mapped to AHRQ Care Coordination Measures Framework. This study used a constrained set of clinician-validated clinical scenarios. Terminology models for goals and decisions are unavailable in SNOMED CT, limiting the ability to evaluate these aspects of the proposed infrastructure. Defining and linking subsets of care planning concepts appears to be feasible, but also essential to model interprofessional care planning for common co-occurring conditions and chronic diseases. We recommend the creation of goal dynamics and decision concepts in SNOMED CT to further enable the necessary models. Systems with flexible terminology management infrastructure may enable intelligent decision support to identify conflicting and aligned concerns, goals, decisions, and interventions in shared care plans, ultimately decreasing documentation effort and cognitive burden for clinicians and
van Schaik, Sandrijn M; O'Sullivan, Patricia S; Eva, Kevin W; Irby, David M; Regehr, Glenn
Receptiveness to interprofessional feedback, which is important for optimal collaboration, may be influenced by 'in-group or out-group' categorisation, as suggested by social identity theory. We used an experimental design to explore how nurses and resident physicians perceive feedback from people within and outside their own professional group. Paediatric residents and nurses participated in a simulation-based team exercise. Two nurses and two physicians wrote anonymous performance feedback for each participant. Participants each received a survey containing these feedback comments with prompts to rate (i) the usefulness (ii) the positivity and (iii) their agreement with each comment. Half of the participants received feedback labelled with the feedback provider's profession (two comments correctly labelled and two incorrectly labelled). Half received unlabelled feedback and were asked to guess the provider's profession. For each group, we performed separate three-way anovas on usefulness, positivity and agreement ratings to examine interactions between the recipient's profession, actual provider profession and perceived provider profession. Forty-five out of 50 participants completed the survey. There were no significant interactions between profession of the recipient and the actual profession of the feedback provider for any of the 3 variables. Among participants who guessed the source of the feedback, we found significant interactions between the profession of the feedback recipient and the guessed source of the feedback for both usefulness (F1,48 = 25.6; p feedback they guessed to be from nurses were higher than ratings of feedback they guessed to be from physicians, and vice versa. Among participants who received labelled feedback, we noted a similar interaction between the profession of the feedback recipient and labelled source of feedback for usefulness ratings (F1,92 = 4.72; p feedback to the in-group than to the out-group. This finding has potential
Full Text Available Diabetic foot ulcers (DFU are increasingly prevalent, and associated with significant morbidity, mortality, and cost. An interprofessional approach to DFU management is critical given the etiological complexity involved. This study aimed to assess the impact of an interprofessional team approach on DFU diagnosis and management for a cohort of patients receiving treatment in an Ontario Canada home care setting.A retrospective cohort study of patients attending a large regional Community Care Access Centre (CCAC between February 11, 2013-September 30, 2014 was conducted. Following CCAC referral, patients were assessed by an interprofessional team at the Toronto Regional Wound Healing Centre (TRWHC. Those aged > 18 years with a DFU of > 6 weeks duration were included. The primary outcome was the precision of the initial diagnosis relating to DFU etiology (i.e. neuropathic, ischemic or mixed etiology. Secondary outcomes included wound healing, and infection parameters. Analysis was completed with STATA 13.1 (College Stn., TX of pre-determined outcomes with 2 sided α of 0.05.A total of 308 patients were screened, and 49 patients (67.3% male of mean age 64.2 years (SD 13.7 with a diagnosis of DFU > 6 weeks duration were included for analysis. Of these, 95% were referred with unspecified DFU, and were reclassified to a precise diagnosis relating to etiology, including neuropathy, ischemia or neuroischemic etiology following TRWHC assessment (p < 0.001. For secondary outcomes post-assessment, healability assessment was conducted for a greater proportion of patients (100% versus 44%, p < 0.001. Infection was identified in a greater number of patients (p = 0.04, and of the 35 patients, 94.5% had deep and surrounding infection, and 88.0% were initiated on systemic antibiotics. Vascular insufficiency was diagnosed in an additional 14.3% of the cohort (p = 0.03. Offloading/footwear assessment was conducted in all patients compared with 30.6% prior to
Full Text Available Martin Stocker,1 Sina B Pilgrim,2 Margarita Burmester,3 Meredith L Allen,4 Wim H Gijselaers5 1Neonatal and Pediatric Intensive Care Unit, Children's Hospital Lucerne, Lucerne, 2Pediatric Intensive Care, University Children's Hospital Berne, Berne, Switzerland; 3Pediatric Intensive Care Unit, Royal Brompton Hospital, London, UK; 4Department of Pediatrics, The Royal Children's Hospital, Victoria, Australia; 5Educational Research and Development, School of Business and Economics, Maastricht University, Maastricht, the Netherlands Background: Aiming for and ensuring effective patient safety is a major priority in the management and culture of every health care organization. The pediatric intensive care unit (PICU has become a workplace with a high diversity of multidisciplinary physicians and professionals. Therefore, delivery of high-quality care with optimal patient safety in a PICU is dependent on effective interprofessional team management. Nevertheless, ineffective interprofessional teamwork remains ubiquitous.Methods: We based our review on the framework for interprofessional teamwork recently published in association with the UK Centre for Advancement of Interprofessional Education. Articles were selected to achieve better understanding and to include and translate new ideas and concepts.Findings: The barrier between autonomous nurses and doctors in the PICU within their silos of specialization, the failure of shared mental models, a culture of disrespect, and the lack of empowering parents as team members preclude interprofessional team management and patient safety. A mindset of individual responsibility and accountability embedded in a network of equivalent partners, including the patient and their family members, is required to achieve optimal interprofessional care. Second, working competently as an interprofessional team is a learning process. Working declared as a learning process, psychological safety, and speaking up are pivotal
Munro, Sarah; Kornelsen, Jude; Grzybowski, Stefan
interprofessional primary maternity care has emerged as one potential solution to the current health human resource shortage in many developed nations. This study explores the barriers to and facilitators of interprofessional models of maternity care between physicians, nurses, and midwives in rural British Columbia, Canada, and the changes that need to occur to facilitate such models. a qualitative, exploratory framework guided data collection and analysis. four rural communities in British Columbia, Canada. Two rural communities had highly functional and collaborative interprofessional relationships between midwives and physicians, and two communities lacked interprofessional activities. 55 participants were interviewed and 18 focus groups were conducted with midwives, physicians, labour and delivery nurses, public health nurses, community-based providers, birthing women, administrators, and decision makers. in models of interprofessional collaboration, primary maternity care providers - physicians, midwives, nurses - work together to meet the needs of birthing women in their community. There are significant barriers to such collaboration given the disciplinary differences between care provider groups including skill sets, professional orientation, and funding models. Data analysis confirmed that interprofessional tensions are exacerbated in geographically isolated rural communities, due to the stress of practicing maternity care in a fee-for-service model with limited health resources and a small patient caseload. The participants we spoke with identified specific barriers to interprofessional collaboration, including physician and nurses' negative perceptions of midwifery and homebirth, inequities in payment between physicians and midwives, differences in scopes of practice, confusion about roles and responsibilities, and a lack of formal structures for supporting shared care practice. Participants expressed that successful interprofessional collaboration
Rodriguez, Amanda I; Zupancic, Steven; Song, Michael M; Cordero, Joehassin; Nguyen, Tam Q; Seifert, Charles
Because of its multifaceted nature, dizziness is difficult for clinicians to diagnose and manage independently. Current treatment trends suggest that patients are often referred to the otolaryngologist for intervention despite having a nonotologic disorder. Additionally, many individuals with atypical presentations are often misdiagnosed and spend a significant amount of time waiting for consultation by the otolaryngologist. Few studies have alluded that implementation of an interprofessional team approach in the diagnosis and management of the dizzy patient can improve clinical decision-making. However, to the authors' knowledge, there is no information specifically quantifying the outcomes and potential benefits of using an interprofessional balance care team approach. To compare dizziness diagnoses trends and referral practices with and without the use of an interprofessional management approach within a university healthcare system. Over the course of a 3-yr period, a retrospective review of the diagnosis and management of dizziness was performed with and without implementation of an interprofessional team. To observe potential differences, year 3 incorporated the interprofessional management approach while years 1-2 did not. The two periods were then compared to each other. A total of 134 patients referred to a university hearing clinic for a vestibular and balance function evaluation. Diagnoses and management trends were examined with descriptive statistics (percentages and frequencies). Fisher's exact tests, analysis of contingency tables, were conducted to evaluate the influence of interprofessional management on dizziness diagnoses and treatment patterns. Results demonstrated that before implementation of an interprofessional team approach, (1) referring clinicians used unspecific dizziness diagnosis codes (e.g., dizziness and giddiness), (2) a low number of patients with dizziness were referred for balance function testing, (3) diagnoses remained
Körner, Mirjam; Bütof, Sarah; Müller, Christian; Zimmermann, Linda; Becker, Sonja; Bengel, Jürgen
To identify key features of teamwork and interventions for enhancing interprofessional teamwork (IPT) in chronic care and to develop a framework for further research, we conducted a systematic literature review of IPT in chronic care for the years 2002-2014. Database searches yielded 3217 abstracts, 21 of which fulfilled inclusion criteria. We identified two more studies on the topic by scanning the reference lists of included articles, which resulted in a final total of 23 included studies. The key features identified in the articles (e.g., team member characteristics, common task, communication, cooperation, coordination, responsibility, participation, staff satisfaction, patient satisfaction, and efficiency) were structured in line with the input-process-output model, and evaluated interventions, such as tools, workshops, and changes in team structure, were added to the model. The most frequently evaluated team interventions were complex intervention programs. All but one of the 14 evaluation studies resulted in enhancement of teamwork and/or staff-related, patient-related, and organization-related outcome criteria. To date, there is no consensus about the main features of IPT and the most effective team interventions in chronic care. However, the findings may be used to standardize the implementation and evaluation of IPT and team interventions in practice and for further research.
Evaluation of interprofessional education: lessons learned through the development and implementation of an interprofessional seminar on team communication for undergraduate health care students in Heidelberg – a project report
Berger, Sarah; Mahler, Cornelia; Krug, Katja; Szecsenyi, Joachim; Schultz, Jobst-Hendrik
Introduction: This project report describes the development, “piloting” and evaluation of an interprofessional seminar on team communication bringing together medical students and Interprofessional Health Care B.Sc. students at the Medical Faculty of Heidelberg University, Germany. Project Description: A five-member interprofessional team collaborated together on this project. Kolb’s experiential learning concept formed the theoretical foundation for the seminar, which explored three interprofessional competency areas: team work, communication and values/ethics. Evaluation for the purposes of quality assurance and future curricula development was conducted using two quantitative measures: descriptive analysis of a standardized course evaluation tool (EvaSys) ANOVA analysis of the German translation of the University of the West of England Interprofessional Questionnaire (UWE-IP-D). Results: The key finding from the standardized course evaluation was that the interprofessional seminars were rated more positively [M=2.11 (1 most positive and 5 most negative), SD=1, n=27] than the monoprofessional seminars [M=2.55, SD=0.98, n=90]. The key finding from the UWE-IP-D survey, comparing pre and post scores of the interprofessional (IP) (n=40) and monoprofessional (MP) groups (n=34), was that significant positive changes in mean scores for both groups towards communication, teamwork and interprofessional learning occurred. Conclusions: Lessons learnt included: a) recognising the benefit of being pragmatic when introducing interprofessional education initiatives, which enabled various logistical and attitudinal barriers to be overcome; b) quantitative evaluation of learning outcomes alone could not explain positive responses or potential influences of interprofessional aspects, which highlighted the need for a mixed methods approach, including qualitative methods, to enrich judgment formation on interprofessional educational outcomes. PMID:27280133
Greer, Annette G; Clay, Maria; Blue, Amy; Evans, Clyde H; Garr, David
Given the emphasis on prevention in U.S. health care reform efforts, the importance of interprofessional education (IPE) that prepares health professions students to be part of effective health care teams is greater than ever. This study examined the prevalence and nature of IPE and interprofessional (IP) prevention education in U.S. academic health centers. The authors extracted a 10-item survey from the longer published IPE Assessment and Planning Instrument. In September 2010, they sent the survey to 346 health professions leaders in health sciences schools and colleges at 100 academic health centers. These institutions were identified via the online membership list of the Association of Academic Health Centers. The authors conducted descriptive statistical analysis and cross-tabulations. Surveys were completed by 127 contacts at 68 universities in 31 states and the District of Columbia. IPE was more prevalent than IP prevention education in all categories of measurement. Respondents affirmed existence of IPE in courses (85.0%) and in clinical rotations/internships (80.3%). The majority reported personnel with responsibility for IPE (68.5%) or prevention education (59.8%) at their institutional unit, and 59.8% reported an IPE office or center. This study provides evidence that IPE and IP prevention education exist in academic health centers, but additional attention should be paid to the development of IP prevention education. Sample syllabi, job descriptions, and policies may be available to support adoption of IPE and IP prevention education. Further effort is needed to increase the integration of IP and prevention education into practice.
Measuring attitudes towards interprofessional learning. Testing two German versions of the tool "Readiness for Interprofessional Learning Scale" on interprofessional students of health and nursing sciences and of human medicine.
Luderer, Christiane; Donat, Matthias; Baum, Ute; Kirsten, Angelika; Jahn, Patrick; Stoevesandt, Dietrich
Objective: In order to verify the methodological quality of two versions of a tool for measuring attitudes towards interprofessional learning, we adapted - in terms of translation and scale form - the Heidelberg Version  of Readiness for Interprofessional Learning Scale - RIPLS , a methodologically controversial tool that had been translated into German, and compared both the original and new versions. Method: Three items were reworded and the scale form altered (from five to four levels), leading to the Halle Version that was validated by means of a cognitive pretest ( n =6). Both questionnaires were completed by students taking the interprofessional degree program in Health and Nursing Sciences (HNS) and by students of Human Medicine. The test quality of both tools was examined by analyzing the main components and reliability using the scales allocation of the items as according to Parsell and Bligh . Results: The questionnaires were randomly assembled and distributed to 331 students. The response was n =320 (HNS n =109; Medicine n =211). The Halle Version "RIPLS-HAL" of the questionnaire was completed by n =166 and the Heidelberg Version "RIPLS-HDB" by n =154. In the main component analysis the data could not depict the scale patterns of the original Australian tool. The reliability values of both the Heidelberg and Halle versions were only satisfactory for the "Teamwork and Collaboration" and "Professional Identity" scales. Conclusions: The German version of the Readiness for Interprofessional Learning Scale has only limited suitability for recording the attitude towards interprofessional learning. The present versions can be regarded as an approach towards developing a more suitable tool.
Vafadar, Zohreh; Vanaki, Zohreh; Ebadi, Abbas
Aim: Interprofessional education has been recognized as an effective educational approach towards enabling students to provide comprehensive and safe team care for promotion of health outcomes of patients. This study was conducted in order to assess the readiness of postgraduate health science students for interprofessional education/learning, as well as identify barriers to the implementation of such an approach in Iran from the students’ point of view. Methods: This was a cross–sectional and descriptive-analytical study conducted in 2013 on 500 postgraduate students in three main professional groups: medical, nursing and other allied health professions across a number of Iranian Universities using the convenience sampling method. Quantitative Data were collected through self-administering the Readiness for InterProfessional Learning Scale (RIPLS) questionnaire with acceptable internal consistency (α = 0.86). The data were analyzed by SPSS18. Qualitative data were gathered by an open–ended questionnaire and analyzed by qualitative content analysis method. Results: The mean score of the students’ readiness (M=80, SD=8.6) was higher than the average score on the Scale (47.5). In comparison between groups, there was no statistically significant difference between groups in their readiness (p>0.05). Also four main categories were identified as barriers to implementation of interprofessional education from the students’ point of view; the categories were an inordinately profession-oriented, individualistic culture, style of management and weak evidence. Conclusion: An acceptable degree of readiness and a generally favorable attitude among students towards interprofessional education show that there are appropriate attitudinal and motivational backgrounds for implementation of interprofessional education, but it is necessary to remove the barriers by long-term strategic planning and advancing of interprofessional education in order to address health
McLelland, Gayle; Perera, Chantal; Morphet, Julia; McKenna, Lisa; Hall, Helen; Williams, Brett; Cant, Robyn; Stow, Jill
Simulation-based learning is an approach recommended for teaching undergraduate health professionals. There is a scarcity of research around interprofessional simulation training for pre-professional students in obstetric emergencies that occur prior to arrival at the maternity ward. The primary aims of the study were to examine whether an interprofessional team-based simulated birth scenario would improve undergraduate paramedic, nursing, and midwifery students' self-efficacy scores and clinical knowledge when managing birth in an unplanned location. The secondary aim was to assess students' satisfaction with the newly developed interprofessional simulation. Quasi-experimental descriptive study with repeated measures. Simulated hospital emergency department. Final year undergraduate paramedic, nursing, and midwifery students. Interprofessional teams of five students managed a simulated unplanned vaginal birth, followed by debriefing. Students completed a satisfaction with simulation survey. Serial surveys of clinical knowledge and self-efficacy were conducted at three time points. Twenty-four students participated in one of five simulation scenarios. Overall, students' self-efficacy and confidence in ability to achieve a successful birth outcome was significantly improved at one month (psimulation experience was high (M=4.65/5). Results from this study indicate that an interprofessional simulation of a birth in an unplanned setting can improve undergraduate paramedic, nursing and midwifery students' confidence working in an interprofessional team. There was a significant improvement in clinical knowledge of the nursing students (who had least content about managing birth in their program). All students were highly satisfied with the interprofessional simulation experience simulation. Copyright © 2017 Elsevier Ltd. All rights reserved.
Kaminetzky, Catherine P; Beste, Lauren A; Poppe, Anne P; Doan, Daniel B; Mun, Howard K; Woods, Nancy Fugate; Wipf, Joyce E
Gaps in chronic disease management have led to calls for novel methods of interprofessional, team-based care. Population panel management (PPM), the process of continuous quality improvement across groups of patients, is rarely included in health professions training for physicians, nurses, or pharmacists. The feasibility and acceptance of such training across different healthcare professions is unknown. We developed and implemented a novel, interprofessional PPM curriculum targeted to diverse health professions trainees. The curriculum was implemented annually among internal medicine residents, nurse practitioner students and residents, and pharmacy residents co-located in a large, academic primary care site. Small groups of interprofessional trainees participated in supervised quarterly seminars focusing on chronic disease management (e.g., diabetes mellitus, hypertension, or chronic obstructive pulmonary disease) or processes of care (e.g., emergency department utilization for nonacute conditions or chronic opioid management). Following brief didactic presentations, trainees self-assessed their clinic performance using patient-level chart review, presented individual cases to interprofessional staff and faculty, and implemented subsequent feedback with their clinic team. We report data from 2011 to 2015. Program evaluation included post-session participant surveys regarding attitudes, knowledge and confidence towards PPM, ability to identify patients for referral to interprofessional team members, and major learning points from the session. Directed content analysis was performed on an open-ended survey question. Trainees (n = 168) completed 122 evaluation assessments. Trainees overwhelmingly reported increased confidence in using PPM and increased knowledge about managing their patient panel. Trainees reported improved ability to identify patients who would benefit from multidisciplinary care or referral to another team member. Directed content analysis
Jafari Varjoshani, Nasrin; Hosseini, Mohammad Ali; Khankeh, Hamid Reza; Ahmadi, Fazlollah
A highly important factor in enhancing quality of patient care and job satisfaction of health care staff is inter-professional communication. Due to the critical nature of the work environment, the large number of staff and units, and complexity of professional tasks and interventions, inter-professional communication in an emergency department is particularly and exceptionally important. Despite its importance, inter-professional communication in emergency department seems unfavorable. Thus, this study was designed to explain barriers to inter-professional communication in an emergency department. This was a qualitative study with content analysis approach, based on interviews conducted with 26 participants selected purposively, with diversity of occupation, position, age, gender, history, and place of work. Interviews were in-depth and semi-structured, and data were analyzed using the inductive content analysis approach. In total, 251 initial codes were extracted from 30 interviews (some of the participants re-interviewed) and in the reducing trend of final results, 5 categories were extracted including overcrowded emergency, stressful emergency environment, not discerning emergency conditions, ineffective management, and inefficient communication channels. Tumultuous atmosphere (physical, mental) was the common theme between categories, and was decided to be the main barrier to effective inter-professional communication. Tumultuous atmosphere (physical-mental) was found to be the most important barrier to inter-professional communication. This study provided a better understanding of these barriers in emergency department, often neglected in most studies. It is held that by reducing environmental turmoil (physical-mental), inter-professional communication can be improved, thereby improving patient care outcomes and personnel job satisfaction.
Vafadar, Zohreh; Vanaki, Zohreh; Ebadi, Abbas
Interprofessional education has been recognized as an effective educational approach towards enabling students to provide comprehensive and safe team care for promotion of health outcomes of patients. This study was conducted in order to assess the readiness of postgraduate health science students for interprofessional education/learning, as well as identify barriers to the implementation of such an approach in Iran from the students' point of view. This was a cross-sectional and descriptive-analytical study conducted in 2013 on 500 postgraduate students in three main professional groups: medical, nursing and other allied health professions across a number of Iranian Universities using the convenience sampling method. Quantitative Data were collected through self-administering the Readiness for InterProfessional Learning Scale (RIPLS) questionnaire with acceptable internal consistency (? = 0.86). The data were analyzed by SPSS18. Qualitative data were gathered by an open-ended questionnaire and analyzed by qualitative content analysis method. The mean score of the students' readiness (M=80, SD=8.6) was higher than the average score on the Scale (47.5). In comparison between groups, there was no statistically significant difference between groups in their readiness (p>0.05). Also four main categories were identified as barriers to implementation of interprofessional education from the students' point of view; the categories were an inordinately profession-oriented, individualistic culture, style of management and weak evidence. An acceptable degree of readiness and a generally favorable attitude among students towards interprofessional education show that there are appropriate attitudinal and motivational backgrounds for implementation of interprofessional education, but it is necessary to remove the barriers by long-term strategic planning and advancing of interprofessional education in order to address health challenges.
Kvarnström, Susanne; Jangland, Eva; Abrandt Dahlgren, Madeleine
The first nurse practitioners in surgical care were introduced into Swedish surgical wards in 2014. Internationally, organisations that have adopted nurse practitioners into care teams are reported to have maintained or improved the quality of care. However, close qualitative descriptions of teamwork practice may add to existing knowledge of interprofessional collaboration when introducing nurse practitioners into new clinical areas. The aim was to report on an empirical study describing how interprofessional teamwork practice was enacted by nurse practitioners when introduced into surgical ward teams. The study had a qualitative, ethnographic research design, drawing on a sociomaterial conceptual framework. The study was based on 170 hours of ward-based participant observations of interprofessional teamwork practice that included nurse practitioners. Data were gathered from 2014 to 2015 across four surgical sites in Sweden, including 60 interprofessional rounds. The data were analysed with an iterative reflexive procedure involving inductive and theory-led approaches. The study was approved by a Swedish regional ethics committee (Ref. No.: 2014/229-31). The interprofessional teamwork practice enacted by the nurse practitioners that emerged from the analysis comprised a combination of the following characteristic role components: clinical leader, bridging team colleague and ever-present tutor. These role components were enacted at all the sites and were prominent during interprofessional teamwork practice. The participant nurse practitioners utilised the interprofessional teamwork practice arrangements to enact a role that may be described in terms of a quality guarantee, thereby contributing to the overall quality and care flow offered by the entire surgical ward team. © 2017 Nordic College of Caring Science.
Lê, Quynh; Spencer, Judy; Whelan, Jessica
The Rural Interprofessional Programme Emergency Retreat (RIPPER) is an educational programme collaboratively developed and evaluated by an interprofessional team from Schools within Faculty of Health Science (FHS), University of Tasmania (UTAS), Australia. The aims of RIPPER are to foster and facilitate positive and productive interprofessional learning experiences for undergraduate students in a rural setting; and to develop a firmly embedded and sustainable interprofessional healthcare module within the health science curriculum. This paper reports on the development of a reliable and valid survey tool to evaluate students' understandings and experiences of this interprofessional learning programme. Twenty-nine students from the Schools of Nursing, Medicine and Pharmacy of the FHS, UTAS participated in the RIPPER programme which offers a number of interactive rural emergency healthcare scenarios using high- and low-fidelity simulation. To evaluate the programme a survey which consisted of 2 main components was developed and implemented before and after the programme. The first component was designed to gather students' demographic information, their understanding of the interprofessional practice concepts, and their expectations of the RIPPER programme using open-ended questions. The second component consisted of a 5-point Likert scale for students to rank their level of agreement pre- and post- intervention with 12 statements about team working, programme evaluation and collaborative learning. Three processes were used to establish the validity and reliability of the survey. Content validity was assessed by academics and experts in health science education. Construct validity was assessed using exploratory factor analysis. The internal consistency and reliability of the survey was checked using Cronbach's alpha coefficient. Factor analysis of the 12 statements identified 3 main factors including appreciation of professional roles and responsibilities, improved
Full Text Available Background: With the rapid aging of the population, collaboration among the various medical professions throughout the country is becoming increasingly indispensable in Japan. To promote collaboration in medical care, it is necessary to introduce the concept of collaboration to students at an early stage of their professional education. Despite this need, there are no core medical, healthcare and welfare education curricula in Japan that include interprofessional education (IPE. Therefore, the status of IPE in Japanese schools of medicine and other healthcare-related services is unclear. Methods: We sent 3,430 questionnaires to 13 schools of medicine and related healthcare providers: doctors, nurses, physical therapists, registered dieticians, dentists, dental hygienists, social workers, pharmacists, occupational therapists, clinical psychologists, medical administrators, certified care workers, and speech therapists. The items addressed implementation rate of IPE, teaching methods and grading methods. Results: Of the 3,430 surveys distributed, 572 completed surveys were returned (response rate 17%. Of the completed surveys, 493 qualified as valid, resulting in a final response rate of 14%. Only 19% (n = 93 of the analysed medical educational institutions included IPE instruction in their curricula. Conclusion: While many educational institutions were conducting IPE, there were important inter-institutional differences with respect to attitudes towards IPE, teaching methods, and evaluation methods. This study was unprecedented in scale, and provides important basic information for the future development of IPE in Japan.
Gordon, Morris; Fell, Christopher W. R.; Box, Helen; Farrell, Michael; Stewart, Alison
ABSTRACT Background: Healthcare increasingly recognises and focusses on the phenomena of ‘safe practice’ and ‘patient safety.’ Success with non-technical skills (NTS) training in other industries has led to widespread transposition to healthcare education, with communication and teamwork skills central to NTS frameworks. Objective: This study set out to identify how the context of interprofessional simulation learning influences NTS acquisition and development of ‘safety’ amongst learners. Methods: Participants receiving a non-technical skills (NTS) safety focussed training package were invited to take part in a focus group interview which set out to explore communication, teamwork, and the phenomenon of safety in the context of the learning experiences they had within the training programme. The analysis was aligned with a constructivist paradigm and took an interactive methodological approach. The analysis proceeded through three stages, consisting of open, axial, and selective coding, with constant comparisons taking place throughout each phase. Each stage provided categories that could be used to explore the themes of the data. Additionally, to ensure thematic saturation, transcripts of observed simulated learning encounters were then analysed. Results: Six themes were established at the axial coding level, i.e., analytical skills, personal behaviours, communication, teamwork, context, and pedagogy. Underlying these themes, two principal concepts emerged, namely: intergroup contact anxiety – as both a result of and determinant of communication – and teamwork, both of which must be considered in relation to context. These concepts have subsequently been used to propose a framework for NTS learning. Conclusions: This study highlights the role of intergroup contact anxiety and teamwork as factors in NTS behaviour and its dissipation through interprofessional simulation learning. Therefore, this should be a key consideration in NTS education. Future
Sangaleti, Carine; Schveitzer, Mariana Cabral; Peduzzi, Marina; Zoboli, Elma Lourdes Campos Pavone; Soares, Cassia Baldini
focused on qualitative data including designs such as phenomenology, grounded theory, ethnography, action research and feminist research. A three-step search strategy was utilized. Ten databases were searched for papers published from 1980 to June 2015. Studies published in English, Portuguese and Spanish were considered. Methodological quality was assessed using the Qualitative Assessment and Review Instrument developed by the Joanna Briggs Institute. All included studies received a score of at least 70% the questions in the instrument, 11 studies did not address the influence of the researcher on the research or vice-versa, and six studies did not present a statement locating the researcher culturally or theoretically. Qualitative findings were extracted using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Qualitative research findings were pooled using a pragmatic meta-aggregative approach and the Joanna Briggs Institute Qualitative Assessment and Review Instrument software. This review included 21 research studies, representing various countries and healthcare settings. There were 223 findings, which were aggregated into 15 categories, and three synthesized findings: CONCLUSIONS: This review shows that health professionals experience teamwork and interprofessional collaboration as a process in primary health care settings; its conditions, consequences (benefits and barriers), and finally shows its determinants. Health providers face enormous ideological, organizational, structural and relational challenges while promoting teamwork and interprofessional collaboration in primary health care settings. This review has identified possible actions that could improve implementation of teamwork and interprofessional collaboration in primary health care.
Bondevik, Gunnar Tschudi; Holst, Lone; Haugland, Mildrid; Baerheim, Anders; Raaheim, Arild
Interprofessional education may be defined as an occasion when two or more professions learn with, from, and about each other in order to improve collaboration and quality of care. We studied the self-reported experiences from Norwegian health care students participating in interprofessional workplace learning in primary care. We discuss the…
Goldberg, Lynette R.; Koontz, Jennifer Scott; Rogers, Nicole; Brickell, Jean
The health care needs of older adults can be complex and multifaceted. Safe, effective, equitable, and person-centered service provision relies on skilled interprofessional, team-based practice. Too often, students seeking a career specializing in gerontology are not exposed to such interprofessional, team-based learning and practice during their…
Shaw, James; Kearney, Colleen; Glenns, Brenda; McKay, Sandra
Home-based palliative care is increasingly dependent on interprofessional teams to deliver collaborative care that more adequately meets the needs of clients and families. The purpose of this pilot evaluation was to qualitatively explore the views of an interprofessional group of home care providers (occupational therapists, nurses, personal support work supervisors, community care coordinators, and a team coordinator) regarding a pilot project encouraging teamwork in interprofessional palliative home care services. We used qualitative methods, informed by an interprofessional conceptual framework, to analyse participants' accounts and provide recommendations regarding strategies for interprofessional team building in palliative home health care. Findings suggest that encouraging practitioners to share past experiences and foster common goals for palliative care are important elements of team building in interprofessional palliative care. Also, establishing a team leader who emphasises sharing power among team members and addressing the need for mutual emotional support may help to maximise interprofessional teamwork in palliative home care. These findings may be used to develop and test more comprehensive efforts to promote stronger interprofessional teamwork in palliative home health care delivery.
Dunn, Sandra I; Cragg, Betty; Graham, Ian D; Medves, Jennifer; Gaboury, Isabelle
Shared decision-making provides an opportunity for the knowledge and skills of care providers to synergistically influence patient care. Little is known about interprofessional shared decision-making processes in critical care settings. The aim of this study was to explore interprofessional team members' perspectives about the nature of interprofessional shared decision-making in a neonatal intensive care unit (NICU) and to determine if there are any differences in perspectives across professional groups. An exploratory qualitative approach was used consisting of semi-structured interviews with 22 members of an interprofessional team working in a tertiary care NICU in Canada. Participants identified four key roles involved in interprofessional shared decision-making: leader, clinical experts, parents, and synthesizer. Participants perceived that interprofessional shared decision-making happens through collaboration, sharing, and weighing the options, the evidence and the credibility of opinions put forward. The process of interprofessional shared decision-making leads to a well-informed decision and participants feeling valued. Findings from this study identified key concepts of interprofessional shared decision-making, increased awareness of differing professional perspectives about this process of shared decision-making, and clarified understanding of the different roles involved in the decision-making process in an NICU.
Templeman, Kate; Robinson, Anske; McKenna, Lisa
BackgroundImproved teamwork between conventional and complementary medicine (CM) practitioners is indicated to achieve effective healthcare. However, little is known about interprofessional collaboration and education in the context of integrative medicine (IM). MethodsThis paper reports the findings from a constructivist-grounded theory method study that explored and highlighted Australian medical students' experiences and opportunities for linking interprofessional collaboration and learning in the context of IM. Following ethical approval, in-depth semi-structured interviews were conducted with 30 medical students from 10 medical education faculties across Australian universities. Results Medical students recognised the importance of interprofessional teamwork between general medical practitioners and CM professionals in patient care and described perspectives of shared responsibilities, profession-specific responsibilities, and collaborative approaches within IM. While students identified that limited interprofessional collaboration currently occurred in the medical curriculum, interprofessional education was considered a means of increasing communication and collaboration between healthcare professionals, helping coordinate effective patient care, and understanding each healthcare team members' professional role and value. Conclusions The findings suggest that medical curricula should include opportunities for medical students to develop required skills, behaviours, and attitudes for interprofessional collaboration and interprofessional education within the context of IM. While this is a qualitative study that reflects theoretical saturation from a selected cohort of medical students, the results also point to the importance of including CM professionals within interprofessional collaboration, thus contributing to more person-centred care.
Shoemaker, Michael J; de Voest, Margaret; Booth, Andrew; Meny, Lisa; Victor, Justin
The purpose of the present study was to determine whether an interprofessional virtual patient educational activity improved interprofessional competencies in pharmacy, physician assistant, and physical therapy graduate students. Seventy-two fifth semester pharmacy (n = 33), fourth semester physician assistant (n = 27) and fourth semester physical therapy (n = 12) graduate students participated in the study. Participants were stratified by discipline and randomized into control (n = 38) and experimental groups (n = 34). At baseline and at study completion, all participants completed an original, investigator-developed survey that measured improvement in selected Interprofessional Education Collaborative (IPEC) competencies and the Readiness for Interprofessional Learning Scale (RIPLS). The experimental group had statistically significantly greater odds of improving on a variety of IPEC competencies and RIPLS items. The use of a single, interprofessional educational activity resulted in having a greater awareness of other professions' scopes of practice, what other professions have to offer a given patient and how different professions can collaborate in patient care.
Gunn, James; Conroy, Christine; Komperda, Kathy; Van Kanegan, Kevin; Krumdick, Nathaniel; Lee, Michelle; Kanjirath, Preetha; Lempicki, Kelly; Heinking, Kurt; Spiegel, Jacqueline
Objective. To design, implement, and assess an interprofessional education (IPE) course in the first professional year of students enrolled in eight different health professions programs. Design. An interprofessional faculty committee created a 1-credit hour required IPE course to not only teach students about the roles and responsibilities of each discipline and how they may contribute to an interprofessional team, but to also improve collaboration and team-based communication skills among health care professions students. Students were placed in interprofessional groups and met weekly to participate in didactic lectures, discussion sessions, and a standardized patient encounter. Assessment. Seven hundred and eighty-three health professions students were enrolled in the course, of which 130 students completed questionnaires at all three time points. Students were neutral about the course and found it moderately valuable (Mean 6.23 [on a scale from 1 to 10], interesting (Mean 5.61), and enjoyable (Mean 5.57). Written feedback from the course indicated that the majority of students enjoyed the standardized patient encounter and thought the course provided a valuable opportunity to interact with other students in other health professions programs. Conclusion. This required course served as an introductory interprofessional approach in preparing health professions students to learn from each other about their various roles and responsibilities and how each can contribute to the health care team. PMID:28720922
Vogler, Carrie; Arnoldi, Jennifer; Moose, Helen; Hingle, Susan T
The transition of care from hospital to home is susceptible to clinical errors and adverse drug events. Despite this risk and the benefits of an interprofessional approach to patient care, medicine and pharmacy do not often collaborate during transitions of care. The purpose of this study was to evaluate the impact of an interprofessional education experience consisting of medical and pharmacy students performing transitions of care. A total of 88 students (13 pharmacy students and 75 medical students) participated and were surveyed before and after the experience, to evaluate their confidence in performing aspects of the transition of care process as well as their attitudes towards interprofessional care. Pharmacy students had higher baseline levels of confidence compared with the medical students, and both student groups revealed a significantly greater level of confidence in their abilities after the experience. The impact of the experience on students' attitudes towards interprofessional care varied, with medical students showing very little change from baseline and pharmacy students showing improved attitudes in several areas. The results of this study have positive implications for an interprofessional approach to transitions of care while highlighting potential future areas of study.
Lachmann, Hanna; Fossum, Bjöörn; Johansson, Unn-Britt; Karlgren, Klas; Ponzer, Sari
Students' engagement and reflection on learning activities are important during interprofessional clinical practice. The contextual activity sampling system (CASS) is a methodology designed for collecting data on experiences of ongoing activities by frequent distribution of questionnaires via mobile phones. The aim of this study was to investigate if the use of the CASS methodology affected students' experiences of their learning activities, readiness for interprofessional learning, academic emotions and experiences of interprofessional team collaboration. Student teams, consisting of 33 students in total from four different healthcare programs, were randomized into an intervention group that used CASS or into a control group that did not use CASS. Both quantitative (questionnaires) and qualitative (interviews) data were collected. The results showed that students in the intervention group rated teamwork and collaboration significantly higher after than before the course, which was not the case in the control group. On the other hand, the control group reported experiencing more stress than the intervention group. The qualitative data showed that CASS seemed to support reflection and also have a positive impact on students' experiences of ongoing learning activities and interprofessional collaboration. In conclusion, the CASS methodology provides support for students in their understanding of interprofessional teamwork.
The purpose of this grounded theory study was to generate a theory of the interprofessional collaborative learning process of occupational therapy (OT) students who were engaged in a collaborative learning experience with students from other allied health disciplines. Data consisted of semi-structured interviews with nine OT students from four different interprofessional collaborative learning experiences at three universities. The emergent theory explained OT students' need to build a culture of mutual respect among disciplines in order to facilitate interprofessional collaborative learning. Occupational therapy students went through a progression of learned skills that included learning how to represent the profession of OT, hold their weight within a team situation, solve problems collaboratively, work as a team, and ultimately, to work in an actual team in practice. This learning process occurred simultaneously as students also learned course content. The students had to contend with barriers and facilitators that influenced their participation and the success of their collaboration. Understanding the interprofessional learning process of OT students will help allied health faculty to design more effective, inclusive interprofessional courses.
Aase, Ingunn; Hansen, Britt Sæthre; Aase, Karina
Little is known about the ways in which nursing and medical students perceive and understand their roles in interprofessional teamwork. A 2010 report by the World Health Organization highlights the importance of students' understanding of teamwork in healthcare, and their ability to be effective team players. This study aims at describing nursing and medical students' perceptions of interprofessional teamwork, focusing on experiences and recommendations that can be used to guide future educational efforts. The study uses a qualitative research design. Data were collected from four focus group interviews: two homogenous groups (one with medical students, one with nursing students) and two mixed groups (medical and nursing students). The results show that traditional patterns of professional role perception still prevail and strongly influence students' professional attitudes about taking responsibility and sharing responsibility across disciplinary and professional boundaries. It was found that many students had experienced group cultures detrimental to team work. Focusing on clinical training, the study found a substantial variation in perception with regard to the different arenas for interprofessional teamwork, ranging from arenas with collaborative learning to arenas characterized by distrust, confrontation, disrespect and hierarchical structure. This study underlines the importance of a stronger focus on interprofessional teamwork in health care education, particularly in clinical training. The study results suggest that the daily rounds and pre-visit "huddles," or alternatively psychiatric wards, offer arenas suitable for interprofessional training, in keeping with the students' assessments and criteria proposed in previous studies.
Background Little is known about the ways in which nursing and medical students perceive and understand their roles in interprofessional teamwork. A 2010 report by the World Health Organization highlights the importance of students’ understanding of teamwork in healthcare, and their ability to be effective team players. This study aims at describing nursing and medical students’ perceptions of interprofessional teamwork, focusing on experiences and recommendations that can be used to guide future educational efforts. Methods The study uses a qualitative research design. Data were collected from four focus group interviews: two homogenous groups (one with medical students, one with nursing students) and two mixed groups (medical and nursing students). Results The results show that traditional patterns of professional role perception still prevail and strongly influence students’ professional attitudes about taking responsibility and sharing responsibility across disciplinary and professional boundaries. It was found that many students had experienced group cultures detrimental to team work. Focusing on clinical training, the study found a substantial variation in perception with regard to the different arenas for interprofessional teamwork, ranging from arenas with collaborative learning to arenas characterized by distrust, confrontation, disrespect and hierarchical structure. Conclusions This study underlines the importance of a stronger focus on interprofessional teamwork in health care education, particularly in clinical training. The study results suggest that the daily rounds and pre-visit “huddles,” or alternatively psychiatric wards, offer arenas suitable for interprofessional training, in keeping with the students’ assessments and criteria proposed in previous studies. PMID:25124090
Heath, Olga; Church, Elizabeth; Curran, Vernon; Hollett, Ann; Cornish, Peter; Callanan, Terrence; Bethune, Cheri; Younghusband, Lynda
The benefits of interprofessional care in providing mental health services have been widely recognized, particularly in rural communities where access to health services is limited. There continues to be a need for more continuing interprofessional education in mental health intervention in rural areas. There have been few reports of rural programs in which mental health content has been combined with training in collaborative practice. The current study used a sequential mixed-method and quasi-experimental design to evaluate the impact of an interprofessional, intersectoral education program designed to enhance collaborative mental health capacity in six rural sites. Quantitative results reveal a significant increase in positive attitudes toward interprofessional mental health care teams and self-reported increases in knowledge and understanding about collaborative mental health care delivery. The analysis of qualitative data collected following completion of the program, reinforced the value of teaching mental health content within the context of collaborative practice and revealed practice changes, including more interprofessional and intersectoral collaboration. This study suggests that imbedding explicit training in collaborative care in content focused continuing professional education for more complex and chronic health issues may increase the likelihood that professionals will work together to effectively meet client needs.
Lewis, Krystina B; Stacey, Dawn; Squires, Janet E; Carroll, Sandra
Patient engagement in collaboration with health professionals is essential to deliver quality health care. A shared decision-making (SDM) approach requires that patients are involved in decisions regarding their health. SDM is expanding from the patient-physician dyad to incorporate an interprofessional perspective. Conceptual models can be used to better understand theoretical underpinnings for application in clinical practice. The aim of this article was to conduct a theory analysis of conceptual models using an interprofessional approach to SDM and discuss each model's relevance to nursing practice. Walker and Avant's theory analysis approach was used. Three conceptual models were eligible. For all models, the decision-making process was considered iterative. The development process was described for 1 model. All models were logical, parsimonious, and generalizable. One was supported by empirical testing. No model described how partnerships are enacted to achieve interprofessional SDM. Also, there was limited articulation as to how nurses' roles and contributions differ from other team members. This theory analysis highlights the need for a model that explains how partnerships among interprofessional team members are enacted to better understand the operationalization of interprofessional SDM. Implications for nursing practice at all system levels are offered and supported by the 3 models.
Morphet, Julia; Hood, Kerry; Cant, Robyn; Baulch, Julie; Gilbee, Alana; Sandry, Kate
The establishment of interprofessional teamwork training in the preprofessional health care curriculum is a major challenge for teaching faculties. Interprofessional clinical placements offer an opportunity for teamwork education, as students in various professions can work and learn together. In this sequential, mixed-method study, focus group and survey techniques were used to evaluate students' educational experiences after 2-week ward-based interprofessional clinical placements. Forty-five senior nursing, medicine, and other health care students cared for patients in hospital wards under professional supervision, with nursing-medicine student "teams" leading care. Thirty-six students attended nine exit focus groups. Five central themes that emerged about training were student autonomy and workload, understanding of other professional roles, communication and shared knowledge, interprofessional teamwork/collaboration, and the "inner circle", or being part of the unit team. The learning environment was described as positive. In a postplacement satisfaction survey (n=38), students likewise rated the educational experience highly. In practicing teamwork and collaboration, students were able to rehearse their future professional role. We suggest that interprofessional clinical placements be regarded as an essential learning experience for senior preprofessional students. More work is needed to fully understand the effect of this interactive program on students' clinical learning and preparation for practice.
Ødegård, Atle; Strype, Jon
The present study investigates professionals' perceptions of interprofessional collaboration (IPC) in the field of mental health care for children and adolescents. In this study, a 48-item questionnaire was developed to measure perceptions of interprofessional collaboration. A theoretical model (PINCOM) is presented and suggests that interprofessional collaboration is perceived at the individual-, group- and organizational level. The questionnaire was distributed to a sample consisting of 157 professionals in Western Norway. The results of this exploratory study show that the most prominent constructs of collaboration perceived by the professionals were: motivation, group leadership, social support and organizational culture. Furthermore, results indicate that women are more oriented than men toward IPC aspects of communication, coping and organizational domain. It is suggested that the questionnaire may be used to help improve interprofessional collaboration in clinical practice by indicating new ways to enhance dialogue between professionals and to investigate changes in perception of interprofessional collaboration over time. Limitations of the present study were identified and suggestions for future studies within the field are provided.
Hertweck, Mark L; Hawkins, Susan R; Bednarek, Melissa L; Goreczny, Anthony J; Schreiber, Jodi L; Sterrett, Susan E
Since the release of the 1988 World Health Organization report on the need for interprofessional education (IPE) programs, various forms of IPE curricula have been implemented within institutions of higher education. The purpose of this paper is to describe results of a study using the Readiness for Interprofessional Learning Scale (RIPLS) to compare physician assistant (PA) students with other health professions students. The RIPLS survey was completed by 158 health professions graduate students, including 71 PA students, at a small northeastern university in the fall of 2010. Students were enrolled in either counseling psychology, occupational therapy, physical therapy, or PA studies. Students completed the RIPLS survey, demographic questions, and a question regarding experience with the health care environment. PA students scored significantly lower on three of the four subscales of the RIPLS survey, as well as lower in total score. Females of all health professions scored significantly higher on the RIPLS total score and on the Teamwork and Collaboration subscale than did males. Students with prior exposure to the health care system as a patient or as an immediate family member of a patient scored significantly higher on the Negative Professional Identity subscale than did students without such exposure. Results indicate that PA students may value interprofessional collaboration less than other health professions students. Also, there may be gender and experiential differences in readiness for interprofessional learning. These findings may affect the design of IPE experiences and support integration of interprofessional experiences into PA education.
Nørgaard, Birgitte; Draborg, Eva; Vestergaard, Erik; Odgaard, Eva; Jensen, Didde Cramer; Sørensen, Jan
Interprofessional collaboration potentially enhances patient safety and satisfaction, and reduces tensions and conflicts among health professionals. However, health professionals often lack sufficient knowledge of other professional roles and competences to engage in interprofessional teamwork. The aim of this study was to assess the impact of an interprofessional training programme on students' perceived self-efficacy. A quasi-experimental study with an intervention group (239 students) and a control group (405 students). The intervention was an interprofessional clinical study (ICS) unit including students from nursing, medicine, physiotherapy, occupational therapy, laboratory technology and radiography. Data on students' perceived self-efficacy were collected through web-based questionnaires. Aspects of self-efficacy measured were: (1) collaboration with other professions in planning goals and actions for patients; (2) collaboration with other professions for rehabilitation; (3) identifying the functions of other professions and (4) assessing and describing patients' needs and problems. All scores of perceived self-efficacy for the ICS group improved over time although one score change was non-significant (p = 0.08). After adjustment for baseline differences and the score change for the control group, the ICS group's self-efficacy score gain remained statistically significant. The study showed that interprofessional training improved students' perception of self-efficacy more than traditional clinical training.
Sincak, Carrie; Gunn, James; Conroy, Christine; Komperda, Kathy; Van Kanegan, Kevin; Krumdick, Nathaniel; Lee, Michelle; Kanjirath, Preetha; Lempicki, Kelly; Heinking, Kurt; Spiegel, Jacqueline
Objective. To design, implement, and assess an interprofessional education (IPE) course in the first professional year of students enrolled in eight different health professions programs. Design. An interprofessional faculty committee created a 1-credit hour required IPE course to not only teach students about the roles and responsibilities of each discipline and how they may contribute to an interprofessional team, but to also improve collaboration and team-based communication skills among health care professions students. Students were placed in interprofessional groups and met weekly to participate in didactic lectures, discussion sessions, and a standardized patient encounter. Assessment. Seven hundred and eighty-three health professions students were enrolled in the course, of which 130 students completed questionnaires at all three time points. Students were neutral about the course and found it moderately valuable (Mean 6.23 [on a scale from 1 to 10], interesting (Mean 5.61), and enjoyable (Mean 5.57). Written feedback from the course indicated that the majority of students enjoyed the standardized patient encounter and thought the course provided a valuable opportunity to interact with other students in other health professions programs. Conclusion. This required course served as an introductory interprofessional approach in preparing health professions students to learn from each other about their various roles and responsibilities and how each can contribute to the health care team.
Hansen, Bodil Winther; Hatt, Camusa
Title: Facilitating cooperation in interprofessional education using a study activity model- An action research project . Background Metropolitan University College has over the years developed interprofessional courses for students from 12 different professions, and since 2013 worked with a nati......Title: Facilitating cooperation in interprofessional education using a study activity model- An action research project . Background Metropolitan University College has over the years developed interprofessional courses for students from 12 different professions, and since 2013 worked...... for students and lecturers due to