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Shimizu I, Matsuyama Y, Duvivier R, van der Vleuten C. Contextual attributes to promote positive social interdependence in problem-based learning: a focus group study. BMC MEDICAL EDUCATION 2021; 21:222. [PMID: 33879160 PMCID: PMC8059308 DOI: 10.1186/s12909-021-02667-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/13/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Problem-based learning (PBL) is classified as a collaborative learning approach, wherein students learn while contributing meaning to experiences and interactions with others. An important theoretical fundament of PBL is social interdependence theory (SIT) because positive social interdependence within a group has been found to be key to better learning performance and future attitudes towards team practice. However, most previous studies in health professions education focused on cognitive outcomes, and few studies have focused on collaborative behaviors in PBL groups. The lack of this empirical insight makes implementation of PBL difficult, especially in contexts where there is limited experience with collaborative learning. Therefore, the aim of this study was to elucidate what promotes or hinders positive social interdependence and how the attributes work during PBL. METHODS We conducted four focus groups among clinical year medical students (n = 26) who participated in PBL tutorials in the formal curriculum. We asked semi-structured questions that corresponded with the overall concept of SIT. We analyzed the transcript using constructivist grounded theory and developed a model to explain contextual attributes that promote or hinder positive social interdependence in PBL. RESULTS Two contextual attributes of "academic inquisition" and "desire for efficiency" affect social interdependence among a student group in PBL. Academic inquisition is students' desire to engage in their academic learning, and desire for efficiency is students' attitude toward learning as an imposed duty and desire to complete it as quickly as possible. These attributes are initially mutually conflicting and constructing social interdependence through multiple steps including inquisition from a case, seeking efficient work, sharing interest in problem solving, expecting mutual contributions, and complementing learning objectives. CONCLUSION These findings will contribute to understanding collaborative learning environments in PBL and may help explain contexts where PBL is less successful. The model can also be used as a tool to support innovation of PBL as collaborative learning.
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Affiliation(s)
- Ikuo Shimizu
- Center for Medical Education and Clinical Training, Shinshu University, 3-1-1 Asahi, Matsumoto, 3908621 Japan
| | - Yasushi Matsuyama
- Medical Education Centre, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi Japan
| | - Robbert Duvivier
- Center for Educational Development and Research in Health Sciences (CEDAR), University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Cees van der Vleuten
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 60, 6229 ER Maastricht, The Netherlands
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Miles A, Ginsburg S, Sibbald M, Tavares W, Watling C, Stroud L. Feedback from health professionals in postgraduate medical education: Influence of interprofessional relationship, identity and power. MEDICAL EDUCATION 2021; 55:518-529. [PMID: 33259070 DOI: 10.1111/medu.14426] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/13/2020] [Accepted: 11/27/2020] [Indexed: 05/28/2023]
Abstract
INTRODUCTION Capitalising on direct workplace observations of residents by interprofessional team members might be an effective strategy to promote formative feedback in postgraduate medical education. To better understand how interprofessional feedback is conceived, delivered, received and used, we explored both feedback provider and receiver perceptions of workplace feedback. METHODS We conducted 17 individual interviews with residents and eight focus groups with health professionals (HPs) (two nurses, two rehabilitation therapists, two pharmacists and two social workers), for a total of 61 participants. Using a constructivist grounded theory approach, data collection and analysis proceeded as an iterative process using constant comparison to identify and explore themes. RESULTS Conceptualisations and content of feedback were dependent on whether the resident was perceived as a learner or a peer within the interprofessional relationship. Residents relied on interprofessional role understanding to determine how physician competencies align with HP roles. The perceived alignment was unique to each profession and influenced feedback credibility judgements. Residents prioritised feedback from physicians or within the Medical Expertise domain-a role that HPs felt was over-valued. Despite ideal opportunities for direct observation, operational enactment of feedback was influenced by power differentials between the professions. DISCUSSION Our results illuminate HPs' conceptualisation of feedback for residents and the social constructs influencing how their feedback is disseminated. Professional identity and social categorisation added complexity to feedback acceptance and incorporation. To ensure that interprofessional feedback can achieve desired outcomes, education programmes should implement strategies to help mitigate intergroup bias and power imbalance.
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Affiliation(s)
- Amy Miles
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Shiphra Ginsburg
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- The Wilson Centre, University of Toronto, Toronto, ON, Canada
| | - Matthew Sibbald
- Department of Medicine, Centre for Simulation-Based Learning, McMaster University, Hamilton, ON, Canada
| | - Walter Tavares
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- The Wilson Centre, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Chris Watling
- Department of Oncology, Centre for Education Research and Innovation, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Lynfa Stroud
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- The Wilson Centre, University of Toronto, Toronto, ON, Canada
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Price SL, Sim SM, Little V, Almost J, Andrews C, Davies H, Harman K, Khalili H, Sutton E, LeBrun J. A longitudinal, narrative study of professional socialisation among health students. MEDICAL EDUCATION 2021; 55:478-485. [PMID: 33332659 DOI: 10.1111/medu.14437] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 12/07/2020] [Accepted: 12/10/2020] [Indexed: 06/12/2023]
Abstract
PURPOSE Interprofessional collaboration (IPC) among health professionals is well-recognised to enhance care delivery and patient outcomes. Emerging evidence suggests that the early socialisation of students in health professional programmes to teamwork may have a positive impact on their future as collaborative practitioners. With a purpose of contributing to growing evidence on the processes of professional identity construction, and to explore how early expectations and perceptions of IPC develop during professional socialisation and pre-licensure education, our study examined the early professional socialisation experiences among five groups of health professional students. METHOD A qualitative, narrative approach was used to examine early professional socialisation among five programmes of health professional students (dentistry, medicine, nursing, pharmacy, physiotherapy) at an Atlantic Canadian University. In March and October 2016, students participated in interviews after first term (n = 44) and first year of study (n = 39). Interviews focused on participants' professional identify formation, as well as their perceptions and experiences of IPC. The authors analysed interview transcripts using narrative analysis. RESULTS Findings identify that despite the espoused importance of IPC within health professional training, students have a limited understanding of their professional roles and are largely focused on developing a uniprofessional, vs. interprofessional identity. Clinical experiences, role models and exposure to teamwork are critical to contextualise collaborative practice and enhance the development of an interprofessional identity. CONCLUSIONS Findings can be used to guide the development of curricula that promote interprofessional identity development and IPC during early professional socialisation.
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Affiliation(s)
- Sheri L Price
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Sarah Meaghan Sim
- Canadian Institutes of Health Research (CIHR) Health Populations Institute, Dalhousie University, Halifax, NS, Canada
| | - Victoria Little
- School of Nursing, Dalhousie University, Halifax, NS, Canada
| | - Joan Almost
- School of Nursing, Queen's University, Kingston, ON, Canada
| | - Cynthia Andrews
- Department of Dental Clinical Sciences, Division of Periodontics & Orofacial Pain, Dalhousie University, Halifax, NS, Canada
| | - Harriet Davies
- College of Pharmacy, Dalhousie University, Halifax, NS, Canada
| | - Katherine Harman
- School of Physiotherapy, Dalhousie University, Halifax, NS, Canada
| | - Hossein Khalili
- UW Center for Interprofessional Practice and Education, University of Wisconsin-Madison, Madison, WI, USA
| | - Evelyn Sutton
- Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Jeffery LeBrun
- School of Nursing, Dalhousie University, Halifax, NS, Canada
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Mette M, Hänze M. Arrogant or caring? Influence of transactive communication in interprofessional learning on knowledge gains and stereotype changes. GMS JOURNAL FOR MEDICAL EDUCATION 2021; 38:Doc66. [PMID: 33824902 PMCID: PMC7994881 DOI: 10.3205/zma001462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 09/14/2020] [Accepted: 10/19/2020] [Indexed: 06/12/2023]
Abstract
Objective: In interprofessional peer tutoring, medical students and physiotherapy trainees teach and practice examination techniques and work out profession-specific similarities and differences. In small interprofessional groups, we investigated the influence of transactive communication - alternately referring to and building on the statements made by the dialogue partner in the process of conveying information - on knowledge gains and changes in stereotypes of the other profession. Methods: A total of 132 medical students and 48 physiotherapy trainees divided into 24 small interprofessional groups indicated the extent of their stereotypes of the other profession before and after the practice session, as well as their perceived increase in knowledge. They evaluated the group work and the perceived intensity of transactive communication. We used regression analyses to test the hypotheses. Results: The intensity of transactive communication in the physiotherapy trainees was positively related to knowledge gains in the medical students. However, this did not apply to the knowledge gains in physiotherapy trainees. With regard to stereotype changes, the intensity of one's own transactive communication unexpectedly turned out to be a significant, albeit weak, influencing factor: The more intensive one's own transactive communication was, the more negative the stereotypes of the other profession became. Conclusion: Transactive communication in interprofessional groups can improve the exchange of knowledge in peer tutoring and bring about changes in stereotypes. Measures to improve transactive communication, e.g. training sessions or specific communication exercises, could help to improve the effectiveness of interprofessional learning.
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Affiliation(s)
- Mira Mette
- Medical Faculty Mannheim, Heidelberg University, Division for Study and Teaching Development, Mannheim, Germany
| | - Martin Hänze
- University of Kassel, Educational Psychology, Department of Psychology, Kassel, Germany
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Paton M, Kuper A, Paradis E, Feilchenfeld Z, Whitehead CR. Tackling the void: the importance of addressing absences in the field of health professions education research. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:5-18. [PMID: 32144528 DOI: 10.1007/s10459-020-09966-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 03/02/2020] [Indexed: 05/28/2023]
Abstract
Many processes and practices in the field of health professions education have been based more on tradition and assumption than on evidence and theory. As the field matures, researchers are increasingly seeking evidence to support various teaching and assessment methods. However, there is a tendency to focus on a limited set of topics, leaving other areas under-examined and limiting our understanding of the field. By explicitly examining areas that are undescribed, i.e. absences in the literature, researchers and scholars have the potential to enrich our practice and our field's understanding of what counts as legitimate research. Using the theoretical framework of Bourdieu's concept of field, we conducted an instrumental case study of three published research projects that each had a finding of absence. We examined each case individually, and then analyzed across cases. Our dataset included published papers, peer-review feedback, and reflective notes. Each of the cases interrogated a different form of absence: absence of content, absence of research, and absence of evidence. While the typology suggests that each absence was different, there were similarities across cases in terms of challenges in 'proving' the reality of the absence and some disbelief or discomfort with accepting the findings as rigorous and/or legitimate. Absence research has potential to add to our theoretical and methodological approaches to the field. This type of research is potentially an exciting and productive new way for scholars to shed light on aspects of health professions education that have received limited attention to date.
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Affiliation(s)
- Morag Paton
- Continuing Professional Development, PostMD Education, Faculty of Medicine, University of Toronto, 500 University Avenue, 6th Floor, Toronto, ON, M5G 1V7, Canada.
- Department of Leadership, Higher and Adult Education, Ontario Institute for Studies in Education, University of Toronto, Toronto, Canada.
| | - Ayelet Kuper
- The Wilson Centre for Research in Education, University Health Network/University of Toronto, Toronto, Canada
- Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Elise Paradis
- The Wilson Centre for Research in Education, University Health Network/University of Toronto, Toronto, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
- Department of Sociology, Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada
- Department of Anesthesia, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Zac Feilchenfeld
- Division of General Internal Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Cynthia R Whitehead
- The Wilson Centre for Research in Education, University Health Network/University of Toronto, Toronto, Canada
- Women's College Hospital, Toronto, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada
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Byerly LK, Floren LC, Yukawa M, O'Brien BC. Getting outside the box: exploring role fluidity in interprofessional student groups through the lens of activity theory. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:253-275. [PMID: 32705403 DOI: 10.1007/s10459-020-09983-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 07/13/2020] [Indexed: 05/15/2023]
Abstract
Health professionals' roles and scopes often overlap, creating a need for role clarity in interprofessional teamwork. Yet, such clarity does not mean roles are fixed within teams and some literature suggests role flexibility can enhance team functioning. Interprofessional practice competencies and learning activities often emphasize knowledge and definition of roles, but rarely attend to the dynamic nature of roles and influential contextual factors. This study explores role fluidity in interprofessional student groups using an activity theory framework. Using a collective instrumental case study approach, the authors examine the fluidity of one physical therapy (PT) student's role within 3 different interprofessional (medical, pharmacy, PT) student groups completing nursing home patient care plans. Field notes, group debriefing interviews, and care plans were collected and coded from all care planning sessions. Codes mapped to group-specific activity systems that compared role-influencing interactions and tensions. The PT student's role fluidity varied in each group's activity system, influenced primarily by system tensions from implicit rules (e.g., encouraging questions), division of labor (e.g., rigid profession-based task assignment), and tool use (e.g., computers). Attention to modifiable system elements, such as tool use and explicit rules of inclusivity, could foster role fluidity and improve interprofessional teamwork and learning environments.
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Affiliation(s)
- Laura K Byerly
- Division of General Internal Medicine and Geriatrics, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, L-475, Portland, OR, 97239, USA.
| | - Leslie C Floren
- School of Pharmacy, University of California San Francisco, San Francisco, CA, USA
| | - Michi Yukawa
- Division of Geriatrics, University of California San Francisco, San Francisco, CA, USA
| | - Bridget C O'Brien
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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Sizemore JN, Kurowski-Burt A, Evans K, Hoffman A, Summers A, Baugh GM. Interdisciplinary Education Apartment Simulation (IDEAS) Project: An Interdisciplinary Simulation for Transitional Home Care. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2021; 17:11111. [PMID: 33655077 PMCID: PMC7908376 DOI: 10.15766/mep_2374-8265.11111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 12/01/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Home-based care (HBC) is a valuable tool to provide care to rural, medically underserved populations. By mitigating geographic and transportation barriers for vulnerable populations, HBC is a promising modality of health care delivery. Interprofessional education has become an integral part in undergraduate and professional curricula; however, applications of team-based training in HBC are often missing from curricula. When included, instruction in HBC often utilizes didactic instruction or laboratory experiences, which are discipline-specific and lack a focus on integration of team-based care. METHODS We implemented a standardized patient (SP) simulation of a posthospital discharge home visit using a team of learners from nursing, physical therapy (PT), occupational therapy (OT), dentistry, pharmacy, and medicine in a simulated home environment. Pre- and postsimulation competencies of interprofessional care were measured using the 20-item Interprofessional Collaborative Competency Attainment Survey (ICCAS). RESULTS Throughout the academic years of August 2018 - August 2020, 68 students from nursing, PT, OT, pharmacy, medicine, and dentistry completed a simulated home visit with an SP discharged from a hospital. For all 20 perceived abilities on the ICCAS, learners showed a statistically significant increase in postsurvey measurement. A modest to large (.31 ≤ r ≤ .94) effect size was observed in the majority of responses. DISCUSSION This SP simulation described a novel, interdisciplinary approach to incorporating HBC into interprofessional curricula.
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Affiliation(s)
- Jenna N. Sizemore
- Assistant Professor, Department of Medicine and Associate Program Director, Internal Medicine Residency Program, West Virginia University School of Medicine
| | - Amy Kurowski-Burt
- Associate Professor, Division of Occupational Therapy, West Virginia University
| | - Kimeran Evans
- Associate Professor of Division of Physical Therapy and Academic Coordinator of Integrated Clinical Education, West Virginia University School of Medicine
| | - Adam Hoffman
- Simulation Specialist, David and Jo Ann Shaw Center for Simulation Training and Education for Patient Safety, West Virginia University
| | - Amy Summers
- Program Specialist of Interprofessional Education and Research Coordinator, David and Jo Ann Shaw Center for Simulation Training and Education for Patient Safety, West Virginia University
| | - Gina M. Baugh
- Clinical Professor, West Virginia University School of Pharmacy; Director of Interprofessional Education, West Virginia University Health Sciences Center
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Ganotice FA, Chow AYM, Fan KKH, Khoo US, Lam MPS, Poon RPW, Tsoi FHS, Wang MN, Tipoe GL. To IPAS or not to IPAS? Examining the construct validity of the Interprofessional Attitudes Scale in Hong Kong. J Interprof Care 2021; 36:127-134. [PMID: 33620020 DOI: 10.1080/13561820.2020.1869705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Students' attitudes toward interprofessional teamwork can be linked to successful interprofessional education. This points to the importance of identifying a scale that may be useful in keeping track of the change in students' attitudes over time. In response to this, using a combination of within- and between-network approaches to construct validity, we examined the psychometric acceptability of the Interprofessional Attitude Scale (IPAS) involving 274 Chinese healthcare and social care pre-licensure students in Hong Kong. Overall results indicated that IPAS had good internal consistency. Results of the confirmatory factor analysis provided support to the overall five-factor solution although one negatively worded item obtained non-significant factor loading. Results of the between-network analysis suggest that various subscales of IPAS correlated systematically with other theoretically relevant variables: teamwork attitudes, communication, and team effectiveness. The IPAS is a valid measure to examine predominantly Chinese healthcare and social care students' interprofessional attitudes in online interprofessional education.
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Affiliation(s)
- Fraide A Ganotice
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, SAR
| | - Amy Yin Man Chow
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, SAR
| | - Kelvin Kai Hin Fan
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, SAR
| | - Ui Soon Khoo
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, SAR
| | - May Pui San Lam
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, SAR
| | - Rebecca Po Wah Poon
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, SAR
| | - Francis Hang Sang Tsoi
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, SAR
| | - Michael Ning Wang
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, SAR
| | - George L Tipoe
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, SAR
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Zereshkian A, Wong R, Leifer R, Schneeweiss S, Tavares W, Paton M, Soliman H, Di Prospero L, Harnett N, Szumacher E. Continuing Professional Development Needs Amongst University of Toronto's Department of Radiation Oncology Faculty. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:118-125. [PMID: 31446618 DOI: 10.1007/s13187-019-01607-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Continuing professional development (CPD) and lifelong learning are core tenets of most healthcare disciplines. Where undergraduate coursework lays the foundation for entry into practice, CPD courses and offerings are designed to aid clinicians in maintaining these competencies. CPD offerings need to be frequently revised and updated to ensure their continued utility. The purpose of this qualitative study was to better understand the CPD needs of members of the University of Toronto's Department of Radiation Oncology (UTDRO) and determine how these needs could be generalized to other CPD programs. Given that UTDRO consists of members of various health disciplines (radiation therapist, medical physicists, radiation oncologists, etc.), eleven semi-structured interviews were conducted with various health professionals from UTDRO. Inductive thematic analysis using qualitative data processing with NVivo® was undertaken. The data was coded, sorted into categories, and subsequently reviewed for emergent themes. Participants noted that a general lack of awareness and lack of access made participation in CPD programs difficult. Members also noted that topics were often impractical, irrelevant, or not inclusive of different professions. Some participants did not feel motivated to engage in CPD offerings due to a general lack of time and lack of incentive. To address the deficiencies of CPD programs, a formal needs assessment that engages stakeholders from different centers and health professions is required. Needs assessments of CPD programs should include analyzing elements related to access, how to utilize technology-enhanced learning (TEL), determine barriers to participation, and understand how to better engage members.
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Affiliation(s)
- Arman Zereshkian
- Undergraduate Medical Education, University of Torotno, 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada.
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada.
| | - Rebecca Wong
- Department of Radiation Oncology, University of Toronto, 149 College Street, Suite 504, Toronto, Ontario, M5T 1P5, Canada
- Radiation Medicine Program, University Health Network, 610 University Avenue, Toronto, Ontario, M5G 2C1, Canada
| | - Rachel Leifer
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Susan Schneeweiss
- Continuing Professional Development, University of Toronto, 500 University, Toronto, Ontario, M5G 1V7, Canada
| | - Walter Tavares
- Wilson Centre, 200 Elizabeth Street, Toronto, Ontario, M5G 2C4, Canada
| | - Morag Paton
- Continuing Professional Development, University of Toronto, 500 University, Toronto, Ontario, M5G 1V7, Canada
| | - Hany Soliman
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
- Department of Radiation Oncology, University of Toronto, 149 College Street, Suite 504, Toronto, Ontario, M5T 1P5, Canada
- Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Lisa Di Prospero
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
- Department of Radiation Oncology, University of Toronto, 149 College Street, Suite 504, Toronto, Ontario, M5T 1P5, Canada
- Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Nicole Harnett
- Department of Radiation Oncology, University of Toronto, 149 College Street, Suite 504, Toronto, Ontario, M5T 1P5, Canada
- Radiation Medicine Program, University Health Network, 610 University Avenue, Toronto, Ontario, M5G 2C1, Canada
| | - Ewa Szumacher
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
- Department of Radiation Oncology, University of Toronto, 149 College Street, Suite 504, Toronto, Ontario, M5T 1P5, Canada
- Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
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Neubert A, Kellar J, Miller D, Kulasegaram K(M, Paradis E. Relational professional identity: How do pharmacy students see themselves in relation to others? Can Pharm J (Ott) 2021; 154:36-41. [PMID: 33598058 PMCID: PMC7863286 DOI: 10.1177/1715163520964500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND As the pharmacy profession moves towards patient-centred care, pharmacy schools have updated their curricula to prepare students for a full scope of practice. A critical objective of the new curricula is the professional socialization of pharmacy students into relational aspects of the profession: how pharmacists should interact with patients and other health care professionals. Through an examination of how one cohort of pharmacy students perceives its relationship to patients and physicians, this study aims to determine how these relational aspects of professional identity evolve with time spent in the program. METHODS At 3 time points over a 2-year period, pharmacy students were asked to detail in writing how they would communicate with a physician concerning a hypothetical drug allergy scenario. A directed content analysis of their responses was conducted based on 3 main analytic categories: patient-centredness, physician collaboration and physician deference. These categories were further divided into 6 subcategories that were used as the variables for analysis. Statistical analyses examined longitudinal group trends for these variables. RESULTS Over the 2 years of observation, an examination of the proportion of messages demonstrating the subcategories of interest showed that the only measure of the pharmacy students' relational professional identity that changed significantly over time occurred for the perception of a sense of shared care for the patient. All other aspects of their relational identity were stagnant and did not change as they progressed through training (χ2; 12.772, df = 2, p < 0.002). CONCLUSION Our results suggest that the relational professional identity of participants was poorly developed with regards to both patients and physicians. Pharmacy educators must reexamine the methods currently being employed to foster students' professional identity development to ensure that new graduates are prepared to meet the challenges of a changing scope of practice. Can Pharm J (Ott) 2021;154:xx-xx.
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Affiliation(s)
| | - Jamie Kellar
- Leslie Dan Faculty of Pharmacy, University of Toronto
| | - Daniel Miller
- Leslie Dan Faculty of Pharmacy, University of Toronto
| | | | - Elise Paradis
- Leslie Dan Faculty of Pharmacy, University of Toronto
- The Wilson Centre, Toronto, Ontario
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Bochatay N, Kuna Á, Csupor É, Pintér JN, Muller-Juge V, Hudelson P, Nendaz MR, Csabai M, Bajwa NM, Kim S. The Role of Power in Health Care Conflict: Recommendations for Shifting Toward Constructive Approaches. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:134-141. [PMID: 33394664 DOI: 10.1097/acm.0000000000003604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE The combination of power and conflict is frequently reported to have a detrimental impact on communication and on patient care, and it is avoided and perceived negatively by health care professionals. In view of recent recommendations to explicitly address power and conflict in health professions education, adopting more constructive approaches toward power and conflict may be helpful. This study examined the role of power in conflicts between health care professionals in different cultural contexts to make recommendations for promoting more constructive approaches. METHOD The authors used social bases of power (positional, expert, informational, reward, coercive, referent) identified in the literature to examine the role of power in conflicts between health care professionals in different cultural settings. They drew upon semistructured interviews conducted from 2013 to 2016 with 249 health care professionals working at health centers in the United States, Switzerland, and Hungary, in which participants shared stories of conflict they had experienced with coworkers. The authors used a directed approach to content analysis to analyze the data. RESULTS The social bases of power tended to be comparable across sites and included positional, expert, and coercive power. The rigid hierarchies that divide health care professionals, their professions, and their specialties contributed to negative experiences in conflicts. In addition, the presence of an audience, such as supervisors, coworkers, patients, and patients' families, prevented health care professionals from addressing conflicts when they occurred, resulting in conflict escalation. CONCLUSIONS These findings suggest that fostering more positive approaches toward power and conflict could be achieved by using social bases of power such as referent power and by addressing conflicts in a more private, backstage, manner.
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Affiliation(s)
- Naike Bochatay
- N. Bochatay is a postdoctoral scholar, School of Medicine, University of California, San Francisco, San Francisco, California; ORCID: https://orcid.org/0000-0002-6098-4262
| | - Ágnes Kuna
- Á. Kuna is assistant professor, Department of Applied Linguistics and Phonetics, Eötvös Loránd University, Budapest, Hungary
| | - Éva Csupor
- É. Csupor is a clinical psychologist, Department of Child and Adolescent Psychiatry, Pediatric Clinic, University of Szeged, Szeged, Hungary
| | - Judit Nora Pintér
- J.N. Pintér is associate professor, Department of Psychology of Counseling, Eötvös Loránd University, Budapest, Hungary; ORCID: https://orcid.org/0000-0002-2580-588X
| | - Virginie Muller-Juge
- V. Muller-Juge is an associate specialist, School of Medicine, University of California, San Francisco, San Francisco, California; ORCID: https://orcid.org/0000-0002-2346-8904
| | - Patricia Hudelson
- P. Hudelson is a medical anthropologist, Department of Primary Care, Geneva University Hospitals, and lecturer, Faculty of Medicine, University of Geneva, Geneva, Switzerland; ORCID: https://orcid.org/0000-0003-2601-7479
| | - Mathieu R Nendaz
- M.R. Nendaz is professor and vice-dean, Department of Medicine and Unit of Development and Research in Medical Education, University of Geneva, Geneva, Switzerland; ORCID: https://orcid.org/0000-0003-3795-3254
| | - Marta Csabai
- M. Csabai is professor and head of department, Department of Personality, Clinical, and Health Psychology, University of Szeged, Szeged, Hungary
| | - Nadia M Bajwa
- N.M. Bajwa is residency program director, Department of General Pediatrics, Children's Hospital, Geneva University Hospitals, and faculty member, Unit of Development and Research in Medical Education, University of Geneva, Geneva, Switzerland; ORCID: https://orcid.org/0000-0002-1445-4594
| | - Sara Kim
- S. Kim is research professor, Department of Surgery, School of Medicine, University of Washington, Seattle, Washington; ORCID: https://orcid.org/0000-0002-6623-5393
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Byerly LK, Floren LC, Yukawa M. Fostering Interprofessional Geriatric Patient Care Skills for Health Professions Students Through a Nursing Facility-Based Immersion Rotation. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2020; 16:11059. [PMID: 33409357 PMCID: PMC7780744 DOI: 10.15766/mep_2374-8265.11059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 09/01/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Interprofessional (IP) clinical care is ideally taught in authentic environments; however, training programs often lack authentic opportunities for health professions students to practice IP patient care. Skilled nursing facilities (SNFs) can offer such opportunities, particularly for geriatric patient care, but are underutilized as training sites. We present an IP nursing facility rotation (IP-SNF) in which medical, pharmacy, and physical therapy students provided collaborative geriatric patient care. METHODS Our 10-day immersion rotation focused on four geriatric competencies common to all three professions: appropriate/hazardous medications, patient self-care capacity, evaluating and treating falls, and IP collaboration. Activities included conducting medication reviews, quarterly care planning, evaluating functional status/fall risk, and presenting team recommendations at SNF meetings. Facility faculty/staff provided preceptorship and assessed team presentations. Course evaluations included students' pre/post objective-based self-assessment, as well as facility faculty/staff evaluations of interactions with students. RESULTS Thirty-two students (15 medical, 12 pharmacy, five physical therapy) participated in the first 2 years. Evaluations (n = 31) suggested IP-SNF filled gaps in students' geriatrics and IP education. Pre/post self-assessment showed significant improvement (p < .001) in self-confidence related to course objectives. Faculty/staff indicated students added value to SNF patient care. Challenges included maximizing patient care experiences while allowing adequate team work time. DISCUSSION IP-SNF showcases the feasibility of, and potential for, engaging learners in real-world IP geriatric patient care in a SNF. Activities and materials must be carefully designed and implemented to engage all levels/types of IP learners and ensure valuable learning experiences.
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Affiliation(s)
- Laura K. Byerly
- Assistant Professor of Medicine, Division of General Internal Medicine and Geriatrics, Oregon Health & Science University School of Medicine
| | - Leslie C. Floren
- Adjunct Associate Professor of BioEngineering and Therapeutic Sciences, University of California, San Francisco, School of Pharmacy
| | - Michi Yukawa
- Professor of Medicine, Division of Geriatrics, University of California, San Francisco, School of Medicine and San Francisco VA Medical Center
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63
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Lestari E, Scherpbier A, Stalmeijer R. Stimulating Students' Interprofessional Teamwork Skills Through Community-Based Education: A Mixed Methods Evaluation. J Multidiscip Healthc 2020; 13:1143-1155. [PMID: 33116560 PMCID: PMC7568678 DOI: 10.2147/jmdh.s267732] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 09/24/2020] [Indexed: 12/31/2022] Open
Abstract
Background Interprofessional education (IPE) is suggested as a good means to prepare future healthcare professionals for collaborative work in interprofessional teams enabling them to solve complex health problems. Previous studies have advocated experiential IPE, including community-based IPE (CBIPE). This study aims to evaluate a CBIPE programme by exploring the students’ perception toward CBIPE design and toward groups’ teamwork. Methods To identify students’ perceptions of teamwork, the Interprofessional Teamwork Evaluation questionnaire was administered to 254 students of medical, nursing and midwifery programme. Three uni-professional focus group (FG) discussions were conducted to analyse the students’ perception of the design of community-based education and underlying reasons for teamwork. Results FGs reported three aspects that influence skills development in collaborative practice among students that shed light on why midwifery and nursing students held less positive perceptions of communication and mutual support: 1) communication gap due to lack of confidence, 2) contrasting ways of thinking affect communication in decision-making, and 3) the leadership culture in the health services. Conclusion A CBIPE programme was successfully implemented at Universitas Islam Sultan Agung. It demonstrated that students in the health professions can develop skills in collaborative practice despite having some problems with communication and mutual support.
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Affiliation(s)
- Endang Lestari
- Medical and Health Professions Education Unit, Faculty of Medicine, Universitas Islam Sultan Agung, Semarang, Indonesia
| | - Albert Scherpbier
- School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Renee Stalmeijer
- School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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Visser CL, Oosterbaan S, Mørk Kvist B, Croiset G, Kusurkar RA. Twelve tips on how to motivate healthcare professions students and their supervisors for Interprofessional Education. MEDEDPUBLISH 2020; 9:243. [PMID: 38058897 PMCID: PMC10697523 DOI: 10.15694/mep.2020.000243.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023] Open
Abstract
This article was migrated. The article was marked as recommended. Special efforts in rotations are necessary to have students from different professions learn with, from and about each other to improve their collaboration and the quality of care. The twelve tips derived from the lived experiences and research from the authors, are intended to stimulate motivation for interprofessional education in students and their supervisors. Internalization of the value students place on interprofessional learning will improve their readiness for future interprofessional collaboration. While creating an autonomy-supportive learning environment, supervisors are capable of both scaffolding the learning of students from all professions, and learning themselves from these authentic situations. The authors promote a central place for the clinical reasoning of each profession in both the profession specific skills as well as in the communication, collaboration and team skills, thus enhancing the 'T shaped-professional' ( Visser, 2018).
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Liaw SY, Wu LT, Soh SLH, Ringsted C, Lau TC, Lim WS. Virtual Reality Simulation in Interprofessional Round Training for Health Care Students: A Qualitative Evaluation Study. Clin Simul Nurs 2020. [DOI: 10.1016/j.ecns.2020.03.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Choudhury RI, Salam MAU, Mathur J, Choudhury SR. How interprofessional education could benefit the future of healthcare - medical students' perspective. BMC MEDICAL EDUCATION 2020; 20:242. [PMID: 32727494 PMCID: PMC7391494 DOI: 10.1186/s12909-020-02170-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 07/22/2020] [Indexed: 06/01/2023]
Abstract
As British medical students, we believe the impact that interprofessional education can have upon the future of healthcare to be a positive one. This is if it is implemented in health professions' pre-registration curricula worldwide. Our motivations for producing this article stem from our own experiences with IPE or rather our limited experiences during our medical school journey. We have exemplified the UK's NHS to demonstrate how IPE would positively impact a nation's healthcare system. With patient safety, patient experience and the economical functioning of the NHS always pertaining mainstream topics of discussion within the healthcare field, the need for improved interprofessional cohesion is now more important than ever before; especially with an increasingly demanding population. Through this article, we deeply analyse and expand upon the significance IPE has in enhancing interprofessional interactions at a pre-registration stage, in preparation for work within the NHS.
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Affiliation(s)
| | | | - Jai Mathur
- St George's University of London, Cranmer Terrace, Tooting, London, SW17 0RE, UK
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67
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Grace S. Models of interprofessional education for healthcare students: a scoping review. J Interprof Care 2020; 35:771-783. [DOI: 10.1080/13561820.2020.1767045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Sandra Grace
- School of Health and Human Sciences, Southern Cross University, Lismore, Australia
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68
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Violato E, King S. Disruption and innovation in interprofessional attitude assessment. J Interprof Care 2020; 35:325-327. [PMID: 32394784 DOI: 10.1080/13561820.2020.1758045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Efrem Violato
- Department of Educational Psychology, Faculty of Education, University of Alberta, Edmonton, AB, Canada
| | - Sharla King
- Department of Educational Psychology, Faculty of Education, Health Sciences Education and Research Commons, University of Alberta, Edmonton, AB, Canada
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Matulewicz AT, Lanning SK, Lockeman K, Frankart LM, Peron EP, Powers K, Slattum PW, Dow AW. Using a Mixed Methods Approach to Explore Perceptions of Early Learners in Classroom-Based Interprofessional Education Experiences. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2020; 84:7693. [PMID: 32577036 PMCID: PMC7298218 DOI: 10.5688/ajpe7693] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/26/2019] [Indexed: 06/11/2023]
Abstract
Objective. To explore attitudes and learning outcomes among early-level health professions students who completed foundational interprofessional education (IPE) courses. Methods. This study used a mixed methods approach to examine assessment and evaluation data from two student cohorts enrolled in two one-credit, semester-long interprofessional courses taught in fall and spring 2017. Attitudinal changes following the fall course were measured and compared in a retrospective pretest-posttest manner across student disciplines using the Student Perceptions of Interprofessional Clinical Education-Revised Instrument, version 2 (SPICE-R2). Course evaluation comments and narrative reflection assignments for both courses were analyzed qualitatively via data reduction and compilation to identify evidence of learning. Results. Significant increases in positive student perceptions regarding IPE were found, with variation in the increase seen between professions following the first course. Core themes identified in the narrative reflections demonstrated student learning in interprofessional attitudes, communication, professional identity, collaborative behaviors, and systems of care. Conclusion. Student attitudes toward interprofessional learning were more positive following completion of a foundational IPE course. In addition, learning in the course shaped students' professional identities, collaborative behaviors, and understanding of systems of care. These findings suggest value in early IPE and directions for better structuring curriculum and timing of IPE.
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Affiliation(s)
| | - Sharon K Lanning
- Virginia Commonwealth University School of Pharmacy, Richmond, Virginia
| | - Kelly Lockeman
- Virginia Commonwealth University School of Pharmacy, Richmond, Virginia
| | - Laura M Frankart
- Virginia Commonwealth University School of Pharmacy, Richmond, Virginia
| | - Emily P Peron
- Virginia Commonwealth University School of Pharmacy, Richmond, Virginia
| | - Kacie Powers
- Virginia Commonwealth University School of Pharmacy, Richmond, Virginia
| | | | - Alan W Dow
- Virginia Commonwealth University School of Pharmacy, Richmond, Virginia
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Liaw SY, Ooi SW, Rusli KDB, Lau TC, Tam WWS, Chua WL. Nurse-Physician Communication Team Training in Virtual Reality Versus Live Simulations: Randomized Controlled Trial on Team Communication and Teamwork Attitudes. J Med Internet Res 2020; 22:e17279. [PMID: 32267235 PMCID: PMC7177432 DOI: 10.2196/17279] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/02/2020] [Accepted: 01/27/2020] [Indexed: 12/22/2022] Open
Abstract
Background Interprofessional team training is needed to improve nurse-physician communication skills that are lacking in clinical practice. Using simulations has proven to be an effective learning approach for team training. Yet, it has logistical constraints that call for the exploration of virtual environments in delivering team training. Objective This study aimed to evaluate a team training program using virtual reality vs conventional live simulations on medical and nursing students’ communication skill performances and teamwork attitudes. Methods In June 2018, the authors implemented nurse-physician communication team training using communication tools. A randomized controlled trial study was conducted with 120 undergraduate medical and nursing students who were randomly assigned to undertake team training using virtual reality or live simulations. The participants from both groups were tested on their communication performances through team-based simulation assessments. Their teamwork attitudes were evaluated using interprofessional attitude surveys that were administered before, immediately after, and 2 months after the study interventions. Results The team-based simulation assessment revealed no significant differences in the communication performance posttest scores (P=.29) between the virtual and simulation groups. Both groups reported significant increases in the interprofessional attitudes posttest scores from the baseline scores, with no significant differences found between the groups over the 3 time points. Conclusions Our study outcomes did not show an inferiority of team training using virtual reality when compared with live simulations, which supports the potential use of virtual reality to substitute conventional simulations for communication team training. Future studies can leverage the use of artificial intelligence technology in virtual reality to replace costly human-controlled facilitators to achieve better scalability and sustainability of team-based training in interprofessional education. Trial Registration ClinicalTrials.gov NCT04330924; https://clinicaltrials.gov/ct2/show/NCT04330924
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Affiliation(s)
- Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
| | - Sim Win Ooi
- National University Hospital, Singapore, Singapore
| | | | - Tang Ching Lau
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Wilson Wai San Tam
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
| | - Wei Ling Chua
- Alice Lee Centre for Nursing Studies, National University of Singapore, Singapore, Singapore
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Lucas C, Schindel TJ, Saini B, Paslawski T. Game changer: Pharmacy students' perceptions of an educational "Party Hat" game to enhance communication and collaboration skills. CURRENTS IN PHARMACY TEACHING & LEARNING 2020; 12:442-449. [PMID: 32334761 DOI: 10.1016/j.cptl.2019.12.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 11/13/2019] [Accepted: 12/07/2019] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND PURPOSE Educational games can be utilized as a tool to enhance communication and collaboration skill development and to bridge the gap between classroom learning and the practice environment. This study explores pharmacy students' perceptions of a game to enhance communication and collaboration. EDUCATIONAL ACTIVITY AND SETTING Pre-licenced pharmacy students from an Australian metropolitan university engaged in a "Party Hat" game, where the goal was to communicate and collaborate with their peers to provide a discharge plan for a patient. "Party hats" with different instructions (e.g., agree with everything they say) were randomly provided to all students. Students were not privy to the instruction on their own party hat. The other students in the group were required to adhere to the instruction on their peers' hats while communicating. To gauge barriers to effective communication and collaboration, a debriefing session was conducted and written feedback was obtained. The debriefing session was transcribed verbatim and thematic analysis was conducted. FINDINGS Forty-nine students participated in the game. All students provided written feedback, and 15 students participated in the debriefing session. Emergent themes included: (1) inherent biases affecting communication and patient outcomes, (2) importance for an effective group leader, (3) importance for respect for other opinions, and (4) words can affect people. SUMMARY Effective communication and collaboration between healthcare professionals is an important skill. Using educational games to engage students is one of the ways in which educators can teach students the importance of delivering effective communication and of engaging in collaboration with their peers for better patient outcomes.
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Affiliation(s)
- Cherie Lucas
- Graduate School of Health, University of Technology Sydney, Address: 67 Thomas Street, Ultimo, Building 7, Level 4, Room 48, Sydney, NSW 2007, Australia.
| | - Theresa J Schindel
- University of Alberta, Faculty of Pharmacy and Pharmaceutical Sciences, 3-216 Edmonton Clinic Health Academy, 11405 87 Avenue, Edmonton, AB T6G 1C9, Canada.
| | - Bandana Saini
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, Australia.
| | - Teresa Paslawski
- University of Saskatchewan, School of Rehabilitation Science, College of Medicine, 104 Clinic Place, Health Sciences E-Wing, Room 3420, Saskatoon, SK S7N 2Z4, Canada.
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Williams E, Presti CR, Rivera H, Agarwal G. Preparing students for clinical practice: The impact of a TeamSTEPPS® inter professional education session. NURSE EDUCATION TODAY 2020; 86:104321. [PMID: 31896033 DOI: 10.1016/j.nedt.2019.104321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/12/2019] [Accepted: 12/18/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Eva Williams
- Michael S. Gordon Center for Research in Medical Education, University of Miami Miller School of Medicine, PO Box 016960 (D-41), Miami, FL 33101, United States of America.
| | - Carmen R Presti
- University of Miami School of Nursing and Health Studies, 5030 Brunson Drive, Suite 405, Coral Gables, FL 33146, United States of America.
| | - Hector Rivera
- Jackson Memorial Hospital, 1611 Northwest 20th Avenue, Central Building 4th Floor, 409, Miami, FL 33136, United States of America.
| | - Gauri Agarwal
- University of Miami Miller School of Medicine, 2500 North Military Trail, Suite 260, Boca Raton, FL 33431, United States of America.
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Miller DW, Paradis E. Making it real: the institutionalization of collaboration through formal structure. J Interprof Care 2020; 34:528-536. [PMID: 32064972 DOI: 10.1080/13561820.2020.1714563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Collaboration has achieved widespread acceptance as an indispensable element of healthcare delivery in recent decades, despite modest evidence for its impact on healthcare outcomes. Attempts to understand this seeming paradox have been based mostly in functionalist or conflict-theoretical approaches. Currently lacking, however, is an articulation of how collaborative ideals are embedded in broadly shared beliefs about what healthcare is and how it operates. In this article, we examine how language used in the CanMEDS competency framework and in two guides for Family Health Teams construct idealized versions of rational, autonomous physicians and primary care organizations, respectively. Informed by phenomenological sociology and neo-institutional theory, we characterize these documents as elements of formal structure, the putative "blueprints" for healthcare planning and activity. Drawing on this analysis, we argue that these documents and "collaborative" formal structures in general, not only function as tools to make healthcare more collaborative, but also create an appearance of "real" collaboration, independently of the realities of practice. We argue that they thus instill confidence that the current healthcare system functions according to deep-seated societal values of justice and progress. We conclude by emphasizing the potentially distorting influence of this on efforts to understand and improve healthcare.
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Affiliation(s)
- Daniel W Miller
- Leslie Dan Faculty of Pharmacy, University of Toronto , Toronto, Canada
| | - Elise Paradis
- Leslie Dan Faculty of Pharmacy, University of Toronto , Toronto, Canada
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Tong R, Brewer M, Flavell H, Roberts LD. Professional and interprofessional identities: a scoping review. J Interprof Care 2020:1-9. [PMID: 32053408 DOI: 10.1080/13561820.2020.1713063] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 12/19/2019] [Accepted: 01/02/2020] [Indexed: 10/25/2022]
Abstract
Identity development within the interprofessional field is an emerging area of research. This scoping review aims to establish how professional and interprofessional identities are defined, conceptualized, theorized and measured within the interprofessional literature. Six databases were systematically searched for papers focusing on professional and/or interprofessional identities in interprofessional healthcare and education using a scoping review methodology. A total of 84 papers were included. Most papers discussed professional identity only; the minority discussed both identities. There were three key findings. First, no universal definition of interprofessional identity exists. Second, there is no shared understanding of interprofessional identity and its relationship with professional identity. Third, poor alignment between definitions, conceptualizations, theories and measures of interprofessional identity exists. The absence of a psychometrically robust instrument that specifically measures interprofessional identity and the short-term focus of current interprofessional identity research further limits understanding. Research that critically examines professional and interprofessional identity development should be underpinned by clear definitions, concepts, theories and measures of both identities. High-quality research will allow greater understanding of interprofessional identity development and its impact on interprofessional practice.
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Affiliation(s)
- R Tong
- School of Psychology, Curtin University, Perth, Australia
| | - M Brewer
- Faculty of Health Sciences, Curtin University, Perth, Australia
| | - H Flavell
- Faculty of Health Sciences, Curtin University, Perth, Australia
| | - L D Roberts
- School of Psychology, Curtin University, Perth, Australia
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Dow AW, Sewell DK, Lockeman KS, Micalizzi EA. Evaluating a Center for Interprofessional Education via Social Network Analysis. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:207-212. [PMID: 31577587 DOI: 10.1097/acm.0000000000003010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Centers and institutes are created to support interdisciplinary collaboration. However, all centers and institutes face the challenge of how best to evaluate their impact since traditional counts of productivity may not fully capture the interdisciplinary nature of this work. The authors applied techniques from social network analysis (SNA) to evaluate the impact of a center for interprofessional education (IPE), a growing area for centers because of the global emphasis on IPE.The authors created networks based on the connections between faculty involved in programs supported by an IPE center at Virginia Commonwealth University from 2014 to 2017. They used mathematical techniques to describe these networks and the change in the networks over time. The results of these analyses demonstrated that, while the number of programs and involved faculty grew, the faculty maintained a similar amount of connection between members. Additional faculty clusters emerged, and certain key faculty were important connectors between clusters. The analysis also confirmed the interprofessional nature of faculty collaboration within the network.SNA added important evaluation data beyond typical metrics such as counts of learners or faculty. This approach demonstrated how a center was evolving and what strategies might be needed to support further growth. With further development of benchmarks, SNA could be used to evaluate the effectiveness of centers and institutes relative to each other. SNA should guide strategic decisions about the future of centers and institutes as they strive to meet their overarching goal of tackling a social challenge through interdisciplinary collaboration.
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Affiliation(s)
- Alan W Dow
- A.W. Dow is assistant vice president of health sciences for interprofessional education and collaborative care and professor of medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia; ORCID: https://orcid.org/0000-0002-9004-7528. D.K. Sewell is assistant professor of biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa; ORCID: https://orcid.org/0000-0002-9238-4026. K.S. Lockeman is assistant professor of medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia; ORCID: https://orcid.org/0000-0003-1890-3710. E.A. Micalizzi is center administrator, Virginia Commonwealth University Center for Interprofessional Education and Collaborative Care, Richmond, Virginia
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Kent F, Glass S, Courtney J, Thorpe J, Nisbet G. Sustainable interprofessional learning on clinical placements: the value of observing others at work. J Interprof Care 2020; 34:812-818. [DOI: 10.1080/13561820.2019.1702932] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Fiona Kent
- Education Portfolio, FMNHS (Faculty Medicine, Nursing and Health Sciences), Monash University, Melbourne, Australia
| | - Sharon Glass
- WISER Unit (Workforce, Innovation, Strategy, Education and Research unit), Monash Health, Melbourne, Australia
| | - Jade Courtney
- WISER Unit (Workforce, Innovation, Strategy, Education and Research unit), Monash Health, Melbourne, Australia
| | - Jo Thorpe
- WISER Unit (Workforce, Innovation, Strategy, Education and Research unit), Monash Health, Melbourne, Australia
| | - Gillian Nisbet
- Work Integrated Learning, The University of Sydney, Sydney, Australia
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Rivera J, O'Brien B, Wamsley M. "Getting Out of That Siloed Mentality Early": Interprofessional Learning in a Longitudinal Placement for Early Medical Students. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:122-128. [PMID: 31274523 DOI: 10.1097/acm.0000000000002853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE Although descriptions of interprofessional education often focus on interactions among students from multiple professions, embedding students from 1 profession in clinical settings may also provide rich opportunities for interprofessional learning (IPL). This study examines affordances and barriers to medical students' interactions with and opportunities to learn from health care professionals while learning health systems science in clinical workplaces. METHOD In May 2017, 14 first-year medical students at the University of California, San Francisco participated in a semistructured interview about IPL experiences during a 17-month, weekly half-day clinical microsystem placement focused on systems improvement (SI) projects and clinical skills. Communities of practice and workplace learning frameworks informed the interview guide. The authors analyzed interview transcripts using conventional qualitative content analysis. RESULTS The authors found much variation among the 14 students' interprofessional interactions and experiences in 12 placement sites (7 outpatient, 4 inpatient, 1 emergency department). Factors influencing the depth of interprofessional interactions included the nature of the SI project, clinical workflow, student and staff schedules, workplace culture, and faculty coach facilitation of interprofessional interactions. Although all students endorsed the value of learning about and from diverse health care professionals, they were reluctant to engage with, or "burden," them. CONCLUSIONS There are significant IPL opportunities for early medical students in longitudinal placements focused on SI and clinical skills. Formal curricular activities, SI projects conducive to interprofessional interactions, and faculty development can enhance the quality of workplace-based IPL.
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Affiliation(s)
- Josette Rivera
- J. Rivera is associate professor of medicine, Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, California. B. O'Brien is professor of medicine, Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, California. M. Wamsley is professor of medicine, Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, California
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Lockeman KS, Dow AW, Randell AL. Validity evidence and use of the IPEC Competency Self-Assessment, Version 3. J Interprof Care 2019; 35:107-113. [PMID: 31852416 DOI: 10.1080/13561820.2019.1699037] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
To guide interprofessional education (IPE), a variety of frameworks have been suggested for defining competency in interprofessional practice, but competency-based assessment remains challenging. One self-report measure developed to facilitate competency-based assessment in IPE is the IPEC Competency Self-Assessment. It was originally described as a 42-item measure constructed on the four domains defined by the Interprofessional Education Collaborative (IPEC) Expert Panel. Response data, however, identified only two factors labeled Interprofessional Interaction and Interprofessional Values. In this study, we tested a revised 19-item, two-factor scale based on these prior findings with a new sample (n = 608) and found good model fit with three items not loading on either factor. This led to a 16-item instrument, which was then tested with an additional sample (n = 676). Internal consistency was high, and scores for both subscales showed variance based on prior healthcare experience. The interprofessional interaction subscale was primarily comprised of items from the Teams and Teamwork domain, with one item each based on competencies from the Interprofessional Communication and Values/Ethics domains; and scores varied by year of enrollment. The interprofessional values subscale was comprised solely of items from the Values/Ethics domain. Scores for both subscales were strongly correlated with scores from the Interprofessional Socialization and Valuing Scale. This study further establishes the validity, reliability, and usability of an assessment tool based on interprofessional competency. The findings also suggest the constructs underlying the subscales may be affected differently by experience and training. Additional study using longitudinal data is needed to test this hypothesis.
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Affiliation(s)
- Kelly S Lockeman
- School of Medicine, Virginia Commonwealth University , Richmond, VA, USA
| | - Alan W Dow
- School of Medicine, Virginia Commonwealth University , Richmond, VA, USA
| | - Autumn L Randell
- School of Education, Virginia Commonwealth University , Richmond, VA, USA
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Bochatay N. Discussing teamwork in health care: from interprofessional collaboration to coordination and cooperation. Health Info Libr J 2019; 36:367-371. [PMID: 31829501 DOI: 10.1111/hir.12282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This doctoral research investigates teamwork, specifically collaboration, at two different hospitals both of which were highly involved in the promotion of interprofessional collaboration. The analysis of the field observations and data collected revealed that this concept did not accurately reflect daily interactions between health care professionals, but that other forms of interaction such as coordination and cooperation were more frequent. Furthermore, the use of these more specific concepts to discuss teamwork in health care enabled important differences to be observed between the clinical settings. The impact of this research in practice suggests that adopting more specific concepts would make it easier to identify relevant literature and to design policies and educational programmes that address teamwork in health care. FJ.
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Affiliation(s)
- Naike Bochatay
- Institute of Sociological Research, University of Geneva, Geneva, Switzerland
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Lestari E, Stalmeijer RE, Widyandana D, Scherpbier A. Does PBL deliver constructive collaboration for students in interprofessional tutorial groups? BMC MEDICAL EDUCATION 2019; 19:360. [PMID: 31533721 PMCID: PMC6751883 DOI: 10.1186/s12909-019-1802-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 09/09/2019] [Indexed: 06/02/2023]
Abstract
BACKGROUND Training health professional students in teamwork is recognized as an important step to create interprofessional collaboration in the clinical workplace. Interprofessional problem-based learning (PBL) is one learning approach that has been proposed to provide students with the opportunity to develop the necessary skills to work collaboratively with various health professionals. This study aimed to explore the extent to which students in interprofessional tutorial groups demonstrate constructive collaboration during group discussions. METHODS Students (N = 52) from the Medical, Midwifery and Nursing programmes took part in the study. Video-recordings were made of interprofessional PBL discussions (N = 40) in five groups, eight videos per group. Over a period of 4 weeks, participants discussed four scenarios concerned with the reproductive system. The resulting 67 h of video data were analysed qualitatively. To ensure inter-rater reliability, two tutors assessed the students' constructive, collaborative activities using the Maastricht Peer-Activity Rating Scale (MPARS). Finally, to gain an understanding of students' perceptions of their performance and participation in the interprofessional PBL tutorial, we organized three uni-professional focus groups (FGs) at the end of pilot project. RESULTS The translated MPARS was reliable (Kappa coefficient 0.01-0.20 and p < 0.05). Students were actively involved in the discussion and contributed to a better understanding regardless of their professional background. Group members from different professions complemented one another in solving learning issues. They were open, feeling free to question and argue from the viewpoint of their own profession, and also understood their strengths and limitations. The statistical test of the scores for constructive and collaborative activities indicated a significant difference between students and the various healthcare professionals, p = 0.000, with medical students scoring highest on both activities. Focus groups further clarified some of the observed dynamics. CONCLUSION Implementing interprofessional PBL could motivate students to engage collaboratively in co-constructing knowledge to solve the patients' problem. Medical students scored highest on constructive and collaborative activities.
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Affiliation(s)
- Endang Lestari
- Medical Education Unit, Faculty of Medicine, Universitas Islam Sultan Agung, Semarang, Indonesia
| | - Renée E. Stalmeijer
- School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Doni Widyandana
- Department of Medical Education, Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia
| | - Albert Scherpbier
- School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Donnelly C, Ashcroft R, Mofina A, Bobbette N, Mulder C. Measuring the performance of interprofessional primary health care teams: understanding the teams perspective. Prim Health Care Res Dev 2019; 20:e125. [PMID: 31455458 PMCID: PMC6719251 DOI: 10.1017/s1463423619000409] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 03/27/2019] [Accepted: 04/27/2019] [Indexed: 11/06/2022] Open
Abstract
AIM The aim of the study was to describe practices that support collaboration in interprofessional primary health care teams, and identify performance indicators perceived to measure the impact of this collaboration from the perspective of interprofessional health providers. BACKGROUND Despite the surge of interprofessional primary health care models implemented across Canada, there is little evidence as to whether or not the intended outcomes of primary health care teams have been achieved. Part of the challenge is determining the most appropriate measures that can demonstrate the value of collaborative care. To date, little remains known about performance measurement from the providers contributing to the collaborative care process in interprofessional primary care teams. Having providers from a range of disciplinary backgrounds assist in the development of performance measures can help identify measures most relevant to demonstrate the value of collaborative care on the intended outcomes of interprofessional primary care models. METHODS A qualitative study; part of a larger mixed methods developmental evaluation to examine performance measurement in interprofessional primary health care teams. A stakeholder workshop was conducted at an annual association meeting of interprofessional primary health care teams in the province of Ontario, Canada. Six questions guided the workshop groups and participant responses were documented on worksheets and flip charts. All responses were collected and entered verbatim into a word document. Qualitative analytic strategies were applied to each question. FINDINGS A total of 283 primary health care providers from 14 health professions working in interprofessional primary health care teams participated. Top three elements of interprofessional collaboration (total n = 628) were communication (n = 146), co-treatment (n = 112) and patient-based conferences (n = 81). Top three performance indicators currently used to demonstrate the value of interprofessional collaboration (total n = 241) were patient experience (n = 71), patient health status (n = 35) and within team referrals (n = 30).
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Affiliation(s)
- Catherine Donnelly
- School of Rehabilitation Therapy, Occupational Therapy Program, Queen’s University, Kingston, ONCanada
| | | | - Amanda Mofina
- School of Rehabilitation Therapy, Occupational Therapy Program, Queen’s University, Kingston, ONCanada
| | - Nicole Bobbette
- School of Rehabilitation Therapy, Occupational Therapy Program, Queen’s University, Kingston, ONCanada
| | - Carol Mulder
- Quality Improvement Decision Support Program, Provincial Lead, Association of Family Health Teams of Ontario, Toronto, ONCanada
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Firn J, Rui C, Vercler C, De Vries R, Shuman A. Identification of core ethical topics for interprofessional education in the intensive care unit: a thematic analysis. J Interprof Care 2019; 34:453-460. [PMID: 31405312 DOI: 10.1080/13561820.2019.1632814] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Medical educators have not identified effective approaches for interprofessional ethics education of clinicians who work in intensive care units (ICUs), in spite of the fact that ICUs have a high incidence of ethical conflicts. As a first step in designing an interprofessional ethics education initiative tailored to the needs of ICU team members, we interviewed 12 professionals from the medical and surgical ICUs of a tertiary care academic medical center to understand what they know about medical ethics. Respondents were interviewed between November 2016 and February 2017. We used the 'think aloud' approach and realist thematic analysis of the sessions to evaluate the extent and content of interprofessional team members' knowledge of medical ethics. We found wide variation in their knowledge of and facility in applying the principles and concepts of biomedical ethics and ways of resolving ethical conflicts. Ethics education tailored to these areas will help equip critical care professionals with the necessary knowledge and skills to discuss and address ethical conflicts encountered in the ICU. Preventive ethics rounds are one approach for providing real-time, embedded interprofessional ethics education in the clinical setting.
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Affiliation(s)
- Janice Firn
- Center for Bioethics and Social Sciences (CBSSM), University of Michigan Medical School , Ann Arbor, MI, USA
| | - Crystal Rui
- M4101 Medical Science Building I- C Wing, University of Michigan Medical School , Ann Arbor, MI, USA
| | - Christian Vercler
- Center for Bioethics and Social Sciences (CBSSM), University of Michigan Medical School , Ann Arbor, MI, USA
| | - Raymond De Vries
- Center for Bioethics and Social Sciences (CBSSM), University of Michigan Medical School , Ann Arbor, MI, USA
| | - Andrew Shuman
- Center for Bioethics and Social Sciences (CBSSM), University of Michigan Medical School , Ann Arbor, MI, USA
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Violato EM, King S. A Validity Study of the Interprofessional Collaborative Competency Attainment Survey: An Interprofessional Collaborative Competency Measure. J Nurs Educ 2019; 58:454-462. [DOI: 10.3928/01484834-20190719-04] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 04/24/2019] [Indexed: 11/20/2022]
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Kesselheim JC, Stockman LS, Growdon AS, Murray AM, Shagrin BS, Hundert EM. Discharge Day: A Case-Based Interprofessional Exercise About Team Collaboration in Pediatrics. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2019; 15:10830. [PMID: 31583273 PMCID: PMC6759138 DOI: 10.15766/mep_2374-8265.10830] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 04/09/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Interprofessional education, which gives medical students the opportunity to learn from, with, and about other health professionals, is an essential component of the undergraduate medical education curriculum. Nonetheless, deliberate and sustained integration of interprofessional education into the undergraduate medical learning experience can be challenging, especially within the clinical setting. METHODS We implemented a 75-minute, interactive, collaborative, case-based conference focusing on an interprofessional clinical challenge in a pediatric setting. Medical students on their pediatrics core rotation and trainees within social work, nursing, pharmacy, and nutrition explored the concept of a team, reflected on roles, and considered how interprofessional collaboration could influence patient outcomes. RESULTS One hundred ninety-two health professions students participated in 15 sessions at three sites over a 10-month period (September 2017-July 2018). After each session, participants completed a session evaluation. They gave high ratings to the effectiveness and relevance of the experience and the case vignette. Responses to open-ended questions revealed that students had learned the importance of leveraging the expertise of team members and had resolved to speak up when faced with an interprofessional challenge in the future. DISCUSSION This case-based session is a logistically feasible and positively received opportunity for health professions students to discuss interprofessional collaboration. It could be adapted for a variety of learner populations and academic environments and could be incorporated into existing curricula.
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Affiliation(s)
| | - Leah S. Stockman
- Research Project Manager, Department of Medical Oncology, Dana-Farber Cancer Institute
| | - Amanda S. Growdon
- Assistant Professor of Pediatrics, Harvard Medical School
- Pediatric Hospitalist, Department of Pediatrics, Boston Children's Hospital
| | - Ann M. Murray
- Instructor of Pediatrics, Harvard Medical School
- Pediatric Infectious Disease Specialist, MGH Pediatric Group Practice
- Associate Director, Pediatric Core Clerkship, MassGeneral Hospital for Children
| | - Bianca S. Shagrin
- Instructor of Pediatrics, Harvard Medical School
- Pediatric Clerkship Director, Cambridge Integrated Clerkship, Department of Pediatrics, Cambridge Health Alliance
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85
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Sklar DP. Training Models for Physician Assistants and Nurse Practitioners: Disruptive Innovations That Could Improve Health Professions Education and Practice. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:917-920. [PMID: 31241562 DOI: 10.1097/acm.0000000000002738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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Lutfiyya MN, Chang LF, McGrath C, Dana C, Lipsky MS. The state of the science of interprofessional collaborative practice: A scoping review of the patient health-related outcomes based literature published between 2010 and 2018. PLoS One 2019; 14:e0218578. [PMID: 31242239 PMCID: PMC6594675 DOI: 10.1371/journal.pone.0218578] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 06/03/2019] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION If interprofessional collaborative practice is to be an important component of healthcare reform, then an evidentiary base connecting interprofessional education to interprofessional practice with significantly improved health and healthcare outcomes is an unconditional necessity. This study is a scoping review of the current peer reviewed literature linking interprofessional collaborative care and interprofessional collaborative practice to clearly identified healthcare and/or patient health-related outcomes. The research question for this review was: What does the evidence from the past decade reveal about the impact of Interprofessional collaborative practice on patient-related outcomes in the US healthcare system? MATERIALS AND METHODS A modified preferred reporting items for systematic reviews and meta-analyses (PRISMA) approach was followed. RESULTS Of an initial 375 articles retrieved 20 met review criteria. The most common professions represented in the studies reviewed were physicians, pharmacists and nurses. Primary care was the most common care delivery setting and measures related to chronic disease the most commonly measured outcomes. No study identified negative impacts of interprofessional collaborative practice. Eight outcome categories emerged from a content analysis of the findings of the reviewed studies. CONCLUSIONS The results suggest a need for more research on the measurable impact of interprofessional collaborative practice and/or care on patient health-related outcomes to further document its benefits and to explore the models, systems and nature of collaborations that best improve population health, increase patient satisfaction, and reduce cost of care.
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Affiliation(s)
- May Nawal Lutfiyya
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah, United States of America
| | - Linda Feng Chang
- Department of Family and Community Medicine, University of Illinois-Chicago, College of Medicine at Rockford, Rockford, Illinois, United States of America
| | - Cynthia McGrath
- Saint Anthony College of Nursing, Rockford, Ilinois, United States of America
| | - Clark Dana
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah, United States of America
| | - Martin S. Lipsky
- Office of the Chancellor, Roseman University of Health Sciences, South Jordan, Utah, United States of America
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87
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Onyura B, Crann S, Tannenbaum D, Whittaker MK, Murdoch S, Freeman R. Is postgraduate leadership education a match for the wicked problems of health systems leadership? A critical systematic review. PERSPECTIVES ON MEDICAL EDUCATION 2019; 8:133-142. [PMID: 31161480 PMCID: PMC6565666 DOI: 10.1007/s40037-019-0517-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
PURPOSE There have been a growing number of leadership education programs for physicians. However, debates about the value and efficacy of leadership education in medicine persist, and there are calls for systematic and critical perspectives on medical leadership development. Here, we review evidence on postgraduate leadership education and discuss findings in relation to contemporary evidence on leadership education and practice. METHOD We searched multiple databases for papers on postgraduate leadership development programs, published in English between 2007 and 2017. We identified 4,691 papers; 31 papers met the full inclusion criteria. Data regarding curricular content and design, learner demographics, instructional methods, and learning outcomes were abstracted and synthesized. RESULTS There was modest evidence for effectiveness of programs in influencing knowledge and skills gains in select domains. However, the conceptual underpinnings of the 'leadership' training delivered were often unclear. Contemporary theory and evidence on leadership practice was not widely incorporated in program design. Programs were almost exclusively uni-professional, focused on discrete skill development, and did not address systems-level leadership issues. Broader leadership capacity building strategies were underutilized. A new wave of longitudinal, integrated clinical and leadership programming is observed. CONCLUSIONS Our findings raise questions about persistent preparation-practice gaps in leadership education in medicine. Leadership education needs to evolve to incorporate broader collective capacity building, as well as evidence-informed strategies for leadership development. Barriers to educational reform need to be identified and addressed as educators work to re-orientate education programs to better prepare budding physician leaders for the challenges of health system leadership.
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Affiliation(s)
- Betty Onyura
- Centre for Faculty Development, Faculty of Medicine, University of Toronto, St. Michael's Hospital, Ontario, Canada.
- Department of Family and Community Medicine, University of Toronto, Ontario, Canada.
| | - Sara Crann
- Department of Psychology, University of Windsor, Ontario, Canada
| | - David Tannenbaum
- Department of Family and Community Medicine, University of Toronto, Ontario, Canada
| | - Mary Kay Whittaker
- Department of Family and Community Medicine, University of Toronto, Ontario, Canada
| | - Stuart Murdoch
- Department of Family and Community Medicine, University of Toronto, Ontario, Canada
| | - Risa Freeman
- Department of Family and Community Medicine, University of Toronto, Ontario, Canada
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Nimmon L, Artino AR, Varpio L. Social Network Theory in Interprofessional Education: Revealing Hidden Power. J Grad Med Educ 2019; 11:247-250. [PMID: 31210849 PMCID: PMC6570428 DOI: 10.4300/jgme-d-19-00253.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Paradis E, Whitehead CR. The Complexities of Care and Conflict. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:152. [PMID: 30694896 DOI: 10.1097/acm.0000000000002526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Elise Paradis
- Assistant professor, Leslie Dan Faculty of Pharmacy, Department of Anesthesia, and Department of Sociology, University of Toronto, and scientist, Wilson Centre, Toronto, Ontario, Canada; . Associate professor, Department of Community and Family Medicine, University of Toronto, director and scientist, Wilson Centre, and vice president for education, Women's College Hospital, Toronto, Ontario, Canada
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90
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Gowda D, Curran T, Khedagi A, Mangold M, Jiwani F, Desai U, Charon R, Balmer D. Implementing an interprofessional narrative medicine program in academic clinics: Feasibility and program evaluation. PERSPECTIVES ON MEDICAL EDUCATION 2019; 8:52-59. [PMID: 30721400 PMCID: PMC6382622 DOI: 10.1007/s40037-019-0497-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Interprofessional education (IPE) is a critical component of medical education and is affected by the characteristics of the clinical teams in which students and residents train. However, clinical teams are often shaped by professional silos and hierarchies which may hinder interprofessional collaborative practice (IPCP). Narrative medicine, a branch of health humanities that focuses on close reading, reflective writing, and sharing in groups, could be an innovative approach for improving IPE and IPCP. In this report, we describe the structure, feasibility, and a process-oriented program evaluation of a narrative medicine program implemented in interprofessional team meetings in three academic primary care clinics. Program evaluation revealed that a year-long narrative medicine program with modest monthly exposure was feasible in academic clinical settings. Staff members expressed engagement and acceptability as well as support for ongoing implementation. Program success required administrative buy-in and sustainability may require staff training in narrative medicine.
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Affiliation(s)
- Deepthiman Gowda
- Department of Medicine, Columbia University Irving Medical Center, Columbia University Vagelos College of Physicians and Surgeons, New York, USA.
| | - Tayla Curran
- Columbia University Vagelos College of Physicians and Surgeon, New York, USA
| | - Apurva Khedagi
- Columbia University Vagelos College of Physicians and Surgeon, New York, USA
| | - Michael Mangold
- Columbia University Vagelos College of Physicians and Surgeon, New York, USA
| | - Faiz Jiwani
- Department of Medicine, Baylor College of Medicine, New York, USA
| | - Urmi Desai
- The Center for Family and Community Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, USA
| | - Rita Charon
- Department of Medical Humanities and Ethics, Columbia University Irving Medical Center, Columbia University Vagelos College of Physicians and Surgeons, New York, USA
| | - Dorene Balmer
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, USA
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Tassone M, Lising D, Langlois S. Shedding More Light on the State of Interprofessional Education. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2018; 93:1751. [PMID: 30489299 DOI: 10.1097/acm.0000000000002461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Maria Tassone
- Director, Centre for Interprofessional Education, University of Toronto, Toronto, Ontario, Canada; . Strategy lead, Interprofessional Education Curriculum/Collaborative Practice Lead, Centre for Interprofessional Education, University of Toronto, Toronto, Ontario, Canada. Faculty lead, Interprofessional Education Curriculum and Scholarship, Centre for Interprofessional Education, University of Toronto, Toronto, Ontario, Canada
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Nasmith L, Wood V, Krekoski C. Shedding More Light on the State of Interprofessional Education. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2018; 93:1750-1751. [PMID: 30489298 DOI: 10.1097/acm.0000000000002457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Louise Nasmith
- Professor, Office of UBC Health, University of British Columbia, Vancouver, British Columbia, Canada; . Curriculum manager, Office of UBC Health, University of British Columbia, Vancouver, British Columbia, Canada. Practice education manager, Office of UBC Health, University of British Columbia, Vancouver, British Columbia, Canada
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Paradis E, Whitehead CR. In Reply to Nasmith et al and to Tassone et al. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2018; 93:1751-1752. [PMID: 30489300 DOI: 10.1097/acm.0000000000002456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Elise Paradis
- Assistant professor, Leslie Dan Faculty of Pharmacy, Department of Anesthesia, and Department of Sociology, University of Toronto, and scientist, Wilson Centre, Toronto, Ontario, Canada; . Associate professor, Department of Community and Family Medicine, University of Toronto, director and scientist, Wilson Centre, and vice president for education, Women's College Hospital, Toronto, Ontario, Canada
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Sklar DP. Implementing Curriculum Change: Choosing Strategies, Overcoming Resistance, and Embracing Values. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2018; 93:1417-1419. [PMID: 30252731 DOI: 10.1097/acm.0000000000002350] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Landoll RR, Maggio LA, Cervero RM, Quinlan JD. Training the Doctors: A Scoping Review of Interprofessional Education in Primary Care Behavioral Health (PCBH). J Clin Psychol Med Settings 2018; 26:243-258. [PMID: 30255408 DOI: 10.1007/s10880-018-9582-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Primary care behavioral health (PCBH) is a model of integrated healthcare service delivery that has been well established in the field of psychology and continues to grow. PCBH has been associated with positive patient satisfaction and health outcomes, reduced healthcare expenditures, and improved population health. However, much of the education and training on PCBH has focused on developing behavioral health providers to practice in this medical setting. Less attention has been paid to physician team members to support and practice within an integrated environment. This is problematic as underdeveloped physician team members may contribute to low utilization and attrition of behavioral health consultants. A scoping review was conducted to examine the training of physicians in this domain since 2006. Twenty-one studies were identified, predominantly in Family Medicine training programs. Although PCBH training was generally well received, more program evaluation, formalized curriculum, and faculty development are needed to establish best practices.
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