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McKinlay E, Brown M, Beckingsale L, Burrow M, Coleman K, Darlow B, Donovan S, Gorte T, Hilder J, Neser H, Perry M, Sutherland D, Wallace D, Waterworth C, Pullon S. Forming inter-institutional partnerships to offer pre-registration IPE: a focus group study. J Interprof Care 2019; 34:380-387. [PMID: 31750747 DOI: 10.1080/13561820.2019.1685476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Interprofessional education (IPE) programs for pre-registration health science students are largely offered within one institution including different schools or faculties. Sometimes in small or regional institutions where there are limited student numbers or few professional training programs, or where larger institutions do not offer particular professional programs, it may be necessary to partner with other institutions to offer IPE. This study sought to explore teacher perspectives of forming inter-institutional partnerships to deliver IPE, in particular, to identify the elements that influence the formation of partnerships. An interpretive descriptive approach was used to thematically analyze data from three focus groups with teachers (n = 21) working in three different partnerships to deliver IPE to students in Wellington, New Zealand. Two main themes were identified which enabled the development of a model of partnership, with a continuum of complexity depending on whether institutions were on the same page and whether the partnership formed to join an existing IPE program or to create a new IPE program. Forming inter-institution partnerships is a pragmatic solution to providing IPE with benefits to all taking part. Our work showed that time, effort, working with complexity, and ability to stay on the same page are necessary elements for building successful partnerships and all need to be taken into account when planning inter-institution partnerships.
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Affiliation(s)
- Eileen McKinlay
- Department of Primary Health Care & General Practice, University of Otago, Wellington, New Zealand
| | - Melanie Brown
- Department of Primary Health Care & General Practice, University of Otago, Wellington, New Zealand
| | - Louise Beckingsale
- Department of Human Nutrition, University of Otago, Christchurch, New Zealand
| | - Marla Burrow
- School of Nursing, Massey University, Palmerston North, New Zealand
| | - Karen Coleman
- Department of Radiation Therapy, University of Otago, Wellington, New Zealand
| | - Ben Darlow
- Department of Primary Health Care & General Practice, University of Otago, Wellington, New Zealand
| | - Sarah Donovan
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Tom Gorte
- Clinical Nurse Educator, Hutt Valley District Health Board, Lower Hutt, New Zealand
| | - Jo Hilder
- Department of Primary Health Care & General Practice, University of Otago, Wellington, New Zealand
| | - Hazel Neser
- Department of Radiation Therapy, University of Otago, Wellington, New Zealand
| | - Meredith Perry
- School of Physiotherapy, University of Otago, Wellington, New Zealand
| | | | - Debbie Wallace
- EVOLVE Programme Manager, Pharmaceutical Society, Wellington, New Zealand
| | | | - Sue Pullon
- Department of Primary Health Care & General Practice, University of Otago, Wellington, New Zealand
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152
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Yang A, Fernando S, Tighe J, O-Halloran M, Morphet J, Kumar A. Introduction of an interprofessional gynaecology surgical skills workshop for undergraduate medical and nursing students. Aust N Z J Obstet Gynaecol 2019; 60:238-243. [PMID: 31650525 DOI: 10.1111/ajo.13086] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 09/19/2019] [Accepted: 09/24/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Medical and nursing students may feel under-prepared to perform basic surgical and gynaecology procedural skills. There also remains scope within undergraduate programs to integrate interprofessional education, and better prepare students for interprofessional collaboration to improve patient care. AIMS A simulation-based gynaecology surgical skills workshop program was introduced for undergraduate medical and nursing students. The aim of this study was to explore students' perceptions of a simulation-based interprofessional gynaecological skills program, using students' pre- and post-workshop confidence in taught skills reported in a post-workshop questionnaire as an outcome measure. MATERIALS AND METHODS One hundred and sixty undergraduate medical (n = 133) and nursing (n = 27) students attended the workshop program at a tertiary university in Melbourne, Australia. A survey was completed by all students immediately after the workshop, addressing students' perceptions of surgical education, the four skill-stations (gowning/gloving, suturing, intrauterine device insertion, and urethral catheterisation), and interprofessional education. A Wilcoxon signed-rank test was performed to compare students' pre- and post-workshop confidence scores. RESULTS Most medical and nursing students (86%) agreed their course should provide more structured surgical education. There was a statistically significant increase in post-workshop self-reported confidence scores for medical and nursing students in all four taught skills. Confidence in interprofessional behaviours also improved in both cohorts, but the improvement in nursing students did not reach statistical significance. CONCLUSIONS Simulation-based, interprofessional, gynaecological surgery skills workshops are practical and valuable additions to undergraduate medical and nursing curricula. Further research should explore long-term retention of procedural skills and changes in interprofessional attitudes in clinical practice.
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Affiliation(s)
- Amy Yang
- Austin Health, Melbourne, Australia
| | - Shavi Fernando
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - Josie Tighe
- School of Nursing and Midwifery, Monash University, Melbourne, Australia
| | - Monica O-Halloran
- School of Nursing and Midwifery, Monash University, Melbourne, Australia
| | - Julia Morphet
- School of Nursing and Midwifery, Monash University, Melbourne, Australia
| | - Arunaz Kumar
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
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153
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Webb L, Lindqvist SM, Bowker L, Leinster S. Clinical skills as a vehicle for interprofessional learning. CLINICAL TEACHER 2019; 16:448-453. [DOI: 10.1111/tct.12809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Lucy‐Anne Webb
- Core Surgical Trainee, Urology, Norfolk and Norwich University NHS Foundation Trust Norwich UK
| | - Susanne M Lindqvist
- Centre for Interprofessional PracticeFaculty of Medicine and Health SciencesUniversity of East Anglia Norwich UK
| | - Lesley Bowker
- Norwich Medical SchoolFaculty of Medicine and Health SciencesUniversity of East Anglia Norwich UK
| | - Sam Leinster
- Norwich Medical SchoolFaculty of Medicine and Health SciencesUniversity of East Anglia Norwich UK
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154
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Regnier K, Chappell K, Travlos DV. The Role and Rise of Interprofessional Continuing Education. ACTA ACUST UNITED AC 2019. [DOI: 10.30770/2572-1852-105.3.6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
ABSTRACT
For decades, health leadership organizations have identified interprofessional education and team-based care as a critical component of health care quality and safety. The Institute of Medicine (IOM) has issued a series of reports demonstrating the relationship between poor team performance and negative patient outcome and has called on accreditors, licensing and certifying bodies to use their oversight processes as levers for change. Toward that end, three of the national accreditors in medicine, nursing and pharmacy collaborated to create a unified accreditation system, setting standards for interprofessional continuing education (IPCE) and establishing an IPCE credit that designates activities planned by and for health care teams. There is evidence supporting the relationship between engagement in IPCE and improvements in health care professionals' knowledge, attitudes, competence and performance, as well as patient and system outcomes. The accreditors believe that this evidence base is strong enough to justify including IPCE in regulatory requirements. In 2018, the Federation of State Medical Boards (FSMB) recognized IPCE credit as an additional means of satisfying CME requirements for medical license renewal. The increasing recognition of IPCE demonstrates the pivotal role of accreditors and regulators in driving the advancement of IPCE and team care now and in the future.
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155
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Lee SY, Cho E. A Systematic Review of Outcomes Research in the Hospital Pharmacists’ Interventions in South Korea. ACTA ACUST UNITED AC 2019. [DOI: 10.24304/kjcp.2019.29.3.193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- So Young Lee
- College of Pharmacy, Sookmyung Women’s University, Seoul 04310, Republic of Korea
| | - Eun Cho
- College of Pharmacy, Sookmyung Women’s University, Seoul 04310, Republic of Korea
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156
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O'Leary N, Salmon N, Clifford A, O'Donoghue M, Reeves S. 'Bumping along': a qualitative metasynthesis of challenges to interprofessional placements. MEDICAL EDUCATION 2019; 53:903-915. [PMID: 31074023 DOI: 10.1111/medu.13891] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/19/2018] [Accepted: 03/05/2019] [Indexed: 06/09/2023]
Abstract
CONTEXT Interprofessional practice is required to manage complex health care needs globally. It is well established that interprofessional placements (IPP) prepare students to work collaboratively, yet IPP implementation remains limited and disjointed. OBJECTIVES This review synthesised student, educator and service user perspectives in order to better understand challenges of IPP and provide recommendations for sustainable IPP implementation. METHODS A systematic metasynthesis of qualitative literature sourced from databases including CINAHL, Embase and PsycINFO was completed. Studies that incorporated student, educator and/or service user perspectives on IPP experiences were included. We focused specifically on factors limiting implementation of IPP. The presage-process-product (3P) theory provided the theoretical framework for inductive synthesis of 41 empirical studies. A confidence rating for findings was formulated using CERQual (confidence in evidence from reviews of qualitative research). RESULTS We developed three themes, which represent key challenges to IPP becoming embedded in placement culture: (i) thin theoretical foundations underpinned IPP, limiting understanding of the learning processes involved; (ii) implementation relied heavily on individual champions, which curtails investment and sustainability when personnel change, and (iii) students, educators and service users were unsure of the function of IPP and their respective roles, leading to uncertainty along with some negative perceptions of this placement approach. CONCLUSIONS In line with the 3P theoretical framework, IPP would benefit from explicit connections with educational and change management theories during presage stage IPP requires coordinated leadership and resource investment, and during product stage clear integration of interprofessional learning outcomes in curricula is advised. Addressing the identified challenges across the stages of IPP will support further development of IPP, firmly establishing this approach within placement culture. IPP can them make a significant contribution to the development of a collaborative practice-ready workforce. This in turn will enhance service user outcomes and safety.
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Affiliation(s)
- Noreen O'Leary
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Nancy Salmon
- Department of Occupational Therapy, School of Allied Health, University of Limerick, Limerick, Ireland
| | - Amanda Clifford
- Department of Physiotherapy, School of Allied Health, University of Limerick, Limerick, Ireland
| | - Michelle O'Donoghue
- Department of Speech and Language Therapy, School of Allied Health, University of Limerick, Limerick, Ireland
| | - Scott Reeves
- Centre for Health and Social Care Research, Faculty of Health, Social Care and Education, Kingston University and St George's, University of London, London, UK
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157
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Brewer ML, Flavell HL. Teamwork, collaboration and networking: self-reported behavioural change following pre-licensure interprofessional clinical learning. J Interprof Care 2019; 34:184-192. [DOI: 10.1080/13561820.2019.1645649] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Margo L. Brewer
- Pro-Vice Chancellor’s Office, Curtin University, Perth, Australia
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158
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Boshoff K, Murray C, Worley A, Berndt A. Interprofessional education placements in allied health: A scoping review. Scand J Occup Ther 2019; 27:80-97. [DOI: 10.1080/11038128.2019.1642955] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Kobie Boshoff
- School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Carolyn Murray
- School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Anthea Worley
- School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Angela Berndt
- School of Health Sciences, University of South Australia, Adelaide, Australia
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159
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Curley LE, Jensen M, McNabb C, Ram S, Torrie J, Jowsey T, McDonald M. Pharmacy Students' Perspectives on Interprofessional Learning in a Simulated Patient Care Ward Environment. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2019; 83:6848. [PMID: 31507282 PMCID: PMC6718511 DOI: 10.5688/ajpe6848] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 02/15/2018] [Indexed: 05/22/2023]
Abstract
Objective. To assess pharmacy students' opinions of an interprofessional learning (IPL) course in their final year of the Bachelor of Pharmacy program at The University of Auckland. Methods. Pharmacy students participated in the second day of a two-day simulation-based course, WardSim, alongside medical and nursing students in an acute care, hospital ward setting. After finishing the course, all students were asked to complete a questionnaire. The responses of pharmacy, nursing, and medical students on the scaled questions were compared. An in-depth thematic analysis of the pharmacy students' responses to the open-ended questions was completed using an iterative process. Results. Significant differences were found among the students' responses regarding the prioritization of care, systematic assessment of patients, and communication strategies. Pharmacy students had less favourable responses regarding the IPL experience than medical and nursing students. However, overall responses were positive. Some of the themes that emerged among the pharmacy students' responses included: learning communication tools, being assertive in communicating with other health care professionals, and understanding their own and others' roles in the health care team. Furthermore, some pharmacy students reported feeling underprepared for and underutilized during patient care scenarios. Conclusion. An IPL experience in an acute patient care setting demonstrated clear and beneficial learning outcomes for pharmacy students, especially in regards to communicating and understanding their roles and those of others on their team. Tailoring the pre-work or scenarios for the IPL experience to be more pharmacy orientated and having pharmacy students participate on both days may improve the preparedness for IPL.
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Affiliation(s)
- Louise E. Curley
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Maree Jensen
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Carolyn McNabb
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Sanya Ram
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Jane Torrie
- Department of Anaesthesiology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Tanisha Jowsey
- Centre for Medical and Health Sciences Education, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Maureen McDonald
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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160
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Hepps JH, Yu CE, Calaman S. Simulation in Medical Education for the Hospitalist: Moving Beyond the Mock Code. Pediatr Clin North Am 2019; 66:855-866. [PMID: 31230627 DOI: 10.1016/j.pcl.2019.03.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Simulation in medical education has grown due to an evolution in health care. It uses 4 main modalities to re-create a situation from the clinical environment to allow experiential learning and improve patient care. Simulation must be considered as an educational strategy within a larger curriculum. Building an exercise requires first developing goals and objectives and then designing the scenario. There are 4 phases of implementation, wherein the final debrief phase is critical for learning. Educators have used simulation for multiple curricular needs: communication skills, interprofessional education, clinical reasoning, procedural training, and patient safety, which apply to the inpatient setting.
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Affiliation(s)
- Jennifer H Hepps
- Department of Pediatrics, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, 8901 Wisconsin Avenue, Bethesda, MD 20889, USA
| | - Clifton E Yu
- Department of Pediatrics, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, 8901 Wisconsin Avenue, Bethesda, MD 20889, USA
| | - Sharon Calaman
- St. Christopher's Hospital for Children, Drexel College of Medicine, 160 East Erie Avenue, Philadelphia, PA 19134, USA.
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161
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Costa MVD, Azevedo GD, Vilar MJP. Aspectos institucionais para a adoção da Educação Interprofissional na formação em enfermagem e medicina. SAÚDE EM DEBATE 2019. [DOI: 10.1590/0103-11042019s105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Os marcos teórico-conceituais e metodológicos da Educação Interprofissional (EIP) em saúde vêm sendo amplamente reconhecidos em todo o mundo como úteis para o desenvolvimento de competências colaborativas para o efetivo trabalho em equipe. O artigo teve como objetivo explorar as percepções de estudantes de enfermagem e medicina sobre os fatores institucionais que interferem na adoção de iniciativas de EIP em seus contextos de formação. Trata-se de um estudo de caso, que adotou a abordagem qualitativa e a perspectiva exploratória. Os participantes da pesquisa foram estudantes de enfermagem e medicina de duas universidades públicas de um estado do Nordeste - uma estadual e outra federal. O grupo focal foi escolhido para coleta de dados, e foi utilizada a técnica de análise de conteúdo categorial, observando as fases de pré-análise, exploração do material e tratamento dos resultados. Três categorias temáticas foram construídas a posteriori: a importância do trabalho em equipe, contextos institucionais para adoção da EIP e desafios para a adoção da EIP. Embora as realidades pesquisadas apresentem avanços nas mudanças curriculares, como a aproximação do ensino com a realidade dos serviços, a adoção de métodos mais ativos para a formação de sujeitos críticos e reflexivos, ainda são notórias as lacunas no desenvolvimento de competências colaborativas.
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162
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El-Awaisi A, Joseph S, El Hajj MS, Diack L. Pharmacy academics' perspectives toward interprofessional Education prior to its implementation in Qatar: a qualitative study. BMC MEDICAL EDUCATION 2019; 19:278. [PMID: 31340790 PMCID: PMC6657143 DOI: 10.1186/s12909-019-1689-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 06/26/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The aim of this study was to explore the perspectives of faculty members and academic administrators, at Qatar University College of Pharmacy, towards interprofessional education (IPE) and collaborative practice by identifying enablers, barriers and resources needed to implement IPE within the pharmacy curriculum. METHODS A qualitative methodology was employed using focus groups discussions. Two focus groups were conducted, one focus group with faculty members (n = 5) and another focus group with academic administrators (n = 5) at Qatar University College of Pharmacy. Focus groups were audio recorded and transcribed verbatim by an independent experienced transcriber and validated by the study principal researcher. Thematic analysis was undertaken to generate key themes and subthemes. RESULTS The study participants highlighted a number of enablers and challenges encountered as a result of the initial IPE events, for integrating IPE into the pharmacy curriculum. Many provided recommendations and suggestions for effective implementation of IPE. Analysis of the results focused on three main categories: enablers, barriers and recommendations. Overall, seven major themes were identified: 1) intrinsic enabling factors (initial IPE experiences, cross-appointed faculty, accreditation); 2) extrinsic enabling factors (national policy & legislation and advances in pharmacists' role); 3) student related benefits (roles & responsibilities and agents for change); 4) student hindering factors (student engagement, perceptions & attitudes and gender issues); 5) partnering academic institutions (logistical issues, familiarity with other curricula and commitment); 6) practice environment (hierarchy, healthcare professionals' attitude and lack of collaborative practice) and 7) IPE delivery (dedicated structure, IPE curriculum and extrinsic support). CONCLUSION Pharmacy academics had positive perceptions towards IPE suggesting a high level of support and readiness to pursue IPE and an opportunity for pharmacy academics to drive the IPE agenda forward in Qatar. However, a number of challenges were reported. These are important to consider to ensure the development of effective strategies for the integration and enhancement of IPE and collaborative practice.
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Affiliation(s)
- Alla El-Awaisi
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Sundari Joseph
- Center for the Advancement in Interprofessional Education, London, UK
| | | | - Lesley Diack
- School of Pharmacy and Life Sciences, Faculty of Health and Social Care, The Robert Gordon University, Aberdeen, Scotland, UK
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163
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Fujita J, Fukui S, Ikezaki S, Tsujimura M. Evaluation of the elements of interprofessional education for end-of-life care among homecare nurses, care managers, and head care workers: A cluster-randomized controlled trial. J Interprof Care 2019:1-8. [PMID: 31331199 DOI: 10.1080/13561820.2019.1633291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 12/17/2018] [Accepted: 06/13/2019] [Indexed: 10/26/2022]
Abstract
Our group developed an interprofessional education (IPE) program for home-based end-of-life (EOL) care among health and welfare professionals, with the purpose of understanding professional roles in EOL care and promoting mutual respect among team members. This study aimed to verify the understanding and awareness of the elements of IPE. Seven districts in a city in Japan were cluster-randomized into an education group or a control group. A questionnaire survey using original items to evaluate two purposes of the IPE program was conducted before the IPE workshop and seven months later. In total, 291 professionals participated in the study: 64 homecare nurses, 129 care managers, and 98 head care workers. Care managers and care workers in the education group significantly understood their own and other professional roles in EOL care (p= .01, p < .0001, respectively) and gained confidence in collaboration among health and welfare professionals (p = .02, p < .0001, respectively). Care workers in the education group felt respect for team members (p = .02). For homecare nurses, no significant effects were observed. The IPE was more effective for welfare professionals who had difficulty cooperating in end-of-life care.
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Affiliation(s)
- Junko Fujita
- a Graduate School of Health Care and Nursing, Juntendo University , Chiba , Japan
| | - Sakiko Fukui
- b Department of Nursing, Graduate School of Medicine, Osaka University , Osaka , Japan
| | - Sumie Ikezaki
- c Graduate School of Nursing, Chiba University , Chiba , Japan
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164
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McKeown A, Cliffe C, Arora A, Griffin A. Ethical challenges of integration across primary and secondary care: a qualitative and normative analysis. BMC Med Ethics 2019; 20:42. [PMID: 31269930 PMCID: PMC6610833 DOI: 10.1186/s12910-019-0386-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 06/26/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND This paper explores ethical concerns arising in healthcare integration. We argue that integration is necessary imperative for meeting contemporary and future healthcare challenges, a far stronger evidence base for the conditions of its effectiveness is required. In particular, given the increasing emphasis at the policy level for the entire healthcare infrastructure to become better integrated, our analysis of the ethical challenges that follow from the logic of integration itself is timely and important and has hitherto received insufficient attention. METHODS We evaluated an educational intervention which aims to improve child health outcomes by making transitions between primary to secondary care more efficient, ensuring children and parents are better supported throughout. The programme provided skills for trainee paediatricians and general practitioners (GPs) in co-designing integrated clinical services. RESULTS The key ethical challenges of integrated care that arose from a clinical perspective are: professional identity and autonomy in an integrated working environment; the concomitant extent of professional responsibility in such an environment; and the urgent need for more evidence to be produced on which strategies for integrating at scale can be based. CONCLUSIONS From our analysis we suggest a tentative way forward, viewed from a normative position broadly situated at the intersection of deontology and care ethics. We adopt this position because the primary clinical ethical issues in the context of integrated care concern: how to ensure that all duties of care to individual patients are met in a newly orientated working environment where clinical responsibility may be ambiguous; and the need to orientate care around the patient by foregrounding their autonomous preferences and ensuring good patient clinician relationships in clinical decision-making.
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Affiliation(s)
- Alex McKeown
- Department of Psychiatry, University of Oxford, Warneford Lane, Oxford, OX3 7JX England
| | - Charlotte Cliffe
- University College London Medical School, 74 Huntley Street, London, WC1E 6AU England
| | - Arun Arora
- University of Manchester Medical School, Oxford Road, Manchester, M13 9PL UK
| | - Ann Griffin
- Research Department for Medical Education, University College London Medical School, 74 Huntley Street, London, WC1E 6AU England
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165
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Hulme JA. “Giving psychology away” to non-psychologists: Comment on Dutke et al., 2019. PSYCHOLOGY LEARNING AND TEACHING-PLAT 2019. [DOI: 10.1177/1475725719827710] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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166
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Evans S, Knight T, Walker A, Sutherland-Smith W. Facilitators' teaching and social presence in online asynchronous interprofessional education discussion. J Interprof Care 2019; 34:435-443. [PMID: 31211615 DOI: 10.1080/13561820.2019.1622517] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Asynchronous discussion boards have been increasingly used to engage teams of interprofessional learners in interactive and reflective discourse. Facilitation of this interprofessional discourse is critical, yet largely unexplored. The Community of Inquiry (CoI) framework provides a lens through which facilitators' contributions on asynchronous discussion boards can be explored. The aim of this study was to apply the CoI framework teaching and social presence indicators to an online asynchronous IPE facilitation environment to determine if they comprehensively describe the kind of contributions made by IPE facilitators in two types of interprofessional team discussions. Directed content analysis based on the teaching and social presence indicators from the CoI framework was used to analyse seven facilitators' contributions to four asynchronous team discussion points (two key dimensions and two case study discussions). Sixteen of the 31 teaching and social presence indicators, along with a new indicator (feedback on assessment tasks), comprehensively described the facilitators' contributions. Many of the teaching presence indicators were used in a greater proportion of the key dimension discussions than in the case study discussions. This study demonstrates that the teaching and social presence indicators of the CoI framework are a valuable way to describe the contributions made by facilitators to asynchronous interprofessional team discussions.
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Affiliation(s)
- Sherryn Evans
- School of Psychology, Deakin University , Geelong, Australia
| | - Tess Knight
- Psychology, Counselling and Psychotherapy, The Cairnmiller Institute , Melbourne, Australia
| | - Arlene Walker
- School of Psychology, Deakin University , Geelong, Australia
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167
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Harrison-Bernard LM, Naljayan MV, Mercante DE, Gunaldo TP, Edwards S. Longitudinal interprofessional education in a graduate physiology course. ADVANCES IN PHYSIOLOGY EDUCATION 2019; 43:241-245. [PMID: 31088161 PMCID: PMC6747629 DOI: 10.1152/advan.00007.2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/29/2019] [Accepted: 04/03/2019] [Indexed: 06/09/2023]
Abstract
The primary purpose of conducting two interprofessional education (IPE) experiences during a multidisciplinary physiology graduate-level course was to provide basic science, physical therapy, and physician assistant graduate students opportunities to work as a team in the diagnosis, treatment, and collaborative care when presented with a patient case focused on acute kidney injury (first case) and female athlete triad (second case). The secondary purpose was to apply basic physiology principles to patient case presentations of pathophysiology. The overall purpose was to assess the longitudinal effects and the value of IPE integrated within a basic science course. The following Interprofessional Education Collaborative subcompetencies were targeted: roles/responsibilities (RR1, RR4). Students were given a pre- and postsurvey to assess their IPE perceptions and knowledge of professional roles. There were statistically significant increases from the presurvey renal IPE experience to the presurvey endocrine IPE experience for two perception questions regarding the ability to explain the roles and responsibilities of a physical therapist (PT) and physician assistant using a Likert scale. In addition, student knowledge of the role of a PT increased significantly when comparing the renal IPE presurvey to the endocrine IPE presurvey results to open-ended questions. Students' perceptions of their knowledge as well as their ability to express, in writing, their newly learned knowledge of the role of a PT was sustained over time. Incorporating multiple IPE experiences into multidisciplinary health science courses represents an appropriate venue to have students learn and apply interprofessional competencies.
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Affiliation(s)
- Lisa M Harrison-Bernard
- Department of Physiology, Louisiana State University Health Sciences Center-New Orleans School of Medicine , New Orleans, Louisiana
| | - Mihran V Naljayan
- Section of Nephrology and Hypertension, Louisiana State University Health Sciences Center-New Orleans School of Medicine , New Orleans, Louisiana
| | - Donald E Mercante
- Department of Biostatistics, Louisiana State University Health Sciences Center-New Orleans School of Public Health , New Orleans, Louisiana
| | - Tina Patel Gunaldo
- Center for Interprofessional Education and Collaborative Practice, Louisiana State University Health Sciences Center-New Orleans , New Orleans, Louisiana
| | - Scott Edwards
- Department of Physiology, Louisiana State University Health Sciences Center-New Orleans School of Medicine , New Orleans, Louisiana
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Rosenthal B, Gravrand H, Lisi AJ. Interprofessional collaboration among complementary and integrative health providers in private practice and community health centers. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.xjep.2019.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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169
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Vuurberg G, Vos J, Christoph L, de Vos R. The effectiveness of interprofessional classroom-based education in medical curricula: A systematic review. ACTA ACUST UNITED AC 2019. [DOI: 10.1016/j.xjep.2019.01.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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170
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Ascione FJ. Preparing Pharmacists for Collaborative/Integrated Health Settings. PHARMACY 2019; 7:pharmacy7020047. [PMID: 31137532 PMCID: PMC6630742 DOI: 10.3390/pharmacy7020047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 05/14/2019] [Accepted: 05/16/2019] [Indexed: 11/24/2022] Open
Abstract
Pharmacy practice is changing to accommodate the need for pharmacists to be better team members in newly emerging collaborative care and integrated health systems. Pharmacy schools could lead this change by educating students to be effective participants in these relatively new models of care. Schools are encouraged to follow the approach outlined in the recent guidance published by the Health Professions Accreditors Collaborative (HPAC) for interprofessional practice and education (“the new IPE”). This approach includes articulating an IPE plan, establishing goals, assessing student achievement of the necessary IPE competencies, developing educational plans that are multi-faceted and longitudinal, and modifying the existing assessment/evaluation process to ensure the quality of the IPE effort. These curricular decisions should be based on existing and new research on the effectiveness of IPE on student’s attitudes, knowledge, skills, and behavior. A key decision is how to create effective interactions between pharmacy students and those of other professions. Educational emphasis should be directed toward team building skills, not just individual competencies. The pharmacy faculty probably need to enhance their teaching abilities to accommodate this change, such as learning new technology (e.g., simulations, managing online exchanges) and demonstrating a willingness to teach students from other professions.
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Affiliation(s)
- Frank J Ascione
- UM Center for Interprofessional Education, University of Michigan College of Pharmacy, Ann Arbor, MI 48109, USA.
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171
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Ward W, Zagoloff A, Rieck C, Robiner W. Interprofessional Education: Opportunities and Challenges for Psychology. J Clin Psychol Med Settings 2019; 25:250-266. [PMID: 29453507 DOI: 10.1007/s10880-017-9538-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
This manuscript is an outgrowth of an invited panel presentation at the national Association for Psychologists in Academic Health Centers Conference in 2017 on Interprofessional Education (IPE). IPE is a structured and transformative educational strategy designed to provide active learning experiences where trainees from diverse healthcare professions gain shared content knowledge plus collaboration skills as they learn about, from, and with each other. Collaboration skills include understanding professional role distinctions and overlap, effective team-based communication, shared values/ethics and respect for each other's expertise, and teamwork dynamics. It is increasingly important to expand training beyond the intraprofessional activities in which psychology trainees engage to prepare them to participate in interprofessional collaborative care. As healthcare systems move to team-based collaborative practice and value-based reimbursement models, the profession of psychology needs leaders at every academic health center to facilitate the design and/or implementation of IPE activities. The panel of psychologists presented roles that psychologists play in IPE institutional program design and implementation, graduate training programs, and the perspectives of an early career psychologist and psychology trainee. Opportunities and challenges are highlighted, culminating in a call to action. Psychologists must embrace their identity as health professionals and engage their learners in IPE so that the emerging cognitive schemata of healthcare that is developed includes the profession of psychology. Otherwise, healthcare teams and health professionals will not understand the value, roles, or potential contributions of psychologists in enhancing patient care outcomes, ultimately jeopardizing psychologists' referrals, involvement in healthcare delivery, and career opportunities.
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Affiliation(s)
- Wendy Ward
- College of Medicine, University of Arkansas for Medical Sciences, 1 Children's Way, Slot 512-21, Little Rock, AR, USA.
| | | | - Cortney Rieck
- College of Medicine, University of Arkansas for Medical Sciences, 1 Children's Way, Slot 512-21, Little Rock, AR, USA
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172
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Mobile obstetric and neonatal simulation based skills training in India. Midwifery 2019; 72:14-22. [DOI: 10.1016/j.midw.2019.02.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 01/26/2019] [Accepted: 02/06/2019] [Indexed: 11/19/2022]
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173
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Pawłowska M, Del Rossi L, Kientz M, McGinnis P, Padden-Denmead M. Immersing students in family-centered interprofessional collaborative practice. J Interprof Care 2019; 34:50-58. [PMID: 31037990 DOI: 10.1080/13561820.2019.1608165] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The goal of interprofessional education (IPE) is to improve outcomes and experience of healthcare services for patients and families through collaborative practice. While patients and families may participate in IPE experiences as recipients of healthcare services, their perspective on students' emerging collaborative skills is rarely sought. We describe a pediatric IPE activity in which participating families rated students' performance of the targeted interprofessional collaborative competencies. We asked whether family ratings would be consistent with student self-ratings and independent observer ratings. Participants were 40 interprofessional pre-licensure student teams representing physical therapy, occupational therapy, nursing, and speech-language pathology. Each team developed a joint assessment plan, conducted a 1-h play-based observation of a child, 30 months of age or under, and interviewed an accompanying parent/caregiver. Quantitative rating scale data indicated consistency between family, student and independent observer ratings of interprofessional collaborative skills displayed by the students. Qualitative data suggested that students gained a better understanding of ways in which an interprofessional team can provide effective family-centered care. Our results suggest that patient/family feedback can provide a useful measure of the effectiveness of IPE activities and should be included in such activities targeting interprofessional collaborative competences across settings and patient populations.
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Affiliation(s)
- Monika Pawłowska
- School of Health Sciences, Stockton University, Galloway, NJ, USA
| | - Lauren Del Rossi
- School of Health Sciences, Stockton University, Galloway, NJ, USA
| | - Mary Kientz
- School of Health Sciences, Stockton University, Galloway, NJ, USA
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Disentangling the complexity of mobility of older medical patients in routine practice: An ethnographic study in Denmark. PLoS One 2019; 14:e0214271. [PMID: 30990802 PMCID: PMC6467370 DOI: 10.1371/journal.pone.0214271] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 03/11/2019] [Indexed: 11/19/2022] Open
Abstract
Aim Many older medical patients experience persistent functional limitations after hospitalization, such as dependency in activities of daily living, recurring fall incidents and increased mortality. Therefore, increased activity and mobilization during hospitalization are essential to prevent functional decline in older medical patients. No previous studies have explored how the social context influences how health professionals decide whether or not to mobilize patients. This qualitative study aimed to explore how social contextual circumstances affect the mobility of older medical patients in medical departments. Methods An ethnographic field study was conducted in six medical departments in three public hospitals in the capital region of Copenhagen, Denmark. Participant observations were carried out from January to June 2017. The researchers were present for up to 14 days (range, 8–14 days) in the six departments. A total of 210 pages of field notes were produced. The participants were health professionals involved in the care of older medical patients: physiotherapists, registered nurses, nursing assistants and physicians. A content analysis was conducted. Findings Five themes concerning mobility of patients emerged: (1) materialities; (2) professional roles; (3) encouraging moments; (4) patients and relatives; and (5) organization and management. Of these, professional roles seem to be the most important because it pervaded all themes. Different health professionals in the medical departments recognized, spoke and acted based on different cultural models. Conclusion It was found that mobility of older medical patients is entangled in a complex network of social contextual circumstances. Mobility of older medical patients is based on health professionals’ different cultural models, which shape distinct professional identities and lead to contradictions and blurring of the priorities and responsibilities among the health professionals involved in mobilization. The consequence is that no profession “owns” the responsibility for mobilization, thus restricting mobilization of the patients during hospitalization.
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175
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Abstract
OBJECTIVE To assess hospital unit culture and clinician attitudes associated with varying rates of primary cesarean delivery. DATA SOURCES/STUDY SETTING Intrapartum nurses, midwives, and physicians recruited from 79 hospitals in California participating in efforts to reduce cesarean overuse. STUDY DESIGN Labor unit culture and clinician attitudes measured using a survey were linked to the California Maternal Data Center for birth outcomes and hospital covariates. METHODS Association with primary cesarean delivery rates was assessed using multivariate Poisson regression adjusted for hospital covariates. PRINCIPAL FINDINGS 1718 respondents from 70 hospitals responded to the Labor Culture Survey. The "Unit Microculture" subscale was strongly associated with primary cesarean rate; the higher a unit scored on 8-items describing a culture supportive of vaginal birth (eg, nurses are encouraged to spend time in rooms with patients, and doulas are welcomed), the cesarean rate decreased by 41 percent (95% CI = -47 to -35 percent, P < 0.001). Discordant attitudes between nurses and physicians were associated with increased cesarean rates. CONCLUSIONS Hospital unit culture, clinician attitudes, and consistency between professions are strongly associated with primary cesarean rates. Improvement efforts to reduce cesarean overuse must address culture of care as a key part of the change process.
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Affiliation(s)
- Emily White VanGompel
- The University of Chicago Pritzker School of MedicineEvanstonIllinois
- NorthShore University HealthSystemEvanstonIllinois
| | - Susan Perez
- Department of Kinesiology and Health ScienceCalifornia State University, SacramentoSacramentoCalifornia
| | - Avisek Datta
- NorthShore University HealthSystemEvanstonIllinois
| | - Chi Wang
- Biostatistics and ResearchNorthShore University HealthSystemEvanstonIllinois
| | - Valerie Cape
- California Maternal Quality Care CollaborativeStanford UniversityStanfordCalifornia
| | - Elliott Main
- Department of Obstetrics and GynecologyStanford University School of MedicineStanfordCalifornia
- California Maternal Quality Care CollaborativeStanford University School of MedicineStanfordCalifornia
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176
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Marcussen M, Nørgaard B, Arnfred S. The Effects of Interprofessional Education in Mental Health Practice: Findings from a Systematic Review. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2019; 43:200-208. [PMID: 29998376 PMCID: PMC6422974 DOI: 10.1007/s40596-018-0951-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 06/20/2018] [Indexed: 05/29/2023]
Abstract
OBJECTIVE The aim of this study was to conduct a systematic review of studies describing the effects of interprofessional education (IPE) on undergraduate healthcare students' educational outcomes, compared with conventional clinical training in mental health. METHODS MEDLINE, CINAHL, PsychINFO, and EMBASE were searched for studies published in January 2001-August 2017. All retrieved papers were assessed for methodological quality; Kirkpatrick's model was employed to analyze and synthesize the included studies. The following search terms were used: undergraduate, interprofessional education, and educational outcomes. RESULTS The eight studies that met the inclusion criteria were highly diverse regarding the studied IPE interventions, methods, and outcomes. Participants included students receiving clinical training in mental health from the following professions: medicine, nursing, occupational therapy, physiotherapy, psychology, and social work. The results of the studies suggest that students respond well to IPE in terms of more positive attitudes toward other professions and improvement in knowledge and collaborative skills. Limited evidence of changes in behavior, organizational practice, and benefits to patients was found. CONCLUSION Based on the eight included studies, IPE interventions appear to have an impact regarding positive attitudes toward other professions and increased knowledge of and skills in collaboration compared to conventional clinical training. However, further study of both the processes and the long-term impacts of undergraduate IPE in mental health is needed. The authors recommend that service users are involved in the implementation and evaluation of IPE interventions in mental health to undergraduate healthcare students.
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177
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Hays RB, McKinley RK, Sen Gupta TK. Twelve tips for expanding undergraduate clinical teaching capacity. MEDICAL TEACHER 2019; 41:271-274. [PMID: 29400107 DOI: 10.1080/0142159x.2018.1429587] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Undergraduate medical education has expanded substantially in recent years, through both establishing new programs and increasing student numbers in existing programs. This expansion has placed pressure on the capacity for training students in clinical placements, raising concerns about the risk of dilution of experience, and reducing work readiness. The concerns have been greatest in more traditional environments, where clinical placements in large academic medical centers are often the "gold standard". However, there are ways of exposing medical students to patient interactions and clinical supervisors in many other contexts. In this paper, we share our experiences and observations of expanding clinical placements for both existing and new medical programs in several international locations. While this is not necessarily an easy task, a wide range of opportunities can be accessed by asking the right questions of the right people, often with only relatively modest changes in resource allocation.
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Affiliation(s)
- Richard B Hays
- a Remote and Rural Health , James Cook University , Townsville , Australia
| | | | - Tarun K Sen Gupta
- c Medical Education , James Cook University , Townsville , Australia
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178
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Mendes-Da-Silva W. Contribuições e Limitações de Revisões Narrativas e Revisões Sistemáticas na Área de Negócios. RAC: REVISTA DE ADMINISTRAÇÃO CONTEMPORÂNEA 2019. [DOI: 10.1590/1982-7849rac2019190094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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179
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Reitsma G, Scrooby B, Rabie T, Viljoen M, Smit K, Du Preez A, Pretorius R, Van Oort A, Swanepoel M, Naudé A, Dolman R. Health students' experiences of the process of interprofessional education: a pilot project. J Interprof Care 2019; 33:298-307. [PMID: 30777493 DOI: 10.1080/13561820.2019.1572600] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The need for interprofessional education (IPE) in health science disciplines is a current global trend. However, despite international support and demand, IPE is still new to many health professions curricula in South Africa. Furthermore, while ample existing academic literature addresses commonly encountered barriers to IPE, there is still a need to investigate the dynamics and challenges associated with the process of implementing IPE at universities. IPE is not yet part of the formal curriculum at a faculty of health sciences at a South African Higher Education Institute, so a pilot project was conducted to investigate the experiences of an IPE process by students from different health professions toward informing the planning and implementation of IPE in the formal curriculum. To this effect, a multi-layered IPE project was piloted across pharmacy, nursing, social work, psychology, dietetics, and human movement sciences within this Faculty of Health Sciences. The aim of this research was to determine the dynamics between the different health professions by exploring and describing the students' experiences of the IPE process. Theoretical case studies were presented to third-year students, who were grouped into interprofessional teams from the six different health professions at the Higher Education Institute's health sciences faculty. Data were gathered from reflective journals over a five-week period and a questionnaire was administered at the end of the project. Data were analysed and evaluated based on the interprofessional learning domains listed in the IPE framework of the World Health Organization. All participating health professions students felt positive about the project and agreed that it provided them with valuable IPE experiences. However, their long-term participation and commitment presented difficulty in an already demanding curriculum. The interprofessional dynamics were influenced by the relevance of the scenarios presented in the case studies to the different professions, the students' personalities and their previous experiences. Although the nursing students took initial leadership, contributions from the other professions became more prominent as the case studies unfolded. The findings indicated that the inclusion of different health professions in an interprofessional team should be guided by the specific scenarios incorporated to simulate interprofessional cooperation. The availability of the students and their scope of practice at third-year level should also be taken into account.
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Affiliation(s)
- Gerda Reitsma
- a Centre for Health Professions Education, Faculty of Health Sciences , Potchefstroom Campus, NWU , Potchefstroom , South Africa
| | - Belinda Scrooby
- b School of Nursing, Faculty of Health Sciences , Potchefstroom Campus, NWU , Potchefstroom , South Africa
| | - Tinda Rabie
- b School of Nursing, Faculty of Health Sciences , Potchefstroom Campus, NWU , Potchefstroom , South Africa
| | - Michelle Viljoen
- c School of Pharmacy, Faculty of Health Sciences , Potchefstroom Campus, NWU , Potchefstroom , South Africa.,d School of Pharmacy , University of the Western Cape , Cape Town , South Africa
| | - Karlien Smit
- e Africa Unit for Transdisciplinary Health Research (AUTHeR), Faculty of Health Sciences , Potchefstroom Campus, NWU , Potchefstroom , South Africa
| | - Antoinette Du Preez
- b School of Nursing, Faculty of Health Sciences , Potchefstroom Campus, NWU , Potchefstroom , South Africa
| | - Ronel Pretorius
- e Africa Unit for Transdisciplinary Health Research (AUTHeR), Faculty of Health Sciences , Potchefstroom Campus, NWU , Potchefstroom , South Africa
| | - Abie Van Oort
- f Physical Activity, Sport and Recreation (PHASReC), Faculty of Health Sciences , Potchefstroom Campus, NWU , Potchefstroom , South Africa
| | - Mariëtte Swanepoel
- f Physical Activity, Sport and Recreation (PHASReC), Faculty of Health Sciences , Potchefstroom Campus, NWU , Potchefstroom , South Africa
| | - Adéle Naudé
- c School of Pharmacy, Faculty of Health Sciences , Potchefstroom Campus, NWU , Potchefstroom , South Africa
| | - Robin Dolman
- g School of Nutrition, Physiology and Consumer Sciences, Faculty of Health Sciences , Potchefstroom Campus, NWU , Potchefstroom , South Africa
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Zahra D, Belfield L, Bennett J, Zaric S, Mcilwaine C. The benefits of integrating dental and dental therapy and hygiene students in undergraduate curricula. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2019; 23:e12-e16. [PMID: 30294830 DOI: 10.1111/eje.12394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/03/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE The purpose of the current study was to evaluate the impact of integrating the teaching of Bachelor of Dental Surgery (BDS) and Bachelor of Dental Therapy and Hygiene (BScDTH) students in enquiry-based learning (EBL) sessions, using performance on multiple related integrated dental science (IDS) multiple-choice question assessments. METHOD IDS assessments are sat twice in the first stages of both the BDS and BScDTH programmes. IDS scores from integrated and non-integrated cohorts were collated and compared across test occasions (first or second assessment of the stage) and programmes (BDS and BScDTH). RESULTS The results revealed that IDS scores were, overall, significantly higher for students in integrated (M = 63.46, SD = 13.06) than non-integrated EBL groups (M = 60.75, SD = 13.67; F(1,207) = 4.277, P = 0.040, < ! [ C D A T A [ η p 2 ] ] > = 0.020). Although this effect was not statistically significant when each programme was considered separately, the effect of integration on both programmes was nevertheless positive, with a more pronounced improvement for BScDTH (+7.88) than BDS (+0.63) students. CONCLUSIONS Integrating students from different programmes for the teaching of core dental knowledge in team environments improves student performance in subsequent dental science assessments-and more so for BScDTH than BDS students. The fact that both groups benefit from integration should go some way towards reassuring institutions that are considering integration but are cautious of threats to "established" programmes.
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Affiliation(s)
- Daniel Zahra
- Peninsula Dental School, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - Louise Belfield
- Peninsula Dental School, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - Jon Bennett
- Peninsula Dental School, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - Svetislav Zaric
- Peninsula Dental School, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - Clare Mcilwaine
- Peninsula Dental School, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
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181
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Evans SM, Ward C, Reeves S. Online interprofessional education facilitation: A scoping review. MEDICAL TEACHER 2019; 41:215-222. [PMID: 29683015 DOI: 10.1080/0142159x.2018.1460656] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
INTRODUCTION The use of online media to deliver interprofessional education (IPE) is becoming more prevalent across health professions education settings. Facilitation of IPE activities is known to be critical to the effective delivery of IPE, however, specifics about the nature of online IPE facilitation remains unclear. AIM To explore the health professions education literature to understand the extent, range and nature of research on online IPE facilitation. METHODS Scoping review methodology was used to guide a search of four electronic databases for relevant papers. Of the 2095 abstracts initially identified, after screening of both abstracts and full-text papers, 10 studies were selected for inclusion in this review. Following abstraction of key information from each study, a thematic analysis was undertaken. RESULTS Three key themes emerged to describe the nature of the IPE facilitation literature: (1) types of online IPE facilitation contributions, (2) the experience of online IPE facilitation and (3) personal outcomes of online IPE facilitation. These IPE facilitation themes were particularly focused on facilitation of interprofessional student teams on an asynchronous basis. DISCUSSION While the included studies provide some insight into the nature of online IPE facilitation, future research is needed to better understand facilitator contributions, and the facilitation experience and associated outcomes, both relating to synchronous and asynchronous online environments.
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Affiliation(s)
| | - Catherine Ward
- a School of Psychology , Deakin University , Geelong , Australia
| | - Scott Reeves
- b Centre for Health & Social Care Research , Kingston University & St George's, University of London , London , UK
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182
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Park SE, Salihoglu-Yener E, Fazio SB. Use of team-based learning pedagogy for predoctoral teaching and learning. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2019; 23:e32-e36. [PMID: 30338610 DOI: 10.1111/eje.12396] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/03/2018] [Indexed: 05/20/2023]
Abstract
PURPOSE The purpose of the study was to describe the development and implementation of a Team-based Learning (TBL) educational model in a predoctoral education course to assess its effectiveness in promoting student learning as measured by knowledge acquisition and student satisfaction. METHODS An interprofessional education course used the TBL structure for the second-year dental students, in which students had an opportunity to first work on the questions individually and then in groups. Each instruction session began with a readiness assurance test (RAT), which students were asked to complete in two formats: each student answered on their own, then each team worked on the same questions to arrive at a consensus decision followed by a team-based application exercise. RESULTS A significant difference existed in which team scores were higher than individual scores and on average, the teams scored higher than when students worked alone. Student feedback showed a strong preference of TBL over the traditional lecture format. Students found that the sessions helped them to understand the clinical cases from the perspective of other health care fields in this pedagogical approach. CONCLUSION The TBL methods facilitated an interactive learning environment to promote student-centred learning in a predoctoral education course and the teams performed better in correct evaluation compared with the individual students.
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Affiliation(s)
- Sang E Park
- Harvard School of Dental Medicine, Boston, Massachusetts
| | | | - Sara B Fazio
- Harvard School of Dental Medicine, Boston, Massachusetts
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183
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Marcussen M, Nørgaard B, Borgnakke K, Arnfred S. Interprofessional clinical training in mental health improves students' readiness for interprofessional collaboration: a non-randomized intervention study. BMC MEDICAL EDUCATION 2019; 19:27. [PMID: 30658648 PMCID: PMC6339379 DOI: 10.1186/s12909-019-1465-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 01/10/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Over the past decades, the health sector in general has increasingly acknowledged the effectiveness of interprofessional clinical training in enhancing teamwork. In psychiatry, however, knowledge of the benefits of collaborative clinical training is sparse. This study aimed to investigate the impact of interprofessional training on students' readiness for interprofessional collaboration in a psychiatric ward. METHODS An intervention study assessed interprofessional clinical training in a training ward. Undergraduate students from the disciplines of medicine, nursing, psychotherapy, pedagogy, and social work were allocated either to an intervention group receiving interprofessional training or to a comparison group receiving conventional clinical training. Outcomes were assessed using the Readiness for Interprofessional Learning Scale (RIPLS) and the Assessment of Interprofessional Team Collaboration Scale (AITCS). Linear mixed regression was used to compare differences in mean scores postintervention, adjusted for baseline score, gender, and profession. RESULTS Mean postintervention scores were higher in the intervention group (n = 87) than in the comparison group (n = 108) for both scales (overall sum score). For the RIPLS, the mean difference was 2.99 (95% CI 0.82 to 5.16; p = 0.007); for the AITCS it was 8.11 (95% CI 2.92-13.30; p = 0.002). Improvement in readiness for interprofessional learning and team collaboration in the intervention group remained statistically significant after adjustment for baseline differences between the two groups. CONCLUSION Students' self-reported readiness for interprofessional learning and their team collaboration were improved after interprofessional clinical training. Still, further studies of both the processes and the long-term effects of undergraduate IPE in mental healthcare are needed. The study was registered March 62,017 on ClinicalTrials.gov: NCT03070977 (Retrospectively registrered).
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Affiliation(s)
- Michael Marcussen
- Department of Clinical Medicine, University of Copenhagen and Psychiatry Slagelse, Region Zealand, Fælledvej 6, 4200 Slagelse, Denmark
| | - Birgitte Nørgaard
- Department of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Karen Borgnakke
- Department of Media, Cognition and Communication, University of Copenhagen, Copenhagen, Denmark
| | - Sidse Arnfred
- Department of Clinical Medicine, University of Copenhagen and Psychiatry Slagelse, Region Zealand, Fælledvej 6, 4200 Slagelse, Denmark
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Maeno T, Haruta J, Takayashiki A, Yoshimoto H, Goto R, Maeno T. Interprofessional education in medical schools in Japan. PLoS One 2019; 14:e0210912. [PMID: 30653563 PMCID: PMC6336262 DOI: 10.1371/journal.pone.0210912] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 01/03/2019] [Indexed: 11/19/2022] Open
Abstract
Interprofessional education (IPE) for medical students is becoming increasingly important, as reflected in the increasing number of medical schools adopting IPE. However, the current status of and barriers to pre-registration IPE implementation in Japanese medical schools remain unknown. The purpose of this study was to clarify the status and barriers of IPE implementation in medical schools in Japan. We conducted a curriculum survey from September to December 2016 of all 81 medical schools in Japan. We mailed the questionnaire and asked the schools' undergraduate education staff to respond. The survey items were the IPE implementation status and barriers to program implementation. Sixty-four of the 81 schools responded (response rate 79.0%), of which 46 (71.9%) had implemented IPE, 42 (89.1%) as compulsory programs. Half of IPE programs were implemented in the first 2 years, while less than 10% were implemented in the latter years of medical programs. As part of the IPE programs, medical students collaborated with a wide range of professional student groups. The most common learning strategy was lectures. However, one-third of IPE programs used didactic lectures without interaction between multi-professional students. The most common perceived major barrier to implementing IPE was adjustment of the academic calendar and schedule (82.8%), followed by insufficient staff numbers (73.4%). Our findings indicate that IPE is being promoted in undergraduate education at medical schools in Japan. IPE programs differed according to the circumstances of each school. Barriers to IPE may be resolved by improving learning methods, introducing group discussions between multi-professional students in lectures or introducing IPE programs using team-based learning. In summary, we demonstrated the current status and barriers of IPE implementation in Japanese medical schools. Our findings will likely lead to the promotion of IPE programs in Japan.
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Affiliation(s)
- Takami Maeno
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Junji Haruta
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | | | | | - Ryohei Goto
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Tetsuhiro Maeno
- Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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185
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Organizational Factors Associated With Quality Perinatal Care. Health Care Manag (Frederick) 2019; 38:61-70. [PMID: 30640234 DOI: 10.1097/hcm.0000000000000241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Perinatal care has been recognized as an integral part of ensuring quality health care in hospitals, and the focus on perinatal care quality is increasing. The previous hospital literature has focused much attention on measuring and improving quality of care generally, but recently there has been a call for a more comprehensive approach to measuring quality in the perinatal care setting. The perinatal literature is limited in addressing the association between organizational factors and perinatal quality. Using chart audit data for more than 10 000 maternity patients, we used multiple regression analysis to examine the association of organizational factors and perinatal quality of care. Findings show that ownership, setting (location), and hospital policy on infant feeding were statistically significant. Findings suggest that it is important that hospital boards and leaders develop and implement organizational policies to enhance perinatal quality of care.
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186
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Zheng YHE, Palombella A, Salfi J, Wainman B. Dissecting through Barriers: A Follow-up Study on the Long-Term Effects of Interprofessional Education in a Dissection Course with Healthcare Professional Students. ANATOMICAL SCIENCES EDUCATION 2019; 12:52-60. [PMID: 29659188 DOI: 10.1002/ase.1791] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 03/24/2018] [Accepted: 03/26/2018] [Indexed: 06/08/2023]
Abstract
Several studies have shown significant improvements in the attitudes and perceptions of healthcare professional students toward interprofessional education (IPE) immediately following intervention with IPE courses. However, there remains little evidence on the lasting effects of IPE courses and the long-term influences of these IPE experiences are poorly documented. The purpose of this study is to assess the long-term effects of an intensive, ten-week interprofessional gross anatomy dissection course at McMaster University. Attitudes and perceptions of past participants towards interprofessional learning were evaluated, now that they have started working with other healthcare professionals outside of the IPE course setting. Thirty-four past participants who have clinical experience working in interprofessional settings or are currently working in the healthcare field completed a follow-up questionnaire consisting of a modified Readiness for Interprofessional Learning Scale (RIPLS) and open-ended questions. Quantitative analysis revealed a significant decrease in their attitude towards teamwork and collaboration and respect for other health professions, but a significant improvement in their understanding of roles and responsibilities compared to their results immediately after the IPE intervention. Qualitative analysis of open-ended questions revealed several themes such as developing interprofessional competencies, developing relationships, and remembering the strengths of the IPE dissection course. The results of this study indicate that the IPE experience in anatomy was highly valued by the students and that past participants maintain a clear understanding of their scope of practice, but the reality of clinical practice may have eroded gains made in the program. Anat Sci Educ. © 2018 American Association of Anatomists.
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Affiliation(s)
| | - Andrew Palombella
- Education Program in Anatomy, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jenn Salfi
- Department of Nursing, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Bruce Wainman
- Education Program in Anatomy, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
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187
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Braun B, Grünewald M, Adam-Paffrath R, Wesselborg B, Wilm S, Schendel L, Hoenen M, Müssig K, Rotthoff T. Impact of interprofessional education for medical and nursing students on the nutritional management of in-patients. GMS JOURNAL FOR MEDICAL EDUCATION 2019; 36:Doc11. [PMID: 30993169 PMCID: PMC6446465 DOI: 10.3205/zma001219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 08/26/2018] [Accepted: 10/26/2018] [Indexed: 05/13/2023]
Abstract
Introduction: Despite its frequency, malnutrition is underestimated in its importance for morbidity and mortality. Interprofessional nutrition management can improve patient safety and clinical outcomes. An interprofessional education is considered as the basis for good team cooperation. So far, little data is available on the effects of interprofessional education on measurable outcomes for patients. The objective is to determine to what extent student feedback leads to a change of in-patient nutritional management for a selected internal medical ward. Methodology: In a teaching project based on the method of research oriented learning, medical and nursing students conducted an analysis of the nutritional situation of patients and developed individual treatment plans. The students orally reported their findings to the care teams as well as via a poster presentation to decision-makers of the clinic. A prospective cohort intervention study was conducted to assess the nutritional status of patients before and after student interventions using established screening tools. Differences were tested using t-test and Fisher's exact test. Institutional consequences for nutrition management were recorded descriptively. The teaching unit was evaluated by the students before and after. Results: Malnutrition was found in 59% of patients. Inspired by student feedback, institutional consequences followed: a) routine inpatient screening using Nutritional Risk Screening; and b) the use of pie charts to estimate food intake. Conclusion: The feedback from the results of student interprofessional cooperation led to a sensitization of decision-makers and enabled new measures to improve nutritional management. These can increase patient safety.
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Affiliation(s)
- Benedikt Braun
- Heinrich-Heine-University Düsseldorf, Medical Faculty, Düsseldorf, Germany
| | | | - Renate Adam-Paffrath
- Fliedner Fachhochschule Düsseldorf, University of Applied Sciences, Düsseldorf, Germany
| | - Bärbel Wesselborg
- Fliedner Fachhochschule Düsseldorf, University of Applied Sciences, Düsseldorf, Germany
| | - Stefan Wilm
- Heinrich-Heine-University Düsseldorf, Institute for General Practice, Düsseldorf, Germany
| | - Lena Schendel
- Fliedner Fachhochschule Düsseldorf, University of Applied Sciences, Düsseldorf, Germany
| | - Matthias Hoenen
- Heinrich-Heine-University Düsseldorf, Institute for General Practice, Düsseldorf, Germany
| | - Karsten Müssig
- Heinrich-Heine-University Düsseldorf, Medical Faculty, Division of Endocrinology and Diabetology, Institute for Clinical Diabetology, Düsseldorf, Germany
- German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - Thomas Rotthoff
- University Augsburg, Medical Faculty, Department for Medical Education and Educational Research, Augsburg, Germany
- *To whom correspondence should be addressed: Thomas Rotthoff, University Augsburg, Medical Faculty, Department for Medical Education and Educational Research, Universitätsstr. 2, D-86159 Augsburg, Germany, Tel.: +49 (0)821/598-3719, E-mail:
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188
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Bell SK, Langer T, Luff D, Rider EA, Brandano J, Meyer EC. Interprofessional Learning to Improve Communication in Challenging Healthcare Conversations: What Clinicians Learn From Each Other. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2019; 39:201-209. [PMID: 31306279 DOI: 10.1097/ceh.0000000000000259] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Although contemporary health care involves complex interactions among clinicians of varying professions, opportunities to learn together are relatively few. The authors assessed participants' views about the educational value of learning with colleagues of mixed health care professions in communication and relational skills training focused on challenging conversations. METHODS Between 2010 and 2013, 783 participants enrolled in 46 workshops hosted by the Institute for Professionalism and Ethical Practice at Boston Children's Hospital, Boston, USA. Participants received pre-, post-, and 3-month follow-up questionnaires with quantitative and qualitative questions about their experiences learning with clinicians of varying professions ("interprofessional learning"). Descriptive statistics and chi-square tests were used to compare participant groups. Responses to open-ended questions were coded according to standard principles of content analysis. RESULTS Seven hundred twenty-two (92%) participants completed surveys. Previous interprofessional learning was reported by 60% of respondents, but generally comprised <30% of their education. Clinicians with <3 years of work experience were least likely to have previous interprofessional learning. Nearly all (96%) participants reported interprofessional colleagues contributed valuably to their learning. Asked specifically what they learned, participants described five themes: Stronger Teamwork, Patient-Centered Focus, Specific Communication Skills, Content-Specific Knowledge, and Shared Global Values. After 3 months, 64% of respondents reported that workshop participation helped make their interactions with interprofessional colleagues more collaborative. DISCUSSION Communication skills training for challenging health care conversations is a valuable opportunity for interprofessional learning and generates sustained positive attitudes about collaboration. Clinicians learn from their colleagues a deeper understanding of each other's professional roles, challenges, and unique contributions; specific communication approaches; and a sense of belonging to a collaborative community reinforcing the patient at the center of care.
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Affiliation(s)
- Sigall K Bell
- Dr. Bell: Associate Professor, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, and Associate Professor, Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Harvard Medical School, Boston, MA. Dr. Langer: Research Associate, Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Harvard Medical School, Boston, MA, and Attending in Pediatric Neurology, Department of Neuropediatrics and Muscle Disorders, Center for Pediatrics, Faculty of Medicine, University of Freiburg, Freiburg, Germany. Dr. Luff: Associate Director, Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Harvard Medical School, Boston, MA. Dr. Rider: Director of Academic Programs, Assistant Professor, Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Harvard Medical School, Boston, MA, Director of Academic Programs, Assistant Professor, Department of Pediatrics, Harvard Medical School, Boston, MA, and Director of Academic Programs, Assistant Professor, Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, MA. Dr. Brandano: Senior Clinical Coordinator, Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Harvard Medical School, Boston, MA, and Senior Clinical Coordinator, Department of Psychology, Simmons College, Boston, MA. Dr. Meyer: Senior Attending Psychologist, Associate Professor, Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Harvard Medical School, Boston, MA, and Senior Attending Psychologist, Associate Professor, Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston MA
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189
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Morano C, Damiani G. Interprofessional education at the meso level: taking the next step in IPE. GERONTOLOGY & GERIATRICS EDUCATION 2019; 40:43-54. [PMID: 30321121 DOI: 10.1080/02701960.2018.1515739] [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: 06/08/2023]
Abstract
The downstream demand for professionals with competence in Interprofessional Collaboration (IPC) has contributed to the substantial growth in the upstream demand for interprofessional education (IPE). The majority of IPE programs focuses exclusively on direct care practitioners and seldom include those responsible for the administration and management of care. Unfortunately, complex reimbursement mechanisms along with the multiple agencies and departments regulating the delivery, evaluation, and reimbursement of care can result in unintended barriers to IPC and eventually IPE. The Healthcare Services Planning and Management Program (HSPMP) is an innovative model of IPE that was designed to improve system wide collaboration among those responsible for the reimbursement, management and administration of the delivery of care. Although HSPMP was not developed in the US, this innovative model has the potential to develop the systemic integration needed to break down the barriers to the delivery and evaluation of IPE and IPC. The aim of this article is to introduce HSPMP to the US as a model of IPE that could help facilitate better integration of the US health care system and help to reduce some of the consequences resulting from the current fragmented system of care.
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Affiliation(s)
- Carmen Morano
- School of Social Welfare, University at Albany, State University of New York, Albany, NY, USA
| | - Gianfranco Damiani
- Unità Organizzativa Complessa Igiene Ospedaliera, Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Roma, Italia
- Istituto di Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italia
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190
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Berger S, Whelan B, Mahler C, Szecsenyi J, Krug K. Encountering complexity in collaborative learning activities: an exploratory case study with undergraduate health professionals. J Interprof Care 2018; 33:490-496. [DOI: 10.1080/13561820.2018.1562423] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Sarah Berger
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Benedict Whelan
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Newmarket, New Zealand
| | - Cornelia Mahler
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Joachim Szecsenyi
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Katja Krug
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
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191
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Richard A, Gagnon M, Careau E. Using reflective practice in interprofessional education and practice: a realist review of its characteristics and effectiveness. J Interprof Care 2018; 33:424-436. [PMID: 30513235 DOI: 10.1080/13561820.2018.1551867] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This article presents the results of a realist review of the use of reflective practice interventions aimed at improving interprofessional education and collaborative practice (IPECP). Reflective practice is recognized as one of the determining factors in health and social service professionals' skills development and maintenance, as well as in the establishment of good collaboration practices. In this respect, it is a key element of interprofessional education (IPE) and its relevance in this field is being asserted more and more strongly. However, few studies have been conducted to document its effectiveness. The purpose of this article is therefore to advance knowledge in this field. Searches in health and social services electronic databases identified six studies presenting reflective practice interventions in IPECP aimed at enhancing collaboration among students or practicing professionals. Analysis provided preliminary answers as to the effectiveness of reflective practice interventions in IPECP, as well as pertinent information on the best methods for achieving effectiveness. It concludes by proposing recommendations designed to change reflective practice interventions in IPECP and by stressing the importance of further research in order to document more fully the effectiveness of reflective practice in IPECP and to identify the most promising intervention methods in this regard.
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Affiliation(s)
- Amélie Richard
- Centre for interdisciplinary research in rehabilitation and social integration (CIRRIS) , Quebec City , Canada
| | - Mathieu Gagnon
- Education Faculty, Université de Sherbrooke , Sherbrooke , Canada.,Centre de recherche interuniversitaire sur la formation et la profession enseignante-CRIFPE (Centre for interuniversity research in teacher training and the teaching profession) , Sherbrooke , Canada
| | - Emmanuelle Careau
- Centre for interdisciplinary research in rehabilitation and social integration (CIRRIS) , Quebec City , Canada.,Rehabilitation department, Faculty of medicine, Université Laval , Quebec City , Canada.,Centre de recherche sur les soins et les services de première ligne de l'Université Laval- CERSSPL-UL (Centre for research on primary care of Université Laval) , Quebec City , Canada
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192
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Soubra L, Badr SB, Zahran EM, Aboul-Seoud M. Effect of Interprofessional Education on Role Clarification and Patient Care Planning by Health Professions Students. HEALTH PROFESSIONS EDUCATION 2018. [DOI: 10.1016/j.hpe.2017.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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193
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Sheehan D, de Bueger TM, Thorogood J, Sitters S, Deo A. Beyond competencies - describing work ready plus graduates for the New Zealand medical imaging workforce. J Med Radiat Sci 2018; 65:275-281. [PMID: 29962009 PMCID: PMC6275251 DOI: 10.1002/jmrs.290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 06/05/2018] [Accepted: 06/06/2018] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Medical imaging is a profession where technology and practice is moving forward at a fast pace, while also being situated within rapidly evolving models of healthcare delivery. This requires capabilities in our graduates beyond the competencies to undertake the role. This study used an existing Professional Capability Framework as the foundation for the development of a survey tool to identify those capabilities most valued by the health services that provide placement opportunities for students. METHODS A prospective survey, conducted online, was used to gather the data from senior medical imaging staff who work regularly with students and new graduates. RESULTS The results identified the top capabilities within each of three domains of personal, interpersonal, and cognitive capabilities. The results from the personal domain show that remaining calm under pressure or when things take an unexpected turn; understanding personal strengths and limitations; being willing to face and learn from errors; wanting to do as good a job as possible and having energy, passion and enthusiasm for the profession and role are most valued by the profession. We have identified links between the most desired interpersonal capabilities and attributes of well-functioning interprofessional teams and the cognitive capabilities align to those required for critical thinking and clinical reasoning. CONCLUSIONS These results have allowed the curriculum development team to review the graduate profile of medical imaging technology graduates. The curriculum development team has begun a process to incorporate learning strategies that will encourage the development of these capabilities in our graduates.
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Affiliation(s)
- Dale Sheehan
- Gold Coast University HospitalGold CoastQueenslandAustralia
- UnitecAucklandNew Zealand
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194
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Odole AC, Odunaiya NA, Ajadi OI. Interprofessional education among Nigerian clinical students: implications for interprofessional care. J Interprof Care 2018; 33:645-653. [PMID: 30428727 DOI: 10.1080/13561820.2018.1544545] [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: 10/27/2022]
Abstract
Interprofessional education (IPE) is effective for teaching health profession students about the roles of different healthcare professionals for collaborative practice. This study was designed to investigate clinical students' awareness, knowledge, and perception of IPE. A mixed method convergent parallel design of Cross-Sectional Survey (CSS) and Focus Group Discussion (FGD) was used. Data on awareness, perception and knowledge about IPE were collected using a self-developed, content-validated questionnaire and Readiness for Interprofessional Learning Scale, respectively, and was analysed using Chi-Square, and Mann-Whitney U test at α = 0.05. For the FGD, data were collected from 13 purposively selected students in a Nigerian university and analysed through content thematic analysis. Participants in the CSS were aged 21.9 ± 2.0 years. Over half of the participants (57.4%) reported being unaware of IPE. More than half (73.0%) of the participants that were aware had good knowledge. Majority (93.3%) had a positive perception of IPE. There was a significant association between participants' knowledge and perception (p = 0.008) of IPE; however, there was no significant association (p = 0.051) between their awareness and perception. Also, there were no significant sex variations in the knowledge of IPE (0.371). However, there was a significant sex difference in their perception (p = 0.008). Some of the discussants in the FGD reported being aware of the term IPE. Discussants had at least fair knowledge of IPE and reported that IPE is important; and supports its formal implementation and inclusion in the curricula of study; emphasizing that it should be started early enough in their training. Awareness of interprofessional education is sub-optimal among these clinical students, however more than half of those who were aware had good knowledge. Most of them had a positive perception. There is a need to improve clinical students' awareness and knowledge about IPE by using integrated seminars and implementing IPE into the curricula of their training.
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Affiliation(s)
| | - Nse AyoOluwa Odunaiya
- Department of Physiotherapy, College of Medicine, University of Ibadan, Ibadan, Nigeria
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195
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Johnston S, Coyer FM, Nash R. Kirkpatrick's Evaluation of Simulation and Debriefing in Health Care Education: A Systematic Review. J Nurs Educ 2018; 57:393-398. [PMID: 29958308 DOI: 10.3928/01484834-20180618-03] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 02/09/2018] [Indexed: 01/09/2023]
Abstract
BACKGROUND Simulation is an integral component of health care education. Research suggests a positive relationship between simulation and learning outcomes. Kirkpatrick's framework is a four-level model based on the premise that learning resulting from training programs can be classified into four levels: reaction, learning, behavior, and results. Evaluation of educational impact provides valuable feedback to educators that may assist with development and improvement of teaching methods. METHOD This review is based on the PRISMA guidelines for conducting a systematic review. Inclusion criteria included articles (a) written in the English language, (b) published between 2000 and 2016, (c) describing a debriefing intervention after high-fidelity patient simulation, and (d) based in health care. RESULTS Thirteen studies met criteria for inclusion in the review. CONCLUSION Results indicated a paucity of studies at the highest levels of evaluation, indicating an area where future research is needed to assist with the development and improvement of simulation education. [J Nurs Educ. 2018;57(7):393-398.].
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196
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Jennings A, McLoughlin K, Boyle S, Thackeray K, Quinn A, O'Sullivan T, Foley T. Development and evaluation of a primary care interprofessional education intervention to support people with dementia. J Interprof Care 2018; 33:579-582. [PMID: 30422731 DOI: 10.1080/13561820.2018.1541876] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
International policy documents emphasize the need to develop interprofessional education (IPE) to support collaborative dementia care in the community. The aim of this short report is to describe the development and pilot evaluation of an interprofessional dementia education workshop for primary care healthcare professionals. A three-hour workshop was iteratively developed through consultation with an expert reference group and people with dementia. The workshop was piloted with three separate primary care teams. A total of fifty-four primary care based healthcare staff who represented fourteen different health care roles in primary care participated in the pilot evaluation. The pilot workshops were evaluated using a mixed method approach which included post-workshop questionnaires for participants (n= 54)and a post-workshop focus group (n=8) with the program design team and workshop facilitators. The results of the pilot phase indicated that the workshop was useful and feasible. The workshop improved participants' self-reported knowledge, understanding and confidence to support people with dementia and their families.Areas for improvement were identified and will be used to inform improvements to the workshop content and delivery in advance of a national roll-out. Future evaluations of the implementation of this interprofessional educational workshop will focus on its impact on healthcare professional behavior and outcomes for the person with dementia and their families.
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Affiliation(s)
- Aisling Jennings
- Department of General Practice, University College Cork , Cork , Ireland
| | | | - Siobhan Boyle
- Department of General Practice, University College Cork , Cork , Ireland
| | | | - Anne Quinn
- Advanced Nurse Practitioner in Dementia, Health Service Executive , Clonmel, Tipperary , Ireland
| | - Trish O'Sullivan
- Neurological Services, Health Service Executive Cork South Lee , Cork , Ireland
| | - Tony Foley
- Department of General Practice, University College Cork , Cork , Ireland
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Brack P, Shields N. Short duration clinically-based interprofessional shadowing and patient review activities may have a role in preparing health professional students to practice collaboratively: a systematic literature review. J Interprof Care 2018; 33:446-455. [DOI: 10.1080/13561820.2018.1543256] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Peter Brack
- Northern Centre for Health Education and Research, Northern Health, EPPING, VIC, Australia
| | - Nora Shields
- Northern Centre for Health Education and Research, Northern Health, EPPING, VIC, Australia
- School of Allied Health, La Trobe University, Bundoora, VIC, Australia
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Shen N, Sockalingam S, Charow R, Bailey S, Bernier T, Freeland A, Hawa A, Sur D, Wiljer D. Education programs for medical psychiatry collaborative care: A scoping review. Gen Hosp Psychiatry 2018; 55:51-59. [PMID: 30384004 DOI: 10.1016/j.genhosppsych.2018.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 08/25/2018] [Accepted: 08/29/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To understand the current state of collaborative care education programs reported in the literature. METHODS Following Arksey and O'Malley methodology for scoping reviews, data was abstracted in following domains: article details, program details, program outcomes, and implementation factors. Numerical summaries were calculated where necessary. Implementation factors underwent a qualitative thematic analysis. RESULTS This review identified 40 unique collaborative care education programs. Most programs (n = 25; 62.5%) were delivered to a multi-disciplinary group of learners through didactic (n = 34; 85.0%) and/or in vivo (n = 32; 80.0%) training methods. The majority of programs focused on clinical knowledge/skill acquisition (n = 38; 95.0%) as opposed to attitudes towards mental health and collaboration (n = 27; 67.5%). Implementation factors fell within four themes: program development, supportive environment, necessary resources, and clinical change agents/leaders. CONCLUSION Despite the growing evidence for collaborative care, few collaborative care education programs are reported in the literature. Key elements of collaborative care education programs include: routine multi-disciplinary interaction, curriculum focus on attitudes; clinical change agents and leaders to accelerate implementation; and a user-centred design development process. Future implementations can learn from these experiences to avoid potential barriers and focus on enabling successful programs to enhance care.
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Affiliation(s)
- Nelson Shen
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 4th Floor, Toronto, Ontario M5T 3M6, Canada; University Health Network, 200 Elizabeth Street, 8 Eaton South, Toronto, Ontario M5G 2C4, Canada; Education, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada.
| | - Sanjeev Sockalingam
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8, Canada; Education, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada.
| | - Rebecca Charow
- University Health Network, 200 Elizabeth Street, 8 Eaton South, Toronto, Ontario M5G 2C4, Canada.
| | - Sharon Bailey
- Education, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada.
| | - Thérèse Bernier
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 4th Floor, Toronto, Ontario M5T 3M6, Canada.
| | - Alison Freeland
- Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8, Canada; Trillium Health Partners, 100 Queensway W, Mississauga, Ontario L5B 1B8, Canada.
| | - Aceel Hawa
- Education, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada
| | - Deepy Sur
- Trillium Health Partners, 100 Queensway W, Mississauga, Ontario L5B 1B8, Canada.
| | - David Wiljer
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 4th Floor, Toronto, Ontario M5T 3M6, Canada; Department of Psychiatry, University of Toronto, 250 College Street, 8th Floor, Toronto, Ontario M5T 1R8, Canada; University Health Network, 200 Elizabeth Street, 8 Eaton South, Toronto, Ontario M5G 2C4, Canada; Education, Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario M5S 2S1, Canada.
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Ahmady S, Khabaz Mafinejad M. Another look at what teachers and students think about interprofessional learning as a shared experience in Iran: a qualitative research. BMJ Open 2018; 8:e020015. [PMID: 30381310 PMCID: PMC6224738 DOI: 10.1136/bmjopen-2017-020015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To explore experiences of interprofessional learning (IPL), and how faculty and students might want to participate in IPL opportunities as a form of shared learning. DESIGN Qualitative study. SETTING The Ministry of Health and Medical Education which is accountable for rendering service to the public, providing healthcare needs and improving the quality of medical education was established in Iran in 1985, to integrate medical education with healthcare services. PARTICIPANTS A sample of six faculty members and seven students, purposively sampled for demographic characteristics and their experience regarding shared learning. METHODS A descriptive qualitative study using thematic analysis of content was conducted. Data were obtained using semistructured interviews and then analysed thematically. Data collection and analysis were concurrent. RESULTS Three categories were identified: the role of prologues in IPL, the role of structured IPL, and the role of context and structure in such a system for learning, representing seven subcategories. CONCLUSION The findings indicate that experiences of learning with different professionals are complex, and these experiences shape their present and future workplace relations. Matching the existing educational context and structure with IPL and providing planned interaction and reflection among professionals are necessary to support IPL.
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Affiliation(s)
- Soleiman Ahmady
- School of Management and Medical Education, Department of Medical Education, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahboobeh Khabaz Mafinejad
- Education Development Center, Health Professions Education Research Center, Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran
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Machin L, Bellis KM, Dixon C, Morgan H, Pye J, Spencer P, Williams R. Interprofessional education and practice guide: designing ethics-orientated interprofessional education for health and social care students. J Interprof Care 2018; 33:608-618. [DOI: 10.1080/13561820.2018.1538113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- L.L. Machin
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - K. M. Bellis
- School of Health Sciences, University of Central Lancashire, Preston, UK
| | - C. Dixon
- Doctorate of Clinical Psychology, Lancaster University, Lancaster, UK
| | - H. Morgan
- Department of Sociology, Lancaster University, Lancaster, UK
| | - J. Pye
- Department of Sociology, Lancaster University, Lancaster, UK
| | - P. Spencer
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - R.A. Williams
- Department of Management Science, Lancaster University, Lancaster, UK
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