1
|
Khanyola J, Reid M, Dadasovich R, Derbew M, Couper I, Dassah ET, Forster M, Gachuno O, Haruzivishe C, Kazembe A, Martin S, Molwantwa M, Motlhatlhedi K, Mteta KA, Nadesan-Reddy N, Suleman F, Ngoma C, Odaibo GN, Mubuuke R, von Zinkernagel D, Kiguli-Malwadde E, Sears D. Improving interprofessional collaboration: building confidence using a novel HIV curriculum for healthcare workers across sub-Saharan africa. J Interprof Care 2024; 38:963-969. [PMID: 39092781 DOI: 10.1080/13561820.2024.2375639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 01/04/2024] [Accepted: 04/09/2024] [Indexed: 08/04/2024]
Abstract
The 21st century presents significant global health challenges that necessitate an integrated health workforce capable of delivering person-centered and integrated healthcare services. Interprofessional collaboration (IPC) plays a vital role in achieving integration and training an IPC-capable workforce in sub-Saharan Africa (SSA) has become imperative. This study aims to assess changes in IPC confidence among learners participating in a team-based, case-based HIV training programme across diverse settings in SSA. Additionally, it sought to examine the impact of different course formats (in-person, synchronous virtual, or blended learning) on IPC confidence. Data from 20 institutions across 18 SSA countries were collected between May 1 and December 31, 2021. Logistic regression analysis was conducted to estimate associations between variables of interest and the increases in IPC confidence. The analysis included 3,842 learners; nurses comprised 37.9% (n = 1,172) and physicians 26.7% (n = 825). The majority of learners (67.2%, n = 2,072) were pre-service learners, while 13.0% (n = 401) had graduated within the past year. Factors significantly associated with increased IPC confidence included female gender, physician cadre, completion of graduate training over 12 months ago, and participation in virtual or in-person synchronous workshops (p < .05). The insights from this analysis can inform future curriculum development to strengthen interprofessional healthcare delivery across SSA.
Collapse
Affiliation(s)
- Judy Khanyola
- Center for Nursing and Midwifery, University of Global Health Equity, Kigali, Rwanda
| | - Mike Reid
- School of Medicine, University of California San Francisco, San Francisco, USA
| | - Rand Dadasovich
- School of Medicine, University of California San Francisco, San Francisco, USA
| | - Miliard Derbew
- Department of Surgery, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ian Couper
- Department of Global Health, Ukwanda Centre for Rural Health, Stellenbosch University, Stellenbosch, South Africa
| | - Edward T Dassah
- Department of Population, Family and Reproductive Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Maeve Forster
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, USA
| | - Onesmus Gachuno
- Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya
| | - Clara Haruzivishe
- Department of Nursing Science, University of Zimbabwe, Harare, Zimbabwe
| | - Abigail Kazembe
- Midwifery Department, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Shayanne Martin
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, USA
| | - Mmoloki Molwantwa
- Department of Medical Education, University of Botswana, Gaborone, Botswana
| | | | - Kien Alfred Mteta
- Department of Urology, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Nisha Nadesan-Reddy
- Centre for Rural Health, School of Nursing and Public Health, University of Kwazulu-Natal, Durban, South Africa
| | - Fatima Suleman
- Discipline of Pharmaceutical Sciences, School of Health Sciences, University of Kwazulu-Natal, Durban, South Africa
| | - Catherine Ngoma
- School of Nursing Sciences, University of Zambia, Lusaka, Zambia
| | - Georgina N Odaibo
- Department of Virology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Roy Mubuuke
- School of Medicine, Makerere University, Kampala, Uganda
| | - Deborah von Zinkernagel
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, USA
| | | | - David Sears
- School of Medicine, University of California San Francisco, San Francisco, USA
| |
Collapse
|
2
|
Dzhioeva ON. Ultrasound-assisted examinations are a competence formed in the process of interdisciplinary interactions in clinical practice. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- O. N. Dzhioeva
- National Medical Research Center for Therapy and Preventive Medicine;
Russian Society for the Prevention of Non-Communicable Diseases
| |
Collapse
|
3
|
DiPasquale L, Libera R, Do-Nguyen CC, Brehman E, Tatagari V, Waring H, Appelt D, Sesso A. The Philadelphia surgery conference: a value analysis of a hands-on surgical skill-building event. J Osteopath Med 2021; 121:271-280. [PMID: 33635958 DOI: 10.1515/jom-2020-0179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Context Limited opportunities exist to practice technical skills and to be exposed to various surgical specialties during preclinical medical education. Objectives To assess the value of workshop-based educational opportunities to medical students during preclinical training. Methods One hundred and 75 medical and physician assistant students from 10 medical schools attended the 2019 Philadelphia Surgery Conference. All students received STOP THE BLEED® bleeding control training and participated in four workshops, chosen from a list of 23, that demonstrated a variety of surgical skills. Data collection was accomplished using both a pre- and postconference survey to assess changes in confidence of personal capabilities, knowledge base, and opinions regarding preclinical medical training. Results Preconference survey results indicated low baseline confidence in personal surgical skills (mean [SD], 1.9 [1.0], on a Likert scale of 1-5), and knowledge of various surgical specialties (2.7 [1.0]). Students highly valued skill-building experiences (mean [SD], 4.2 [1.1]) and face-to-face interactions with resident and attending physicians (4.4 [0.9]). Postconference survey analysis demonstrated increased confidence in surgical ability by 52.6% (mean [SD], 2.9 [1.0]; p<0.001) and knowledge base by 34.6% (3.5 [0.8]; p<0.001). Value scores increased for both preclinical surgical skill-building opportunities (mean [SD], 4.4 [0.9]; p=0.014) and interactions with resident and attending physicians (4.7 [0.6]; p=0.002). Conclusions The Philadelphia Surgery Conference provided a highly valuable experience to participating students, increasing confidence in personal knowledge base and surgical skills while facilitating a collaboration between students and resident and attending physicians from various surgical specialties.
Collapse
Affiliation(s)
- Luke DiPasquale
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Robert Libera
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | | | | | | | - Heather Waring
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Denah Appelt
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| | - Arthur Sesso
- Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA
| |
Collapse
|
4
|
Clouder L, Bluteau P, Jackson JA, Adefila A, Furlong J. Education for integrated working: A qualitative research study exploring and contextualizing how practitioners learn in practice. J Interprof Care 2021; 36:24-33. [PMID: 34402733 DOI: 10.1080/13561820.2021.1889485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Integrated working can be a means of providing efficient and cost-effective care, which benefits both service users and health professionals. However, it does require readiness of practitioners to work in new and innovative ways to achieve integration. This paper describes the findings of a qualitative study exploring the nature of practice-based education and training underpinning successful integrated care teams using an ecological systems theory lens. Nine teams in the West Midlands region of the United Kingdom (UK) participated in this study. A total of 27 participants were involved in semi-structured interviews during which they shared their views and experiences of learning in practice. Thematic analysis of interview transcripts highlighted the shifting context of working in integrated teams impacting on learning, the influence of leadership on education and training, the nature of in-service training, and the knowledge-sharing culture. The findings highlight that the learning climate is highly dependent on the leadership ethos in the practice context, which influences the allocation of time and resources for training and clinical supervision. Whilst formal education and training has an important role to play in fostering integrated working, informal learning is pivotal to successful integration and potentially has greater impact making it worthy of further study.
Collapse
Affiliation(s)
- Lynn Clouder
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Patricia Bluteau
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | | | - Arinola Adefila
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| | - Jan Furlong
- Faculty of Health and Life Sciences, Coventry University, Coventry, UK
| |
Collapse
|
5
|
Mays KA. Designing Oral Health Curriculum That Facilitates Greater Integration of Oral Health Into Overall Health. FRONTIERS IN DENTAL MEDICINE 2021. [DOI: 10.3389/fdmed.2021.680520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
For several decades, health professions education has been transforming; pedagogical constructs such as active learning, recorded lectures, electronic assessment, asynchronous content delivery, and interprofessional education and practice. However, the typical oral health curriculum has need for further transformation to ensure graduates' ability to function in an integrated health system. There is significant literature outlining associations between oral health and overall health, therefore, it is paramount that oral health learners develop skills to collaborate in an integrated model. Satcher, in 2000, outlined the gravity of oral health inequities and the importance of oral health. He said, “Too little time is devoted to oral health and disease topics in the education of non-dental health professional.” However, on the contrary typical oral health curriculum provide knowledge acquisition of topics related to overall health but isn't specifically designed to guide integrated care. In order to increase integrated care, groups like the Interprofessional Education Collaborative (IPEC) have developed competencies for interprofessional education and collaborative practice that guides the training of health professionals. One way to improve integration is accreditation standards that guide transformation as well incorporate IPEC competencies. Having competencies is important to prepare learners to function in clinics like Kaiser Permanente's medical-dental integration model that rely upon teams and teamwork and clarity of roles and responsibilities. This manuscript outlines principle of oral health curriculum that facilitate graduates ability to work in an integrated health system and how that contributes to the improvement overall health of patients.
Collapse
|
6
|
Er HM, Nadarajah VD, Chen YS, Misra S, Perera J, Ravindranath S, Hla YY. Twelve tips for institutional approach to outcome-based education in health professions programmes. MEDICAL TEACHER 2021; 43:S12-S17. [PMID: 31522577 DOI: 10.1080/0142159x.2019.1659942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Outcome-based education (OBE) has brought along a significant development in health professions education in the past decade. The shift from a process-driven to product-driven model of education is valuable for ensuring graduate quality and facilitating global movement of healthcare workers. Such a model can align the expectations of key stakeholders in an era of rapid knowledge expansion and technological advancement. Nevertheless, the experienced benefits of OBE depend on the effectiveness of its implementation. This article therefore provides practical tips and strategies for implementing OBE in order to maximize its potential.
Collapse
Affiliation(s)
- Hui Meng Er
- Faculty of Medicine and Health, International Medical University, Kuala Lumpur, Malaysia
| | - Vishna Devi Nadarajah
- Faculty of Medicine and Health, International Medical University, Kuala Lumpur, Malaysia
| | - Yu Sui Chen
- Faculty of Medicine and Health, International Medical University, Kuala Lumpur, Malaysia
| | - Snigdha Misra
- Faculty of Medicine and Health, International Medical University, Kuala Lumpur, Malaysia
| | - Joachim Perera
- Faculty of Medicine and Health, International Medical University, Kuala Lumpur, Malaysia
| | - Sneha Ravindranath
- Faculty of Medicine and Health, International Medical University, Kuala Lumpur, Malaysia
| | - Yee Yee Hla
- Faculty of Medicine and Health, International Medical University, Kuala Lumpur, Malaysia
| |
Collapse
|
7
|
Spaulding EM, Marvel FA, Jacob E, Rahman A, Hansen BR, Hanyok LA, Martin SS, Han HR. Interprofessional education and collaboration among healthcare students and professionals: a systematic review and call for action. J Interprof Care 2021; 35:612-621. [PMID: 31865823 PMCID: PMC7305974 DOI: 10.1080/13561820.2019.1697214] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 07/22/2019] [Accepted: 11/20/2019] [Indexed: 12/17/2022]
Abstract
Interprofessional education (IPE) is a prerequisite to building a collaborative practice environment and optimizing patient care. The purpose of this systematic review was to assess the impact of IPE on outcomes related to health-care pre-licensure learners and professionals, including: changes in attitudes/perceptions; acquisition of knowledge regarding other disciplines' roles and development of collaborative skills; and change in collaborative behavior. We searched PubMed, CINAHL, Embase, and ERIC for studies published from 2007 to 2017 in English; 19 studies were eligible. The Joanna Briggs Institute appraisal tool was used to assess the quality of the studies. Thirteen studies used a quasi-experimental design. The studies varied in terms of setting, teaching methods, assessment measures, and quality. Seventeen of the 19 studies (89%) that assessed change in attitudes toward other disciplines and value placed on a team-based approach for improving patient care, found statistically significant improvements. All seven of the studies that assessed change in collaborative behavior found statistically significant improvements. Among the 12 studies that assessed the development of collaborative skills, there were mixed results. Future directions include: conducting more studies among health-care professionals, assessing the long-term impact of IPE, objectively assessing change in collaborative behavior, and assessing the impact of IPE on patient-centered outcomes.
Collapse
Affiliation(s)
| | - Francoise A. Marvel
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Elsen Jacob
- Department of Pharmacy, Johns Hopkins Bayview Medical Center, Baltimore, MD
| | - Alphie Rahman
- Interprofessional Practice and Patient Safety, Johns Hopkins Bayview Medical Center, Baltimore, MD
| | | | - Laura A. Hanyok
- Department of Pharmacy, Johns Hopkins Bayview Medical Center, Baltimore, MD
- Interprofessional Practice and Patient Safety, Johns Hopkins Bayview Medical Center, Baltimore, MD
| | - Seth S. Martin
- Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Hae-Ra Han
- Johns Hopkins School of Nursing, Baltimore, MD
- Center for Cardiovascular and Chronic Care, Johns Hopkins University School of Nursing, Baltimore, MD
| |
Collapse
|
8
|
Vincent-Lambert C, Kotzé D. Doctors', nurses' and clinical associates' understanding of emergency care practitioners. Health SA 2021; 26:1523. [PMID: 33824727 PMCID: PMC8008012 DOI: 10.4102/hsag.v26i0.1523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 01/20/2021] [Indexed: 11/05/2022] Open
Abstract
Background Healthcare professionals’ understanding of the knowledge, skills and training of their counterparts from other disciplines cultivates appreciation and respect within the workplace. This, in turn, results in better teamwork and improved patient care. Emergency departments are places where emergency care practitioners (ECPs) engage with doctors, nurses and clinical associates. Whilst the importance of inter-professional communication and teamwork between in-hospital professionals and pre-hospital emergency care providers is acknowledged, no literature could be found describing exactly how much these in-hospital professionals understand about the training and capabilities of their ECP colleagues. Aim The aim of this study was to assess the level of understanding that prospective doctors, nurses and clinical associates have regarding the training and capabilities of ECPs. Setting The research was conducted in Johannesburg, South Africa, at two universities. Methods Seventy-seven participants completed a purpose-designed questionnaire assessing their understanding regarding the education and clinical capabilities of ECPs. Results In total, 64% of participants demonstrated a poor understanding of the level of education and clinical capabilities of ECPs. The remaining 36% showed only moderate levels of understanding. Conclusion Medical, nursing and clinical associate graduates have a generally poor understanding of the education and clinical capabilities of their ECP colleagues who practise predominantly in the pre-hospital environment. This lack of understanding can become a barrier to effective communication between ECPs and in-hospital staff during patient handover in emergency departments. Contribution This research highlights a lack of understanding about the role and function of South African ECPs as pre-hospital emergency care providers and the need for more effective inter-professional education.
Collapse
Affiliation(s)
- Craig Vincent-Lambert
- Department of Emergency Medical Care, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| | - Dirk Kotzé
- Department of Emergency Medical Care, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
| |
Collapse
|
9
|
Hlongwa P, Rispel LC. Interprofessional collaboration among health professionals in cleft lip and palate treatment and care in the public health sector of South Africa. HUMAN RESOURCES FOR HEALTH 2021; 19:25. [PMID: 33639981 PMCID: PMC7912817 DOI: 10.1186/s12960-021-00566-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Collaboration among different categories of health professionals is essential for quality patient care, especially for individuals with cleft lip and palate (CLP). This study examined interprofessional collaboration (IPC) among health professionals in all CLP specialised centres in South Africa's public health sector. METHODS During 2017, a survey was conducted among health professionals at all the specialised CLP centres in South Africa's public health sector. Following informed consent, each member of the CLP team completed a self-administered questionnaire on IPC, using the Interprofessional Competency Framework Self-Assessment Tool. The IPC questionnaire consists of seven domains with 51 items: care expertise (8 items); shared power (4 items); collaborative leadership (10 items); shared decision-making (2 items); optimising professional role and scope (10 items); effective group function (9 items); and competent communication (8 items). STATA®13 was used to analyse the data. Descriptive analysis of participants and overall mean scores were computed for each domain and analysed using ANOVA. All statistical tests were conducted at 5% significance level. RESULTS We obtained an 87% response rate, and 52 participants completed the questionnaire. The majority of participants were female 52% (n = 27); with a mean age of 41.9 years (range 22-72). Plastic surgeons accounted for 38.5% of all study participants, followed by speech therapists (23.1%), and professional nurses (9.6%). The lowest mean score of 2.55 was obtained for effective group function (SD + -0.50), and the highest mean score of 2.92 for care expertise (SD + -0.37). Explanatory factor analysis showed that gender did not influence IPC, but category of health professional predicted scores on the five categories of shared power (p = 0.01), collaborative leadership (p = 0.04), optimising professional role and scope (p = 0.03), effective group function (p = 0.01) and effective communication (p = 0.04). CONCLUSION The seven IPC categories could be used as a guide to develop specific strategies to enhance IPC among CLP teams. Institutional support and leadership combined with patient-centred, continuing professional development in multi-disciplinary meetings will also enrich IPC.
Collapse
Affiliation(s)
- Phumzile Hlongwa
- School of Oral Health Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Laetitia C. Rispel
- Centre for Health Policy & SARChI Chair, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
10
|
Bhatia JK, Chaturvedi A, Datta K, Ciraj A. Enhancing communication skills among residents in India: An interprofessional education approach. Med J Armed Forces India 2021; 77:S115-S121. [PMID: 33612941 PMCID: PMC7873706 DOI: 10.1016/j.mjafi.2020.12.027] [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: 10/15/2020] [Accepted: 12/30/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Interprofessional education (IPE) provides opportunities to postgraduates to develop communication skills which are vital for interactions with patients, their relatives, colleagues, paramedical and nursing staff. There is a need to develop an innovative IPE based module on communication skills for postgraduates stressing upon the existing lacunae and requirements detected by a validated assessment tool. We assessed the residents' appraisal of communication skills by a validated questionnaire to identify key areas to improve their communication skills and to determine perceptions of all the stakeholders i.e. faculty, nursing staff and paramedical staff. METHODS A descriptive correlational design using an online self-administered questionnaire on a sample of a total of 200 participants comprising residents, paramedical staff, nursing staff and faculty of tertiary care hospital. Study was approved by the Institutional Ethical Committee. Data was analysed by SPSS Version 22.0 used. (p value < 0.05 significant). RESULTS The participants included 113 residents, 17 paramedical staff, 33 Nursing staff and 37 faculty members. The present study found a significant difference of scores of means between the residents, faculty, paramedical staff and nursing staff p value < 0.05 except for alter centrism, interaction management and environmental control. The mean scores were also significantly different between the first, second and third year residents. CONCLUSION This study validates the need to enhance the communication skills of residents. The scores obtained will help us design and refine IPE module for the benefit of the residents.
Collapse
Affiliation(s)
| | - Abhishek Chaturvedi
- Senior Grade Lecturer (Biochemistry), Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Karuna Datta
- Professor, Department of Sports Medicine, Convener MCIRC for MET & Coordinator, Department of Medical Education, Armed Forces Medical College, Pune, India
| | - A.M. Ciraj
- Professor & Course Director, MAHE FAIMER International Institute, Centre for Continuing Education & Professional Development, Manipal Academy of Higher Education, Manipal, Karnataka, India
| |
Collapse
|
11
|
Poitras ME, Légaré F, Tremblay Vaillancourt V, Godbout I, Poirier A, Prévost K, Spence C, Chouinard MC, Zomahoun HTV, Khadhraoui L, Massougbodji J, Bujold M, Pluye P, Hudon C. High Users of Healthcare Services: Development and Alpha Testing of a Patient Decision Aid for Case Management. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2020; 13:757-766. [PMID: 33083997 DOI: 10.1007/s40271-020-00465-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Some patients with complex healthcare needs become high users of healthcare services. Case management allows these patients and their interprofessional team to work together to evaluate their needs, priorities and available resources. High-user patients must make an informed decision when choosing whether to engage in case management and currently there is no tool to support them. OBJECTIVE The objective of this study was to develop and conduct a pilot alpha testing of a patient decision aid that supports high-user patients with complex needs and the teams who guide those patients in shared decision making when engaging in case management. METHODS We chose a user-centered design to co-develop a patient decision aid with stakeholders informed by the Ottawa Research Institute and International Patient Decision Aid Standards frameworks. Perceptions and preferences for the patient decision aid's content and format were assessed with patients and clinicians and were iteratively collected through interviews and focus groups. We developed a prototype and assessed its acceptability by using a think-aloud method and a questionnaire with three patient-partners, six clinicians and seven high-user patients with complex needs. RESULTS The three rounds of evaluation to assess the decision aid's acceptability highlighted comments related to simplicity, readability and visual aspect. A section presenting clinical vignettes including story telling was identified as the most helpful. CONCLUSIONS We created and evaluated a patient decision aid. Considering the positive comments, we believe that this aid has the potential to help high-user patients with complex care needs make better choices concerning case management.
Collapse
Affiliation(s)
- Marie-Eve Poitras
- Department of Family Medicine and Emergency Medicine/Nursing School, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Campus Saguenay, Saguenay, QC, Canada. .,Département de la recherche, Centre Intégré Universitaire de Santé et de Services Sociaux du Saguenay-Lac-Saint-Jean, Saguenay, QC, Canada. .,Centre de Recherche Charles-LeMoyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé, Saguenay, QC, Canada.
| | - France Légaré
- Department of Family Medicine and Emergency Medicine, Université Laval, Québec, QC, Canada.,Population Health and Practice-Changing Research, CHU de Québec, Université Laval, Québec, QC, Canada
| | - Vanessa Tremblay Vaillancourt
- Department of Family Medicine and Emergency Medicine/Nursing School, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Campus Saguenay, Saguenay, QC, Canada.,Département de la recherche, Centre Intégré Universitaire de Santé et de Services Sociaux du Saguenay-Lac-Saint-Jean, Saguenay, QC, Canada.,Centre de Recherche Charles-LeMoyne-Saguenay-Lac-Saint-Jean Sur Les Innovations en Santé, Saguenay, QC, Canada
| | - Isabelle Godbout
- Québec SPOR Support Unit, Université du Québec à Montréal, Montréal, QC, Canada
| | | | - Karina Prévost
- Département de la recherche, Centre Intégré Universitaire de Santé et de Services Sociaux du Saguenay-Lac-Saint-Jean, Saguenay, QC, Canada
| | - Claude Spence
- Department of Family Medicine and Emergency Medicine/Nursing School, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Campus Saguenay, Saguenay, QC, Canada
| | | | - Hervé Tchala Vignon Zomahoun
- Department of Social and Preventive Medicine, Université Laval, Québec, QC, Canada.,Centre de Recherche sur ses Soins et les Services de Première Ligne, Université Laval, Québec, QC, Canada
| | | | | | - Mathieu Bujold
- Family Medicine Department, McGill University, Montréal, QC, Canada
| | - Pierre Pluye
- Family Medicine Department, McGill University, Montréal, QC, Canada
| | - Catherine Hudon
- Department of Family Medicine and Emergency Medicine/Nursing School, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Campus Saguenay, Saguenay, QC, Canada.,Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Université de Sherbrooke, Sherbrooke, QC, Canada
| |
Collapse
|
12
|
Robiner WN, Hong BA, Ward W. Psychologists' Contributions to Medical Education and Interprofessional Education in Medical Schools. J Clin Psychol Med Settings 2020; 28:666-678. [PMID: 32564215 DOI: 10.1007/s10880-020-09730-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Recognition of the importance of behavioral and psychological phenomena has grown. Patients and physicians are receptive to psychological insights and processes in health and healthcare. Psychologists serve in diverse roles in medical schools, spanning activities such as didactics, rounds, precepting, supervising, mentoring, participating in educational projects, directing courses, and serving on educational committees. They address multiple content areas fundamental to medicine. Their participation in medical education and professional development activities for faculty are well-regarded. As healthcare becomes more interprofessional, with services delivered via interprofessional teams, opportunities for psychologists to contribute to, and play leadership roles in, interprofessional education (IPE) are expanding. It is critical that psychologists seize them. This article reviews psychologists' historic roles in medical education and provides a snapshot of their educational, faculty development, and IPE activities based on the 2017 survey of members of the Association of Psychologists in Academic Health Centers and their colleagues.
Collapse
Affiliation(s)
- William N Robiner
- Departments of Medicine and Pediatrics, University of Minnesota Medical School, MMC 741, 420 Delaware Street, S. E., Minneapolis, MN, 55455, USA.
| | - Barry A Hong
- Department of Psychiatry, Washington University School of Medicine in St Louis, St. Louis, MO, USA
| | - Wendy Ward
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| |
Collapse
|
13
|
Fullerton LM, Brooks S, Sweezie R, Ahluwalia V, Bombardier C, Gagliardi AR. Patient, Rheumatologist and Therapist Perspectives on the Implementation of an Allied Health Rheumatology Triage (AHRT) Initiative in Ontario Rheumatology Clinics. Pragmat Obs Res 2020; 11:1-12. [PMID: 32095089 PMCID: PMC6995293 DOI: 10.2147/por.s213966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 10/15/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose The objective of this qualitative study was to explore patient, rheumatologist, and extended role practitioner (ERP) perspectives on the integration of an allied health rheumatology triage (AHRT) intervention in Ontario rheumatology clinics. Triage is the process of identifying the urgency of a patient's condition to ensure they receive specialist care within an appropriate length of time. This research explores the clinical/logistical impact of triage by occupational and physical therapists with advanced arthritis training (ERPs), including facilitators and barriers of success, and recommendations for future application. Participants and Methods Semi-structured telephone interviews were held with participating rheumatologists, ERPs, and a sample of patients from each clinical site (4 community, 3 hospital) in five Ontario cities. Interviews were audio-recorded and transcribed verbatim. Transcripts were analyzed using basic qualitative description. Two independent researchers compared coding and achieved consensus. Results Patients (n=10), rheumatologists (n=6), and ERPs (n=5) participated in the study and reported reduced wait-times to rheumatology care, diagnosis, and treatment for those with inflammatory arthritis (IA). Rheumatologists and ERPs perceived that the intervention improved clinical efficiency and quality of care. Patients reported high satisfaction with ERP assessments, valuing early joint examination/laboratory tests, urgent referral if needed, and the provision of information, support, and management strategies. Facilitators of success included: supportive clinical staff, regular communication and collaboration between rheumatologist and ERP, and sufficient clinical space. Recommendations included extending ERP roles to include stable patient follow-up, and ERP care between scheduled rheumatology appointments. Conclusion Findings support the integration of ERPs in a triage role in the community and hospital-based rheumatology models of care. Future research is needed to explore the impact of utilizing ERPs for stable patient follow-up in rheumatology settings.
Collapse
Affiliation(s)
- Laura M Fullerton
- Ontario Best Practices Research Initiative, Toronto General Research Institute, Toronto, ON, Canada
| | - Sydney Brooks
- Ontario Division, Arthritis Society, Toronto, ON, Canada
| | - Raquel Sweezie
- Ontario Division, Arthritis Society, Toronto, ON, Canada
| | - Vandana Ahluwalia
- Department of Rheumatology, William Osler Health System, Brampton, ON, Canada
| | - Claire Bombardier
- Toronto General Research Institute, University of Toronto, Toronto, ON, Canada
| | - Anna R Gagliardi
- Toronto General Research Institute, University of Toronto, Toronto, ON, Canada
| |
Collapse
|
14
|
Agreli HF, Peduzzi M, Silva MC, Mascarelle RCV, Espinoza P. Effects of interprofessional education on teamwork and on knowledge chronic conditions management. Rev Lat Am Enfermagem 2019; 27:e3203. [PMID: 31664411 PMCID: PMC6818655 DOI: 10.1590/1518-8345.3095.3203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 06/30/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Evaluate the effect of interprofessional education on the climate of Primary Health Care teams and on the acquisition of knowledge about management of chronic non-communicable diseases. METHOD Quasi-experimental study of interprofessional education intervention. Seventeen Primary Health Care teams (95 professionals) participated in the study, of which nine teams (50 professionals) composed the intervention group and eight teams (45 participants) composed the control group. The team climate inventory scale and a questionnaire on knowledge about management of chronic conditions in Primary Health Care were applied before and after intervention. Type I error was fixed as statistically significant (p<0.05). RESULTS In the analysis of knowledge about management of chronic conditions, the teams that participated in the interprofessional education intervention presented higher mean post-intervention increase than the teams of the control group (p < 0.001). However, in the analysis of both groups, there was no significant variation in the teamwork climate scores (0.061). CONCLUSION The short interprofessional education intervention carried out during team meetings resulted in improved apprehension of specific knowledge on chronic conditions. However, the short intervention presented no significant impacts on teamwork climate.
Collapse
Affiliation(s)
| | - Marina Peduzzi
- Universidade de São Paulo, Escola de Enfermagem, São Paulo, SP, Brazil
| | | | | | - Pilar Espinoza
- Universidad San Sebastian, Facultad de Ciencias para el Cuidado de la Salud, Santiago, Chile
| |
Collapse
|
15
|
Lovell K, Bee P, Bower P, Brooks H, Cahoon P, Callaghan P, Carter LA, Cree L, Davies L, Drake R, Fraser C, Gibbons C, Grundy A, Hinsliff-Smith K, Meade O, Roberts C, Rogers A, Rushton K, Sanders C, Shields G, Walker L. Training to enhance user and carer involvement in mental health-care planning: the EQUIP research programme including a cluster RCT. PROGRAMME GRANTS FOR APPLIED RESEARCH 2019. [DOI: 10.3310/pgfar07090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background
Service users and carers using mental health services want more involvement in their care and the aim of this research programme was to enhance service user and carer involvement in care planning in mental health services.
Objectives
Co-develop and co-deliver a training intervention for health professionals in community mental health teams, which aimed to enhance service user and carer involvement in care planning. Develop a patient-reported outcome measure of service user involvement in care planning, design an audit tool and assess individual preferences for key aspects of care planning involvement. Evaluate the clinical effectiveness and the cost-effectiveness of the training. Understand the barriers to and facilitators of implementing service user- and carer-involved care planning. Disseminate resources to stakeholders.
Methods
A systematic review, focus groups and interviews with service users/carers/health professionals informed the training and determined the priorities underpinning involvement in care planning. Data from focus groups and interviews were combined and analysed using framework analysis. The results of the systematic review, focus groups/interviews and a review of the training interventions were synthesised to develop the final training intervention. To develop and validate the patient-reported outcome measure, items were generated from focus groups and interviews, and a psychometric analysis was conducted. Patient-reported outcome measure items and a three-round consensus exercise were used to develop an audit tool, and a stated preference survey was undertaken to assess individual preferences for key aspects of care planning. The clinical effectiveness and cost-effectiveness of the training were evaluated using a pragmatic cluster trial with cohort and cross-sectional samples. A nested longitudinal qualitative process evaluation using multiple methods, including semistructured interviews with key informants involved locally and nationally in mental health policy, practice and research, was undertaken. A mapping exercise was used to determine current practice, and semistructured interviews were undertaken with service users and mental health professionals from both the usual-care and the intervention arms of the trial at three time points (i.e. baseline and 6 months and 12 months post intervention).
Results
The results from focus groups (n = 56) and interviews (n = 74) highlighted a need to deliver training to increase the quality of care planning and a training intervention was developed. We recruited 402 participants to develop the final 14-item patient-reported outcome measure and a six-item audit tool. We recruited 232 participants for the stated preference survey and found that preferences were strongest for the attribute ‘my preferences for care are included in the care plan’. The training was delivered to 304 care co-ordinators working in community mental health teams across 10 NHS trusts. The cluster trial and cross-sectional survey recruited 1286 service users and 90 carers, and the primary outcome was the Health Care Climate Questionnaire. Training was positively evaluated. The results showed no statistically significant difference on the primary outcome (the Health Care Climate Questionnaire) (adjusted mean difference –0.064, 95% confidence interval –0.343 to 0.215; p = 0.654) or secondary outcomes at the 6-month follow-up. Overall, the training intervention was associated with a net saving of –£54.00 (95% confidence interval –£193.00 to £84.00), with a net quality-adjusted life-year loss of –0.014 (95% confidence interval –0.034 to 0.005). The longitudinal process evaluation recruited 54 service users, professionals and carers, finding a failure of training to become embedded in routine care.
Limitations
Our pragmatic study was designed to improve service user and care involvement in care planning among routine community mental health services. We intervened in 18 sites with > 300 care co-ordinators. However, our volunteer sites may not be fully representative of the wider population, and we lacked data with which to compare our participants with the eligible population.
Conclusions
We co-developed and co-delivered a training intervention and developed a unidimensional measure of service user and carer involvement in care planning and an audit tool. Despite a high level of satisfaction with the training, no significant effect was found; therefore, the intervention was ineffective. There was a failure of training to become embedded and normalised because of a lack of organisational readiness to accept change. Working with NHS trusts in our ‘Willing Adopters’ programme with enhanced organisational buy-in yielded some promising results.
Future work
Research should focus on developing and evaluating new organisational initiatives in addition to training health-care professionals to address contextual barriers to service and carer involvement in care planning, and explore co-designing and delivering new ways of enhancing service users’ and carers’ capabilities to engage in care planning.
Trial registration
Current Controlled Trials ISRCTN16488358.
Funding
This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 7, No. 9. See the NIHR Journals Library website for further project information.
Collapse
Affiliation(s)
- Karina Lovell
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Penny Bee
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Peter Bower
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - Helen Brooks
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Patrick Cahoon
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | - Lesley-Anne Carter
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - Lindsey Cree
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Linda Davies
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - Richard Drake
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
| | - Claire Fraser
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Chris Gibbons
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Andrew Grundy
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | | | - Oonagh Meade
- School of Health Sciences, University of Nottingham, Nottingham, UK
| | - Chris Roberts
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - Anne Rogers
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Kelly Rushton
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Caroline Sanders
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - Gemma Shields
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, University of Manchester, Manchester, UK
| | - Lauren Walker
- Division of Nursing, Midwifery and Social Work, School of Health Sciences, University of Manchester and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| |
Collapse
|
16
|
Charrette AL, Sullivan KM, Kucharski-Howard J, Seed S, Lorenz L. Physical therapy and pharmacy interprofessional education in the context of a university pro bono physical therapy setting. J Interprof Care 2019; 34:315-323. [PMID: 31538507 DOI: 10.1080/13561820.2019.1663160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Interprofessional care is the standard for quality in healthcare. Interprofessional education (IPE) is an accreditation requirement in many health-care fields. This qualitative study evaluated the benefits of an interprofessional education program for Doctor of Physical Therapy (DPT) and Doctor of Pharmacy (PharmD) students in the context of a pro bono physical therapy setting focused on reducing fall risk among older adults. For each pro bono participant, PharmD and DPT students worked together to analyze fall risk of the participating older adults. PharmD students completed a medication review while the DPT students completed balance assessments. Each profession recommended adjustments to care and presented their findings to peers, faculty, and participants. Following completion of the IPE program, students completed a voluntary evaluation with seven questions requiring semi-structured written reflection regarding their IPE experience. Student reflective responses from 2014-2016 were coded by IPE faculty using a coding guide collaboratively developed by the study team. Descriptive analysis included a summary of code frequency by year, discipline and Interprofessional Education Collaborative core competency: Values and Ethics, Communication, Teams and Teamwork, and Roles and Responsibilities. Values and Ethics were the most frequently coded core competency. Students consistently noted the importance of valuing the other profession, understanding each other's roles, having good interprofessional communication, and working within a health-care team. Additional codes emerged during the analysis process. Written reflective findings suggest that hands-on collaboration, focused on a real-world problem (fall risk) relevant to both PharmD and DPT students, enabled interprofessional care that benefited students through real-world practice of skills learned during coursework, and benefited clinical participants through increased awareness of physical function and medication factors that could affect fall risk. Findings indicate that a pro bono physical therapy setting can provide hands-on learning that meets IPE accreditation requirements and student learning needs while addressing a public health concern.
Collapse
Affiliation(s)
- Ann L Charrette
- School of Physical Therapy, MCPHS University, Worcester, MA, USA
| | | | | | - Sheila Seed
- School of Pharmacy, MCPHS University, Worcester, MA, USA
| | - Laura Lorenz
- Department of Education, Center on Disability Studies, University of Hawaii Manoa, Honolulu, HI, USA
| |
Collapse
|
17
|
Nigenda G, Elliott P, Flores H, Aristizabal P, Martinez-Davalos A. Interprofessional training for the delivery of community health services in Mexico: the experience of Partners in Health. J Interprof Care 2019; 33:382-388. [PMID: 31429333 DOI: 10.1080/13561820.2019.1641475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Interprofessional training in health is scarce in Mexico. Partners in Health (CES in Spanish), is the branch of an international civil society organization that provides health services to poor and rural populations. CES runs a set of ten health centers in Chiapas, Mexico, in partnership with the local Ministry of Health. A key component of the provision strategy is to train healthcare providers, mainly medical and nursing students in their final year of training, to create healthcare teams that work together while fostering their individual capacities. CES offers a diploma on Global Health and Social Medicine, where medical and nursing students -also called pasantes- interact to discuss jointly the effects of global and social determinants of health in local communities, as well as specific clinical topics. A qualitative study including interviews and nonparticipant observations was undertaken to identify initial achievements and challenges of the experience. CES has achieved important benefits related to teamwork as well as clinical capacities of individuals as healthcare providers. However, challenges have emerged: differences in social origin, personal development expectations, professional identity and institutional roles hinder team cohesion. Consequently, CES has introduced adjustments to reduce the negative impact of these differences. Although the training model needs further development, the possibility of transferring some of its good practices to non-CES scenarios should be seriously considered by health authorities.
Collapse
Affiliation(s)
- G Nigenda
- School of Nursing and Obstetrics, National University Autonomous of Mexico , Mexico
| | - P Elliott
- Partners in Health, Mexico and Brigham and Women's Hospital , Boston
| | - H Flores
- Partners in Health , Boston , Mexico
| | - P Aristizabal
- Iztacala School of Higher Studies, National University Autonomous of Mexico , Mexico
| | | |
Collapse
|
18
|
Shell LP, Newton M, Soltis-Jarrett V, Ragaisis KM, Shea JM. Quality improvement and models of behavioral healthcare integration: Position paper #2 from the International Society of Psychiatric-Mental Health Nurses. Arch Psychiatr Nurs 2019; 33:414-420. [PMID: 31280788 DOI: 10.1016/j.apnu.2019.05.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/19/2019] [Indexed: 11/27/2022]
Abstract
This is the second article in a series written to present and address the position of the International Society of Psychiatric-Mental Health Nurses (ISPN) related to the notion of behavioral healthcare integration and the role of nurses in the 21st century. The first article addressed assumptions, definitions and roles related to the integration of behavioral healthcare. The purpose of this article is to focus on Integrated Care within the context of recent initiatives that endeavor to improve quality, safety and reduce costs in the US healthcare system also known as the "Triple Aim" (or more recently, the Quadruple Aim). This paper specifically focuses on the role of nurses and nursing practice by: (a) connecting the concept of integrated behavioral healthcare to quality improvement (QI) and the Quadruple Aim, and (b) highlighting examples of models of integration currently in use. Discussion of models of integration compares ways various models reinforce and actualize integration of behavioral health within primary care, in various special populations across the continuum of care, and in both inpatient and community settings. This paper also stresses innovative training programs offering nurses the skills for learning behavioral health integration through online modules and participation in Interprofessional Education (IPE) activities often through simulation approaches. This 2nd manuscript is consistent with the ISPN 2016 Position Paper and reinforces the necessity for all nurses to be educated on both the Quadruple Aim and behavioral health integration to improve patient care and subsequent care outcomes.
Collapse
Affiliation(s)
- Lynn P Shell
- Rutgers University School of Nursing, Newark, NJ, United States of America.
| | - Marian Newton
- Retention and Progression, Director Psychiatric Mental Health Nursing Practitioner Program, Shenandoah University, Eleanor Wade Custer School of Nursing, Winchester, VA, United States of America
| | - Victoria Soltis-Jarrett
- Carol Morde Ross Distinguished Professor of Psychiatric-Mental Health Nursing, University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, NC, United States of America
| | - Karen M Ragaisis
- Quinnipiac University School of Nursing, Hamden, CT, United States of America
| | - Joyce M Shea
- Fairfield University, Egan School of Nursing and Health Studies, Fairfield, CT, United States of America
| |
Collapse
|
19
|
Lemaire JB, Miller EN, Polachek AJ, Wong H. Stakeholder Groups' Unique Perspectives About the Attending Physician Preceptor Role: A Qualitative Study. J Gen Intern Med 2019; 34:1158-1166. [PMID: 30937665 PMCID: PMC6614296 DOI: 10.1007/s11606-019-04950-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Attending physician preceptors are accountable to many stakeholder groups, yet stakeholders' views about what the preceptor role entails have not been sufficiently considered. OBJECTIVE To explore stakeholder groups' unique perspectives of the preceptor role. DESIGN Qualitative study with a constructivist orientation. PARTICIPANTS Semi-structured interviews were conducted with 73 participants from two university teaching hospitals between October 2012 and March 2014. Participants included representatives from seven stakeholder groups: patients and their families, allied healthcare providers, bedside nurses, nurse managers, medical students, internal medicine residents, and preceptors. APPROACH An inductive thematic analysis was conducted where researchers coded transcripts, abstracted codes into themes, and then mapped themes onto six focus areas: role dimensions, role performance, stressors and rewards, mastery, fulfillment, and impact on others. Two authors then identified "recurrent themes" (emerging in two or more focus areas) and compared them across groups to identify "unique themes" (emerging from a maximum of two stakeholder groups). "Unique thematic emphases" (unique themes that would not have emerged if a stakeholder group was not interviewed) are described. KEY RESULTS Patients and their families emphasized preceptors' ultimate authority. Allied healthcare providers described preceptors as engaged collaborators involved in discharge planning and requiring a sense of humor. Bedside nurses highlighted the need for role standardization. Nurse managers stressed preceptors' need for humanism. Medical students highlighted preceptors' emotional labor and their influence on learners' emotional well-being. Residents emphasized preceptors' responsibilities to multiple stakeholders. Preceptors described lifelong learning and exercising control over one's environment. CONCLUSIONS Various stakeholder groups hold unique and nuanced views of the attending physician preceptor role. These views could broaden formal role guidance for medical education and patient care. This study generated real-world, practical examples of what stakeholders feel are important preceptor skills. These skills should be practiced, taught, and role modeled in this clinical setting.
Collapse
Affiliation(s)
- Jane B Lemaire
- Division of General Internal Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Canada. .,W21C Research and Innovation Center, Cumming School of Medicine, University of Calgary, Calgary, Canada.
| | - Erin Nicole Miller
- Division of Endocrinology and Metabolism, University of Ottawa, Ottawa, Canada
| | - Alicia J Polachek
- W21C Research and Innovation Center, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Holly Wong
- W21C Research and Innovation Center, Cumming School of Medicine, University of Calgary, Calgary, Canada
| |
Collapse
|
20
|
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.
Collapse
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
| | | |
Collapse
|
21
|
Harrison-Blount M, Nester C, Williams A. The changing landscape of professional practice in podiatry, lessons to be learned from other professions about the barriers to change - a narrative review. J Foot Ankle Res 2019; 12:23. [PMID: 31015864 PMCID: PMC6469120 DOI: 10.1186/s13047-019-0333-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 04/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The delivery of healthcare is changing and aligned with this, the podiatry profession continues to change with evidence informed practice and extending roles. As change is now a constant, this gives clinicians the opportunity to take ownership to drive that change forward. In some cases, practitioners and their teams have done so, where others have been reluctant to embrace change. It is not clear to what extent good practice is being shared, whether interventions to bring about change have been successful, or what barriers exist that have prevented change from occurring. The aim of this article is to explore the barriers to changing professional practice and what lessons podiatry can learn from other health care professions. MAIN BODY A literature search was carried out which informed a narrative review of the findings. Eligible papers had to (1) examine the barriers to change strategies, (2) explore knowledge, attitudes and roles during change interventions, (3) explore how the patients/service users contribute to the change process (4) include studies from predominantly primary care in developed countries.Ninety-two papers were included in the final review. Four papers included change interventions involving podiatrists. The barriers influencing change were synthesised into three themes (1) the organisational context, (2) the awareness, knowledge and attitudes of the professional, (3) the patient as a service user and consumer. CONCLUSIONS Minimal evidence exists about the barriers to changing professional practice in podiatry. However, there is substantial literature on barriers and implementation strategies aimed at changing professional practices in other health professions. Change in practice is often resisted at an organisational, professional or service user level. The limited literature about change in podiatry, a rapidly changing healthcare workforce and the wide range of contexts that podiatrists work, highlights the need to improve the ways in which podiatrists can share successful attempts to change practice.
Collapse
|
22
|
Introduction to four reviews addressing critical topics identified by the 2015 Nurse Practitioner Research Agenda Roundtable: Priorities for policy, workforce, education, and practice. J Am Assoc Nurse Pract 2019; 30:667-672. [PMID: 29846306 DOI: 10.1097/jxx.0000000000000035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
BACKGROUND AND PURPOSE In 2015, an invitational think tank was convened by the Fellows of the American Association of Nurse Practitioners to update the 2010 Nurse Practitioner (NP) Research Agenda Roundtable. This effort was undertaken to provide guidance for future health care research. The purpose of this article is to introduce the process used for conducting four reviews that address critical topics related to specific research priorities emanating from the 2015 NP Research Agenda Roundtable. The four reviews are published in this issue of Journal of the American Association of Nurse Practitioners (JAANP) to address the state of current research relevant to NP policy, workforce, education, and practice. METHODS This introductory article provides an overview of the systematic process used to evaluate the four topical area. The type of review selected, the search strategy, critical appraisal, data extraction, and data synthesis will be further described in the four review articles. CONCLUSIONS Four reviews that examine literature regarding specific aims important to NPs will address strengths as well as gaps in the literature. IMPLICATIONS FOR PRACTICE The knowledge offered by the four reviews has the potential to inform future research, which will benefit NPs and other health care stakeholders.
Collapse
|
23
|
McComas MJ, Doctor J, Inglehart MR. Dental and Dental Hygiene Students' Perceptions of Status Quo, Benefits of, and Curricular Suggestions for Shared Learning: On the Road to IPE? J Dent Educ 2019; 83:322-333. [PMID: 30692182 DOI: 10.21815/jde.019.028] [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] [Received: 06/04/2018] [Accepted: 09/12/2018] [Indexed: 11/20/2022]
Abstract
In 29 U.S. academic institutions, dental and dental hygiene students are educated on the same campus. The aims of this study were to explore the perceptions of dental and dental hygiene students on the same campus concerning the status quo of shared educational experiences, the benefits of shared education, and their curricular suggestions for shared education. Additionally, the study investigated whether the number of shared courses was correlated with the perceived benefits of shared learning. A survey was sent in 2016 to a chief administrator at all 29 dental school and dental hygiene programs that were on the same campus, with a request that the administrators forward the invitation email to all their students. A total of 375 dental and 117 dental hygiene students at 12 universities responded. The students reported that three of the nine dental hygiene programs and two of the six dental programs had no shared courses. The majority of dental/dental hygiene students agreed or agreed strongly that having joint classes would allow them to develop better relationships between dental and dental hygiene students (57%/57%) and gain a better understanding of each other's roles (50%/63%) and of what the other discipline "is all about" (54%/46%). Compared to dental hygiene students, dental students were less supportive of suggestions for curricular interventions such as partnering up in lab (on a five-point scale with 5=most positive: 3.99 vs. 3.56; p<0.001), using in-class time for shared group projects (3.83 vs. 3.27; p<0.001), and shadowing in clinics (4.26 vs. 3.16; p<0.001). The more courses dental and dental hygiene students jointly attended, the higher their percentage of clinic time spent on collaborative care (r=0.19; p<0.001). Having dental and dental hygiene programs on the same campus offers opportunities for shared learning, and this study's results suggest those opportunities may translate into increased shared learning.
Collapse
Affiliation(s)
- Martha J McComas
- Martha J. McComas, RDH, MS, is Clinical Assistant Professor, Department of Periodontics and Oral Medicine, Division of Dental Hygiene, University of Michigan School of Dentistry; Julianne Doctor, BS, is Research Assistant, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry; and Marita R. Inglehart, Dr phil habil, is Professor, Department of Periodontics and Oral Medicine, School of Dentistry and Adjunct Professor, Department of Psychology, College of Literature, Science, and Arts, University of Michigan
| | - Julianne Doctor
- Martha J. McComas, RDH, MS, is Clinical Assistant Professor, Department of Periodontics and Oral Medicine, Division of Dental Hygiene, University of Michigan School of Dentistry; Julianne Doctor, BS, is Research Assistant, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry; and Marita R. Inglehart, Dr phil habil, is Professor, Department of Periodontics and Oral Medicine, School of Dentistry and Adjunct Professor, Department of Psychology, College of Literature, Science, and Arts, University of Michigan
| | - Marita R Inglehart
- Martha J. McComas, RDH, MS, is Clinical Assistant Professor, Department of Periodontics and Oral Medicine, Division of Dental Hygiene, University of Michigan School of Dentistry; Julianne Doctor, BS, is Research Assistant, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry; and Marita R. Inglehart, Dr phil habil, is Professor, Department of Periodontics and Oral Medicine, School of Dentistry and Adjunct Professor, Department of Psychology, College of Literature, Science, and Arts, University of Michigan.
| |
Collapse
|
24
|
Desveaux L, Halko R, Marani H, Feldman S, Ivers NM. Importance of Team Functioning as a Target of Quality Improvement Initiatives in Nursing Homes: A Qualitative Process Evaluation. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2019; 39:21-28. [PMID: 30789377 PMCID: PMC6400643 DOI: 10.1097/ceh.0000000000000238] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Quality improvement interventions demonstrate variable degrees of effectiveness. The aim of this work was to (1) qualitatively explore whether, how, and why an academic detailing intervention could improve evidence uptake and (2) identify perceived changes that occurred to inform outcomes appropriate for quantitative evaluation. METHODS A qualitative process evaluation was conducted involving semistructured interviews with nursing home staff. Interviews were analyzed inductively using the framework method. RESULTS A total of 29 interviews were conducted across 13 nursing homes. Standard processes to reduce falls are well-known but not fully implemented due to a range of mostly postintentional factors that influence staff behavior. Conflicting expectations around professional roles impeded evidence uptake; physicians report a disconnection between the information they would like to receive and the information communicated; and a high proportion of casual and part-time staff creates challenges for those looking to effect change. These factors are amenable to change in the context of an active, tailored intervention such as academic detailing. This seems especially true when the entire care team is actively engaged and when the intervention can be tailored to the varied determinants of behaviors across different team members. DISCUSSION Interventions aiming to increase evidence-based practice in the nursing home sector need to move beyond education to explicitly address team functioning and communication. Variability in team functioning requires a flexible intervention with the ability to tailor to individual- and home-level needs. Evaluations in this setting may benefit from measuring changes in team functioning as an early indicator of success.
Collapse
Affiliation(s)
- Laura Desveaux
- Dr. Desveaux: Scientist, Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada, and Assistant Professor, Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada. Ms. Halko: MPH student, Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. Mr. Marani: Research Assistant, Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada. Dr. Feldman: Consultant, Center for Effective Practice, Toronto, Ontario, Canada, and Staff Physician, Baycrest Health Sciencies, Toronto, Ontario, Canada. Dr. Ivers: Clinician-Scientist, Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada, Assistant Professor, Institute for Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada, and Family Physician, Family Practice Health Center, Women's College Hospital, Toronto, Ontario, Canada
| | | | | | | | | |
Collapse
|
25
|
Burgess A, McGregor D. Peer teacher training for health professional students: a systematic review of formal programs. BMC MEDICAL EDUCATION 2018; 18:263. [PMID: 30442139 PMCID: PMC6238310 DOI: 10.1186/s12909-018-1356-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 10/22/2018] [Indexed: 05/21/2023]
Abstract
BACKGROUND Skills in peer teaching, assessment and feedback are documented internationally as required graduate attributes for health professional students, placing emphasis on universities to prepare health professional graduates with teaching skills. The aim of this systematic review was to determine the rational, design, content and evaluation of student peer teacher training skills programs across the health professions. METHODS In October 2017, a search was conducted of five databases (Pubmed, Embase, CINAHL, ERIC and Cochrane Collection) using combinations of key search terms: 'Student as teacher', 'near-peer teaching', 'student teacher', 'peer teacher', 'peer-to-peer', 'undergraduate', 'medical education', 'curriculum', 'program', 'training', 'allied health', 'health science', 'pharmacy', 'nurse', and 'medicine', with results restricted to articles published in English within the decade. Articles were excluded if they were not original research, focused on a teaching approach other than peer assisted learning or teaching, did not adequately describe a student teacher training component of at least 3 hrs duration, or addressed only clinical skills training and not teaching skills training. RESULTS The two authors independently assessed 42 full-text articles for eligibility, with 19 articles satisfying criteria for inclusion. Dominating results were uni-disciplinary, faculty-led, non-mandated programs, targeting participants in senior years of training. Medicine was the dominant profession, with an obvious underrepresentation of the other health professions. Common program content included the foundations of education theory, teaching methods and techniques, and providing feedback. Summary and comparison of program design is restricted by gaps and inconsistencies in reporting, while the evaluation of programs remains largely subjective. CONCLUSIONS Teaching is increasingly recognised as a core professional skill across the health workforce, with expectations to teach peers and colleagues, within and across professional disciplines, as well as to educate patients. Students, faculty and institutes may benefit from training programs being designed for implementation in any health profession; and further to this, implemented within an interprofessionally context. Consistent reporting of teacher training programs, and objective methods of evaluation would enable more in-depth investigation.
Collapse
Affiliation(s)
- Annette Burgess
- The University of Sydney School of Medicine, Education Office, Faculty of Medicine and Health, Sydney, Australia
- Sydney Health Education Research Network (SHERN), The University of Sydney, Sydney, Australia
| | - Deborah McGregor
- The University of Sydney School of Medicine, Education Office, Faculty of Medicine and Health, Sydney, Australia
| |
Collapse
|
26
|
Seselja Perisin A, Mestrovic A, Bozic J, Kacic J, Bukic J, Leskur D, Rusic D, Zekan L, Stipic M, Modun D. Interprofessional pharmacotherapy workshop: intervention to improve health professionals' and students' attitudes towards collaboration between physicians and pharmacists. J Interprof Care 2018; 33:456-463. [PMID: 30403903 DOI: 10.1080/13561820.2018.1541875] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Collaboration between physicians and pharmacists is recognized as an important factor for reducing medication errors and improving patient outcomes. Therefore, two pharmacotherapy workshops were delivered in Croatia - one for pre-registration medical (n=42, 4th-6th year) and pharmacy (n=38, 4th-5th year) students, and the other one for physicians (n=18) and pharmacists (n=23). The purpose of this study was to determine whether participation in common pharmacotherapy workshop could improve attitudes among participants towards interprofessional collaboration between pharmacists and physicians. Attitudes were measured by validated questionnaire "Scale of Attitudes Towards Collaboration Between Pharmacists and Physicians" at the beginning and at the end of the workshops. Three complex clinical scenarios were presented during the workshops. Participants were given general information about cases (all participants) and 2 groups of specific information (only for medical students/physicians and only for pharmacy students/pharmacists). For the first scenario, medical and pharmacy students/professionals were not allowed to exchange their specific information. However, participants collaborated for the 2nd and 3rd scenarios in order to achieve the hypothesized therapeutic goals. Before the workshops, pharmacists and pharmacy students showed more positive attitudes than physicians and medical students. However, the workshop contributed in closing the gap by equating health care professionals' attitudes. Additionally, students' attitudes were more positive after the workshop with an increase of 10% for medical and 2.2% for pharmacy students. This study indicates that interprofessional pharmacotherapy workshops could significantly improve attitudes toward collaboration between physicians and pharmacists for both students and practicing professionals.
Collapse
Affiliation(s)
- Ana Seselja Perisin
- Department of Pharmacy, University of Split School of Medicine , Split , Croatia
| | - Arijana Mestrovic
- Department of Pharmacy, University of Split School of Medicine , Split , Croatia
| | - Josko Bozic
- Department of Pathophysiology, University of Split School of Medicine , Split , Croatia
| | - Jelena Kacic
- Department of Pharmacy, University of Split School of Medicine , Split , Croatia
| | - Josipa Bukic
- Department of Pharmacy, University of Split School of Medicine , Split , Croatia
| | - Dario Leskur
- Department of Pharmacy, University of Split School of Medicine , Split , Croatia
| | - Doris Rusic
- Department of Pharmacy, University of Split School of Medicine , Split , Croatia
| | - Lovre Zekan
- Department of Pharmacy, University of Split School of Medicine , Split , Croatia
| | - Marija Stipic
- Department of Pharmacy, University of Split School of Medicine , Split , Croatia
| | - Darko Modun
- Department of Pharmacy, University of Split School of Medicine , Split , Croatia
| |
Collapse
|
27
|
Hallin K, Gordon M, Sköldenberg O, Henriksson P, Kiessling A. Readmission and mortality in patients treated by interprofessional student teams at a training ward compared with patients receiving usual care: a retrospective cohort study. BMJ Open 2018; 8:e022251. [PMID: 30341125 PMCID: PMC6196845 DOI: 10.1136/bmjopen-2018-022251] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE This study aimed to compare the rate of patient readmissions and mortality between care provided at an orthopaedic interprofessional training ward (IPTW) and usual care. DESIGN Retrospective cohort study. SETTING Orthopaedic wards at a level II trauma centre at a Swedish university teaching hospital between 2006 and 2011. PARTICIPANTS Two cohorts were identified: (1) a control cohort that had not received care at the IPTW, and (2) patients who had been treated for at least 1 day at the IPTW. MAIN OUTCOME MEASURES Readmission at 90 days and 1-year mortality. RESULTS We included 4652 controls and 1109 in the IPTW group. The mean age was 63 years, and 58% were women. The groups did not differ in any of the outcomes: the readmission rate in the control and IPTW groups was 13.5% and 14.0%, respectively, while mortality was 5.2% and 5.3%, respectively. This lack of difference remained after adjusting for confounders. CONCLUSION Interprofessional undergraduate training in patient-based settings can be performed in a level II trauma hospital with satisfactory patient safety.
Collapse
Affiliation(s)
- Karin Hallin
- Division of Orthopaedics, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Max Gordon
- Division of Orthopaedics, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Olof Sköldenberg
- Division of Orthopaedics, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Peter Henriksson
- Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Anna Kiessling
- Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
28
|
Christiansen A, Jacob E, Twigg D. Is it time to consider a four year Nursing Bachelor Degree in Australia? A discussion paper. Collegian 2018. [DOI: 10.1016/j.colegn.2018.01.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
29
|
El-Awaisi A, Joseph S, El Hajj MS, Diack L. A comprehensive systematic review of pharmacy perspectives on interprofessional education and collaborative practice. Res Social Adm Pharm 2018; 14:863-882. [DOI: 10.1016/j.sapharm.2017.11.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 10/25/2017] [Accepted: 11/01/2017] [Indexed: 10/18/2022]
|
30
|
Reid AM, Fielden SA, Holt J, MacLean J, Quinton ND. Learning from interprofessional education: A cautionary tale. NURSE EDUCATION TODAY 2018; 69:128-133. [PMID: 30055406 DOI: 10.1016/j.nedt.2018.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 07/06/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Interprofessional education (IPE) is time consuming to develop and sustain and presents many logistical and practical challenges to curriculum developers. Drawing on findings from an evaluation study of an IPE pilot, this paper brings new insights into both positive implications and potentially negative consequences of delivering large scale IPE. OBJECTIVE The aim of the study was to evaluate a large scale IPE pilot delivered to students in the first year of their training. DESIGN AND SETTING The IPE pilot took place on campus and was focused on patient safety (human factors). PARTICIPANTS The study involved 630 first year undergraduates across 10 programmes at a UK university. METHODS A mixed methods evaluation was conducted comprising a paper-based survey circulated at the end of the taught session followed by uni-professional focus groups (n = 4). Questionnaire data was subject to descriptive statistical analysis and key themes were generated from the focus group data. RESULTS Three overarching themes emerged from analysis of the qualitative data: Understanding differences in roles, Learning about stereotypes and Unintended perpetuation of stereotypes. CONCLUSIONS IPE is an important part of the training of all health and social care professionals and the study revealed many benefits of this approach. However, we should be sensitive to the possibility of inadvertently perpetuating negative stereotypes as a consequence of IPE activities. Our work highlights the need for caution when considering the planning and executing IPE activities.
Collapse
Affiliation(s)
- Anne-Marie Reid
- Leeds Institute of Medical Education, University of Leeds, Woodhouse Lane, Leeds LS2 9JT, UK.
| | - Shelley A Fielden
- Leeds Institute of Medical Education, University of Leeds, Woodhouse Lane, Leeds LS2 9JT, UK.
| | - Janet Holt
- School of Healthcare, University of Leeds, Woodhouse Lane, Leeds LS2 9JT, UK.
| | - Joan MacLean
- School of Healthcare, University of Leeds, Woodhouse Lane, Leeds LS2 9JT, UK.
| | - Naomi D Quinton
- Leeds Institute of Medical Education, University of Leeds, Woodhouse Lane, Leeds LS2 9JT, UK.
| |
Collapse
|
31
|
Silver IL, Leslie K. Faculty Development for Continuing Interprofessional Education and Collaborative Practice. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2018; 37:262-267. [PMID: 29227431 DOI: 10.1097/ceh.0000000000000178] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This article proposes a framework for faculty development in continuing interprofessional education (CIPE) and collaborative practice. The framework is built on best practices in faculty development and CIPE. It was informed by local experience in the development, delivery, and evaluation of a faculty development program to promote capacity for dissemination of concepts relating to interprofessional education (IPE) and interprofessional collaboration (IPC) in health care environments. Interprofessional education has been demonstrated in clinical contexts to enhance interprofessional collaboration, patient care, and health outcomes. With curriculum design, teaching methods, and educational strategies in faculty development, it is possible to enhance the impact of IPE in clinical contexts. Faculty development activities themselves can model effective interprofessional education methods and practice. An IPE curriculum and teaching and education strategies are outlined. Strategic planning, including the application of a systems approach, attention to the principles of effective learning, and an outcomes-based curriculum design are recommended for the development of continuing IPE faculty development programs that enhance interprofessional collaboration.
Collapse
Affiliation(s)
- Ivan L Silver
- Dr. Silver: Vice-Dean, Continuing Education and Professional Development, Director of the Centre for Faculty Development at St. Michael's Hospital, Department of Psychiatry, Faculty of Medicine, University of Toronto. Dr. Leslie: Associate Director, Centre for Faculty Development at St. Michael's Hospital, Department of Paediatrics, Faculty of Medicine, University of Toronto
| | | |
Collapse
|
32
|
Sollami A, Caricati L, Mancini T. Does the readiness for interprofessional education reflect students' dominance orientation and professional commitment? Evidence from a sample of nursing students. NURSE EDUCATION TODAY 2018; 68:141-145. [PMID: 29929100 DOI: 10.1016/j.nedt.2018.06.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 04/20/2018] [Accepted: 06/05/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Interprofessional education is an important factor in facilitating subsequent interprofessional collaboration. Therefore, implementing this teaching strategy is important to increase the chances that future professionals will work effectively together. Group membership, status and the power differential among professional groups are factors that can hinder both interprofessional education and collaboration. From a psychosocial point of view, interprofessional education may be described as an intergroup context in which members of different status groups interact. It involves at least two main psychosocial processes: commitment to the profession and acceptance or challenge of interprofessional hierarchy. OBJECTIVES The purpose of this research was to analyse the effects of professional commitment and social dominance orientation on attitudes toward interprofessional education. DESIGN A cross-sectional design was conducted. PARTICIPANTS A total of 137 nursing science students from an Italian university were enrolled in this research. METHODS Participants were surveyed using a questionnaire measuring attitudes toward interprofessional education, professional commitment and social dominance orientation. RESULTS The more that students showed social dominance orientation, the less they were willing to engage in interprofessional education. This effect was qualified by an interaction with professional commitment. When professional commitment was higher, social dominance orientation was weakly related to attitude toward interprofessional learning. CONCLUSIONS These results suggest that there is a belief that professional hierarchy is deserved and that this may decrease a nursing student's engagement in interprofessional education; however, this may be contrasted by an increased professional commitment.
Collapse
Affiliation(s)
| | - Luca Caricati
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Italy
| | - Tiziana Mancini
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Italy
| |
Collapse
|
33
|
Adamson K, Loomis C, Cadell S, Verweel LC. Interprofessional empathy: A four-stage model for a new understanding of teamwork. J Interprof Care 2018; 32:752-761. [DOI: 10.1080/13561820.2018.1511523] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Keith Adamson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Colleen Loomis
- O’Leary Faculty of Science, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Susan Cadell
- School of Social Work, Renison University College, Waterloo, Ontario, Canada
| | | |
Collapse
|
34
|
Halle AD, Mroz TM, Fogelberg DJ, Leland NE. Occupational Therapy and Primary Care: Updates and Trends. Am J Occup Ther 2018; 72:7203090010p1-7203090010p6. [PMID: 29689169 PMCID: PMC5915228 DOI: 10.5014/ajot.2018.723001] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
As our health care system continues to change, so do the opportunities for occupational therapy. This article provides an update to a 2012 Health Policy Perspectives on this topic. We identify new initiatives and opportunities in primary care, explore common challenges to integrating occupational therapy in primary care environments, and highlight international works that can support our efforts. We conclude by discussing next steps for occupational therapy practitioners in order to continue to progress our efforts in primary care.
Collapse
Affiliation(s)
- Ashley D Halle
- Ashley D. Halle, OTD, OTR/L, is Assistant Professor and Coordinator of Primary Care Residency & Services, Mrs. T. H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles;
| | - Tracy M Mroz
- Tracy M. Mroz, PhD, OTR/L, is Assistant Professor, Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Donald J Fogelberg
- Donald J. Fogelberg, PhD, OTR/L, is Associate Professor, Division of Occupational Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Natalie E Leland
- Natalie E. Leland, PhD, OTR/L, BCG, FAOTA, is Associate Professor, Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA
| |
Collapse
|
35
|
El-Awaisi A, Saffouh El Hajj M, Joseph S, Diack L. Perspectives of pharmacy students in Qatar toward interprofessional education and collaborative practice: a mixed methods study. J Interprof Care 2018; 32:674-688. [PMID: 30052106 DOI: 10.1080/13561820.2018.1498466] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
In an IPE environment, students are expected to have better understanding of the roles, responsibilities, and contribution of other health care professions to enhance interprofessional working and collaboration with an end result of improving patient-centred and team-based care. Although many studies have investigated students' attitudes, very few employ a mixed methods design and hardly are from Middle Eastern countries. A two-staged sequential explanatory mixed method design was used to comprehensively capture the perspectives of pharmacy students toward IPE and collaborative practice. A quantitative survey was conducted as the first stage of the study, followed by an in-depth discussion of these perspectives through a qualitative phase by conducting two focus groups. For the quantitative surveys, the overall response rate was 102/132 (77%) for pharmacy students in Qatar. This was followed by two focus groups with a total of 27 participants from senior and junior students. In exploring the qualitative data, three main themes were identified in relation to the pharmacy students' perspectives. These were on the pharmacy students' perception on the enablers (professional related benefits, patient-related benefits and current positive influences), barriers (previous IPE experiences, educational related issues and current working practices and processes), and recommendations to implementing IPE and collaborative practice (future IPE and pharmacy profession).Overall, the results demonstrate a strong readiness and positive perception by pharmacy students toward IPE and collaborative practice. This study has highlighted different dimensions in pharmacy students' perceptions. It also provided a useful insight into the readiness of pharmacy students in a Middle Eastern university. Students are seeking more IPE experiences formally incorporated into their curriculum and hence educators should capitalise on these positive and enthusiastic attitudes to identify the most effective means for delivering IPE and inform curricula planning. Collaborative practice-ready graduates will produce better-educated professionals delivering higher quality care.
Collapse
Affiliation(s)
- Alla El-Awaisi
- College of Pharmacy, Qatar University, Doha, Qatar.,School of Nursing & Midwifery, Faculty of Health and Social Care, The Robert Gordon University, Scotland, UK
| | | | - Sundari Joseph
- School of Nursing & Midwifery, Faculty of Health and Social Care, The Robert Gordon University, Scotland, UK
| | - Lesley Diack
- School of Pharmacy and Life Sciences, Faculty of Health and Social Care, The Robert Gordon University, Scotland, UK
| |
Collapse
|
36
|
Riskiyana R, Claramita M, Rahayu GR. Objectively measured interprofessional education outcome and factors that enhance program effectiveness: A systematic review. NURSE EDUCATION TODAY 2018; 66:73-78. [PMID: 29684835 DOI: 10.1016/j.nedt.2018.04.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 03/14/2018] [Accepted: 04/12/2018] [Indexed: 06/08/2023]
Abstract
Several studies have been conducted to evaluate the implementation of interprofessional education (IPE) across the globe. By looking at the timeline of each previous study, it can be inferred that the implementation of IPE has been improving continuously. However, the effectiveness of IPE still cannot be easily generalized due to misconceptions regarding how interprofessional collaboration capabilities should be evaluated. This study aims to generalize the learning outcomes that were produced by IPE in a global context and analyse the contributing factors. A systematic review was conducted within seven online databases as well as paperback periodical publications to search for the intended articles. A set of four criterions were assigned prior to the study using the standard Population-Intervention-Context-Outcome (PICO) model to ensure the included articles matched the study objectives. The quality of studies were appraised using the Medical Education Research Study Quality Improvement (MERSQI). Each included article was analysed using the narrative method to obtain the relevant information. Sixteen articles included in this study showed that IPE improved interprofessional collaborative knowledge, skills, and behaviour based on objective measurements. Complexity of the learning material, appropriateness of the program design, and referral to a specific standard of competence were assumed to play significant role towards the effectiveness of interprofessional education. This study results in several recommendation for future development of IPE, including a specific suggestion for its development in Asia region.
Collapse
Affiliation(s)
- R Riskiyana
- Postgraduate Program of Medical Education, Faculty of Medicine, Universitas Gadjah Mada, Indonesia.
| | - M Claramita
- Department of Medical Education, Faculty of Medicine, Universitas Gadjah Mada, Indonesia
| | - G R Rahayu
- Department of Medical Education, Faculty of Medicine, Universitas Gadjah Mada, Indonesia
| |
Collapse
|
37
|
Liaw SY, Carpio GAC, Lau Y, Tan SC, Lim WS, Goh PS. Multiuser virtual worlds in healthcare education: A systematic review. NURSE EDUCATION TODAY 2018; 65:136-149. [PMID: 29571002 DOI: 10.1016/j.nedt.2018.01.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 11/27/2017] [Accepted: 01/11/2018] [Indexed: 05/22/2023]
Abstract
BACKGROUND The use of multiuser virtual worlds (MUVWs) for collaborative learning has generated interest among healthcare educators. Published evidence to support its use is growing, but none has synthesized the evidence to guide future work. OBJECTIVE This study sought to provide a comprehensive and systematic evaluation of MUVWs in healthcare education. DESIGN A systematic review METHODS: A systematic search of five databases including CINAHL, Cochrane library, EMBASE, PubMed, and Scopus, was conducted from inception up to January 2017. Two independent researchers selected studies that met the inclusion criteria and assessed for methodological quality using the Medical Education Research Study Quality Instrument (MERSQI). A total of 18 studies were reviewed and their data were synthesized narratively using a 3-P model (presage-process-product). RESULTS Average scores in the MERSQI for methodological quality are 10/18, which is modest. A rally by the government or professional bodies towards more collaborative working among healthcare professionals is a key driver behind implementing MUVWs. Funding is important for its development and evaluation. Team training in acute care and communication training were the most frequent learning objectives, and predominant learning activities include practice on simulation scenario and debriefing. Two-thirds of the studies did not explain their theoretical framework that underpinned their design and implementation of MUVWs. While MUVWs in healthcare education is generally well-received, learning outcomes remain inconclusive. CONCLUSION Despite a growth of studies on the use of MUVW in healthcare education, there is a need for more understanding of the application of theories to inform the learning activities. Therefore, we suggest educators to incorporate a theoretical model to explain the learning processes behind MUVWs. To improve the quality of evidence, we call for researchers to employ a more rigorous and broader approach to evaluation that explicates longer-term outcomes, including cost benefit analyses.
Collapse
Affiliation(s)
- Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Guiller Augustin C Carpio
- Centre for Learning Environment & Assessment Development (CoLEAD), Singapore Institute of Technology, Singapore.
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Seng Chee Tan
- National Institute of Education, Nanyang Technological University, Singapore.
| | - Wee Shiong Lim
- Department of Geriatric Medicine, Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Singapore.
| | - Poh Sun Goh
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| |
Collapse
|
38
|
Thomas J, Kumar K, Chur-Hansen A. What does learning together mean for pharmacy and medicine students: is it really about from and with? MEDEDPUBLISH 2018; 7:110. [PMID: 38074612 PMCID: PMC10699384 DOI: 10.15694/mep.2018.0000110.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023] Open
Abstract
This article was migrated. The article was marked as recommended. Healthcare students from different professional backgrounds are often brought together under the banner of Interprofessional Education (IPE) in an effort to improve collaborative practice. Despite the demonstrated positive impact of IPE on students' knowledge, skills and attitudes, it is not clear what students think about learning with students from another health profession. The aim of this study was to explore pharmacy and medicine students' views and experiences of learning together. Participants were Year 3 Pharmacy and Year 4 Medicine students, with qualitative data gathered via a written reflection. Three main themes were identified. Students were accepting of learning with the other professional group. Learning about was evident, particularly in relation to each other's roles and contributions to patient care. Learning from another professional group was the most problematic as students tended to view and treat knowledge as a commodity to be acquired from another rather than something that could be jointly developed. While medicine and pharmacy students' valued learning with and about each other, they were less likely to engage in co-constructing and sharing new meanings and thus learn from one another. To provide a basis for meaningful collaborative practice, IPE needs to challenge students' fundamental assumptions, beliefs and values about learning with, from and about other professions.
Collapse
|
39
|
Kaste LM, Halpern LR. The Barber Pole Might Have Been an Early Sign for Patient-Centered Care: What Do Interprofessional Education and Interprofessional Collaborative Practice Look Like Now? Dent Clin North Am 2018; 60:765-88. [PMID: 27671953 DOI: 10.1016/j.cden.2016.05.011] [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: 11/28/2022]
Abstract
In 2009, the Interprofessional Education Collaborative (IPEC) was initiated. Its release of interprofessional collaborative practice (ICP) core competencies in 2011 was pivotal for the engagement of health care professionals, including dentistry; in patient-centered, collaborative efforts for interprofessional education (IPE); and ICP. Thereby, IPEC is helping to put into application, in North America, the 2010 World Health Organization (WHO) Framework for Action on Interprofessional Education and Collaborative Practice. This article introduces IPE/ICP in 5 phases of evolution, emphasizing dental influence and inclusion, from historical perspectives through current applications that are expanded on in the accompanying articles elsewhere in this issue.
Collapse
Affiliation(s)
- Linda M Kaste
- Department of Pediatric Dentistry, College of Dentistry, University of Illinois at Chicago, 801 South Paulina Street, MC 850, Room 563A, Chicago, IL 60612, USA.
| | - Leslie R Halpern
- Department of Oral and Maxillofacial Surgery, Meharry Medical College, 1005 DB Todd Jr. Boulevard, Nashville, TN 37208, USA
| |
Collapse
|
40
|
Butterworth K, Rajupadhya R, Gongal R, Manca T, Ross S, Nichols D. A clinical nursing rotation transforms medical students' interprofessional attitudes. PLoS One 2018; 13:e0197161. [PMID: 29795598 PMCID: PMC5967832 DOI: 10.1371/journal.pone.0197161] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 04/27/2018] [Indexed: 11/19/2022] Open
Abstract
This study explores the extent to which a one-week nursing rotation for medical students changed the interprofessional attitudes of the participating nurses and students. Third-year medical students worked with nurses before starting clinical rotations. Pre- and post-experience surveys assessing perceptions of mutual respect, nurse-doctor roles, and interprofessional communication and teamwork were given to 55 nurses and 57 students. The surveys consisted of qualitative questions and a Likert scale questionnaire that was analyzed using qualitative and quantitative content analyses. The response rate was 51/57 (89%) students and 44/55 (80%) nurse preceptors. Nurses reported that students met nurses’ expectations by displaying responsibility, respect, effective communication, and an understanding of nursing roles. Medical students’ narratives demonstrated two significant changes. First, their views of nurses changed from that of physician helpers to that of collaborative patient-centred professionals. Second, they began defining nursing not by its tasks, but as a caring- and communication-centred profession. Responses to Likert-scaled questions showed significant differences corresponding to changes described in the narrative. A one-week immersive clinical nursing rotation for medical students was a transformative way of learning interprofessional competencies. Learning in an authentic workplace during a clinical rotation engendered mutual respect between nurses and future doctors. Students’ view of the role of nurses changed from nurses working for doctors with patients, to working with doctors for patients.
Collapse
Affiliation(s)
- Katrina Butterworth
- Department of General Practice, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Rashmi Rajupadhya
- School of Nursing, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Rajesh Gongal
- Department of General Surgery, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Terra Manca
- Canadian Center for Vaccinology, Dalhousie University, Halifax, Canada
| | - Shelley Ross
- Department of Family Medicine, University of Alberta, Edmonton, Canada
| | - Darren Nichols
- Department of Family Medicine, University of Alberta, Edmonton, Canada
- * E-mail:
| |
Collapse
|
41
|
Homeyer S, Hoffmann W, Hingst P, Oppermann RF, Dreier-Wolfgramm A. Effects of interprofessional education for medical and nursing students: enablers, barriers and expectations for optimizing future interprofessional collaboration - a qualitative study. BMC Nurs 2018; 17:13. [PMID: 29643742 PMCID: PMC5891914 DOI: 10.1186/s12912-018-0279-x] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 02/27/2018] [Indexed: 01/10/2023] Open
Abstract
Background To ensure high quality patient care an effective interprofessional collaboration between healthcare professionals is required. Interprofessional education (IPE) has a positive impact on team work in daily health care practice. Nevertheless, there are various challenges for sustainable implementation of IPE. To identify enablers and barriers of IPE for medical and nursing students as well as to specify impacts of IPE for both professions, the 'Cooperative academical regional evidence-based Nursing Study in Mecklenburg-Western Pomerania' (Care-N Study M-V) was conducted. The aim is to explore, how IPE has to be designed and implemented in medical and nursing training programs to optimize students' impact for IPC. Methods A qualitative study was conducted using the Delphi method and included 25 experts. Experts were selected by following inclusion criteria: (a) ability to answer every research question, one question particularly competent, (b) interdisciplinarity, (c) sustainability and (d) status. They were purposely sampled. Recruitment was based on existing collaborations and a web based search. Results The experts find more enablers than barriers for IPE between medical and nursing students. Four primary arguments for IPE were mentioned: (1) development and promotion of interprofessional thinking and acting, (2) acquirement of shared knowledge, (3) promotion of beneficial information and knowledge exchange, and (4) promotion of mutual understanding. Major barriers of IPE are the coordination and harmonization of the curricula of the two professions. With respect to the effects of IPE for IPC, experts mentioned possible improvements on (a) patient level and (b) professional level. Experts expect an improved patient-centered care based on better mutual understanding and coordinated cooperation in interprofessional health care teams. To sustainably implement IPE for medical and nursing students, IPE needs endorsement by both, medical and nursing faculties. Conclusion In conclusion, IPE promotes interprofessional cooperation between the medical and the nursing profession. Skills in interprofessional communication and roles understanding will be primary preconditions to improve collaborative patient-centered care. The impact of IPE for patients and caregivers as well as for both professions now needs to be more specifically analysed in prospective intervention studies.
Collapse
Affiliation(s)
- Sabine Homeyer
- 1Institute for Community Medicine, Department Epidemiology of Health Care and Community Health, University Medicine Greifswald, Ellernholzstr. 1-2, 17487 Greifswald, Germany
| | - Wolfgang Hoffmann
- 1Institute for Community Medicine, Department Epidemiology of Health Care and Community Health, University Medicine Greifswald, Ellernholzstr. 1-2, 17487 Greifswald, Germany
| | - Peter Hingst
- 2Nursing Board, University Medicine Greifswald, Fleischmannstraße 8, 17475 Greifswald, Germany
| | - Roman F Oppermann
- 3Department Nursing, Health and Administration, University of Applied Science Neubrandenburg, Brodaerstr. 2, 17033 Neubrandenburg, Germany
| | - Adina Dreier-Wolfgramm
- 1Institute for Community Medicine, Department Epidemiology of Health Care and Community Health, University Medicine Greifswald, Ellernholzstr. 1-2, 17487 Greifswald, Germany
| |
Collapse
|
42
|
de Oliveira VF, Bittencourt MF, Navarro Pinto ÍF, Lucchetti ALG, da Silva Ezequiel O, Lucchetti G. Comparison of the Readiness for Interprofessional Learning and the rate of contact among students from nine different healthcare courses. NURSE EDUCATION TODAY 2018; 63:64-68. [PMID: 29407263 DOI: 10.1016/j.nedt.2018.01.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 12/11/2017] [Accepted: 01/19/2018] [Indexed: 06/07/2023]
Abstract
BACKGROUND Despite the growth in the interprofessional literature, there are still few studies that have evaluated the differences among courses and periods in relation to Readiness for Interprofessional Learning. Likewise, the relationship between the influences of contact among students from different professions is still controversial. OBJECTIVES To evaluate whether greater contact among students from diverse health courses could be associated with improved Readiness for Interprofessional Learning (RIPLS) at the undergraduate level and to compare the RIPLS among healthcare courses, analyzing differences among courses and periods of their academic training. DESIGN Cross-sectional study. SETTING A Brazilian public university. PARTICIPANTS Students enrolled in the first and final periods of nine healthcare courses. METHODS The rates of contact between students and the Readiness for Interprofessional Learning were assessed. A comparison between students from these nine healthcare courses was carried out. RESULTS A total of 545 (73.45%) students answered the questionnaire. The highest RIPLS scores were from Nursing (42.39), Dentistry (41.33) and Pharmacy students (40.72) and the lowest scores were from Physical Education (38.02), Medicine (38.17) and Psychology (38.66) students. The highest rates of contact between students (RC) were from Physical Education, Nutrition and Psychology students and the lowest RC were from Pharmacy, Social service and Dentistry. There was a significant effect of "healthcare course" on RIPLS. Comparing RIPLS and RC between the first and final years we found that, considering all courses, there was an increase in the RC, whereas a decrease in RIPLS scores. No correlation was found between RIPLS and RC in general. CONCLUSION The current study found that RIPLS scores are very different between healthcare students. Although we found a significant increase in the RC, there was a decrease in the RIPLS scores. These findings lead to a greater understanding of the difficulties facing and potential for interprofessional education.
Collapse
Affiliation(s)
| | | | | | | | | | - Giancarlo Lucchetti
- Department of Medical Education, School of Medicine, Federal University of Juiz de Fora, Brazil.
| |
Collapse
|
43
|
Baert V, Escutnaire J, Nehme Z, Mols P, Lagadec S, Vilhelm C, Jacob L, Wiel E, Adnet F, Hubert H. Development of an online, universal, Utstein registry-based, care practice report card to improve out-of-hospital resuscitation practices. J Eval Clin Pract 2018; 24:431-438. [PMID: 29356255 DOI: 10.1111/jep.12880] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/20/2017] [Accepted: 12/21/2017] [Indexed: 11/28/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Care quality is a primary concern in health field. In France, the care practice report card (CPRC) is compulsory for practitioners. It is the first step towards the culture of excellence. In this context, practitioners have to assess and improve their practices. Competent authorities define registries as reliable sources for CPRC. The first aim of this work is to describe how we designed and built a universally transposable CPRC model based on an Utstein-style cardiac arrest registry. The second aim is to measure the adherence of practitioners to this approach and to show how such a tool can be used in real situation. METHODS Our report card is adapted from in-hospital CA care quality and safety indicators. We built a 2-section grid. The first part described the quality and completeness of the analysed data. The second part distinguished medical and traumatic CA and assesses care practices. We analysed the practitioners' adherence thanks to a satisfaction survey. Finally, we presented a CPRC case study. RESULTS This tool was tested in 92 centres gathering 8433 patients. The satisfaction survey showed that this CPRC was well accepted by emergency professionals. We presented an implementation example of this tool in a centre in real-life situation. CONCLUSIONS We designed and implemented a fully automated CPRC tool routinely usable for Utstein-style CA registries. This CPRC is easily transferable in all other Utstein CA registries. The debriefing report source codes are freely distributed upon request. This tool enables the care assessment and improvement.
Collapse
Affiliation(s)
- Valentine Baert
- French National Out-of-Hospital Cardiac Arrest Registry (RéAC), Lille, France.,Public Health Department (EA 2694), Lille University, Lille, France
| | - Joséphine Escutnaire
- French National Out-of-Hospital Cardiac Arrest Registry (RéAC), Lille, France.,Public Health Department (EA 2694), Lille University, Lille, France
| | - Ziad Nehme
- Department of Research and Evaluation, Ambulance Victoria, Doncaster, and Department of Epidemiology and Preventive Medicine, Monash University, Prahran, Victoria, Australia
| | - Pierre Mols
- Saint-Pierre University Hospital, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Steven Lagadec
- Centre Sud-Francilien Hospital, Corbeil Essonnes, France
| | - Christian Vilhelm
- French National Out-of-Hospital Cardiac Arrest Registry (RéAC), Lille, France.,Public Health Department (EA 2694), Lille University, Lille, France
| | - Line Jacob
- Department of Emergency Medicine, SAMU 77, Melun, France
| | - Eric Wiel
- Public Health Department (EA 2694), Lille University, Lille, France.,Department of Emergency Medicine, SAMU du Nord and Emergency Department for Adults, Lille, France
| | - Frédéric Adnet
- AP-HP, Department of Emergency Medicine, Hôpital Avicenne, Inserm U942, Paris 13 University, Bobigny, France
| | - Hervé Hubert
- French National Out-of-Hospital Cardiac Arrest Registry (RéAC), Lille, France.,Public Health Department (EA 2694), Lille University, Lille, France
| | -
- French National Out-of-Hospital Cardiac Arrest Registry (RéAC), Lille, France
| |
Collapse
|
44
|
Interprofessional Education of Allied Health Professionals – Perspectives of Experts / Interprofessionelles Lehren und Lernen in den Gesundheitsprofessionen aus Sicht von Experten/-innen. INTERNATIONAL JOURNAL OF HEALTH PROFESSIONS 2018. [DOI: 10.2478/ijhp-2018-0004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Given increasing requirements for health care services, interprofessional cooperation between healthcare professions has been recently gaining momentum. To ensure that cooperation with other healthcare professionals does not occur for the first time in clinical settings, several projects have been developed over the past years in Germany, aiming to prepare future clinicians for interprofessional cooperation during their study or vocational training programs. The conceptual diversity underlying these projects is reflected for instance in their target groups, as well as in their different structures, contents and aims. The prevailing heterogeneity in this field partly results of structural decisions made by project designers. The present study aims to explore the perspectives of experts involved in the development of those interprofessional education programs. Accordingly, this paper aims to provide information on the perspectives of a population which has until now received little consideration in this context, and to identify and describe opportunities and challenges for the implementation of interprofessional teaching and learning processes.
Relevant categories providing a systematic representation of the study results could be extracted based on the content analysis of qualitative, semi-structured expert interviews.
The study results show that interprofessional cooperation between health professions is inextricably linked with interprofessional education. At the same time, current projects and publications still rank low on the general and relevant policy-making agenda. This points to the need for the provision of more support and necessary structural and organizational conditions for interprofessional teaching, as well as to significantly intensify discussions on the topic on various levels.
Collapse
|
45
|
Jasper R, Chester H, Hughes J, Abendstern M, Loynes N, Sutcliffe C, Davies L, Challis D. Practitioners preferences of care coordination for older people: A discrete choice experiment. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2018; 61:151-170. [PMID: 29252115 DOI: 10.1080/01634372.2017.1417342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
These findings demonstrate the importance of organisations providing care coordination for older people receiving long-term funding. Further research is required to investigate the influence of service setting on practitioner preferences. This study explored practitioner preferences about the relative value of attributes of care coordination services for older people. A Discrete Choice Experiment (DCE) survey was used to identify the views of 120 practitioners from 17 services in England in 2015. The survey design was informed by an analysis of standards of care coordination, a postal survey and a consultation with carers of older people. Results of the DCE survey were supplemented by a content analysis of qualitative comments and fieldwork notes. Most respondents were over 30 years of age, female and almost half worked part-time. Continuity of care (care provided by the same care coordinator) and the ability to access the range of services outlined in the care plan were the most important service attributes. Service setting influenced practitioner preferences. Those in specialist services for people with dementia identified the length of time a service was provided as another important attribute. The DCE methodology has provided the opportunity to systematically canvas practitioner preferences.
Collapse
Affiliation(s)
- Rowan Jasper
- a Personal Social Services Research Unit , University of Manchester , Manchester , UK
| | - Helen Chester
- a Personal Social Services Research Unit , University of Manchester , Manchester , UK
| | - Jane Hughes
- a Personal Social Services Research Unit , University of Manchester , Manchester , UK
| | - Michele Abendstern
- a Personal Social Services Research Unit , University of Manchester , Manchester , UK
| | - Niklas Loynes
- a Personal Social Services Research Unit , University of Manchester , Manchester , UK
| | - Caroline Sutcliffe
- a Personal Social Services Research Unit , University of Manchester , Manchester , UK
| | - Linda Davies
- b Manchester Centre for Health Economics , University of Manchester , Manchester , UK
| | - David Challis
- a Personal Social Services Research Unit , University of Manchester , Manchester , UK
| |
Collapse
|
46
|
Henry M, Frenkiel S, Chartier G, MacDonald C, Payne RJ, Black MJ, Mlynarek AM, Zeitouni A, Kost K, Loiselle C, Ehrler A, Rosberger Z, Tamilia M, Chang YX, de la Mora C, Arbaud C, Hier MP. Thyroid cancer patients receiving an interdisciplinary team-based care approach (ITCA-ThyCa) appear to display better outcomes: Program evaluation results indicating a need for further integrated care and support. Psychooncology 2018; 27:937-945. [PMID: 29178318 DOI: 10.1002/pon.4590] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 10/18/2017] [Accepted: 11/14/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND Thyroid cancer (ThyCa) is generally associated with a favorable prognosis and excellent surgical outcomes. Consequently, its treatment is medically focused and current guidelines recommend interdisciplinary care including access to a nurse for complex cases alone. To date, no studies have evaluated the need for and impact of an Interdisciplinary Team-based Care Approach (ITCA-ThyCa) for general thyroid cancer patients, including a dedicated nurse as part of a larger interdisciplinary team, as well as patient-reported outcomes, as is recommended worldwide in cancer care. Our aim was to evaluate such a program. METHODS The ITCA-ThyCa was evaluated within a quasi-experimental design using the Centers for Disease Control Framework for Program Evaluation, including process and outcome measures. Patients eligible were adults with a biopsy indicating confirmed or highly suspicious ThyCa (TNM-Classification + Bethesda score of V/VI). The intervention group (IG) received ITCA-ThyCa and the comparison group (CG), usual care alone. RESULTS In our sample comprised of 200 participants (122 IG; 78 CG), ITCA-ThyCa patients appeared to show significantly better outcomes than CG patients, namely, higher levels of overall well-being (P = .001) and fewer physical (P = .003) and practical (P = .003) issues and concerns. More satisfied with their overall care (P = .028), including care coordination (P = .049), they reported their health care provider as more approachable (P = .007), respectful (P = .005), and trustworthy (P = .077; trend) and were more likely to recommend their hospital (P = .02). Ninety-eight percent of IG patients recommended ITCA-ThyCa. CONCLUSION Data from our program illustrates that hospital resources should not be allocated based on medical trajectory alone and challenges the idea that ThyCa is "straightforward." ThyCa patients seem to experience symptom distress at a level comparable to-or exceeding-that of general oncological patients despite their promising medical outcomes, indicating that better integrated care and support are in order.
Collapse
Affiliation(s)
- Melissa Henry
- Department of Oncology, McGill University, Montreal, Quebec, Canada.,Department of Psychology, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Oncology and Segal Cancer Centre, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychology, Jewish General Hospital, Montreal, Quebec, Canada
| | - Saul Frenkiel
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | - Gabrielle Chartier
- Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | - Christina MacDonald
- Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | - Richard J Payne
- Department of Oncology, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Martin J Black
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| | - Alex M Mlynarek
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Anthony Zeitouni
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Karen Kost
- Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Carmen Loiselle
- Department of Oncology, McGill University, Montreal, Quebec, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,McGill Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Antoinette Ehrler
- Department of Oncology and Segal Cancer Centre, Jewish General Hospital, Montreal, Quebec, Canada
| | - Zeev Rosberger
- Department of Oncology, McGill University, Montreal, Quebec, Canada.,Department of Psychology, McGill University, Montreal, Quebec, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Oncology and Segal Cancer Centre, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Psychology, Jewish General Hospital, Montreal, Quebec, Canada
| | - Michael Tamilia
- Department of Medicine, Division of Endocrinology and Metabolism, McGill University, Montreal, Quebec, Canada.,Department of Endocrinology, Jewish General Hospital, Montreal, Quebec, Canada
| | - Yu Xin Chang
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Cecilia de la Mora
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Camille Arbaud
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada
| | - Michael P Hier
- Department of Oncology, McGill University, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, McGill University, Montreal, Quebec, Canada.,Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.,Department of Otolaryngology - Head and Neck Surgery, Jewish General Hospital, Montreal, Quebec, Canada
| |
Collapse
|
47
|
Silva LC, Teixeira MCTV, Ribeiro EL, Paula CS. Impact of a provider training program on the treatment of children with autism spectrum disorder at psychosocial care units in Brazil. ACTA ACUST UNITED AC 2017; 40:296-305. [PMID: 29267601 PMCID: PMC6899388 DOI: 10.1590/1516-4446-2016-2090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 07/10/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To develop, implement, and verify the impact of a training program for health care providers working with children with autism spectrum disorder (ASD) in psychosocial care centers for children and adolescents (Centro de Atenção Psicossocial à Infância e à Adolescência - CAPSi) in São Paulo, Brazil. METHODS This quasi-experimental study was conducted with 14 professionals from four CAPSi units. The training program consisted of six phases: 1) pre-intervention observation; 2) meeting with staff to assess the main needs of the training program; 3) developing materials for training and evaluation; 4) meetings to discuss program implementation; 5) a final meeting for case discussion and evaluation; and 6) distance supervision. Three measures were used to evaluate the training program: i) the Knowledge, Attitudes, and Practices (KAP) questionnaire; ii) videos containing questions designed to assess program comprehension; and iii) a satisfaction survey. RESULTS Thirteen videos were produced to as visual aids for use during the training program, and a further 26 videos were developed to evaluate it. The program was well evaluated by the participants. The video responses and KAP questionnaire scores suggest that staff knowledge and attitudes improved after training. CONCLUSION The positive findings of this study suggest that the tested training program is feasible for use with multidisciplinary teams working in the CAPSi environment.
Collapse
Affiliation(s)
- Luciana C Silva
- Programa de Pós-Graduação em Distúrbios do Desenvolvimento, Universidade Presbiteriana Mackenzie, São Paulo, SP, Brazil
| | - Maria C T V Teixeira
- Programa de Pós-Graduação em Distúrbios do Desenvolvimento, Universidade Presbiteriana Mackenzie, São Paulo, SP, Brazil
| | - Edith L Ribeiro
- Secretaria Municipal da Saúde, São Paulo, SP, Brazil.,Curso de Especialização em Saúde Mental da Infância e Adolescência (CESMIA), Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Cristiane S Paula
- Programa de Pós-Graduação em Distúrbios do Desenvolvimento, Universidade Presbiteriana Mackenzie, São Paulo, SP, Brazil.,Departamento de Psiquiatria, UNIFESP, São Paulo, SP, Brazil
| |
Collapse
|
48
|
Illingworth P, Chelvanayagam S. The benefits of interprofessional education 10 years on. ACTA ACUST UNITED AC 2017; 26:813-818. [PMID: 28745961 DOI: 10.12968/bjon.2017.26.14.813] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Interprofessional education (IPE) was first conceived in 1973 by a World Health Organization (WHO) expert group in Geneva. WHO member states were then charged with implementing medical education IPE pilot projects and from then to today there has a been a rapid proliferation in the number of publications on the subject. IPE has generated research into its use, conferences specific to IPE, organisations dedicated to it and policy championing it. The authors question whether there has been any major shift in the silos in which different professions might be working. The authors published an article on the benefits of IPE ( Illingworth and Chelvanayagam, 2007 ). Ten years have now passed and many changes have been implemented and experienced in health and social care and therefore a review of the literature is required. Also, it is 7 years since the publication of WHO's report outlining the role of IPE in the preparation of health professionals ( WHO, 2010 ) and, increasingly, UK Government policy champions collaborative and integrated working. The conclusions from the 2007 article acknowledged the development of IPE; however, it highlighted the need for empirical evidence to demonstrate the effectiveness of IPE in service user and carer outcomes. This article will explore whether IPE has achieved the benefits discussed in the previous article and what developments have occurred since it was published.
Collapse
Affiliation(s)
- Paul Illingworth
- Head of School Allied Health Sciences, De Montfort University, Leicester
| | - Sonya Chelvanayagam
- Lecturer in Mental Health Nursing, School of Nursing & Clinical Sciences, Bournemouth University, Bournemouth
| |
Collapse
|
49
|
Storms H, Marquet K, Claes N. General practitioners' and primary care nurses' care for people with disabilities: quality of communication and awareness of supportive services. J Multidiscip Healthc 2017; 10:367-376. [PMID: 29033579 PMCID: PMC5614790 DOI: 10.2147/jmdh.s140962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND General practitioners (GPs) and primary-care nurses (PCNs) often feel inexperienced or inadequately educated to address unmet needs of people with disabilities (PDs). In this research, GPs' and PCNs' communication with PDs and health care professionals, as well as their awareness of supportive measures relevant to PDs (sensory disabilities excluded), was examined. MATERIALS AND METHODS An electronic questionnaire was sent out to 545 GPs and 1,547 PCNs employed in Limburg (Belgium). GPs and PCNs self-reported about both communication with parties involved in care for PDs (scale very good, good, bad, very bad) and their level of awareness of supportive measures relevant for PDs (scale unaware, inadequately aware, adequately aware). RESULTS Of the questionnaire recipients, 6.6% (36 of 545) of GPs and 37.6% (588 of 1,547) of PCNs participated: 68.8% of 32 GPs and 45.8% of 443 PCNs categorized themselves as communicating well with PDs, and attributed miscommunication to limited intellectual capacities of PDs. GPs and PCNs reported communicating well with other health care professionals. Inadequate awareness was reported for tools to communicate (88.3% of GPs, 89% of PCNs) and benefits for PDs (44.1% of GPs, 66.9% of PCNs). CONCLUSION GPs' and PCNs' lacking awareness of communication aids is problematic. Involvement in a multidisciplinary, expert network might bypass inadequate awareness of practical and social support measures.
Collapse
Affiliation(s)
- Hannelore Storms
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Kristel Marquet
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- Quality and Safety Department, Jessa Hospital, Hasselt, Belgium
| | - Neree Claes
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
- vzw Wit-Gele Kruis Limburg, Genk, Belgium
| |
Collapse
|
50
|
van der Biezen M, Wensing M, Poghosyan L, van der Burgt R, Laurant M. Collaboration in teams with nurse practitioners and general practitioners during out-of-hours and implications for patient care; a qualitative study. BMC Health Serv Res 2017; 17:589. [PMID: 28830410 PMCID: PMC5568365 DOI: 10.1186/s12913-017-2548-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 08/15/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increasingly, nurse practitioners (NPs) are deployed in teams along with general practitioners (GPs) to help meet the demand for out-of-hours care. The purpose of this study was to explore factors influencing collaboration between GPs and NPs in teams working out-of-hours. METHODS A descriptive qualitative study was done using a total of 27 semi-structured interviews and two focus group discussions. Data was collected between June, 2014 and October, 2015 at an out-of-hours primary care organisation in the Netherlands. Overall, 38 health professionals (GPs, NPs, and support staff) participated in the study. The interviews were audio-taped and transcribed verbatim. Two researchers conducted an inductive content analysis, involving the identification of relevant items in a first phase and clustering into themes in a second phase. RESULTS The following four themes emerged from the data: clarity of NP role and regulation, shared caseload and use of skills, communication concerning professional roles, trust and support in NP practice. Main factors influencing collaboration between GPs and NPs included a lack of knowledge regarding the NPs' scope of practice and regulations governing NP role; differences in teams in sharing caseload and using each other's skills effectively; varying support of GPs for the NP role; and limited communication between GPs and NPs regarding professional roles during the shift. Lack of collaboration was perceived to result in an increased risk of delay for patients who needed treatment from a GP, especially in teams with more NPs. Collaboration was not perceived to improve over time as teams varied across shifts. CONCLUSION In out-of-hours primary care teams constantly change and team members are often unfamiliar with each other or other's competences. In this environment, knowledge and communication about team members' roles is continuously at stake. Especially in teams with more NPs, team members need to use each other's skills to deliver care to all patients on time.
Collapse
Affiliation(s)
- Mieke van der Biezen
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, IQ Healthcare, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Michel Wensing
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, IQ Healthcare, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
- Department of General Practice and Health Services Research, Health Services Research and Implementation Science, Heidelberg University, Marsilius Arkaden-Turm West, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - Lusine Poghosyan
- Columbia University School of Nursing, 168th St., Suite 219, New York, NY 10032 USA
| | - Regi van der Burgt
- Foundation for Development of Quality Care in General Practice, Tilburgseweg-West 100, 5652 NP, Eindhoven, The Netherlands
| | - Miranda Laurant
- Radboud University Medical Center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, IQ Healthcare, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands
- HAN University of Applied Sciences, Faculty of Health and Social Studies, P.O. BOX 6960, Nijmegen, 6503 GL The Netherlands
| |
Collapse
|