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Fleig K, Tiroke P, Pittau F, Mücke U. [Interprofessional Team Training for Nursing Trainees and Medical Students in Pediatrics: Comparing Analog and Digital Formats]. KLINISCHE PADIATRIE 2024. [PMID: 38959954 DOI: 10.1055/a-2339-3826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
BACKGROUND Pediatrics places highest demands on interprofessional teams. Although training and studies are evolving, interprofessional teaching units are regularly lacking in German-speaking countries. Analog and digitally convertible formats are rare. METHOD Since 2018, a voluntary one-day team training named "SICKO Junior" for nursing trainees and medical students has been conducted regularly in analog and in the meantime digitally. Evaluation results on the analog and digital format are compared. The content of the one-day workshop is based on a concept for medical employees. Exemplary communication in the ward round is reflected in simulations, training on the simulator for lumbar punctures serves the change of perspective. RESULTS A total of 104 participants took part, 21 of them digital. The recommendation rate is 100%. All of the participants are convinced that the workshop has a positive impact on collaborative interprofessional work. There were no significant differences in the evaluation of the different workshop elements between the digital and analog trainings. DISCUSSION The present work sheds light on the positive influence independent of the digital/analogue form. The presentation forms a blueprint for dissemination. A curricular integration seems worthwhile.Conclusion Voluntary interprofessional team training for nursing trainees and medical students with a focus on communication and error culture is as popular in digital as in analog form. Future studies should prove the influence on competence development and safety culture.
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Affiliation(s)
- Katharina Fleig
- Klinik für Pädiatrische Hämatologie und Onkologie, Medizinische Hochschule Hannover Zentrum fur Kinderheilkunde und Jugendmedizin, Hannover, Germany
| | - Petra Tiroke
- Klinik für Pädiatrische Hämatologie und Onkologie, Medizinische Hochschule Hannover Zentrum fur Kinderheilkunde und Jugendmedizin, Hannover, Germany
| | - Fabian Pittau
- Klinik für Pädiatrische Hämatologie und Onkologie, Medizinische Hochschule Hannover Zentrum fur Kinderheilkunde und Jugendmedizin, Hannover, Germany
| | - Urs Mücke
- Klinik für Pädiatrische Hämatologie und Onkologie, Medizinische Hochschule Hannover Zentrum fur Kinderheilkunde und Jugendmedizin, Hannover, Germany
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Fisher C, McDonald V, Carroll MJ, Walker C, Durand SC, Fogger S. Outcomes of an Interprofessional Opioid Training Program for Graduate Students in Nursing and Social Work. SOCIAL WORK IN PUBLIC HEALTH 2024; 39:379-392. [PMID: 38482834 DOI: 10.1080/19371918.2024.2327576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Social workers and other behavioral health professionals trained to provide prevention, treatment, and recovery services for opioid use disorders (OUD) remain urgently needed in the U.S. particularly in states with widespread health professional shortage areas. To help mitigate this workforce gap, faculty in social work and nursing at a public university in Alabama developed and piloted an innovative HRSA-funded interprofessional traineeship to prepare graduate-level nursing and social work students to assess and treat opioid use disorders (OUD). The yearlong traineeship included specialized coursework on evidenced-based practice in addictions, interprofessional telemedicine and simulation training, and multi-semester field practica in outpatient treatment settings. Impact of the pilot training was evaluated using a pre-experimental one group design. Baseline and post-training surveys assessed knowledge, attitudes, and skills related to OUD and interprofessional practice and perceived program impact. Significant increases were observed for trainees' self-reported knowledge, attitudes, and skills. Moreover, at graduation students reported that the traineeship had improved their abilities to interact with underserved populations, collaborate interprofessionally, and understand ethical issues in SUD treatment as well as enhancing their professional competence, clinical problem-solving, and health workforce skills. Findings suggest that the interprofessional training program may prepare social work and nursing graduate students to effectively serve clients with OUD and help to address a critical workforce gap in medically underserved communities.
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Affiliation(s)
- Colleen Fisher
- Department of Social Work, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Victoria McDonald
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mary Jacque Carroll
- Department of Social Work, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Chris Walker
- Department of Social Work, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Simone C Durand
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Susanne Fogger
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
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Hellinger A, Hörscher D, Biber FC, Haasenritter J, Jost K, Kreuzer T, Müller HH, Wächtershäuser EM, Weber J, Weise C, Opitz E. [Safety of patient care on an interprofessional training ward in visceral surgery]. CHIRURGIE (HEIDELBERG, GERMANY) 2024; 95:299-306. [PMID: 38319344 DOI: 10.1007/s00104-024-02034-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/09/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Interprofessional training wards (ITW) are increasingly being integrated into teaching and training concepts in visceral surgery clinics. OBJECTIVE How safe is patient care on an ITW in visceral surgery? MATERIAL AND METHODS Data collection took place from November 2021 to December 2022. In this nonrandomized prospective evaluation study the frequency and severity of adverse events (AE) in 3 groups of 100 patients each in a tertiary referral center hospital for visceral surgery were investigated. The groups consisted of patients on the ITW and on the conventional ward before and after implementation of the ITW. The Global Trigger Tool (GTT) was used to search for AE. Simultaneously, a survey of the treatment was conducted according to the Picker method to measure patient reported outcome. RESULTS Baseline characteristics and clinical outcome parameters of the patients in the three groups were comparable. The GTT analysis found 74 nonpreventable and 5 preventable AE in 63 (21%) of the patients and 12 AE occurred before the hospital stay. During the hospital stay 50 AE occurred in the operating theater and 17 on the conventional ward. None of the five preventable AE (in 1.7% of the patients) was caused by the treatment on the ITW. Patients rated the safety on the ITW better than in 90% of the hospitals included in the Picker benchmark cohort and as good as on the normal ward. CONCLUSION The GTT-based data as well as from the patients' point of view show that patient care on a carefully implemented ITW in visceral surgery is safe.
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Affiliation(s)
- A Hellinger
- Klinik für Allgemein‑, Viszeral‑, Endokrine und Onkologische Chirurgie, Klinikum Fulda gAG, Campus Fulda der Universitätsmedizin Marburg, Pacelliallee 4, 36043, Fulda, Deutschland.
| | - D Hörscher
- Klinik für Allgemein‑, Viszeral‑, Endokrine und Onkologische Chirurgie, Klinikum Fulda gAG, Campus Fulda der Universitätsmedizin Marburg, Pacelliallee 4, 36043, Fulda, Deutschland
| | - F C Biber
- Klinik für Allgemein‑, Viszeral‑, Endokrine und Onkologische Chirurgie, Klinikum Fulda gAG, Campus Fulda der Universitätsmedizin Marburg, Pacelliallee 4, 36043, Fulda, Deutschland
| | - J Haasenritter
- Institut für Allgemeinmedizin, Philipps-Universität Marburg, Marburg, Deutschland
| | - K Jost
- Klinik für Allgemein‑, Viszeral‑, Endokrine und Onkologische Chirurgie, Klinikum Fulda gAG, Campus Fulda der Universitätsmedizin Marburg, Pacelliallee 4, 36043, Fulda, Deutschland
| | - T Kreuzer
- Studiendekanat des Fachbereichs Medizin, Philipps-Universität Marburg, Marburg, Deutschland
| | - H-H Müller
- Institut für Medizinische Bioinformatik und Biostatistik, Philipps-Universität Marburg, Marburg, Deutschland
| | - E M Wächtershäuser
- Klinik für Allgemein‑, Viszeral‑, Endokrine und Onkologische Chirurgie, Klinikum Fulda gAG, Campus Fulda der Universitätsmedizin Marburg, Pacelliallee 4, 36043, Fulda, Deutschland
| | - J Weber
- Apotheke, Klinikum Fulda gAG, Campus Fulda der Universitätsmedizin Marburg, Fulda, Deutschland
| | - C Weise
- Medizinische Klinik III - Nephrologie, Klinikum Fulda gAG, Campus Fulda der Universitätsmedizin Marburg, Fulda, Deutschland
| | - E Opitz
- Studiendekanat des Fachbereichs Medizin, Philipps-Universität Marburg, Marburg, Deutschland
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Croxford S, Stirling E, MacLaren J, McWhorter JW, Frederick L, Thomas OW. Culinary Medicine or Culinary Nutrition? Defining Terms for Use in Education and Practice. Nutrients 2024; 16:603. [PMID: 38474731 DOI: 10.3390/nu16050603] [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: 02/06/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
Examination of how terms such as culinary nutrition, culinary nutrition science, culinary medicine, culinary nutrition professional, culinary nutrition intervention, culinary nutrition activity, and culinary nutrition competency are used in practice, and the creation of consensus definitions will promote the consistent use of these terms across work areas and disciplines. Thirty leading practitioners, academics, and researchers in the fields of food and nutrition across Australia, the United States, Canada, United Kingdom, Europe, and Asia were approached by investigators via email to submit definitions of key terms using a Qualtrics survey link. Further participants were reached through snowball recruitment. Initial emails were sent in October and November 2021 with subsequent reminders between November 2021 and March 2022. Two researchers undertook content analysis of the text answers for each of the terms and generated definitions for discussion and consensus. Thirty-seven participants commenced the survey and twenty-three submitted one or more definitions. Agreed definitions fell into two categories: practice concepts and practitioners. Further discussion amongst investigators led to the creation of a visual map to demonstrate the interrelationship of terms. Culinary nutrition science underpins, and interprofessional collaboration characterizes practice in this area, however, further work is needed to define competencies and model best practice.
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Affiliation(s)
- Sharon Croxford
- Melbourne Campus, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Fitzroy, VIC 3065, Australia
| | - Emma Stirling
- Melbourne Campus, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Fitzroy, VIC 3065, Australia
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Schlosser-Hupf S, Aichner E, Meier M, Albaladejo-Fuertes S, Ruttmann K, Rusch S, Michels B, Mehrl A, Kunst C, Schmid S, Müller M. Evaluating the impact of interprofessional training wards on patient satisfaction and clinical outcomes: a mixed-methods analysis. Front Med (Lausanne) 2024; 11:1320027. [PMID: 38444410 PMCID: PMC10912604 DOI: 10.3389/fmed.2024.1320027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 02/02/2024] [Indexed: 03/07/2024] Open
Abstract
Introduction Interprofessional teamwork is pivotal in modern healthcare, prompting the establishment of interprofessional training wards since 1996. While these wards serve as hubs for optimizing healthcare professional collaboration and communication, research into patient outcomes remains notably sparse and geographically limited, predominantly examining patient satisfaction and sparingly exploring other metrics like mortality or self-discharge rates. This study seeks to bridge this gap, comparing patient outcomes in interprofessional training wards and conventional wards under the hypothesis that the former offers no disadvantage to patient outcomes. Materials and methods We explored patient outcomes within an interprofessional student ward called A-STAR at a University Hospital from October 2019 to December 2022. Engaging with patients discharged between May 2021 and April 2022, we utilized digital and paper-based anonymous questionnaires, catering to patient preference, to gather pertinent data. Results Analysis of outcomes for 1,482 A-STAR (interprofessional student ward) and 5,752 conventional ward patients revealed noteworthy findings. A-STAR patients tended to be younger (59 vs. 61 years, p < 0.01) and more frequently male (73.5% vs. 70.4%, p = 0.025). Vital clinical outcomes, such as discharges against medical advice, complication-driven readmissions, and ICU transfers, were statistically similar between groups, as were mortality rates (1.2% vs. 1.3%, p = 0.468). A-STAR demonstrated high patient satisfaction, underscored by positive reflections on team competence, ward atmosphere, and responsiveness to concerns, emphasizing the value placed on interprofessional collaboration. Patient narratives commended team kindness, lucid explanations, and proactive involvement. Discussion This data collectively underscores the safety and reliability of patient care within training wards, affirming that patients can trust the care provided in these settings. Patients on the interprofessional ward demonstrated high satisfaction levels: 96.7% appreciated the atmosphere and conduct of ward rounds. In comparison, 98.3% were satisfied with the discussion and information about their treatment during their hospital stay.
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Affiliation(s)
- Sophie Schlosser-Hupf
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Elisabeth Aichner
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Marcus Meier
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Sheila Albaladejo-Fuertes
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Kirstin Ruttmann
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
- Nursing Development Department of the Care Management Head Office, University Hospital Regensburg, Humboldt-Universität zu Berlin, Regensburg, Germany
| | - Sophia Rusch
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Bernhard Michels
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Alexander Mehrl
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Claudia Kunst
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Stephan Schmid
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Martina Müller
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
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Straub C, Bode SFN, Willems J, Farin-Glattacker E, Friedrich S. Challenges and opportunities of evaluating work based interprofessional learning: insights from a pediatric interprofessional training ward. Front Med (Lausanne) 2023; 10:1244681. [PMID: 38116035 PMCID: PMC10729382 DOI: 10.3389/fmed.2023.1244681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/17/2023] [Indexed: 12/21/2023] Open
Abstract
Introduction Interprofessional collaboration among healthcare professionals is fostered through interprofessional education (IPE). Work-based IPE has demonstrated effectiveness within interprofessional training wards. We developed the Interprofessional Training Ward in Pediatrics (IPAPED) and employ a combination of established assessment tools and a newly created IPAPED questionnaire, directed at to assess both students' learning experiences and program structure. This paper presents the development and analysis of the psychometric properties of the IPAPED questionnaire. Methods Nursing trainees and medical students participated in IPAPED. The IPAPED questionnaire was developed to complement established instruments, based on IPE frameworks. Interprofessional collaboration and communication were represented in subscales in part 1 of the questionnaire. Part 2 focused on the IPAPED program itself. Statistical analyses included calculation of internal consistency for part 1 and exploratory factor analyses for part 2. Results All IPAPED participants between November 2017 and November 2022 completed the questionnaire (n = 105). 94 of 105 questionnaires were analyzed. Internal consistency for part 1 was low (Cronbach's α <0.58). Exploratory factor analyses revealed three distinct factors: teaching and learning material, interprofessional learning facilitation and professional guidance by nurses on the ward. Discussion Our results illustrate the challenge of performing high quality, theory based evaluation in a work-based setting. However, exploratory factor analyses highlighted the opportunity of focusing on both learning facilitators and staff on the wards to ensure a maximum learning output for participants. Developing program-specific questionnaires to gain insight into local structures has the potential to improve work-based IPE formats.
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Affiliation(s)
- Christine Straub
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Neuropediatrics and Muscle Disorders, Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Sebastian F. N. Bode
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm University, Ulm, Germany
| | - Jana Willems
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Erik Farin-Glattacker
- Section of Health Care Research and Rehabilitation Research, Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Sebastian Friedrich
- Department of Neuropediatrics and Muscle Disorders, Medical Centre, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Mitzkat A, Mink J, Arnold C, Mahler C, Mihaljevic AL, Möltner A, Trierweiler-Hauke B, Ullrich C, Wensing M, Kiesewetter J. Development of individual competencies and team performance in interprofessional ward rounds: results of a study with multimodal observations at the Heidelberg Interprofessional Training Ward. Front Med (Lausanne) 2023; 10:1241557. [PMID: 37828945 PMCID: PMC10566636 DOI: 10.3389/fmed.2023.1241557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/07/2023] [Indexed: 10/14/2023] Open
Abstract
Introduction Interprofessional training wards (IPTW) aim to improve undergraduates' interprofessional collaborative practice of care. Little is known about the effects of the different team tasks on IPTW as measured by external assessment. In Heidelberg, Germany, four nursing and four medical undergraduates (= one cohort) care for up to six patients undergoing general surgery during a four-week placement. They learn both professionally and interprofessionally, working largely on their own responsibility under the supervision of the medical and nursing learning facilitators. Interprofessional ward rounds are a central component of developing individual competencies and team performance. The aim of this study was to evaluate individual competencies and team performance shown in ward rounds. Methods Observations took place in four cohorts of four nursing and four medical undergraduates each. Undergraduates in one cohort were divided into two teams, which rotated in morning and afternoon shifts. Team 1 was on morning shift during the first (t0) and third (t1) weeks of the IPTW placement, and Team 2 was on morning shift during the second (t0) and fourth (t1) weeks. Within each team, a tandem of one nursing and one medical undergraduate cared for a patient room with three patients. Ward round observations took place with each team and tandem at t0 and t1 using the IP-VITA instrument for individual competencies (16 items) and team performance (11 items). Four hypotheses were formulated for statistical testing with linear mixed models and correlations. Results A total of 16 nursing and medical undergraduates each were included. There were significant changes in mean values between t0 and t1 in individual competencies (Hypothesis 1). They were statistically significant for all three sum scores: "Roles and Responsibilities", Patient-Centeredness", and "Leadership". In terms of team performance (Hypothesis 2), there was a statistically significant change in mean values in the sum score "Roles and Responsibilities" and positive trends in the sum scores "Patient-Centeredness" and "Decision-Making/Collaborative Clinical Reasoning". Analysis of differences in the development of individual competencies in the groups of nursing and medical undergraduates (Hypothesis 3) showed more significant differences in the mean values of the two groups in t0 than in t1. There were significant correlations between individual competencies and team performance at both t0 and t1 (Hypothesis 4). Discussion The study has limitations due to the small sample and some sources of bias related to the external assessment by means of observation. Nevertheless, this study offers insights into interprofessional tasks on the IPTW from an external assessment. Results from quantitative and qualitative analysis of learners self-assessment are confirmed in terms of roles and responsibilities and patient-centeredness. It has been observed that medical undergraduates acquired and applied skills in collaborative clinic reasoning and decision-making, whereas nursing undergraduates acquired leadership skills. Within the study sample, only a small group of tandems remained constant over time. In team performance, the group of constant tandems tended to perform better than the group of random tandems. The aim of IPTW should be to prepare healthcare team members for the challenge of changing teams. Therefore, implications for IPTW implementation could be to develop learning support approaches that allow medical and nursing undergraduates to bring interprofessional competencies to team performance, independent of the tandem partner or team.
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Affiliation(s)
- Anika Mitzkat
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Johanna Mink
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Christine Arnold
- Division of Neonatology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Cornelia Mahler
- Department of Nursing Science, University Hospital Tübingen, Tübingen, Germany
| | - André L. Mihaljevic
- Department of General Visceral and Transplantation Surgery, University Hospital Ulm, Ulm, Germany
| | - Andreas Möltner
- Department of Medical Examinations, Medical Faculty Heidelberg, Heidelberg, Germany
| | - Birgit Trierweiler-Hauke
- Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Charlotte Ullrich
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Jan Kiesewetter
- Institute of Medical Education, LMU University Hospital, LMU München, München, Germany
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