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Hosny S, Thistlethwaite J, El-Wazir Y, Gilbert J. Interprofessional learning in practice-based settings: AMEE Guide No. 169. MEDICAL TEACHER 2024:1-13. [PMID: 38828523 DOI: 10.1080/0142159x.2024.2352162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 05/02/2024] [Indexed: 06/05/2024]
Abstract
The provision of optimum health care services requires collaboration of health care professionals in integrated interprofessional (IP) teams. This guide addresses the practical aspects of establishing and delivering pre-licensure IP programs to prepare graduates of health professional programs to work in teams and wider collaboration, and consequently enhance the quality of health care. The main updated IP frameworks are presented to highlight commonalities that represent the essential competencies and outcomes of programs implementing interprofessional education (IPE). We discuss how these may be adapted to the local context, and present examples of models of implementation to guide the initial steps of establishing similar programs. Examples of pre-licensure IP practice-based learning, such as community-based, simulation-based, student-run and led clinics, and interprofessional training wards, and post-licensure interprofessional learning (IPL), are described. We consider assessment of IPL along the continuum of learning IP. This guide also emphasises the need to tailor faculty development programs for local contexts and consider factors affecting sustainability such as funding and accreditation. We finish with the governance of IP programs and how global IP networks may support interprofessional practice-based learning from development to delivery.
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Affiliation(s)
- Somaya Hosny
- Faculty of Medicine, Suez Canal University, Egypt
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Kent F, Haruta J. Culture and context in Interprofessional education: Expectations in Australia and Japan. MEDICAL EDUCATION 2024. [PMID: 38728120 DOI: 10.1111/medu.15424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 04/08/2024] [Accepted: 04/17/2024] [Indexed: 05/12/2024]
Abstract
The attributes of collaborative practice in health care vary across contexts, necessitating the adaptation of interprofessional education curricula to prepare students for the collaborative practice expected in their respective health care systems. Culture, when conceptualised through an organisational lens, allows an analysis of the shared assumptions, beliefs and values, without seeking to reduce to a uniform construct. This article explores the differences in interprofessional education competencies between Australia and Japan and considers the systems and patient expectations, which underpin each. While collaborative competence exhibits some similarities across contexts, competency frameworks differ in emphasis, language and key terminology, which highlight multiple points of difference in the expectations of interprofessional collaborative practice across contexts. There are education and practice consequences of these different perspectives of collaborative practice, in an increasingly mobile international workforce.
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Affiliation(s)
- Fiona Kent
- Education Portfolio, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
- Health Professions Education Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Junji Haruta
- Medical Education Center, School of Medicine, Keio University, Tokyo, Japan
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Yoshida Y, Hirakawa Y, Hong YJ, Mamun MR, Shimizu H, Nakano Y, Yatsuya H. Factors influencing interprofessional collaboration in long-term care from a multidisciplinary perspective: a case study approach. Home Health Care Serv Q 2024:1-20. [PMID: 38521999 DOI: 10.1080/01621424.2024.2331452] [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: 03/25/2024]
Abstract
Systematic assessments of interprofessional collaboration barriers and enablers in long-term care settings are critical for delivering person-centered healthcare. However, research on factors influencing interprofessional collaboration in long-term care settings is limited. For this study, 65 healthcare professionals across multiple facilities experienced in long-term care in Japan participated in online focus group discussions and individual interviews to discuss cases. The qualitative data were analyzed using qualitative content analysis. Seven themes emerged: coordination, the need for care manager training, hierarchy among healthcare professionals, specialization but not the mind-set of overspecialization, casual conversations, electronic group communication tools, and excessive fear of personal information protection. These findings highlight the need to develop coordinator roles and for interprofessional education on the proper approach to personal information protection laws. Furthermore, daily casual conversations, the use of online platforms, and the prevention of patients being left behind due to overspecialization are required.
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Affiliation(s)
- Yuko Yoshida
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Department of Psychiatry, Daido Hospital, Kojunkai Social Medical Corporation, Nagoya, Japan
| | - Yoshihisa Hirakawa
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
- Department of Health Research and Innovation, Aichi Comprehensive Health Science Center (Aichi Health Plaza), Chita-Gun, Japan
| | - Young Jae Hong
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Md Razib Mamun
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Hiroko Shimizu
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Yoshihisa Nakano
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Hiroshi Yatsuya
- Department of Public Health and Health Systems, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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Chou KR, Huang MS, Chiu WC, Chen YH, Chen YY, Xiao Q, Yang SC. A comprehensive assessment of oral health, swallowing difficulty, and nutritional status in older nursing home residents. Sci Rep 2023; 13:19914. [PMID: 37964096 PMCID: PMC10645724 DOI: 10.1038/s41598-023-47336-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 11/12/2023] [Indexed: 11/16/2023] Open
Abstract
Declines in oral consumption and swallowing function are common reasons which may elevate the risk of malnutrition in the older adults. This study aimed to provide valuable information and contribute to the existing body of knowledge in this field as well as highlight the importance of a comprehensive assessment of oral health, swallowing function, and nutritional status in long-term care residents. This was a cross-sectional study. Thirty-nine participants were recruited from a nursing home. The comprehensive assessment was evaluated in participants, including oral health (Oral Health Assessment Tool (OHAT)), swallowing function (Functional Oral Intake Scale (FOIS) and Eating Assessment Tool (EAT)-10), and nutritional status (Mini Nutritional Assessment-Short Form (MNA-SF). The average age of participants was 80.4 ± 11.7 years, and 46% of these older adults were found to be at the risk of malnutrition. There was a negative correlation between the OHAT and MNA-SF scores. In addition, subjects with poor oral health (OHAT score = 5~8), oral consumption of a modified diet (FOIS score = 4~6), and reduced swallowing function (EAT-10 score ≥ 3) were more likely to be at risk of malnutrition. A comprehensive evaluation of oral health and swallowing function was closely connected with the nutritional status of older nursing home dwellers.
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Affiliation(s)
- Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Mao-Suan Huang
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wan-Chun Chiu
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- Research Center of Geriatric Nutrition, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan
- Department of Nutrition, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hsiu Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Yu-Yoh Chen
- Graduate Institute of Health and Biotechnology Law, Taipei Medical University, Taipei, Taiwan
| | - Qian Xiao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Suh-Ching Yang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan.
- Research Center of Geriatric Nutrition, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan.
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan.
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Rider EA, Chou C, Abraham C, Weissmann P, Litzelman DK, Hatem D, Branch W. Longitudinal faculty development to improve interprofessional collaboration and practice: a multisite qualitative study at five US academic health centres. BMJ Open 2023; 13:e069466. [PMID: 37076167 PMCID: PMC10124268 DOI: 10.1136/bmjopen-2022-069466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
OBJECTIVES Interprofessional (IP) collaboration and effective teamwork remain variable in healthcare organisations. IP bias, assumptions and conflicts limit the capacity of healthcare teams to leverage the expertise of their members to meet growing complexities of patient needs and optimise healthcare outcomes. We aimed to understand how a longitudinal faculty development programme, designed to optimise IP learning, influenced its participants in their IP roles. DESIGN In this qualitative study, using a constructivist grounded theory approach, we analysed participants' anonymous narrative responses to open-ended questions about specific knowledge, insights and skills acquired during our IP longitudinal faculty development programme and applications of this learning to teaching and practice. SETTING Five university-based academic health centres across the USA. PARTICIPANTS IP faculty/clinician leaders from at least three different professions completed small group-based faculty development programmes over 9 months (18 sessions). Site leaders selected participants from applicants forecast as future leaders of IP collaboration and education. INTERVENTIONS Completion of a longitudinal IP faculty development programme designed to enhance leadership, teamwork, self-knowledge and communication. RESULTS A total of 26 programme participants provided 52 narratives for analysis. Relationships and relational learning were the overarching themes. From the underlying themes, we developed a summary of relational competencies identified at each of three learning levels: (1) Intrapersonal (within oneself): reflective capacity/self-awareness, becoming aware of biases, empathy for self and mindfulness. (2) Interpersonal (interacting with others): listening, understanding others' perspectives, appreciation and respect for colleagues and empathy for others. (3) Systems level (interacting within organisation): resilience, conflict engagement, team dynamics and utilisation of colleagues as resources. CONCLUSIONS Our faculty development programme for IP faculty leaders at five US academic health centres achieved relational learning with attitudinal changes that can enhance collaboration with others. We observed meaningful changes in participants with decreased biases, increased self-reflection, empathy and understanding of others' perspectives and enhanced IP teamwork.
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Affiliation(s)
- Elizabeth A Rider
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Calvin Chou
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Corrine Abraham
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Peter Weissmann
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Debra K Litzelman
- Department of Medicine, Regenstrief Institute, Indianapolis, Indiana, USA
- Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - David Hatem
- Department of Medicine, University of Massachusetts T H Chan School of Medicine, Worcester, Massachusetts, USA
| | - William Branch
- Medicine, Emory University, Atlanta, Georgia, USA
- Medicine, Emory Clinic, Atlanta, Georgia, USA
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Goto R, Haruta J. Current status of interprofessional competency among healthcare professions in Japan: A cross-sectional web-based survey. J Gen Fam Med 2023; 24:119-125. [PMID: 36909786 PMCID: PMC10000264 DOI: 10.1002/jgf2.601] [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: 07/10/2022] [Revised: 11/29/2022] [Accepted: 12/09/2022] [Indexed: 01/01/2023] Open
Abstract
Background Self-assessment of professionals' interprofessional competency is meaningful for benchmarking oneself and helping to identify training needs. We aimed to clarify differences in self-assessment of interprofessional competency in Japan by profession and type of facility. Methods We conducted a cross-sectional study using a web survey among primary healthcare providers in Japan, especially members of the Japan Primary Care Association, between June and October 2020. After sampling using the e-mail list, we used an exponential nondiscriminative snowball method as purposive sampling through key professional informants between November 2020 and February 2021. The questionnaire covered items including participant demographics (age, gender, years of experience as professionals, years of experience working at the current institution, attendance type (regular or part-time work), administrative experience, profession, and facility type) and included the Japanese version of the Self-assessment Scale of Interprofessional Competency (JASSIC). Differences between healthcare professions (physician, nurse, pharmacist, rehabilitation therapist, and social worker) and between types of facility (university hospital, medium-sized hospital, small hospital, and clinics) were compared using the Kruskal-Wallis test. Results A total of 593 people responded to the survey. Their mean age was 41.2 ± 11.3 years, and 312 (52.6%) were female. JASSIC scores of physicians and social workers were significantly higher than those of rehabilitation therapists (p < 0.01). Concerning facilities, professionals working in clinics rated themselves higher than those in medium-sized hospitals (p < 0.01). Conclusions We revealed that self-assessment of interprofessional competency in Japan varied by profession and type of facility.
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Affiliation(s)
- Ryohei Goto
- Department of Primary Care and Medical Education, Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Junji Haruta
- Department of Primary Care and Medical Education, Faculty of Medicine University of Tsukuba Tsukuba Japan.,Medical Education Center, School of Medicine Keio University Tokyo Japan
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Haruta J, Goto R. Factors associated with interprofessional competencies among healthcare professionals in Japan. J Interprof Care 2022; 37:473-479. [PMID: 35880788 DOI: 10.1080/13561820.2022.2099818] [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: 10/16/2022]
Abstract
We aimed to explore factors associated with interprofessional competencies among healthcare professionals in Japan. From June to October 2020, we conducted a cross-sectional survey via a validated self-administered web-based questionnaire using the Japanese version of the Self-assessment Scale of Interprofessional Competency (JASSIC). We recruited participants from an e-mail list. The questionnaire asked about JASSIC, basic demographic information, whether they had undertaken pre- and post-licensure interprofessional education (IPE), and administrative experience; as well as an organizational climate scale, including "Plan, Do, See" factor for management (PDS factor), and the "Do" factor in a leader-centered direction for people who work unwillingly. Factors associated with the total JASSIC score as interprofessional competencies were determined using multiple regression analysis. We analyzed data from 560 participants with an average age of 41.0 years, comprising 132 nurses, 127 doctors, and 120 social workers. The median of the total JASSIC score was 72/90 (range: 66-78). On multiple regression analysis, total JASSIC score was significantly associated with age, PDS factor, administrative experience, pre-licensure IPE, and pos-licensure IPE. These findings emphasize the importance of pre- and post-licensure IPE, and administrative experience for improving interprofessional competencies in Japan.
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Affiliation(s)
- Junji Haruta
- Medical Education Center, School of Medicine, Keio University, Tokyo, Japan.,Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Ryohei Goto
- Department of Family Medicine, General Practice and Community Health Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Koskimäki M, Mikkonen K, Kääriäinen M, Lähteenmäki ML, Kaunonen M, Salminen L, Koivula M. An empirical model of social and healthcare educators' continuing professional development in Finland. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1433-1441. [PMID: 34138504 DOI: 10.1111/hsc.13473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 03/04/2021] [Accepted: 05/15/2021] [Indexed: 06/12/2023]
Abstract
The objective of this work was to develop and test an empirical model of social and healthcare educators' continuing professional development. A cross-sectional survey study design was adopted, and a total of 422 part-time and full-time social and healthcare educators from 28 universities of applied sciences and vocational schools in different regions of Finland participated. Data were collected from October to December in 2018. The participants taught in the fields of healthcare, social services, and rehabilitation. The questionnaire included the EduProDe scale and background questions. Confirmatory factor analysis and structural equation modelling were used to develop the model, and its quality was assessed by computing goodness of fit indexes. The main finding was that when educators understand the benefits of continuing professional development, they will recognise their developmental needs and proactively seek support from their superiors. The results obtained provide insight into the preconditions for professional development and offer guidance for the design of future shared development programmes or activities for social and healthcare educators.
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Affiliation(s)
- Minna Koskimäki
- Faculty of Social Sciences, Nursing Science/Health Sciences, Tampere University, Tampere, Finland
| | - Kristina Mikkonen
- Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland
| | - Maria Kääriäinen
- Research Unit of Nursing Science and Health Management, Medical Research Center Oulu, The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence, University of Oulu, Oulu, Finland
| | | | - Marja Kaunonen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- General Administration, Pirkanmaa Hospital District, Tampere, Finland
| | - Leena Salminen
- Department of Nursing Science, University of Turku, Turku University Hospital, Turku, Finland
| | - Meeri Koivula
- Department of Nursing Science, Tampere University, Tampere, Finland
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Higashitsuji A, Majima T. Factors Associated with Japanese Nurses' Support on End-of-life Decision-making: A Cross-sectional Study. J Community Health Nurs 2022; 39:139-149. [PMID: 35653795 DOI: 10.1080/07370016.2022.2073790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE This study aimed to clarify the factors associated with Japanese nurses' end-of-life decision-making support. DESIGN Cross-sectional study. METHODS An online survey was conducted among 278 nurses. FINDINGS Significantly associated factors included visiting nursing, nursing experience duration, female sex, workshop participation, and time spent on end-of-life care. CONCLUSION Visiting nursing was the most significant factor associated with nurses' end-of-lifedecision-making support. CLINICAL EVIDENCE Consideration should be given to the curriculum in basic nursing education related to visiting nursing. It shouldinclude end-of-life care as well as resources for end-of-life decision-making to increase the number of patients who die in their preferred setting.
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Affiliation(s)
| | - Tomoko Majima
- Graduate School of Nursing, Chiba University, Chiba, Japan
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Haruta J, Goto R, Sachiko O, Kimura S, Teruyama J, Hama Y, Maeno T. How do general practitioners handle complexities? A team ethnographic study in Japan. BMC PRIMARY CARE 2022; 23:133. [PMID: 35624417 PMCID: PMC9137137 DOI: 10.1186/s12875-022-01741-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 05/09/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND General practitioners (GPs) are often faced with complex problems, including patients with socio-economic and medical problems. However, the methods they use to approach these complexities are still not understood. We speculated that elucidating these methods using complex adaptive systems (CAS) methodology to comprehensively assess GPs' daily activities would contribute to improving the professional development of GPs. This study aimed to clarify how expert GPs handle complex problems and adapt to their community context through the ethnography of GPs and other healthcare professionals in terms of CAS. METHODS We adopted the interdisciplinary team-ethnographic research approach. Five hospitals and four clinics in Japan which were considered to employ expert GPs were selected by purposive sampling. 62 individuals of various backgrounds working in these nine facilities were interviewed. Using field notes and interview data, the researchers iteratively discussed the adequacy of our interpretations. The first author (JH) prepared a draft report, which was reviewed by the GPs at the participating facilities. Through critical and iterative consideration of the different insights obtained, the final findings emerged together with representative data. RESULTS We identified four approaches used by GPs to deal with complexities. First, GPs treat patients with complex problems as a whole being and address their problems multi-directionally. Second, GPs build horizontal, trusting relationships with other healthcare professionals and stakeholders, and thereby reduce the degree of complexity of problems. Third, GPs change the learning climate while committing to their own growth based on societal needs and by acting as role models for other professionals through daily interpersonal facilitation. Fourth, GPs share community vision with multi-professionals and thereby act as a driving force for organizational change. These various interactions among GPs, healthcare professionals, organizations and communities resulted in systematization of the healthcare and welfare network in their community. CONCLUSIONS Expert GPs developed interconnected multidimensional systems in their community health and welfare networks to adapt to fluctuating social realities using four approaches. GPs' work environment may be considered as a complex adaptive system (CAS) and the approach of GPs to complexities is CAS-based. Our findings are expected to have practical applications for GPs.
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Affiliation(s)
- Junji Haruta
- Medical Education Center, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku ku, Tokyo, 160-8582, Japan.
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.
| | - Ryohei Goto
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Ozone Sachiko
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shuhei Kimura
- Faculty of Humanities and Social Sciences, University of Tsukuba, Tsukuba, Japan
| | - Junko Teruyama
- Faculty of Library, Information and Media Science, University of Tsukuba, Tsukuba, Japan
| | - Yusuke Hama
- Tokyo Junior College of Transportation, Tokyo, Japan
| | - Tetsuhiro Maeno
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Shimizu I, Kimura T, Duvivier R, van der Vleuten C. Modeling the effect of social interdependence in interprofessional collaborative learning. J Interprof Care 2022; 36:820-827. [DOI: 10.1080/13561820.2021.2014428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ikuo Shimizu
- Center for Medical Education and Clinical Training, Shinshu University, Matsumoto, Japan
| | - Teiji Kimura
- Department of Fundamental Physical Therapy, Shinshu University, Matsumoto, Japan
| | - Robbert Duvivier
- Center for Educational Development and Research in Health Sciences (CEDAR), University Medical Center Groningen, Groningen, The Netherlands
| | - Cees van der Vleuten
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Goto R, Haruta J, Ozone S. Verification of a Sense of Community Scale for Hospitals in Japan. J Prim Care Community Health 2022; 13:21501319221107317. [PMID: 35726750 PMCID: PMC9218502 DOI: 10.1177/21501319221107317] [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] [Indexed: 11/16/2022] Open
Abstract
Introduction/Objectives: We aimed to verify whether a sense of community scale developed for hospital wards can be applied to hospitals. Methods: A cross-sectional study was conducted using a self-administered questionnaire between July and October 2018 in 3 hospitals in Japan. The subjects were staff members working in these hospitals who provide direct medical or administrative services to patients and their families. The questionnaire inquired about the participants’ basic attributes and workplace satisfaction, and included the sense of community scale and the Japanese version of the Assessment of Interprofessional Team Collaboration Scale-II. We evaluated the scale’s structural validity, internal consistency, and hypothesis testing for construct validity. Results: Of 826 eligible staff members, 539 were included in the analysis. Mean age was 40.4 years and 77.4% were female. Exploratory factor analysis showed that 24 of the 28 items in the sense of community scale could be categorized under 3 factors. Confirmatory factor analysis demonstrated a goodness of fit index of 0.794, adjusted goodness of fit index of 0.752, comparative fit index of 0.885 and root mean square error of approximation of 0.092. Cronbach’s α for score in the sense of community scale was high (.96). Participants who reported high workplace satisfaction had significantly higher scores in the sense of community scale than those who indicated low workplace satisfaction (P < .001). Conclusions: We verified the reliability and validity of the Japanese version of the sense of community scale, which was originally developed for hospital wards, for the community in hospitals. With further verification, we hope the scale will be useful for evaluating the sense of community in hospitals.
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Affiliation(s)
- Ryohei Goto
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Junji Haruta
- Medical Education Center, School of Medicine, Keio University, Shinanomachi, Shinjuku ku, Tokyo, Japan
| | - Sachiko Ozone
- Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Xiao SQ, Liu JE, Chang H. Physician-Nurse Communication Surrounding Computerized Physician Order Entry Systems From Social and Technical Perspective: An Ethnographic Study. Comput Inform Nurs 2021; 40:258-268. [PMID: 35394959 DOI: 10.1097/cin.0000000000000809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Although computerized physician order entry systems improve order transmission and patient safety, overdependence on these systems can impede users' communication. This ethnographic study explored physician-nurse communication surrounding computerized physician order entry systems using a sociotechnical framework. Fieldwork conducted in a tertiary teaching hospital comprised 89 hours of participant observation, and individual semistructured interviews were held with seven nurses and five physicians. In addition, documents and artifacts were collected. Three core themes emerged. First, computerized physician order entry quality-related issues undermined the work efficiency of physicians and nurses. Specifically, usability was error prone because of cognitive overload, and the system was unable to perform relevant traces and raise alerts, demonstrating poor interoperability. Second, social factors, including insufficient training, unclear responsibilities, and a lack of awareness concerning interdisciplinary communication, compounded communication problems. Last, environmental factors, including noncoterminous spaces and times and insufficient technical support, impeded the resolution of communication problems. Technical and social contextual factors relating to computerized physician order entry systems jointly affected physician-nurse communication. Cognitive issues and insufficient alerts impacted work efficiency the most and were compounded by contextual individual- and team-related factors and environmental factors. Therefore, improved functions of computerized physician order entry systems and interprofessional communication training are required to optimize technical and social aspects of physician-nurse communication.
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Affiliation(s)
- Shu-Qin Xiao
- Author Affiliations: School of Nursing (Ms Xiao and Dr Liu) and Department of Neurology, Xuanwu Hospital (Ms Chang), Capital Medical University, Beijing, China
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14
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Goto R, Haruta J. The process of transprofessional collaboration: how caregivers integrated the perspectives of rehabilitation through working with a physical therapist. Fam Med Community Health 2021; 8:fmch-2020-000378. [PMID: 33172854 PMCID: PMC7656945 DOI: 10.1136/fmch-2020-000378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Objectives To clarify the process of how caregivers in a nursing home integrate the perspectives of rehabilitation into their responsibilities through working with a physical therapist. Design This study was conducted under an action research approach. Setting The target facility was a nursing home located in Japan. The researcher, a physical therapist, worked at the nursing home once a week from April 2016 to March 2017. During the study period, he created field notes focused on the dialogue and action of caregivers regarding care, responses of caregivers to the physical therapist and reflections as a physical therapist. Caregivers were also given a short informal interview about their relationship with the nursing home residents. For data analysis, two researchers discussed the content based on the field notes, consolidating the findings. Participants The participants were caregivers who worked at the target facility. Thirty-eight caregivers agreed to participate. Average age was 39.6±11.1 years, 14 (37%) were male and average caregiver experience was 9.8 years. Results Two cycles of action research were conducted during the study period. There were four stages in the process of how caregivers in the nursing home integrated the perspectives of rehabilitation through their work with the physical therapist. First, caregivers resisted having the rehabilitation programme carried out in the unit because they perceived that rehabilitation performed by a physical therapist was a special process and not under their responsibility. However, the caregivers were given a shared perspective on rehabilitation by the physical therapist, which helped them to understand the meaning of care to adapt the residents’ abilities to their daily life. They practised resident-centred care on a trial basis, although with a sense of conflict between their new and previous role, which emphasised the safety of residents’ lives and personhood. The caregivers increased their self-efficacy as their knowledge and skills were supplemented by the physical therapist and his approval of their attempted care. They were then able to commit to their newly conceived specialty of care as a means of supporting the lives of residents. Conclusions The process of working with a physical therapist led to a change in caregivers’ perception and behaviours, which occurred in four stages: resistance to incorporation, recapture of other perspectives, conflicts and trials in the role of caregiver and transformation to a resident-centred perspective.
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Affiliation(s)
- Ryohei Goto
- Department of Family Medicine, General Practice and Community Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Junji Haruta
- Medical Education Center, Keio University, Tokyo, Japan
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Haruta J, Goto R. Development of a Japanese version of the Self-assessment Scale of Interprofessional Competency (JASSIC). J Interprof Care 2021; 36:599-606. [PMID: 34355655 DOI: 10.1080/13561820.2021.1951188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study aimed to develop a Japanese version of the Self-assessment Scale of Interprofessional Competency (JASSIC), which consists of six domains: Patient-/Client-/Family-/Community-Centered, Interprofessional Communication, Role Contribution, Facilitation Relationship, Reflection, and Understanding of Others. Validity of JASSIC was confirmed through a four-step process consisting of expert discussion, cognitive debriefing, feasibility, and statistical analysis. Confirmatory factor analysis (CFA) was performed by testing the correlation between the sum scores of JASSIC and the Assessment of Interprofessional Team Collaboration Scale-II(AITCS-II). First, 24 items were created through discussions among physicians, a nurse, a medical educator, and an information sociologist. Second, the items were modified by cognitive debriefing of a physician, nurse, pharmacist, occupational therapist, and social worker. Third, we provided the developed JASSIC for professionals at Hospital X (n = 139) and revised the wording and composition of the items. Finally, CFA among professionals at Hospital Y (n = 153) identified a 6-domain structure (GFI: 0.847, AGFI: 0.782, RMSEA: 0.088). Cronbach's alpha was 0.92, and the correlation coefficient with AITCS-II was 0.72. Ongoing research into JASSIC will promote effective interprofessional collaborative practice not only in Japan but also other countries which share a similar culture and system.
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Affiliation(s)
- Junji Haruta
- Medical Education Center, School of Medicine, Keio University, Tokyo, Japan.,Department of Primary Care and Medical Education, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Ryohei Goto
- Department of General Medicine and Primary Care, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Ohta R, Ryu Y, Yoshimura M. Realist evaluation of interprofessional education in primary care through transprofessional role play: what primary care professionals learn together. EDUCATION FOR PRIMARY CARE 2020; 32:91-99. [PMID: 33375910 DOI: 10.1080/14739879.2020.1858349] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Interprofessional collaboration (IPC) is vital to primary care. Improving IPC requires cooperation between medical and other healthcare professionals. Transprofessional role plays can enhance the quality of IPC; thus, in this study, we conducted transprofessional role plays, based on existing theories regarding IPC and medical education, with healthcare professionals in primary care. As a study design, the realist approach was used to clarify the effectiveness of transprofessional role plays. Five Likert-scale questionnaires regarding the competency of IPC were used to assess the change in perception of medical and care professionals through educational intervention. The realist approach was employed for the clarification of contexts, mechanisms and outcomes of transprofessional role play using one-on-one interview data. Sixty-two medical care professionals participated in the transprofessional role plays, and 31 participants were interviewed. The difference in the score of the competency scale of IPC was statistically significant in all six competencies (p-value <0.001). Three context, mechanism and outcome theories were clarified from the qualitative analysis of the interviews: reflection on others, realisation of own roles and driving humanistic relationship. Additionally, contextual factors, the mechanisms that facilitated them and the clarified outcomes were identified. Ultimately, in this realist evaluation transprofessional role plays proved to be effective in driving IPC in primary care through improving compassion and reliability across professions. The constant provision of the role play and mutual discussion of each professional's role can facilitate effective IPC in primary care.
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Affiliation(s)
- Ryuichi Ohta
- Community Care, Unnan City Hospital, Unnan City, Shimane Prefecture, Japan
| | - Yoshinori Ryu
- Community Care, Unnan City Hospital, Unnan City, Shimane Prefecture, Japan
| | - Manabu Yoshimura
- Department of Family Medicine and Community Health, University of Miyazaki, Miyazaki City, Miyazaki Prefecture, Japan
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Haruta J, Tsugawa S, Ogura K. Exploring the structure of social media application-based information-sharing clinical networks in a community in Japan using a social network analysis approach. Fam Med Community Health 2020; 8:e000396. [PMID: 32978234 PMCID: PMC7520901 DOI: 10.1136/fmch-2020-000396] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Currently, use of social networking services (SNSs) for interprofessional collaboration is increasing. However, few studies have reported on virtual interprofessional interactions in community healthcare services. Revealing such structural characteristics of the networks can provide insight into the functions of the interprofessional information-sharing network and lead to smoother collaboration. Thus, we aimed to explore the structure of SNS-based information-sharing clinical networks. DESIGN Social network analysis (SNA). SETTING We selected a community in City X in Japan. DATA COLLECTION We analysed SNS-based information-sharing clinical network data linked to patients receiving home medical care or care services between January and December 2018. A network was created for each patient to allow healthcare professionals to post and view messages on the web platform. In the SNA, healthcare professions registered in a patient group were represented as nodes, and message posting/viewing relationships were represented as links in the patient network. We investigated the structural characteristics of the target networks using several measures for SNA, including indegree centrality and outdegree centrality, which reflect the number of incoming and outgoing links to/from a node, respectively. Additionally, the professions forming the most central nodes were investigated based on their ranking to identify those with a central role in the networks. Finally, to compare the networks of nursing care levels 1-3 (lighter care requirement) and those with nursing care levels 4-5 (heavier care requirement), we analysed the structural differences in the networks and investigated the roles of healthcare professionals using centrality measures of nodes. RESULTS Among 844 groups, 247 groups with any nursing care level data were available for analysis. Increasing nursing care level showed higher density, reciprocity and lower centralisation. Healthcare professions with high indegree centrality (physicians, care workers and physical therapists) differed from those with high outdegree centrality (home care workers, physical therapists, and registered dieticians). Visiting nurses and nurses in the clinic played a central role, but visiting nurses tended to have higher indegree and outdegree centrality, while nurses in the clinic had higher closeness and betweenness centrality in networks with heavier care requirement. CONCLUSION The SNS-based information-sharing clinical network structure showed that different professions played some form of a central role. Associations between network structures and patient outcomes, cost effectiveness and other factors warrant further investigation.
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Affiliation(s)
- Junji Haruta
- Medical Education Center, Keio University, Tokyo, Japan
- School of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Sho Tsugawa
- Division of Information Engineering, University of Tsukuba, Tsukuba, Japan
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Ohta R, Ryu Y, Katsube T. Care managers in rural Japan: Challenges to interprofessional collaboration. Home Health Care Serv Q 2019; 38:270-285. [PMID: 31564222 DOI: 10.1080/01621424.2019.1673867] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Effective interprofessional collaboration for care managers is vital for the care of older people. This study's aim was to inquire into the obstacles to interprofessional collaboration faced by care managers in rural areas of Japan. Forty-six care managers participated in group discussions and semi-structured interviews, and the qualitative data were analyzed using thematic analysis. Five themes related to obstacles emerged from the analysis regarding relationships with physicians, professional competency, relationships among other professionals, environmental constraints, and relationships with nonprofessionals. Other professionals' unfamiliarity with the care manager's role and a lack of mutual understanding, boundaries, and information sharing among medical professionals were also cited as issues.
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Affiliation(s)
- Ryuichi Ohta
- Community Care, Unnan City Hospital , Unnan , Shimane Prefecture , Japan
| | - Yoshinori Ryu
- Community Care, Unnan City Hospital , Unnan , Shimane Prefecture , Japan
| | - Takuji Katsube
- Community Care, Unnan City Hospital , Unnan , Shimane Prefecture , Japan
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