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Janssens O, Haerens L, Valcke M, Embo M, Debacker J, Van Hecke A, Gauwe V, Van Hecke M, De Vriendt P, Pype P. The development of a research-based interprofessional communication behaviors repository in healthcare education: A systematic review. J Interprof Care 2024:1-18. [PMID: 39074503 DOI: 10.1080/13561820.2024.2372017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 03/23/2024] [Accepted: 06/18/2024] [Indexed: 07/31/2024]
Abstract
Interprofessional communication is crucial for patient care, yet there is a dearth of comprehensive assessment tools essential to train and assess healthcare students. While the Interprofessional Educational Collaborative framework (IPEC) outlines eight sub-competencies, it lacks detailed behavioral indicators. This study aimed to create a repository of interprofessional communication behaviors to complement the IPEC sub-competencies. From 12,448 articles, 55 were selected and thematically analyzed with NVivo18®. We identified 230 interprofessional communication behaviors, organized into 10 themes and 61 sub-themes, aligning with the IPEC sub-competencies. This comprehensive repository could be foundational for developing interprofessional communication assessment tools in healthcare education and aiding healthcare institutions in improving interprofessional communication practices.
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Affiliation(s)
- Oona Janssens
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Leen Haerens
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Martin Valcke
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Mieke Embo
- Expertise Network Health and Care, Artevelde University of Applied Sciences, Ghent, Belgium
- Department of Nursing and Midwifery, University of Antwerp, Antwerp, Belgium
| | - Jens Debacker
- Vrije Universiteit Brussel (VUB),Molecular Imaging and Therapy Research Group (MITH), Brussels, Belgium
- Department of Nuclear Medicine, Vrije Universiteit Brussel (VUB),University Hospital Brussels (UZ Brussel), Brussels, Belgium
| | - Ann Van Hecke
- Department of Public Health and Primary Care, University Centre for Nursing and Midwifery, Ghent University, Ghent, Belgium
- Nursing Department, Ghent University Hospital, Ghent, Belgium
| | - Vanessa Gauwe
- Expertise Network Health and Care, Artevelde University of Applied Sciences, Ghent, Belgium
| | - Marlies Van Hecke
- Expertise Network Health and Care, Artevelde University of Applied Sciences, Ghent, Belgium
| | - Patricia De Vriendt
- Expertise Network Health and Care, Artevelde University of Applied Sciences, Ghent, Belgium
- Frailty in Ageing (FRIA) research group, Mental Health and Wellbeing research group (MENT), Gerontology department, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Ghent, Belgium
| | - Peter Pype
- Department of Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Occupational Therapy, Physiotherapy and Speech-language Pathology/Audiology, Ghent University, Ghent, Belgium
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Centre for Interprofessional Collaboration in Education, Research and Practice, Ghent University, Ghent, Belgium
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Royani, Hamid AYS, Rekawati E, Darmawan ES. Exploring the implementation of multidisciplinary collaboration at nursing homes in Jakarta, Indonesia: A descriptive phenomenological study. BELITUNG NURSING JOURNAL 2024; 10:332-340. [PMID: 38947308 PMCID: PMC11211744 DOI: 10.33546/bnj.3226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/21/2024] [Accepted: 04/16/2024] [Indexed: 07/02/2024] Open
Abstract
Background A well-functioning multidisciplinary team optimizes resource utilization and reduces care redundancy, fragmentation, and wastage. Collaborative efforts yield a clearer understanding of older people's needs and desires, significantly reducing hospitalization days. Despite limited studies, particularly in Indonesia, investigating professionals' experiences in implementing multidisciplinary collaboration in government nursing homes, nursing care quality remains a concern. Objective This study aimed to explore the implementation of multidisciplinary collaboration in nursing homes from the perspectives of various disciplines. Methods A descriptive phenomenological study was used with semi-structured interviews and focus group discussions with multidisciplinary care providers, including nurses, doctors, social workers, physiotherapists, psychologists, occupational and recreational activity instructors, and clergy in nursing homes owned by the Jakarta provincial government. A total of 64 participants were involved, and data were collected from September 2022 to July 2023. Data were analyzed using content-based analysis. Results Three main themes emerged: 1) context of multiple collaborations, 2) barriers to implementing multiple collaborations, and 3) impacts of non-optimal multidisciplinary collaborations. Nursing home management's multidisciplinary teams predominantly implement professional-centered care with limited support systems. While providers generally perceive collaboration positively, shared responsibility and joint work among professionals are lacking. Conclusion This study highlights the need to improve multidisciplinary collaboration in nursing homes to enhance care quality for older individuals. While providers view collaboration positively, barriers like a lack of shared responsibility and joint work persist. Enhancing teamwork cohesion through improved communication and integrated case reporting systems is crucial. Addressing human resource and systemic barriers is also vital. By overcoming these challenges, nursing homes can optimize resource use, reduce care redundancy, and better meet the diverse needs of older residents.
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Affiliation(s)
- Royani
- Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia
- Sekolah Tinggi Ilmu Kesehatan Banten, Banten, Indonesia
| | | | - Etty Rekawati
- Faculty of Nursing, Universitas Indonesia, Depok, West Java, Indonesia
| | - Ede Surya Darmawan
- Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia
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Schwartz BD, Rogers SL, Michels N, Van Winkle LJ. Substantial Increases in Healthcare Students' State Empathy Scores Owing to Participation in a Single Improvisation Session. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:531. [PMID: 38791746 PMCID: PMC11120652 DOI: 10.3390/ijerph21050531] [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: 03/02/2024] [Revised: 04/12/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024]
Abstract
PURPOSE To determine whether the 12-item state empathy scale could be modified reliably to measure empathy in healthcare professions students and to detect changes in their empathy owing to a single improvisation (improv) session. METHODS Three cohorts of students from two healthcare professions programs (total = 165 students) participated in an improv session. During the session, one of the researchers (BS) tasked the students with several improv activities. Participants' self-reported state empathy scores were assessed at three time points (pre-improv, post-improv, and end of semester) using revised, in-class paper versions of the State Empathy Scale. RESULTS The exploratory factor analysis revealed a single factor solution for the revised scale, justifying the creation of an overall state empathy score from the questionnaire. Cronbach's alpha reliability values averaged 0.87. Students' mean empathy scores were higher directly after the improv session than directly prior to the session (p < 0.0001; effect size = r = 0.67, 0.55, and 0.79 for cohorts 1, 2, and 3, respectively). CONCLUSIONS These findings show that a single one- or two-hour improv session can foster substantial increases in healthcare professional students' state empathy for one another. Greater healthcare professional empathy and compassion foster better healthcare team cooperation and patient outcomes, so healthcare professionals and their students should engage in such empathy-enhancing activities at regular intervals throughout their training and careers.
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Affiliation(s)
- Brian D. Schwartz
- Department of Medical Humanities, Rocky Vista University, Englewood, CO 80112, USA; (B.D.S.); (N.M.)
| | - Shane L. Rogers
- School of Arts and Humanities, Edith Cowan University, Joondalup, WA 6027, Australia;
| | - Nicole Michels
- Department of Medical Humanities, Rocky Vista University, Englewood, CO 80112, USA; (B.D.S.); (N.M.)
| | - Lon J. Van Winkle
- Department of Medical Humanities, Rocky Vista University, Englewood, CO 80112, USA; (B.D.S.); (N.M.)
- Department of Biochemistry, Midwestern University, Downers Grove, IL 60515, USA
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Yannamani P, Gale NK. The ebbs and flows of empathy: a qualitative study of surgical trainees in the UK. BMC MEDICAL EDUCATION 2024; 24:131. [PMID: 38336765 PMCID: PMC10858458 DOI: 10.1186/s12909-024-05105-x] [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: 08/16/2023] [Accepted: 01/28/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Empathy is widely recognised as an important element of medical practice contributing to patient outcomes and satisfaction. It is also an important element of collaborative work in a healthcare team. However, there is evidence to suggest that empathy towards patients declines over time, particularly in surgical specialities. There is little qualitative research on this decline in surgical trainees, particularly in the UK. Therefore, the aim of this study was to explore how trainee surgeons experience empathy over the course of their career, both towards patients and colleagues and how they perceive it in others. METHODS 10 semi-structured interviews were carried out with surgical trainees of different grades and specialties in January and February 2022. Framework analysis was used to interpret the data. RESULTS Participants experienced an evolution in empathy over their career as their personal and professional experience was added to. They drew a distinction between desensitisation and actual decline in empathy and identified more with experiencing the former in their careers. Participants also felt interprofessional relationships require empathy, and this could be improved upon. Finally, they highlighted specific impacts of the COVID-19 pandemic upon their training, including reduced theatre time. CONCLUSIONS Participants felt training could be improved in regard to accessing training opportunities and relationships with colleagues, although many felt empathy between colleagues is better than it has been in the past. This project highlighted areas for future research, such as with surgeons in later stages of their careers, or mixed-methods projects.
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Affiliation(s)
| | - Nicola Kay Gale
- Health Policy and Sociology, Health Services Management Centre, School of Social Policy, University of Birmingham, Birmingham, UK
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Krecko LK, Stalter LN, Quamme SRP, Steege LM, Zelenski AB, Greenberg CC, Jung S. Discussion-based interprofessional education: A positive step toward promoting shared understanding between surgical residents and nurses. J Interprof Care 2023; 37:974-989. [PMID: 37161400 PMCID: PMC10636242 DOI: 10.1080/13561820.2023.2206434] [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: 07/07/2022] [Revised: 01/30/2023] [Accepted: 04/06/2023] [Indexed: 05/11/2023]
Abstract
Interprofessional education during medical training may improve communication by promoting collaboration and the development of shared mental models between professions. We implemented a novel discussion-based intervention for surgical residents and nurses to promote mutual understanding of workflows and communication practices. General surgery residents and inpatient nurses from our institution were recruited to participate. Surveys and paging data were collected prior to and following the intervention. Surveys contained original questions and validated subscales. Interventions involved facilitated discussions about workflows, perceptions of urgency, and technology preferences. Discussions were recorded and transcribed for qualitative content analysis. Pre and post-intervention survey responses were compared with descriptive sample statistics. Group characteristics were compared using Fisher's exact tests. Eleven intervention groups were conducted (2-6 participants per group) (n = 38). Discussions achieved three aims: Information-Sharing (learning about each other's workflows and preferences), 2) Interpersonal Relationship-Building (establishing rapport and fostering empathy) and 3) Interventional Brainstorming (discussing strategies to mitigate communication challenges). Post-intervention surveys revealed improved nurse-reported grasp of resident schedules and tailoring of communication methods based on workflow understanding; however, communication best practices remain limited by organizational and technological constraints. Systems-level changes must be prioritized to allow intentions toward collegial communication to thrive.
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Affiliation(s)
- Laura K Krecko
- Department of Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Lily N Stalter
- Department of Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Sudha R Pavuluri Quamme
- Department of Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Linsey M Steege
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
| | - Amy B Zelenski
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Caprice C Greenberg
- Department of Surgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - Sarah Jung
- Department of Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
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Chen HW, O’Donnell JM, Chiu YJ, Chen YC, Kang YN, Tuan YT, Kuo SY, Wu JC. Comparison of learning outcomes of interprofessional education simulation with traditional single-profession education simulation: a mixed-methods study. BMC MEDICAL EDUCATION 2022; 22:651. [PMID: 36042449 PMCID: PMC9429663 DOI: 10.1186/s12909-022-03640-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Interprofessional collaborative practice is essential for meeting patients' needs and improving their health outcomes; thus, the effectiveness of interprofessional education (IPE) should be clearly identified. There is insufficient evidence in the literature to determine the outcomes of IPE compared to traditional single-profession education (SPE). This study aimed to compare the outcomes of IPE and SPE during a simulation training course. METHODS The study design was a mixed-methods, incorporated cross-over design and a qualitative survey. A total of 54 students including 18 medical students and 36 nursing students were recruited from March to April 2019. The 4-week simulation course was designed based on Kolb's experimental learning theory and Bandura's social learning theory. Participants were evenly divided into group 1 (received IPE-learning followed by SPE-learning), and group 2 (received SPE-learning followed by IPE-learning). Students' medical task performance, team behavior performance, teamwork attitude, and patient safety attitude were collected at pretest, mid-test, and posttest. Descriptive statistics and repeated measures analysis of variance were used. End-of-study qualitative feedback was collected, and content analysis was performed. RESULTS Both groups demonstrated moderate-to-large within-group improvements for multiple learning outcomes at mid-test. Group 1 students' medical task performance (F = 97.25; P < 0.001) and team behavior performance (F = 31.17; P < 0.001) improved significantly. Group 2 students' medical task performance (F = 77.77; P < 0.001), team behavior performance (F = 40.14; P < 0.001), and patient safety attitude (F = 6.82; P < 0.01) improved significantly. Outcome differences between groups were nonsignificant. Qualitative themes identified included: personal factor, professional factor, interprofessional relationship, and learning. The IPE program provided students with exposure to other professions and revealed differences in expertise and responsibilities. CONCLUSION IPE-simulation and SPE-simulation were effective interventions that enabled medical and nursing students to develop critical medical management and team behavior performance. IPE-simulation provided more opportunities for improving competencies in interprofessional collaborative practice. In circumstances with limited teaching resources, SPE-simulation can be an acceptable alternative to IPE-simulation.
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Affiliation(s)
- Hui-Wen Chen
- Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - John M. O’Donnell
- Department of Nurse Anesthesia, University of Pittsburgh Nurse Anesthesia Program, Pittsburgh, Pennsylvania USA
- Winter Institute for Simulation, Education and Research (WISER) VB 360A, 230 McKee Place, Suite 300., PA 15213 Pittsburgh, USA
| | - Yu-Jui Chiu
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yi-Chun Chen
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yi-No Kang
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 110 Taiwan
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Health Care Management, College of Health Technology, National Taipei University of Nursing Health Sciences, Taipei, Taiwan
| | - Yueh-Ting Tuan
- Department of Emergency Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Shu-Yu Kuo
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, Taipei, 11031 Taiwan
- Department of Nursing, Taipei Medical University Hospital Taipei Medical University, 252 Wuxing St., Taipei, 11031 Taiwan
| | - Jen-Chieh Wu
- Department of Emergency, Taipei Medical University Hospital, 252 Wuxing Street, Taipei, 110301 Taiwan
- Department of Education and Humanities in Medicine, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing Street, Taipei, 11031 Taiwan
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Zhao QJ, Cupido N, Whitehead CR, Mylopoulos M. What role can education play in integrated care? Lessons from the ECHO (Extensions for Community Health Outcomes) Concussion program. JOURNAL OF INTEGRATED CARE 2022. [DOI: 10.1108/jica-01-2022-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeDesign, implementation, and evaluation are all important for integrated care. However, they miss one critical factor: education. The authors define “integrated care education” as meaningful learning that purposefully supports collaboration and the development of adaptive expertise in integrated care. The ECHO (Extensions for Community Health Outcomes) model is a novel digital health solution that uses technology-enabled learning (TEL) to facilitate, support, and model integrated care education. Using ECHO Concussion as a case study, the authors describe the effects of technology-enabled integrated care education on the micro-, meso-, and macro-dimensions of integrated care.Design/methodology/approachThis case study was constructed using data extracted from ECHO Concussion from video-archived sessions, participant observation, and internal program evaluation memos. The research team met regularly to discuss the development of relevant themes to the dimensions of integrated care.FindingsOn the micro-level, clinical integration occurs through case-based learning and the development of adaptive expertise. On the meso-level, professional integration is achieved through the development of the “specialist generalist,” professional networks and empathy. Finally, on the macro-level, ECHO Concussion and the ECHO model achieve vertical and horizontal system integration in the delivery of integrated care. Vertical integration is achieved through ECHO by educating and connecting providers across sectors from primary to quaternary levels of care. Horizontal integration is achieved through the establishment of lateral peer-based networks across sectors as a result of participation in ECHO sessions with a focus on population-level health.Originality/valueThis case study examines the role of education in the delivery of integrated care through one program, ECHO Concussion. Using the three dimensions of integrated care on the micro-, meso-, and macro-levels, this case study is the first explicit operationalization of ECHO as a means of delivering integrated care education and supporting integrated care delivery.
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Improving the Quality of Patient Care and Healthcare Staff Well-Being through an Empathy Immersion Educational Programme in New Zealand: Protocol of a Feasibility and Pilot Study. Methods Protoc 2021; 4:mps4040089. [PMID: 34940400 PMCID: PMC8706397 DOI: 10.3390/mps4040089] [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: 11/01/2021] [Revised: 12/08/2021] [Accepted: 12/13/2021] [Indexed: 11/17/2022] Open
Abstract
Empathy is positively related to healthcare workers and patients’ wellbeing. There is, however, limited research on the effects of empathy education delivered in acute clinical settings and its impact on healthcare consumers. This research tests the feasibility and the potential efficacy outcomes of an immersive education programme developed by the research team in collaboration with clinical partners and a multidisciplinary advisory group. Healthcare worker participants in the intervention ward will receive an 8-week immersive empathy education. The primary outcome (feasibility) will be assessed by evaluating the acceptability of the intervention and the estimated resources. The secondary outcome (efficacy) will be assessed using a quasi-experimental study design. Non-parametric tests will be used to test healthcare worker participants’ empathy, burnout, and organisational satisfaction (within-group and across groups), and healthcare consumer participants’ satisfaction (between-group) over time. Despite growing interest in the importance of empathy in professional relationships, to our knowledge, the present pilot study is the first to explore the feasibility and efficacy of an immersive empathy education in New Zealand. Our findings will provide critical evidence to support the development of a randomised cluster trial and potentially provide preliminary evidence for the effectiveness of this type of empathy education.
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Fenn N, Reyes C, Mushkat Z, Vinacco K, Jackson H, Al Sanea A, Robbins ML, Hulme J, Dupre AM. Empathy, better patient care, and how interprofessional education can help. J Interprof Care 2021; 36:660-669. [PMID: 34382506 DOI: 10.1080/13561820.2021.1951187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Interprofessional education (IPE) has been promoted as one way to prepare healthcare students for interprofessional encounters they might experience in the workplace. However, the link between IPE, interprofessional care in the workforce, and better patient outcomes is tenuous, perhaps in part due to the inability of IPE programs to adequately address barriers associated with interprofessional care (e.g., power differentials, role disputes). Empathy, or understanding the experiences of others, has emerged as a critical tool to breaking down barriers inherent to working in teams. Given the evidence connecting empathy to stronger team collaboration and better patient care, researchers significantly revamped programming from a prior training called Interprofessional Education for Complex Neurological Cases (IPE Neuro) to enhance empathy, foster stronger team collaboration, and improve information integration among participants. In this improved three-session program, participants from seven different professions were grouped into teams, assessed a patient volunteer with neurological disorder, and created and presented an integrated, patient-centric treatment plan. Students (N = 31) were asked to report general empathy levels, as well as attitudes, team skills, and readiness toward interprofessional care, before and after the program. We conducted paired samples t-tests and thematic analysis to analyze the data. Results showed that participants reported higher empathy levels, more positive attitudes, and greater team skills pre- to posttest with moderate to large effects. Results bolster IPE Neuro programming as one approach to prepare students for interprofessional care while underscoring the potential implications of IPE to improve empathy levels of healthcare professionals.
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Affiliation(s)
- Natalie Fenn
- Department of Psychology, University of Rhode Island, Kingston, RI United States
| | - Cheyenne Reyes
- Department of Psychology, University of Rhode Island, Kingston, RI United States
| | - Zoe Mushkat
- Department of Psychology, University of Rhode Island, Kingston, RI United States
| | - Kenneth Vinacco
- Department of Physical Therapy, University of Rhode Island, Kingston, RI United States
| | - Heather Jackson
- Department of Physical Therapy, University of Rhode Island, Kingston, RI United States
| | - Alia Al Sanea
- Department of Psychology, University of Rhode Island, Kingston, RI United States
| | - Mark L Robbins
- Department of Psychology, University of Rhode Island, Kingston, RI United States
| | - Janice Hulme
- Department of Physical Therapy, University of Rhode Island, Kingston, RI United States
| | - Anne-Marie Dupre
- Department of Physical Therapy, University of Rhode Island, Kingston, RI United States
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Kowalek K, Bochatay N, Ju M, Van Schaik S. The impact of interprofessional perspective-taking on moral distress in the pediatric intensive care unit. J Interprof Care 2021:1-8. [PMID: 34030556 DOI: 10.1080/13561820.2021.1892613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 02/03/2021] [Accepted: 02/12/2021] [Indexed: 10/21/2022]
Abstract
Moral distress arises when constraints outside of healthcare professionals' control prohibit them from acting according to the ethically sound course of action. It can be triggered by poor communication and different perspectives between professionals. We examined whether and how taking the perspective of the other profession reduces moral distress among pediatric intensive care nurses and physicians. Using elements of a previously published scale, we created a Vignette-based Moral Distress Rating Scale (V-MDRS). Study participants from three sites included 105 nurses and 34 physicians who read a patient vignette with their own profession's perspective, completed the V-MDRS, then received the other profession's perspective and completed the V-MDRS again. We conducted semi-structured interviews with nine nurses and nine physicians who completed the V-MDRS to explore how interprofessional perspective-taking impacts moral distress. Nurses experienced higher baseline moral distress than physicians (mean ± standard deviation 31.1 ± 6.9 vs 26.4 ± 5, P < .001), and at two study sites nurses' moral distress declined after reading the physician's perspective. Findings from interviews suggest that physicians were already sensitized to nurses' perspective and that perspective-taking may be particularly beneficial to cohesive teams with strong relationships. Thus, encouraging interprofessional perspective-taking may mitigate moral distress in healthcare professionals.
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Affiliation(s)
- Katie Kowalek
- Department of Pediatrics, University of Arizona, Tucson, USA
| | - Naike Bochatay
- Department of Pediatrics, University of California, San Francisco, USA
- Institute of Sociological Research, University of Geneva, Geneva, Switzerland
| | - Mindy Ju
- Department of Pediatrics, University of California, San Francisco, USA
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