The interdisciplinary condition of work in relational professions of the health and social care field: A theoretical standpoint

Describing a Clinical Group Coding Method for Identifying Competencies in an Allied Health Single Session

Introduction

Competencies that integrate research findings and practice expertise are necessary to maintain comprehensive evidence-based practice for allied health professions, such as social work. The context of modern multidisciplinary healthcare, especially in acute or emergency settings, means that an individual clinician may only have a single session with a patient. Maximizing the benefit of single sessions requires advanced competence that extends beyond diagnostics and biomedical treatments to the impact of social systems on health outcomes; multi-level advocacy for reduction of existing health disparities and equity in access to health and mental health services; and “working knowledge” of non-pharmacological treatments.

Methods

This study employed a practice-based research methodology whereby health social workers group coded 32 simulation videos, drawn from an advanced social work practice course, to develop a practice-based competency framework that incorporates these advanced skills. Constructivist grounded theory was employed through a cyclical coding process of viewing video data, identifying and discussing skills and competencies, and summarizing/synthesizing the discussions for critical reflection.

Results

The resulting Clinician Group Coding Method utilized systematic and collaborative group coding of practice simulation videos by three clinicians and two researchers to identify relevant competencies for a single session. Emphasis was placed on the progressive phases of single-session patient interactions (eg, joining, working, ending), a practice format that frequently occurs in social work and other allied health professions. These phases include themes of preparing, agenda setting and refining, addressing context, providing education, planning the next steps, and encouraging success.

Discussion

The group coding process allowed for immediate discussions and clarifications, supporting the clinicians to synthesize their experiences toward shared understandings of “best practices” in single-session healthcare contexts. This approach facilitated the understanding of critical actions that allied health clinicians could undertake to improve single-session interactions. This practice-based competency framework may have significant utility for multidisciplinary healthcare education and practice.

How oncology teams can be patient-centred? opportunities for theoretical improvement through an empirical examination

BACKGROUND

In the context of interprofessional practice, a patient-centred approach is recommended, which generally means power-sharing, shared decision making and involving patients as part of the health-care team. These aspects, which are essential to "patient-centred" practice, do not appear to be sufficient to illustrate the full richness of this practice.

OBJECTIVE

This article aimed to understand how interprofessional patient-centred (IPPC) practice in oncology teams contributes to creating a more positive experience for patients. Objectives were to (a) describe the IPPC practice of oncology teams using the IPPC Practice Framework; (b) determine the usefulness of this framework; and (c) offer alternative proposals for expanding our understanding of IPPC practice.

DESIGN

A secondary analysis was performed with data from a multicase study designed to explore the effects of interdisciplinary work among oncology teams. Data were provided from six focus groups with professionals (n = 22) and patients diagnosed with cancer (n = 16). An iterative content analysis was performed.

RESULTS

Applying the theoretical framework to data analysis enabled us to distinguish between the IPPC practice of the different teams and structure the data collected in order to show the processes and place them in context. However, it proved to be difficult to describe the central component of the theoretical framework, patient-centred processes. This situation raises new hypotheses for representing practice in a real-life context. An alternative perspective for illustrating IPPC practice is therefore proposed.

CONCLUSION

This study emphasizes the importance of exploring the utility of theoretical frameworks and refining them in order to broaden our understanding of IPPC practice.

Social Work Intervention Research With Adult Cancer Patients: A Literature Review and Reflection on Knowledge-Building for Practice

The results of a literature review of social work intervention research with adult cancer patients found only a small number of studies conducted by social work researchers. The findings of the review are presented followed by a reflective discussion on the nature of knowledge-building and research knowledge for practice. Knowledge building is considered as a continuous, negotiated process within communities of practice focused on psychosocial perspectives that draw on a range of knowledge sources. Epistemology, worldviews and research orientations are considered along with the values and stance of social work, all of which create the domain of the practice-researcher.

Interprofessional patient-centred practice in oncology teams: utopia or reality?

Studies on interprofessional practice usually report professionals' viewpoints and document organizational, procedural and relational factors influencing that practice. Considering the importance of interprofessional patient-centred (IPPC) practice, it seems necessary to describe it in detail in an actual context of care, from the perspective of patients, their families and health-care professionals. The goal of this study was to describe IPPC practice throughout the continuum of cancer care. A qualitative multiple case study was completed with two interprofessional teams from a Canadian teaching hospital. Interviews were conducted with patients, their families and professionals, and observation was carried out. Three themes were illustrated by current team practice: welcoming the person as a unique individual, but still requiring the patient to comply; the paradoxical coexistence of patient-centred discourse and professional-centred practice; and triggering team collaboration with the culmination of the patient's situation. Several influential factors were described, including the way the team works; the physical environment; professionals' and patients'/family members' stance on the collaboration; professionals' stance on patients and their families; and patients' stance on professionals. Finally, themes describing the desired IPPC practice reflect the wish of most participants to be more involved. They were: providing support in line with the patient's experience and involvement; respecting patients by not imposing professionals' values and goals; and consistency and regularity in the collaboration of all members.

Interdisciplinary collaboration in gerontology and geriatrics in Latin America: conceptual approaches and health care teams

The underlying rationale to support interdisciplinary collaboration in geriatrics and gerontology is based on the complexity of elderly care. The most important characteristic about interdisciplinary health care teams for older people in Latin America is their subjective-basis framework. In other regions, teams are organized according to a theoretical knowledge basis with well-justified priorities, functions, and long-term goals, in Latin America teams are arranged according to subjective interests on solving their problems. Three distinct approaches of interdisciplinary collaboration in gerontology are proposed. The first approach is grounded in the scientific rationalism of European origin. Denominated "logical-rational approach," its core is to identify the significance of knowledge. The second approach is grounded in pragmatism and is more associated with a North American tradition. The core of this approach consists in enhancing the skills and competences of each participant; denominated "logical-instrumental approach." The third approach denominated "logical-subjective approach" has a Latin America origin. Its core consists in taking into account the internal and emotional dimensions of the team. These conceptual frameworks based in geographical contexts will permit establishing the differences and shared characteristics of interdisciplinary collaboration in geriatrics and gerontology to look for operational answers to solve the "complex problems" of older adults.

Peeling the layers: a grounded theory of interprofessional co-learning with residents of a homeless shelter

Clients, patients, families, and communities must be conceived as partners in care delivery, not just as recipients (D'Amour, D. & Oandasan, I. (2005). Journal of Interprofessional Care, 19(Suppl.), 8-20). Health-care students need an opportunity to understand community member self-determination, partnership, and empowerment (Scheyett, A., & Diehl, M. ( 2004 ). Social Work Education, 23(4), 435-450), within the frame of interprofessional education (IPE) where community members are involved as teachers and learners. The aim of this grounded theory research was to determine the conditions that support health-care students to learn with, from, and about community members. This study took place in a shelter for the homeless where nursing and social work students learned interprofessionally along with residents and clients of the shelter. Data were gathered through 7 months of participant observation, interviews, and focus groups. The interprofessional co-learning theory that emerged introduces the three phases of entering, engaging, and emerging, which co-learners experienced at different levels of intensity. This article outlines the conditions that support each of these phases of the co-learning process. This interprofessional co-learning theory provides a basis for further development and evaluation of IPE programs that strive to actively include community members as teachers and learners, experts, and novices together with service providers, students, and faculty members.