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Babu D, Rowett D, Kalisch Ellett L, Marotti S, Wisdom A, Lim R, Harmon J. Exploration of 'micro' level factors that affect the involvement of clinical pharmacists in interprofessional ward rounds in hospitals: Through the lens of social cognitive theory. Res Social Adm Pharm 2024; 20:654-664. [PMID: 38627153 DOI: 10.1016/j.sapharm.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/05/2024] [Accepted: 04/07/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Macro and meso level factors that influence the participation by clinical pharmacists in ward rounds include pharmacy management culture, commitment to ward rounds and adequate time for ward rounds being included in workload models. The 'micro' level factors that affect the involvement of clinical pharmacists in ward rounds have not been widely explored. OBJECTIVE Explore 'micro' level factors to gain insight into clinical pharmacists' participation in interprofessional ward rounds in inpatient settings through the lens of social cognitive theory. METHOD A qualitative focused ethnographic study with five clinical pharmacists, four medical practitioners, one allied health professional and one nurse was conducted in three metropolitan hospitals in Southern Australia. Seven hours of semi-structured interview (n = 11) and 76-h of observations (n = 5) were conducted. A qualitative descriptive analysis was conducted (guided by Spradley) followed by reflexive thematic-analysis (according to Braun and Clarke's technique). RESULTS Three micro level factors influencing clinical pharmacist participation in ward rounds are: (1) Cognitive mindset of clinical pharmacists, (2) Behavioural conduct of clinical pharmacists, and (3) Social rules of the ward. Clinical pharmacists that did not participate in ward round reconciled their moral distress by transferring information without clinical judgement or interpretation of the patient scenario to medical practitioners. Clinical pharmacists that did participate in ward rounds demonstrated credibility by making relevant recommendations with a holistic lens. This enabled clinical pharmacists to be perceived as trustworthy by medical practitioners. Positive experiences of participating in ward rounds contributed to their cognitive upward spiral of thoughts and emotions, fostering continued participation. CONCLUSION Clinical pharmacists participate in ward rounds when they develop a positive mindset about ward round participation and perceive ward rounds as an enabler to the establishment of trusted professional relationships with medical practitioners. This trusted relationship creates an environment where the pharmacist develops confidence in making relevant recommendations.
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Affiliation(s)
- Dona Babu
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia; SA Pharmacy, SA Health, Adelaide, SA, 5000, Australia.
| | - Debra Rowett
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia; Drug and Therapeutics Information Service, Southern Adelaide Local Health Network, Adelaide, SA, 5000, Australia
| | - Lisa Kalisch Ellett
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Sally Marotti
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia; SA Pharmacy, SA Health, Adelaide, SA, 5000, Australia
| | - Alice Wisdom
- SA Pharmacy, SA Health, Adelaide, SA, 5000, Australia
| | - Renly Lim
- Quality Use of Medicines and Pharmacy Research Centre, UniSA Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
| | - Joanne Harmon
- Rosemary Bryant AO Research Centre, Clinical and Health Sciences, University of South Australia, GPO Box 2471, Adelaide, SA, 5001, Australia
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Al-Hammouri MM, Rababah JA. Testing a modified motivational interviewing counseling program. J Prof Nurs 2024; 51:90-96. [PMID: 38614680 DOI: 10.1016/j.profnurs.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 02/26/2024] [Accepted: 02/26/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Motivational Interviewing is a well-established person-centered counseling approach toward positive behavioral change. However, several limitations have been reported using motivational interviewing applications. PURPOSE This study explored the potential of an innovative intervention (namely, modified motivational interviewing) to address the limitations associated with the original form of Motivational Interviewing. METHODS The research used a phenomenological qualitative design to include three focus groups with a total sample size of 24 university nursing students to examine their experiences with the Modified Motivational Interviewing. The focus groups were transcribed verbatim and then coded to extract the themes. RESULTS The following ten themes emerged from the data analysis: increasing discrepancy; ambivalence; ready, willing, and able; change as a natural process; the role of the modified motivational interviewing facilitator; spontaneous generalization; peer support facilitates change; help-seeking behavior; practical applications of the modified motivational interviewing; and problems encountered during the implementation of modified motivational interviewing. CONCLUSIONS The proposed intervention can potentially be a cost-effective replacement for the original format of motivational interviewing intervention. Further research is needed to support the modified motivational interviewing.
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Affiliation(s)
| | - Jehad A Rababah
- Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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Verhees MJM, Engbers R, Landstra AM, Bremer AE, van de Pol M, Laan RFJM, Assendelft WJJ. Workplace-based learning about health promotion in individual patient care: a scoping review. BMJ Open 2023; 13:e075657. [PMID: 37963689 PMCID: PMC10649380 DOI: 10.1136/bmjopen-2023-075657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/25/2023] [Indexed: 11/16/2023] Open
Abstract
OBJECTIVE To outline current knowledge regarding workplace-based learning about health promotion in individual patient care. DESIGN Scoping review. DATA SOURCES PubMed, ERIC, CINAHL and Web of Science from January 2000 to August 2023. ELIGIBILITY CRITERIA We included articles about learning (activities) for healthcare professionals (in training), about health promotion in individual patient care and in the context of workplace-based learning. DATA EXTRACTION AND SYNTHESIS The studies were evaluated using a charting template and were analysed thematically using a template based on Designable Elements of Learning Environments model. RESULTS From 7159 studies, we included 31 that described evaluations of workplace-based learning about health promotion, around a variety of health promotion topics, for different health professions. In the articles, health promotion was operationalised as knowledge, skills or attitudes related to specific lifestyle factors or more broadly, with concepts such as health literacy, advocacy and social determinants of health. We assembled an overview of spatial and instrumental, social, epistemic and temporal elements of learning environments in which health promotion is learnt. CONCLUSIONS The studies included in our analysis varied greatly in their approach to health promotion topics and the evaluation of learning outcomes. Our findings suggest the importance of providing opportunities for health profession learners to engage in authentic practice situations and address potential challenges they may experience translating related theory into practice. Additionally, our results highlight the need for conscious and articulated integration of health promotion in curricula and assessment structures. We recommend the exploration of opportunities for health profession students, professionals and patients to learn about health promotion together. Additionally, we see potential in using participatory research methods to study future health promotion learning. STUDY REGISTRATION Open Science Framework, https://doi.org/10.17605/OSF.IO/6QPTV.
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Affiliation(s)
| | - Rik Engbers
- Radboudumc Health Academy, Radboudumc, Nijmegen, The Netherlands
| | - Anneke M Landstra
- Radboudumc Health Academy, Radboudumc, Nijmegen, The Netherlands
- Paediatrics, Rijnstate, Arnhem, The Netherlands
| | - Anne E Bremer
- Radboudumc Health Academy, Radboudumc, Nijmegen, The Netherlands
| | - Marjolein van de Pol
- Radboudumc Health Academy, Radboudumc, Nijmegen, The Netherlands
- Department of Primary and Community Care, Radboudumc, Nijmegen, The Netherlands
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Badowski D, Rossler KL, Reiland N, Gill Gembala LT. Integration of Motivational Interviewing Within Prelicensure Nursing Programs: A National Survey. Nurse Educ 2022; 47:168-173. [PMID: 34711754 DOI: 10.1097/nne.0000000000001127] [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
BACKGROUND Vital to the nurse-patient partnership is the use of active listening and a clear understanding of the patient's health care goals. Motivational Interviewing is an evidence-based, patient-centered communication technique that assists patients in self-identifying and committing to health behavior change. PURPOSE This study explored whether, where, and how Motivational Interviewing is integrated into current prelicensure nursing curricula. METHODS An exploratory, descriptive study incorporated a researcher-developed survey. RESULTS Participants (N = 112) represented 5 types of prelicensure nursing programs from across the United States. Forty-one participants reported using Motivational Interviewing within their program with accreditation being the primary rationale. Seventy-one participants reported not integrating Motivational Interviewing within their program with lack of knowledge being the primary rationale. CONCLUSION Further research on optimizing the integration of Motivational Interviewing educational content and practice into all levels and specialty areas of nursing education would help to identify best practices.
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Affiliation(s)
- Donna Badowski
- Associate Director, RN-to-MS Nursing Program, and Associate Professor (Dr Badowski), DePaul University School of Nursing, Chicago, Illinois; Associate Professor (Dr Rossler), Baylor University Louise Herrington School of Nursing, Dallas, Texas; Associate Professor of Nursing/Coordinator of Continuing Education/BAC-BSN Program and Director (Dr Reiland), Lewis University Romeoville, Illinois; and Assistant Professor of Instruction (Dr Gill Gembala), Adjunct Graduate Faculty, Department of Nursing, College of Public Health, Temple University, Philadelphia, Pennsylvania
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Andreassen P, Christensen MK, Møller JE. Focused ethnography as an approach in medical education research. MEDICAL EDUCATION 2020; 54:296-302. [PMID: 31850537 DOI: 10.1111/medu.14045] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 12/06/2019] [Accepted: 12/11/2019] [Indexed: 06/10/2023]
Abstract
CONTEXT Over recent decades, the use of qualitative methodologies has increased in medical education research. These include ethnographic approaches, which have been used to explore complex cultural norms and phenomena by way of long-term engagement in the field of research. Often, however, medical education consists of short-term episodes that are not bound to single sites, but take place in a myriad of locations and contexts such as classrooms, examination stations, clinical settings and online. This calls for methodologies that allow us to grasp what is at stake in an increasingly multifaceted and diverse field. METHODS In this article, we direct attention to focused ethnography, which has emerged as a useful, suitable and feasible applied qualitative research approach, and which uses adapted classic ethnographic methods, such as direct observation, to gain new insights and nuanced understandings of distinct phenomena, themes and interactions in specific settings in medical education (eg the learning potential of ward rounds, or how hierarchical positions affect learning situations). We introduce methodological key features of focused ethnography to give insights into how the approach can be used, and we offer examples of how the method has been used in medical education research to show how it has contributed in different ways to the field of medical education research. Furthermore, we address and discuss some of the main challenges and limitations of the approach. CONCLUSIONS Focused ethnography offers a methodological approach that sheds light over limited and well-defined social episodes and interactions. Precisely because the field of medical education consists to a large degree of such fragmented interactions, focused ethnography can be seen as a methodology tailored to these characteristics and should become an integrated part of the toolkit of medical education research.
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Affiliation(s)
- Pernille Andreassen
- Centre for Health Sciences Education, Aarhus University, INCUBA Skejby, Aarhus, Denmark
| | - Mette K Christensen
- Centre for Health Sciences Education, Aarhus University, INCUBA Skejby, Aarhus, Denmark
| | - Jane E Møller
- Centre for Health Sciences Education, Aarhus University, INCUBA Skejby, Aarhus, Denmark
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Bush AA, Amechi MH. Conducting and presenting qualitative research in pharmacy education. CURRENTS IN PHARMACY TEACHING & LEARNING 2019; 11:638-650. [PMID: 31213322 DOI: 10.1016/j.cptl.2019.02.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 11/18/2018] [Accepted: 02/18/2019] [Indexed: 05/12/2023]
Abstract
SITUATION The evolution of practices in healthcare and the content and delivery of pharmacy education have generated new challenges for practitioners and academicians. Fittingly, pharmacy education research in the academic setting has grown rapidly to provide innovative solutions to these challenges. One approach for addressing these challenges includes the collection and analysis of qualitative research (QR). Though a useful methodological tool, many pharmacy educators are not trained to appropriately conduct QR and present the findings of their work. METHODOLOGICAL LITERATURE REVIEW QR offers many advantages for pharmacy education researchers. However, prior to delving into QR projects it is important to understand the key distinctions of the approach, role of the researcher, and the significance of situating the study so that the research question, data collection techniques, and analysis procedures are aligned. RECOMMENDATIONS We provide recommendations for several key components for conducting QR, articulating the process, and presenting and contextualizing the findings. IMPLICATIONS This article serves as a primer on QR methods, offering relevant background information, ways to apply this approach in pharmacy education research, and recommendations for presenting qualitative findings. Employing rigorous qualitative approaches in pharmacy education and appropriately presenting the procedures and findings will increase the visibility of QR and provide an opportunity for scholars to become familiar with the approach.
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Affiliation(s)
- Antonio A Bush
- Division of Practice Advancement and Clinical Education, Office of Strategic Planning and Assessment, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, 324 Beard Hall, Chapel Hill, NC 27599, United States.
| | - Mauriell H Amechi
- School of Education, Department of Leadership and Higher Education, University of Redlands, United States
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Norris M, Eva G, Fortune J, Frater T, Breckon J. Educating undergraduate occupational therapy and physiotherapy students in motivational interviewing: the student perspective. BMC MEDICAL EDUCATION 2019; 19:117. [PMID: 31029114 PMCID: PMC6486966 DOI: 10.1186/s12909-019-1560-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/15/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Motivational Interviewing (MI) is an evidenced based talking therapy designed to affect client Health Behaviour Change. Previous research indicates that Allied Health Professionals (AHP) can effectively use the approach and training at pre-registration level has been piloted. However, student experiences of training is underexplored. AIM To explore Physiotherapy and Occupational Therapy students' experiences of training in and implementation of Motivational Interviewing. METHODS Four focus groups including 24 undergraduates (14 OT and 10 PT) were conducted at the completion of the training and a subsequent clinical placement. Transcribed texts were analysed thematically. Data were triangulated with student written post-it notes and open questions in a post training questionnaire. RESULTS Two overarching themes were developed from the data. Learning different ways to interact and the challenge of transformation illuminates specific aspects of the training which enabled learning as well as areas of contention. Using the spirit of MI, but not every contact counts highlights the facilitators and challenges of implementation on placements. CONCLUSIONS Motivational interviewing is a useful addition to training neophyte health students. Key skills were adopted and in some cases transferred into practice. The process of learning indicates areas of potential improvement to enhance relevance of practice scenarios. The transfer to practice is more complex illustrating a need to negotiate professional and institutional expectations which should be considered in training.
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Affiliation(s)
- Meriel Norris
- Department of Clinical Sciences, Brunel University London, Uxbridge, UB8 3PH UK
- College of Health and Life Sciences, Brunel University London, Kingston Lane, Uxbridge, UB8 3PH UK
| | - Gail Eva
- Faculty of Health and Life Sciences, Oxford Brookes University, Marston Road Campus, Oxford, OX3 0FL UK
| | - Jennifer Fortune
- Academic Unit of Neurology, Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Tai Frater
- Department of Clinical Sciences, Brunel University London, Uxbridge, UB8 3PH UK
| | - Jeff Breckon
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Collegiate Crescent, Sheffield, S10 2BP UK
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