Towards an understanding of the dynamic sociomaterial embodiment of interprofessional collaboration

Sociomaterial perspective as applied in interprofessional education and collaborative practice: a scoping review

Learning and working together towards better health outcomes today have become more complex requiring an investigation on how interprofessional education (IPE) and interprofessional collaboration (IPC) practices could be sustained and further developed. Through a sociomaterial perspective, we can better understand IPE and IPC practices by foregrounding the material aspect of learning and working together and examining its relationship with humans and their interactions. This article aimed to examine existing literature that discusses the application of sociomaterial perspectives in IPE and IPC. A scoping review was conducted following Arksey and O'Malley's framework to explore the extent within the current body of knowledge that discuss how sociomaterial perspective is applied in IPE and IPC practices. A systematic database search was performed in September 2021 to retrieve literature published from 2007 onwards, with forty-three papers meeting the inclusion criteria. These papers included research articles, book chapters, conference papers and commentaries, with the majority originating from Europe. The thematic analysis revealed the following themes: (1) power as a sociomaterial entity shaping IPE and IPC; (2) inclusion of non-health professionals in reimagining IPE and IPC practices, and (3) the critical understanding of sociomateriality. The findings suggest that a sociomaterial perspective can allow for the reimagination of the contemporary and future practices of interprofessionalism.

Realist evaluation of interprofessional education in primary care through transprofessional role play: what primary care professionals learn together

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.

Perspectives about Interprofessional Collaboration and Patient-Centred Care

Interprofessional collaboration is understood to improve efficiencies and quality of care but is associated with challenges such as professionals' differing routines, knowledge, and identities, as well as professional hierarchies and time constraints. Given these challenges, there is limited understanding of how professionals collaborate effectively in providing patient-centred care. This study, with a convergence triangulation mixed-methods study design, explored interprofessional staffs' perceptions of interprofessional collaboration and patient-centred care when working with hospitalized older adults. Thirty-six staff responded to a survey which included the Patient-Centred Care measure and the Modified Index of Interdisciplinary Collaboration; we also interviewed 14 nursing staff. Although all scores suggested a high value was placed on interprofessional collaboration, scores were low related to activities that facilitated team processes. We identified three themes from the data: knowing the patient/family, functional needs, and communication processes. Staff identified daily rounds with interprofessional teams as supportive of interprofessional collaboration and patient-centred-care.

Actor-network theory and ethnography: Sociomaterial approaches to researching medical education

Medical education is a messy tangle of social and material elements. These material entities include tools, like curriculum guides, stethoscopes, cell phones, accreditation standards, and mannequins; natural elements, like weather systems, disease vectors, and human bodies; and, objects, like checklists, internet connections, classrooms, lights, chairs and an endless array of others.We propose that sociomaterial approaches to ethnography can help us explore taken for granted, or under-theorized, elements of a situation under study, thereby enabling us to think differently. In this article, we describe ideas informing Actor-Network Theory approaches, and how these ideas translate into how ethnographic research is designed and conducted. We investigate epistemological (what we can know, and how) positioning of the researcher in an actor-network theory informed ethnography, and describe how we tailor ethnographic methods-document and artefact analysis; observation; and interviews-to align with a sociomaterial worldview.Untangling sociomaterial scenarios can offer a novel perspective on myriad contemporary medical education issues. These issues include examining how novel tools (e.g. accreditation standards, assessment tools, mannequins, videoconferencing technologies) and spaces (e.g. simulation suites, videoconferenced lecture theatres) used in medical education impact how teaching and learning actually happen in these settings.

Using a sociomaterial approach to generate new insights into the nature of interprofessional collaboration: Findings from an inpatient medicine teaching unit

Today's hospitals are burdened with patients who have complex health needs. This is readily apparent in an inpatient internal medicine setting. While important elements of effective interprofessional collaboration have been identified and trialled across clinical settings, their promise continues to be elusive. One reason may be that caring for patients requires understanding the size and complexity of healthcare networks. For example, the non-human 'things' that healthcare providers work with and take for granted in their professional practice-patient beds, diagnostic imaging, accreditation standards, work schedules, hospital policies, team rounds-also play a role in how care is shaped. To date, how the human and non-human act together to exclude, invite, and regulate particular enactments of interprofessional collaboration has been subject to limited scrutiny. Our paper addresses this gap by attending specifically to the sociomaterial. Drawing on empirical data collected from an Academic Health Sciences Centre's inpatient medicine teaching unit setting in Ontario, Canada, we explore the influence of the sociomaterial on the achievement of progressive collaborative refinement, an ideal of how teams should work to support safe and effective patient care as patients move through the system. Foregrounding the sociomaterial, we were able to trace how assemblies of the human and the non-human are performed into existence to produce particular enactments of interprofessional collaboration that, in many instances, undermined the quality of care provided. Our research findings reveal the "messiness" of interprofessional collaboration, making visible how things presently assemble within the inpatient setting, albeit not always in the ways intended. These findings can be used to guide future innovation work in this and other similar settings.

The educational needs of nursing staff when working with hospitalised older people

OBJECTIVES

To examine nursing staffs' geriatric knowledge, perceptions about interprofessional collaboration and patient-centred care, and perceived learning needs related to working with hospitalised older people.

METHOD

A triangulation mixed methods design was used. A survey was administered to nursing staff that contained the Knowledge About Older Patients Quiz, the patient-centered Care measure and the Modified Index of Interdisciplinary Collaboration measure. Interviews were conducted to understand nursing staffs' learning needs. Survey data were analysed using descriptive statistics. Interview data were analysed using content analysis. Survey and interview data were then compared and contrasted.

RESULTS

Twenty-two nursing staff (response rate 26%) completed surveys and 14 participated in interviews. The mean knowledge about older patients score was 22.95, indicating moderately high gerontological knowledge. The mean scores on the patient-centered Care measure and Modified Index of Interdisciplinary Collaboration were moderately high at 3.75 and 3.86, respectively. Themes developed from analysis of the interview data were as follows: complex vulnerable population, clinical care concerns and working as a team. In spite of scores on knowledge surveys, nursing staff identified learning needs related to managing the responsive behaviours of older patients with cognitive impairment, chemical and physical restraints, mobility and continence.

CONCLUSIONS

There was an incongruence between survey and interview data as nursing staff reported gaps in their knowledge despite moderately high scores on the Knowledge about Older People Quiz. Further research is needed to understand additional factors that influence nurses' educational needs.

Older people and their families' perceptions about their experiences with interprofessional teams

Aim

To examine older people and their families’ perceptions about their experiences with interprofessional teams.

Design

Naturalistic inquiry using qualitative descriptive methods to provide a comprehensive summary of older people and their families’ experiences with interprofessional teams.

Methods

Interviews were conducted with 22 people from 11 families. The families had experiences with teams in a variety of settings, such as community, residential care and hospital. Data were analysed using inductive content analysis. NiVivo was used to record preliminary codes. Analysis included comparing and contrasting families’ experiences.

Results

Older people and their families wanted communication about what was going on, regardless of whether the news was good, bad or unknown. They also wanted care that took the concerns of the older person into consideration. Communication was a necessary ingredient to ensuring that the older person's unique concerns were known to the interprofessional team. These percepectives were discussed in the themes of communication and patient‐centred care.

Labouring Together: collaborative alliances in maternity care in Victoria, Australia-protocol of a mixed-methods study

INTRODUCTION

For over a decade, enquiries into adverse perinatal outcomes have led to reports that poor collaboration has been detrimental to the safety and experience of maternity care. Despite efforts to improve collaboration, investigations into maternity care at Morecambe Bay (UK) and Djerriwarrh Health Services (Australia) have revealed that poor collaboration and decision-making remain a threat to perinatal safety. The Labouring Together study will investigate how elements hypothesised to influence the effectiveness of collaboration are reflected in perceptions and experiences of clinicians and childbearing women in Victoria, Australia. The study will explore conditions that assist clinicians and women to work collaboratively to support positive maternity outcomes. Results of the study will provide a platform for consumers, clinician groups, organisations and policymakers to work together to improve the quality, safety and experience of maternity care.

METHODS AND ANALYSIS

4 case study sites have been selected to represent a range of models of maternity care in metropolitan and regional Victoria, Australia. A mixed-methods approach including cross-sectional surveys and interviews will be used in each case study site, involving both clinicians and consumers. Quantitative data analysis will include descriptive statistics, 2-way multivariate analysis of variance for the dependent and independent variables, and χ² analysis to identify the degree of congruence between consumer preferences and experiences. Interview data will be analysed for emerging themes and concepts. Data will then be analysed for convergent lines of enquiry supported by triangulation of data to draw conclusions.

ETHICS AND DISSEMINATION

Organisational ethics approval has been received from the case study sites and Deakin University Human Research Ethics Committee (2014-238). Dissemination of the results of the Labouring Together study will be via peer-reviewed publications and conference presentations, and in written reports for each case study site to support organisational change.