Why we need interprofessional education to improve the delivery of safe and effective care

Impact of an interprofessional training on students' attitudes toward interprofessional education

In Lausanne, Switzerland, Interprofessional Education (IPE) is embedded in the curriculum of every undergraduate healthcare student. Since 2011, five educational and healthcare institutions have implemented a short interprofessional education course to bring together 2307 undergraduates from six different disciplines (medicine, midwifery, nursing, occupational therapy, physiotherapy, medical radiology technician) between 2017 and 2020. This pre-post study aimed to explore how this course influenced students' attitudes toward IPE using a French translation of the validated questionnaire called the "University West of England Interprofessional Questionnaire." Students were asked to complete an online survey prior to and at the end of the IPE course to measure students' attitudes toward interprofessional (IP) relationships and collaborative learning. A total of 942 students answered the survey between 2017 and 2020, before and after the course. Each year, students' attitudes toward IP relationships improved after the course whereas a positive change in students' attitudes toward IP learning was observed only in 2020. A short exposure to an IPE course could improve students' attitudes toward IPE and, more specifically, toward IP relationships. Our findings could inform IP leaders to design repetitive, various, and longitudinal IPE experiences to balance the development of uniprofessional and interprofessional identity.

Interprofessional education in cardiothoracic surgery: a narrative review

Interprofessional education, an approach where healthcare professionals from various disciplines learn with, from, and about each other, is widely recognized as an important strategy for improving collaborative practice and patient outcomes. This narrative review explores the current state and future directions of interprofessional education in cardiothoracic surgery. We conducted a literature search using the PubMed, Scopus, and Web of Science databases, focusing on English-language articles published after 2000. Our qualitative synthesis identified key themes related to interprofessional education interventions, outcomes, and challenges. The integration of interprofessional education in cardiothoracic surgery training programs varies across regions, with a common focus on teamwork and interpersonal communication. Simulation-based training has emerged as a leading modality for cultivating these skills in multidisciplinary settings, with studies showing improvements in team performance, crisis management, and patient safety. However, significant hurdles remain, including professional socialization, hierarchies, stereotypes, resistance to role expansion, and logistical constraints. Future efforts in this field should prioritize deeper curricular integration, continuous faculty development, strong leadership support, robust outcome evaluation, and sustained political and financial commitment. The integration of interprofessional education in cardiothoracic surgery offers considerable potential for enhancing patient care quality, but realizing this vision requires a multifaceted approach. This approach must address individual, organizational, and systemic factors to build an evidence-based framework for implementation.

Educational strategies for PET-Health Interprofessionality in Southwestern Goiás state, Brazil: a qualitative approach

This study aimed to present educational interventions in the context of the Education Program through PET-Health Interprofessionality (PET-I), carried out in teaching and in healthcare service of a municipality of Goiás state, based on the analysis of focus groups and portfolios made by participants. A descriptive exploratory study with a qualitative approach was carried out, based on the theoretical-conceptual and methodological foundations of interprofessional education, from August 2019 to November 2020. It was observed that students perceived participation in PET-I as an opportunity to interact with other professions, to associate theory with practice and to act as leading actors. Participants believe that working together to provide the best care for patients requires a basic understanding of the different perspectives and responsibilities of professionals involved. They emphasized informal conversations, meetings, and case discussions as opportunities to understand professional's opinions and assignments, and deepen their understanding of the importance of collaborative communication.

Identifying competencies for an advanced practice physiotherapy role within an interprofessional chronic pain clinic

BACKGROUND

Advanced practice physiotherapy (APP) models of care have shown success in access, safety, satisfaction, and care quality for musculoskeletal pain conditions in various settings. Yet, there is a gap in defining competencies for physiotherapists to be the initial point of contact for people with chronic pain. This study aims to identify and agree upon the competencies necessary for a physiotherapist to fulfill the role of an APP in an interprofessional chronic pain clinic.

METHODS

Three focus groups were conducted using a Nominal Group Technique and a modified Delphi process. Consensus on the competency, defined as agreement by ≥ 75% of participants, was sought.

RESULTS

Twenty-three experts (17 healthcare providers and six individuals with chronic pain) participated in the focus group discussions. Twenty completed the follow-up Delphi surveys. Ten essential competencies for an APP role in interprofessional chronic pain clinics were identified and achieved consensus: 1) use an evidence-based approach to practice; 2) communicate effectively with the patient; 3) perform a comprehensive assessment; 4) determine pain-related diagnoses; 5) develop therapeutic relationships; 6) provide appropriate care; 7) support patients through transitions in care; 8) collaborate with members of the interprofessional team; 9) advocate for the needs of the patients; and 10) use a reflective approach to practice.

CONCLUSION

This study identified ten competencies essential for physiotherapists to fulfill an APP role within interprofessional chronic pain clinics. These competencies serve as a foundation for informing a training program and future research evaluating the effectiveness of the APP model in this setting.

Evaluating Interprofessional Education Readiness and Perceptions Among Health Professions Students

Background

Inter-professional learning (IPL) or more broadly Inter-professional Education (IPE) refer to a pedagogical approach that involves creating a learning experience where students from different professions learn about, from, and with each other. IPE is crucial for preparing health professionals to offer patient-centered care as part of an interdisciplinary team. This study aims to assess the readiness for IPL among students from different health professions colleges at King Saud bin Abdulaziz University for Health Sciences.

Methods

A cross-sectional design was conducted for this study, with a total of 476 undergraduate students from College of Medicine, College of Nursing, and College of Applied Medical Sciences. By using quota sampling, the readiness for interprofessional learning scale (RIPLS) was used to assess the student's readiness for interprofessional learning.

Results

The overall mean score of RIPLS for the students participating was 76.20, with the highest mean score in teamwork and collaboration at 39.73. The lowest mean score was in roles and responsibility at 8.45. The professional identity subscale had a mean score of 26.85. A significant difference in professional identity was found between students in applied medical sciences, nursing, and medicine colleges.

Conclusion

The study reveals that undergraduate students have positive attitudes towards interprofessional education, which can enhance their engagement in developing competencies necessary for effective contribution to interprofessional healthcare teams. High readiness among medical, nursing, and applied medical sciences students allows for the Introduction of IPL.

Characterization and analysis of the proposals submitted to the PET-Health Interprofessionality in Brazil: advancements and future directions

The Program of Education through Work for Health (PET-Health), with a focus on interprofessionality, is one of the actions of the Plan for the Strengthening of Interprofessional Education in Brazil. This research aimed to systematically analyze the characteristics of the proposals submitted to the public notice of the PET-Health Interprofessionality specifically in relation to the theoretical-conceptual and methodological alignment of interprofessional education (IPE). The study is a qualitative document content analysis. We analyzed one hundred and twenty projects submitted to the selection process from institutions participating in the PET-Health Interprofessionality. Content analysis followed three steps: pre-analysis, exploration of the material, and treatment and interpretation of results. Seven categories were identified: a) alignment with the theoretical-conceptual frameworks of IPE, b) curriculum changes, c) faculty development with a focus on IPE, d) articulation among objectives, actions, and results expected related to IPE, e) strategies for monitoring and evaluation, f) involvement of users/families and community, and g) development of collaborative competencies. We conclude that while some advancements have been made, there remains a need for more in-depth discussion in Brazil to ensure the development of competencies capable of assuring more integral, resolute, and safer healthcare services, with capacity to (re)signify user-centered care in the planning and delivery of healthcare.

Evaluating the impact of a blended interprofessional education course on students' attitudes towards interprofessional education: a pre-post study

BACKGROUND

Since 2011, five educational and healthcare institutions have implemented a short interprofessional education (IPE) course to bring together undergraduates from five disciplines. To meet the logistical challenges of IPE implementation, more specifically, the large number of classrooms needed to gather students together and the need for human resources to guide learning activities, a face-to-face IPE course was redesigned into a blended (online and face-to-face collaborative learning activities) IPE course. In March 2023, 183 medical, 378 nursing, 46 radiologic technology, 69 physiotherapy, and 74 occupational therapy students participated in a one-day IPE blended course to learn interprofessional team functioning and dynamics, role clarification and responsibilities of other professions, and interprofessional communication skills. This study aimed to assess students' changes in attitudes towards IPE after being involved in a large-scale interprofessional blended learning course.

METHODS

A before-after study was conducted using a French translation of the validated questionnaire "University of West of England Interprofessional Questionnaire" (UWE-IP questionnaire). Students' attitudes towards interprofessional (IP) relationships and IP learning were measured before and after the course. In March 2023, two hundred fifty-six students from five professions answered two subscales of the UWE-IP questionnaire before and after the course (response rate 34%).

RESULTS

Students' attitudes towards IP relationships improved significantly after the course. The score on this subscale (min 8; max 24) changed from 11.18 (SD 2,67) before the course to 10,38 (SD 2,55) after the course, indicating a significant improvement in attitudes towards IP relationships (p < 0,001). More specifically, students had more positive attitudes on the item "I have a good understanding of the roles of different health and social care professionals." and the item "I feel that I am respected by people from other health and social care disciplines." after the course. A positive change in students' attitudes towards IP learning was observed, but the results were not significative.

CONCLUSION

A face-to-face IPE course redesigned as a blended course helped overcome existing challenges to implementing an IPE course. The results suggest a blended IPE course improves students' attitudes towards interprofessionality.

A study of the impact of an interprofessional education module in Vietnam on students' readiness and competencies

INTRODUCTION

The literature puts forward a range of challenges of interprofessional education (IPE) related to its planning, initiation, implementation, and especially to IPE assessment. The present study aims to map changes in students' readiness and interprofessional collaboration competence (IPCC) in implementing an innovative IPE module. Potential differences in impact related to the health education programs and IPCC scores resulting from self-, peer-, and tutor assessments will also be analysed.

METHODS

A pre-post design was adopted. The student's readiness for interprofessional learning was assessed using the Readiness for Interprofessional Learning Scale, and the student's IPCC score was calculated based on self-, peer-, and tutor assessments with the interprofessional collaborator assessment rubric.

RESULTS

Students' mean post-test readiness scores and mean post-test IPCC scores were significantly higher than the total and subscales/domain pre-test scores (p<0.01). No significant within-subject differences were observed in students' readiness total or subscale scores when comparing health educational programs. However, significant differences were observed in students' mean total IPCC scores between programs (p<0.01). Significant differences in students' average IPCC scores were found when comparing self-, peer- and tutor assessment scores in six domains (p<0.01). Also, significant correlations between peer and tutor assessment scores were observed (p<0.01).

CONCLUSION

The IPE module, designed and implemented to focus on patient-centred practice within a primary care context, positively impacted students' readiness and IPCC development. These results offer insights to expand the implementation of the IPE module to all health educational programs.

A psychometric evaluation of inter-professional education competency tool in nursing and medicine students

INTRODUCTION

Collaboration between nurses and doctors is necessary for offering care to patients. Using team performance assessment tools and surveying them can be effective in promoting inter-professional collaboration, and the lack of a credible tool to assess inter-professional collaboration competency between the two groups is a major challenge in the healthcare sector. The present study aimed to translate and conduct a psychometric investigation on the inter-professional education collaboration (IPEC) tool for the students of medicine and nursing.

METHODS

The present study was a cross-sectional one conducted as a psychometric investigation of the IPEC tool at the Iran University of Medical Sciences in 2022. The initial tool contained 42 items developed according to a 5-point Likert scale, which was translated into Persian with the consent of the original researcher. The validity index and the content validity ratio were investigated by a panel of 11 specialists in medical and clinical education, and its construct validity was evaluated using confirmatory factor analysis. Also, the second population of the study included medical and nursing students of Iran University of Medical Sciences and simple random sampling method. Moreover, the reliability of the instrument was investigated using internal consistency, Cronbach's Alpha, and test-retest methods.

RESULTS

Based on the indicators calculated to perform a psychometric investigation over the above tool, it had acceptable reliability and validity according to the specialists. The tool evaluates inter-professional collaboration competency between the students of medicine and nursing across four areas (values and ethics, roles and responsibilities, inter-professional communication, and team-based care and teamwork). Moreover, Cronbach's Alpha coefficient for the tool was determined at 0.84.

CONCLUSION

The results of the study showed that the above tool could evaluate inter-professional competency as a valid and reliable questionnaire, and its results could be utilized in planning and education.

Which factors influenced the adoption of interprofessionality in health based on the reports of the PET-Health Interprofessionality projects in Brazil? A document analysis

The Program of Education through Work - Health (PET-Health) Interprofessionality is one of the strategic actions of the "Plan for the Strengthening of Interprofessionality" in healthcare in Brazil. Based on the experience of the program, this paperexamines the aspects that impact the adoption and strengthening of interprofessional education and collaborative practices, and issues recommendations for the strengthening of interprofessionality as a guiding principle of training and working in healthcare. This is a document analysis of partial reports from the six- and 12-months of execution of 120 PET-Health Interprofessionality projects in Brazil. The data were analyzed based on content analysis and the categories elaborated a priori. The aspects that impact the adoption and strengthening of interprofessionality in training and working in healthcare, and future recommendations, were organized in the relational, processual, organizational, and contextual dimensions, according to the framework by Reeves et al. The PET-Health Interprofessionality expanded the understanding of elements of interprofessional education and practice and showed that the discussion must take on a more political, critical, and reflexive character. The analysis points to the need for continuity of teaching-learning activities as a strategy to foster interprofessional capacity in healthcare services and consequent strengthening of the Unified Healthcare System in Brazil.

Characterization of interprofessional education experiences in health education at the University of São Paulo

OBJECTIVE

To map the experiences of Interprofessional Education (IPE) in Health at the São Paulo campus of the University of São Paulo.

METHOD

This is a descriptive, exploratory study with a quantitative approach and data collection through an online questionnaire addressed to teachers from eight teaching units and 14 health courses. The data was analyzed using absolute and percentage frequencies.

RESULTS

The majority of teachers do not take part in IPE experiences (70.4%). Most of the experiences are between six and ten years old, involving up to four teachers and small groups of students, mostly extracurricular or extension activities. The teaching and assessment strategies are diverse and open to students of all years.

CONCLUSION

IPE experiences involve a small number of students and teachers and, although consolidated in terms of the time they have been offered, are limited to extracurricular spaces. Factors such as improvements in institutional support and teacher development are pointed out as important for making progress in strengthening IPE in the analyzed context.

Potentialities and limitations of Interprofessional Education during graduation: a systematic review and thematic synthesis of qualitative studies

BACKGROUND

Rapid demographic, epidemiological, technological, cultural/behavioural, and educational transitions, as they become more complex, demand new integrated and complementary professional skills and abilities. Interprofessional Education (IPE) is a promising alternative to deal with these changes, especially in courses in the health area. This systematic review was to explore the potentialities and limitations of IPE, from the perspective of undergraduate students, through a thematic synthesis of qualitative studies.

METHODS

A thematic synthesis of qualitative studies was conducted. The question elaborated for this review was: "What is the impact of interprofessional education on the teaching and learning of students in the health area inserted in Higher Education Institutions?". The search strategy was performed in the electronic databases PubMed, Latin American and Caribbean Literature in Health Sciences (LILACS), Cochrane Library, and Scientific Electronic Library Online (SciELO). In addition, searches were carried out in grey literature on the ERIC platforms, ProQuest Disserts and Theses, and Academic Google. The assessment of the quality of the studies was carried out using the Critical Appraisal Skills Programme tool. Data were summarized through thematic synthesis. From the databases, 8,793 studies were identified. After standardized filters procedures, critical summaries, and assessment of relevance to the eligibility criteria, 14 articles were included.

RESULTS

The synthesis of the studies revealed the potential of this teaching approach, arranged in three analytical themes: learning from each other and about them; the value of education and interprofessional practice; patient-centred health care. On the other hand, some limitations were also identified, such as barriers related to EIP; the difficulties related to teaching methodologies.

CONCLUSION

Overcoming the identified limitations can enhance the results of the IPE, in view of its impact on the education of students and on the health care of the population.

Interprofessional education at a Brazilian public university: A document analysis

Background

Interprofessional Education is considered a necessary approach to develop skills for collaborative work in the training of professionals in order to improve the quality of health care. The curricula are the guiding documents for training and should explain how Interprofessional Education is adopted in undergraduate health courses.

Objective

To analyze curricula of undergraduate health courses, from the perspective of Interprofessional Education, in a Brazilian public university.

Design

Qualitative study of document analysis.

Settings

Undergraduate health courses at a Brazilian public university.

Methods

13 undergraduate health courses were analyzed. Data collection was conducted based on an adapted quality assessment script for Interprofessional Education. From the thematic content analysis, three analytical categories emerged.

Results

In the category "Curriculum organization and interprofessionality", the courses do not make free periods available in the curriculum, and each of the courses provide space for elective subjects at different times. In the category "Training guided by social reality and health needs" the courses propose training based on the health needs of patients from the Brazilian public health system. In the category "Learning for interprofessional action", the term "multiprofessional" characterizes learning for teamwork, with a discrete number of interprofessional disciplines.

Conclusions

The theoretical bases of IPE and organizational goals are necessary to establish training objectives, specific shared times, and mutual interests that are directed to interprofessionality. Interprofessional Education can be expanded from activities that already exist in the curricula of undergraduate courses.

Education and Mentoring of Specialist Pediatric Palliative Care Medical and Nursing Trainees: The Quality of Care Collaborative Australia

BACKGROUND

The Quality of Care Collaborative Australia (QuoCCA) builds capability in the generalist and specialist paediatric palliative care (PPC) workforce throughout Australia. It supports regional and community services to provide care close to families' homes, as well as building expertise in tertiary centers.

OBJECTIVE

Medical Fellows and Nurse Practitioner candidates (specialist trainees) were funded by QuoCCA at four tertiary hospitals throughout Australia supported by an education and mentoring framework. This study explored the activity and experiences of clinicians who had occupied these roles to evaluate their effectiveness to build PPC capability.

METHODS

Online surveys recorded the monthly activity of Medical Fellows, with a point in time check of knowledge, skills and confidence in 2019. Discovery Interview methodology was used to collect detailed experiences of 11 trainees employed between 2018 to 2022 in Queensland.

RESULTS

A combination of mentoring and formal and informal education, peer support and practical experience was valuable for trainees. They found the support of the whole interdisciplinary team advantageous to learning. Shadowing experienced team members gave them the opportunity to learn practical skills, especially regarding communication with families. Practicing clinical skills was beneficial, through being on call, attending home visits, supporting families, prescribing medications and developing treatment plans in collaboration with the team. The trainee experience was optimised through learning from families, personal reflection, involvement in research projects and delivering QuoCCA education.

CONCLUSION

The QuoCCA trainee roles for Medical Fellows and Nurse Practitioner candidates exhibit a valuable and effective education and mentorship framework that could be applied to other specialties. The service leadership and collaborative interdisciplinary team support various modes of education and mentoring. The roles not only develop the trainees' specialised PPC clinical skills, they also improve their general clinical practice, including communication, empathy and holistic care. A structured curriculum of education is recommended to protect these positive outcomes.

Effectiveness of interprofessional simulation-based education programs to improve teamwork and communication for students in the healthcare profession: A systematic review and meta-analysis of randomized controlled trials

BACKGROUND

Factors, such as the dynamic and variable structure of healthcare services, the introduction of new care models and technological developments, and requirements for patient safety, quality, and accreditation, require new content, goals, and models in the education and practice of health disciplines. Curriculum studies should be planned by today's requirements and competencies to be gained in interprofessional simulation-based education.

OBJECTIVES

This systematic review and meta-analysis study was conducted to evaluate the effectiveness of interprofessional simulation-based education programs for improving teamwork and communication among students in the healthcare profession.

METHODS

In this study, Web of Science, Cochrane Library, Springer Link, Science Direct, Ovid, PubMed, Scopus, ProQuest, EBSCOhost/CINAHL Complete, and MEDLINE databases were searched without year limitations until April 2022. Two independent researchers reviewed the studies and analyzed the data. Two researchers evaluated the methodological quality of the studies using the Cochrane Collaboration tool (RoB 2.0). This study was prepared in line with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. Comprehensive Meta-Analysis (CMA) 3 software was used for meta-analysis.

RESULTS

Eight randomized controlled trials conducted with 819 participants were included in this study. The evaluation of meta-analysis data showed that interprofessional simulation-based education programs significantly improved teamwork (Hedge's g = 0.41, p < 0.001, 95 % CI = 0.25 to 0.56) and communication (Hedge's g = 0.54, p < 0.001, 95 % CI = 0.26 to 0.82). The results of the sensitivity analysis showed that teamwork and communication were stable.

CONCLUSION

Interprofessional simulation-based education programs seem to be an appropriate method for improving teamwork and communication among healthcare students. In the future, it is thought that there is a need to individualize interprofessional simulation-based education programs based on cultural differences and socio-demographic characteristics of healthcare students and to plan studies that examine long-term results.

REGISTRATION NUMBER

CRD42022325514 (PROSPERO).

Considerations for promoting the implementation of work-based interprofessional education programmes: A scoping review

BACKGROUND

Effective inter-professional collaboration may improve healthcare outcomes, including maternal and child healthcare settings where unfavourable outcomes are often due to communication and collaboration failures.

OBJECTIVE

Explore the considerations for promoting the implementation of work-based interprofessional education programmes.

METHODS

A scoping review guided by the methodological framework of Arksery and O'Malley was used to analyse 28 articles published between 2000 and 2020. The reporting was guided by the PRISMA extension for Scoping Reviews.

RESULTS

Twenty-seven of 28 articles were studies conducted in high-income countries. The review revealed considerations which were themed as 1) mobilisation of resources, 2) helpful learning environment, 3) healthcare professional's valuation and 4) barriers prior to implementing IPE/IPC. Successful implementation of interventions triggered motivation, confidence, self-efficacy, value for IPE/IPC.

CONCLUSION

Our findings demonstrate that there are specific considerations that can contribute to the uptake of IPE/IPC interventions in the clinical setting.

Developing an interprofessional education programme for a health science faculty in South Africa: A multi-method study

Objective

Work-ready graduates need to be equipped with expertise and therefore, critical changes are required in the curricula for health professions. Here, we aimed to review the design of an interprofessional education programme (IPE) with regards to appropriateness and implementation for the Faculty of Health Sciences at North-West University, South Africa.

Methods

This study employed a sequential multi-method design to develop an IPE programme for a health science faculty in South Africa. A scoping review was conducted to synthesise the structure, development and implementation processes of IPE programmes globally. This was followed by an analysis of IPE programmes from institutions on five continents. Subsequently, the perspectives of international experts on the development and implementation of IPE programmes were explored in a qualitative study. This was followed by a university context analysis and the development of a draft IPE programme was designed based on the data synthesised from all preliminary studies. The programme was presented to faculty to evaluate and provide input by applying a nominal group technique.

Results

For the scoping review, ten steps to the IPE programme development process were developed. For the qualitative document analysis, a step-by-step guide and to-do list were provided to guide educators in conceptualising, developing, implementing and reviewing their IPE programmes. For the qualitative exploratory descriptive design, four themes were identified after the analysis of transcripts. An optional 3-year IPE programme was developed to serve as a precursor for full credit integration of the IPE into the faculty of health science curricula during future development of the health science curricula.

Conclusion

The optional 3-year IPE programme developed will serve as a precursor for the integration of a credit-bearing IPE programme into the Faculty of Health Sciences curricula during future development.

Perceptions and barriers of health-care professionals to develop and implement interprofessional education in UAE: A qualitative study

BACKGROUND

This study aimed to determine the perception, perspectives, and behaviors of health-care providers, as well as cues to action toward interprofessional education (IPE).

MATERIALS AND METHODS

The interview sessions were conducted from August 2020 to November 2020 at the College of Pharmacy, Gulf Medical University (GMU), Ajman. The invited participants belonged to all the colleges which are a part of GMU, providing academic and practice support to the university. All were residents of UAE, and both genders were considered for qualitative assessment. The sample size based on data saturation plus two as standard guidelines in qualitative res earch. All the interviews were audiotaped for verbatim transcriptions. All the recorded interviews were transcribed to avoid bias. The prepared transcripts were then verified for accuracy by the relevant participant and after approval, data were analyzed. In case of an emergent theme, all the investigators were focused on refining the analysis.

RESULTS

A total of 17 health-care professionals (HCPs) were interviewed. The participants were chosen from five different colleges at GMU. All the participants had similar perceptions about IPE, as it is a collaboration between different HCPs to achieve better patient outcomes. A diversity in perspectives toward IPE was found among the participants. Several barriers were identified during the interview session and also highlighted the importance of choosing the right topic for IPE, as it affects planning of the activities greatly. The participants also stressed that the lack of communication also contributes to decreased involvement of HCPs.

CONCLUSION

This study identified inefficient implementation of IPE. The barriers were lack of team effort, lack of communication within the institute, and administrative support, despite the availability of resources and infrastructure in the university.

Preceptor's perceptions about the teaching-learning process and collaborative practices in primary health care

OBJECTIVE

To analyze the perceptions of preceptors about the teaching-learning process, as well as the strengths and weaknesses to implement collaborative practices in Primary Health Care.

METHOD

Qualitative study carried out between October and December 2019 with 96 preceptors (surgeons- dentists, nurses and doctors) of the Family Health Strategy. Data were collected with the use of a questionnaire and submitted to Content Analysis, using the Maxqda-2020 software.

RESULTS

Three categories were highlighted: 1. A new know-how needs to be taught to those who teach, 2. teaching and assisting in the preceptorship process and 3. person-centered approach: paradigm for collaborative work reveal difficulties and tensions in the preceptor work and collaborative practices.

CONCLUSION

The study identified the need to qualify preceptors with new approaches for the development of the teaching-learning process, for teamwork and collaborative interprofessional practices in the context of Primary Health Care.

Cross-cultural adaptation, validation and reliability of the Medication Safety Thermometer tool for use in Brazil

OBJECTIVES

to perform cross-cultural adaptation, face and content validation and reliability analysis of the Medication Safety Thermometer tool for use in Brazil.

METHODS

the process of cross-cultural adaptation and validation followed the stages of translation, synthesis of translations, back-translation, content validation performed by experts, and face validation through pre-testing. Reliability was determined by calculating the Kappa coefficient.

RESULTS

the two translated versions were synthesized into a single version, which was back-translated and showed no divergences. The expert committee judged the adapted tool as equivalent, reaching a Content Validity Index higher than 0.8. The mean global understanding was 1.82, demonstrating face validity. The assessed items had Kappa coefficient greater than 0.61, showing agreement between observers.

CONCLUSIONS

the cross-cultural adaptation of the tool was performed following an established methodology. The adapted tool showed inter-rater reliability and validity for use in Brazil.

Interprofessional education for shared decision making in drug therapy: a scoping review

The current complex scenario of medication use calls for the implementation of interprofessional education (IPE) initiatives focused on shared decision making (SDM) in drug therapy. A scoping review was conducted to collate, summarize, and report the evidence available on IPE teaching and learning approaches in this context, involving pre-licensure healthcare students. Searches were conducted in seven electronic databases, with 21 articles meeting the inclusion criteria. This review examines educational strategies employed for interprofessional SDM as well as characteristics of students, teachers, and tutors involved in IPE interventions. The reviewed studies lack detailed description of the students' decision-making process, and none addresses aspects related to patient preferences as a part of learning outcomes. We identified shortcomings in how IPE interventions are assessed and reported. Only a few of the studies explicitly describe the use of competency-based frameworks proposed by national and international organizations, and less than 60% describe learning outcomes. The absence of experiences focused on interprofessional SDM in drug therapy suggests a gap that needs to be addressed with future studies evaluated in a robust way. We argue that such experiences enable students, as a team, to learn to share decisions with the patient as an effective team member.

Interprofessional education in the Dentistry curriculum: Analysis of a teaching-service-community integration experience

INTRODUCTION

Interprofessional education (IPE) offers relevant theoretical, conceptual and methodological approaches to the development of effective teamwork competencies.

OBJECTIVE

To analyse an interprofessional experience of teaching-service-community integration carried out at a public university in the South of Brazil.

METHODS

A case study with a qualitative approach was carried out. The study's participants were thirty-eight undergraduate dental students who attended the IPE activity between 2012 and 2019. Data collection was developed in two sequential steps that included the application of an online instrument and semi-structured interviews. The textual material was interpreted by content analysis, considering Kirkpatrick's evaluation levels (reaction, learning and behaviour).

RESULTS

In the reaction level, students highlighted the contents provided by the National Curricular Guidelines regarding public health system and teamwork, as well as the pedagogical teaching proposal by tutoring groups, which stimulated students' autonomy. It was observed that the learning was geared towards the development of collaborative teamwork competencies and cultural competencies. In the behaviour level, students perceived positive changes in their attitudes and behaviours towards patients, focused on needs related to life conditions, realising that dentists may work within a team. The elective/optional nature of the experience allied with the absence of other IPE activities in the curricular grid showed to be challenging.

CONCLUSION

IPE in undergraduate education presented positive results related to the reaction, learning and behaviour of dental students. We recommend the inclusion of interprofessional activities of teaching-service-community integration in Dentistry curricular structure to complement uniprofessional education.

PET-Saúde/Interprofessionality and the development of curricular changes and collaborative practices

ABSTRACT This study aimed to analyze the changes in training induced by the Education through Work for Health Program (PET-Saúde), Interprofessionality edition, and to identify whether the assumptions of Interprofessional Education (IPE) and collaborative practices are being applied in the development of projects. This is a qualitative, descriptive, and exploratory case study, developed in the state of Rio de Janeiro. Open interviews were carried out with 32 actors working in the program, whose contents were analyzed in the light of the theoretical-methodological framework of IPE. Three categories were produced: PET-Saúde/Interprofessionality as a constructive dynamics of collaborative practices; Interprofessionality as a foundation for structuring curricula and pedagogical practices; The evaluation mechanisms of PETSaúde/Interprofessionality. The Interprofessionality edition triggered assertive experiences from the application of the assumptions of IPE and collaborative practices, such as induction of curricular reforms and the creation of interprofessional disciplines; however, it still does not represent a policy incorporated by teaching institutions. Special attention must be given to the evaluation processes, which are very incipient, and to the sustainability of the advances achieved, which require political and institutional support. PET-Saúde has progressively contributed to changes in teaching and to the dissemination of concepts and assumptions that guide IPE.

PET-Saúde/Interprofissionalidade e o desenvolvimento de mudanças curriculares e práticas colaborativas

RESUMO Este estudo objetivou analisar as mudanças na formação induzidas pelo Programa Educação pelo Trabalho para a Saúde (PET-Saúde), edição Interprofissionalidade, e identificar se os pressupostos da Educação Interprofissional (EIP) e das práticas colaborativas foram aplicados no desenvolvimento dos projetos. Trata-se de estudo de caso qualitativo, descritivo e exploratório, desenvolvido no estado do Rio de Janeiro. Entrevistas abertas foram realizadas com 32 atores do programa, cujos conteúdos foram analisados à luz do referencial teórico-metodológico da EIP. Três categorias foram produzidas: O PET-Saúde/Interprofissionalidade como dinâmica construtiva de práticas colaborativas; A interprofissionalidade como fundamento de estruturação de currículos e práticas pedagógicas; Os mecanismos de avaliação do PET-Saúde/Interprofissionalidade. A edição Interprofissionalidade deflagrou experiências assertivas mediante aplicação dos pressupostos da EIP e práticas colaborativas, resultando em indução de reformas curriculares e criação de disciplinas interprofissionais; porém, ainda não representa uma política incorporada pelas instituições de ensino. Atenção especial deve ser dada aos processos avaliativos, ainda muito incipientes, e à sustentabilidade dos avanços alcançados, que requer apoio político e institucional. Conclui-se que o PET-Saúde tem contribuído progressivamente para as transformações no ensino e para a disseminação dos conceitos e pressupostos que orientam a EIP.

Percepções do preceptor sobre o processo ensino-aprendizagem e práticas colaborativas na atenção primária à saúde

RESUMO Objetivo Analisar as percepções dos preceptores acerca do processo ensino-aprendizagem, bem como as fortalezas e as fragilidades para implementar as práticas colaborativas na Atenção Primária à Saúde. Método Pesquisa qualitativa, desenvolvida entre outubro e dezembro de 2019 com 96 preceptores (cirurgiões-dentistas, enfermeiros e médicos) da Estratégia de Saúde da Família. Os dados foram obtidos através de questionário e submetidos a Análise de Conteúdo, utilizando o software Maxqda-2020. Resultados Foram evidenciadas três categorias: 1. Um novo saber-fazer precisa ser ensinado a quem ensina, 2. o ensinar e o assistir no processo da preceptoria e 3. abordagem centrada na pessoa: paradigma para o trabalho colaborativo revelam dificuldades e tensões no trabalho do preceptor e de práticas colaborativas. Conclusão O estudo identificou a necessidade de qualificar os preceptores com novas abordagens para o desenvolvimento do processo ensino-aprendizagem, para o trabalho em equipe e práticas interprofissionais colaborativas no contexto da Atenção Primária à Saúde.

Adaptação transcultural, validação e confiabilidade da ferramenta Medication Safety Thermometer para uso no Brasil

RESUMO Objetivos: realizar adaptação transcultural, validação de face e conteúdo e análise da confiabilidade da ferramenta Medication Safety Thermometer para uso no Brasil. Métodos: o processo de adaptação transcultural e validação seguiu as etapas de tradução, síntese das traduções, retrotradução, validação de conteúdo realizada por especialistas e validação de face mediante o pré teste. A confiabilidade foi determinada pelo cálculo do coeficiente de Kappa. Resultados: as duas versões traduzidas foram sintetizadas em uma única versão, que foi retrotraduzida e não demonstrou divergências. O comitê de experts julgou a ferramenta adaptada como equivalente, alcançando Índice de Validade de Conteúdo maior que 0,8. A média de compreensão global foi de 1,82, demonstrando validade de face. Os itens avaliados apresentaram coeficiente de Kappa maior que 0,61, evidenciando concordância entre observadores. Conclusões: a adaptação transcultural da ferramenta foi realizada seguindo metodologia estabelecida. A ferramenta adaptada mostrou confiabilidade entre observadores e validade para utilização no Brasil.

Impact of interprofessional education on the teaching and learning of higher education students: A systematic review

AIM

This systematic review was to explore the potentialities and limitations of Interprofessional Education (IPE), from the perspective of undergraduate students.

BACKGROUND

The increasing complexity in health increasingly demand professionals with the capacity to act in the face of new global challenges. Thus, this pedagogical approach presents itself as one of the most promising choices in facing these new obstacles.

DESIGN

A synthesis of quantitative studies and mixed methods.

METHODS

Studies involving quantitative analyzes were included, with no restriction on the date of publication and language. The search strategy was carried out in the electronic databases: PubMed, Latin American and Caribbean Literature in Health Sciences (LILACS), Cochrane Library and Scientific Electronic Library Online (SciELO). In addition, searches were carried out in gray literature on the ERIC platforms (ProQuest), ProQuest Disserts and Theses Full text and Academic Google. The assessment of the quality of the studies was carried out using the instrument by Downs and Black. The risks of bias in the studies were examined with the aid of the adapted version of the Cochrane Collaboration tool, with the domains of the Downs and Black instrument.

RESULTS

After standardized filter procedures, critical summaries and assessment of relevance to the eligibility criteria, 11 articles were included. The results showed that most students have a positive perception of IPE, with different factors influencing this research finding. The need to develop more robust assessment instruments is highlighted, in view of the insufficiency of tools with sufficient methodological rigor to measure real changes in attitudes among different groups of students.

CONCLUSION

More consistent research is needed, which assesses, in a longitudinal way, the effects that the IPE has on the teaching and learning of undergraduate students and its impact after professional training.

Developing and implementing a co-curricular IPE program: AHEC Scholars Program

As part of a new directive, the Human Resources Services Administration (HRSA) mandated Area Health Education Center (AHEC) Programs across the nation to implement an interprofessional education (IPE) program for health professional students, with the goal of fostering collaborative practice among health profession students and motivating students to work in medically underserved areas post-graduation. The South Texas AHEC Program collaboratively developed and implemented a co-curricular IPE initiative, the AHEC Scholars Program, including didactic and practicum components, focused on the needs of communities in our area. A pre-post quasi-experimental design was used to evaluate the student outcomes related to IPEC Competencies and knowledge and preparation for the practice of core topic areas mandated by HRSA. Student outcomes showed statistically significant improvement in all measures. In order to obtain more detailed accounts of students' practicum experiences, students were asked to complete reflective journals after each practicum. The AHEC Scholars Program provides students with opportunities to work with underserved populations and enables students to explore the benefits of team-based care. This article summarizes the collaborative process of the development and implementation of the AHEC Scholars Program; secondly, it details student outcomes from a 3-month pilot study.

Multiprofessional family health residency as a setting for education and interprofessional practices

OBJECTIVE

to know the experiences lived during the residency by graduates of a Multiprofessional Residency Program in Family Health that could contribute to the development of Interprofessional Education and/or Collaborative Practice.

METHOD

a qualitative study with residents who entered a Multiprofessional Residency Program of a Brazilian public university in 2017, a period in which the theme of interprofessionality was implemented in the activities of the residency. Data was collected using an electronic form built from the theoretical framework of interprofessional education. Content analysis was used to process the data.

RESULTS

nine residents participated, distributed among the professions of Physical Education, Nursing, Nutrition, Dentistry, Psychology and Social Work, five of whom were female and with a mean age of 28.4. Two categories emerged: the Residency as a setting for learning from the other, and the Residency as a setting for understanding the role of the other. Interprofessional education and practice provided opportunities for the development of collaborative skills, enhancing teamwork and interprofessional work.

CONCLUSION

the multiprofessional logic was evidenced in the resident's practice; and the gradual insertion of activities such as case discussions, shared services and inter-sectoral actions aligned with the theoretical-methodological framework of interprofessionality favored an approach to interprofessional work.

Spanish version of the readiness for interprofessional learning scale (RIPLS) in an undergraduate health sciences student context

The Readiness for Interprofessional Learning Scale (RIPLS) has been widely used to measure students' and professionals' attitudes toward interprofessional learning. However, inconsistencies have been reported concerning its validity and reliability. This study aimed to translate, adapt, and validate the RIPLS questionnaire to be applied to Spanish-speaking health sciences students in Chile. Content and construct validity evidence of the newly created Spanish version of the RIPLS scale were analyzed. An exploratory (EFA) and confirmatory (CFA) analysis were conducted, determining goodness-of-fit indexes. Reliability was evaluated through Cronbach's Alpha Coefficient. We assessed sensitivity to change of the RIPLS scale by comparing pre- and post-interprofessional education workshop scores. The EFA showed that there were three factors. In the CFA, most of the standardized factor loadings were higher than 0.3. Regarding internal consistency, Cronbach's Alpha was 0.86. The differences between the total RIPLS scores before and after the workshops were statistically significant. The Spanish version of RIPLS showed evidence of validity and reliability for use amongst health sciences students. The construct was adequately measured and was shown that it could be used to assess the impact of interprofessional education workshops.

Interprofessional collaboration and barriers among health and social workers caring for older adults: a Philippine case study

BACKGROUND

There is limited information on how the barriers to interprofessional collaboration (IPC) across various professionals, organizations, and care facilities influence the health and welfare of older adults. This study aimed to describe the status of IPC practices among health and social workers providing care for older adults in the Philippines; investigate the perceived barriers to its implementation and perceived effects on geriatric care; and identify possible solutions to address the barriers limiting collaborative practice.

METHODS

A case study approach was utilized employing 12 semi-structured in-depth interviews and 29 focus group discussions with care workers from selected primary health care units, public and private hospitals, and nursing homes that are directly involved in geriatric care delivery in two cities in the Philippines. Overall, 174 health and social workers consented to participate in this study. All interviews were audio-recorded and transcribed verbatim. An inductive thematic analysis using NVivo 12® was used to identify and categorize relevant thematic codes.

RESULTS

Interprofessional geriatric care provided by health and social workers was observed to be currently limited to ad hoc communications typically addressing only administrative concerns. This limitation is imposed by a confluence of barriers such as personal values and beliefs, organizational resource constraints, and a silo system care culture which practitioners say negatively influences care delivery. This in turn results in inability of care providers to access adequate care information, as well as delays and renders inaccessible available care provided to vulnerable older adults. Uncoordinated care of older adults also led to reported inefficient duplication and overlap of interventions.

CONCLUSION

Geriatric care workers fear such barriers may aggravate the increasing unmet needs of older adults. In order to address these potential negative outcomes, establishing a clear and committed system of governance that includes IPC is perceived as necessary to install a cohesive service delivery mechanism and provide holistic care for older adults. Future studies are needed to measure the effects of identified barriers on the potential of IPC to facilitate an integrated health and social service delivery system for the improvement of quality of life of older adults in the Philippines.

The Integral Role of Organisational Governance in Promoting Interprofessional Education in Rural Settings

One of the key challenges with implementing and sustaining interprofessional education initiatives is the lack of governance structures and processes to guide them. This case study presents a process evaluation of an intersectoral advisory group that facilitated a novel interprofessional clinical education model in rural health settings in the state of Queensland, Australia. The group consisted of health and academic partners to guide the implementation and promote sustainability of this new model. The advisory group process was evaluated mid-way and at conclusion of the group functions, using focus group discussions. The focus group audio recordings were transcribed verbatim and subjected to inductive content analysis. Categories were developed for reporting. Three broad categories were identified: Characteristics of the group, functions of the group and multifaceted communication within the group and between sectors. By identifying and mapping the processes used by a strategic, high-level intersectoral advisory group consisting of members from the health and academic fields, key recommendations have been formulated to guide similar work in the future.

Interprofessional simulation effects for healthcare students: A systematic review and meta-analysis

OBJECTIVE

To conduct a systematic review of studies describing the effects of interprofessional education (IPE) on collaborative competence using simulated-based training of undergraduate healthcare students.

DESIGN

A systematic review and meta-analysis based on PRISMA guidelines.

DATA SOURCES

PubMed and Cumulative Index to Nursing and Allied Health Literature databases were searched to identify articles in all languages published up to 2018. The systematic review protocol was registered at PROSPERO under number 133330.

REVIEW METHODS

In total, 419 articles were identified. The following articles were excluded: non-English articles, articles for which the full text was not available, articles that did not employ a validated tool, articles that did not use quasi-experimental methods and that did not assess healthcare student populations. Eleven studies were included, and 6 were submitted to meta-analysis using forest plots through RevMan 5.3.

RESULTS

Interprofessional simulation analysis yielded results regarding participants, protocols, scenarios, validated tools, collaborative competencies and primary outcomes. The meta-analysis was organized based on assessment tool, and summary value, confidence interval, and Z test results for the random-effects model are presented.

CONCLUSION

Quantitative analysis reveals a positive impact and the effectiveness of interprofessional simulation. However, more research should be conducted utilizing clinical trials with distinguished analyses for each collaborative competency factor to assess long-term effects on the outcome.

High and low functioning team-based pre-licensure interprofessional learning: an observational evaluation

Interprofessional education (IPE) is embedded in many health professional training programs, often with a focus on collaborative teamwork. Most studies into whether IPE delivers the desired collaborative teamwork capabilities has tended to rely on short term, self-assessed changes in learners' attitudes, knowledge and skills. This study adopted overt ethnographic observation to understand how a convenience sample of students behave in groups during interprofessional team-based clinical placements. Interprofessional student teams were observed by two independent observers on eight occasions (a total of 720 hours) across three sites. Thematic analysis of the observational data indicates that student teams fell into two categories: higher and lower functioning. Higher functioning teams were observed using humor to build rapport, reduce tension and express humility, and evidenced a greater emphasis on shared client goals. In contrast, lower functioning teams were more formal, with no evidence of humor and less interaction. The higher functioning teams, therefore, not only demonstrated greater interprofessional collaboration they also appeared to have higher levels of psychological safety. Participants in the higher functioning teams also demonstrated mutual trust and confidence and took more risks, often speaking up to provide suggestions, share knowledge and skills, and seek or offer feedback. The results suggest that further explicit training in, and assessment of, psychological safety in IPE needs to be undertaken.

Students' Assessment on the Patient Safety Education: The Case of College of Medicine and Health Sciences, University of Gondar

Background:

It is well-known that clinical practice could never be free from medical errors. Respectively, in the case of a large number of students with a huge diversity of disciplines, the breach of patients' safety is not uncommon. Thus, this study aimed to assess students' evaluation of patients' safety education in their curriculum.

Materials and Methods:

A cross-sectional study was conducted among 338 students at the University of Gondar. A descriptive analysis was done by using Stata version 13 software and data were presented in tables and text.

Results:

As stated by 33.40% of medical interns and 51.10% of nursing students, patients' safety education was given as a chapter of a course. On the contrary, 48.20% of midwifery and 32.10% of health officer students stated that it was given as a small portion in a chapter in their curriculum. Almost 60% of students of all professional categories self-reported that their average level of knowledge on the patients' safety rested between “fair” and “poor.” Likewise, more than half of students of all professional categories had a “neutral” to “disagree” level of attitude for attitude items. Concerning teaching methods, most students preferred real-life examples and problem-based learning approaches as helpful in patients' safety education.

Conclusions:

Patients' safety education has been given less emphasis. Students also self-reported that their average level of knowledge was low. Real-life examples and problem-based learning approaches were preferred learning methods among most of the students.

Effect of a rapid e-learning module and brief interprofessional simulation event on medical and nursing student collaborative attitudes and behaviors

Objectives Undergraduate nursing and first-year medical students participated in a brief, scenario-based, interprofessional event. The experimental group only was provided an innovative, rapid e-learning instructional module focused on interprofessional roles/responsibilities and communication prior to the event. Methods Pre-post attitudes toward physician-nurse collaboration were surveyed, and collaborative behaviors were observed during the event. Results For the experimental group, a statistically significant (p<0.05) attitude improvement was found between pre-post e-learning module scores as well as pre-e-learning module and post-simulation event scores. For the control group, a statistically significant (p=0.001) attitude improvement was found between pre-post simulation event scores. No statistically significant differences in team collaborative behaviors were observed between experimental and control. Conclusions The combination of module and simulation event was not a more effective option than the event alone. As both interventions present unique challenges in regards to technology and facility requirements, having multiple effective intervention options will be of benefit to educational institutions.

Using a Mixed Methods Approach to Explore Perceptions of Early Learners in Classroom-Based Interprofessional Education Experiences

Objective. To explore attitudes and learning outcomes among early-level health professions students who completed foundational interprofessional education (IPE) courses. Methods. This study used a mixed methods approach to examine assessment and evaluation data from two student cohorts enrolled in two one-credit, semester-long interprofessional courses taught in fall and spring 2017. Attitudinal changes following the fall course were measured and compared in a retrospective pretest-posttest manner across student disciplines using the Student Perceptions of Interprofessional Clinical Education-Revised Instrument, version 2 (SPICE-R2). Course evaluation comments and narrative reflection assignments for both courses were analyzed qualitatively via data reduction and compilation to identify evidence of learning. Results. Significant increases in positive student perceptions regarding IPE were found, with variation in the increase seen between professions following the first course. Core themes identified in the narrative reflections demonstrated student learning in interprofessional attitudes, communication, professional identity, collaborative behaviors, and systems of care. Conclusion. Student attitudes toward interprofessional learning were more positive following completion of a foundational IPE course. In addition, learning in the course shaped students' professional identities, collaborative behaviors, and understanding of systems of care. These findings suggest value in early IPE and directions for better structuring curriculum and timing of IPE.

Analysis of an interprofessional education activity in the occupational health field

OBJECTIVE

to analyze the results of an Interprofessional Education activity in the ​​Occupational Health field.

METHOD

this is an Action Research, which encompassed the implementation and evaluation stages of the activity. It was developed in a Public Higher Education Institution through 15 meetings, totaling 60 hours. It had 16 participants, five undergraduate students, three graduate students, five teachers and three health professionals, representing the areas of Nursing, Physical Education, Physiotherapy, Gerontology and Psychology. Data regarding the implementation of the activity were collected in a field diary and analyzed through Thematic Analysis. An evaluation form constructed exclusively for this purpose was applied, whose data were submitted to descriptive statistical analysis.

RESULTS

three thematic categories were identified: (1) Comprehensive care; (2) Work as a social determinant of the health-disease process; and (3) Interprofessional teamwork. The activity of Interprofessional Education was positively evaluated by the participants, who pointed out the contributions of this strategy in the construction of knowledge directed to Occupational Health.

CONCLUSION

the activity of Interprofessional Education proved to be possible and important in the context of the formation of health professions to strengthen occupational health care.

Perception and manifestation of collaborative competencies among undergraduate health students

Objective:

to analyze the perception and manifestation of collaborative teamwork competencies among undergraduate health students who experienced the curricular internship’s integration module from the perspective of interprofessional education.

Method:

qualitative study, developed with the intervention research strategy. Twenty-eight students from five undergraduate health courses participated. Data were collected in three focus group interviews conducted with the undergraduate students at the end of each semester. For data analysis, the technique of intervention research and dialectical hermeneutics adopted was based on the theoretical framework of interprofessional education in health.

Results:

uniprofessional culture, the experience of integration of different fields of knowledge and collaborative competencies were manifested by the students in their reports and in the actions developed by the multidisciplinary team with individuals and families, during the experience of the curricular internship’s integration module.

Conclusion:

the experience of integration of the curricular internship from the perspective of interprofessionality favored the perception and manifestation of collaborative competencies that are necessary for teamwork among the students.

Realist approach to evaluating an interprofessional education program for medical students in clinical practice at a community hospital

Introduction: We examined the interrelationships between context, mechanism, and outcome using a realist approach following the introduction of interprofessional education (IPE) to clinical practice for medical students in the community.Methods: Through participant observation and interviews, a working hypothesis was developed. To evaluate IPE in clinical practice, medical students' reports were thematically analyzed, and configuration on contexts, mechanisms, and outcomes were identified using a realist approach.Results: Influential contexts were medical students' experience of clinical practice and learning characteristics, the capacity of other professionals, interprofessional relationships, and characteristics of the community hospital. One key mechanism was observational learning. Others were self-regulated learning, legitimate peripheral participation, experiential learning, contact hypotheses, awareness of social structure, and cognitive empathy. As faculties supported these key mechanisms, medical students became aware of the legitimacy of community-oriented primary care, noting the roles of physicians who support patients' and/or their family's life in collaboration with other professionals, and reflecting the necessity of shifting from physician-centered perspectives. As a result, medical students deepened their empathic understanding for other professionals.Conclusion: Faculties should develop IPE programs in clinical practice based on the 'mechanism', 'context', 'outcome' pattern and 'context-mechanism-outcome' configuration in primary care settings.

A experiência de psicólogos em um programa de residência multiprofissional em saúde

Resumo Esta pesquisa objetivou compreender a experiência de psicólogos que vivenciaram a formação em residência multiprofissional em saúde. Consistiu em pesquisa qualitativa de caráter exploratório inspirada na fenomenologia husserliana. Realizaram-se encontros dialógicos, entre a pesquisadora e seis participantes provenientes de programas de residência de um município de São Paulo, analisados por meio de narrativas compreensivas e uma narrativa síntese. Evidenciaram-se quatro elementos experienciais significativos: (1) transformação pessoal e profissional desencadeada pela dedicação integral característica da aprendizagem em serviço; (2) apropriação do ser psicólogo privilegiando a construção de práticas interdisciplinares e integralidade no cuidado; (3) apropriação da atenção psicológica estrategicamente desenvolvida conforme a rede assistencial à saúde; e (4) tensão entre exigências e estratégias de ensino e serviço, que se revelou prejudicial ao processo de aprendizagem. Concluiu-se que as vivências intersubjetivas propiciaram aprendizagens significativas de cunho pessoal e profissional, sinalizando a importância de estratégias pedagógicas que considerem os processos afetivo-emocionais vividos pelos residentes.

Educação interprofissional e as ações formativas do eixo do provimento emergencial do Programa Mais Médicos

RESUMO Este artigo objetivou identificar se as ações formativas do eixo do provimento emergencial do Programa Mais Médicos se apoiam em elementos teórico-metodológicos da educação interprofissional, na perspectiva dos participantes do programa. Trata-se de estudo exploratório, desenvolvido em 2016, em Minas Gerais. Os dados foram coletados mediante entrevistas individuais (n=30) e nove grupos focais (n=52) com participantes do programa, e tratados por análise de conteúdo, que produziu três categorias: Os pressupostos da educação interprofissional enunciados nos ciclos formativos do Programa Mais Médicos; As mudanças no processo de trabalho em equipe, na perspectiva dos elementos da educação interprofissional, desencadeadas pelos ciclos formativos; e Dificuldades para a abordagem da educação interprofissional nos ciclos formativos. Entre os elementos enunciados nos processos formativos, estão o aprendizado sobre o papel de cada profissão, o compartilhamento de experiências e a centralidade do cuidado no paciente. Por outra via, o preceito fundamental da educação interprofissional de aprendizado entre duas ou mais profissões não é aplicado sistematicamente. O Mais Médicos se constitui política propícia para o fortalecimento da interprofissionalidade, especialmente porque sua proposta se assenta na lógica da educação permanente, que demanda o estabelecimento de uma relação de mútua influência entre a educação e o trabalho em saúde.

A interface entre o PET-Saúde/Interprofissionalidade e a Política Nacional de Educação Permanente em Saúde

RESUMO Este ensaio teve como objetivo refletir sobre as contribuições da edição mais recente do Programa de Educação pelo Trabalho para a Saúde - PET-Saúde/Interprofissionalidade para a implementação da Política Nacional de Educação Permanente em Saúde (PNEPS) no âmbito do Sistema Único de Saúde. Nesse contexto, resgata-se a contemporaneidade da formação em saúde, a Educação Interprofissional e o processo formativo, e a execução do PET-Saúde/Interprofissionalidade como potencializador da prática colaborativa na atenção primária. Ressalta-se que, diante dos inúmeros desafios vivenciados pelos serviços de saúde para responder às demandas populacionais variadas e influenciadas pela transição demográfica e epidemiológica, entende-se como necessário ensaiar reflexões sobre a interprofissionalidade e suas contribuições para a implementação da PNEPS. Acredita-se que este material possa subsidiar a discussão e atuação profissional na elaboração e realização de intervenções interprofissionais apropriadas para as diferentes demandas em saúde.

[Interprofessional approaches in undergraduate medical education]

Social change and the subsequent increase in the complexity of patient care create new challenges for all health care professionals that can only be met by close collaboration. Good cooperation between professionals from all healthcare backgrounds has proven to be essential and should therefore play a larger role in educational and study contexts.It is for this reason that over the past few years more and more countries are requiring cooperative skills and competencies in formal medical training and consequently implementing this training in their healthcare systems. This is certainly true in countries such as Sweden, Canada, England, and most recently Switzerland, where interprofessional teaching is being systematically introduced into medical training.The current situation in Germany is demonstrated by the selected projects from the Robert Bosch Foundation's support program "Operation Team." The existing need for interprofessional qualification opportunities and advanced training programs for teaching staff, the need for exam content for medical state examinations, as well as to establish a structural framework and research structure in the area of interprofessional education and competence development are outlined and discussed.

Benefit-cost analysis of an interprofessional education program within a residential aged care facility in Western Australia

Interprofessional education (IPE) programs in residential aged care facilities (RACF) contributes to the care of older adults whilst providing an environment for students to learn and practise in an interprofessional manner. Clinical placements are provided by RACF through funding and support from universities in collaboration with the RACF. Conducting a benefit-cost analysis (BCA) can determine the sustainability of a clinical placement program such as an IPE program but there is limited research reporting the economic aspects of clinical placements even though it is a university and government priority. This study provides a benefit-cost analysis of an interprofessional education program offered by a residential aged care provider in Western Australia. Analysis using a BCA methodology was conducted to provide information about the level and distribution of the costs and benefits from different analytical perspectives over the three-year period of the IPE program. The analysis showed that the program was highly beneficial from an economic efficiency viewpoint, even though it did not present a financial gain for the aged care provider. The benefits accrued mainly to students in terms of increased education and skill, and to residents in terms of health outcomes and quality of life, while the cost was mostly incurred by the care provider. An IPE program in a RACF is a valuable educational learning experience for students and is also socially beneficial for residents and the broader health sector. For IPE programs in aged care to be sustainable, they require the development of collaborative partnerships with external funding.