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Sweeney KD, Donaghy E, Henderson D, Wang HH, Thompson A, Guthrie B, Mercer SW. Patients' views on primary care multidisciplinary teams in Scotland: a mixed-methods evaluation. BJGP Open 2024:BJGPO.2023.0200. [PMID: 38663983 DOI: 10.3399/bjgpo.2023.0200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/11/2024] [Accepted: 02/23/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND Expanding primary care multidisciplinary teams (MDTs) was a key component of the 2018 Scottish GP contract, with more than 4700 MDT staff appointed since then. AIM To explore patients' views on primary care MDT expansion in Scotland. DESIGN & SETTING A mixed-methods evaluation, which included a postal survey and semi-structured telephone interviews with patients in Scotland. METHOD A survey was undertaken of patients who had recently consulted a GP in deprived urban, affluent urban, and remote and rural areas, assessing awareness of five MDT roles and attitudes towards receptionist signposting. In addition, 30 individual interviews were conducted, exploring patients' MDT-care experiences. RESULTS Of 1053 survey responders, most were unaware of the option of MDT rather than GP consultations for three out of five roles (69% unaware of link worker appointments; 69% mental health nurse; and 58% pharmacist). Reception signposting was less popular in deprived urban areas (34% unhappy versus 29% in remote and rural versus 21% affluent urban; P<0.001), and in patients with multimorbidity (31% unhappy versus 24% in non-multimorbid; P<0.05). Just over two-thirds of interviewees had multimorbidity and almost all reported positive MDT-care experiences. However, MDT care was generally seen as a supplement rather than a substitute for GP care. Around half of patients expressed concerns about reception signposting. These patients were more likely to also express concerns about GP access in general. Both of these concerns were more common in deprived urban areas than in remote and rural or affluent urban areas. CONCLUSION MDT care has expanded in Scotland with limited patient awareness. Although patients understand its potential value, many are unhappy with reception signposting to first-contact MDT care, especially those in deprived urban areas living with multimorbidity. This represents a barrier to the aims of the new GP contract.
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Affiliation(s)
- Kieran D Sweeney
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Eddie Donaghy
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - David Henderson
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Harry Hx Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, China
| | - Andrew Thompson
- School of Social and Political Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Bruce Guthrie
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Stewart W Mercer
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
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Lampridis S, Scarci M, Cerfolio RJ. Interprofessional education in cardiothoracic surgery: a narrative review. Front Surg 2024; 11:1467940. [PMID: 39296347 PMCID: PMC11408362 DOI: 10.3389/fsurg.2024.1467940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2024] [Accepted: 08/21/2024] [Indexed: 09/05/2024] Open
Abstract
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.
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Affiliation(s)
- Savvas Lampridis
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
- Department of Thoracic Surgery, 424 General Military Hospital, Thessaloniki, Greece
| | - Marco Scarci
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
- Department of Cardiothoracic Surgery, Hammersmith Hospital, London, United Kingdom
| | - Robert J Cerfolio
- Department of Cardiothoracic Surgery, New York University Langone Health, New York, NY, United States
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de Gans ST, van der Zwaard BC, Labordus-van Helvoirt REM, Cornegé-Blokland E, Adang EM, van de Pol MHJ, Keijsers CJPW. Improved Care, Similar Costs, and Improved Health Equity by Interprofessional Collaboration: An Economic Evaluation. J Am Med Dir Assoc 2024; 25:105200. [PMID: 39134093 DOI: 10.1016/j.jamda.2024.105200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/04/2024] [Accepted: 07/07/2024] [Indexed: 08/22/2024]
Affiliation(s)
- Simon T de Gans
- Jeroen Bosch Academy, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands.
| | | | | | - E Cornegé-Blokland
- Department of Geriatric Medicine, Dutch Geriatric Society, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
| | - Eddy M Adang
- Department of IQ Health, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marjolein H J van de Pol
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Carolina J P W Keijsers
- Department of Geriatric Medicine, Department of Clinical Pharmacology, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands
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Lunghi C, Domenicali M, Vertullo S, Raschi E, De Ponti F, Onder G, Poluzzi E. Adopting STOPP/START Criteria Version 3 in Clinical Practice: A Q&A Guide for Healthcare Professionals. Drug Saf 2024:10.1007/s40264-024-01453-1. [PMID: 38990488 DOI: 10.1007/s40264-024-01453-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2024] [Indexed: 07/12/2024]
Abstract
The growing complexity of geriatric pharmacotherapy necessitates effective tools for mitigating the risks associated with polypharmacy. The Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (STOPP)/Screening Tool to Alert doctors to Right Treatment (START) criteria have been instrumental in optimizing medication management among older adults. Despite their large adoption for improving the reduction of potentially inappropriate medications (PIM) and patient outcomes, the implementation of STOPP/START criteria faces notable challenges. The extensive number of criteria in the latest version and time constraints in primary care pose practical difficulties, particularly in settings with a high number of older patients. This paper critically evaluates the challenges and evolving implications of applying the third version of the STOPP/START criteria across various clinical settings, focusing on the European healthcare context. Utilizing a "Questions & Answers" format, it examines the criteria's implementation and discusses relevant suitability and potential adaptations to address the diverse needs of different clinical environments. By emphasizing these aspects, this paper aims to contribute to the ongoing discourse on enhancing medication safety and efficacy in the geriatric population, and to promote more person-centred care in an aging society.
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Affiliation(s)
- Carlotta Lunghi
- Department of Medical and Surgical Sciences, University of Bologna, Via Irnerio 48, 40126, Bologna, Italy.
- Population Health and Optimal Health Practices Research Unit, CHU de Québec-Université Laval Research Centre, Quebec, Quebec, Canada.
| | - Marco Domenicali
- Department of Medical and Surgical Sciences, University of Bologna, Via Irnerio 48, 40126, Bologna, Italy
| | - Stefano Vertullo
- Department of Medical and Surgical Sciences, University of Bologna, Via Irnerio 48, 40126, Bologna, Italy
- Department of Medical Biotechnology and Translational Medicine, Postgraduate School of Clinical Pharmacology and Toxicology, University of Milan, Milan, Italy
| | - Emanuel Raschi
- Department of Medical and Surgical Sciences, University of Bologna, Via Irnerio 48, 40126, Bologna, Italy
| | - Fabrizio De Ponti
- Department of Medical and Surgical Sciences, University of Bologna, Via Irnerio 48, 40126, Bologna, Italy
| | - Graziano Onder
- Department of Gerontology, Neuroscience and Orthopedics, Sacred Heart Catholic University, Rome, Italy
| | - Elisabetta Poluzzi
- Department of Medical and Surgical Sciences, University of Bologna, Via Irnerio 48, 40126, Bologna, Italy
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Peduzzi M, Fernandes Agreli HL, da Silva JAM, Hara Koyama MA, Fracolli LA, Xyrichis A. Team climate and patients' perception of primary healthcare attributes in Brazil: a cross-sectional study. J Interprof Care 2024; 38:705-712. [PMID: 38755950 DOI: 10.1080/13561820.2024.2351006] [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: 05/04/2023] [Accepted: 04/28/2024] [Indexed: 05/18/2024]
Abstract
Team climate and attributes of primary healthcare (PHC) are key elements for collaborative practice. Few researchers have explored the relationship between team climate and patients' perceptions of PHC. This study aimed to assess the association between team climate and patients' perceptions of primary healthcare attributes. A quantitative approach was adopted. In Stage 1, Team climate was assessed using Team Climate Inventory in 118 Family Health Strategy (FHS) teams at a PHC setting. In Stage 2, Patients' perceptions of PHC attributes were assessed using the Primary Care Assessment Tool (PCATool) in a sample of 844 patients enrolled in teams studied in Stage 1. Cluster analysis was used to identify team climate groups. The analysis used multilevel linear regression models. Patients assigned to teams with the highest team climate scores had the highest PHC attributes scores. Patients who reported affiliation at the team level had the highest PCATool scores overall. They also scored higher on the attributes of comprehensiveness and coordinated care compared to patients with affiliation to the health unit. In conclusion, patients under the care of FHS teams exhibiting a more favorable team climate had more positive patient perceptions of PHC attributes.
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Affiliation(s)
- Marina Peduzzi
- School of Nursing, University of São Paulo, São Paulo, Brazil
| | | | | | | | | | - Andreas Xyrichis
- Florence Nightingale Faculty of Nursing & Midwifery, King's College London, London, UK
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Battle K, Lockeman KS, Dow AW, Donohoe KL, Hanley L, Slattum PW. Unpacking interactions among student teams in a practice-based IPE setting: a qualitative evaluation study. J Interprof Care 2024; 38:713-721. [PMID: 38717845 DOI: 10.1080/13561820.2024.2345829] [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: 06/30/2022] [Accepted: 04/16/2024] [Indexed: 05/31/2024]
Abstract
In many healthcare settings, teams change composition regularly, so healthcare students must be trained to function effectively in dynamic teams before entering the workforce. Interprofessional clinical rotations provide an ideal venue for learners to practice these skills, but little is known about how student teams interact in such settings. In this qualitative observational evaluation, learners from multiple health professions at a single institution participated in scheduled clinics in low-income housing communities for older adults. Interprofessional student teams met with program participants for care coordination, health and wellness assessments, and assistance in setting and achieving health goals; team composition changed from week-to-week. A purposive sample was selected from video-recorded encounters between student teams and their program participants. The aim of this study was to explore team interactions and document learner behaviors. Two researchers independently reviewed discrete segments of each video, recorded their observations and reflections, and then the team discussed, categorized, and identified relevant examples of both effective and ineffective behaviors. Four major themes were observed: inclusiveness, leadership, joy of practice, and sharing of clinical knowledge. Students demonstrated both positive and negative examples of behaviors that aligned with each theme. Understanding how students behave on teams in dynamic settings where patient care is taking place can help educators establish practice-based interprofessional education models that better prepare learners to function effectively and strategies that may improve team interactions.
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Affiliation(s)
- Kimberly Battle
- School of Nursing, Virginia Commonwealth University, Richmond, VA, USA
| | - Kelly S Lockeman
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Alan W Dow
- School of Medicine, Asst. Vice President of Health Sciences for Interprofessional Education and Collaborative Care, Virginia Commonwealth University, Richmond, VA, USA
| | - Krista L Donohoe
- School of Pharmacy, Virginia Commonwealth University, Richmond, VA, USA
| | - Lauren Hanley
- Medical Student, Virginia Commonwealth University, Richmond, VA, USA
| | - Patricia W Slattum
- School of Pharmacy, Virginia Center on Aging, Virginia Commonwealth University, Richmond, VA, USA
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7
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Neubauer FB, Wagner FL, Lörwald A, Huwendiek S. Sharpening the lens to evaluate interprofessional education and interprofessional collaboration by improving the conceptual framework: a critical discussion. BMC MEDICAL EDUCATION 2024; 24:615. [PMID: 38835006 DOI: 10.1186/s12909-024-05590-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 05/22/2024] [Indexed: 06/06/2024]
Abstract
It has been difficult to demonstrate that interprofessional education (IPE) and interprofessional collaboration (IPC) have positive effects on patient care quality, cost effectiveness of patient care, and healthcare provider satisfaction. Here we propose a detailed explanation for this difficulty based on an adjusted theory about cause and effect in the field of IPE and IPC by asking: 1) What are the critical weaknesses of the causal models predominantly used which link IPE with IPC, and IPE and IPC with final outcomes? 2) What would a more precise causal model look like? 3) Can the proposed novel model help us better understand the challenges of IPE and IPC outcome evaluations? In the format of a critical theoretical discussion, based on a critical appraisal of the literature, we first reason that a monocausal, IPE-biased view on IPC and IPC outcomes does not form a sufficient foundation for proper IPE and IPC outcome evaluations; rather, interprofessional organization (IPO) has to be considered an additional necessary cause for IPC; and factors outside of IPC additional causes for final outcomes. Second, we present an adjusted model representing the "multi-stage multi-causality" of patient, healthcare provider, and system outcomes. Third, we demonstrate the model's explanatory power by employing it to deduce why misuse of the modified Kirkpatrick classification as a causal model in IPE and IPC outcome evaluations might have led to inconclusive results in the past. We conclude by applying the derived theoretical clarification to formulate recommendations for enhancing future evaluations of IPE, IPO, and IPC. Our main recommendations: 1) Focus should be placed on a comprehensive evaluation of factual IPC as the fundamental metric and 2) A step-by-step approach should be used that separates the outcome evaluation of IPE from that of IPC in the overarching quest for proving the benefits of IPE, IPO and IPC for patients, healthcare providers, and health systems. With this critical discussion we hope to enable more effective evaluations of IPE, IPO and IPC in the future.
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Affiliation(s)
- Florian B Neubauer
- Institute for Medical Education, Department for Assessment and Evaluation, University of Bern, Bern, Switzerland.
| | - Felicitas L Wagner
- Institute for Medical Education, Department for Assessment and Evaluation, University of Bern, Bern, Switzerland
| | - Andrea Lörwald
- Institute for Medical Education, Department for Assessment and Evaluation, University of Bern, Bern, Switzerland
| | - Sören Huwendiek
- Institute for Medical Education, Department for Assessment and Evaluation, University of Bern, Bern, Switzerland
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Cadet T, Cusimano J, McKearney S, Honaker J, O'Neal C, Taheri R, Uhley V, Zhang Y, Dreker M, Cohn JS. Describing the evidence linking interprofessional education interventions to improving the delivery of safe and effective patient care: a scoping review. J Interprof Care 2024; 38:476-485. [PMID: 38124506 PMCID: PMC11009096 DOI: 10.1080/13561820.2023.2283119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 11/02/2023] [Indexed: 12/23/2023]
Abstract
Empirical evidence indicates that collaborative interprofessional practice leads to positive health outcomes. Further, there is an abundance of evidence examining student and/or faculty perceptions of learning or satisfaction about the interprofessional education (IPE) learning experience. However, there is a dearth of research linking IPE interventions to patient outcomes. The objective of this scoping review was to describe and summarize the evidence linking IPE interventions to the delivery of effective patient care. A three-step search strategy was utilized for this review with articles that met the following criteria: publications dated 2015-2020 using qualitative, quantitative or mixed methods; the inclusion of healthcare professionals, students, or practitioners who had experienced IPE or training that included at least two collaborators within coursework or other professional education; and at least one of ten Centers for Medicare & Medicaid Services quality measures (length of stay, medication errors, medical errors, patient satisfaction scores, medication adherence, patient and caregiver education, hospice usage, mortality, infection rates, and readmission rates). Overall, n=94 articles were identified, providing overwhelming evidence supporting a positive relationship between IPE interventions and several key quality health measures including length of stay, medical errors, patient satisfaction, patient or caregiver education, and mortality. Findings from this scoping review suggest a critical need for the development, implementation, and evaluation of IPE interventions to improve patient outcomes.
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Affiliation(s)
- Tamara Cadet
- School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA, USA
| | - Joseph Cusimano
- Bernard J. Dunn School of Pharmacy, Shenandoah University, Winhester, VA, USA
| | - Shelley McKearney
- Interprofessional Education Collaborative, BS Seton Hall University, South Orange, NJ, USA
| | | | - Cynthia O'Neal
- School of Nursing, University of Texas Health Science Center, San Antonio, Texas, USA
| | - Reza Taheri
- Pharmacy Practice Department, Chapman University, Irvine, CA, USA
| | - Virginia Uhley
- Department of Foundational Medical Studies, Department of Family Medicine and Community Health, Oakland University, Rochester, MI, USA
| | - Yingting Zhang
- Department of Medicine, Research Services Librarian Library Faculty, Robert Wood Johnson Library of the Health Sciences, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Margaret Dreker
- Hackensack Meridian School of Medicine, Seton Hall University, Nutley, NJ, USA
| | - Judith S Cohn
- Health Sciences Library, Information Services and Department of Health Sciences Libraries Department, George F. Smith Library of the Health Sciences, The State University of New Jersey, Newark, NJ, USA
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de Mendonça BFS, de Carvalho RB, Pacheco KTS. Interprofessional education in undergraduate dental curricula: A systematic review. J Dent Educ 2024; 88:554-566. [PMID: 38361493 DOI: 10.1002/jdd.13464] [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: 05/03/2023] [Revised: 11/14/2023] [Accepted: 01/06/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION Health professionals who effectively communicate and coordinate their work increase patient safety and quality of care. Therefore, an interprofessional education (IPE) program may be a valuable addition to the curriculum of health science courses. This study aims to verify how IPE has been implemented in undergraduate dental program curricula. METHODS This is a qualitative systematic review performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with qualitative and qualitative-quantitative studies selected in the period between 2011 and 2021. The guiding question was as follows: how has IPE been implemented in undergraduate dentistry curricula around the world? The quality of the included articles was assessed using the CASP Qualitative Checklist (2018). RESULTS After the review, 22 studies were selected and data were extracted following the acronym PICo (Population, phenomenon of Interest, and COntext). The majority of studies in which IPE is included in Dentistry come from North American universities. Regarding the IPE teaching methodology, the use of active methodologies was observed and the interprofessional skills most common were role clarity, teamwork, and communication. CONCLUSION This systematic review indicated that Dentistry is included in interprofessional activities in many studies around the world, and primarily with colleagues in medicine, nursing, and pharmacy programs. IPE teaching takes place through the use of active methodologies and develops important skills for interprofessional work.
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Affiliation(s)
- Brígida F S de Mendonça
- Master Program of Dental Sciences/Programa de Pós-Graduação em Ciências Odontológicas, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Raquel B de Carvalho
- Department of Social Medicine, Master Program of Dental Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Karina T S Pacheco
- Department of Social Medicine, Master Program of Dental Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
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Will KK, Liang Y, Chi CL, Lamb G, Todd M, Delaney C. Measuring the Impact of Primary Care Team Composition on Patient Activation Utilizing Electronic Health Record Big Data Analytics. J Patient Cent Res Rev 2024; 11:18-28. [PMID: 38596347 PMCID: PMC11000700 DOI: 10.17294/2330-0698.2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
Purpose Team-based care has been linked to key outcomes associated with the Quadruple Aim and a key driver of high-value patient-centered care. Use of the electronic health record (EHR) and machine learning have significant potential to overcome previous barriers to studying the impact of teams, including delays in accessing data to improve teamwork and optimize patient outcomes. Methods This study utilized a large EHR dataset (n=316,542) from an urban health system to explore the relationship between team composition and patient activation, a key driver of patient engagement. Teams were operationalized using consensus definitions of teamwork from the literature. Patient activation was measured using the Patient Activation Measure (PAM). Results from multilevel regression analyses were compared to machine learning analyses using multinomial logistic regression to calculate propensity scores for the effect of team composition on PAM scores. Under the machine learning approach, a causal inference model with generalized overlap weighting was used to calculate the average treatment effect of teamwork. Results Seventeen different team types were observed in the data from the analyzed sample (n=12,448). Team sizes ranged from 2 to 5 members. After controlling for confounding variables in both analyses, more diverse, multidisciplinary teams (team size of 4 or more) were observed to have improved patient activation scores. Conclusions This is the first study to explore the relationship between team composition and patient activation using the EHR and big data analytics. Implications for further research using EHR data and machine learning to study teams and other patient-centered care are promising and could be used to advance team science.
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Affiliation(s)
| | - Yue Liang
- University of Minnesota, Minneapolis, MN
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Mohamed N, Peck CW, Senekal J. Perceptions of interprofessional collaborative practice in South Africa: A systematic review. Health SA 2024; 29:2413. [PMID: 38445033 PMCID: PMC10913126 DOI: 10.4102/hsag.v29i0.2413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 11/20/2023] [Indexed: 03/07/2024] Open
Abstract
Background Interprofessional education (IPE) and interprofessional collaborative practice (IPCP) were developed to address the health needs of communities through collaborative practice across healthcare disciplines. The impact of IPE on IPCP and clinical service delivery in South Africa is not evident, possibly because of the lack of IPCP experiences among healthcare professionals. Aim International literature reports facilitators and barriers of IPCP implementation, but there was a need to filter the evidence to identify literature from the South African context regarding the perceptions of healthcare workers' perceived barriers and facilitators of IPCP. Setting South African literature. Methods A systematic review was conducted to synthesise evidence from articles published between January 2017 and December 2021. Only qualitative studies targeting health professionals in South Africa who had been exposed to IPCP were included. Consistent with Preferred Reporting Items for Systematic reviews and Meta-Analysis, a multi-database search yielded 424 articles, which were screened for relevance and appraised for quality using the Critical Appraisal Skills Programme (CASP) tool. A thematic synthesis of the findings was conducted by applying ethical principles. Results Synthesis of barriers and enablers for IPCP implementation in the South African context included key aspects of healthcare systems, management and team leadership. Conclusion The integration of IPCP into clinical practice in South Africa is still limited as healthcare professionals operate in silos. Contribution Recommendations of this study include greater integration of services combined with competent management and visionary leadership, together with the incorporation of IPE into undergraduate professional training programmes.
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Affiliation(s)
- Nadia Mohamed
- Department of Paediatric Dentistry, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa
| | - Craig W Peck
- Department of Paediatric Dentistry, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa
| | - Janine Senekal
- Research Development and Postgraduate Support, University of the Western Cape, Cape Town, South Africa
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Musits AN, Khan H, Cassara M, McKenna RT, Penttila A, Ahmed RA, Wong AH. Fellowship Accreditation: Experiences From Health Care Simulation Experts. J Grad Med Educ 2024; 16:41-50. [PMID: 38304604 PMCID: PMC10829926 DOI: 10.4300/jgme-d-23-00388.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/14/2023] [Accepted: 11/10/2023] [Indexed: 02/03/2024] Open
Abstract
Background The field of health care simulation continues to grow, accompanied by a proliferation of fellowship programs, leading to fellowship accreditation efforts. There is controversy around the best approach to accreditation. Objective The authors sought to understand perspectives of simulation leaders on fellowship accreditation to best inform the growth and maturation of fellowship accreditation. Methods In 2020, simulation leaders identified through snowball sampling were invited to participate in a qualitative study. During one-on-one semistructured interviews, participants were asked about experiences as simulation leaders and their perspective on the purpose and impact of accreditation. The interviews were audio recorded and transcribed. Thematic analysis informed by a phenomenology framework was performed using a masked open coding technique with iterative refinement. The resulting codes were organized into themes and subthemes. Results A total of 45 simulation experts participated in interviews ranging from 25 to 67 minutes. Participants described discord and lack of consensus regarding simulation fellowship accreditation, which included a spectrum of opinions ranging from readiness for accreditation pathways to concern and avoidance. Participants also highlighted how context drove the perception of accreditation value for programs and individuals, including access to resources and capital. Finally, potential impacts from accreditation included standardization of training programs, workforce concerns, and implications for professional societies. Conclusions Simulation leaders underscored how the value of accreditation is dependent on context. Additional subthemes included reputation and resource variability, balancing standardization with flexibility and innovation, and implications for professional societies.
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Affiliation(s)
- Andrew N. Musits
- Andrew N. Musits, MD, MS, is Assistant Professor, Department of Emergency Medicine, Alpert Medical School of Brown University, Director, Lifespan Medical Simulation Center, and Fellowship Director, Brown Emergency Medicine Simulation Fellowship, Providence, Rhode Island, USA
| | - Humera Khan
- Humera Khan, MD, is Associate Professor and Founding Director of Simulation, Orlando College of Osteopathic Medicine, Horizon West, Florida, USA
| | - Michael Cassara
- Michael Cassara, DO, MSEd, is Associate Professor, Department of Emergency Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Associate Professor, Hofstra Northwell School of Nursing, Vice President, Interprofessional Education, Research and Practice, and Medical Director, Northwell Health Patient Safety Institute/Emergency Medical Institute, Uniondale, New York, USA
| | - Ryan T. McKenna
- Ryan T. McKenna, DO, is Assistant Professor, Division of Emergency Medicine, University of South Florida Morsani College of Medicine, Simulation Director, University of South Florida Emergency Medicine Residency, and Fellowship Director, The Interprofessional Simulation Fellowship at USF Health CAMLS, Tampa, Florida, USA
| | - Atte Penttila
- Atte Penttila, PhD, is a Researcher, E2 Research, Helsinki, Finland
| | - Rami A. Ahmed
- Rami A. Ahmed, DO, MHPE, is Professor, Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA; and
| | - Ambrose H. Wong
- Ambrose H. Wong, MD, MSEd, MHS, is Assistant Professor, Department of Emergency Medicine, Yale School of Medicine, and Director of Simulation Research and Fellowship Director, Yale Center for Medical Simulation, New Haven, Connecticut, USA
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Sampson S, Nelson A, Cardarelli R, Roper KL. Ensuring the "health" of a curricular program evaluation: Alignment and analytic quality of two instruments for use in evaluating the effectiveness of an interprofessional collaboration curriculum. EVALUATION AND PROGRAM PLANNING 2024; 102:102377. [PMID: 37783173 DOI: 10.1016/j.evalprogplan.2023.102377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 07/17/2023] [Accepted: 09/20/2023] [Indexed: 10/04/2023]
Abstract
To cultivate competencies in interprofessional collaboration (IPC) for patient-centered, team-based care, a multi-faceted training enhancement initiative was implemented at our academic primary care residency site. Evaluation of the activities from previously collected survey data occurred upon a 2-year review. First, the evaluation team scrutinized the instruments for alignment and appropriateness with planned IPC educational learning and behavior objectives. We found the two instruments were well supported by the literature and with appropriate evidence for validation, but were not well aligned to the objectives of this IPC training initiative, reducing appropriateness of potential inferences of the findings for this context. Second, the team assessed the analytic quality of survey results in item difficulty distribution and item fit to the requirements of a Rasch measurement model. This revealed low person separation due to high overall item agreement. Most residents agreed with most items, so the measures lacked the precision necessary to capture change in residents' IPC competency. Our instrument review serves as a reminder of the need to gather validity evidence for the use of any existing tool within a new context, and offers a generalizable strategy to evaluate data sources for appropriateness and quality within a specific program.
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Affiliation(s)
- Shannon Sampson
- University of Kentucky College of Education, Department of Educational Policy Studies and Evaluation, USA
| | - Andrew Nelson
- University of Kentucky College of Education, Department of Educational Policy Studies and Evaluation, USA
| | - Roberto Cardarelli
- University of Kentucky College of Medicine, Department of Family and Community Medicine, USA
| | - Karen L Roper
- University of Kentucky College of Medicine, Department of Family and Community Medicine, USA.
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14
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Guck TP, Walters RW, Abdul-Greene C, Doll J, Greene MA, McGaha AL. Sustainable and replicable clinical and financial outcomes in an interprofessional education and collaborative practice nexus. J Interprof Care 2024; 38:70-77. [PMID: 34139943 DOI: 10.1080/13561820.2021.1932776] [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: 08/28/2020] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
Our Interprofessional Education and Collaborative Practice (IPECP) Nexus previously reported significant reductions in Emergency Department (ED) visits, hospitalizations, hemoglobin A1c levels, and patient charges. This study examines sustainability of these results over two additional years and replication in two subsequent independent patient cohorts. Participants in the sustainability cohort (N = 276) met ≥1 of the following criteria: (a) ≥3 ED visits in first or second half of the year, (b) hemoglobin A1c level ≥ 9, or (c) Length of Stay, Acuity, Comorbidities, and ER (Emergency Room) Visits (LACE) score ≥ 10. Participants in two replicability cohorts (N = 255) and (N = 160) met the same criteria, but the LACE criterion was changed to ≥3 hospitalizations in baseline years. The Nexus, housed in a family medicine (FM) residency clinic, included professionals and students from multiple disciplines. IPECP skills and interventions included communication, team building, and conflict engagement skills training, daily huddles and pre-visit planning, immediate consultations, small teamlet IPECP interactions, and weekly IPECP case conferences for complex patients. Original health improvements and charge reductions were sustained for two additional years for ED visits, hospitalizations, A1c, and patient charges, and replicated in two additional patient cohorts. The IPECP Nexus interventions were associated with Quadruple Aim outcomes while training the next generation of health care professionals.
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Affiliation(s)
- Thomas P Guck
- Creighton University School of Medicine, Creighton University, Omaha, NE, USA
| | - Ryan W Walters
- Creighton University School of Medicine, Creighton University, Omaha, NE, USA
| | | | - Joy Doll
- Creighton University School of Medicine, Creighton University, Omaha, NE, USA
| | - Michael A Greene
- Creighton University School of Medicine, Creighton University, Omaha, NE, USA
- CHI Health Creighton University Medical Center, University Campus
| | - Amy L McGaha
- Creighton University School of Medicine, Creighton University, Omaha, NE, USA
- CHI Health Creighton University Medical Center, University Campus
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15
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O'Donnell A, Gonyea J, Wensley T, Nizza M. High-quality patient-centered palliative care: interprofessional team members' perceptions of social workers' roles and contribution. J Interprof Care 2024; 38:1-9. [PMID: 37525994 DOI: 10.1080/13561820.2023.2238783] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 07/11/2023] [Indexed: 08/02/2023]
Abstract
A core tenet of interprofessional collaborative practice (IPCP) is that efficient and effective teams are critical for the delivery of high-quality, patient-centered care. Although palliative care has a history of excellent care, increasing demands and larger patient loads are challenging teams to adapt and strengthen team functioning in hospital settings. The purpose of this qualitative study was to better understand the IPCP contributions of advanced palliative social workers (PSWs) through the eyes of their colleagues. Twenty-four interprofessional palliative care (IPPC) team members from other professions (i.e. nurse practitioners, physicians, physician assistants) from 16 hospitals across the U.S. participated in 20-minute semi-structured interviews. The Patient-Centered Clinical Method (PCCM) was used as a conceptual model to aid in the interpretation of the data. This model illuminated the centrality of PSWs' role in building and sustaining a therapeutic alliance between the patient and the IPPC team, through assessing and promoting care that centers the patient's experience with illness, creating space to initiate, process and revisit difficult healthcare conversations and helping to modulate the pace and intensity of emotionally laden discussions. PSWs also support the therapeutic relationship with the IPPC team by providing continuity and connection across and during the hospital experience and supporting the well-being of the IPPC team. This study offers novel insights into how PSWs contribute to patient-centered IPPC and furthers the articulation of the role of PSWs in hospital settings.
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Affiliation(s)
| | - Judith Gonyea
- School of Social Work, Boston University, Boston, USA
| | | | - Megan Nizza
- School of Social Work, Boston University, Boston, USA
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16
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Dulay M, Bowen JL, Weppner WG, Eastburn A, Poppe AP, Spanos P, Wojtaszek D, Printz D, Kaminetzky CP. Interprofessional population health advocacy: Developing and implementing a panel management curriculum in five Veterans Administration primary care practices. J Interprof Care 2023; 37:S75-S85. [PMID: 29746221 DOI: 10.1080/13561820.2018.1469476] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 12/04/2017] [Accepted: 04/23/2018] [Indexed: 10/16/2022]
Abstract
Health care systems expect primary care clinicians to manage panels of patients and improve population health, yet few have been trained to do so. An interprofessional panel management (PM) curriculum is one possible strategy to address this training gap and supply future primary care practices with clinicians and teams prepared to work together to improve the health of individual patients and populations. This paper describes a Veterans Administration (VA) sponsored multi-site interprofessional PM curriculum development effort. Five VA Centers of Excellence in Primary Care Education collaborated to identify a common set of interprofessionally relevant desired learning outcomes (DLOs) for the PM and to develop assessment instruments for monitoring trainees' PM learning. Authors cataloged teaching and learning activities across sites. Results from pilot testing were systematically discussed leading to iterative revisions of curricular elements. Authors completed a retrospective self-assessment of curriculum implementation for the academic year 2015-16 using a 5-point scale: contemplation (score = 0), pilot (1), action (2), maintenance (3), and embedded (4). Implementation scores were analyzed using descriptive statistics. DLOs were organized into five categories (individual patients, populations, guidelines/measures, teamwork, and improvement) along with a developmental continuum and mapped to program competencies. Instruction and implementation varied across sites based on resources and priorities. Between 2015 and 2016, 159 trainees (internal medicine residents, nurse practitioner students and residents, pharmacy residents, and psychology post-doctoral fellows) participated in the PM curriculum. Curriculum implementation scores for guidelines/measures and improvement DLOs were similar for all trainees; scores for individual patients, populations, and teamwork DLOs were more advanced for nurse practitioner and physician trainees. In conclusion, collaboratively identified DLOs for PM guided development of assessment instruments and instructional approaches for panel management activities in interprofessional teams. This PM curriculum and associated tools provide resources for educators in other settings.
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Affiliation(s)
- Maya Dulay
- Center of Excellence in Primary Care Education, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Judith L Bowen
- Schools of Medicine and Nursing, Oregon Health & Science University, Portland, WA, USA
- Office of Academic Affiliations, Department of Veterans Affairs (VA), Washington DC, USA
| | - William G Weppner
- Center of Excellence in Primary Care Education, Boise VA Medical Center, Boise, ID, USA
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Abigail Eastburn
- Center of Excellence in Primary Care Education, San Francisco, CA, USA
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Anne P Poppe
- Center of Excellence in Primary Care Education, Seattle, WA, USA
- School of Nursing, University of Washington, Seattle, WA, USA
| | - Pete Spanos
- Center of Excellence in Primary Care Education, Louis Stokes Cleveland VAMC, Cleveland, OH, USA
| | - Danielle Wojtaszek
- West Haven Center of Excellence in Primary Care Education, VA Connecticut Health Care System, West Haven, CT, USA
| | - Destiny Printz
- Center of Excellence in Primary Care Education, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, West Haven, CT, USA
| | - Catherine P Kaminetzky
- VA Puget Sound Health Care System, Seattle, WA, USA
- School of Medicine, University of Washington, Seattle, WA
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17
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Bradley KJ, Wros P, Bookman N, Mathews LR, Voss H, Ostrogorsky TL, LaForge K. The Interprofessional Care Access Network (I-CAN): achieving client health outcomes by addressing social determinants in the community. J Interprof Care 2023; 37:S45-S52. [PMID: 30585089 DOI: 10.1080/13561820.2018.1560246] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 11/26/2018] [Accepted: 11/28/2018] [Indexed: 01/17/2023]
Abstract
Four health professions schools at an academic health science university and a partner state university collaborated to develop the Interprofessional Care Access Network (I-CAN), a model of healthcare delivery and interprofessional education that addresses the Triple Aims for vulnerable populations in three underserved neighborhoods. Program goals were achieved through community-based partnerships and the development of a health-care workforce prepared for competent practice in emerging models of care. In the first three years, almost 600 nursing, medicine, dentistry, and pharmacy students worked with clients referred from community partners, providing interprofessional care coordination addressing life instability and social determinants of health. The evaluation has demonstrated substantial improvement of health-related outcomes for clients who began in the first three years of the program and specifically those who completed intake and follow-up documentation (N = 38). There were substantial reductions in the aggregate number of emergency department visits, emergency medical service calls, and hospitalizations when compared to the 6 months prior to starting I-CAN. Estimated cost savings for the 38 clients, based on minimal estimated costs for these indicators alone, were over $224,000. A three-year qualitative review of client progress notes indicated that as a result of interprofessional student team interventions, many clients improved access to health insurance and primary care, and stabilized housing. Since the evaluation was completed, three programs have been added in rural and urban communities, demonstrating the model is scalable and replicable.
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Affiliation(s)
| | - Peggy Wros
- OHSU School of Nursing, Portland, OR, USA
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18
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Brandt BF, Stumpf Kertz J, Arenson C. National Center for Interprofessional Practice and Education 2023: reflecting back, looking forward. J Interprof Care 2023; 37:S4-S14. [PMID: 37073117 DOI: 10.1080/13561820.2023.2197939] [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: 08/11/2022] [Revised: 02/21/2023] [Accepted: 03/14/2023] [Indexed: 04/20/2023]
Abstract
The United States (US) National Center for Interprofessional Practice and Education was funded at the University of Minnesota to serve as the National Coordinating Center for Interprofessional Education and Collaborative Practice (IPECP) in the US In 2012, the funders had specific expectations for operationalizing their vision that included scholarship, programs and leadership as an unbiased, neutral convener to align education with health system redesign. While US specific, the National Center benefited from and contributed to the international maturity of the field over the past decade. Through its various services and technology platforms, the National Center has a wide reach nationally and internationally. This perspective provides a unique view of the field in the US with observations and implications for the future.
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Affiliation(s)
- Barbara F Brandt
- National Center for Interprofessional Practice & Education; Professor, Pharmaceutical Care and Health Systems, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jennifer Stumpf Kertz
- National Center for Interprofessional Practice & Education, University of Minnesota, Minneapolis, Minnesota, USA
| | - Christine Arenson
- National Center for Interprofessional Practice & Education; Professor in the Department of Family Medicine and Community Health, School of Medicine University of Minnesota, Minneapolis, Minnesota, USA
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19
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Baker C, Coats H, Jankowski CM, Baik D. Heart Failure Family Caregivers' Perspectives of Physical Activity Engagement: A Qualitative Study. West J Nurs Res 2023; 45:807-814. [PMID: 37403774 PMCID: PMC10990472 DOI: 10.1177/01939459231186339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
Research on caregiver burden and related psychological distress has been widely studied. However, little research has focused on perspectives and experiences of older family caregivers of persons with heart failure on engaging in physical exercise to improve their health and wellness. We investigated barriers and facilitators influencing physical activity engagement for older family caregivers of persons with heart failure through a qualitative descriptive study design utilizing participant interviews. The social cognitive theory framework guided the thematic analysis. Identified themes and subthemes that emerged were centered around the framework's interrelated personal, environmental, and behavioral factors. Self-efficacy emerged as a central construct facilitating engagement in physical activity. The older family caregivers embraced technology for physical activity interventions more readily since the COVID-19 pandemic encouraged increased technology use. The age-related and caregiving barriers to physical activity found in this study highlight considerations for an older family caregiver and guide interventions for future family caregivers' engagement.
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Affiliation(s)
- Christina Baker
- PhD, College of Nursing, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Heather Coats
- Assistant Professor, University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO, USA
| | - Catherine M Jankowski
- Professor, University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO, USA
| | - Dawon Baik
- Assistant Professor, University of Colorado College of Nursing, Anschutz Medical Campus, Aurora, CO, USA
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20
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Summerside N, Abu-Rish Blakeney E, Brashers V, Dyer C, Hall LW, Owen JA, Ottis E, Odegard P, Haizlip J, Liner D, Moore A, Zierler BK. Early outcomes from a national Train-the-Trainer Interprofessional Team Development Program. J Interprof Care 2023; 37:S41-S44. [PMID: 30388914 PMCID: PMC6934916 DOI: 10.1080/13561820.2018.1538115] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 08/29/2018] [Accepted: 10/03/2018] [Indexed: 01/20/2023]
Abstract
The imperative need to train health professions faculty (educators and clinicians) to lead interprofessional education efforts and promote interprofessional team-based care is widely recognized. This need stems from a growing body of research that suggests collaboration improves patient safety and health outcomes. This short report provides an overview of a Train-the-Trainer Interprofessional Team Development Program (T3 Program) that equips faculty leaders with the skills to lead interprofessional education and interprofessional collaborative practice across the learning continuum. We also describe the history, approach, and early outcomes of this innovative program.
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Affiliation(s)
| | | | - Valentina Brashers
- School of Nursing, School of Medicine, University of Virginia, Charlottesville, U.S
| | - Carla Dyer
- Department of Medicine, University of Missouri School of Medicine, Columbia, U.S
| | - Les W Hall
- University of South Carolina School of Medicine, Columbia, U.S
| | - John A Owen
- School of Nursing, Center for Academic Strategic Partnerships for Interprofessional Research and Education (ASPIRE), University of Virginia, Charlottesville, U.S
| | | | - Peggy Odegard
- School of Pharmacy, University of Washington, Seattle, U.S
| | - Julie Haizlip
- School of Nursing & Department of Pediatrics, Center for Academic Strategic Partnerships for Interprofessional Research and Education (ASPIRE), University of Virginia, Charlottesville, U.S
| | - Debra Liner
- School of Nursing, University of Washington, Seattle, U.S
| | - Amanda Moore
- School of Nursing, University of Washington, Seattle, U.S
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21
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Ulvestad I, Kirkbakk Fjær K, Skundberg-Kletthagen H. "It Is Not About Us and Them": Nursing Students' Perception of Interdisciplinary Collaboration in Mental Health Clinical Studies. Issues Ment Health Nurs 2023:1-9. [PMID: 37319407 DOI: 10.1080/01612840.2023.2212774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Through interdisciplinary collaboration, a synthesis can be made together across subject boundaries that basically separate the subjects. This means that in addition to their own expertise, the professions can create a new understanding, new attitudes and new knowledge. In other words, a shared additional knowledge. The purpose of this study was to explore and describe nursing students' experiences of interdisciplinary collaboration in clinical studies in mental health services. A qualitative, explorative study was performed based on three focus group interviews. A qualitative content analysis was conducted. The analysis resulted in the categories: 'Community'-The students experienced the interaction and the communication in different ways. 'Learning'-The students could gain both knowledge and understanding. In conclusion when the interdisciplinary collaboration was optimal, the students experienced it as enriching both in terms of interaction, communication, learning and understanding. Interdisciplinary collaboration can give students knowledge of cultural forms of expression so that they can better meet patients' needs. The students also gain an increased understanding related to care. Students can get good learning opportunities when different professions are taught together.
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Affiliation(s)
- Ingunn Ulvestad
- Faculty of Medicine and Health, Institute of Health Sciences Norwegian University of Science and Technology (NTNU), Høgskoleringen, Trondheim, Norway
| | - Kari Kirkbakk Fjær
- Faculty of Medicine and Health, Institute of Health Sciences Norwegian University of Science and Technology (NTNU), Høgskoleringen, Trondheim, Norway
| | - Hege Skundberg-Kletthagen
- Faculty of Medicine and Health, Institute of Health Sciences Norwegian University of Science and Technology (NTNU), Høgskoleringen, Trondheim, Norway
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22
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Foo YY, Xin X, Rao J, Tan NCK, Cheng Q, Lum E, Ong HK, Lim SM, Freeman KJ, Tan K. Measuring Interprofessional Collaboration's Impact on Healthcare Services Using the Quadruple Aim Framework: A Protocol Paper. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095704. [PMID: 37174222 PMCID: PMC10178681 DOI: 10.3390/ijerph20095704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/13/2023] [Accepted: 04/17/2023] [Indexed: 05/15/2023]
Abstract
Despite decades of research on the impact of interprofessional collaboration (IPC), we still lack definitive proof that team-based care can lead to a tangible effect on healthcare outcomes. Without return on investment (ROI) evidence, healthcare leaders cannot justifiably throw their weight behind IPC, and the institutional push for healthcare manpower reforms crucial for facilitating IPC will remain variable and fragmentary. The lack of proof for the ROI of IPC is likely due to a lack of a unifying conceptual framework and the over-reliance on the single-method study design. To address the gaps, this paper describes a protocol which uses as a framework the Quadruple Aim which examines the ROI of IPC using four dimensions: patient outcomes, patient experience, provider well-being, and cost of care. A multimethod approach is proposed whereby patient outcomes are measured using quantitative methods, and patient experience and provider well-being are assessed using qualitative methods. Healthcare costs will be calculated using the time-driven activity-based costing methodology. The study is set in a Singapore-based national and regional center that takes care of patients with neurological issues.
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Affiliation(s)
- Yang Yann Foo
- Department of Technology Enhanced Learning and Innovation, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Xiaohui Xin
- Health Services Research Unit, Singapore General Hospital, Singapore 169608, Singapore
| | - Jai Rao
- Department of Neurosurgery, National Neuroscience Institute, Singapore 308433, Singapore
- Duke-NUS Medical School, Singapore 169857, Singapore
| | - Nigel C K Tan
- Duke-NUS Medical School, Singapore 169857, Singapore
- Department of Neurology, National Neuroscience Institute, Singapore 308433, Singapore
| | - Qianhui Cheng
- Department of Neuroradiology, National Neuroscience Institute, Singapore 308433, Singapore
| | - Elaine Lum
- Health Services & Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Hwee Kuan Ong
- Department of Physiotherapy, Singapore General Hospital, Singapore 169608, Singapore
- Singapore Institute of Technology, Singapore 138683, Singapore
| | - Sok Mui Lim
- Singapore Institute of Technology, Singapore 138683, Singapore
| | - Kirsty J Freeman
- Office of Education, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Kevin Tan
- Duke-NUS Medical School, Singapore 169857, Singapore
- Department of Neurology, National Neuroscience Institute, Singapore 308433, Singapore
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23
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Gilbert JHV, Girard MA, Grymonpre RE, Mahler C, Maxwell B. The applicability of interprofessional education for collaborative people-centered practice and care to health plans and workforce issues: A thematic global case review. EDUCATION FOR HEALTH (ABINGDON, ENGLAND) 2023; 36:67-75. [PMID: 38047334 DOI: 10.4103/efh.efh_459_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background This article focuses on a growing, global recognition of the importance of the field of interprofessional education for person-centered collaborative practice (IPECP) expressed through high-level policy and accreditation decisions/actions taking place in 5 countries. Policy decisions are used to motivate strategies related to IPECP that align with national health plans, and workforce issues. Methods Using a collective of representative stories from around the globe, a grouping of case studies were developed to illustrate different approaches and challenges to IPECP implementation. Results Institutions from countries of various income levels face many similar challenges in the execution, delivery, and sustainability of IPECP. All programs face issues of financing, of preparing faculty, of developing and organizing curricula, and of bridging between campus and community. Discussion Policies are being developed that promote a global approach to the inclusion of IPECP in the accreditation and regulation of postsecondary institutions and health service organizations, in keeping with WHO National Health Workforce Accounts. Policies developed promote and demonstrate the benefits of IPECP through remote emergency learning methods. The policies also build national systems for IPECP as an integral part of continuing professional development and lifelong learning. The organization of interprofessional research programs and the increasing publication of their results of such programs will lead to a clearer understanding of the efficacy of the field of IPECP. To ensure sustainability, stakeholders and policymakers should continue to foster policies that facilitate IPECP.
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Affiliation(s)
- John H V Gilbert
- School of Audiology and Speech Sciences, University of British Columbia, Vancouver, Canada
| | | | | | - Cornelia Mahler
- Department of Nursing Sciences, University of Tübingen, Tübingen, Germany
| | - Barbara Maxwell
- Interprofessional Practice and Education Center, Indiana University, Indianapolis, Indiana, USA
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24
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Hood K, Cross WM, Cant R. Evaluation of interprofessional student teams in the emergency department: opportunities and challenges. BMC MEDICAL EDUCATION 2022; 22:878. [PMID: 36536393 PMCID: PMC9764718 DOI: 10.1186/s12909-022-03954-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 12/12/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Interprofessional education opportunities are commonly university-based and require further development during clinical practice. Many clinical contexts offer the potential for meaningful learning of both collaborative and discipline-specific practice. The emergency department (ED) demands efficient teamwork, so presents a logical location for interprofessional learning. METHODS An interprofessional clinical placement program was implemented with the aim to enhance students' capacity and self-efficacy for collaborative practice. Fifty-five medical and nursing students participated as interdisciplinary pairs in a two-week clinical placement in the ED. Students' perceptions of the learning environment were measured pre- and post-placement with the Self-efficacy for Interprofessional Experiential Learning Scale and the Interprofessional Clinical Placement Learning Inventory was completed post-placement. Non-parametric tests were used to establish change differences. RESULTS The Placement Learning Inventory revealed positive outcomes; the majority (16/19) agreed/agreed strongly that the placement provided sufficient learning opportunities, was interesting, and made them feel as if they belonged and most (14/19) reported they achieved the discipline specific learning objectives set by the university. Self-efficacy improved significantly (p = 0.017), showing promise for future use of the placement model Challenges were identified in the organisation and supervision of students. In the absence of additional dedicated student supervision, this model of interprofessional student pairs in the ED was challenging. CONCLUSIONS Interprofessional clinical placements in ED are an effective clinical learning approach for final year undergraduate medicine and nursing students. Recommendations for improvements for students' clinical supervision are proposed for the placement model.
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Affiliation(s)
- Kerry Hood
- Institute of Health and Wellbeing, Federation University Australia, PO Box 859, Berwick VIC 3806, 100 Clyde Rd, Berwick, Victoria Australia
| | - Wendy M. Cross
- Institute of Health and Wellbeing, Federation University Australia, PO Box 859, Berwick VIC 3806, 100 Clyde Rd, Berwick, Victoria Australia
| | - Robyn Cant
- Institute of Health and Wellbeing, Federation University Australia, PO Box 859, Berwick VIC 3806, 100 Clyde Rd, Berwick, Victoria Australia
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25
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de Gans S, Penturij-Kloks M, Scheele F, van de Pol M, van der Zwaard B, Keijsers C. Combined interprofessional and intraprofessional clinical collaboration reduces length of stay and consultations: a retrospective cohort study on an intensive collaboration ward (ICW). J Interprof Care 2022; 37:523-531. [DOI: 10.1080/13561820.2022.2137117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Simon de Gans
- Jeroen Bosch Academy, Jeroen Bosch Hospital, s-Hertogenbosch, The Netherlands
| | | | - Fedde Scheele
- School of medical sciences, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - Marjolein van de Pol
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Carolina Keijsers
- Department of geriatrics, Jeroen Bosch Hospital, s-Hertogenbosch, The Netherlands
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26
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Wirth A, Berger F, Ulrich G, Kaap-Fröhlich S. Discovering new perspectives - strengthening autonomy. Students from different healthcare professions interact with patients and provide care in a self-determined and interprofessional manner. GMS JOURNAL FOR MEDICAL EDUCATION 2022; 39:Doc39. [PMID: 36310884 PMCID: PMC9585414 DOI: 10.3205/zma001560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 06/17/2022] [Accepted: 07/05/2022] [Indexed: 06/16/2023]
Abstract
The Careum Summer School (CSS) is a learning setting that enables self-regulated learning in an environment in which trainees and students from the various medical, nursing and therapeutic healthcare professions taught in the Swiss education system (upper secondary and tertiary levels A and B) develop project ideas together with patients and their caregivers. The aim of this learning setting is to promote a positive attitude among trainees and students towards interprofessional collaboration that includes patients as cooperation partners. Objective: The evaluation examines the extent to which trainees' and students' attitudes towards interprofessional collaboration changed. Information was also obtained on the experiences patients and their caregivers had during their participation in the CSS programme. Methodology: A total of 69 trainees and students were given access to an online survey in the form of the German version of the University of the West of England Interprofessional Questionnaire (UWE-IP) one week before the CSS programme began and six weeks after it concluded. Problem-focused interviews were also conducted with 11 patients and their caregivers. Results: The attitudes of the trainees and students in the UWE-IP Interprofessional Learning Scale improved significantly after the CSS programme was conducted (median t1=22.0/t2=16.0). The effect size was r=0.839 (Wilcoxon test for dependent samples). No significant results could be identified for the other three UWE-IP scales. Patients and their caregivers reported that they were able to actively participate in the CSS programme and felt valued and appreciated. Conclusion: The CSS offered a learning environment in which all participants were able to exchange knowledge and information in an interprofessional manner and work collaboratively on the development of a project idea - for example an interprofessional competency passport with a spider diagram.
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Affiliation(s)
| | | | | | - Sylvia Kaap-Fröhlich
- Careum Foundation, Zurich, Switzerland
- Zurich University of Applied Sciences, Bachelor “Biomedical Laboratory Diagnostics”, Wädenswil, Switzerland
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Collaboration between First Year Undergraduate Nursing Students – A Focused Ethnographic Study. Nurse Educ Pract 2022; 64:103427. [DOI: 10.1016/j.nepr.2022.103427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/01/2022] [Accepted: 08/03/2022] [Indexed: 11/23/2022]
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Ogando YM, Rodriguez de Bittner M, Park L, Osotimehin S, Sokan O, Tran D, Sebastian DG, Beaulieu M, Onukwugha E. The impact of an interprofessional care transitions clinic on readmission rates and costs. J Interprof Care 2022; 37:689-692. [PMID: 35895580 DOI: 10.1080/13561820.2022.2095363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The objective of this study was to assess the effectiveness of the Interprofessional Care Transitions Clinic (ICTC) in reducing preventable readmissions and their associated costs among Medicare/Medicaid patients. A prospective cohort study was conducted among adults who were discharged from the University of Maryland Prince George's Hospital Center to assess the comparative effectiveness of a clinic-based intervention in terms of readmission events, potentially avoidable utilization, length of stay, and hospital charges. Outcomes were evaluated at 1 month, 3 months, and 6 months post-discharge. There were statistically significant differences in the following outcomes (follow-up period): proportion of readmissions (3 months), potentially avoidable utilization (1 month), and mean medical charges for ICTC patients compared to non-ICTC patients (1 month). This program was aimed at testing the impact of having an interprofessional team focused on providing holistic patient-centered care.
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Affiliation(s)
- Yoscar M Ogando
- Department of Pharmacy Practice and Science, University of Maryland Baltimore, Baltimore, MD, USA
| | | | - Leah Park
- Department of Pharmacy Practice and Science, University of Maryland Baltimore, Baltimore, MD, USA
| | - Sadé Osotimehin
- Department of Pharmacy Practice and Science, University of Maryland Baltimore, Baltimore, MD, USA
| | - Olufunke Sokan
- Department of Pharmacy Practice and Science, University of Maryland Baltimore, Baltimore, MD, USA
| | - Deanna Tran
- Department of Pharmacy Practice and Science, University of Maryland Baltimore, Baltimore, MD, USA
| | | | - Michele Beaulieu
- University of Maryland Baltimore School of Social Work, Baltimore, MD, USA
| | - Eberechukwu Onukwugha
- Department of Pharmaceutical Health Services Research, University of Maryland Baltimore, Baltimore, MD, USA
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Craig TW, Comnick CL, Leary KS, Hartshorn JE, Johnsen DC, Marchini L. A tool for incorporating interprofessional perspectives into dental students decision‐making: A 2‐year follow‐up on this learning outcome. Clin Exp Dent Res 2022; 8:1295-1301. [PMID: 35719016 PMCID: PMC9562570 DOI: 10.1002/cre2.615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 06/07/2022] [Accepted: 06/10/2022] [Indexed: 11/07/2022] Open
Abstract
Objectives Methods Results Conclusions
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Affiliation(s)
- Trevor W. Craig
- D4 Predoctoral Dental Student University of Iowa College of Dentistry Iowa City Iowa USA
| | - Carissa L. Comnick
- Division of Biostatistics University of Iowa College of Dentistry Iowa City Iowa USA
| | - Kecia S. Leary
- Department of Pediatric Dentistry University of Iowa College of Dentistry Iowa City Iowa USA
| | - Jennifer E. Hartshorn
- Department of Preventive and Community Dentistry University of Iowa College of Dentistry Iowa City Iowa USA
| | - David C. Johnsen
- Department of Pediatric Dentistry University of Iowa College of Dentistry Iowa City Iowa USA
- Department of Preventive and Community Dentistry University of Iowa College of Dentistry Iowa City Iowa USA
| | - Leonardo Marchini
- Department of Preventive and Community Dentistry University of Iowa College of Dentistry Iowa City Iowa USA
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Becker V, Jedlicska N, Scheide L, Nest A, Kratzer S, Hinzmann D, Wijnen-Meijer M, Berberat PO, Haseneder R. Changes in medical students´ and anesthesia technician trainees´ attitudes towards interprofessionality - experience from an interprofessional simulation-based course. BMC MEDICAL EDUCATION 2022; 22:273. [PMID: 35418136 PMCID: PMC9006475 DOI: 10.1186/s12909-022-03350-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/07/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Interprofessional simulation based education (IPSBE) programs positively impact participants' attitudes towards interprofessional collaboration and learning. However, the extent to which students in different health professions benefit and the underlying reasons for this are subject of ongoing debate. METHODS We developed a 14-h IPSBE course with scenarios of critical incidents or emergency cases. Participants were final year medical students (FYMS) and final year anesthesia technician trainees (FYATT). To assess attitudes towards interprofessionalism, the University of the West of England Interprofessional Questionnaire was administrated before and after the course. Using focus group illustration maps, qualitative data were obtained from a subcohort of the participants (n = 15). RESULTS After the course, self-assessment of communication and teamwork skills, attitudes towards interprofessional interactions and relationships showed comparative improvement in both professions. Attitudes towards interprofessional learning improved only in FYMS. Qualitative data revealed teamwork, communication, hierarchy and the perception of one's own and other health profession as main topics that might underlie the changes in participants' attitudes. An important factor was that participants got to know each other during the course and understood each other's tasks. CONCLUSIONS Since adequate communication and teamwork skills and positive attitudes towards interprofessionality account to effective interprofessional collaboration, our data support intensifying IPSBE in undergraduate health care education.
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Affiliation(s)
- Veronika Becker
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Nana Jedlicska
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Laura Scheide
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Alexandra Nest
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Stephan Kratzer
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, Department of Anaesthesiology and Intensive Care, Munich, Germany
| | - Dominik Hinzmann
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, Department of Anaesthesiology and Intensive Care, Munich, Germany
| | - Marjo Wijnen-Meijer
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Pascal O Berberat
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany
| | - Rainer Haseneder
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, TUM Medical Education Center, Munich, Germany.
- Technical University of Munich, TUM School of Medicine, Klinikum rechts der Isar, Department of Anaesthesiology and Intensive Care, Munich, Germany.
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Janes TL, Rees JL, Zupan B. Is interprofessional education a valued contributor to interprofessional practice and collaboration within allied health in Australia and New Zealand: A scoping review. J Interprof Care 2022; 36:750-760. [PMID: 35363118 DOI: 10.1080/13561820.2021.1975666] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Research on the value of interprofessional education (IPE), collaboration and practice in the health sector at both a pre- and post-registration level has increased in recent years. A scoping review of Australian and New Zealand studies was conducted on the value of IPE to interprofessional practice in allied health professionals from 2013 to 2019. A scoping review framework was used to identify 109 studies. Twenty-one articles met the eligibility criteria. The studies were grouped into undergraduate students in academic and WIL settings, allied health professionals and clinical educators. Results suggest that IPE is necessary for the maintenance of interprofessional practice and that it is strongly connected to the development of successful communication within the interprofessional environment. Authentic IPE experience and socialization opportunities appear to be major facilitators of interprofessional practice but no consensus regarding the ideal length of time or timing of IPE was found. The studies also provided an insight into facilitators and barriers to successful implementation of IPE and interprofessional practice in rural environments. As IPE has been shown to contribute to improved interprofessional practice and patient outcomes, future research should explore how to create IPE opportunities for implementation within rural communities where adequate resourcing is most challenged.
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Affiliation(s)
- Tina L Janes
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Jenni-Lee Rees
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Barbra Zupan
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
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Skinner K, Maxwell B, Baskerville A, Milanović J. Audiology, an Important Contributor to Interprofessional Holistic Care: An Interprofessional Collaborative Case Example. Am J Audiol 2022; 31:204-210. [PMID: 34874748 DOI: 10.1044/2021_aja-21-00118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Interprofessional collaboration improves health outcomes, enhances health care satisfaction, and facilitates more effective use of resources. Interprofessional collaborators increasingly understand and value other professions. A.T. Still University provides students from multiple programs with opportunities to develop interprofessional collaboration skills. This research note presents details of one such interprofessional education (IPE) opportunity, a collaborative case. Audiology was part of this case in two ways: Audiologic details of the simulated patient were provided to all students, and audiology students participated in the experience. The results of this involvement are reported. This research note is primarily descriptive in nature; however, the question of whether students viewed their interprofessional competencies as improving following the IPE experience was explored using a validated self-report tool, the Interprofessional Collaborative Competency Attainment Survey (ICCAS). METHOD A total of 23 students completed the ICCAS. Additionally, student case presentations were reviewed and audiology-based recommendations were tallied. RESULTS Highly significant differences (p ≤ .01) for all 20 items on the ICCAS were observed for differences in self-assessed interprofessional skills knowledge. All but one of the 12 teams made specific recommendations regarding the communication needs of the patient. CONCLUSIONS Students viewed their own competencies related to interprofessional collaboration as improved following the collaborative case experience. Overall, the collaborative case experience was effective in providing students with the opportunity to develop a breadth of skills needed for interprofessional collaboration. Providing audiologic information in the case history prompted all but one team to consider patient communication needs.
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Affiliation(s)
- Kimberly Skinner
- Department of Audiology and Speech-Language Pathology, A.T. Still University, Mesa, AZ
| | | | - Amanda Baskerville
- Department of Audiology and Speech-Language Pathology, A.T. Still University, Mesa, AZ
| | - Jovan Milanović
- Department of Audiology and Speech-Language Pathology, A.T. Still University, Mesa, AZ
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Hsu HY, Tung HH, Kau K, Huang SS, Tsay SL. Effects of Professional Autonomy and Leadership Style on the Team-Based Practice of Acute Care Nurse Practitioners in Taiwan. J Nurs Res 2022; 30:e191. [PMID: 35050955 DOI: 10.1097/jnr.0000000000000461] [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: 11/25/2022] Open
Abstract
BACKGROUND Little is known regarding the factors that affect the team-based practice of nurse practitioners (NPs). Examining the relationships between these factors and team-based practice may provide important insights into the strength of the NP practice. PURPOSE This study was designed to examine the effects of practice autonomy and leadership style on the team-based practice of acute care NPs working in hospitals. METHODS A cross-sectional, national survey design was conducted to examine the autonomy, leadership, and team-based practice of NPs. One thousand three hundred ninety-one NPs completed the questionnaire, which included demographic and practice variables, the Dempster Practice Behavior Scale, the Multifactor Leadership Questionnaire, and the NP-physician relations subscale of the Nurse Practitioner Primary Care Organizational Climate Questionnaire. The hierarchical linear model was used to differentiate between the NP-level and organization-level effects on team-based practice. Multiple regression was applied to explore the factors associated with team-based practice. RESULTS The hierarchical linear model results identified no organization-level effect on team-based practice. Moreover, the results of the regression model found that NPs with greater autonomy in actualization, empowerment and readiness, and idealized influence leadership style enhanced the performance of the doctor of medicine-NP team-based practice. The final model explained 39% of the variance in doctor of medicine-NP team-based practice. Autonomy in actualization and empowerment were identified as the two most important predictors. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The practice autonomy and leadership style of NPs influence the efficiency of team-based practice in Taiwan. To improve the team-based practice of NPs, healthcare administrators must support the practice autonomy of NPs.
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Affiliation(s)
- Hsiu-Ying Hsu
- MS, RN, NP, Changhua Christian Hospital; and Adjunct Lecturer, College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan, ROC
| | - Heng-Hsin Tung
- PhD, RN, NP, Professor, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Kevin Kau
- MA, Lecturer, Academic Writing Education Center, National Taiwan University, Taipei, Taiwan, ROC
| | - Sheng-Shiung Huang
- PhD, Assistant Professor, College of Nursing and Health Sciences, Da-Yeh University, Taiwan, ROC
| | - Shiow-Luan Tsay
- PhD, RN, APN, Professor, College of Nursing and Health Sciences, Da-Yeh University, Taiwan, ROC
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McLaney E, Morassaei S, Hughes L, Davies R, Campbell M, Di Prospero L. A framework for interprofessional team collaboration in a hospital setting: Advancing team competencies and behaviours. Healthc Manage Forum 2022; 35:112-117. [PMID: 35057649 PMCID: PMC8873279 DOI: 10.1177/08404704211063584] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Healthcare teams that practice collaboratively enhance the delivery of person-centred care and improve patient and systems outcomes. Many organizations have adopted existing interprofessional frameworks that define the competencies of individual health professionals that are required to meet practice standards and advance interprofessional goals. However, to support the collective efforts of team members to deliver optimal care within complex hospital settings, healthcare organizations may benefit from adopting team-based competencies for interprofessional collaboration. The Sunnybrook framework for interprofessional team collaboration was intentionally created as a set of collective team competencies. The framework was developed using a comprehensive literature search and consensus building by a multi-stakeholder working group and supported by a broad consultation process that included patient representation, organizational development and leadership, and human resources. The six core competencies are actionable and include associated team behaviours that can be easily referenced by teams and widely implemented across the hospital.
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Affiliation(s)
- Elizabeth McLaney
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Centre for Interprofessional Education, University of Toronto, Toronto, Ontario, Canada
| | - Sara Morassaei
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Faculty of Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Leanne Hughes
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Robyn Davies
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Unity Health Toronto, Toronto, Ontario, Canada
| | - Mikki Campbell
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lisa Di Prospero
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Will KK, Lamb G. A Theory-Based Approach for Identifying Nurse and Team Member Contributions in the Electronic Health Record. J Nurs Scholarsh 2021; 53:781-789. [PMID: 34668654 DOI: 10.1111/jnu.12702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Team-based care delivered by an interprofessional team has been shown to be an effective strategy for caring for diverse, complex patient populations. Interprofessional teams can improve outcomes, reduce costs, and enhance the patient experience through patient-centered care. Nurses are essential members of healthcare teams within and across settings. BACKGROUND It is imperative for practicing nurses, educators, and researchers to be able to identify and report the contributions of nurses to team performance and care outcomes to prepare students for high-performance teamwork to improve practice and influence healthcare policy. Currently, the work of many nurses and other team members is not discoverable in electronic health records. Methods used to identify all members of the healthcare team may not be aligned with theories and definitions of teamwork embedded in emerging nursing and interprofessional accreditation guidelines. PURPOSE This paper describes a promising new, theoretically grounded approach to identify team members, including nurses, in electronic health records. METHODS Using operational constructs from a common team definition, grounded in theory, primary care teams were data mined from EHR data to find the hidden members of the team. DISCUSSION/CONCLUSION Further testing and use of this approach have the potential to provide a robust strategy to identify and distinguish each team member's contributions to clinical outcomes while laying the foundation for a meaningful study of teams in large data sets like the electronic health record. CLINICAL RELEVANCE New strategies to study nursing and team member contributions utilizing EHR data may lead to improved clinical outcomes. A better understanding of how teams are structured may enhance the understanding of each team member's contribution to outcomes and lead to more equitable recognition and reimbursement for all team members.
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Affiliation(s)
- Kristen K Will
- Clinical Associate Professor, College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Gerri Lamb
- Professor, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
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Rodrigues da Silva Noll Gonçalves J, Noll Gonçalves R, da Rosa SV, Schaia Rocha Orsi J, Moysés SJ, Iani Werneck R. Impact of interprofessional education on the teaching and learning of higher education students: A systematic review. Nurse Educ Pract 2021; 56:103212. [PMID: 34571466 DOI: 10.1016/j.nepr.2021.103212] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/08/2021] [Accepted: 09/12/2021] [Indexed: 12/22/2022]
Abstract
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.
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Affiliation(s)
| | - Rodrigo Noll Gonçalves
- Postgraduate Programme in Public Policy at the Federal University of Paraná, No. 632, Prefeito Lothário Meissner Avenue, Curitiba, Paraná 80210-170, Brazil.
| | - Saulo Vinicius da Rosa
- School of Life Sciences, Pontifical Catholic University of Paraná, No. 1155, Imaculada Conceição Street, Curitiba, Paraná 80215-901, Brazil.
| | - Juliana Schaia Rocha Orsi
- School of Life Sciences, Pontifical Catholic University of Paraná, No. 1155, Imaculada Conceição Street, Curitiba, Paraná 80215-901, Brazil.
| | - Samuel Jorge Moysés
- School of Life Sciences, Pontifical Catholic University of Paraná, No. 1155, Imaculada Conceição Street, Curitiba, Paraná 80215-901, Brazil.
| | - Renata Iani Werneck
- School of Life Sciences, Pontifical Catholic University of Paraná, No. 1155, Imaculada Conceição Street, Curitiba, Paraná 80215-901, Brazil.
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Montano AR, Cornell PY, Gravenstein S. Barriers and facilitators to interprofessional collaborative practice for community-dwelling older adults: An integrative review. J Clin Nurs 2021; 32:1534-1548. [PMID: 34405476 DOI: 10.1111/jocn.15991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/28/2021] [Accepted: 07/23/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES The aim of this integrative review was to synthesise empirical reports of interprofessional collaborative practice (IPCP) for community-dwelling older adults and uncover barriers and facilitators related to its success as a model of care for this population. BACKGROUND IPCP is a model of care that has demonstrated positive outcomes for community-dwelling older adults. However, a summary of barriers and facilitators to IPCP models has not been presented. METHODS An integrative review using the method posited by Whittemore and Knafl was completed to identify barriers and facilitators to IPCP for community-dwelling older adults. The literature search was reported following PRISMA guidelines. RESULTS Four themes emerged as barriers to IPCP: (1) A (Potential) Logistical Nightmare, (2) All About the Money, (3) If We Can't Test It, Can We Recommend It? and (4) Challenging for the Team, Challenging for the Client. Three themes emerged as facilitators to IPCP: (1) Reducing Resource Waste, (2) The "C" in IPCP and (3) What Matters Most. CONCLUSIONS IPCP models for community-dwelling older adults must adapt to the setting of care and client needs. Interprofessional education opportunities for team members facilitate effective IPCP. Healthcare policies and funding structures need to address IPCP for community-dwelling older adults for this model to be successful and sustainable. RELEVANCE TO CLINICAL PRACTICE Nurses participate on and lead IPCP teams caring for community-dwelling older adults and, therefore, need to be aware of barriers and facilitators to this model of care.
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Affiliation(s)
- Anna-Rae Montano
- Brown University School of Public Health, Providence, RI, USA.,Providence VA Medical Center, Providence, RI, USA
| | - Portia Y Cornell
- Brown University School of Public Health, Providence, RI, USA.,Providence VA Medical Center, Providence, RI, USA
| | - Stefan Gravenstein
- Brown University School of Public Health, Providence, RI, USA.,Providence VA Medical Center, Providence, RI, USA.,Brown University Warren Alpert Medical School, Providence, RI, USA
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Azzam M, Puvirajah A, Girard MA, Grymonpre RE. Interprofessional education-relevant accreditation standards in Canada: a comparative document analysis. HUMAN RESOURCES FOR HEALTH 2021; 19:66. [PMID: 33985513 PMCID: PMC8120702 DOI: 10.1186/s12960-021-00611-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 05/06/2021] [Indexed: 05/18/2023]
Abstract
BACKGROUND Increasing evidence suggests that sustainable delivery of interprofessional education (IPE) has the potential to lead to interprofessional collaborative practice (IPCP), which in turn has the potential to lead to enhanced healthcare systems and improved patient-centered care health outcomes. To enhance IPE in Canada, the Accreditation of Interprofessional Health Education (AIPHE) project initiated collaborative efforts among accrediting organizations of six health professions to embed IPE language into their respective accreditation standards. To further understand the impact of the AIPHE project, this study evaluated the accountability of the IPE language currently embedded in Canadian health professions' accreditation standards documents and examined whether such language spanned the five accreditation standards domains identified in the AIPHE project. METHODS We conducted a comparative content analysis to identify and examine IPE language within the "accountable" statements in the current accreditation standards for 11 Canadian health professions that met our eligibility criteria. RESULTS AND DISCUSSION A total of 77 IPE-relevant accountable statements were identified across 13 accreditation standards documents for the 11 health professions. The chiropractic, pharmacy, and physiotherapy documents represented nearly 50% (38/77) of all accountable statements. The accountable statements for pharmacy, dentistry, dietetics, and nursing (registered) spanned across three-to-four accreditation standards domains. The remaining nine professions' statements referred mostly to "Students" and "Educational program." Furthermore, the majority of accreditation standards documents failed to provide a definition of IPE, and those that did, were inconsistent across health professions. CONCLUSIONS It was encouraging to see frequent reference to IPE within the accreditation standards of the health professions involved in this study. The qualitative findings, however, suggest that the emphasis of these accountable statements is mainly on the students and educational program, potentially compromising the sustainability and development, implementation, and evaluation of this frequently misunderstood pedagogical approach. The findings and exemplary IPE-relevant accountable statements identified in this paper should be of interest to all relevant stakeholders including those countries, where IPE accreditation is still emerging, as a means to accelerate and strengthen achieving desired educational and health outcomes.
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Affiliation(s)
- Mohammad Azzam
- Curriculum Studies and Studies in Applied Linguistics, Faculty of Education, Western University, London, ON, Canada.
| | - Anton Puvirajah
- Curriculum Studies and Studies in Applied Linguistics, Faculty of Education, Western University, London, ON, Canada
| | - Marie-Andrée Girard
- Anesthesiology and Pain Medicine Department, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Health Hub: Politics, Organizations and Law, Montreal, QC, Canada
- Faculty of Law, University of Montreal, Montreal, QC, Canada
| | - Ruby E Grymonpre
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
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Homberg A, Krug K, Klafke N, Glassen K, Mahler C, Loukanova S. Consensus views on competencies and teaching methods for an interprofessional curriculum on complementary and integrative medicine: A Delphi study. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2021; 19:282-290. [PMID: 33745897 DOI: 10.1016/j.joim.2021.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 02/03/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE A collaborative team is necessary to help patients achieve their healthcare goals using complementary medicine. At present, healthcare professionals do not feel sufficiently qualified to provide this service. This study sought to identify competencies and teaching methods for interprofessional training on complementary and integrative medicine at medical schools. METHODS Sixty-five German-speaking experts with various professional backgrounds were invited to take part in a three-round Delphi study. In the first round, predefined competencies were assessed on a seven-point Likert scale, and participants were invited to propose additional competencies that would be evaluated in the subsequent rounds. The competencies were ranked based on the participant assessments and were assigned to four relevance groups. In the second and third rounds, suitable teaching methods were identified using free-text fields and multiple-choice questions. In a final workshop, participants synthesized the outcomes of the previous sessions and derived key competencies that would be a benefit to undergraduate interprofessional training in complementary and integrative medicine at medical schools. RESULTS The three rounds plus final worksop were attended by 50, 40, 36 and 11 experts. The competencies that these experts determined to be highly relevant to teaching complementary and integrative medicine emphasized, in particular, the respectful treatment of patients and the importance of taking a medical history. From these highly relevant competencies, three key targets were agreed upon in the final workshop: students are able to 1) classify and assess complementary medical terms and methods; 2) work collaboratively and integrate patients into the interprofessional team; 3) involve patients and their relatives respectfully and empathetically in all healthcare processes. To achieve these competency goals, the following teaching methods were highlighted: students discuss therapy options based on authentic patient cases with each other and practice empathic patient communication incorporating complementary medicine. Further, the theoretical background of complementary medicines could be provided as online-training, to use the class sessions for hands-on exercises and interprofessional exchange and discussion. CONCLUSION Despite the heterogeneous panel of experts, a consensus was reached on the competency orientation and teaching approaches. The results can promote the implementation of interprofessional training for complementary medicine in undergraduate education.
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Affiliation(s)
- Angelika Homberg
- Department of General Practice and Health Services Research, University Hospital Heidelberg, 69120 Heidelberg, Germany.
| | - Katja Krug
- Department of General Practice and Health Services Research, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Nadja Klafke
- Department of General Practice and Health Services Research, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Katharina Glassen
- Department of General Practice and Health Services Research, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Cornelia Mahler
- Department of Nursing Science, University Hospital Tübingen, 72076 Tübingen, Germany
| | - Svetla Loukanova
- Department of General Practice and Health Services Research, University Hospital Heidelberg, 69120 Heidelberg, Germany
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Ulrich G, Breitbach AP. Interprofessional collaboration among sport science and sports medicine professionals: an international cross-sectional survey. J Interprof Care 2021; 36:4-14. [PMID: 33685327 DOI: 10.1080/13561820.2021.1874318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
As in other areas of healthcare, the quality of patient care in the field of sport science and sports medicine (SSSM) could benefit from interprofessional collaboration between the professions involved. As a prerequisite, healthcare providers in the SSSM field should be equipped with positive attitudes and perceptions toward interprofessional collaboration (IPC) and interprofessional education (IPE), however detailed investigations are lacking. This study aimed to collect and compare socio-demographic data as well as interprofessional attitudes of SSSM professionals from an international perspective. Subjects were invited via professional SSSM organizations, personal networks and social media to participate in a cross-sectional online survey. Three-hundred and twenty complete datasets of SSSM professionals from the regions USA (n = 83), Canada (n = 179) and Europe (n = 58) were evaluated. In this survey, socio-demographic data as well as attitudes toward IPC and IPE using the 4 subscales of the University of West of England interprofessional Questionnaire (UWE-IP) were collected and analyzed with descriptive and inferential statistics. In the socio-demographic data, there was a diversity of participants representing different regional healthcare, sports and educational framing conditions. On average, in all regions clear positive attitudes were shown in the UWE-IP subscales communication & teamwork, interprofessional learning and interprofessional relationship, whereas in the subscale interprofessional interaction negative perceptions were observed on average across all regions. Significant effects of participants' demographic variables region, age and gender on some of the subscales were detected. Practitioners in the SSSM field have a high willingness and a beneficial preparedness for IPC and IPE, however, the framing conditions and the systems the respondents surveyed are working in do not support IPC. Interprofessional settings in learning and in workplace (e.g., theme-centred workshops, patient-centred case studies, health promotion activities) may help to improve interprofessional interactions in SSSM.
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Affiliation(s)
- G Ulrich
- Department of Education Management, Careum Foundation, Zurich, Switzerland
| | - A P Breitbach
- Department of Physical Therapy and Athletic Training, Saint Louis University, Saint Louis, USA
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McNaughton SM, Flood B, Morgan CJ, Saravanakumar P. Existing models of interprofessional collaborative practice in primary healthcare: a scoping review. J Interprof Care 2021; 35:940-952. [PMID: 33657957 DOI: 10.1080/13561820.2020.1830048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Educating students to provide interprofessional collaborative practice (IPCP) in primary healthcare (PHC) requires a robust rigorous model relevant to future practice. A scoping review was undertaken to identify existing models of IPCP in PHC, the interprofessional or collaborative theories on which the models were based, reported outcomes, and enablers of and barriers to IPCP in PHC. The 35 eligible studies included 27 models, most of which were designed for a specific PHC site or program. Although almost half of the studies cited established interprofessional competencies in support of the models, only 13 included theoretical support, and only two cited interprofessional theory. Outcomes for clients, practitioners, practices, and students were primarily experiential and positive. A few researchers reported negative experiences or no difference between comparison groups. Key enablers of IPCP in PHC were strong supportive, inclusive relationships and practices. The most common barriers were time and resource constraints and poor understanding of IPCP. The review suggests a need for a stronger theoretical basis for IPCP in PHC that can accommodate different settings, and for more observational research that links relationship factors to outcomes at the practice, population, and wider health system levels.
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Affiliation(s)
- Susan M McNaughton
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Brenda Flood
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - C Jane Morgan
- School of Public Health and Interdisciplinary Studies, Auckland University of Technology, Auckland, New Zealand
| | - Priya Saravanakumar
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
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Shaw LK, Kiegaldie D, Jones C, Morris ME. Improving hospital falls screening and mitigation using a health professional education framework. NURSE EDUCATION TODAY 2021; 98:104695. [PMID: 33517181 DOI: 10.1016/j.nedt.2020.104695] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/13/2020] [Accepted: 11/30/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Although health professional education has the potential to mitigate hospital falls risk, the best methods to develop, deliver and evaluate health professional education remain unclear. This study applied evidence-based approaches to education design to improve falls risk mitigation. DESIGN Mixed methods using questionnaires to evaluate health professionals knowledge of evidence-based falls risk assessment and mitigation, followed by semi-structured interviews with individual health professionals. SETTING Five large Australian hospitals. PARTICIPANTS For each hospital, 10 clinical leaders from nursing and allied health professions were invited to participate in falls workshops. METHODS 46 participants received a three-hour education program on the latest evidence in hospital falls risk assessment and how to implement evidence-based falls screening and management. This was based on the "4P" education model (Presage, Planning, Process and Product). They were taught practical skills to enable them to educate other health professionals. RESULTS The education workshop significantly changed participants' views about best practice guidelines for falls screening and prevention. Participants felt more confident in assessing falls risk and judging and implementing the best mitigation strategies. They were prepared and motivated to educate others about falls prevention and satisfied with the skills gained. CONCLUSIONS A high-quality education program grounded in a rigorous quality framework improved health professionals knowledge regarding evidence-based falls prevention. Use of evidence-based rationales for behaviour change promotes effective learning.
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Affiliation(s)
- Louise K Shaw
- Faculty of Health Science, Youth and Community Studies, Holmesglen Institute, 488 South Road, Moorabbin, Vic 3189, Australia.
| | - Debra Kiegaldie
- Faculty of Health Science, Youth and Community Studies, Holmesglen Institute, 488 South Road, Moorabbin, Vic 3189; Monash University, Australia; Healthscope ARCH, Victorian Rehabilitation Centre, Glen Waverley 3150, Australia.
| | - Cathy Jones
- Healthscope, Level 1, 312 St Kilda Rd, Melbourne, 3004, Australia.
| | - Meg E Morris
- School of Allied Health, La Trobe Centre for Sport and Exercises Medicine Research, La Trobe University, Victoria 3086, Australia; Healthscope ARCH, Victorian Rehabilitation Centre, Glen Waverley 3150, Australia.
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Grymonpre RE, Bainbridge L, Nasmith L, Baker C. Development of accreditation standards for interprofessional education: a Canadian Case Study. HUMAN RESOURCES FOR HEALTH 2021; 19:12. [PMID: 33472633 PMCID: PMC7818738 DOI: 10.1186/s12960-020-00551-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 12/21/2020] [Indexed: 05/18/2023]
Abstract
BACKGROUND Academic institutions worldwide are embedding interprofessional education (IPE) into their health/social services education programs in response to global evidence that this leads to interprofessional collaborative practice (IPC). The World Health Organization (WHO) is holding its 193 member countries accountable for Indicator 3-06 ('IPE Accreditation') through its National Health Workforce Accounts. Despite the major influence of accreditation on the quality of health and social services education programs, little has been written about accreditation of IPE. CASE STUDY Canada has been a global leader in IPE Accreditation. The Accreditation of Interprofessional Health Education (AIPHE) projects (2007-2011) involved a collaborative of eight Canadian organizations that accredit pre-licensure education for six health/social services professions. The AIPHE vision was for learners to develop the necessary knowledge, skills and attitudes to provide IPC through IPE. The aim of this paper is to share the Canadian Case Study including policy context, supporting theories, preconditions, logic model and evaluation findings to achieve the primary project deliverable, increased awareness of the need to embed IPE language into the accreditation standards for health and social services academic programs. Future research implications are also discussed. CONCLUSIONS As a result of AIPHE, Canada is the only country in the world in which, for over a decade, a collective of participating health/social services accrediting organizations have been looking for evidence of IPE in the programs they accredit. This puts Canada in the unique position to now examine the downstream impacts of IPE accreditation.
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Affiliation(s)
- Ruby E Grymonpre
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, 750 McDermot Ave, Winnipeg, MB, R3E 0T5, Canada.
| | - Lesley Bainbridge
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
- Associate Faculty, School of Leadership Studies, Royal Roads University, Victoria, BC, Canada
| | - Louise Nasmith
- Department of Family Practice, University of British Columbia, Vancouver, BC, Canada
| | - Cynthia Baker
- Canadian Association of Schools of Nursing and Professor Emeritus, Queens University, Kingston, ON, Canada
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Pan TY, Bruschwein HM, Ward WL. Interprofessional Education: Psychology Trainee Experiences and Perspectives on Team Skills. J Clin Psychol Med Settings 2021; 29:1-9. [PMID: 33389364 DOI: 10.1007/s10880-020-09756-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2020] [Indexed: 11/28/2022]
Abstract
Interprofessional education (IPE) is defined as educational activities involving trainees from two or more professions learning about, from, and with each other with the goal of building team-based collaboration skills. The degree to which psychology trainees are involved in IPE is unknown. A national survey was distributed to gather information regarding the nature and prevalence of IPE experiences and psychology trainees' perceived competence in collaboration skills. Participant responses (n = 143) are presented overall and by training level. Some respondents reported no IPE activities in their training, especially trainees earlier in their training. Highest rated competencies were in acting with honesty and integrity and developing/maintaining mutual respect and trust of other professions. Lowest rated were in giving feedback to others and managing differences in opinion. More research related to the nature and impact of IPE on psychology trainees is critical.
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Affiliation(s)
| | | | - Wendy L Ward
- College of Medicine, University of Arkansas for Medical Sciences/Arkansas Children's Hospital, 1 Children's Way, Slot 512-21, Little Rock, 72202, USA.
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Ten Cate O, Pool IA. The viability of interprofessional entrustable professional activities. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2020; 25:1255-1262. [PMID: 31872327 DOI: 10.1007/s10459-019-09950-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 12/18/2019] [Indexed: 06/10/2023]
Abstract
Interprofessional education (IPE) and entrustable professional activities (EPAs) represent two topics in health professions education that have attracted significant attention in recent years. IPE (when different health professionals learn with, from and about each other with the aim of optimal care) has an inherent focus on the collective. EPAs (units of professional practice that can be fully entrusted to a trainee, once he or she has demonstrated the necessary competence to execute this activity unsupervised) have a focus on the individual. Attempts to relate the two may cause friction and the question is: can they be reconciled? Are interprofessional EPAs or team-EPAs useful concepts and if so what should they look like? The authors argue that most work in modern healthcare involves interprofessional collaboration. Some EPAs have an inherent strong interprofessional nature, such as emergency teamwork, running multidisciplinary team meetings, and surgery. Other EPAs are less inherently dependent on interprofessional collaboration. The authors conclude that neither interprofessional team-EPAs (for which a team can or should be certified), nor IP-EPAs for individuals, as opposed to other EPAs, are viable concepts. However, the authors do not question that certifying health care professionals and entrusting trainees with most clinical tasks will require to ascertain their competence in interprofessional collaboration. This must be included when assessing learners for most EPAs and making entrustment decisions. This can help to strengthen interprofessional competence in the clinical workplace.
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Affiliation(s)
- Olle Ten Cate
- Center for Research and Development of Education, University Medical Center Utrecht, P.O. Box # 85500, 3508 GA, Utrecht, The Netherlands.
| | - Inge A Pool
- Center for Research and Development of Education, University Medical Center Utrecht, P.O. Box # 85500, 3508 GA, Utrecht, The Netherlands
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Morgan KH, Barroso CS, Bateman S, Dixson M, Brown KC. Patients' Experiences of Interprofessional Collaborative Practice in Primary Care: A Scoping Review of the Literature. J Patient Exp 2020; 7:1466-1475. [PMID: 33457603 PMCID: PMC7786771 DOI: 10.1177/2374373520925725] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Interprofessional collaboration (IPC) has been shown to improve patient safety and quality of care. Particularly, IPC assists health care providers to manage complex and chronic diseases. To this end, primary care centers around the world have begun practicing IPC; however, little is known about the patient's experience of IPC in primary care (IPC-pc). The goals of this scoping review were to identify the studies exploring patients' perspectives on IPC-pc and to reveal gaps in the literature for future research in order to inform policy and practice. A key word search strategy was conducted using PubMed to identify studies published from 1997 to 2017 on IPC-pc that included data collected from patients or their caregivers about patient experience or satisfaction. Seven studies met the inclusion criteria for the scoping review, and these studies were evaluated by interprofessional intervention, collaboration, and outcomes.
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Affiliation(s)
| | | | | | - Melanie Dixson
- Knoxville Libraries, University of Tennessee, Knoxville, TN, USA
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47
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Shaw L, Kiegaldie D, Farlie MK. Education interventions for health professionals on falls prevention in health care settings: a 10-year scoping review. BMC Geriatr 2020; 20:460. [PMID: 33167884 PMCID: PMC7653707 DOI: 10.1186/s12877-020-01819-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 10/05/2020] [Indexed: 02/06/2023] Open
Abstract
Background Falls in hospitals are a major risk to patient safety. Health professional education has the potential to be an important aspect of falls prevention interventions. This scoping review was designed to investigate the extent of falls prevention education interventions available for health professionals, and to determine the quality of reporting. Method A five stage scoping review process was followed based on Arksey and O’Malley’s framework and refined by the Joanna Briggs Institute Methodology for JBI Scoping Reviews. Five online databases identified papers published from January 2008 until May 2019. Papers were independently screened by two reviewers, and data extracted and analysed using a quality reporting framework. Results Thirty-nine publications were included. Interventions included formal methods of educational delivery (for example, didactic lectures, video presentations), interactive learning activities, experiential learning, supported learning such as coaching, and written learning material. Few studies employed comprehensive education design principles. None used a reporting framework to plan, evaluate, and document the outcomes of educational interventions. Conclusions Although health professional education is recognised as important for falls prevention, no uniform education design principles have been utilised in research published to date, despite commonly reported program objectives. Standardised reporting of education programs has the potential to improve the quality of clinical practice and allow studies to be compared and evaluated for effectiveness across healthcare settings.
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Affiliation(s)
- L Shaw
- Faculty of Health Science, Youth and Community Studies, Holmesglen Institute, 488 South Road, Moorabbin, VIC, 3189, Australia. .,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, 3086, Australia.
| | - D Kiegaldie
- Faculty of Health Science, Youth and Community Studies and Healthscope Hospitals, Holmesglen Institute, 488 South Road, Moorabbin, VIC, 3189, Australia.,Eastern Clinical School, Faculty of Medicine, Nursing & Health Sciences, Monash University, Melbourne, Australia
| | - M K Farlie
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Moorooduc Highway, Frankston, VIC, 3199, Australia
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48
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Brown DK, Kushner Benson SN. Does Time in Team Training Matter? Evaluation of Team-Level Attitudes With Interprofessional Education. Clin Simul Nurs 2020. [DOI: 10.1016/j.ecns.2020.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Witt Sherman D, Flowers M, Rodriguez Alfano A, Alfonso F, De Los Santos M, Evans H, Gonzalez A, Hannan J, Harris N, Munecas T, Rodriguez A, Simon S, Walsh S. An Integrative Review of Interprofessional Collaboration in Health Care: Building the Case for University Support and Resources and Faculty Engagement. Healthcare (Basel) 2020; 8:E418. [PMID: 33105607 PMCID: PMC7712448 DOI: 10.3390/healthcare8040418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND In 2010, the World Health Organization issued a clarion call for action on interprofessional education and collaboration. This call came forty years after the concept of interprofessional collaboration (IPC) was introduced. AIM To conduct an integrative review of interprofessional collaboration in health care education in order to evaluate evidence and build the case for university support and resources and faculty engagement, and propose evidence-based implications and recommendations. SEARCH STRATEGY A literature search was conducted by an interprofessional faculty from a college of nursing and health sciences. Databases searched included CINAHL, Medline, Eric, Pubmed, Psych Info Lit., and Google Scholar. Keywords were interdisciplinary, interprofessional, multidisciplinary, transdisciplinary, health care team, teamwork, and collaboration. Inclusion criteria were articles that were in the English language, and published between 1995 and 2019. REVIEW METHODS Thirteen interprofessional team members searched assigned databases. Based on key words and inclusion criteria, over 216,885 articles were identified. After removing duplicates, educational studies, available as full text were reviewed based on titles, and abstracts. Thirty-two articles were further evaluated utilizing the Sirriyeh, Lawton, Gardner, and Armitage (2012) review system. Faculty agreed that an inclusion score of 20 or more would determine an article's inclusion for the final review. Eighteen articles met the inclusion score and the data was reduced and analyzed using the Donabedian Model to determine the structure, processes, and outcomes of IPC in health care education. RESULTS Structure included national and international institutions of higher education and focused primarily on undergraduate and graduate health care students' experiences. The IPC processes included curricular, course, and clinical initiatives, and transactional and interpersonal processes. Outcomes were positive changes in faculty and health care students' knowledge, attitudes, and skills regarding IPC, as well as challenges related to structure, processes, and outcomes which need to be addressed. Implications/Recommendations/Conclusions: The creation of a culture of interprofessional collaboration requires a simultaneous "top-down" and "bottom-up" approach with commitment by the university administration and faculty. A university Interprofessional Strategic Plan is important to guide the vision, mission, goals, and strategies to promote and reward IPC and encourage faculty champions. University support and resources are critical to advance curricular, course, and clinical initiatives. Grassroots efforts of faculty to collaborate with colleagues outside of their own disciplines are acknowledged, encouraged, and established as a normative expectation. Challenges to interprofessional collaboration are openly addressed and solutions proposed through the best thinking of the university administration and faculty. IPC in health care education is the clarion call globally to improve health care.
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Affiliation(s)
- Deborah Witt Sherman
- Department of Graduate Nursing, Florida International University, Miami, FL 33199, USA;
| | - Monica Flowers
- Department of Undergraduate Nursing, Florida International University, Miami, FL 33199, USA; (M.F.); (M.D.L.S.); (A.G.); (J.H.); (S.S.)
| | - Alliete Rodriguez Alfano
- Department of Communication Science and Disorders, Florida International University, Miami, FL 33199, USA;
| | - Fernando Alfonso
- Department of Anesthesia, Florida International University, Miami, FL 33199, USA; (F.A.); (H.E.)
| | - Maria De Los Santos
- Department of Undergraduate Nursing, Florida International University, Miami, FL 33199, USA; (M.F.); (M.D.L.S.); (A.G.); (J.H.); (S.S.)
| | - Hallie Evans
- Department of Anesthesia, Florida International University, Miami, FL 33199, USA; (F.A.); (H.E.)
| | - Arturo Gonzalez
- Department of Undergraduate Nursing, Florida International University, Miami, FL 33199, USA; (M.F.); (M.D.L.S.); (A.G.); (J.H.); (S.S.)
| | - Jean Hannan
- Department of Undergraduate Nursing, Florida International University, Miami, FL 33199, USA; (M.F.); (M.D.L.S.); (A.G.); (J.H.); (S.S.)
| | - Nicolette Harris
- Department of Athletic Training, Florida International University, Miami, FL 33199, USA;
| | - Teresa Munecas
- Department of Physical Therapy, Florida International University, Miami, FL 33199, USA;
| | - Ana Rodriguez
- Department of Occupational Therapy, Florida International University, Miami, FL 33199, USA;
| | - Sharon Simon
- Department of Undergraduate Nursing, Florida International University, Miami, FL 33199, USA; (M.F.); (M.D.L.S.); (A.G.); (J.H.); (S.S.)
| | - Sandra Walsh
- Department of Graduate Nursing, Florida International University, Miami, FL 33199, USA;
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Ross LA, Bloodworth LS, Brown MA, Malinowski SS, Crane R, Sutton V, Karimi M, Dove Brown AC, Dobbs T, Hites L. The Mississippi Delta Health Collaborative Medication Therapy Management Model: Public Health and Pharmacy Working Together to Improve Population Health in the Mississippi Delta. Prev Chronic Dis 2020; 17:E108. [PMID: 32945767 PMCID: PMC7553214 DOI: 10.5888/pcd17.200063] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Introduction The Mississippi Delta has high rates of chronic disease and is known for its poor health outcomes and health disparities. The University of Mississippi School of Pharmacy (UMSOP) and the Mississippi State Department of Health partnered in 2009 through the Mississippi Delta Health Collaborative to reduce health disparities and improve clinical outcomes by expanding the UMSOP’s evidence-based medication therapy management (MTM) initiative, focused in Mississippi’s 18-county Delta region, to federally qualified health centers (FQHCs) in 4 of those counties. Methods Between January 2009 and August 2018, the MTM initiative targeted FQHC patients aged 18 years or older with a diagnosis of diabetes, hypertension, and/or dyslipidemia. Pharmacists initially met face-to-face with patients to review all medications, provide education about chronic diseases, identify and resolve drug therapy problems, and take appropriate actions to help improve the effectiveness of medication therapies. Clinical parameters evaluated were systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and hemoglobin A1c (HbA1c). Results The analysis included 335 patients with hypertension (n = 287), dyslipidemia (n = 131), and/or diabetes (n = 331). Significant mean reductions occurred in the following metrics: SBP (7.1 mm Hg), DBP (6.3 mm Hg), LDL cholesterol (24.9 mg/dL), triglycerides (45.5 mg/dL), total cholesterol (37.7 mg/dL), and HbA1c (1.6% [baseline ≥6%] and 1.9% [baseline ≥9%]). Conclusion Despite the cultural and environmental disadvantages present in the Mississippi Delta, the integrated MTM treatment program demonstrated significant health improvements across 3 chronic diseases: hypertension, dyslipidemia, and diabetes. This model demonstrates that a partnership between public health and pharmacy is a successful and innovative approach to care.
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Affiliation(s)
- Leigh Ann Ross
- University of Mississippi School of Pharmacy, 2500 North State St, Jackson, MS 39216.
| | | | - Meagan A Brown
- University of Mississippi School of Pharmacy, Oxford, Mississippi
| | | | - Rebecca Crane
- Aaron E. Henry Community Health Services Center, Clarksdale, Mississippi
| | - Victor Sutton
- Mississippi State Department of Health, Jackson, Mississippi
| | - Masoumeh Karimi
- Mississippi State Department of Health, Jackson, Mississippi
| | | | - Thomas Dobbs
- Mississippi State Department of Health, Jackson, Mississippi
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