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Vo MTH, Nakamura K, Seino K, Moncatar TJRT, Han TDT, Siongco KLL, Tashiro Y, Van Vo T. Can collaboration among health and social care workers play a role in addressing geriatric care challenges? A qualitative case study in Central Vietnam. Int Health 2024; 16:387-398. [PMID: 37757862 PMCID: PMC11218886 DOI: 10.1093/inthealth/ihad082] [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: 02/08/2023] [Revised: 08/19/2023] [Accepted: 08/30/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Vietnam's healthcare system offers limited services and facilities for older adults. This study explored the perceptions of health and social care workers regarding geriatric care issues, their impact on older adults and the potential of collaboration for enhancing older adults' health and well-being. METHODS This qualitative case study employed 27 focus group discussions and two in-depth interviews with 174 participants in Thua Thien Hue Province, Vietnam. An inductive thematic analysis was conducted. RESULTS According to the participants, the major challenges that hindered geriatric care consisted of caregiver and care recipient issues, which were identified to constrain care accessibility, resulting in decreased physical, mental and social health. Across different settings and professions, collaboration was considered a routine and natural aspect of daily work. It was perceived that establishing and strengthening collaboration could facilitate improvement in health and social welfare services through the prioritization of needs and enhancement of caregiver skills and training. CONCLUSIONS Collaboration was viewed as ad hoc but indispensable for addressing the identified geriatric care issues that could improve the general health and well-being of older adults. The findings indicate a need for better collaboration in Vietnam, achieved through defined guidelines, training and improved interprofessional education and practice.
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Affiliation(s)
- Man Thi Hue Vo
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
- College of Public Health Sciences, Chulalongkorn University, Bangkok 10330, Thailand
| | - Keiko Nakamura
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
- World Health Organization Collaborating Centre for Healthy Cities and Urban Policy Research, Tokyo, Japan
| | - Kaoruko Seino
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
- World Health Organization Collaborating Centre for Healthy Cities and Urban Policy Research, Tokyo, Japan
| | - T J Robinson T Moncatar
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
- Department of Health Policy and Administration, College of Public Health, University of the Philippines Manila, Manila 1000, Philippines
| | - Tran Dai Tri Han
- Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Hue 530000, Vietnam
| | - Kathryn Lizbeth L Siongco
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
- College of Nursing, University of the Philippines Manila, Manila, Philippines
| | - Yuri Tashiro
- Department of Global Health Entrepreneurship, Tokyo Medical and Dental University, Tokyo 113-8510, Japan
| | - Thang Van Vo
- Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Hue 530000, Vietnam
- Institute for Community Health Research, University of Medicine and Pharmacy, Hue University, Hue, Vietnam
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Bouchez T, Cagnon C, Hamouche G, Majdoub M, Charlet J, Schuers M. Interprofessional clinical decision-making process in health: A scoping review. J Adv Nurs 2024; 80:884-907. [PMID: 37705486 DOI: 10.1111/jan.15865] [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: 12/27/2021] [Revised: 07/19/2023] [Accepted: 08/30/2023] [Indexed: 09/15/2023]
Abstract
AIMS To describe the key elements of the interprofessional decision-making process in health, based on published scientific studies. To describe the authors, reviews and subject matter of those publications. DESIGN Scoping review of the literature. DATA SOURCES MEDLINE, APA Psycinfo OpenGrey, Lissa and Cochrane databases were searched in December 2019 and January 2023. REVIEW METHODS References were considered eligible if they (i) were written in French or English, (ii) concerned health, (iii) studied a clinical decision-making process, (iv) were performed in an interprofessional context. 'PRISMA-scoping review' guidelines were respected. The eligible studies were analysed and classified by an inductive approach RESULTS: We identified 1429 sources of information, 145 of which were retained for the analysis. Based on these studies, we identified five key elements of interprofessional decision-making in health. The process was found to be influenced by group dynamics, the available information and consideration of the unique characteristics of the patient. An organizational framework and specific training favoured improvements in the process. CONCLUSION Decision-making can be based on a willingness of the healthcare organization to promote models based on more shared leadership and to work on professional roles and values. It also requires healthcare professionals trained in the entire continuum of collaborative practices, to meet the unique needs of each patient. Finally, it appears essential to favour the sharing of multiple sources of accessible and structured information. Tools for knowledge formalization should help to optimize interprofessional decision-making in health. IMPACT The quality of a team decision-making is critical to the quality of care. Interprofessional decision-making can be structured and improved through different levels of action. These improvements could benefit to patients and healthcare professionals in every settings of care involving care collaboration. IMPACT STATEMENT Interprofessional decision-making in health is an essential lever of quality of care, especially for the most complex patients which are a contemporary challenge. This scoping review article offers a synthesis of a large corpus of data published to date about the interprofessional clinical decision-making process in healthcare. It has the potential to provide a global vision, practical data and a list of references to facilitate the work of healthcare teams, organizations and teachers ready to initiate a change.
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Affiliation(s)
- Tiphanie Bouchez
- Department of Education and Research in General Practice, University Côte d'Azur, RETINES, HEALTHY, Nice, France
- Sorbonne University, INSERM, University Sorbonne Paris-Nord, LIMICS, Paris, France
| | - Clémence Cagnon
- Department of Education and Research in General Practice, University Côte d'Azur, RETINES, HEALTHY, Nice, France
| | - Gouraya Hamouche
- Department of Education and Research in General Practice, University Côte d'Azur, RETINES, HEALTHY, Nice, France
| | - Marouan Majdoub
- Department of Education and Research in General Practice, University Côte d'Azur, RETINES, HEALTHY, Nice, France
| | - Jean Charlet
- Sorbonne University, INSERM, University Sorbonne Paris-Nord, LIMICS, Paris, France
- Assistance Publique-Hôpitaux de Paris/DRCI, Paris, France
| | - Matthieu Schuers
- Sorbonne University, INSERM, University Sorbonne Paris-Nord, LIMICS, Paris, France
- Department of General Practice, University of Rouen, Rouen, France
- Department of Medical Informatic, Academic Hospital of Rouen, Rouen, France
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Yang W, Li Z, Yang T, Li Y, Xie Z, Feng L, Peng Z, Liu J. Experts' Consensus on the Management of Respiratory Disease Syndemic. China CDC Wkly 2024; 6:131-138. [PMID: 38476822 PMCID: PMC10926044 DOI: 10.46234/ccdcw2024.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 02/13/2024] [Indexed: 03/14/2024] Open
Affiliation(s)
- Weizhong Yang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- State Key Laboratory of Respiratory Health and Multimorbidity, Beijing, China
- Key Laboratory of Pathogen Infection Prevention and Control, Peking Union Medical College, Ministry of Education, Beijing, China
| | - Zhongjie Li
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- State Key Laboratory of Respiratory Health and Multimorbidity, Beijing, China
- Key Laboratory of Pathogen Infection Prevention and Control, Peking Union Medical College, Ministry of Education, Beijing, China
| | - Ting Yang
- National Center for Respiratory Diseases, State Key Laboratory of Respiratory Health and Multimorbidity, National Clinical Research Center for Respiratory Diseases, Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Yanming Li
- Department of Pulmonary and Critical Care Medicine, National Center of Gerontology, Beijing Hospital, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhengde Xie
- Beijing Key Laboratory of Pediatric Respiratory Infection Diseases, Key Laboratory of Major Diseases in Children, Ministry of Education, National Clinical Research Center for Respiratory Diseases, Research Unit of Critical Infection in Children, Chinese Academy of Medical Sciences, 2019RU016, National Key Discipline of Pediatrics (Capital Medical University), Beijing Pediatric Research Institute, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Luzhao Feng
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- State Key Laboratory of Respiratory Health and Multimorbidity, Beijing, China
- Key Laboratory of Pathogen Infection Prevention and Control, Peking Union Medical College, Ministry of Education, Beijing, China
| | - Zhibin Peng
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of PublicHealth, Key Laboratory of Epidemiology of Major Diseases, Ministry of Education, Peking University Health Science Center-Weifang Joint Research Center for Maternal and Child Health,Peking University, Beijing, China
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Pagano L, McKeough Z, Wootton SL, Chan ASL, Mahadev S, Zwar N, Pallavicini D, Dennis S. Acceptability and barriers of a GP-physiotherapist partnership in the diagnosis and management of COPD in primary care: A qualitative study. Health Expect 2024; 27:e13935. [PMID: 38063819 PMCID: PMC10757211 DOI: 10.1111/hex.13935] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/24/2023] [Accepted: 11/27/2023] [Indexed: 01/01/2024] Open
Abstract
INTRODUCTION Chronic obstructive pulmonary disease (COPD) is commonly diagnosed and managed in primary care but there is evidence that this has been suboptimal, with low confidence expressed in providing interventions requiring behaviour change. The aim of this study was to determine the acceptability of a general practitioner (GP)-physiotherapist partnership in the diagnosis and management of COPD in primary care and to explore the experiences of participants during the implementation of the model. METHODS Semi-structured interviews were conducted with physiotherapists (n = 3), GPs (n = 2), practice nurses (PNs) (n = 2) and patients (n = 12) who had participated in the InNovaTivE Gp-physiotheRapist pArTnErship for copD (INTEGRATED) trial. We sought to explore participants' views about their experiences and perceived benefits, barriers and facilitators to the implementation of this model of care. Interviews were transcribed, coded and thematically analysed. Synthesis of the data was guided by the Theoretical Domains Framework for clinician interviews and the health belief model for patient interviews. RESULTS All clinicians felt that this integrated model helped to optimise care for patients with COPD by facilitating evidence-based practice. GPs and PNs valued the physiotherapist's knowledge and skills relating to diagnosis and management, which was reported to complement their own management and improve patient outcomes. Patients reported a sense of empowerment following their appointments and acknowledged improved self-management skills. However, physiotherapists reported many patients were already engaging in positive health behaviours. Responses were mixed on the effectiveness of the model in facilitating teamwork between clinicians with different perspectives concerning management, communication pathways and logistical issues, such as time and room availability, being cited as barriers. CONCLUSIONS An experienced cardiorespiratory physiotherapist embedded into a small number of primary care practices to work in partnership with GPs for COPD diagnosis and management was acceptable and viewed as beneficial for patients. Barriers relating to logistics and resources remain, which must be addressed to optimise implementation. PATIENT OR PUBLIC CONTRIBUTION Patient input was obtained from qualitative feedback from a prior study conducted by two authors and was used to refine the model of care to determine the added value of a physiotherapist integrated into the primary care team. This feedback was also used to refine the interview guides utilised in this study determine the acceptability of this model of care. We had health service involvement from the rehabilitation service of the local health district who were directly involved in determining study aims and establishing the project around the priorities for their chronic disease integration service. For example, this project aimed to engage with a less severe patient population in primary care who would benefit from pulmonary rehabilitation. The findings from this study will be used to further tailor the model of care to the needs of the public and patients. TRIAL REGISTRATION ACTRN12619001127190.
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Affiliation(s)
- Lisa Pagano
- Sydney School of Health Sciences, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
- Present address:
Australian Institute of Health Innovation, Faculty of Medicine, Health and Human SciencesMacquarie UniversitySydneyNSWAustralia
| | - Zoe McKeough
- Sydney School of Health Sciences, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
| | - Sally L. Wootton
- Sydney School of Health Sciences, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
- Chronic Disease Community Rehabilitation ServiceNorthern Sydney Local Health DistrictSydneyNew South WalesAustralia
| | - Andrew S. L. Chan
- Department of Respiratory and Sleep MedicineRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
- Northern Clinical SchoolUniversity of SydneySydneyNew South WalesAustralia
| | - Sriram Mahadev
- Department of Respiratory and Sleep MedicineRoyal North Shore HospitalSt LeonardsNew South WalesAustralia
- Northern Clinical SchoolUniversity of SydneySydneyNew South WalesAustralia
| | - Nicholas Zwar
- Faculty of Health Sciences and MedicineBond UniversityGold CoastQueenslandAustralia
| | | | - Sarah Dennis
- Sydney School of Health Sciences, Faculty of Medicine and HealthUniversity of SydneySydneyNew South WalesAustralia
- Ingham Institute for Applied Medical ResearchSydneyNew South WalesAustralia
- South Western Sydney Local Health DistrictLiverpoolNew South WalesAustralia
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McNulty JP, Politis Y. Empathy, emotional intelligence and interprofessional skills in healthcare education. J Med Imaging Radiat Sci 2023; 54:238-246. [PMID: 37032263 DOI: 10.1016/j.jmir.2023.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 04/11/2023]
Abstract
According to the World Health Organization (WHO), health professionals maintain the health of citizens through evidence-based medicine and caring. Students enroled in health professional programmes are required to have successfully attained all core learning outcomes by reaching key milestones throughout the course of their studies, demonstrating they have developed the required graduate skills and attributes upon completion of the programme. While some of the knowledge, skills and competencies that make up these learning outcomes are very discipline specific, there are more general professional skills across all disciplines which are difficult to define, such as empathy, emotional intelligence and interprofessional skills. These are at the heart of all health professional programmes that once defined, can be mapped through curricula and further evaluated. Literature will be presented on these three professional skills: empathy, emotional intelligence, and interprofessional skills, based on studies that focussed primarily in health professional programmes and highlight some of the key findings and issues at undergraduate and postgraduate levels. The paper will present the need for these skills to be defined and then mapped through curricula so that students are better supported in their professional development. Empathy, emotional intelligence and interprofessional skills transcend the discipline specific skills and as such it is important that all educators consider how best these may be fostered. Efforts should also be made to further the integration of these professional skills within curricula to produce health professionals with an enhanced focus on person-centred care.
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Affiliation(s)
- Jonathan P McNulty
- Radiography and Diagnostic Imaging, School of Medicine, University College, Ireland.
| | - Yurgos Politis
- Center for Teaching and Learning, Central European University, Vienna, Austria
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Razzaq A, Stephenson N, Raynes-Greenow C, Travaglia J, Alam NA. Understanding the relationship between the public sector healthcare workers and NGO-based HIV counsellors while providing HIV counselling and testing services to pregnant women: A Qualitative Study in Suva, Fiji. Midwifery 2023; 120:103634. [PMID: 36842250 DOI: 10.1016/j.midw.2023.103634] [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: 08/14/2021] [Revised: 02/06/2023] [Accepted: 02/12/2023] [Indexed: 02/21/2023]
Abstract
Human immunodeficiency virus (HIV) counselling and testing plays a significant role in the prevention of mother-to-child transmission of HIV. HIV counselling and testing during pregnancy is an essential gateway for HIV prevention, timely treatment, and care services. Lack of proper counselling could jeopardise the quality of services. This paper aims to understand the relationship between the government employed hospital healthcare workers and the Non-Governmental Organisation based counsellors while providing HIV counselling and testing services to pregnant women attending antenatal clinic in one of the main hospitals in Suva, Fiji. Data were collected via individual, in-depth, interviews held in a single hospital and an associated reproductive health centre in Suva in April-May 2013. A total of 15 healthcare providers including doctors (n = 4), midwives (n = 5), nurses (n = 4), and counsellors (n = 2) were interviewed. The data were analysed using thematic analysis. Ethical approvals were obtained. We found that there was tension between the government employed hospital healthcare workers and the Non-Governmental Organisation based counsellors involved in the provision of HIV counselling and testing services to pregnant women. The predominant causes of tension were poor referral for HIV test counselling, long counselling time, lack of cooperation and conflict due to the differences in counselling approaches. Tension between the government employed hospital healthcare workers and the Non- Governmental Organisation based HIV counsellors appear to be the main challenge to effective provision of HIV test counselling services in the hospital. Ongoing tension between both groups could restrict healthcare workers abilities to provide quality HIV counselling services. Our findings would be useful in developing strategies to overcome tension amongst healthcare workers as it would be an imperative step in providing streamlined HIV counselling services to women attending antenatal clinic in Fiji.
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Affiliation(s)
- Amina Razzaq
- Sydney School of Public Health, The University of Sydney, Faculty of Medicine and Health, Sydney Australia; School of Public Health and Community Medicine, Samuels Building (F25), University of New South Wales, Kensington, NSW 2033, Australia.
| | - Niamh Stephenson
- School of Public Health and Community Medicine, Samuels Building (F25), University of New South Wales, Kensington, NSW 2033, Australia
| | - Camille Raynes-Greenow
- Sydney School of Public Health, The University of Sydney, Faculty of Medicine and Health, Sydney Australia
| | - Joanne Travaglia
- School of Public Health and Community Medicine, Samuels Building (F25), University of New South Wales, Kensington, NSW 2033, Australia
| | - Neeloy Ashraful Alam
- Sydney School of Public Health, The University of Sydney, Faculty of Medicine and Health, Sydney Australia
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Characteristics of Successful International Pharmacy Partnerships. PHARMACY 2023; 11:pharmacy11010007. [PMID: 36649017 PMCID: PMC9844321 DOI: 10.3390/pharmacy11010007] [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: 11/29/2022] [Revised: 12/23/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023] Open
Abstract
Recommendations for global pharmacy collaborations are predominately derived from US institutions. This study utilized semi-structured interviews of global collaborators to assess important partnership components. Interviewees stated personal connections and understanding of each other's programs/systems were key components. Additionally, collaborators indicate that mutual benefits between partners can exist without the requirement for bidirectional exchange of learning experiences, and request and value partners and learners who are culturally aware, global citizens. This structured interview approach provided key insight into how to develop mutually beneficial, sustainable partnerships and provides additional confirmation that the five pillars of global engagement align with an international audience.
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Shinkaruk K, Carr E, Lockyer JM, Hecker KG. Exploring the development of interprofessional competence and professional identity: A Situated Learning Theory study. J Interprof Care 2022; 37:613-622. [DOI: 10.1080/13561820.2022.2140129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
- Kelly Shinkaruk
- Department of Anesthesiology, Perioperative, and Pain Medicine, Faculty of Medicine, Cumming School of Medicine, University of Calgary, T2N 4Z6, Calgary, AB, Canada
| | - Eloise Carr
- Faculty of Nursing, PF3238 Professional Faculties Building, 2500 University Drive NW, University of Calgary, T2N 1N4, Calgary, AB, Canada
| | - Jocelyn M Lockyer
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Dr NW, T2N 4Z6, Calgary, AB, Canada
| | - Kent G. Hecker
- Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, T2N 4Z6, Calgary, AB, CANADA
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Soemantri D, Findyartini A, Werdhani RA, Koesnoe S, Dahlia D. Are we ready to collaborate? The interprofessional collaborative competencies of healthcare professionals in the Global South context. Front Med (Lausanne) 2022; 9:904658. [PMID: 36341234 PMCID: PMC9633846 DOI: 10.3389/fmed.2022.904658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 10/04/2022] [Indexed: 11/25/2022] Open
Abstract
Background Current evidence of interprofessional collaboration suggests the importance of measuring and identifying the current state of the health professions’ interprofessional competencies. Therefore, this study was aimed at measuring the interprofessional competencies of health professionals in the Global South context using the validated CICS29. Materials and methods This was a cross-sectional study involving 300 healthcare professionals of a newly established teaching hospital. Prior to the measurement of interprofessional competencies, the 29-items CICS29, which has been translated into Indonesian language, was revalidated using a confirmatory factor analysis (CFA). The 29 items of CICS29 were grouped into six subscales and each item was measured using a 5-point Likert scale. Data on gender, age, type of profession, and the length of working experience was also collected to identify whether discernible differences between grouping variables exists. Results Prior to measuring the interprofessional competencies, the validity of the instrument was established. Based on the CFA, the same six-factor model was found in the current study. The Indonesian CICS29 was reliable, with Cronbach alpha values of 0.921 for the whole instrument and that of each subscale ranged between 0.656 and 0.726. The mean total score of CICS29 was 128.53 (out of 145), ranged from 123 to 133.40 obtained by pharmacists and dentists respectively. No significant differences of CICS29 scores were found between grouping variables. Conclusion The current study has revealed relatively good interprofessional competencies of healthcare professionals working in a newly established teaching hospital in the Global South healthcare context. Measuring the interprofessional competencies serves as baseline for further intervention to nurture and maintain collaborative practice. In addition, the current study has further proven the cross-cultural validity of CICS29, thus appropriate to be utilized in different setting and context.
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Affiliation(s)
- Diantha Soemantri
- Department of Medical Education, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Center for Administration, Health Sciences Cluster, Universitas Indonesia, Depok, Indonesia
- *Correspondence: Diantha Soemantri, ,
| | - Ardi Findyartini
- Department of Medical Education, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Retno Asti Werdhani
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Sukamto Koesnoe
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia—Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Debie Dahlia
- Department of Medical Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Depok, Indonesia
- Universitas Indonesia Hospital, Depok, Indonesia
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Millstein LS, Rosenblatt P, Bellin MH, Whitney L, Eveland SR, Lee MC, Allen J, Mutchie HL, Becker TD, Cagle J. Advance Care Planning and Communication Skills Improve after an Interprofessional Team Simulation with Standardized Patients. Palliat Med Rep 2022; 3:123-131. [PMID: 36059907 PMCID: PMC9438443 DOI: 10.1089/pmr.2021.0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Improving rates of advance care planning (ACP) and advance directive completion is a recognized goal of health care in the United States. No prior study has examined the efficacy of standardized patient (SP)-based student interprofessional ACP trainings. Objectives: The present study aims to evaluate an interprofessional approach to ACP education using SP encounters. Design: We designed a pre–post evaluation of an innovative interprofessional ACP training curriculum using multimodal adult learning techniques to test the effects of completing ACP discussions with SPs. Three surveys (pre-training T1, post-training T2, and post-clinical encounter T3) evaluated student knowledge, Communication Self-Efficacy (CSES), ACP self-efficacy, and interprofessional teamwork (using SPICE-R2). Setting/Subjects: Students from the schools of medicine, nursing, and social work attended three training modules and two SP encounters focused on ACP. Measurements/Results: During academic year 2018–2019, 36 students participated in the training at University of Maryland. Results demonstrated statistically significant improvements in ACP self-efficacy, MT1 = 2.9 (standard deviation [SD]T1 = 0.61) compared with MT3 = 3.9 (SDT3 = 0.51), p < 0.001, and CSES, MT1 = 4.6 (SDT1 = 1.35) versus MT3 = 7.3 (SDT3 = 0.51), p < 0.001, from T1 to T3. There was a medium-to-large improvement in knowledge from an average score of 4.3 (SD = 1.0) at T1 to an average score of 5.5 (SD = 1.4) at T2, p = 0.005, d = 0.67. Conclusions: Our interprofessional training module and SP encounter was successful in improving medical, social work, and nursing students' self-reported communication skills and knowledge regarding ACP.
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Affiliation(s)
- Leah S. Millstein
- Department of Medicine, University of Maryland School of Medicine, University of Maryland, Baltimore, Maryland, USA
- Department of Pediatrics, University of Maryland School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Paula Rosenblatt
- Department of Medicine, University of Maryland School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Melissa H. Bellin
- University of Maryland School of Social Work, University of Maryland, Baltimore, Maryland, USA
| | - Laura Whitney
- University of Maryland School of Social Work, University of Maryland, Baltimore, Maryland, USA
| | - Steven R. Eveland
- University of Maryland Medical Center, University of Maryland, Baltimore, Maryland, USA
| | - Mei Ching Lee
- University of Maryland School of Nursing, University of Maryland, Baltimore, Maryland, USA
| | - John Allen
- Department of Medicine, University of Maryland School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Heather L. Mutchie
- Department of Medicine, University of Maryland School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Todd D. Becker
- University of Maryland School of Social Work, University of Maryland, Baltimore, Maryland, USA
| | - John Cagle
- University of Maryland School of Social Work, University of Maryland, Baltimore, Maryland, USA
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Ludwick T, Endriyas M, Morgan A, Kane S, Kelaher M, McPake B. Challenges in Implementing Community-Based Healthcare Teams in a Low-Income Country Context: Lessons From Ethiopia's Family Health Teams. Int J Health Policy Manag 2022; 11:1459-1471. [PMID: 34273919 PMCID: PMC9808330 DOI: 10.34172/ijhpm.2021.52] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/27/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Addressing chronic diseases and intra-urban health disparities in low- and middle-income countries (LMICs) requires new health service models. Team-based healthcare models can improve management of chronic diseases/complex conditions. There is interest in integrating community health workers (CHWs) into these teams, given their effectiveness in reaching underserved populations. However healthcare team models are difficult to effectively implement, and there is little experience with team-based models in LMICs and with CHW-integrated models more generally. Our study aims to understand the determinants related to the poor adoption of Ethiopia's family health teams (FHTs); and, raise considerations for initiating CHW-integrated healthcare team models in LMIC cities. METHODS Using the Consolidated Framework for Implementation Research (CFIR), we examine organizational-level factors related to implementation climate and readiness (work processes/incentives/resources/leadership) and system-level factors (policy guidelines/governance/financing) that affected adoption of FHTs in two Ethiopian cities. Using semi-structured interviews/focus groups, we sought implementation perspectives from 33 FHT members and 18 administrators. We used framework analysis to deductively code data to CFIR domains. RESULTS Factors associated with implementation climate and readiness negatively impacted FHT adoption. Failure to tap into financial, political, and performance motivations of key stakeholders/FHT members contributed to low willingness to participate, while resource constraints restricted capacity to implement. Workload issues combined with no financial incentives/perceived benefit contributed to poor adoption among clinical professionals. Meanwhile, staffing constraints and unavailability of medicines/supplies/transport contributed to poor implementation readiness, further decreasing willingness among clinical professionals/managers to prioritize non-clinic based activities. The federally-driven program failed to provide budgetary incentives or tap into political motivations of municipal/health centre administrators. CONCLUSION Lessons from Ethiopia's challenges in implementing its FHT program suggest that LMICs interested in adopting CHW-integrated healthcare team models should closely consider health system readiness (budgets, staffing, equipment/medicines) as well as incentivization strategies (financial, professional, political) to drive organizational change.
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Affiliation(s)
- Teralynn Ludwick
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Misganu Endriyas
- Health Research and Technology Transfer Office, SNNPR Regional Health Bureau, Hawassa, Ethiopia
| | - Alison Morgan
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Sumit Kane
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Margaret Kelaher
- Centre for Health Policy, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Barbara McPake
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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Yamashita T, Osawa S, Ota K, Minami T, Morisaki Y, Takahashi Y, Itatani T, Hara S, Tamai T, Fujiu M, Nomura H, Okamoto R. Interdisciplinary groups perform better than intradisciplinary groups in online group discussion activities. MEDICAL EDUCATION ONLINE 2021; 26:1886649. [PMID: 33557724 PMCID: PMC8676687 DOI: 10.1080/10872981.2021.1886649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Online classes have been provided for health-care pre-licensure learners during the novel coronavirus disease 2019 pandemic. The purpose of this study was to evaluate the utility of online group work in interprofessional education. A total of 209 students were assigned to 50 groups (18 medical student groups, 13 nursing student groups, and 19 mixed medical/nursing student groups). Learners performed group work during the orientation for the course, which was hosted using an online video conferencing system. The learners first performed the activity individually (10 min) and then engaged in a group discussion to reach consensus on their answers (30 min). We calculated the scores before and after the group discussion and shared the results with the students. Scores were improved after the group discussion (mean ± SEM, 23.7 ± 0.9) compared with before (37.3 ± 1.3) (P < .0001). Lower scores after the group discussion, which indicated the effect of the group discussion on making better decisions, were observed most in the mixed medical/nursing student groups, followed by the nursing student and medical student groups. We noted only 3 groups in which the group discussion showed a negative effect on decision-making: all 3 of these groups were mixed (3 of 19 groups; 16%). These data demonstrated the power of group discussion for solving tasks when the participants' professional fields were mixed. However, the small size of the interdisciplinary groups might have resulted in less effective discussion, which might be due in part to psychological barriers arising from professional differences. Online group work is effective for facilitating discussion and building consensus about decisions in interprofessional education for medical and nursing students. Potential psychological barriers may exist in about 16% of mixed group students at the start, which should be kept in mind by instructors. Abbreviations: COVID-19: coronavirus disease 2019; IPE: Interprofessional Education; NASA: National Aeronautics and Space Administration; SD: standard deviation; WHO: World Health Organization.
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Affiliation(s)
- Taro Yamashita
- Department of General Medicine, Kanazawa University Hospital, Kanazawa, Japan
- CONTACT Taro Yamashita Department of General Medicine, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa, Ishikawa920-8641, Japan
| | - Shuji Osawa
- Division of Environmental Engineering Design, Graduate School of Natural Science and Technology, Kanazawa, Japan
| | - Kunio Ota
- Medical Education Research Center, Graduate School of Medical Sciences, Kanazawa, Japan
| | - Takahiro Minami
- Division of Environmental Engineering Design, Graduate School of Natural Science and Technology, Kanazawa, Japan
| | - Yuma Morisaki
- Division of Environmental Engineering Design, Graduate School of Natural Science and Technology, Kanazawa, Japan
| | - Yutaro Takahashi
- Division of Health Sciences, Graduate School of Pharmaceutical Science, Kanazawa University, Kanazawa, Japan
| | - Tomoya Itatani
- Division of Health Sciences, Graduate School of Pharmaceutical Science, Kanazawa University, Kanazawa, Japan
| | - Satoshi Hara
- Medical Education Research Center, Graduate School of Medical Sciences, Kanazawa, Japan
| | - Toshikatsu Tamai
- Medical Education Research Center, Graduate School of Medical Sciences, Kanazawa, Japan
| | - Makoto Fujiu
- Division of Environmental Engineering Design, Graduate School of Natural Science and Technology, Kanazawa, Japan
| | - Hideki Nomura
- Department of General Medicine, Kanazawa University Hospital, Kanazawa, Japan
| | - Rie Okamoto
- Division of Health Sciences, Graduate School of Pharmaceutical Science, Kanazawa University, Kanazawa, Japan
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Eruyar S, Haffejee S, Anderson ES, Vostanis P. Implementation of child mental health service improvement plans in four low- and middle-income countries: stakeholders' perspectives. J Interprof Care 2021:1-8. [PMID: 34657552 DOI: 10.1080/13561820.2021.1982881] [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: 06/10/2020] [Revised: 08/26/2021] [Accepted: 09/11/2021] [Indexed: 10/20/2022]
Abstract
Children in low- and middle-income countries (LMIC) have high levels of unmet mental health needs, especially in disadvantaged communities. To address this gap, we developed a child mental health service improvement programme. This was co-facilitated using interprofessional principles and values in four countries, South Africa, Kenya, Turkey and Brazil. Eighteen stakeholders from different professions were interviewed after six months on their perspectives on enabling factors and challenges they faced in implementing service plans. Participants valued the holistic case management approach and scaled service model that underpinned the service plans. Emerging themes on participants' priorities related to service user participation, integrated care, and different levels of capacity-building. We propose that an integrated care model in LMIC contexts can maximize available resources, engage families and mobilize communities. Implementation requires concurrent actions at micro-, meso- and macro-level.
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Affiliation(s)
- Seyda Eruyar
- Department of Psychology, Necmettin Erbakan University, Konya, Turkey
| | - Sadiyya Haffejee
- Centre for Social Development in Africa, University of Johannesburg, Johannesburg, South Africa
| | - E S Anderson
- School of Medicine, University of Leicester, Leicester, UK
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Ludwick T, Endrias M, Morgan A, Kane S, McPake B. Moving From Community-Based to Health-Centre Based Management: Impact on Urban Community Health Worker Performance in Ethiopia. Health Policy Plan 2021; 37:169-188. [PMID: 34519336 DOI: 10.1093/heapol/czab112] [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] [Received: 04/15/2021] [Revised: 08/10/2021] [Accepted: 09/14/2021] [Indexed: 01/03/2023] Open
Abstract
Community health worker (CHW) performance is influenced by the way in which management arrangements are configured vis-a-vis the community and health services. While low/middle-income contexts are changing, the literature provides few examples of country efforts to strategically modify management arrangements to support evolving CHW roles (e.g. chronic disease care) and operating environments (e.g. urbanization). This paper aims to understand the performance implications of changing from community-based to health centre-based management, on Ethiopia's Urban Health Extension Professionals (UHEPs), and the tensions/trade-offs associated with the respective arrangements. We conducted semi-structured interviews/focus groups to gather perspectives and preferences from those involved with the transition (13 managers/administrators, 5 facility-based health workers, 20 UHEPs). Using qualitative content analysis, we deductively coded data to four program elements impacted by changed management arrangements and known to affect CHW performance (work scope; community legitimacy; supervision/oversight/ownership; facility linkages) and inductively identified tensions/trade-offs. Community-based management was associated with wider work scope, stronger ownership/regular monitoring, weak technical support, and weak health center linkages, with opposite patterns observed for health center-led management. Practical trade-offs included: heavy UHEP involvement in political/administrative activities under Kebele-based management; resistance to working with UHEPs by facility-based workers; and, health centre capacity constraints in managing UHEPs. Whereas the Ministry of Health/UHEPs favoured health centre-led management to capitalize on UHEPs' technical skills, Kebele officials were vested in managing UHEPs and argued for community interests over UHEPs' professional interests; health facility managers/administrators held divided opinions. Management arrangements influence the nature of CHW contributions towards the achievement of health, development, and political goals. Decisions about appropriate management arrangements should align with the nature of CHW roles and consider implementation setting, including urbanization, political decentralization, and relative capacity of managing institutions.
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Affiliation(s)
- Teralynn Ludwick
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, 333 Exhibition Street, Carlton, Victoria, Australia
| | - Misganu Endrias
- Health Research and Technology Transfer Office, SNNPR Regional Health Bureau, Hawassa, Ethiopia
| | - Alison Morgan
- Maternal Sexual and Reproductive Health Unit, Nossal Institute for Global Health Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,Global Financing Facility, The World Bank Group, Washington, DC, USA
| | - Sumit Kane
- Maternal Sexual and Reproductive Health Unit, Nossal Institute for Global Health Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Barbara McPake
- Nossal Institute for Global Health Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Pichonnaz D, Staffoni L, Greppin-Bécherraz C, Menia-Knutti I, Schoeb V. "You Should Maybe Work Together a Little Bit": Formulating Requests in Interprofessional Interactions. QUALITATIVE HEALTH RESEARCH 2021; 31:1094-1104. [PMID: 33615905 PMCID: PMC8114438 DOI: 10.1177/1049732321991508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Based on an empirical analysis of video-recorded collaborative practice situations, this article looks at different ways in which a health professional can direct a request to another professional with the aim that he or she performs an action. Using a corpus of video-recorded interactions in different institutional settings and types of situations, it looks at how requests are formulated, showing that they can range from authoritative to mitigated, direct to indirect, and explicit to implicit. The study shows that professionals use a great deal of strategies to preserve politeness and each other's right not to be told what to do, aiming at mitigating the "face-threatening" aspect of requests. However, by doing so, they frequently produce unclear statements which can impede good communication and professional collaboration.
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Affiliation(s)
- David Pichonnaz
- School of Social Work, University of Applied Sciences and Arts Western Switzerland (HES-SO Valais-Wallis), Sierre, Switzerland
| | - Liliane Staffoni
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | - Camille Greppin-Bécherraz
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
| | | | - Veronika Schoeb
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland
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Evaluation of General Practice Pharmacists: Study Protocol to Assess Interprofessional Collaboration and Team Effectiveness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030966. [PMID: 33499259 PMCID: PMC7908139 DOI: 10.3390/ijerph18030966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 11/16/2022]
Abstract
The inclusion of pharmacists into general practices has expanded in Australia. However, there is a paucity of research examining interprofessional collaboration and team effectiveness after including a pharmacist into the general practice team in primary or community care. This is a protocol for a cross-national comparative mixed-methods study to (i) investigate interprofessional collaboration and team effectiveness within the general practice team after employing pharmacists in general practices in the Australian Capital Territory (ACT) and (ii) to compare interprofessional collaboration and team effectiveness of pharmacists in general practice across Australia with international sites. The first objective will be addressed through a multiphase sequential explanatory mixed-method design, using surveys and semi-structured interviews. The study will recruit general practice pharmacists, general practitioners, and other health professionals from eight general practices in the ACT. Quantitative and qualitative results will be merged during interpretation to provide complementary perspectives of interprofessional collaboration. Secondly, a quantitative descriptive design will compare findings on interprofessional collaboration (professional interactions, relationship initiation, exchange characteristics, and commitment to collaboration) and team effectiveness of general practice pharmacists in Australia with international sites from Canada and the United Kingdom. The results of the study will be used to provide recommendations on how to best implement the role of general practice pharmacists across Australia.
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Ansa BE, Zechariah S, Gates AM, Johnson SW, Heboyan V, De Leo G. Attitudes and Behavior towards Interprofessional Collaboration among Healthcare Professionals in a Large Academic Medical Center. Healthcare (Basel) 2020; 8:healthcare8030323. [PMID: 32899937 PMCID: PMC7551229 DOI: 10.3390/healthcare8030323] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 09/01/2020] [Accepted: 09/03/2020] [Indexed: 11/23/2022] Open
Abstract
The increasing rates of comorbidities among patients and the complexity of care have warranted interprofessional collaboration (IPC) as an important component of the healthcare structure. An initial step towards assessing the effectiveness of collaboration requires the exploration of the attitudes and experience of healthcare professionals towards IPC. This online survey aimed to examine the attitudes of healthcare professionals working in a large public academic medical center toward IPC in patient care and the healthcare team, and their behavior and experience regarding IPC. The rankings, according to the perceived importance among the respondents, of the four Interprofessional Education Collaborative (IPEC) core competencies (values/ethics, roles/responsibilities, interprofessional communication, teams/teamwork) were assessed. There were strong but varying levels of consensus among healthcare professionals (N = 551) that IPC facilitates efficient patient care, improves patient problem-solving ability, and increases better clinical outcomes for patients. They acknowledged that IPC promotes mutual respect within the healthcare team and providers’ ability to make optimal patient care decisions. However, overall more than 35% of the respondents did not attend multidisciplinary education sessions (grand rounds, seminars, etc.), and about 23% did not participate in bedside patient care rounds. Interprofessional communication was ranked as the most important IPEC core competence. Although the attitude towards IPC among healthcare professionals is strongly positive, many healthcare professionals face challenges in participating in IPC. Institutional policies that facilitate interprofessional learning and interactions for this group of healthcare professionals should be formulated. Online distance learning and interactions, and simulation-enhanced interprofessional education, are options for addressing this barrier. Hospital administrators should facilitate conducive work environments that promote IPC, based on IPEC core competencies, and promote programs that address the challenges of IPC.
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Affiliation(s)
- Benjamin E. Ansa
- Applied Health Sciences Program, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA; (S.Z.); (A.M.G.); (S.W.J.)
- Institute of Public and Preventive Health, Augusta University, Augusta, GA 30912, USA
- Correspondence: (B.E.A.); (G.D.)
| | - Sunitha Zechariah
- Applied Health Sciences Program, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA; (S.Z.); (A.M.G.); (S.W.J.)
- Morrison Healthcare, Sandy Springs, GA 30350, USA
| | - Amy M. Gates
- Applied Health Sciences Program, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA; (S.Z.); (A.M.G.); (S.W.J.)
- Neonatal Intensive Care Unit, Augusta University Health, Augusta, GA 30912, USA
| | - Stephanie W. Johnson
- Applied Health Sciences Program, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA; (S.Z.); (A.M.G.); (S.W.J.)
- Occupational Therapy, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA
| | - Vahé Heboyan
- Health Economics and Modeling Division, Population Health Sciences Department, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA;
| | - Gianluca De Leo
- Department of Interdisciplinary Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA 30921, USA
- Correspondence: (B.E.A.); (G.D.)
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Chodzaza E, Mbiza C, Gadama L, Kafulafula U. Midwives' and Medical professionals' perspectives of collaborative practice at Queen Elizabeth Central Hospital Maternity Unit, Malawi: The discovery phase of an appreciative inquiry project. Malawi Med J 2020; 32:13-18. [PMID: 32733654 PMCID: PMC7366164 DOI: 10.4314/mmj.v32i1.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background This paper reports on part of a larger study, the aim of which was to develop an intervention to collaboratively develop innovative strategies to promote effective collaborative practices among midwives and medical professionals working in intrapartum care unit. Collaborative practice is a critical marker for success in improving quality of maternity care. To date, there has been limited exploration of collaborative practices between midwives and medical professionals working in intrapartum care from the African perspective. Aim This paper reports findings of the discovery phase of appreciative inquiry (AI) set out to understand the perspectives of midwives and medical professionals on collaborative practices at Queen Elizabeth Central Hospital labour and delivery ward in Malawi. Methods The study used an exploratory qualitative approach framed in an Appreciative Inquiry theoretical perspective. Appreciative Inquiry consists of four phases :(discovery, dream, design and destiny).The discovery phase consisted of 16 in-depth interviews and 2 focus group discussions among purposively selected midwives (4 nurse midwives, 2 midwifery unit matrons) and medical professionals (2 obstetricians, 4 registrars, 2 intern doctors, 2 clinical officers) working in the labour ward. All interviews and discussions were audiotaped and transcribed verbatim. Data were analysed using thematic analysis. Results Five dominant themes emerged: collaborative breakdown, benefits of collaboration, the importance of positive and respectful attitude, barriers to effective collaborative practices and strategies to improve collaborative practice. Conclusion/Recommendations Aligning the perspectives of the members of the two disciplines is significant to effective implementation of collaborative intrapartum care. Participants demonstrated that there is increased parallel working of midwives and doctors at QECH. This is not professionally healthy. Therefore, putting together the viewpoints of the professions to create a mutually agreeable professional framework of collaborative intrapartum practice is significant. Additionally, there is an obvious need to address the professional concerns of both disciplines.
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Affiliation(s)
- Elizabeth Chodzaza
- University of Malawi Kamuzu College of Nursing, Faculty of Midwifery, Neonatal and Reproductive Health Studies, Blantyre, Malawi
| | - Christina Mbiza
- Queen Elizabeth Central Hospital, Department of Obstetrics and Gynecology, Blantyre, Malawi
| | - Luis Gadama
- University of Malawi, College of Medicine, School of Medicine, Blantyre, Malawi
| | - Ursula Kafulafula
- University of Malawi Kamuzu College of Nursing, Faculty of Midwifery, Neonatal and Reproductive Health Studies, Blantyre, Malawi
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Steeb DR, Miller ML, Schellhase EM, Malhotra JV, McLaughlin JE, Dascanio SA, Haines ST. Global Health Learning Outcomes in Pharmacy Students Completing International Advanced Pharmacy Practice Experiences. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2020; 84:7586. [PMID: 32313278 PMCID: PMC7159007 DOI: 10.5688/ajpe7586] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 08/04/2019] [Indexed: 05/21/2023]
Abstract
Objective. To examine the global health learning outcomes of Doctor of Pharmacy (PharmD) students from three US schools who participated in international advanced pharmacy practice experiences (APPEs). Methods. A mixed-methods, prospective study was used to assess fourth-year PharmD students at three US pharmacy schools who participated in an international APPE during the 2017-2018 academic year and a matched cohort (control group) of PharmD students who did not participate in an international APPE. To evaluate students' self-perceived growth in the Consortium of Universities for Global Health (CUGH) competencies, all students completed a 13-item retrospective pre-post instrument using a five-point Likert scale. The students who had completed an international APPE were invited to participate in a focus group (N=22). Paired and independent t tests and multiple linear regression were used to analyze data. Qualitative open-ended questions and focus group data were mapped to knowledge, skills, and attitudes themes. Results. The students who completed an international APPE (N=81) showed significantly more growth in CUGH competencies than students who did not (mean improvement in total score of 10.3 [7.0] vs 2.4 [6.0]). International APPE participation was the only significant predictor of growth in CUGH competencies. The international APPE students reported improvements in cultural awareness and appreciation, communication skills, problem-solving skills, adaptability, self-awareness, personal and professional outlook, and global health perspective. Conclusion. Pharmacy students' participation in international APPEs led to significant improvement in all CUGH competencies. The CUGH competency framework appears to be a suitable instrument to assess pharmacy students' global health learning outcomes.
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Affiliation(s)
- David R. Steeb
- University of North Carolina at Chapel Hill, UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina
| | | | | | - Jodie V. Malhotra
- University of Colorado, Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado
| | - Jacqueline E. McLaughlin
- University of North Carolina at Chapel Hill, UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina
| | - Sarah A. Dascanio
- University of North Carolina at Chapel Hill, UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina
| | - Stuart T. Haines
- University of Mississippi, School of Pharmacy, Jackson, Mississippi
- Editorial Board Member, American Journal of Pharmaceutical Education, Arlington, Virginia
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Abstract
AIM This article describes the process of developing the Nursing Global Health Competencies Framework. BACKGROUND Despite progress in the identification of global health competencies in nursing education, a theoretical underpinning to guide curriculum development and research in global health nursing was needed. METHOD Scoping review of the literature; deduction. DISCUSSION The framework contains one dimension, nursing core value and principles, delineated with seven subcategories: social justice and equity, holistic care, advocacy, health as human right, sustainability, advocacy, and collaboration. The framework also contains four assumptions: environmental focus, care focus, education focus, and competency leveling. CONCLUSION A framework for global health in nursing education is critical to guide the development of competencies and relevant curricula to reflect the core values and principles of nursing. The literature germane to global health nursing was synthesized to define the relationships of core values in a graphic framework that depicts the essential concepts.
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Costa MVD, Azevedo GD, Vilar MJP. Aspectos institucionais para a adoção da Educação Interprofissional na formação em enfermagem e medicina. SAÚDE EM DEBATE 2019. [DOI: 10.1590/0103-11042019s105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Os marcos teórico-conceituais e metodológicos da Educação Interprofissional (EIP) em saúde vêm sendo amplamente reconhecidos em todo o mundo como úteis para o desenvolvimento de competências colaborativas para o efetivo trabalho em equipe. O artigo teve como objetivo explorar as percepções de estudantes de enfermagem e medicina sobre os fatores institucionais que interferem na adoção de iniciativas de EIP em seus contextos de formação. Trata-se de um estudo de caso, que adotou a abordagem qualitativa e a perspectiva exploratória. Os participantes da pesquisa foram estudantes de enfermagem e medicina de duas universidades públicas de um estado do Nordeste - uma estadual e outra federal. O grupo focal foi escolhido para coleta de dados, e foi utilizada a técnica de análise de conteúdo categorial, observando as fases de pré-análise, exploração do material e tratamento dos resultados. Três categorias temáticas foram construídas a posteriori: a importância do trabalho em equipe, contextos institucionais para adoção da EIP e desafios para a adoção da EIP. Embora as realidades pesquisadas apresentem avanços nas mudanças curriculares, como a aproximação do ensino com a realidade dos serviços, a adoção de métodos mais ativos para a formação de sujeitos críticos e reflexivos, ainda são notórias as lacunas no desenvolvimento de competências colaborativas.
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Yeh HC, Huang SY, Chen TY, Hsieh MC. An objective structured teaching exercise for faculty training and assessment of teaching ability in interprofessional collaborative practice and education. Tzu Chi Med J 2019; 31:188-191. [PMID: 31258296 PMCID: PMC6559028 DOI: 10.4103/tcmj.tcmj_163_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 06/29/2018] [Accepted: 09/06/2018] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Improving clinical teachers' ability to teach interprofessional collaborative practice warrants development in current faculty training programs; in particular, current education training emphasizes experiential learning and multiple teaching strategies. The purpose of this study was to establish a teaching model to apply interdisciplinary collaborative care and to improve clinical teachers' execution of interprofessional practices. MATERIALS AND METHODS Health-care faculty members were studied; this study assessed a teacher education curriculum for interprofessional education (IPE) and applied an objective structured teaching exercise (OSTE) to evaluate IPE execution by clinical teachers. RESULTS The OSTE improved clinical teachers' IPE execution, verifying the necessity for multistrategy teaching in faculty training programs. CONCLUSIONS This study provides different types of interprofessional faculty training and assessments. Development of an OSTE requires long-term planning, and IPE should also be incorporated into formal programs.
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Affiliation(s)
- Hsiu-Chen Yeh
- Department of Nursing, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- Department of Medical Education, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Sin-Yi Huang
- Department of Pharmacy, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Tsung-Ying Chen
- Department of Medical Education, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- School of Medicine, College of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Ming-Chen Hsieh
- Department of Medical Education, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
- School of Medicine, College of Medicine, Tzu Chi University, Hualien, Taiwan
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Dagenais R, Pawluk SA, Rainkie D, Wilby KJ. Team-Based Decision-Making in an Objective Structured Clinical Examination (OSCE): Are Pre-Licensure Healthcare Students "Collaborative Practice-Ready"? Innov Pharm 2018; 9:1-8. [PMID: 34007716 DOI: 10.24926/iip.v9i3.1255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Evaluation of pre-licensure students' competency in team-based decision-making is lacking. The purposes of this study were to evaluate pre-licensure pharmacy students' competency in team-based decision-making in the context of an objective structured clinical examination (OSCE), and to determine whether performance correlated with reflective assignment scores. Students' self-assessment and conceptualization of team-based decision-making in practice was also evaluated. Twenty-three pre-licensure pharmacy students' competency in team-based decision-making was evaluated in an OSCE station and with a reflective journal assignment; rubric scores for both evaluations were compared using Spearman's rank order analysis. Students completed an 18-item questionnaire regarding attitudes, confidence, and perceptions related to team-based decision-making. Descriptive statistics and construct analysis with open coding were used to analyse questionnaire results. Mean OSCE station and reflective journal scores were 45% and 66.3%, respectively, and were not correlated. Students' attitudes toward team-based decision-making were positive, and they reported performing associated behaviours during experiential education rotations. Students appropriately defined 'team-based decision-making' and were highly confident in performing related activities. However, students' conceptualization of team-based decision-making did not align with the pharmacy program's competency framework. Three key themes were identified through the study analyses: 1) student performance is dependent on assessment context when evaluating collaborator-related competencies; 2) there is a mismatch between students' perceived competency and objectively measured competence when collaborator outcomes were assessed within an OSCE; and 3) students' perceptions of team-based decision-making do not align with the program's competency framework. Future research is necessary to assess competency and perceptions of team-based decision-making in students from other healthcare professions, and to further evaluate whether pre-licensure students are "collaborative practice ready".
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Affiliation(s)
- Renee Dagenais
- Faculty of Pharmaceutical Sciences, University of British Columbia
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Roles, Responsibilities, and Implications of Health Care Practitioners Providing Interprofessional Collaborative Practice to the Geriatric Population. TOPICS IN GERIATRIC REHABILITATION 2018. [DOI: 10.1097/tgr.0000000000000189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Vestergaard E, Nørgaard B. Interprofessional collaboration: An exploration of possible prerequisites for successful implementation. J Interprof Care 2017; 32:185-195. [PMID: 29144793 DOI: 10.1080/13561820.2017.1363725] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Poor collaboration among professional groups may be a major cause of incoherent patient pathways in hospital settings. For over a decade, interprofessional collaboration (IPC) have been stressed as an effective method to enhance the delivery of patient care. This article presents a theory-based stakeholder evaluation of the implementation of an intervention aiming to implement the concept of IPC in a Danish regional hospital from 2012 to 2015. Involving five departments and eight professions, the intervention aimed at developing coherent practices across health professions by optimising patient pathways with the establishment of interprofessional teams as a core element. The evaluation assessed the professionals' views of the intervention. Data were collected through focus group interviews and document analysis. We found that a strengthened focus on patient pathways, well-trained instructors, and an evidence-based strategy for implementation facilitates the success of interventions with a focus on IPC in hospital settings. We furthermore found that cultural and organisational factors are barriers to the implementation of IPC practices, that interruptions of uni-professional work may hamper coordination across professions, and that the interprofessional teams may form new isolated organisational structures.
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Affiliation(s)
- Erik Vestergaard
- a Department of Orthopaedic and Surgery and Traumatology , Kolding Hospital, Lillebaelt Hospital , Kolding , Denmark
| | - Birgitte Nørgaard
- b Department of Public Health , University of Southern Denmark , Odense , Denmark
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McInnes S, Peters K, Bonney A, Halcomb E. Understanding collaboration in general practice: a qualitative study. Fam Pract 2017; 34:621-626. [PMID: 28334812 DOI: 10.1093/fampra/cmx010] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND An increased incidence of chronic and complex conditions in the community is placing pressure on human resources in general practice. Improving collaboration between GPs and registered nurses may help alleviate workforce stressors and enhance health outcomes. OBJECTIVE To explore the facilitators and challenges of collaboration between GPs and registered nurses in Australian general practice. METHODS Eight GPs and 14 registered nurses from general practices in New South Wales, Australia, participated in semi-structured face-to-face interviews. Recordings were transcribed verbatim and underwent thematic analysis. RESULTS The overarching theme 'Understanding collaboration in general practice' comprises four sub-themes, namely (i) interpreting collaboration in general practice, (ii) modes of communication, (iii) facilitators of collaboration and (iv) collaboration in practice. CONCLUSION Our findings suggest that regular, formal avenues of communication, professional development and non-hierarchical environments facilitated collaboration between nurses and GPs. Implementing strategies to promote these features has the potential to improve inter-professional collaboration and quality of care within primary care.
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Affiliation(s)
- Susan McInnes
- School of Nursing, University of Wollongong, Wollongong, Australia
| | - Kath Peters
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Andrew Bonney
- School of Medicine, University of Wollongong, Wollongong, Australia
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Gilbert Hunt S. Sylvia Rodger's contribution to a dynamic and diverse curriculum and education evidence base. Aust Occup Ther J 2017; 64 Suppl 1:45-48. [DOI: 10.1111/1440-1630.12404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Susan Gilbert Hunt
- School of Health Sciences; University of South Australia; Adelaide South Australia Australia
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O’Reilly P, Lee SH, O’Sullivan M, Cullen W, Kennedy C, MacFarlane A. Assessing the facilitators and barriers of interdisciplinary team working in primary care using normalisation process theory: An integrative review. PLoS One 2017; 12:e0177026. [PMID: 28545038 PMCID: PMC5436644 DOI: 10.1371/journal.pone.0177026] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 03/24/2017] [Indexed: 11/19/2022] Open
Abstract
Background Interdisciplinary team working is of paramount importance in the reform of primary care in order to provide cost-effective and comprehensive care. However, international research shows that it is not routine practice in many healthcare jurisdictions. It is imperative to understand levers and barriers to the implementation process. This review examines interdisciplinary team working in practice, in primary care, from the perspective of service providers and analyses 1 barriers and facilitators to implementation of interdisciplinary teams in primary care and 2 the main research gaps. Methods and findings An integrative review following the PRISMA guidelines was conducted. Following a search of 10 international databases, 8,827 titles were screened for relevance and 49 met the criteria. Quality of evidence was appraised using predetermined criteria. Data were analysed following the principles of framework analysis using Normalisation Process Theory (NPT), which has four constructs: sense making, enrolment, enactment, and appraisal. The literature is dominated by a focus on interdisciplinary working between physicians and nurses. There is a dearth of evidence about all NPT constructs apart from enactment. Physicians play a key role in encouraging the enrolment of others in primary care team working and in enabling effective divisions of labour in the team. The experience of interdisciplinary working emerged as a lever for its implementation, particularly where communication and respect were strong between professionals. Conclusion A key lever for interdisciplinary team working in primary care is to get professionals working together and to learn from each other in practice. However, the evidence base is limited as it does not reflect the experiences of all primary care professionals and it is primarily about the enactment of team working. We need to know much more about the experiences of the full network of primary care professionals regarding all aspects of implementation work. Systematic review registration International Prospective Register of Systematic Reviews PROSPERO 2015: CRD42015019362.
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Affiliation(s)
- Pauline O’Reilly
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, University of Limerick, Limerick, Republic of Ireland
- * E-mail:
| | - Siew Hwa Lee
- School of Nursing and Midwifery, Robert Gordon University, Aberdeen, United Kingdom
| | - Madeleine O’Sullivan
- Graduate Entry Medical School (GEMS), Faculty of Education and Health Sciences & Health Research Institute, University of Limerick, Limerick, Republic of Ireland
| | - Walter Cullen
- School of Medicine and Medical Sciences, University College Dublin, Dublin, Republic of Ireland
| | - Catriona Kennedy
- School of Nursing and Midwifery, Robert Gordon University, Aberdeen, United Kingdom
| | - Anne MacFarlane
- Graduate Entry Medical School (GEMS), Faculty of Education and Health Sciences & Health Research Institute, University of Limerick, Limerick, Republic of Ireland
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Parker-Tomlin M, Boschen M, Morrissey S, Glendon I. Cognitive continuum theory in interprofessional healthcare: A critical analysis. J Interprof Care 2017; 31:446-454. [PMID: 28388258 DOI: 10.1080/13561820.2017.1301899] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Effective clinical decision making is among the most important skills required by healthcare practitioners. Making sound decisions while working collaboratively in interprofessional healthcare teams is essential for modern healthcare planning, successful interventions, and patient care. The cognitive continuum theory (CCT) is a model of human judgement and decision making aimed at orienting decision-making processes. CCT has the potential to improve both individual health practitioner, and interprofessional team understanding about, and communication of, clinical decision-making processes. Examination of the current application of CCT indicates that this theory could strengthen interprofessional team clinical decision making (CDM). However, further research is needed before extending the use of this theoretical framework to a wider range of interprofessional healthcare team processes. Implications for research, education, practice, and policy are addressed.
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Affiliation(s)
- Michelle Parker-Tomlin
- a School of Applied Psychology , Griffith University , Southport , Queensland , Australia
| | - Mark Boschen
- a School of Applied Psychology , Griffith University , Southport , Queensland , Australia
| | - Shirley Morrissey
- a School of Applied Psychology , Griffith University , Southport , Queensland , Australia
| | - Ian Glendon
- a School of Applied Psychology , Griffith University , Southport , Queensland , Australia
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Owusu Y, Medakkar P, Akinnawo EM, Stewart-Pyne A, Ashu EE, Hammond R, Plata J, Pierre K, Farag E. Emigration of skilled healthcare workers from developing countries: can team-based healthcare practice fill the gaps in maternal, newborn and child healthcare delivery? Int J MCH AIDS 2017; 6:130-138. [PMID: 29367888 PMCID: PMC5777387 DOI: 10.21106/ijma.204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND INTRODUCTION Emigration of healthcare workers from developing countries is on the rise and there is an urgent need for policies that increase access to and continuity of healthcare. In this commentary, we highlight some of the negative impacts of emigration on maternal and child health and discuss whether team-based healthcare delivery could possibly mitigate the shortfall of maternal and child health professionals in developing countries. METHODOLOGY We cross-examine the availability of supporting structures to implement team-based maternal and child healthcare delivery in developing countries. We briefly discuss three key supporting structures: culture of sharing, telecommunication, and inter-professional education. Supporting structures are examined at system, organizational and individual levels. We argue that the culture of sharing, limited barriers to inter-professional education and increasing access to telecommunication will be advantageous to implementing team-based healthcare delivery in developing countries. CONCLUSION AND GLOBAL HEALTH IMPLICATIONS Although most developing countries may have notable supporting structures to implement team-based healthcare delivery, the effectiveness of such models in terms of cost, time and infrastructure in resource limited settings is still to be evaluated. Hence, we call on usual stakeholders, government, regulatory colleges and professional associations in countries with longstanding emigration of maternal and child healthcare workers to invest in establishing comprehensive models needed to guide the development, implementation and evaluation of team-based maternal and child healthcare delivery.
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Affiliation(s)
- Yaw Owusu
- Registered Nurses' Association of Ontario, 158 Pearl St., Toronto, Ontario, CANADA M5H-1L3
| | - Prerana Medakkar
- York University, 158 St. George Street, Toronto, ON, M5S 2V8 CANADA
| | - Elizabeth M Akinnawo
- GlaxoSmithKline, 7333 Mississauga Road North, Mississauga, Ontario, L5N 6L4, CANADA
| | - Althea Stewart-Pyne
- Registered Nurses' Association of Ontario, 158 Pearl St., Toronto, Ontario, CANADA M5H-1L3
| | - Eta E Ashu
- The Center for Global Health and Health Policy, Global Health and Education Projects, Inc., PO Box 234, Riverdale, Maryland 20738, USA
| | - Rodney Hammond
- Department of Public Health, Montclair State University, 1 Normal Avenue, University Hall Room 4162, Montclair NJ 07043, USA
| | - Jesus Plata
- Department of Public Health, Montclair State University, 1 Normal Avenue, University Hall Room 4162, Montclair NJ 07043, USA
| | - Kimberly Pierre
- Department of Public Health, Montclair State University, 1 Normal Avenue, University Hall Room 4162, Montclair NJ 07043, USA
| | - Ehsan Farag
- Department of Public Health, Montclair State University, 1 Normal Avenue, University Hall Room 4162, Montclair NJ 07043, USA
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Costa MVD, Borges FA. O Pró-PET-Saúde frente aos desafios do processo de formação profissional em saúde. INTERFACE-COMUNICACAO SAUDE EDUCACAO 2015. [DOI: 10.1590/1807-57622014.1057] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Este artigo busca explorar as principais mudanças induzidas pelas atuais políticas de reorientação da formação profissional em saúde, mais especificamente, o Programa Nacional de Reorientação da Formação Profissional em Saúde e o Programa de Educação pelo Trabalho para a Saúde – Pró-PET Saúde. Foram utilizados como fonte de dados os relatórios das instituições e de assessoria do Ministério da Saúde que se encontram disponibilizados na Plataforma FORMSUS. Foi adotada a análise de conteúdo temática como técnica de análise dos dados. O Pró-PET-Saúde vem induzindo mudanças nevrálgicas na formação em saúde: fortalecimento da articulação ensino/serviço; diversificação dos cenários de práticas e inovação dos métodos de ensino; fomento à pesquisa em articulação com as necessidades sociais e de saúde e estimulando a educação interprofissional.
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Abstract
Australia, in common with most developed countries, needs to reorientate its health system to meet the needs of the future. There is general acceptance that the current approach geared towards acute episodic care is no longer fit for purpose. This article explores the concept of integration in healthcare in Australia and specifically describes the role of clinicians over the last five years in brokering and supporting change in the way services are delivered.
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Affiliation(s)
- Jenny May
- University of Newcastle Department of Rural Health, Tamworth, NSW, Australia
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Eika M, Dale B, Espnes GA, Hvalvik S. Nursing staff interactions during the older residents' transition into long-term care facility in a nursing home in rural Norway: an ethnographic study. BMC Health Serv Res 2015; 15:125. [PMID: 25888843 PMCID: PMC4380253 DOI: 10.1186/s12913-015-0818-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 03/23/2015] [Indexed: 11/10/2022] Open
Abstract
Background Future challenges in many countries are the recruitment of competent staff in long-term care facilities, and the use of unlicensed staff. Our study describes and explores staff interactions in a long-term care facility, which may facilitate or impede healthy transition processes for older residents in transition. Methods An ethnographic study based on fieldwork following ten older residents admission day and their initial week in the long-term care facility, seventeen individual semi-structured interviews with different nursing staff categories and the leader of the institution, and reading of relevant documents. Results The interaction among all staff categories influenced the new residents’ transition processes in various ways. We identified three main themes: The significance of formal and informal organization; interpersonal relationships and cultures of care; and professional hierarchy and different scopes of practice. Conclusions The continuous and spontaneous staff collaborations were key activities in supporting quality care in the transition period. These interactions maintained the inclusion of all staff present, staff flexibility, information flow to some extent, and cognitive diversity, and the new resident’s emerging needs appeared met. Organizational structures, staff’s formal position, and informal staff alliances were complex and sometimes appeared contradictory. Not all the staff were necessarily included, and the new residents’ needs not always noticed and dealt with. Paying attention to the playing out of power in staff interactions appears vital to secure a healthy transition process for the older residents.
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Affiliation(s)
- Marianne Eika
- Department of Social Work and Health Science, Faculty of Social Sciences and Technology Management, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway. .,Telemark University College, Faculty of Health and Social Studies, Post box 203, , NO-3901, Porsgrunn, Norway. .,Center for Caring Research, Telemark University College, Post box 203, , 3901, Porsgrunn, Norway.
| | - Bjørg Dale
- Department of Health and Nursing Sciences, Agder University, Campus Grimstad, Post box 509, , N-4898, Grimstad, Norway. .,Center for Caring Research - Southern Norway, Campus Grimstad, Post box 509, , N-4898, Grimstad, Norway.
| | - Geir Arild Espnes
- Department of Social Work and Health Science, Faculty of Social Sciences and Technology Management, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway.
| | - Sigrun Hvalvik
- Telemark University College, Faculty of Health and Social Studies, Post box 203, , NO-3901, Porsgrunn, Norway. .,Center for Caring Research, Telemark University College, Post box 203, , 3901, Porsgrunn, Norway.
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Regan S, Orchard C, Khalili H, Brunton L, Leslie K. Legislating interprofessional collaboration: A policy analysis of health professions regulatory legislation in Ontario, Canada. J Interprof Care 2015; 29:359-64. [DOI: 10.3109/13561820.2014.1002907] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ness O, Karlsson B, Borg M, Biong S, Sundet R, McCormack B, Kim HS. Towards a model for collaborative practice in community mental health care. ACTA ACUST UNITED AC 2014. [DOI: 10.15714/scandpsychol.1.e6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Psaila K, Kruske S, Fowler C, Homer C, Schmied V. Smoothing out the transition of care between maternity and child and family health services: perspectives of child and family health nurses and midwives'. BMC Pregnancy Childbirth 2014; 14:151. [PMID: 24766674 PMCID: PMC4016663 DOI: 10.1186/1471-2393-14-151] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Accepted: 04/14/2014] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND In Australia, women who give birth are transitioned from maternity services to child and health services once their baby is born. This horizontal integration of services is known as Transition of Care (ToC). Little is known of the scope and processes of ToC for new mothers and the most effective way to provide continuity of services. The aim of this paper is to explore and describe the ToC between maternity services to CFH services from the perspective of Australian midwives and child and family health (CFH) nurses. METHOD This paper reports findings from phase two of a three phase mixed methods study investigating the feasibility of implementing a national approach to CFH services in Australia (the CHoRUS study). Data were collected through a national survey of midwives (n = 655) and CFH nurses (n = 1098). Issues specifically related to ToC between maternity services and CFH services were examined using descriptive statistics and content analysis of qualitative responses. RESULTS Respondents described the ToC between maternity services and CFH services as problematic. Key problems identified included communication between professionals and services and transfer of client information. Issues related to staff shortages, early maternity discharge, limited interface between private and public health systems and tension around role boundaries were also reported. Midwives and CFH nurses emphasised that these issues were more difficult for families with identified social and emotional health concerns. Strategies identified by respondents to improve ToC included improving electronic transfer of information, regular meetings between maternity and CFH services, and establishment of liaison roles. CONCLUSION Significant problems exist around the ToC for all families but particularly for families with identified risks. Improved ToC will require substantial changes in information transfer processes and in the professional relationships which currently exist between maternity and CFH services.
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Affiliation(s)
- Kim Psaila
- School of Nursing and Midwifery, University of Western Sydney, Sydney, Australia
| | - Sue Kruske
- Director Queensland Centre for Mothers & Babies, The University of Queensland, Brisbane, Queensland, Australia
| | - Cathrine Fowler
- Tresillian Chair for Child & Family Health, Centre for Midwifery, Child & Family Health, Faculty of Nursing, Midwifery & Health, University of Technology Sydney, Australia
| | - Caroline Homer
- Faculty of Nursing, Midwifery & Health, University of Technology Sydney, Sydney, Australia
| | - Virginia Schmied
- School of Nursing and Midwifery & the Family and Community Health Research Group, University of Western Sydney, Sydney, Australia
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Tyastuti D, Onishi H, Ekayanti F, Kitamura K. Psychometric item analysis and validation of the Indonesian version of the Readiness for Interprofessional Learning Scale (RIPLS). J Interprof Care 2014; 28:426-32. [DOI: 10.3109/13561820.2014.907778] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Stringer K, Curran V, Asghari S. Pharmacists and family physicians: improving interprofessional collaboration through joint understanding of our competencies. Front Pharmacol 2013; 4:151. [PMID: 24367335 PMCID: PMC3852059 DOI: 10.3389/fphar.2013.00151] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 11/19/2013] [Indexed: 11/28/2022] Open
Affiliation(s)
- Katherine Stringer
- Discipline of Family Medicine, Faculty of Medicine, Memorial University of NewfoundlandSt. John's, NL, Canada
| | - Vernon Curran
- Faculty of Medicine, Memorial University of NewfoundlandSt. John's, NL, Canada
| | - Shabnam Asghari
- Discipline of Family Medicine, Faculty of Medicine, Memorial University of NewfoundlandSt. John's, NL, Canada
- Primary Health Care Research Unit, Faculty of Medicine, Memorial University of NewfoundlandSt. John's, NL, Canada
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Hoffman SJ, Frenk J. Producing and translating health system evidence for improved global health. J Interprof Care 2012; 26:4-5. [PMID: 22233362 DOI: 10.3109/13561820.2011.577626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Youth health: a challenge for primary care. Prim Health Care Res Dev 2011; 12:281-3. [DOI: 10.1017/s1463423611000429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Rodger S, J. Hoffman S. Where in the world is interprofessional education? A global environmental scan. J Interprof Care 2010; 24:479-91. [DOI: 10.3109/13561821003721329] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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