To collaborate or not-to-collaborate? Behavioral-antecedents and mediating role of intraprofessional collaborative behavior on performance of community pharmacists: A modeling study

Extensive research exists on collaborative behavior between healthcare professionals with different skill sets (interprofessional collaboration). However, research is scarce and evolving on collaborative behavior among members of the same profession (intraprofessional collaboration), community pharmacists in particular. Based on the theory of reasoned action, a hypothetical structural model was developed to evaluate the impact of behavioral antecedents: competitive behavior (CB), knowledge-sharing behavior (KSB), and customer-focused behavior (CFB), and the mediating effects of collaborative behavior (CTB) on work performance (WP) of community pharmacists in southwestern Nigeria. We used a cross-sectional questionnaire-based survey of randomly selected community pharmacists (N = 646). Structural equation modeling was used to test hypotheses. The model had an acceptable fit and data quality. The model showed that CB, KSB, and CFB exert a significant direct influence on CTB. Only CFB significantly influenced WP compared to other antecedents and CTB. The absence of mediating effects of CTB suggests a gap in intraprofessional practice with implications for interprofessional collaboration and performance among community pharmacists. We conclude from our results that overall work performance is enhanced when community pharmacists encourage and adopt a collaborative culture. This culture strengthens the benefits of shared experiential knowledge, focus on patients' welfare, and healthy competition.

Igniting a Movement in a Dual Licensed Dental Workforce: The Minnesota Model

Increased awareness of oral health disparities in the United States has highlighted the need to expand the workforce and access to both primary and preventive dental care. Achieving oral health equity will require new dental team members with appropriate clinical skills dedicated to reaching historically marginalized populations through intra and interprofessional practice. Collective efforts by health care advocates in Minnesota led to legislation that created a dental hygiene-based workforce model inspired by the vision and foresight of the American Dental Hygienists' Association's "Advanced Dental Hygiene Practitioner." In July 2023, there were 141 licensed dental therapists and 99 certified advanced dental therapists, with the majority being dual-licensed dental hygienists/dental therapists, providing primary care services in a variety of settings throughout the state. Current data confirm their contributions to increasing access to primary oral health care services for Minnesotans across the lifespan. While surmountable challenges remain, new opportunities are emerging for dental therapists within Minnesota's transforming health care system. The purpose of this paper is to describe the implementation of this new workforce model in Minnesota, its challenges and successes to assist other states in developing new models for intraprofessional dental team members.

Defining the role of individuals prepared as a doctor of nurse practice in symptoms science research

PURPOSE

The Doctor of Nursing Practice (DNP) programs have grown exponentially for the last 10 years across the United States. However, the intra-professional collaboration among DNP and PhD scholars is not clearly demonstrated in the literature as it relates to frequency, training models, and the outcomes of these collaborations on translation. The purposes of this paper are to: (1) examine the role for DNP nurses in symptom science research and (2) describe training models to cultivate the PhD-DNP collaboration to strengthen the translation of discoveries from nursing research, to facilitate implementation of discoveries, and to improve clinical practice of nurses.

METHODS

A targeted review of the literature was conducted to identify, (1) the role of the DNP, (2) examples of PhD-DNP collaborations, (3) training models that support collaborations, and (4) the outcomes of these intra-professional collaborations.

RESULTS

Two articles reported on PhD-DNP collaboration within a university setting; however, they did not address how the partnership was modeled. One additional article described an academic-hospital partnership model aimed at MSN-prepared advanced practice nurses (APRN) by which outcomes were measured. No examples were found outside of academic settings. The National Institute of Nursing Research (NINR) has established the Symptom Science Center (SSC) with an interest in training the next generation of symptom scientists. By developing a training curriculum through the NINR SSC, DNP-prepared students and practitioners can be exposed to the research enterprise and potentially develop early partnerships with PhD-prepared students and scholars that lead to research translation.

CONCLUSION

The NINR Department of Intramural Research (DIR) and National Institutes of Health Clinical Center are dedicated to building stronger ties between PhD- and DNP-prepared scientists. The SSC can serve as an optimal platform to promote the collaboration of PhD and DNP nurses to advance symptom science translation.

CLINICAL RELEVANCE

Nurses have a remarkable role in early detection of disease progression. Training opportunities to cultivate the PhD-DNP collaboration have significant relevance for expediting the translation of nursing science to nursing practice.

Hospital and Community Pharmacists' Views of and Perspectives on the Establishment of an Intraprofessional Collaboration in the Transition of Care for Newly Discharged Patients

Background

Hospital and community pharmacists are increasingly involved in patients’ medication interventions related to the transition of care from the hospital to a patient’s home. These interventions may enable pharmacists to collaborate across healthcare sector boundaries. However, little is known about pharmacists’ views on intraprofessional collaboration across healthcare sectors and what affects the establishment of such collaboration.

Objectives

The aim of this study was to understand the views and perspectives of hospital pharmacists (HPs) and community pharmacists (CPs) on establishing an intraprofessional collaboration in relation to newly discharging patients.

Methods

Joint focus group interviews with HPs and CPs in the Zealand region of Denmark were conducted. The HPs were employed at the only hospital pharmacy in the region (Region Zealand Hospital Pharmacy). Five HPs and six CPs participated in two focus groups. The focus groups were analyzed using theoretical thematic analysis.

Results

Three themes and seven subthemes were identified. The first theme, “Context”, was divided into two subthemes: “Prioritization of new tasks in the intraprofessional collaboration” and “The lack of insight into the patient’s hospital stay”. The second theme, “The hospital physicians and GPs as the focal points for the HPs’ and CPs’ work”, was divided into three subthemes: “The limitation of the CPs and HPs based on current roles and organizations”, “Lack of regular access to the physician gives the patients more responsibility” and “Lack of support from the GPs for the work conducted by HPs and CPs”. The last theme, “Individuals”, had two subthemes: “The motivation for working intraprofessionally” and “CPs’ hesitancy towards the new tasks in the intraprofessional collaboration”.

Conclusion

Both HPs and CPs are highly influenced by their work context in regard to establishing a new intraprofessional collaboration. Limited resources for intraprofessional collaboration should be taken into account. Likewise, the collaboration should fit into daily routines, which may eliminate hesitancy towards new forms of collaboration and tasks shared between HPs and CPs. The physician was identified as an important key professional, since the work tasks of both HPs and CPs depend on the physician, which in turn limits the capability and success of solely intraprofessional collaboration.

Examining Intraprofessional Competencies for Occupational Therapist and Occupational Therapy Assistant Collaboration

This study examined competencies perceived by occupational therapists and occupational therapy assistants as important for intraprofessional collaboration. While interprofessional practice is well defined, less is known about collaboration within professions with varied levels of practice credentials. Occupational therapy practitioners (N = 351) rated 20 competencies in four domains (Intraprofessional Teamwork, Roles/Responsibilities, Communication, and Values/Ethics) through an online survey. A high percentage of respondents perceived all competencies as important or very important. There were significant differences between occupational therapists and occupational therapy assistants in ratings of five competencies, including: seeking information/support from the team partner, flexibility for effective partnership, engagement in professional development for collaboration, communicating ideas, and providing feedback about performance. Outcomes contribute to understanding intraprofessional collaboration for occupational therapy practice. Competencies can serve as guidelines for education and professional development.