Enhancing an introductory Pharmacy Practice Experience at free medical clinics.

PubMed

Morello, Candis M; Singh, Renu F; Chen, Karen J; Best, Brookie M

2010-02-01

The aim of the study was to assess and improve first-year student pharmacists' satisfaction and learning experience in a Student-Run Free Medical Clinic Project (SFMCP) providing medical care to an underserved population. Two consecutive classes of first-year student pharmacists at the University of California San Diego (UCSD) Skaggs School of Pharmacy and Pharmaceutical Sciences participated in an Introductory Pharmacy Practice Experience (IPPE) at the UCSD SFMCP. This IPPE involved two inter-professional evening free clinics which provide medical care to an underserved population and opportunities for healthcare professional training and service. Year 1 students completed a self-assessment survey instrument and year 2 students completed the survey instrument plus a new competency checklist tool. Average scores from the self-assessment survey instrument were compared between years 1 and 2. Initial survey results showed that students felt the SFMCP was worthwhile; however, they did not experience enough involvement in the patient assistance programme or non-pharmacy-related clinic activities. After the competency checklist tool implementation, overall student pharmacist satisfaction of the SFMCP IPPE remained high (88%), participation in identified weak areas improved and students agreed that the tool helped focus their clinic experience. Areas of improvement were identified with the survey instrument and the competency checklist tool increased achievement of learning objectives. Overall, student pharmacists felt the SFMCP IPPE was a good learning experience. Practising pharmacists can employ these or similar tools in specific practice settings, to evaluate and help ensure that student pharmacists or interns are achieving applicable learning objectives.

Do commencing nursing and paramedicine students differ in interprofessional learning and practice attitudes: evaluating course, socio-demographic and individual personality effects.

PubMed

Hallam, Karen T; Livesay, Karen; Morda, Romana; Sharples, Jenny; Jones, Andi; de Courten, Maximilian

2016-03-03

Interprofessional education (IPE) requires health students to learn with, from and about each other in order to develop a modern workforce with client-centred care at its core. Despite the client centred focus of IPE, training programs often utilize standard approaches across student cohorts without consideration of discipline, sociodemographic and personality variability that attract students to different health disciplines. Knowing the students who engage in IPE to tailor training may prove as beneficial as knowing the client to delivered individualized client centred care in interprofessional practice (IPP). This research investigates whether students commencing undergraduate nursing and paramedicine degrees ener training with existing demographic and personality differences and, if these are associated with different attitudes towards health care teams and interprofessional education. This online study recruited 160 nursing and 50 paramedicine students in their first week of their undergraduate course. Students completed questionnaires regarding their background, personality (General Perceived Self Esteem Scale, International Mini Markers) and the attitudes towards health care teams scale (ATHCTS) and interprofessional education perception scale (IEPS). Results show that commencing nursing and paramedicine students are demographically different on education, gender, speaking a language other than English at home (LOTE) and their own experience with healthcare. The results further demonstrate that LOTE, discipline being studied and personality factors play a role in perceptions regarding interprofessional training whilst discipline being studied impacted on attitudes towards health care teams in the workforce. These results highlight a number of existing personal and psychological differences between individuals who choose to train in these selected professions. This suggests a need for tertiary education IPE programs to move towards tailoring their education to value this student diversity in the same client centred manner that students are asked to develop clinically.

The devil is in the details: the seven deadly sins of organizing and continuing interprofessional education in the US.

PubMed

Clark, Phillip G

2011-09-01

In spite of increased calls for expanding interprofessional practice (IPP) in the US health care system to address concerns about patient safety and quality of care, there has not been a corresponding dramatic growth in interprofessional education (IPE) programs. Indeed, the history of IPE in the US has been a roller-coaster ride of gains and losses, successes and failures. Understanding why this has been so requires the development of a personal and political economy framework, based on an understanding of the structural, ideological, and economic factors and forces that characterize IPE in American higher education. Using a metaphor of the seven deadly sins (lust, pride, greed, gluttony, envy, sloth, and wrath), this discussion focuses on both things that should not be done (sins of commission) and those that should be done but are not (sins of omission) to create successful and sustainable IPE programs. Taken together, these factors help to frame a perspective on IPE that highlights the essential knowledge, attitudes, and skills needed by faculty and administrators to create, implement, and - most importantly - sustain successful programs. Implications of this framework for promoting increased IPE are discussed, particularly with respect to insuring its successful continuation into the future.

The Use of Capacity Ratios in Introductory Pharmacy Practice Experiences

PubMed Central

Haswell, Jamie L.; Byrd, Debbie C.; Foster, Stephan

2012-01-01

Objective. To describe the use of capacity ratios following the assignment of introductory pharmacy practice experiences (IPPEs) to a rising third-year pharmacy (P3) class. Methods. Practice experience availability for IPPEs was collected by means of preceptor response to requests. Following assignment of IPPEs to the rising P3 class, capacity ratios from the IPPEs available across the entire state and within each of 4 geographic zones were calculated. Capacity ratios for both community pharmacy and institutional pharmacy also were calculated. Results. The capacity ratio for IPPEs across the entire state was 2.11, which documents solvency. When the capacity ratios were calculated individually for community pharmacy and institutional pharmacy, solvency was also achieved. Likewise, IPPE capacity ratios were solvent in all 4 geographic zones. Conclusions. Capacity ratios are helpful in evaluating IPPE availability as they can be used to determine practice experience need in either type of practice experience or geographic zone. PMID:23193336

Developing pharmacy student communication skills through role-playing and active learning.

PubMed

Luiz Adrian, Julie Ann; Zeszotarski, Paula; Ma, Carolyn

2015-04-25

To evaluate the impact on pharmacy students of a communication course, which used role-playing to develop active-learning skills. Students role-playing pharmacists in patient care scenarios were critiqued by students and pharmacist faculty members. Grading was performed using the rubric inspired by Bruce Berger's Communication Skills for Pharmacists. Written skills were evaluated using student written critique questionnaires. Students completed precourse and postcourse self-assessment surveys. Preceptor evaluations were analyzed for course impact. Students demonstrated improvement in oral skills based on role-play scores (45.87/50) after practice sessions. The average score based on the student questionnaire was 9.31/10. Gain was demonstrated in all defined course objectives. Impact on introductory pharmacy practice experience (IPPE) communication objectives was insignificant. Student evaluations for course and teaching strategy reflected a high average. Study results demonstrated improvement in oral and written communication skills that may help improve interprofessional teamwork between pharmacists and other health care providers.

Survey highlights the need to expand offerings of introductory pharmacy practice experiences in psychiatry and neurology: Benefits and example experiences.

PubMed

Bostwick, Jolene R; Leung, Gillian P; Smith, Tawny L; Ahmed, Uzma; Bainbridge, Jacquelyn L; Peyronnet, Jean-Xavier

2018-01-01

Introductory pharmacy practice experiences (IPPEs) are 1 requirement schools and colleges of pharmacy must fulfill to meet accreditation standards. The purpose of this manuscript is to report existing IPPEs in psychiatry and neurology across the United States. Two separate electronic surveys were administered to individual College of Psychiatric and Neurologic Pharmacists members with board certification in psychiatric pharmacy with an academic affiliation and academic institutions in the 2014-15 academic year to assess the neuropsychiatric curriculum in pharmacy programs. Results focusing on IPPEs were summarized using descriptive statistics. Academic institutional data reveal only 37.3% offered IPPEs in psychiatry, and 6.7% offered neurology. The number of available IPPEs is low even if a program offered an available rotation. The majority of College of Psychiatric and Neurologic Pharmacists member respondents (69.9%) did not offer IPPEs in psychiatry in the 2014-15 academic year, and none offered an IPPE in neurology. More than half of individual respondents feel their institution should increase IPPEs in psychiatry and neurology in order to enhance their curriculum. To expand IPPE availability, pharmacy programs should increase early exposure of pharmacy students to patients with psychiatric and neurologic conditions. Longitudinal experiences may allow students to engage in hands-on experiences, which may impact future career aspirations and reduce stigma. Current example IPPEs at the authors' institutions are included to stimulate discussion and action among readers on how IPPEs in these practice areas may be developed. Implementation of IPPEs in psychiatry and neurology is needed for students to gain experience working with these patients.

Developing Pharmacy Student Communication Skills through Role-Playing and Active Learning

PubMed Central

Zeszotarski, Paula; Ma, Carolyn

2015-01-01

Objective. To evaluate the impact on pharmacy students of a communication course, which used role-playing to develop active-learning skills. Design. Students role-playing pharmacists in patient care scenarios were critiqued by students and pharmacist faculty members. Grading was performed using the rubric inspired by Bruce Berger’s Communication Skills for Pharmacists. Written skills were evaluated using student written critique questionnaires. Students completed precourse and postcourse self-assessment surveys. Preceptor evaluations were analyzed for course impact. Assessment. Students demonstrated improvement in oral skills based on role-play scores (45.87/50) after practice sessions. The average score based on the student questionnaire was 9.31/10. Gain was demonstrated in all defined course objectives. Impact on introductory pharmacy practice experience (IPPE) communication objectives was insignificant. Student evaluations for course and teaching strategy reflected a high average. Conclusion. Study results demonstrated improvement in oral and written communication skills that may help improve interprofessional teamwork between pharmacists and other health care providers. PMID:25995519

Survey highlights the need to expand offerings of introductory pharmacy practice experiences in psychiatry and neurology: Benefits and example experiences

PubMed Central

2018-01-01

Introduction: Introductory pharmacy practice experiences (IPPEs) are 1 requirement schools and colleges of pharmacy must fulfill to meet accreditation standards. The purpose of this manuscript is to report existing IPPEs in psychiatry and neurology across the United States. Methods: Two separate electronic surveys were administered to individual College of Psychiatric and Neurologic Pharmacists members with board certification in psychiatric pharmacy with an academic affiliation and academic institutions in the 2014-15 academic year to assess the neuropsychiatric curriculum in pharmacy programs. Results focusing on IPPEs were summarized using descriptive statistics. Results: Academic institutional data reveal only 37.3% offered IPPEs in psychiatry, and 6.7% offered neurology. The number of available IPPEs is low even if a program offered an available rotation. The majority of College of Psychiatric and Neurologic Pharmacists member respondents (69.9%) did not offer IPPEs in psychiatry in the 2014-15 academic year, and none offered an IPPE in neurology. More than half of individual respondents feel their institution should increase IPPEs in psychiatry and neurology in order to enhance their curriculum. Discussion: To expand IPPE availability, pharmacy programs should increase early exposure of pharmacy students to patients with psychiatric and neurologic conditions. Longitudinal experiences may allow students to engage in hands-on experiences, which may impact future career aspirations and reduce stigma. Current example IPPEs at the authors' institutions are included to stimulate discussion and action among readers on how IPPEs in these practice areas may be developed. Implementation of IPPEs in psychiatry and neurology is needed for students to gain experience working with these patients. PMID:29955538

Identification of Pediatric Oral Health Core Competencies through Interprofessional Education and Practice.

PubMed

Hallas, D; Fernandez, J B; Herman, N G; Moursi, A

2015-01-01

Over the past seven years, the Department of Pediatric Dentistry at New York University College of Dentistry (NYUCD) and the Advanced Practice: Pediatrics and the Pediatric Nurse Practitioner (PNP) program at New York University College of Nursing (NYUCN) have engaged in a program of formal educational activities with the specific goals of advancing interprofessional education, evidence-based practice, and interprofessional strategies to improve the oral-systemic health of infants and young children. Mentoring interprofessional students in all health care professions to collaboratively assess, analyze, and care-manage patients demands that faculty reflect on current practices and determine ways to enhance the curriculum to include evidence-based scholarly activities, opportunities for interprofessional education and practice, and interprofessional socialization. Through the processes of interprofessional education and practice, the pediatric nursing and dental faculty identified interprofessional performance and affective oral health core competencies for all dental and pediatric primary care providers. Students demonstrated achievement of interprofessional core competencies, after completing the interprofessional educational clinical practice activities at Head Start programs that included interprofessional evidence-based collaborative practice, case analyses, and presentations with scholarly discussions that explored ways to improve the oral health of diverse pediatric populations. The goal of improving the oral health of all children begins with interprofessional education that lays the foundations for interprofessional practice.

Identification of Pediatric Oral Health Core Competencies through Interprofessional Education and Practice

PubMed Central

Hallas, D.; Fernandez, J. B.; Herman, N. G.; Moursi, A.

2015-01-01

Over the past seven years, the Department of Pediatric Dentistry at New York University College of Dentistry (NYUCD) and the Advanced Practice: Pediatrics and the Pediatric Nurse Practitioner (PNP) program at New York University College of Nursing (NYUCN) have engaged in a program of formal educational activities with the specific goals of advancing interprofessional education, evidence-based practice, and interprofessional strategies to improve the oral-systemic health of infants and young children. Mentoring interprofessional students in all health care professions to collaboratively assess, analyze, and care-manage patients demands that faculty reflect on current practices and determine ways to enhance the curriculum to include evidence-based scholarly activities, opportunities for interprofessional education and practice, and interprofessional socialization. Through the processes of interprofessional education and practice, the pediatric nursing and dental faculty identified interprofessional performance and affective oral health core competencies for all dental and pediatric primary care providers. Students demonstrated achievement of interprofessional core competencies, after completing the interprofessional educational clinical practice activities at Head Start programs that included interprofessional evidence-based collaborative practice, case analyses, and presentations with scholarly discussions that explored ways to improve the oral health of diverse pediatric populations. The goal of improving the oral health of all children begins with interprofessional education that lays the foundations for interprofessional practice. PMID:25653873

Interprofessional Education and Practice Guide No. 8: Team-based interprofessional practice placements.

PubMed

Brewer, Margo L; Barr, Hugh

2016-11-01

Whilst interest in interprofessional learning (IPL) in practice contexts has grown in recent years, the complexities involved have led many universities to rely on IPL in the classroom, online, and/or simulated contexts. Curtin University's Faculty of Health Sciences has successfully implemented a multi-award winning, large-scale Interprofessional Practice Programme. This programme, which began with five small pilots in 2009, provides team-based interprofessional practice placements for over 550 students from nine professions per annum. Drawing on both the literature and Curtin University's experience, this Interprofessional Education and Practice Guide aims to assist university and practice-based educators to "weigh the case" for introducing team-based interprofessional placements. The key lessons learned at Curtin University are identified to offer guidance to others towards establishing a similar programme for students during their prequalifying courses in health, social care, and related fields.

An Overview of Continuing Interprofessional Education

ERIC Educational Resources Information Center

Reeves, Scott

2009-01-01

Interprofessional education, continuing interprofessional education, interprofessional collaboration, and interprofessional care are moving to the forefront of approaches with the potential to reorganize the delivery of health professions education and health care practice. This article discusses 7 key trends in the scholarship and practice of…

Toward human resource management in inter-professional health practice: linking organizational culture, group identity and individual autonomy.

PubMed

Tataw, David

2012-01-01

The literature on team and inter-professional care practice describes numerous barriers to the institutionalization of inter-professional healthcare. Responses to slow institutionalization of inter-professional healthcare practice have failed to describe change variables and to identify change agents relevant to inter-professional healthcare practice. The purpose of this paper is to (1) describe individual and organizational level barriers to collaborative practice in healthcare; (2) identify change variables relevant to the institutionalization of inter-professional practice at individual and organizational levels of analysis; and (3) identify human resource professionals as change agents and describe how the strategic use of the human resource function could transform individual and organizational level change variables and therefore facilitate the healthcare system's shift toward inter-professional practice. A proposed program of institutionalization includes the following components: a strategic plan to align human resource functions with organizational level inter-professional healthcare strategies, activities to enhance professional competencies and the organizational position of human resource personnel, activities to integrate inter-professional healthcare practices into the daily routines of institutional and individual providers, activities to stand up health provider champions as permanent leaders of inter-professional teams with human resource professionals as consultants and activities to bring all key players to the table including health providers. Copyright © 2012 John Wiley & Sons, Ltd.

Assessing Interprofessional education in a student-faculty collaborative practice network.

PubMed

Young, Grace J; Cohen, Marya J; Blanchfield, Bonnie B; Jones, Meissa M; Reidy, Patricia A; Weinstein, Amy R

2017-07-01

Although interprofessional relationships are ubiquitous in clinical practice, undergraduate medical students have limited opportunities to develop these relationships in the clinical setting. A few student-faculty collaborative practice networks (SFCPNs) have been working to address this issue, but limited data exist examining the nature and extent of these practices. A systematic survey at a Harvard-affiliated SFCPN is utilised to evaluate the quantity and quality of interprofessional interactions, isolate improvements, and identify challenges in undergraduate interprofessional education (IPE). Our data corroborate previous findings in which interprofessional clinical learning was shown to have positive effects on student development and align with all four domains of Interprofessional Education Collaborative core competencies, including interprofessional ethics and values, roles and responsibilities, interprofessional communication, and teams and teamwork. These results highlight the unique opportunity and growing necessity of integrating IPE in SFCPNs to endorse the development of collaborative and professional competencies in clinical modalities of patient care.

Interprofessional Education and Practice Guide No. 6: Developing practice-based interprofessional learning using a short placement model.

PubMed

Anderson, Elizabeth Susan; Ford, Jenny; Kinnair, Daniel James

2016-07-01

Offering undergraduate and post-qualified learners opportunities to take part in, and reflect on, the nature of interprofessional working when in practice remains an important goal for interprofessional educators. There are a plethora of opportunities within hospital and community care for learners to actively participate in health and social care delivery where collaborative practice prevails. However, it remains challenging to know how to establish and sustain meaningful interprofessional practice-based learning. This is because profession-specific teaching is prioritised and many teams are under-resourced, leaving little time for additional teaching activities. In some instances, practitioners lack the knowledge concerning how to design meaningful interprofessional learning and often feel unprepared for this teaching because of limited interprofessional faculty development. Others are simply unaware of the presence of the different students within their practice area. This guide offers key lessons developed over many years for setting up practice-based interprofessional education. The learning model has been adapted and adopted in different settings and countries and offers a method for engaging clinical front-line practitioners in learning with, and from learners who can help support and in some instances advance care delivery.

Interprofessional practices of physiotherapists working with adults with low back pain in Québec’s private sector: results of a qualitative study

PubMed Central

2014-01-01

Background Collaboration and interprofessional practices are highly valued in health systems, because they are thought to improve outcomes of care for persons with complex health problems, such as low back pain. Physiotherapists, like all health providers, are encouraged to take part in interprofessional practices. However, little is known about these practices, especially for private sector physiotherapists. This study aimed to: 1) explore how physiotherapists working in the private sector with adults with low back pain describe their interprofessional practices, 2) identify factors that influence their interprofessional practices, and 3) identify their perceived effects. Methods Participants were 13 physiotherapists, 10 women/3 men, having between 3 and 21 years of professional experience. For this descriptive qualitative study, we used face-to-face semi-structured interviews and conducted content analysis encompassing data coding and thematic regrouping. Results Physiotherapists described interprofessional practices heterogeneously, including numerous processes such as sharing information and referring. Factors that influenced physiotherapists’ interprofessional practices were related to patients, providers, organizations, and wider systems (e.g. professional system). Physiotherapists mostly viewed positive effects of interprofessional practices, including elements such as gaining new knowledge as a provider and being valued in one’s own role, as well as improvements in overall treatment and outcome. Conclusions This qualitative study offers new insights into the interprofessional practices of physiotherapists working with adults with low back pain, as perceived by the physiotherapists’ themselves. Based on the results, the development of strategies aiming to increase interprofessionalism in the management of low back pain would most likely require taking into consideration factors associated with patients, providers, the organizations within which they work, and the wider systems. PMID:24884757

An evaluation of an interprofessional practice-based learning environment using student reflections.

PubMed

Housley, Cora L; Neill, Kathryn K; White, Lanita S; Tedder, Andrea T; Castleberry, Ashley N

2018-01-01

The 12th Street Health and Wellness Center is an interprofessional, student-led, community-based clinic. Students from all University of Arkansas for Medical Sciences colleges work together to provide healthcare services for residents of an underserved community. Interprofessional student teams assess patients and present to an interprofessional preceptor team. At the conclusion of clinic, teams reflect on their experience. The objective of this study is to generate key themes from the end of clinic reflections to describe learning outcomes in an interprofessional practice environment. Student teams were asked to reflect on what they learned about patient care and interprofessional practice while volunteering at the clinic. Three hundred eighty reflection statements were assessed using the constant comparative approach with open coding by three researchers who identified and categorised themes by selecting key phrases from reflections. Eight themes emerged from this process which illuminated students' self-perceived development during practice-based learning and interprofessional collaboration. Key phrases were also coded to the four core Interprofessional Education Collaborative competency domains. These results suggest learners' perception that the Center is a practice-based environment that provides an opportunity to learn, integrate, and apply interprofessional curricular content.

Collaborating to implement interprofessional educational competencies through an international immersion experience.

PubMed

Bentley, Regina; Engelhardt, Joan A; Watzak, Bree

2014-01-01

Interprofessional collaborative practice is the key to safe, high-quality, accessible, patient-centered care. Achieving this requires the development of interprofessional competencies by health professions students as part of the learning process so that they enter the workforce ready to practice effective team-based care. The authors describe how the immersion process of an international short-term medical mission experience can intensify interprofessional learning by addressing selected Interprofessional Education Collaborative (IPEC), 2011, Core Interprofessional Education Competencies.

An Introductory Pharmacy Practice Experience to Improve Pertussis Immunization Rates in Mothers of Newborns

PubMed Central

Wall, Geoff C.; Soltis, Denise A.

2013-01-01

Objective. To implement an introductory pharmacy practice experience (IPPE) involving discharge counseling on postpartum pertussis immunization recommendations and evaluate its impact on student learning and patient immunization rates. Design. Seventeen pharmacy students provided verbal and written information based on Centers for Disease Control and Prevention (CDC) recommendations regarding pertussis immunization for mothers and caregivers of newborns. Assessment. Educational and clinical outcomes were evaluated using student documentation and pharmacy records. Students completed 615 IPPE hours and provided 1,263 consultations. Students reported that 52% of mothers requested immunization, 27% were undecided, 11% had previously been immunized, and 10% declined. Following counseling, immunization rates, as a percentage of total births, significantly increased by 18.5%. Learning objectives of enhanced counseling and documentation skills were achieved. Conclusions. IPPE students provided patient counseling in an institutional setting that contributed to healthcare team efforts to increase pertussis immunization rates in mothers of newborns. This IPPE may serve as a potential model for additional student involvement in discharge counseling. PMID:23519719

An introductory pharmacy practice experience to improve pertussis immunization rates in mothers of newborns.

PubMed

Clarke, Cheryl; Wall, Geoff C; Soltis, Denise A

2013-03-12

To implement an introductory pharmacy practice experience (IPPE) involving discharge counseling on postpartum pertussis immunization recommendations and evaluate its impact on student learning and patient immunization rates. Seventeen pharmacy students provided verbal and written information based on Centers for Disease Control and Prevention (CDC) recommendations regarding pertussis immunization for mothers and caregivers of newborns. Educational and clinical outcomes were evaluated using student documentation and pharmacy records. Students completed 615 IPPE hours and provided 1,263 consultations. Students reported that 52% of mothers requested immunization, 27% were undecided, 11% had previously been immunized, and 10% declined. Following counseling, immunization rates, as a percentage of total births, significantly increased by 18.5%. Learning objectives of enhanced counseling and documentation skills were achieved. IPPE students provided patient counseling in an institutional setting that contributed to healthcare team efforts to increase pertussis immunization rates in mothers of newborns. This IPPE may serve as a potential model for additional student involvement in discharge counseling.

Knowledge translation and interprofessional collaboration: Where the rubber of evidence-based care hits the road of teamwork.

PubMed

Zwarenstein, Merrick; Reeves, Scott

2006-01-01

Knowledge-translation interventions and interprofessional education and collaboration interventions all aim at improving health care processes and outcomes. Knowledge-translation interventions attempt to increase evidence-based practice by a single professional group and thus may fail to take into account barriers from difficulties in interprofessional relations. Interprofessional education and collaboration interventions aim to improve interprofessional relations, which may in turn facilitate the work of knowledge translation and thus evidence-based practice. We summarize systematic review work on the effects of interventions for interprofessional education and collaboration. The current evidence base contains mainly descriptive studies of these interventions. Knowledge is limited regarding the impact on care and outcomes and the extent to which the interventions increase the practice of evidence-based care. Rigorous multimethod research studies are needed to develop and strengthen the current evidence base in this field. We describe a Health Canada-funded randomized trial in which quantitative and qualitative data will be gathered in 20 general internal medicine units located at 5 Toronto, Ontario, teaching hospitals. The project examines the impact of interprofessional education and collaboration interventions on interprofessional relationships, health care processes (including evidence-based practice), and patient outcomes. Routes are suggested by which interprofessional education and collaboration interventions might affect knowledge translation and evidence-based practice.

The Importance of Interprofessional Education for Students in Communication Sciences and Disorders

ERIC Educational Resources Information Center

Goldberg, Lynette R.

2015-01-01

Interprofessional education (IPE) is recognized as a critical component in preparing students for effective interprofessional practice in health care. IPE is supported by the American Speech-Language-Hearing Association and students' competence in interprofessional practice is expected by clinical supervisors for effective work in any…

National trends in IPPE programs at US schools of pharmacy from 2008-2013.

PubMed

Devine, Patricia S; Darbishire, Patricia L

2015-04-25

To determine trends and challenges in introductory pharmacy practice experience (IPPE) programs from 2008-2013. In 2013, a web-based survey was sent to IPPE program administrators at 107 fully accredited colleges and schools of pharmacy. The survey addressed administrative personnel, program structure, and quality assurance issues. Sixty-nine IPPE administrators responded to the survey (64.5% response rate). Within the past 5 years, 4 significant trends occurred in the area of administrative personnel, 7 trends in program structure, and 6 in quality assurance. Clarifications of ACPE Standards through new guidelines and policy statements likely influence many of the 17 trends. Understaffed programs, competition for institutional sites, difficulty conducting site visits, preceptor training, program assessment, documentation maintenance, and individual site requirements are all challenges. The results of this study can be used as a stimulus to address ongoing issues and to enhance the quality of IPPE programs.

Interprofessional education in academic family medicine teaching units: a functional program and culture.

PubMed

Price, David; Howard, Michelle; Hilts, Linda; Dolovich, Lisa; McCarthy, Lisa; Walsh, Allyn E; Dykeman, Lynn

2009-09-01

The new family health teams (FHTs) in Ontario were designed to enable interprofessional collaborative practice in primary care; however, many health professionals have not been trained in an interprofessional environment. To provide health professional learners with an interprofessional practice experience in primary care that models teamwork and collaborative practice skills. The 2 academic teaching units of the FHT at McMaster University in Hamilton, Ont, employ 6 types of health professionals and provide learning environments for family medicine residents and students in a variety of health care professions. Learners engage in formal interprofessional education activities and mixed professional and learner clinical consultations. They are immersed in an established interprofessional practice environment, where all team members are valued and contribute collaboratively to patient care and clinic administration. Other contributors to the success of the program include the physical layout of the clinics, the electronic medical record communications system, and support from leadership for the additional clinical time commitment of delivering interprofessional education. This academic FHT has developed a program of interprofessional education based partly on planned activities and logistic enablers, and largely on immersing learners in a culture of long-standing interprofessional collaboration.

Finding Common Ground: Interprofessional Collaborative Practice Competencies in Patient-Centered Medical Homes.

PubMed

Swihart, Diana

2016-01-01

The patient-centered medical home model is predicated on interprofessional collaborative practice and team-based care. While information on the roles of various providers is increasingly woven into the literature, the competencies of those providers have been generally profession-specific. In 2011, the Interprofessional Education Collaborative comprising the American Association of Colleges of Nursing, the American Association of Colleges of Osteopathic Medicine, the American Association of Colleges of Pharmacy, the American Dental Education Association, the Association of American Medical Colleges, and the Association of Schools of Public Health sponsored an expert panel of their members to identify and develop 4 domains of core competencies needed for a successful interprofessional collaborative practice: (1) Values/Ethics for Interprofessional Practice; (2) Roles/Responsibilities; (3) Interprofessional Communication; and (4) Teams and Teamwork. Their findings and recommendations were recorded in their Core Competencies for Interprofessional Collaborative Practice: Report of an Expert Panel. This article explores these 4 domains and how they provide common ground for team-based care within the context of the medical home model approach to patient-centered primary care.

Leading interprofessional practice: a conceptual framework to support practitioners in the field of learning disability.

PubMed

McCray, Janet

2003-11-01

One of the key challenges for practitioners in present day health and social care has been responding effectively in the interprofessional teamwork setting, where collaboration is at the centre of professional activity. For whilst practitioners are expected to work interprofessionally there often remains limited attention to the actual process of interprofessional practice itself, within organizational strategy, local workforce development planning and individual continuing professional development. These concerns were a driver for this research with practitioners in the field of learning disability which resulted in the development of a conceptual framework for interprofessional practice. This paper sets out the process of conceptual framework development, underpinned by the concepts of knowledge of learning disabilities, contextual socialisation, empowerment, conflict management, transforming capability and interprofessional reflection on action. The researcher suggests that the framework may offer clinical leaders in learning disabilities and a range of other practice settings a tool to facilitate individual practitioner development, enabling as it does, the identification of a range of critical factors which impact on the outcomes of interprofessional practice intervention.

The Modified Readiness for Interprofessional Learning Scale in Currently Practicing Athletic Trainers

ERIC Educational Resources Information Center

Welsch, Lauren A.; Rutledge, Carolyn; Hoch, Johanna M.

2017-01-01

Context: Athletic trainers are encouraged to work collaboratively with other health care professionals to improve patient outcomes. Interprofessional education (IPE) experiences for practicing clinicians should be developed to improve interprofessional collaborative practice postcertification. An outcome measure, such as the modified Readiness for…

The role of intravesical prostatic protrusion (IPP) in the evaluation and treatment of bladder outlet obstruction (BOO).

PubMed

Kuo, Tricia L C; Teo, Jonathan S M; Foo, K T

2016-04-01

Intravesical prostatic protrusion (IPP) may be an underutilized modality for the assessment of bladder outlet obstruction (BOO). Pressure flow studies or urodynamics have long been the gold standard for the evaluation of lower urinary tract symptoms (LUTS) in men but are invasive, time-consuming and costly. Potentially, IPP may be a useful adjunct prior to performing urodynamics. Measurement of IPP is taken in the sagittal view, using the transabdominal ultrasound. It is the vertical height from the tip of the protrusion to the base of the prostate. This technique was previously described. We reviewed previous publications that studied the accuracy, positive predictive value and clinical use of IPP. In addition, we noted the comments regarding the challenges of using this technique. IPP has been shown to have a positive predictive value of 72% for BOO. It has been calculated to have an area under curve (AUC) value of 0.71 and 0.84 in some stuies. Clinically, it may be used to predict the outcome of a trial without catheter following acute retention of urine. Patients with higher IPP grade were noted to have a higher risk of clinical progression. Studies have also shown that men with higher IPP are poorer responders to medical treatment such as α-blockers. Compared to other modalities, the advantage of IPP in assessing BOO may be its easy applicability and non-invasive nature. Therefore, there is a consideration for a larger role of IPP in bedside assessment and management of BOO in daily practice. Neurourol. Urodynam. 35:535-537, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

Implementing interprofessional education and practice: Lessons from a resource-constrained university.

PubMed

Frantz, J M; Rhoda, A J

2017-03-01

Interprofessional education is seen as a vehicle to facilitate collaborative practice and, therefore, address the complex health needs of populations. A number of concerns have, however, been raised with the implementation of interprofessional education. The three core concerns raised in the literature and addressed in the article include the lack of an explicit framework, challenges operationalising interprofessional education and practice, and the lack of critical mass in terms of human resources to drive activities related to interprofessional education and practice. This article aims to present lessons learnt when attempting to overcome the main challenges and implementing interprofessional education activities in a resource-constrained higher education setting in South Africa. Boyer's model of scholarship, which incorporates research, teaching integration, and application, was used to address the challenge of a lack of a framework in which to conceptualise the activities of interprofressional education. In addition, a scaffolding approach to teaching activities within a curriculum was used to operationalise interprofessional education and practice. Faculty development initiatives were additionally used to develop a critical mass that focused on driving interprofessional education. Lessons learnt highlighted that if a conceptual model is agreed upon by all, it allows for a more focused approach, and both human and financial resources may be channelled towards a common goal which may assist resource-constrained institutions in successfully implementing interprofessional activities.

Interprofessional Education in Neonatal Care.

PubMed

Kenner, Carole

2016-01-01

Interprofessional education is not a new concept. Yet, the operationalization of interprofessional education with related competencies for collaborative team-based practice in neonatal units is often difficult. Changes in healthcare with an emphasis on patient-focused care and the concern for patient safety and quality care are accelerating the need for more interprofessional education. This article briefly outlines the evolution of interprofessional education to support collaborative team-based practice and how that facilitates safety and quality care in neonatal units.

Theory and practice in interprofessional ethics: a framework for understanding ethical issues in health care teams.

PubMed

Clark, Phillip G; Cott, Cheryl; Drinka, Theresa J K

2007-12-01

Interprofessional teamwork is an essential and expanding form of health care practice. While moral issues arising in teamwork relative to the patient have been explored, the analysis of ethical issues regarding the function of the team itself is limited. This paper develops a conceptual framework for organizing and analyzing the different types of ethical issues in interprofessional teamwork. This framework is a matrix that maps the elements of principles, structures, and processes against individual, team, and organizational levels. A case study is presented that illustrates different dimensions of these topics, based on the application of this framework. Finally, a set of conclusions and recommendations is presented to summarize the integration of theory and practice in interprofessional ethics, including: (i) importance of a framework, (ii) interprofessional ethics discourse, and (iii) interprofessional ethics as an emerging field. The goal of this paper is to begin a dialogue and discussion on the ethical issues confronting interprofessional teams and to lay the foundation for an expanding discourse on interprofessional ethics.

Communication, Respect, and Leadership: Interprofessional Collaboration in Hospitals of Rural Ontario.

PubMed

Morris, Diane; Matthews, June

2014-12-01

Health care professionals are expected to work collaboratively across diverse settings. In rural hospitals, these professionals face different challenges from their urban colleagues; however, little is known about interprofessional practice in these settings. Eleven health care professionals from 2 rural interprofessional teams were interviewed about collaborative practice. The data were analyzed using a constant comparative method. Common themes included communication, respect, leadership, benefits of interprofessional teams, and the assets and challenges of working in small or rural hospitals. Differences between the cases were apparent in how the members conceptualized their teams, models of which were then compared with an "Ideal Interprofessional Team". These results suggest that many experienced health care professionals function well in interprofessional teams; yet, they did not likely receive much education about interprofessional practice in their training. Providing interprofessional education to new practitioners may help them to establish this approach early in their careers and build on it with additional experience. Finally, these findings can be applied to address concerns that have arisen from other reports by exploring innovative ways to attract health professionals to communities in rural, remote, and northern areas, as there is a constant need for dietitians and other health care professionals in these practice settings.

Geriatric Care as an Introductory Pharmacy Practice Experience

PubMed Central

Boyce, Eric; Patel, Rajul A.

2011-01-01

Objective. To describe the design, delivery, and impact of a geriatric introductory pharmacy practice experience (IPPE) to develop students’ skills related to consultant pharmacists’ roles and patient care responsibilities. Design. A required 2-unit geriatric IPPE, involving 40 hours in a geriatric-care facility, 5 reflection hours, and 12 classroom-discussion hours, was developed for first- and second-year pharmacy students. Students interviewed patients and caregivers, reviewed patient charts, triaged patient needs, prepared care plans, and performed quality-assurance functions. Assessment. After completing the IPPE, students’ geriatric- and patient-care abilities were enhanced, based on review of their interactions, care plans, reflections, and examinations, and they demonstrated cognitive, affective, and psychomotor-domain learning skills. Students’ care plans and quality assurance activities revealed positive patient outcomes, opportunities for measurable patient health improvement, and a positive impact on quality assurance activities. Student evaluations and feedback from health workers at the facilities also were positive. Conclusions. This geriatric IPPE in which students cared for a specific patient and interacted with other health care providers is an innovative approach to enhancing students’ abilities to serve the growing geriatric population. PMID:21931453

Interprofessional education for physiotherapy, medical and dietetics students: a pilot programme.

PubMed

Pullon, Sue; McKinlay, Eileen; Beckingsale, Louise; Perry, Meredith; Darlow, Ben; Gray, Ben; Gallagher, Peter; Hoare, Kath; Morgan, Sonya

2013-03-01

Interprofessional education (IPE) has been shown to enhance interprofessional practice among health professionals. Until recently there has been limited opportunity to undertake such initiatives within existing pre-registration degree courses in New Zealand. This study aimed to test the feasibility of delivering an interprofessional component within existing health professional courses for medicine, physiotherapy and dietetics at the University of Otago, Wellington, New Zealand. An interprofessional case-based course component (on chronic condition management) was developed by academic clinical teachers from schools of medicine, physiotherapy and dietetics at the same location. Evaluation was undertaken using a previously validated pre- and post-survey tool, to ascertain changes in attitude among students towards interprofessional practice, IPE and the effectiveness of health care teams. Focus groups were conducted with students and teachers. Survey results indicated pre-existing positive attitudes to interprofessional practice and education among students. There was a statistically significant increase in positive attitude towards such practice and education, and increased confidence in the effectiveness of heath care teams. Focus group findings were consistent with the survey results for students, and highlighted challenges experienced by the teachers. Students and teachers alike enjoyed the interprofessional interaction and benefited from a collaborative approach to chronic condition management. The timing and nature of learning activities and assessment methods created logistical challenges. Such course components have potential to improve collaborative practice and the quality and safety of health care among graduates. Interprofessional course components need to be equitable across disciplines and embedded in the unidisciplinary courses.

An Australian hospital-based student training ward delivering safe, client-centred care while developing students' interprofessional practice capabilities.

PubMed

Brewer, Margo L; Stewart-Wynne, Edward G

2013-11-01

Royal Perth Hospital, in partnership with Curtin University, established the first interprofessional student training ward in Australia, based on best practice from Europe. Evaluation of the student and client experience was undertaken. Feedback from all stakeholders was obtained regularly as a key element of the quality improvement process. An interprofessional practice program was established with six beds within a general medical ward. This provided the setting for 2- to 3-week clinical placements for students from medicine, nursing, physiotherapy, occupational therapy, social work, pharmacy, dietetics and medical imaging. Following an initial trial, the training ward began with 79 students completing a placement. An interprofessional capability framework focused on the delivery of high quality client care and effective teamwork underpins this learning experience. Quantitative outcome data showed not only an improvement in students' attitudes towards interprofessional collaboration but also acquisition of a high level of interprofessional practice capabilities. Qualitative outcome data from students and clients was overwhelmingly positive. Suggestions for improvement were identified. This innovative learning environment facilitated the development of the students' knowledge, skills and attitudes required for interprofessional, client centred collaborative practice. Staff reported a high level of compliance with clinical safety and quality.

An ethnographic investigation of junior doctors' capacities to practice interprofessionally in three teaching hospitals.

PubMed

Milne, Jacqueline; Greenfield, David; Braithwaite, Jeffrey

2015-01-01

Collaborative practice among early career staff is at the bedrock of interprofessional care. This study investigated factors influencing the enactment of interprofessional practice by using the day-to-day role of six junior doctors in three teaching hospitals as a gateway to understand the various professions' interactive behaviours. The contextual framework used for the study was Strauss' theory of negotiated order. Ethnographic techniques were applied to observe the actions and interactions of participants on typical working days in their hospital environments. Field notes were created and thematic analysis was applied to the data. Three themes explored were culture, communication, and collaboration. Issues identified highlight the bounded organisational and professional cultures within which junior doctors work, and systemic problems in interprofessional interaction and communication in the wards of hospitals. There are indications that early career doctors are interprofessional isolates. The constraints of short training terms and pressure from multi-faceted demands on junior doctors can interfere with the establishment of meaningful relationships with nurses and other health professionals. The realisation of sustained interprofessional practice is, therefore, practically and structurally difficult. Enabling factors supporting the sharing of expertise are outweighed by barriers associated with professional and hospital organisational cultures, poor interprofessional communication, and the pressure of competing individual task demands in the course of daily practice.

Inter-Professional Practices of Private-Sector Physiotherapists for Low Back Pain Management: Who, How, and When?

PubMed

Perreault, Kadija; Dionne, Clermont E; Rossignol, Michel; Poitras, Stéphane; Morin, Diane

Purpose : Although there have been increasing demands for health care providers to take part in inter-professional practices in recent years, very little attention has been paid to the actualization of such practices in the private sector. This study describes private-sector physiotherapists' inter-professional practices regarding low back pain (LBP) management and identifies organizational and provider-level variables associated with the intensity of such practices. Method : A total of 327 randomly selected physiotherapists were surveyed in the province of Quebec. Data were analyzed using descriptive and multiple regression analyses. Results : Physiotherapists reported frequent interactions with other physiotherapists (daily/weekly for 52.6%), family physicians (51.0%), and physiotherapy (PT) assistants (45.2%), but infrequent interactions with psychologists (3.6%), neurosurgeons (0.9%), and chiropractors (0.3%). Frequently reported means of interactions were written and oral messages sent through clients (55.1% and 24.1%, respectively), face-to-face unplanned discussions (41.9%), and faxed or mailed letters (23.2%). Variables associated with the intensity of inter-professional practices (mean of 6.7 [ SD 1.7] out of 10 on the Intensity of Interprofessional Practices Questionnaire for Private Sector Physiotherapists) were related to physiotherapists' clientele, social activities with other providers, and perceptions of inter-professional practices as well as organizational models, vision, and provision of PT training. Conclusions: There is room to improve inter-professional practices with private-sector physiotherapists involved in managing LBP. Targets for action include physiotherapists and their workplaces.

Introducing the nurse practitioner into the surgical ward: an ethnographic study of interprofessional teamwork practice.

PubMed

Kvarnström, Susanne; Jangland, Eva; Abrandt Dahlgren, Madeleine

2017-08-22

The first nurse practitioners in surgical care were introduced into Swedish surgical wards in 2014. Internationally, organisations that have adopted nurse practitioners into care teams are reported to have maintained or improved the quality of care. However, close qualitative descriptions of teamwork practice may add to existing knowledge of interprofessional collaboration when introducing nurse practitioners into new clinical areas. The aim was to report on an empirical study describing how interprofessional teamwork practice was enacted by nurse practitioners when introduced into surgical ward teams. The study had a qualitative, ethnographic research design, drawing on a sociomaterial conceptual framework. The study was based on 170 hours of ward-based participant observations of interprofessional teamwork practice that included nurse practitioners. Data were gathered from 2014 to 2015 across four surgical sites in Sweden, including 60 interprofessional rounds. The data were analysed with an iterative reflexive procedure involving inductive and theory-led approaches. The study was approved by a Swedish regional ethics committee (Ref. No.: 2014/229-31). The interprofessional teamwork practice enacted by the nurse practitioners that emerged from the analysis comprised a combination of the following characteristic role components: clinical leader, bridging team colleague and ever-present tutor. These role components were enacted at all the sites and were prominent during interprofessional teamwork practice. The participant nurse practitioners utilised the interprofessional teamwork practice arrangements to enact a role that may be described in terms of a quality guarantee, thereby contributing to the overall quality and care flow offered by the entire surgical ward team. © 2017 Nordic College of Caring Science.

A National Survey on the Use of Immersive Simulation for Interprofessional Education in Physical Therapist Education Programs.

PubMed

Stockert, Brad; Ohtake, Patricia J

2017-10-01

There is growing recognition that collaborative practice among healthcare professionals is associated with improved patient outcomes and enhanced team functioning, but development of collaborative practitioners requires interprofessional education (IPE). Immersive simulation, a clinically relevant experience that deeply engages the learner in realistic clinical environments, is used increasingly for IPE. The purpose of this study was to assess the use of immersive simulation as a strategy for IPE in physical therapist (PT) education programs. During fall 2014 and spring 2015, we contacted all 214 Commission on Accreditation in Physical Therapy Education accredited PT education programs in the United States and invited a faculty member to participate in our online survey. One hundred fourteen PT programs responded (53% response rate). Eighty responding programs (70%) identified themselves as users of immersive simulation, and 45 programs (39%) used simulation for IPE. Of these 45 programs, more than 90% included Interprofessional Education Collaborative competency learning objectives of roles/responsibilities, interprofessional communication, and teams/teamwork and 51% reported learning objectives for values/ethics for interprofessional practice. Interprofessional simulations with PT students commonly included nursing (91%). In programs using immersive simulation for IPE, 91% included debriefing and 51% included debriefing by interprofessional teams. Eighty accredited PT programs (70%) that responded to the survey use immersive simulation, and 45 programs (39%) use simulation for IPE. Most programs conduct simulations consistent with recognized best practice, including debriefing and Interprofessional Education Collaborative competency learning objectives for promoting interprofessional collaborative practice. We anticipate an increase in the use of immersive simulation for IPE as an educational strategy to comply with the revised Commission on Accreditation in Physical Therapy Education accreditation standards related to interprofessional collaborative practice that will become effective on January 1, 2018.

Interprofessional communication training: benefits to practicing pharmacists.

PubMed

Luetsch, Karen; Rowett, Debra

2015-10-01

Interprofessional communication skills are important for pharmacists to build collaborative relationships with other health professionals, integrate into healthcare teams, maximise their effectiveness in patient care in addressing complex care needs and meet the demands of health care reforms. This qualitative study explores clinical pharmacists' experiences and reflections after completing a learning and practice module which introduced them to a framework for successful interprofessional communication. The postgraduate clinical pharmacy program at The University of Queensland and the clinical pharmacy practice environments of forty-eight hospital and seven community based pharmacists. A learning and practice module outlining a framework for successful interprofessional communication was designed and integrated into a postgraduate clinical pharmacy program. Enrolled pharmacists applied newly learnt communication skills in pro-actively initiated, clinical discussions with a health professional in their practice environment. They provided written reflections on their experiences which were analysed using thematic analysis. Pharmacists' perceptions of the impact of applying the communication framework during their interaction with a health professional in their practice setting. Themes which emerged from reflections described pharmacists' confidence and capabilities to successfully conduct a clinical discussion with a health professional after initial apprehension and nervousness about the scheduled interaction. The application of the communication framework enhanced their perception of their professional identity, credibility and ability to build a collaborative working relationship with other health professionals. Pharmacists perceived that a learning and practice module for successful interprofessional practice integrated into a postgraduate clinical pharmacy program enhanced their interprofessional communication skills. The development of pro-active, interprofessional communication skills has the potential to increase interprofessional collaboration and pharmacists' personal role satisfaction. Pharmacists also observed it added value to their professional contribution in health care teams when addressing the demands of increasingly complex health care needs and reforms.

Interprofessional team meetings: Opportunities for informal interprofessional learning.

PubMed

Nisbet, Gillian; Dunn, Stewart; Lincoln, Michelle

2015-01-01

This study explores the potential for workplace interprofessional learning, specifically the learning that occurs between health professionals as part of their attendance at their regular interprofessional team meetings. While most interprofessional learning research to date has focused on formal structured education programs, this study adds to our understanding of the complexities of the learning processes occurring between health professionals as part of everyday practice. Through observations of team meetings and semi-structured interviews, we found that the interprofessional team meeting provided a practical, time-efficient, and relevant means for interprofessional learning, resulting in perceived benefits to individuals, teams, and patients. The learning process, however, was influenced by members' conceptions of learning, participation within the meeting, and medical presence. This study provides a basis for further research to assist health professionals capitalize on informal learning opportunities within the interprofessional meeting.

Reinforcing Cultural Competency Concepts During Introductory Pharmacy Practice Experiences

PubMed Central

Caligiuri, Frank J

2010-01-01

Objectives To incorporate cultural competency concepts into various introductory pharmacy practice experiences (IPPE) at the University of Missouri - Kansas City, School of Pharmacy. Design A 6-week series, titled “Becoming a Culturally Competent Provider” was developed to provide IPPE students with the opportunity to apply theory regarding cultural competency in a clinical context. Assessment Pre- and post-intervention attitude survey instruments were administered to 25 students in the spring semester of 2009. Several activities within the series were associated with reflection exercises. Student presentations were evaluated and formal feedback was provided by faculty members. A course evaluation was administered to evaluate the series and determine areas of improvement. Conclusion A special series on cultural competency resulted in positive changes in students' attitudes, highlighting the importance of reinforcing cultural competency concepts during IPPEs. PMID:21088735

Relational learning and interprofessional practice: transforming health education for the 21st century.

PubMed

Konrad, Shelley Cohen; Browning, David M

2012-01-01

Theories and traditions emphasizing the centrality of caring have guided the evolution of the healthcare professions. In contemporary practice, creating a therapeutic context in which healing can occur relies not just on the caring dispositions of individual clinicians, but also on the collective relational capacities of interprofessional healthcare teams. This article describes the intersection and complementarity of relational and interprofessional learning approaches to health education, provides exemplars of shared learning models and discusses the benefits and obstacles to integrating relational and interprofessional philosophies into real world practice.

Articulating nursing in an interprofessional world.

PubMed

Sommerfeldt, Susan C

2013-11-01

It is essential that nurses in practice clearly articulate their role in interprofessional clinical settings. Assumptions, stereotypes, power differentials and miscommunication can complicate the interaction of healthcare professionals when clarity does not exist about nurses' knowledge, skills and roles. Conflicting views among nurse scholars as to the nature of nursing knowledge and its relationship to practice complicate the task of nurses in explaining their performance and role to others in interprofessional environments. Interprofessionality is potentially misunderstood by nurse leaders, practitioners and educators, isolating nurses in an increasingly inter-disciplinary healthcare system. The theorization of contemporary nursing is explored through the views and perspectives of current nurse scholars. The ability to explain nursing knowledge, skills and roles to others in interprofessional interactions is a nursing competency, as well as an interprofessional one. Nurses, nurse leaders and nurse educators are challenged to engage in interprofessionalism so as to have an influence in the evolution of healthcare education and practice environments. Copyright © 2013 Elsevier Ltd. All rights reserved.

Health Promotion Practice and Interprofessional Education in Aging: Senior Wellness Fairs.

PubMed

Diwan, Sadhna; Perdue, Megan; Lee, Sang E; Grossman, Brian R

2016-01-01

Senior wellness fairs (SWFs) offer a unique opportunity for community health promotion and interprofessional education (IPE). The authors describe and evaluate the impact of a 3-year, university-community SWF collaboration on interprofessional competencies among students across multiple professional programs. Participation in the SWF enhanced student knowledge and skills in providing health promotion information to older adults in an interprofessional, collaborative setting as indicated by mean scores on the Perceived Learning Outcomes Survey, an instrument developed for this project. Open-ended data highlighted aspects of the SWF that students found most useful (interaction with seniors, community resources, interprofessional learning, and self-awareness) and most challenging (communication barriers, limited opportunity for interaction, and physical environment). Pre- and posttest scores on the Multidisciplinary SWF Practice Learning Quiz, another instrument developed for this project, illustrated improvement in student understanding of other professions and the importance of interprofessional cooperation to promote and maintain healthy aging. Implications and suggestions for structuring learning opportunities that combine community health promotion practice and interprofessional learning are discussed.

Student engagement in interprofessional working in practice placement settings.

PubMed

Pollard, Katherine

2009-10-01

. To investigate the nature of student engagement in interprofessional interaction while on placement. Due to continuing emphasis on improving interprofessional collaboration, UK educational establishments are required to offer pre-qualifying health and social care students interprofessional education in order that they acquire relevant competencies. However, few formal interprofessional education initiatives occur in practice settings and little is known about pre-qualifying students' non-formal learning about interprofessional issues while on placement. From 2003-2005 an English Faculty of Health and Social Care conducted a qualitative study to explore opportunities for interprofessional learning and working available to students in practice placement settings. Case studies were conducted in a coronary care ward, a medical ward for older patients, a maternity unit, a paediatric unit, an integrated community learning disabilities team and a residential facility for adults with challenging behaviour. Gaining access was complex, due to variable student timetables and UK research governance requirements. Sites were therefore selected according to geographical area and timing of student placements. Details of interprofessional interaction (formal and informal) were observed and recorded. Interviews were conducted with a convenience sample of 20 practitioners and 15 students. Data were analysed thematically. Student experience varied considerably. Contributing factors included the influence of doctors and differing professional cultures; mentors' support for student engagement in interprofessional working; and individual students' confidence levels. Most sites were managed by nurses and some senior nurses were proactive in involving students interprofessionally. However, many students lacked systematic support for interprofessional engagement. Students lack parity of experience concerning interprofessional activity on placement. Where they do not have systematic support, their engagement depends mainly on their own confidence. Senior nurses are ideally placed to promote environments where students can develop interprofessional competencies through systematic interprofessional engagement.

Improving Collaboration Among Social Work and Nursing Students Through Interprofessional Simulation.

PubMed

Kuehn, Mary Beth; Huehn, Susan; Smalling, Susan

2017-08-01

This project implemented first-time simulation with nursing and social work students. Students participated in a contextual learning experience through a patient simulation of interprofessional practice as a health care team member and reflection through debriefing and open response comments. Simulation offers a means to practice interprofessional collaboration prior to entering practice. Participants reported an increased understanding of the scope of practice of other team members through their reflections following simulation. In addition, participants reported increased comprehension of team dynamics and their relationship to improved patient care. Overall, the simulation encouraged development of the skills necessary to function as part of a collaborative, interprofessional team.

The National United States Center Data Repository: Core essential interprofessional practice & education data enabling triple aim analytics.

PubMed

Pechacek, Judith; Shanedling, Janet; Lutfiyya, May Nawal; Brandt, Barbara F; Cerra, Frank B; Delaney, Connie White

2015-01-01

Understanding the impact that interprofessional education and collaborative practice (IPECP) might have on triple aim patient outcomes is of high interest to health care providers, educators, administrators, and policy makers. Before the work undertaken by the National Center for Interprofessional Practice and Education at the University of Minnesota, no standard mechanism to acquire and report outcome data related to interprofessional education and collaborative practice and its effect on triple aim outcomes existed. This article describes the development and adoption of the National Center Data Repository (NCDR) designed to capture data related to IPECP processes and outcomes to support analyses of the relationship of IPECP on the Triple Aim. The data collection methods, web-based survey design and implementation process are discussed. The implications of this informatics work to the field of IPECP and health care quality and safety include creating standardized capacity to describe interprofessional practice and measure outcomes connecting interprofessional education and collaborative practice to the triple aim within and across sites/settings, leveraging an accessible data collection process using user friendly web-based survey design to support large data scholarship and instrument testing, and establishing standardized data elements and variables that can potentially lead to enhancements to national/international information system and academic accreditation standards to further team-based, interprofessional, collaborative research in the field.

The National United States Center Data Repository: Core essential interprofessional practice & education data enabling triple aim analytics

PubMed Central

Pechacek, Judith; Shanedling, Janet; Lutfiyya, May Nawal; Brandt, Barbara F.; Cerra, Frank B.; Delaney, Connie White

2015-01-01

Abstract Understanding the impact that interprofessional education and collaborative practice (IPECP) might have on triple aim patient outcomes is of high interest to health care providers, educators, administrators, and policy makers. Before the work undertaken by the National Center for Interprofessional Practice and Education at the University of Minnesota, no standard mechanism to acquire and report outcome data related to interprofessional education and collaborative practice and its effect on triple aim outcomes existed. This article describes the development and adoption of the National Center Data Repository (NCDR) designed to capture data related to IPECP processes and outcomes to support analyses of the relationship of IPECP on the Triple Aim. The data collection methods, web-based survey design and implementation process are discussed. The implications of this informatics work to the field of IPECP and health care quality and safety include creating standardized capacity to describe interprofessional practice and measure outcomes connecting interprofessional education and collaborative practice to the triple aim within and across sites/settings, leveraging an accessible data collection process using user friendly web-based survey design to support large data scholarship and instrument testing, and establishing standardized data elements and variables that can potentially lead to enhancements to national/international information system and academic accreditation standards to further team-based, interprofessional, collaborative research in the field. PMID:26652631

Interprofessional collaborative practice incorporating training for alcohol and drug use screening for healthcare providers in rural areas.

PubMed

Puskar, Kathy; Mitchell, Ann M; Albrecht, Susan A; Frank, Linda R; Kane, Irene; Hagle, Holly; Lindsay, Dawn; Lee, Heeyoung; Fioravanti, Marie; Talcott, Kimberly S

2016-07-01

Interprofessional collaborative practice expands resources in rural and underserved communities. This article explores the impact of an online education programme on the perceptions of healthcare providers about interprofessional care within alcohol and drug use screening for rural residents. Nurses, behavioural health counsellors, and public health professionals participated in an evidence-based practice (screening, brief intervention, and referral to treatment-SBIRT) model that targets individuals who use alcohol and other drugs in a risky manner. SBIRT is recommended by the United States Preventive Services Task Force as a universal, evidence-based screening tool. Online modules, case simulation practice, and interprofessional dialogues are used to deliver practice-based learning experiences. A quasi-experimental method with pre-tests and post-tests was utilised. Results indicate increased perceptions of professional competence, need for cooperation, actual cooperation, and role values pre-to-post training. Implications suggest that online interprofessional education is useful but the added component of professional dialogues regarding patient cases offers promise in promoting collaborative practice.

Interprofessional communication supporting clinical handover in emergency departments: An observation study.

PubMed

Redley, Bernice; Botti, Mari; Wood, Beverley; Bucknall, Tracey

2017-08-01

Poor interprofessional communication poses a risk to patient safety at change-of-shift in emergency departments (EDs). The purpose of this study was to identify and describe patterns and processes of interprofessional communication impacting quality of ED change-of-shift handovers. Observation of 66 change-of-shift handovers at two acute hospital EDs in Victoria, Australia. Focus groups with 34 nurse participants complemented the observations. Qualitative data analysis involved content and thematic methods. Four structural components of ED handover processes emerged represented by (ABCD): (1) Antecedents; (2) Behaviours and interactions; (3) Content; and (4) Delegation of ongoing care. Infrequent and ad hoc interprofessional communication and discipline-specific handover content and processes emerged as specific risks to patient safety at change-of-shift handovers. Three themes related to risky and effective practices to support interprofessional communications across the four stages of ED handovers emerged: 1) standard processes and practices, 2) teamwork and interactions and 3) communication activities and practices. Unreliable interprofessional communication can impact the quality of change-of-shift handovers in EDs and poses risk to patient safety. Structured reflective analysis of existing practices can identify opportunities for standardisation, enhanced team practices and effective communication across four stages of the handover process to support clinicians to enhance local handover practices. Future research should test and refine models to support analysis of practice, and identify and test strategies to enhance ED interprofessional communication to support clinical handovers. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

A team approach to an undergraduate interprofessional communication course.

PubMed

Doucet, Shelley; Buchanan, Judy; Cole, Tricia; McCoy, Carolyn

2013-05-01

Interprofessional communication is a team-taught upper-level undergraduate course for Nursing and Health Sciences students. In addition to teaching fundamental communication skills, this course weaves interprofessional competencies into weekly learning activities and assignments. The utilization of the principles and practices of team-based learning in the classroom enhances the attainment and practice of communication and interprofessional collaboration skills. Lessons learned from conducting informal course evaluations and delivering the course multiple times are presented.

Preceptors' Perceptions of Interprofessional Practice, Student Interactions, and Strategies for Interprofessional Education in Clinical Settings.

PubMed

Hudak, Nicholas M; Melcher, Betsy; Strand de Oliveira, Justine

2017-12-01

This study describes clinical preceptors' perceptions of interprofessional practice, the nature and variety of physician assistant (PA) students' interprofessional interactions during clinical training, and factors that facilitate or hinder interprofessional education (IPE) in clinical settings. This qualitative study involved interviews with preceptors that were audio-recorded, transcribed, and then analyzed through an iterative process to identify key conceptual themes. Fourteen preceptors from a variety of clinical settings participated. Four themes were identified: (1) preceptors define interprofessional practice differently; (2) students learn about teams by being a part of teams; (3) preceptors separate students to avoid diluting learning experiences; and (4) preceptors can facilitate IPE by introducing students to members of the team and role modeling team skills. The themes may inform PA educators' efforts to increase IPE in clinical settings through educational interventions with both preceptors and students.

The Journey to Interprofessional Collaborative Practice: Are We There Yet?

PubMed

Golom, Frank D; Schreck, Janet Simon

2018-02-01

Interprofessional collaborative practice (IPCP) is a service delivery approach that seeks to improve health care outcomes and the patient experience while simultaneously decreasing health care costs. The current article reviews the core competencies and current trends associated with IPCP, including challenges faced by health care practitioners when working on interprofessional teams. Several conceptual frameworks and empirically supported interventions from the fields of organizational psychology and organization development are presented to assist health care professionals in transitioning their teams to a more interprofessionally collaborative, team-based model of practice. Copyright © 2017 Elsevier Inc. All rights reserved.

Interprofessional education workshops in the workplace for pre-registration learners: Aligning to National Standards.

PubMed

Kent, Fiona; Courtney, Jade; Thorpe, Jo

2018-03-01

The inclusion of formal interprofessional education activities within clinical placements aligns with the national agenda in Australia to increase the focus on collaborative practice. However, the challenge remains for health services to determine how to achieve this goal. The education team at one health service elected to align new interprofessional education initiatives to the National Standards for Quality in Healthcare, to increase student focus on the complex domains of practice that require collaborative practice. An interprofessional falls prevention workshop was created for students on clinical placement. In the pilot phase, the 2h workshops ran four times across three months. Simultaneously, a second group of students were invited to complete an online falls prevention module. Knowledge gains from the two interventions were compared using a Mann Whitney test and qualitative data was thematically coded. There was no significant difference in fall prevention knowledge between the two interventions. Thematic analysis illustrated workshops promoted an increased understanding of others roles, person-centred care, interprofessional communication and collaboration. This pilot study has demonstrated that 2h interprofessional educational workshops are a feasible, replicable and useful addition to profession-specific clinical placements. The interprofessional workshop offered the opportunity for students of different professions to come together, practice interprofessional communication, explore the roles and responsibilities of others and collaborate in the theoretical management of a clinical case. Copyright © 2017 Elsevier Ltd. All rights reserved.

An interprofessional diabetes experience to improve pharmacy and nursing students' competency in collaborative practice.

PubMed

Pittenger, Amy L; Westberg, Sarah; Rowan, Mary; Schweiss, Sarah

2013-11-12

To improve pharmacy and nursing students' competency in collaborative practice by having them participate in an interprofessional diabetes experience involving social networking. An existing elective course on diabetes management was modified to include interprofessional content based on Interprofessional Education Collaborative (IPEC) competency domains. Web-based collaborative tools (social networking and video chat) were used to allow nursing and pharmacy students located on 2 different campuses to apply diabetes management content as an interprofessional team. Mixed-method analyses demonstrated an increase in students' knowledge of the roles and responsibilities of the other profession and developed an understanding of interprofessional communication strategies and their central role in effective teamwork. Interprofessional content and activities can be effectively integrated into an existing course and offered successfully to students from other professional programs and on remote campuses.

Socio-material perspectives on interprofessional team and collaborative learning.

PubMed

McMurtry, Angus; Rohse, Shanta; Kilgour, Kelly N

2016-02-01

Interprofessional teamwork and collaboration have become important parts of health care practice and education. Most of the literature on interprofessional learning, however, assumes that learning is something acquired by individuals and readily transferred to other contexts. This assumption severely limits the ways in which interprofessional educators and researchers can conceptualise and support learning related to collaborative interprofessional health care. Socio-material theories provide an alternative to individualistic, acquisition-oriented notions by reconceiving learning in terms of collective dynamics, participation in social communities and active engagement with material contexts. Socio-material literature and theories were reviewed to identify concepts relevant to interprofessional learning. After briefly summarising the origins and key principles of socio-material approaches, the authors draw upon specific socio-material theories--including complexity theory, cultural-historical activity theory and actor-network theory--in order to reconceive how learning happens in interprofessional contexts. This reframing of interprofessional learning focuses less on individuals and more on collective dynamics and the actual social and material relations involved in practice. The paper proposes five ways in which learning may be enacted in interprofessional teamwork and collaboration from a socio-material perspective: (i) diverse contributions; (ii) social interactions and relationships; (iii) synthesis of professional ideas; (iv) integration of material elements, and (v) connections to large-scale organisations. For each of these categories, the paper provides practical illustrations to assist educators and researchers who wish to identify and assess this learning. Although more exploratory than comprehensive, this paper articulates many key aspects of socio-material learning theories and offers practical guidance for those who wish to employ and assess them in interprofessional contexts. © 2016 John Wiley & Sons Ltd.

Incorporating Interprofessional Teamwork and Communication into a Concept-Based Curriculum to Promote Transition to Practice

ERIC Educational Resources Information Center

Meekins, Eva M.

2016-01-01

Teamwork and communication are essential concepts for new graduate registered nurses working as members of the interprofessional team. Studies have shown the efficacy of applying these interprofessional education concepts by allowing student nurses to round with health teams before graduation. The innovative practice of rounding significantly…

"Refreshed…reinforced…reflective": A qualitative exploration of interprofessional education facilitators' own interprofessional learning and collaborative practice.

PubMed

Evans, Sherryn; Shaw, Nicole; Ward, Catherine; Hayley, Alexa

2016-11-01

While there is extensive research examining the outcomes of interprofessional education (IPE) for students, minimal research has investigated how facilitating student learning influences the facilitators themselves. This exploratory case study aimed to explore whether and how facilitating IPE influences facilitators' own collaborative practice attitudes, knowledge, and workplace behaviours. Sixteen facilitators of an online pre-licensure IPE unit for an Australian university participated in semi-structured telephone interviews. Inductive thematic analysis revealed three emergent themes and associated subthemes characterising participants' reflexivity as IPE facilitators: interprofessional learning; professional behaviour change; and collaborative practice expertise. Participants experienced interprofessional learning in their role as facilitators, improving their understanding of other professionals' roles, theoretical and empirical knowledge underlying collaborative practice, and the use and value of online communication. Participants also reported having changed several professional behaviours, including improved interprofessional collaboration with colleagues, a change in care plan focus, a less didactic approach to supervising students and staff, and greater enthusiasm impressing the value of collaborative practice on placement students. Participants reported having acquired their prior interprofessional collaboration expertise via professional experience rather than formal learning opportunities and believed access to formal IPE as learners would aid their continuing professional development. Overall, the outcomes of the IPE experience extended past the intended audience of the student learners and positively impacted on the facilitators as well.

Integrating interprofessional collaboration skills into the advanced practice registered nurse socialization process.

PubMed

Farrell, Kathleen; Payne, Camille; Heye, Mary

2015-01-01

The emergence of interprofessional collaboration and practice as a means to provide patient-centered care and to decrease the current fragmentation of health care services in the 21st century provides a clear and unique opportunity for the advanced practice registered nurse (APRN) to assume a key role. For APRNs and other health care providers, to participate effectively as team members requires an interprofessional mindset. Development of interprofessional skills and knowledge for the APRN has been hindered by a silo approach to APRN role socialization. The Institute of Medicine Report (IOM; 2010) states that current health care systems should focus on team collaboration to deliver accessible, high-quality, patient-centered health care that addresses wellness and prevention of illness and adverse events, management of chronic illness, and increased capacity of all providers on the team. The purpose of this article is to demonstrate the need to incorporate interprofessional education (IPE) into the socialization models used in advanced practice nursing programs. IPE requires moving beyond profession-specific educational efforts to engage students of different health care professions in interactive learning. Being able to work effectively as member of a clinical team while a student is a fundamental part of that learning (Interprofessional Education Collaborative Expert Panel, 2011). The objective of IPE curriculum models in graduate nursing programs is to educate APRNs in the development of an interprofessional mindset. Interprofessional collaboration and coordination are needed to achieve seamless transitions for patients between providers, specialties, and health care settings (IOM, 2010). Achieving the vision requires the continuous development of interprofessional competencies by APRNs as part of the learning process, so that upon entering the workforce, APRNs are ready to practice effective teamwork and team-based care. Socialization of the professional APRN role must integrate interprofessional competencies and interactions to prepare APRNs accordingly. Copyright © 2015 Elsevier Inc. All rights reserved.

Moving out of one's comfort zone: developing and teaching an interprofessional research course.

PubMed

Berman, Rosemarie O

2013-07-01

Teamwork and interprofessional collaboration have long been identified as core competencies for achieving quality, safe, patient-centered care. The shared learning environment of an interprofessional course is one method for developing the foundation for a collaborative practice-ready work force. Developing and teaching a course for students in a variety of health professions can be challenging as faculty move beyond the comfort level of their discipline. This article describes the development of an interprofessional research course to meet the needs of different health disciplines with specific teaching strategies to develop core competencies for interprofessional collaboration and practice. Copyright 2013, SLACK Incorporated.

Educators' Interprofessional Collaborative Relationships: Helping Pharmacy Students Learn to Work with Other Professions.

PubMed

Croker, Anne; Smith, Tony; Fisher, Karin; Littlejohns, Sonja

2016-03-30

Similar to other professions, pharmacy educators use workplace learning opportunities to prepare students for collaborative practice. Thus, collaborative relationships between educators of different professions are important for planning, implementing and evaluating interprofessional learning strategies and role modelling interprofessional collaboration within and across university and workplace settings. However, there is a paucity of research exploring educators' interprofessional relationships. Using collaborative dialogical inquiry we explored the nature of educators' interprofessional relationships in a co-located setting. Data from interprofessional focus groups and semi-structured interviews were interpreted to identify themes that transcended the participants' professional affiliations. Educators' interprofessional collaborative relationships involved the development and interweaving of five interpersonal behaviours: being inclusive of other professions; developing interpersonal connections with colleagues from other professions; bringing a sense of own profession in relation to other professions; giving and receiving respect to other professions; and being learner-centred for students' collaborative practice . Pharmacy educators, like other educators, need to ensure that interprofessional relationships are founded on positive experiences rather than vested in professional interests.

Considering Accreditation in Gerontology: The Importance of Interprofessional Collaborative Competencies to Ensure Quality Health Care for Older Adults

ERIC Educational Resources Information Center

Goldberg, Lynette R.; Koontz, Jennifer Scott; Rogers, Nicole; Brickell, Jean

2012-01-01

The health care needs of older adults can be complex and multifaceted. Safe, effective, equitable, and person-centered service provision relies on skilled interprofessional, team-based practice. Too often, students seeking a career specializing in gerontology are not exposed to such interprofessional, team-based learning and practice during their…

Resisting Outdated Models of Pedagogical Domination and Subordination in Health Professions Education.

PubMed

Chen, Angel; Brodie, Maureen

2016-09-01

This case highlights a dilemma for interprofessional trainees facing a traditional health professions hierarchy rather than an interprofessional collaborative practice culture within the clinical setting. In the case, the trainee must determine the best way to confront the attending physician, if at all, as well as the best way to mediate the situation with fellow health professions trainees and team members. The commentary provides guidelines for interprofessional collaborative practice as outlined by the Interprofessional Education Collaborative competencies, including determining team members' roles and responsibilities, providing clear communication, adopting clinical huddles, and embracing a sense of inquiry during times of conflict. Role modeling of interprofessional collaborative practice by faculty is crucial in training a future generation of health care professionals who can continue to improve patient outcomes and quality of care. © 2016 American Medical Association. All Rights Reserved.

Developing a comprehensive faculty development program to promote interprofessional education, practice and research at a free-standing academic health science center.

PubMed

Shrader, Sarah; Mauldin, Mary; Hammad, Sammar; Mitcham, Maralynee; Blue, Amy

2015-03-01

There is an on-going transformation in health professions education to prepare students to function as competent members of an interprofessional team in order to increase patient safety and improve patient care. Various methods of health education and practice directed toward students have been implemented, yet descriptions of faculty development initiatives designed to advance interprofessional education and practice are scarce. This article describes a faculty development program at the Medical University of South Carolina, USA, based on the conceptual framework of adult transformational learning theory. Three components comprise the faculty development program: an institute, fellowship and teaching series. Evaluations of the three components indicate that the faculty development program aided in the sustainability of the university's interprofessional program, and built capacity for improvement and growth in interprofessional endeavors.

Foundations, Core Principles, Values, and Necessary Competencies of Interprofessional Team-Based Health Care.

PubMed

Vogt, H Bruce; Vogt, Jeremy J

2017-01-01

Health care reform has focused on improving health care delivery, quality, and patient safety. An interprofessional, team-based approach to health care is considered by many experts to be essential to meeting these goals. The evidence for this is growing. Core principles for team-based care and the interprofessional competencies necessary for a team to function effectively have been identified and can be taught. Resources for interprofessional education, which must begin at the health professions student level, are available to academic institutions, healthcare systems, and professional organizations to prepare students and current health care professionals for this cultural change. Models of successful collaborative practices exist in many forms and will continue to evolve as our expertise in best practices for interprofessional education and practice advance. Copyright© South Dakota State Medical Association.

From Interprofessional Education to Interprofessional Practice: Exploring the Implementation Gap

ERIC Educational Resources Information Center

Ravet, Jackie

2012-01-01

Research repeatedly suggests that a lack of autism awareness, plus poor interprofessional working, is undermining the development of effective autism provision across Scottish services. In response, the University of Aberdeen developed an interprofessional education (IPE) programme in Autism and Learning designed to address these problems. This…

Curriculum renewal: Alignment of introductory pharmacy practice experiences with didactic course content.

PubMed

Nuffer, Wesley; Botts, Sheila; Franson, Kari; Gilliam, Eric; Knutsen, Randy; Nuffer, Monika; O'Brien, Elizabeth; Saseen, Joseph; Thompson, Megan; Vande Griend, Joseph; Willis, Robert

2017-11-01

The University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences (SSPPS) used the opportunity of curriculum renewal to integrate knowledge and skills learned from didactic courses into the introductory pharmacy practice experiences (IPPEs) occurring simultaneously. This paper describes and evaluates the meaningful application of course content into IPPEs, and evaluates the success using qualitative feedback. Students entering the renewed curriculum starting in fall 2012 were provided a list of pharmacy skills and activities from didactic course directors that reinforced course content for that semester. The skills and activities were to be completed during the students' IPPE visits in the community or health systems settings, depending on the program year and semester. Students successfully completed course assignments during their IPPE course program. Not all activities could be completed as designed, and many required modification, including simulated experiences. Feedback from faculty and preceptor members of the school's experiential education committee demonstrated that these activities were valuable and improved learning of course material, but were challenging to implement. A renewed curriculum that mapped course assignments for completion in experiential settings was successfully established, after some modifications. The program was modified at regular intervals to improve the ability of preceptors to complete these activities in their individual practice environment. A balance between the school providing guidance on what activities students should perform and allowing unstructured independent learning with the preceptor is needed for an optimal experience. Copyright © 2017 Elsevier Inc. All rights reserved.

A scoping review to understand "leadership" in interprofessional education and practice.

PubMed

Brewer, Margo L; Flavell, Helen Louise; Trede, Franziska; Smith, Megan

2016-07-01

This scoping study examined how "leadership" is referred to and used in interprofessional education and practice. A total of 114 refereed articles were reviewed to determine how leadership is defined, conceptualised, and theorised. The review also examined what capabilities were identified for effective interprofessional leadership. The majority of papers were empirical studies undertaken by researchers based in North America. The majority of articles did not refer to a specific leadership approach, nor did they define, describe, or theorise leadership. Moreover, "leadership" capabilities were rarely identified. Articles generally focused on health practitioners and educators or students as leaders with little exploration of leadership at higher levels (e.g. executive, accrediting bodies, government). This review indicates the need for a more critical examination of interprofessional leadership and the capabilities required to lead the changes required in both education and practice settings. The goal of this article is to stimulate discussion and more sophisticated, shared understandings of interprofessional leadership for the professions. Recommendations for future research are required in both education and practice settings.

The importance of effective communication in interprofessional practice: perspectives of maternity clinicians.

PubMed

Watson, Bernadette M; Heatley, Michelle L; Gallois, Cindy; Kruske, Sue

2016-01-01

Midwives and doctors require effective information-sharing strategies to provide safe and evidence-based care for women and infants, but this can be difficult to achieve. This article describes maternity care professionals' perceptions of communication in their current workplace in Australia. We invoke social identity theory (SIT) to explore how these perceptions affect interprofessional practice. A survey was conducted with 337 participants (281 midwives and 56 doctors). Using exploratory factor analysis we developed three scales that measured interprofessional workplace practice collaboration. Results indicated an intergroup environment in maternity care in which the professionals found exchange of ideas difficult, and where differences with respect to decision making and professional skills were apparent. Although scores on some measures of collaboration were high, the two professions differed on their ratings of the importance of team behaviors, information sharing, and interprofessional socialization as indicators of collaborative practice. These results highlight the complexities among maternity care providers with different professional identities, and demonstrate the impact of professional identity on interprofessional communication.

Anchoring interprofessional education in undergraduate curricula: The Heidelberg story.

PubMed

Berger, Sarah; Goetz, Katja; Leowardi-Bauer, Christina; Schultz, Jobst-Hendrik; Szecsenyi, Joachim; Mahler, Cornelia

2017-03-01

The ability of health professionals to collaborate effectively has significant potential impact on patient safety and quality-care outcomes, especially given the increasingly complex and dynamic clinical practice environments of today. Educators of the health professions are faced with an immediate challenge to adapt curricula and traditional teaching methods to ensure graduates are equipped with the necessary interprofessional competencies and (inter)professional values for their future practice. The World Health Organization's "Framework for action in interprofessional education (IPE) and collaborative practice" promotes IPE as a key strategy to enhance patient outcomes by preparing a "collaborative practice-ready health workforce." Logistical and attitudinal barriers can hinder integration of IPE into curricula. Lessons learned through the implementation of a planned change to establish four interprofessional seminars (team communication, medical error communication, healthcare English, and small business management) at Heidelberg University Medical Faculty, Germany, are described. A key factor in successfully anchoring IPE seminars in the undergraduate curricula was the structured approach drawing on change management concepts.

How Do Interprofessional Student Teams Interact in a Primary Care Clinic? A Qualitative Analysis Using Activity Theory

ERIC Educational Resources Information Center

Kent, Fiona; Francis-Cracknell, Alison; McDonald, Rachael; Newton, Jennifer M.; Keating, Jennifer L.; Dodic, Miodrag

2016-01-01

Practice based interprofessional education opportunities are proposed as a mechanism for health professionals to learn teamwork skills and gain an understanding of the roles of others. Primary care is an area of practice that offers a promising option for interprofessional student learning. In this study, we investigated what and how students from…

Interprofessional education and practice guide no. 2: developing and implementing a center for interprofessional education.

PubMed

Brashers, Valentina; Owen, John; Haizlip, Julie

2015-03-01

The complexity of implementing interprofessional education and practice (IPEP) strategies that extend across the learning continuum requires that institutions create a structure to support effective and organized coordination among interested administrators, faculty and staff. The University of Virginia Center for Academic Strategic Partnerships for Interprofessional Research and Education (UVA Center for ASPIRE) was formally established in 2013 following five years of dramatic growth in interprofessional education at the School of Nursing, School of Medicine and the UVA Health System. This guide briefly describes the steps that led to the creation of the Center and the key lessons learned that can guide other institutions toward establishing their own IPE centers.

Interprofessional primary care in academic family medicine clinics: implications for education and training.

PubMed

Drummond, Neil; Abbott, Karen; Williamson, Tyler; Somji, Behnaz

2012-08-01

To explore the status and processes of interprofessional work environments and the implications for interprofessional education in a sample of family medicine teaching clinics. Focus group interviews using a purposive sampling procedure. Four academic family medicine clinics in Alberta. Seven family physicians, 9 registered nurses, 5 licensed practical nurses, 2 residents, 1 psychologist, 1 informatics specialist, 1 pharmacist, 1 dietitian, 1 nurse practitioner, 1 receptionist, and 1 respiratory therapist. Assessment of clinic status and performance in relation to established principles of interprofessional work and education was explored using semistructured focus group interviews. Our data supported the D'Amour and Oandasan model of successful interprofessional collaborative practice in terms of the model's main "factors" (ie, shared goals and vision, sense of belonging, governance, and the structuring of clinical care) and their constituent "elements." It is reasonable to conclude that the extent to which these factors and elements are both present and positively oriented in academic clinic settings is an important contributory factor to the establishment of interprofessional collaborative practice in primary care. Using this model, 2 of the 4 clinics were rated as expressing substantial progress in relation to interprofessional work, while the other 2 clinics were rated as less successful on that dimension. None of the clinics was identified as having a clear and explicit focus on providing interprofessional education. The key factor in relation to the implementation of interprofessional work in primary care appears to be the existence of clear and explicit leadership in that direction. Substantial scope exists for improvement in the organization, conduct, and promotion of interprofessional education for Canadian primary care.

Interprofessional education and collaborative practice: Psychometric analysis of the Readiness for Interprofessional Learning Scale in undergraduate Serbian healthcare student context.

PubMed

Milutinović, Dragana; Lovrić, Robert; Simin, Dragana

2018-06-01

There is an implicit expectation for medical sciences students to work together effectively as members of health-care team, and interprofessional education is therefore widely accepted. Students' attitudes, which are affected by various factors, have been recognized as the most important predictors of successful implementation of interprofessional education with the aim of developing collaborative practice. The Readiness for Interprofessional Learning Scale has often been used in studies to measure these perspectives. To describe the psychometric properties of the Serbian cross-culturally adapted version of the original Readiness for Interprofessional Learning Scale, to assess the attitudes of undergraduate health science students towards interprofessional education and to evaluate whether a professional group and student characteristics have influence on attitudes towards collaborative practice and shared learning. A descriptive/analytical and comparative cross-sectional study. Faculty of Medicine in Serbia. Nursing and medical students after completed first clinical rotations (n = 257). The Readiness for Interprofessional Learning Scale for assessing attitudes among students towards interprofessional learning, Professional Identity Questionnaire for Nursing Students for assessing professional identity in nursing students, Professional Nursing Image Survey for assessing attitudes of medical students towards the nursing profession, as well as a socio-demographic questionnaire were the instruments used in this research study. The data were analysed using descriptive and inferential statistics. Exploratory factor analysis on 19 items revealed two-factors accounting for 51.1% of the total variance with the internal reliability α = 0.90. The mean total score of the Readiness for Interprofessional Learning Scale was 73.5 (SD = 11.5) indicating that students are ready for interprofessional learning. Nursing students, female students; students in their first years of studies, and those with previously completed education in the field of health care, have been more ready for interprofessional learning and collaborative practice. In the multiple linear regression analysis, gender and assessing professional nursing skills and abilities were significant predictors of medical students' readiness for interprofessional learning, whereas professional identity was for nursing students. The Serbian version of the Readiness for Interprofessional Learning Scale has proven to be reliable and valid for the "teamwork, collaboration and shared learning" subscale, while the "role and responsibilities" subscale showed lower stability. The results of this study revealed positive students' attitudes towards interprofessional learning, which is important for Serbia, as a candidate country for European Union membership, and thus making our educational system more inclusive for joining the European Higher Education Area. Copyright © 2018 Elsevier Ltd. All rights reserved.

Academic administrators' attitudes towards interprofessional education in Canadian schools of health professional education.

PubMed

Curran, Vernon R; Deacon, Diana R; Fleet, Lisa

2005-05-01

Interprofessional education is an approach to educating and training students and practitioners from different health professions to work in a collaborative manner in providing client and/or patient-centred care. The introduction and successful implementation of this educational approach is dependent on a variety of factors, including the attitudes of students, faculty, senior academic administrators (e.g., deans and directors) and practitioners. The purpose of this study was to examine attitudes towards interprofessional teamwork and interprofessional education amongst academic administrators of post-secondary health professional education programs in Canada. A web-based questionnaire in English and French was distributed via e-mail messaging during January 2004 to academic administrators in Canada representing medicine, nursing, pharmacy, social work, occupational therapy and physiotherapy post-secondary educational programs. Responses were sought on attitudes towards interprofessional teamwork and interprofessional education, as well as opinions regarding barriers to interprofessional education and subject areas that lend themselves to interprofessional education. In general, academic administrators responding to the survey hold overall positive attitudes towards interprofessional teamwork and interprofessional education practices, and the results indicate there were no significant differences between professions in relation to these attitudinal perspectives. The main barriers to interprofessional education were problems with scheduling/calendar, rigid curriculum, turf battles and lack of perceived value. The main pre-clinical subject areas which respondents believed would lend themselves to interprofessional education included community health/prevention, ethics, communications, critical appraisal, and epidemiology. The results of this study suggest that a favourable perception of both interprofessional teamwork and interprofessional education exists amongst academic administrators of Canadian health professional education programs. If this is the case, the post-secondary system in Canada is primed for the introduction of interprofessional education initiatives which support the development of client and patient-centred collaborative practice competencies.

Rethinking Health Professions Education through the Lens of Interprofessional Practice and Education

ERIC Educational Resources Information Center

Brandt, Barbara F.

2018-01-01

Using adult learning principles, health professions educators are well positioned to create interprofessional learning systems for collaborative, team-based practice in the transforming health-care system.

A Framework for Web-Based Interprofessional Education for Midwifery and Medical Students.

PubMed

Reis, Pamela J; Faser, Karl; Davis, Marquietta

2015-01-01

Scheduling interprofessional team-based activities for health sciences students who are geographically dispersed, with divergent and often competing schedules, can be challenging. The use of Web-based technologies such as 3-dimensional (3D) virtual learning environments in interprofessional education is a relatively new phenomenon, which offers promise in helping students come together in online teams when face-to-face encounters are not possible. The purpose of this article is to present the experience of a nurse-midwifery education program in a Southeastern US university in delivering Web-based interprofessional education for nurse-midwifery and third-year medical students utilizing the Virtual Community Clinic Learning Environment (VCCLE). The VCCLE is a 3D, Web-based, asynchronous, immersive clinic environment into which students enter to meet and interact with instructor-controlled virtual patient and virtual preceptor avatars and then move through a classic diagnostic sequence in arriving at a plan of care for women throughout the lifespan. By participating in the problem-based management of virtual patients within the VCCLE, students learn both clinical competencies and competencies for interprofessional collaborative practice, as described by the Interprofessional Education Collaborative Core Competencies for Interprofessional Collaborative Practice. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health. © 2015 by the American College of Nurse-Midwives.

Online interprofessional health sciences education: From theory to practice.

PubMed

Luke, Robert; Solomon, Patty; Baptiste, Sue; Hall, Pippa; Orchard, Carole; Rukholm, Ellen; Carter, Lorraine

2009-01-01

Online learning (e-learning) has a nascent but established history. Its application to interprofessional education (IPE), however, is relatively new. Over the past 2 decades the Internet has been used increasingly to mediate education. We have come past the point of "should we use the Internet for education" to "how should we use the Internet for education." Research has begun on the optimal development of online learning environments to support IPE. Developing online IPE should follow best practices in e-learning generally, though there are some special considerations for acknowledging the interprofessional context and clinical environments that online IPE is designed to support. The design, development, and deployment of effective online IPE must therefore pay special attention to the particular constraints of the health care worker educational matrix, both pre- and postlicensure. In this article we outline the design of online, interprofessional health sciences education. Our work has involved 4 educational and 4 clinical service institutions. We establish the context in which we situate our development activities that created learning modules designed to support IPE and its transfer into new interprofessional health care practices. We illustrate some best practices for the design of effective online IPE, and show how this design can create effective learning for IPE. Challenges exist regarding the full implementation of interprofessional clinical practice that are beginning to be met by coordinated efforts of multiple health care education silos.

Evaluation of perceived collaborative behaviour amongst stakeholders and clinicians of a continuing education programme in arthritis care.

PubMed

Lundon, Katie; Kennedy, Carol; Rozmovits, Linda; Sinclair, Lynne; Shupak, Rachel; Warmington, Kelly; Passalent, Laura; Brooks, Sydney; Schneider, Rayfel; Soever, Leslie

2013-09-01

Successful implementation of new extended practice roles which transcend conventional boundaries of practice entails strong collaboration with other healthcare providers. This study describes interprofessional collaborative behaviour perceived by advanced clinician practitioner in arthritis care (ACPAC) graduates at 1 year beyond training, and relevant stakeholders, across urban, community and remote clinical settings in Canada. A mixed-method approach involved a quantitative (survey) and qualitative (focus group/interview) evaluation issued across a 4-month period. ACPAC graduates work across heterogeneous settings and are on teams of diverse size and composition. Seventy per cent perceived their team as actively working in an interprofessional care model. Mean scores on the Bruyère Clinical Team Self-Assessment on Interprofessional Practice subjective subscales were high (range: 3.66-4.26, scale: 1-5 = better perception of team's interprofessional practice), whereas the objective scale was lower (mean: 4.6, scale: 0-9 = more interprofessional team practices). Data from focus groups (ACPAC graduates) and interviews (stakeholders) provided further illumination of these results at individual, group and system levels. Issues relating to ACPAC graduate role recognition, as well as their deployment, integration and institutional support, including access to medical directives, limitation of scope of practice, remuneration conflicts and tenuous funding arrangements were barriers perceived to affect role implementation and interprofessional working. This study offers the opportunity to reflect on newly introduced roles for health professionals with expectations of collaboration that will challenge traditional healthcare delivery.

Interprofessional primary care in academic family medicine clinics

PubMed Central

Drummond, Neil; Abbott, Karen; Williamson, Tyler; Somji, Behnaz

2012-01-01

Abstract Objective To explore the status and processes of interprofessional work environments and the implications for interprofessional education in a sample of family medicine teaching clinics. Design Focus group interviews using a purposive sampling procedure. Setting Four academic family medicine clinics in Alberta. Participants Seven family physicians, 9 registered nurses, 5 licensed practical nurses, 2 residents, 1 psychologist, 1 informatics specialist, 1 pharmacist, 1 dietitian, 1 nurse practitioner, 1 receptionist, and 1 respiratory therapist. Methods Assessment of clinic status and performance in relation to established principles of interprofessional work and education was explored using semistructured focus group interviews. Main findings Our data supported the D’Amour and Oandasan model of successful interprofessional collaborative practice in terms of the model’s main “factors” (ie, shared goals and vision, sense of belonging, governance, and the structuring of clinical care) and their constituent “elements.” It is reasonable to conclude that the extent to which these factors and elements are both present and positively oriented in academic clinic settings is an important contributory factor to the establishment of interprofessional collaborative practice in primary care. Using this model, 2 of the 4 clinics were rated as expressing substantial progress in relation to interprofessional work, while the other 2 clinics were rated as less successful on that dimension. None of the clinics was identified as having a clear and explicit focus on providing interprofessional education. Conclusion The key factor in relation to the implementation of interprofessional work in primary care appears to be the existence of clear and explicit leadership in that direction. Substantial scope exists for improvement in the organization, conduct, and promotion of interprofessional education for Canadian primary care. PMID:22893347

Practical Strategies for Integrating Interprofessional Education and Collaboration into the Curriculum.

PubMed

Prast, Jean; Herlache-Pretzer, Ellen; Frederick, Andrea; Gafni-Lachter, Liat

2016-01-01

Interprofessional collaboration is vital for the provision of quality patient care. Thoughtfully designed educational programs can help students of health professions develop interprofessional competencies and capacities, including values and ethics, roles and responsibilities, interprofessional communication, and teamwork (Interprofessional Education Collaborative Expert Panel, 2011). The authors were involved in developing Interprofessional Education (IPE) activities and simulations to be infused into the curriculums of the various health professions programs in their College. A review of the IPE experiences revealed students greatly benefited from involvement in a diverse set of IPE activities and simulations.

Educating for interprofessional practice: moving from knowing to being, is it the final piece of the puzzle?

PubMed

Ward, Helena; Gum, Lyn; Attrill, Stacie; Bramwell, Donald; Lindemann, Iris; Lawn, Sharon; Sweet, Linda

2017-01-06

Professional socialisation and identity arise from interactions occurring within university-based interprofessional education, and workplace-based interprofessional practice experience. However, it is unclear how closely language and concepts of academic learning situations align with workplace contexts for interprofessional learning. This paper reports on a study that brought together university-based educators responsible for teaching health professional students and health service-based practitioners who supervise students in the field. Interviews and focus groups with university-based educators and health service-base practitioners were used to explore perceptions of capabilities required for interprofessional practice. The qualitative data were then examined to explore similarities and differences in the language used by these groups. This analysis identified that there were language differences between the university-based educators and health service based practitioners involved in the project. The former demonstrated a curriculum lens, focusing on educational activities, student support and supervision. Conversely, health service-based practitioners presented a client-centred lens, with a focus on communication, professional disposition, attitude towards clients and co-workers, and authenticity of practice. Building on these insights, we theorise about the need for students to develop the self in order to be an interprofessional practitioner. The implications for health professional education in both university and workplace settings are explored.

Embedding technology into inter-professional best practices in home safety evaluation.

PubMed

Burns, Suzanne Perea; Pickens, Noralyn Davel

2017-08-01

To explore inter-professional home evaluators' perspectives and needs for building useful and acceptable decision-support tools for the field of home modifications. Twenty semi-structured interviews were conducted with a range of home modification professionals from different regions of the United States. The interview transcripts were analyzed with a qualitative, descriptive, perspective approach. Technology supports current best practice and has potential to inform decision making through features that could enhance home evaluation processes, quality, efficiency and inter-professional communication. Technological advances with app design have created numerous opportunities for the field of home modifications. Integrating technology and inter-professional best practices will improve home safety evaluation and intervention development to meet client-centred and societal needs. Implications for rehabilitation Understanding home evaluators technology needs for home safety evaluations contributes to the development of app-based assessments. Integrating inter-professional perspectives of best practice and technological needs in an app for home assessments improves processes. Novice and expert home evaluators would benefit from decision support systems embedded in app-based assessments. Adoption of app-based assessment would improve efficiency while remaining client-centred.

Deliberate Practice as a Theoretical Framework for Interprofessional Experiential Education.

PubMed

Wang, Joyce M; Zorek, Joseph A

2016-01-01

The theory of deliberate practice has been applied to many skill-based performance activities. The primary aim of this project was to integrate synergistic principles from deliberate practice and consensus-derived competencies for interprofessional education into a framework upon which educational models to advance interprofessional experiential education (IEE) might be built. CINAHL, ERIC, and MEDLINE databases were searched using the keywords "deliberate practice" and "interprofessional education," both individually and in combination. Relevant articles were selected from the catalog based on support for the premise of the project. Defining characteristics of deliberate practice were distilled with particular emphasis on their application to the Interprofessional Education Collaborative's (IPEC) core competencies. Recommendations for IEE development were identified through the synthesis of deliberate practice principles and IPEC competencies. There is a high degree of synergy between deliberate practice principles and IPEC competencies. Our synthesis of the literature yielded a cyclical four-step process to advance IEE: (1) implement an IEE plan guided by the student's strengths/weaknesses and in consideration of the collaborative practice skills they wish to develop, (2) engage in IPE experiences that will challenge targeted skills according to the IEE plan, (3) embed frequent opportunities for student reflection and preceptor/team feedback within IEE plan, and (4) revise the IEE plan and the IPE experience based on insights gained during step 3. The cyclical four-step process synthesized through this literature review may be used to guide the development of new IEE models. The purposeful development of IEE models grounded in a theory that has already been operationalized in other skill-based performance areas is an important step to address expanding accreditation standards throughout the health professions mandating interprofessional education for pre-licensure health professional students.

A cross-sectional study of paramedics' readiness for interprofessional learning and cooperation: results from five universities.

PubMed

Williams, Brett; Boyle, Malcolm; Brightwell, Richard; McCall, Michael; McMullen, Paula; Munro, Graham; O'Meara, Peter; Webb, Vanessa

2013-11-01

Healthcare systems are evolving to feature the promotion of interprofessional practice more prominently. The development of successful and functional interprofessional practice is best achieved through interprofessional learning. Given that most paramedic programmes take an isolative uni-professional educational approach to their healthcare undergraduate courses, serious questions must be raised as to whether students are being adequately prepared for the interprofessional healthcare workplace. The objective of this study was to assess the attitudes of paramedic students towards interprofessional learning across five Australian universities. Using a convenience sample of paramedic student attitudes towards interprofessional learning and cooperation were measured using two standardised self-reporting instruments: Readiness for Interprofessional Learning Scale (RIPLS) and Interdisciplinary Education Perception Scale (IEPS). Students' readiness for interprofessional learning did not appear to be significantly influenced by their gender nor the type of paramedic degree they were undertaking. As students progressed through their degrees their appreciation for collaborative teamwork and their understanding of paramedic identity grew, however this appeared to negatively affect their willingness to engage in interprofessional learning with other healthcare students. The tertiary institute attended also appeared to influence students' preparedness and attitudes to shared learning. This study has found no compelling evidence that students' readiness for interprofessional learning is significantly affected by either their gender or the type of degree undertaken. By contrast it was seen that the tertiary institutions involved in this study produced students at different levels of preparedness for IPL and cooperation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Interprofessional simulated learning: short-term associations between simulation and interprofessional collaboration

PubMed Central

2011-01-01

Background Health professions education programs use simulation for teaching and maintaining clinical procedural skills. Simulated learning activities are also becoming useful methods of instruction for interprofessional education. The simulation environment for interprofessional training allows participants to explore collaborative ways of improving communicative aspects of clinical care. Simulation has shown communication improvement within and between health care professions, but the impacts of teamwork simulation on perceptions of others' interprofessional practices and one's own attitudes toward teamwork are largely unknown. Methods A single-arm intervention study tested the association between simulated team practice and measures of interprofessional collaboration, nurse-physician relationships, and attitudes toward health care teams. Participants were 154 post-licensure nurses, allied health professionals, and physicians. Self- and proxy-report survey measurements were taken before simulation training and two and six weeks after. Results Multilevel modeling revealed little change over the study period. Variation in interprofessional collaboration and attitudes was largely attributable to between-person characteristics. A constructed categorical variable indexing 'leadership capacity' found that participants with highest and lowest values were more likely to endorse shared team leadership over physician centrality. Conclusion Results from this study indicate that focusing interprofessional simulation education on shared leadership may provide the most leverage to improve interprofessional care. PMID:21443779

Interprofessional immersion: Use of interprofessional education collaborative competencies in side-by-side training of family medicine, pharmacy, nursing, and counselling psychology trainees.

PubMed

Boland, Daubney Harper; Scott, Mary Alice; Kim, Helen; White, Traci; Adams, Eve

2016-11-01

While supported by the Affordable Care Act, in the United States, interprofessional training often takes place after healthcare providers graduate and are practicing in the field. This article describes the implementation and evaluation of an interprofessional training for graduate-level healthcare trainees. A group of interprofessional healthcare faculty provided a weeklong interprofessional immersion for doctoral-level healthcare trainees (n = 24) in Pharmacy, Counselling Psychology, Nursing, and Family Medicine residents. Healthcare faculty and staff from each profession worked side-by-side to provide integrated training utilising the Interprofessional Education Collaborative core competency domains. Trainees were placed into small teams with representatives from each profession; each team observed, learned, and practiced working within teams to provide quality patient care. Qualitative and quantitative data were collected to identify the effect of the training on trainees' self-reported team skills, as well as the extent to which the trainees learned and utilised the competencies. The results suggest that after completing the training, trainees felt more confident in their ability to work within an interprofessional team and more likely to utilise a team-based approach in the future.

Interprofessional collaboration: three best practice models of interprofessional education

PubMed Central

Bridges, Diane R.; Davidson, Richard A.; Odegard, Peggy Soule; Maki, Ian V.; Tomkowiak, John

2011-01-01

Interprofessional education is a collaborative approach to develop healthcare students as future interprofessional team members and a recommendation suggested by the Institute of Medicine. Complex medical issues can be best addressed by interprofessional teams. Training future healthcare providers to work in such teams will help facilitate this model resulting in improved healthcare outcomes for patients. In this paper, three universities, the Rosalind Franklin University of Medicine and Science, the University of Florida and the University of Washington describe their training curricula models of collaborative and interprofessional education. The models represent a didactic program, a community-based experience and an interprofessional-simulation experience. The didactic program emphasizes interprofessional team building skills, knowledge of professions, patient centered care, service learning, the impact of culture on healthcare delivery and an interprofessional clinical component. The community-based experience demonstrates how interprofessional collaborations provide service to patients and how the environment and availability of resources impact one's health status. The interprofessional-simulation experience describes clinical team skills training in both formative and summative simulations used to develop skills in communication and leadership. One common theme leading to a successful experience among these three interprofessional models included helping students to understand their own professional identity while gaining an understanding of other professional's roles on the health care team. Commitment from departments and colleges, diverse calendar agreements, curricular mapping, mentor and faculty training, a sense of community, adequate physical space, technology, and community relationships were all identified as critical resources for a successful program. Summary recommendations for best practices included the need for administrative support, interprofessional programmatic infrastructure, committed faculty, and the recognition of student participation as key components to success for anyone developing an IPE centered program. PMID:21519399

Interprofessional collaboration: three best practice models of interprofessional education.

PubMed

Bridges, Diane R; Davidson, Richard A; Odegard, Peggy Soule; Maki, Ian V; Tomkowiak, John

2011-04-08

Interprofessional education is a collaborative approach to develop healthcare students as future interprofessional team members and a recommendation suggested by the Institute of Medicine. Complex medical issues can be best addressed by interprofessional teams. Training future healthcare providers to work in such teams will help facilitate this model resulting in improved healthcare outcomes for patients. In this paper, three universities, the Rosalind Franklin University of Medicine and Science, the University of Florida and the University of Washington describe their training curricula models of collaborative and interprofessional education.The models represent a didactic program, a community-based experience and an interprofessional-simulation experience. The didactic program emphasizes interprofessional team building skills, knowledge of professions, patient centered care, service learning, the impact of culture on healthcare delivery and an interprofessional clinical component. The community-based experience demonstrates how interprofessional collaborations provide service to patients and how the environment and availability of resources impact one's health status. The interprofessional-simulation experience describes clinical team skills training in both formative and summative simulations used to develop skills in communication and leadership.One common theme leading to a successful experience among these three interprofessional models included helping students to understand their own professional identity while gaining an understanding of other professional's roles on the health care team. Commitment from departments and colleges, diverse calendar agreements, curricular mapping, mentor and faculty training, a sense of community, adequate physical space, technology, and community relationships were all identified as critical resources for a successful program. Summary recommendations for best practices included the need for administrative support, interprofessional programmatic infrastructure, committed faculty, and the recognition of student participation as key components to success for anyone developing an IPE centered program.

An intrepreneurial innovative role: integration of the clinical nurse specialist and infection prevention professional.

PubMed

Pintar, Paula A

2013-01-01

Hospital quality and financial sustainability rely on reducing healthcare-associated events/infections, length of stay, and readmissions. This project focused on designing an integrated role for the clinical nurse specialist (CNS) and the infection prevention professional (IPP) to proactively manage the delivery of evidence-based practice to high-risk surgical patients. The healthcare industry is in the midst of a paradigm shift driven by changing health policy focusing on quality indicators, patient satisfaction, and lowering costs. Coupled with these indicators is the expectation and responsibility to provide evidence-based practice at all levels of the healthcare continuum. This paradigm shift places healthcare facilities in a very competitive atmosphere as they rally for the revenue of a fixed payer mix. A literature search using CINHAL, PubMed, and the CNS national listserve databases was completed to identify if there was any previously written information available on an integrated role of the CNS/IPP. An online business plan template was used to communicate the significance, implications, and return on organizational investment to practice with establishing this role. Chronic health conditions such as diabetes, hypertension, congestive heart failure, and colonization with multidrug-resistant organisms can place patients at an increased risk for developing a surgical site infection or complications. The CNS/IPP will proactively manage these risk factors, including the patient and family in a preventive care model to manage the acute inpatient high-risk surgical patient. Care management will include coordinated, collaborative, and consultative follow-up by the CNS/IPP in the acute care, long-term care facilities, and home settings. The infection prevention skill set brings a level of clinical expertise that makes a unique CNS. The IPP is immersed in using epidemiological principles that examine the impact of comorbidities and the added risk that can contribute to developing a surgical site infection. This CNS/IPP incorporates the CNS Spheres of Influence Model and the Association of Professionals in Infection Prevention Competency Model. This combination advanced practice nurse uses a nurse-managed model of care focused on patient/family education, prevention, and self-care management. Therefore, this specific and specialized practice will bring value to the organization by improving financial outcomes through reducing infections, readmission rates, and length of stay. By providing this level of focused care, patient satisfaction will improve and system financial stability will be supported by decreasing hospital readmissions, length of stay, and other hospital-acquired conditions that the surgical candidate is prone to developing. The critical juncture in healthcare is providing opportunities for innovation by examining the CNS role and considering the feasibility of pairing it with the infection preventionist skills. This pairing provides an unprecedented opportunity to improve patient outcomes across the continuum of care. This provider has the ability to influence the Centers for Medicare and Medicaid Services quality indicators in a positive way by using implementation science to partner with system/organization stakeholders that focuses on prevention rather than reactive care processes. The dynamic trends in healthcare continue to drive "intrepreneurial," innovative, and creative ways of thinking; provide clinical practice that has the ability to perform nimbly; and maintain a proactive vision to provide quality care to a diverse patient population. This CNS/IPP role meets the dynamic proactive planning that will shift with patient, system, and nursing needs to deliver cost-effective managed care to improve the health of our patients.

Interprofessional collaborative teamwork facilitates patient centred care: a student practitioner's perspective.

PubMed

Osbiston, Mark

2013-05-01

Interprofessional teamwork and collaboration are essential for facilitating perioperative patient centred care. Operating department practitioners (ODPs) and nurses are registered professional 'practitioner' members of the perioperative team. Standards of conduct, communication skills, ethical principles and confidentiality legislation associated with documented patient information underpin and guide perioperative practitioner practice. This article will discuss, from a student's theoretical and practice experience perspective, the registered professional 'practitioner' role in the context of the interprofessional team.

Nourishing networks: an interprofessional learning model and its application to the Australian rural health workforce.

PubMed

Little, F; Brown, L; Grotowski, M; Harris, D

2012-01-01

Access to continuing professional development for rural health clinicians requires strategies to overcome barriers associated with finances, travel and a lack of resources. Approaches to providing professional development need to transcend conventional educational methods and consider interprofessional educational opportunities to meet the diverse needs of the rural health workforce. Rural clinicians often work in professional isolation and frequently work collaboratively with clinicians from a range of other health disciplines. Interprofessional learning and practice is therefore important in a rural areas as clinicians working in these settings are often more reliant on each other and require an understanding of other's roles to provide effective health care. In addition, specialist services are limited in rural areas, with health professionals increasingly required to perform extended roles at an advanced-practice level. A model for interprofessional learning has been developed to attempt to address the barriers related to the delivery of interprofessional education in the rural health setting in Australia. This model demonstrates a flexible approach to interprofessional learning which meets different educational needs across a number of health disciplines, and is tailored to varying levels of expertise. It incorporates three learning approaches: traditional learning, flexible learning and advanced practice. Each of these components of the model are described and the Nourishing Networks program is provided as an example of the application of the model in a rural setting, utilising 'eating disorders' as the educational topic. Interprofessional learning can be delivered effectively in a rural setting by utilising technology to help bridge the isolation experienced in rural practice. Challenges in delivering the interprofessional learning program included: engaging rural general practitioners, utilising technology and maintaining participant engagement. The use of technology is essential to access a broad group of rural clinicians however, there are limitations in its use that must be acknowledged. The pilot of the Stepped Interprofessional Rural Learning Model and its application to eating disorders has scope for use in delivering education for other health topics.

Faculty Development for Continuing Interprofessional Education and Collaborative Practice

ERIC Educational Resources Information Center

Silver, Ivan L.; Leslie, Karen

2009-01-01

This article proposes a framework for faculty development in continuing interprofessional education (CIPE) and collaborative practice. The framework is built on best practices in faculty development and CIPE. It was informed by local experience in the development, delivery, and evaluation of a faculty development program to promote capacity for…

Interprofessional mental health training in rural primary care: findings from a mixed methods study.

PubMed

Heath, Olga; Church, Elizabeth; Curran, Vernon; Hollett, Ann; Cornish, Peter; Callanan, Terrence; Bethune, Cheri; Younghusband, Lynda

2015-05-01

The benefits of interprofessional care in providing mental health services have been widely recognized, particularly in rural communities where access to health services is limited. There continues to be a need for more continuing interprofessional education in mental health intervention in rural areas. There have been few reports of rural programs in which mental health content has been combined with training in collaborative practice. The current study used a sequential mixed-method and quasi-experimental design to evaluate the impact of an interprofessional, intersectoral education program designed to enhance collaborative mental health capacity in six rural sites. Quantitative results reveal a significant increase in positive attitudes toward interprofessional mental health care teams and self-reported increases in knowledge and understanding about collaborative mental health care delivery. The analysis of qualitative data collected following completion of the program, reinforced the value of teaching mental health content within the context of collaborative practice and revealed practice changes, including more interprofessional and intersectoral collaboration. This study suggests that imbedding explicit training in collaborative care in content focused continuing professional education for more complex and chronic health issues may increase the likelihood that professionals will work together to effectively meet client needs.

A Curricular Innovation to Promote Interprofessional Collaboration

ERIC Educational Resources Information Center

Liston, Beth W.; Wagner, Janet; Miller, Jackie

2013-01-01

Background: Interprofessional teamwork is a crucial competency in health professions education which improves patient care. However, interprofessional education is not a widespread practice in medical schools. To address this need, we developed an educational pilot utilizing a standardized patient simulation to teach interprofessional…

An Anatomy of Continuing Interprofessional Education

ERIC Educational Resources Information Center

Barr, Hugh

2009-01-01

Continuing interprofessional education is the means by which experienced health, social care, and other practitioners learn with, from, and about each other, formally and informally, to improve their collective practice and to cultivate closer collaboration. It applies principles of interprofessional education through media commonly employed in…

Interprofessional educator development : Build it and they will come.

PubMed

Pien, Lily C; Stiber, Michaela; Prelosky, Allison; Colbert, Colleen Y

2018-04-16

We describe an interprofessional educator development program, designed intentionally, that was implemented at an academic healthcare centre. In 2014, we purposefully adapted our pre-existing educator development program to be able to include all interprofessional educators at our institution. The program's goals were to enhance educator skills, a common need due to requirements of accreditation, and to create a local interprofessional community of teachers. The framework of the program was based upon adult learning principles, reflective practice, experiential learning and peer groups, all key characteristics of faculty development programs. It was also longitudinal and immersive. Kirkpatrick's program evaluation model was used for identifying results; participants' self-reported evaluation forms were collected and their narrative comments were analyzed. After we opened our educator program to all interprofessional staff, our number of program participants increased. The interprofessional participants included, but was not limited to, physicians, physician trainees, nurses, physician assistants, audiologists, perfusionists, and basic science researchers. Our number of program sessions and program faculty were expanded. Our interprofessional participants reported that they were able to learn essential knowledge, skills and attitudes for their growth and development as educators, in the context of an interprofessional community, while also appreciating the diversity of their peers. We share our insights with the redesign and implementation of an interprofessional educator program so that others can learn from our experiences. Key takeaways include using a conceptual framework for teaching effectiveness, involving interprofessional stakeholders and obtaining their perspectives, reviewing interprofessional literature and competencies, and highlighting best practices across the disciplines.

Preparing Nursing Students for Interprofessional Practice: The Interdisciplinary Curriculum for Oncology Palliative Care Education.

PubMed

Hermann, Carla P; Head, Barbara A; Black, Karen; Singleton, Karen

2016-01-01

Interprofessional educational experiences for baccalaureate nursing students are essential to prepare them for interprofessional communication, collaboration, and team work. Nurse educators are ideally positioned to develop and lead such initiatives. The purpose of this article is to describe the development and implementation of an interprofessional education (IPE) project involving students in nursing, medicine, social work, and chaplaincy. The Interdisciplinary Curriculum for Oncology Palliative Care Education project uses team-based palliative oncology education as the framework for teaching students interprofessional practice skills. The need for IPE is apparent, but there are very few comprehensive, successful projects for nurse educators to use as models. This article describes the development of the curriculum by the interprofessional faculty team. Issues encountered by nursing faculty members as they implemented the IPE experience are discussed. Solutions developed to address the issues and ongoing challenges are presented. This project can serve as a model of a successful IPE initiative involving nursing students. Copyright © 2016 Elsevier Inc. All rights reserved.

Integration of systematic clinical interprofessional training in a student-faculty collaborative primary care practice.

PubMed

Weinstein, Amy R; Dolce, Maria C; Koster, Megan; Parikh, Ravi; Hamlyn, Emily; A McNamara, Elizabeth; Carlson, Alexa; DiVall, Margarita V

2018-01-01

The changing healthcare environment and movement toward team-based care are contemporary challenges confronting health professional education. The primary care workforce must be prepared with recent national interprofessional competencies to practice and lead in this changing environment. From 2012 to 2014, the weekly Beth Israel Deaconess Crimson Care Collaborative Student-Faculty Practice collaborated with Northeastern University to develop, implement and evaluate an innovative model that incorporated interprofessional education into primary care practice with the goal of improving student understanding of, and ability to deliver quality, team-based care. In the monthly interprofessional clinic, an educational curriculum empowered students with evidence-based, team-based care principles. Integration of nursing, pharmacy, medicine, and masters of public health students and faculty into direct patient care, provided the opportunity to practice skills. The TeamSTEPPS® Teamwork Attitudes Questionnaire was administered pre- and post-intervention to assess its perceived impact. Seventeen students completed the post-intervention survey. Survey data indicated very positive attitudes towards team-based care at baseline. Significant improvements were reported in attitudes towards situation monitoring, limiting personal conflict, administration support and communication. However, small, but statistically significant declines were seen on one team structure and two communication items. Our program provides further evidence for the use of interprofessional training in primary care.

Continuing Professional Development: Pedagogical Practices of Interprofessional Simulation in Health Care

ERIC Educational Resources Information Center

Nyström, Sofia; Dahlberg, Johanna; Edelbring, Samuel; Hult, Håkan; Abrandt Dahlgren, Madeleine

2017-01-01

The increasing complexity of health care practice makes continuing professional development (CPD) essential for health care professionals. Simulation-based training is a CPD activity that is often applied to improve interprofessional collaboration and the quality of care. The aim of this study is to explore simulation as a pedagogical practice for…

Inter-Professional Education of Prospective Speech-Language Therapists and Primary School Teachers through Shared Professional Practice Placements

ERIC Educational Resources Information Center

Wilson, Leanne; McNeill, Brigid; Gillon, Gail T.

2017-01-01

Background: Preliminary studies of inter-professional education (IPE) among student speech-language therapists (SLTs) and student teachers suggest that workshop-based applications are beneficial in preparing participants for elements of collaborative practice. Situating IPE within the students' professional practice placements may provide another…

Anaerobic Degradation Pathway of the Novel Chiral Insecticide Paichongding and Its Impact on Bacterial Communities in Soils.

PubMed

Cai, Zhiqiang; Wang, Jing; Ma, Jiangtao; Zhu, Xiaolin; Cai, Jinyan; Yang, Guanghua

2015-08-19

To comprehensively understand anaerobic degradation of the novel cis-nitromethylene neonicotinoid insecticide Paichongding (IPP) and its impacts on microbial communities in anaerobic soils, we investigated IPP degradation characteristics, kinetics, and pathway in four different soils. The bacterial community in response to the application of IPP using pyrosequencing of 16S rRNA gene amplicons was also studied. The removal ratio of IPP stereoisomers (RR-IPP, SS-IPP, RS-IPP, and SR-IPP) reached >90% at 60 days after IPP treatment (DAT) in yellow loam soil (F) and paddy field on desalting muddy polder (C), whereas the degradation ratios of RR-IPP and SS-IPP were <30% at 60 DAT in Huangshi soil (J) and yellow paddy soil (H). The results showed that the anaerobic degradation rate of IPP and its stereoisomers was strongly affected by soil physical-chemical characteristics. Furthermore, on the basis of the six metabolites (M1-M6) identified by LC-MS/MS and their behavior, the anaerobic degradation pathway of IPP in soils was proposed. Biodegradation of IPP involved continuous biocatalytic reactions such as nitro reduction and elimination, hydrolysis, demethyl, and ether cleavage reactions. A higher richness of operational taxonomic units (OTUs) was found in soils without IPP application than in soils with IPP application. Both the rarefaction curves and Shannon-Wiener diversity index in anaerobic soils had significant difference after IPP application, and the community composition also differed at both the phyla and genus levels.

Development and initial validation of the interprofessional team learning profiling questionnaire.

PubMed

Nisbet, Gillian; Dunn, Stewart; Lincoln, Michelle; Shaw, Joanne

2016-05-01

Informal workplace interprofessional learning occurs as health professionals interact with each other as part of everyday work practice. Participation in interprofessional team meetings is a practical way to foster learning. However, a gap exists in the availability of a reliable and valid instrument that adequately captures the nuances of informal workplace interprofessional learning in this setting. The purpose of this study was to develop a questionnaire to measure the different components of interprofessional learning that contribute to the quality of interprofessional learning within the interprofessional team meeting. Questionnaire items were developed from a review of the literature and interviews with health professionals. Exploratory factor analysis was used to determine the underlying factor structure. Two hundred and eighty-five health professionals completed a 98-item questionnaire. After elimination of unreliable items, the remaining items (n = 41) loaded onto four factors named personal and professional capacity; turning words into action-"walk the talk"; the rhetoric of interprofessional learning-"talk the talk"; and inclusiveness. Internal consistency was high for all sub-scales (Cronbach's alpha 0.91, 0.87, 0.83, and 0.83, respectively). Content, construct, and concurrent validity were assessed. The instrument developed in this study indicated consistency and robust psychometric properties. Future studies that further test the psychometric properties of the questionnaire will help to establish the usefulness of this measure in establishing evidence for the perceived effectiveness of interprofessional learning in a healthcare setting.

An approach to integrating interprofessional education in collaborative mental health care.

PubMed

Curran, Vernon; Heath, Olga; Adey, Tanis; Callahan, Terrance; Craig, David; Hearn, Taryn; White, Hubert; Hollett, Ann

2012-03-01

This article describes an evaluation of a curriculum approach to integrating interprofessional education (IPE) in collaborative mental health practice across the pre- to post-licensure continuum of medical education. A systematic evaluation of IPE activities was conducted, utilizing a combination of evaluation study designs, including: pretest-posttest control group; one-group pre-test-post-test; and one-shot case study. Participant satisfaction, attitudes toward teamwork, and self-reported teamwork abilities were key evaluative outcome measures. IPE in collaborative mental health practice was well received at both the pre- and post-licensure levels. Satisfaction scores were very high, and students, trainees, and practitioners welcomed the opportunity to learn about collaboration in the context of mental health. Medical student satisfaction increased significantly with the introduction of standardized patients (SPs) as an interprofessional learning method. Medical students and faculty reported that experiential learning in practice-based settings is a key component of effective approaches to IPE implementation. At a post-licensure level, practitioners reported significant improvement in attitudes toward interprofessional collaboration in mental health care after participation in IPE. IPE in collaborative mental health is feasible, and mental health settings offer practical and useful learning experiences for students, trainees, and practitioners in interprofessional collaboration.

Leveraging mobile smart devices to improve interprofessional communications in inpatient practice setting: A literature review.

PubMed

Aungst, Timothy Dy; Belliveau, Paul

2015-01-01

As mobile smart device use has increased in society, the healthcare community has begun using these devices for communication among professionals in practice settings. The purpose of this review is to describe primary literature which reports on the experiences with interprofessional healthcare communication via mobile smart devices. Based on these findings, this review also addresses how these devices may be utilized to facilitate interprofessional education (IPE) in health professions education programs. The literature search revealed limited assessments of mobile smart device use in clinical practice settings. In available reports, communication with mobile smart devices was perceived as more effective and faster among interdisciplinary members. Notable drawbacks included discrepancies in the urgency labeling of messages, increased interruptions associated with constant accessibility to team members, and professionalism breakdowns. Recently developed interprofessional competencies include an emphasis on ensuring that health profession students can effectively communicate on interprofessional teams. With the increasing reliance on mobile smart devices in the absence of robust benefit and risk assessments on their use in clinical practice settings, use of these devices may be leveraged to facilitate IPE activities in health education professions programs while simultaneously educating students on their proper use in patient care settings.

Interprofessional collaboration to improve professional practice and healthcare outcomes.

PubMed

Reeves, Scott; Pelone, Ferruccio; Harrison, Reema; Goldman, Joanne; Zwarenstein, Merrick

2017-06-22

Poor interprofessional collaboration (IPC) can adversely affect the delivery of health services and patient care. Interventions that address IPC problems have the potential to improve professional practice and healthcare outcomes. To assess the impact of practice-based interventions designed to improve interprofessional collaboration (IPC) amongst health and social care professionals, compared to usual care or to an alternative intervention, on at least one of the following primary outcomes: patient health outcomes, clinical process or efficiency outcomes or secondary outcomes (collaborative behaviour). We searched CENTRAL (2015, issue 11), MEDLINE, CINAHL, ClinicalTrials.gov and WHO International Clinical Trials Registry Platform to November 2015. We handsearched relevant interprofessional journals to November 2015, and reviewed the reference lists of the included studies. We included randomised trials of practice-based IPC interventions involving health and social care professionals compared to usual care or to an alternative intervention. Two review authors independently assessed the eligibility of each potentially relevant study. We extracted data from the included studies and assessed the risk of bias of each study. We were unable to perform a meta-analysis of study outcomes, given the small number of included studies and their heterogeneity in clinical settings, interventions and outcomes. Consequently, we summarised the study data and presented the results in a narrative format to report study methods, outcomes, impact and certainty of the evidence. We included nine studies in total (6540 participants); six cluster-randomised trials and three individual randomised trials (1 study randomised clinicians, 1 randomised patients, and 1 randomised clinicians and patients). All studies were conducted in high-income countries (Australia, Belgium, Sweden, UK and USA) across primary, secondary, tertiary and community care settings and had a follow-up of up to 12 months. Eight studies compared an IPC intervention with usual care and evaluated the effects of different practice-based IPC interventions: externally facilitated interprofessional activities (e.g. team action planning; 4 studies), interprofessional rounds (2 studies), interprofessional meetings (1 study), and interprofessional checklists (1 study). One study compared one type of interprofessional meeting with another type of interprofessional meeting. We assessed four studies to be at high risk of attrition bias and an equal number of studies to be at high risk of detection bias.For studies comparing an IPC intervention with usual care, functional status in stroke patients may be slightly improved by externally facilitated interprofessional activities (1 study, 464 participants, low-certainty evidence). We are uncertain whether patient-assessed quality of care (1 study, 1185 participants), continuity of care (1 study, 464 participants) or collaborative working (4 studies, 1936 participants) are improved by externally facilitated interprofessional activities, as we graded the evidence as very low-certainty for these outcomes. Healthcare professionals' adherence to recommended practices may be slightly improved with externally facilitated interprofessional activities or interprofessional meetings (3 studies, 2576 participants, low certainty evidence). The use of healthcare resources may be slightly improved by externally facilitated interprofessional activities, interprofessional checklists and rounds (4 studies, 1679 participants, low-certainty evidence). None of the included studies reported on patient mortality, morbidity or complication rates.Compared to multidisciplinary audio conferencing, multidisciplinary video conferencing may reduce the average length of treatment and may reduce the number of multidisciplinary conferences needed per patient and the patient length of stay. There was little or no difference between these interventions in the number of communications between health professionals (1 study, 100 participants; low-certainty evidence). Given that the certainty of evidence from the included studies was judged to be low to very low, there is not sufficient evidence to draw clear conclusions on the effects of IPC interventions. Neverthess, due to the difficulties health professionals encounter when collaborating in clinical practice, it is encouraging that research on the number of interventions to improve IPC has increased since this review was last updated. While this field is developing, further rigorous, mixed-method studies are required. Future studies should focus on longer acclimatisation periods before evaluating newly implemented IPC interventions, and use longer follow-up to generate a more informed understanding of the effects of IPC on clinical practice.

Preparing Social Work Students for Interprofessional Practice in Geriatric Health Care: Insights from Two Approaches

ERIC Educational Resources Information Center

Bonifas, Robin P.; Gray, Amanda K.

2013-01-01

Although several interprofessional education projects have addressed training allied health students for effective teamwork in geriatrics, few curriculum evaluation studies have examined differences in learning outcomes between interprofessional and traditional uniprofessional approaches, especially for social work students. This paper compares…

Interprofessional E-Learning and Collaborative Work: Practices and Technologies

ERIC Educational Resources Information Center

Bromage, Adrian, Ed.; Clouder, Lynn, Ed.; Thistlethwaite, Jill, Ed.; Gordon, Frances, Ed.

2010-01-01

Interprofessionalism, an emerging model and philosophy of multi-disciplinary and multi-agency working, has in increasingly become an important means of cultivating joint endeavors across varied and diverse disciplinary and institutional settings. This book is therefore, an important source for understanding how interprofessionalism can be promoted…

Framework development for the assessment of interprofessional teamwork in mental health settings.

PubMed

Tomizawa, Ryoko; Shigeta, Masahiro; Reeves, Scott

2017-01-01

In mental health settings, interprofessional practice is regarded as a comprehensive approach to prevent relapse and manage chronic conditions with practice of various teamwork interventions. To reinforce the potential of interprofessional teamwork, it is recommended that theories or conceptual frameworks be employed. There continues, however, to be a limited use of such approaches that assess the quality of interprofessional teamwork in mental health settings. This article aimed to present a new conceptual framework for the assessment of interprofessional teamwork based on the findings of a scoping review of the literature. This review was undertaken to identify conceptual frameworks utilised in interprofessional teamwork in mental health settings. After reviewing 952 articles, the methodological characteristics extracted from 12 articles were considered. The included studies were synthesised into the Donabedian structure-process-outcome model. The findings revealed that structural issues comprised three elements: professional characteristics, client-care characteristics, and contextual characteristics in organisations. Process issues comprised two elements: team mechanisms and community-oriented services. Finally, outcome issues comprised the following elements: clients' outcomes and professionals' outcomes. The review findings suggested possibilities for further development of how to assess the quality of interprofessional teamwork and provided information about what specific approach is required to improve interprofessional teamwork. Future research should utilise various areas and cultures to clarify the adaptation potential.

Preparing Interprofessional Faculty to Be Humanistic Mentors for Medical Students: The GW-Gold Mentor Development Program.

PubMed

Blatt, Benjamin; Plack, Margaret M; Simmens, Samuel J

2018-01-01

The GW-Gold Humanistic Mentor Development Program addresses the challenge faced by medical schools to educate faculty to prepare students for humanistic practice. Grounded in Branch's Teaching Professional and Humanistic Values model, the program prepares interprofessional faculty mentoring teams in humanistic communities of practice. The teams consist of physician-psychosocial professional pairs, each mentoring a small student group in their professional development course. Through GW-Gold workshops, faculty mentors develop interprofessional humanistic communities of practice, preparing them to lead second such communities with their students. This article describes the program and its evaluation. To assess outcomes and better understand the mentor experience, we used a mixed-method validating triangulation design consisting of simultaneous collection of quantitative (mentor and student surveys) and qualitative (open-ended survey questions and focus group) data. Data were analyzed in parallel and merged at the point of interpretation, allowing for triangulation and validation of outcomes. Mentors rated the program highly, gained confidence in their humanistic skills, and received high scores from students. Three themes emerged that validated program design, confirmed outcomes, and expanded on the mentor experience: (1) Interprofessional faculty communities developed through observation, collaboration, reflection, and dialogue; (2) Humanistic mentors created safe environments for student engagement; and (3) Engaging in interprofessional humanistic communities of practice expanded mentors' personal and professional identities. Outcomes support the value of the GW-Gold program's distinctive features in preparing faculty to sustain humanism in medical education: an interprofessional approach and small communities of practice built on humanistic values.

An Interprofessional Approach to Business Planning: A Model of Collaboration

ERIC Educational Resources Information Center

Ross, Cory; Alexander, Kathleen; Gritsyuk, Renata; Morrin, Arleen; Tan, Jackie

2011-01-01

George Brown College is among the leaders in the interprofessional health-care education movement in Canada. Interprofessional Education (IPE) and Collaborative Practice occur "when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes." According to the…

Interprofessional education and the basic sciences: Rationale and outcomes.

PubMed

Thistlethwaite, Jill E

2015-01-01

Interprofessional education (IPE) aims to improve patient outcomes and the quality of care. Interprofessional learning outcomes and interprofessional competencies are now included in many countries' health and social care professions' accreditation standards. While IPE may take place at any time in health professions curricula it tends to focus on professionalism and clinical topics rather than basic science activities. However generic interprofessional competencies could be included in basic science courses that are offered to at least two different professional groups. In developing interprofessional activities at the preclinical level, it is important to define explicit interprofessional learning outcomes plus the content and process of the learning. Interprofessional education must involve interactive learning processes and integration of theory and practice. This paper provides examples of IPE in anatomy and makes recommendations for course development and evaluation. © 2015 American Association of Anatomists.

Praxis and reflexivity for interprofessional education: towards an inclusive theoretical framework for learning.

PubMed

Hutchings, Maggie; Scammell, Janet; Quinney, Anne

2013-09-01

While there is growing evidence of theoretical perspectives adopted in interprofessional education, learning theories tend to foreground the individual, focusing on psycho-social aspects of individual differences and professional identity to the detriment of considering social-structural factors at work in social practices. Conversely socially situated practice is criticised for being context-specific, making it difficult to draw generalisable conclusions for improving interprofessional education. This article builds on a theoretical framework derived from earlier research, drawing on the dynamics of Dewey's experiential learning theory and Archer's critical realist social theory, to make a case for a meta-theoretical framework enabling social-constructivist and situated learning theories to be interlinked and integrated through praxis and reflexivity. Our current analysis is grounded in an interprofessional curriculum initiative mediated by a virtual community peopled by health and social care users. Student perceptions, captured through quantitative and qualitative data, suggest three major disruptive themes, creating opportunities for congruence and disjuncture and generating a model of zones of interlinked praxis associated with professional differences and identity, pedagogic strategies and technology-mediated approaches. This model contributes to a framework for understanding the complexity of interprofessional learning and offers bridges between individual and structural factors for engaging with the enablements and constraints at work in communities of practice and networks for interprofessional education.

Faculty/Librarian Interprofessional Collaboration and Information Literacy in Higher Education

ERIC Educational Resources Information Center

Franklin, Kimberly Y.

2013-01-01

Collaboration is a best practice for integrating information literacy into teaching and learning, but extant research suggests that differences between the professional practice and professional socialization of faculty and librarians can hinder collaboration. This dissertation examines interprofessional factors that facilitate and hinder…

Expanding collaborative boundaries in nursing education and practice: The nurse practitioner-dentist model for primary care.

PubMed

Dolce, Maria C; Parker, Jessica L; Marshall, Chantelle; Riedy, Christine A; Simon, Lisa E; Barrow, Jane; Ramos, Catherine R; DaSilva, John D

The purpose of this paper is to describe the design and implementation of a novel interprofessional collaborative practice education program for nurse practitioner and dental students, the Nurse Practitioner-Dentist Model for Primary Care (NPD Program). The NPD Program expands collaborative boundaries in advanced practice nursing by integrating primary care within an academic dental practice. The dental practice is located in a large, urban city in the Northeast United States and provides comprehensive dental services to vulnerable and underserved patients across the age spectrum. The NPD Program is a hybrid curriculum comprised of online learning, interprofessional collaborative practice-based leadership and teamwork training, and clinical rotations focused on the oral-systemic health connection. Practice-based learning promotes the development of leadership and team-based competencies. Nurse practitioners emerge with the requisite interprofessional collaborative practice competencies to improve oral and systemic health outcomes. Copyright © 2017. Published by Elsevier Inc.

Case-Based Teaching for Interprofessional Postgraduate Trainees in Adolescent Health.

PubMed

Gooding, Holly C; Ziniel, Sonja; Touloumtzis, Currie; Pitts, Sarah; Goncalves, Adrianne; Emans, Jean; Burke, Pam

2016-05-01

Adolescent health providers increasingly work in interprofessional environments. There is a lack of evidence regarding best educational practices for preparing the adolescent health care workforce of the future. We developed, implemented, and evaluated an interprofessional longitudinal case-based curriculum for postgraduate trainees in adolescent health. Faculty in an academic adolescent medicine division worked collaboratively with recent trainees to develop six teaching cases illustrative of interprofessional care of adolescents. During the 2013-2014 academic year, seven trainees (two social workers, two physicians, one nurse practitioner, one psychologist, and one dietician) completed the six month-long case modules while simultaneously working together in an interprofessional clinic. Trainees completed four-item pre- and post-case questionnaires that assessed confidence with assessment and diagnosis, comfort with counseling skills, ability to devise a treatment plan, and understanding of their colleagues' role for each of the six cases. Participants completed the 19-item Readiness for Interprofessional Learning Scale and the 12-item Interdisciplinary Education Perception Scale at three time points during the academic year and a 15-minute interview after their final session. Confidence with assessment/diagnosis, comfort counseling adolescents, and the ability to devise treatment plans increased for most case topics, as did understanding of the role of others on the interprofessional team. Mean Readiness for Interprofessional Learning Scale and Interdisciplinary Education Perception Scale scores were high at baseline and similar at all three time points. Interviews highlighted the value of role clarity, communication, and learning within interprofessional teams along with modeling from interprofessional faculty. Case-based learning in conjunction with collaborative practice provided a successful teaching strategy for interprofessionals in adolescent health. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Exploring new graduate nurse confidence in interprofessional collaboration: a mixed methods study.

PubMed

Pfaff, Kathryn A; Baxter, Pamela E; Jack, Susan M; Ploeg, Jenny

2014-08-01

Confidence is required for effective engagement in interprofessional collaboration. New graduate nurses often lack confidence in interprofessional interactions, and this may compromise the delivery of safe and effective healthcare. The overall objective of this study was to explore new graduate nurse confidence in interprofessional collaboration. An explanatory sequential mixed methods design was used. New graduate nurses from Ontario, Canada (N=514) completed a cross-sectional descriptive survey in 2012. The survey measured perceived confidence in interprofessional collaboration, and it included items that were proposed to have a relationship with new graduate nurse confidence in interprofessional collaboration. Follow-up qualitative telephone interviews were conducted with 16 new graduate nurses. The quantitative findings suggested that several factors have a positive relationship with new graduate nurse confidence in interprofessional collaboration: availability and accessibility of manager, availability and accessibility of educator, number of different disciplines worked with daily, number of team strategies, and satisfaction with team. The qualitative phase supported the quantitative findings and also provided new information about factors that facilitated and challenged new graduate nurse confidence when engaging in interprofessional collaboration. The facilitators were: experience, knowledge, respect, supportive relationships, and opportunities to collaborate. Challenges included: lack of experience, lack of knowledge, communication challenges, and balancing practice expectations. The overall findings relate to team and organizational support, and new graduate nurse development. Interventions that provide support for interprofessional collaboration at the team and organizational levels, and develop new graduate nurse knowledge and experiences regarding collaborative practice, are essential for enhancing new graduate nurse confidence in interprofessional collaboration. Copyright © 2014 Elsevier Ltd. All rights reserved.

Examining the implementation of collaborative competencies in a critical care setting: Key challenges for enacting competency-based education.

PubMed

Goldman, Joanne; Kitto, Simon; Reeves, Scott

2017-11-21

Interprofessional collaboration is recognised as an important factor in improving patient care in intensive care units (ICUs). Competency frameworks, and more specifically interprofessional competency frameworks, are a key strategy being used to support the development of attitudes, knowledge, skills, and behaviours needed for an interprofessional approach to care. However, evidence for the application of competencies is limited. This study aimed to extend our empirically based understanding of the significance of interprofessional competencies to actual clinical practice in an ICU. An ethnographic approach was employed to obtain an in-depth insight into healthcare providers' perspectives, behaviours, and interactions of interprofessional collaboration in a medical surgical ICU in a community teaching hospital in Canada. Approximately 160 hours of observations were undertaken and 24 semi-structured interviews with healthcare workers were conducted over a period of 6 months. Data were analysed using a directed content approach where two national competency frameworks were used to help generate an understanding of the practice of interprofessional collaboration. Healthcare professionals demonstrated numerous instances of interprofessional communication, role understandings, and teamwork in the ICU setting, which supported a number of key collaborative competencies. However, organisational factors such as pressures for discharge and patient flow, staffing, and lack of prioritisation for interprofessional learning undermined competencies designed to improve collaboration and teamwork. The findings demonstrate that interprofessional competencies can play an important role in promoting knowledge, attitudes, skills, and behaviours needed. However, competencies that promote interprofessional collaboration are dependent on a range of contextual factors that enable (or impede) individuals to actually enact these competencies.

Cross-Cultural Pedagogy: Practical Strategies for a Successful Interprofessional Study Abroad Course

ERIC Educational Resources Information Center

Bai, Jieru; Larimer, Susan; Riner, Mary Beth

2016-01-01

This article discusses some practical strategies for designing and implementing a cross-cultural interprofessional study abroad course, including pre-departure preparation, facilitating small groups with local students, establishing a weekly theme, utilizing role-play and reflective assignments, and implementing meaningful evaluation strategies.…

Interprofessional Initiatives at the University of Washington

PubMed Central

Robins, Lynne; Murphy, Nanci; Belza, Basia; Brock, Doug; Gallagher, Thomas H.; Lindhorst, Taryn; Morton, Tom; Schaad, Doug; Mitchell, Pamela

2009-01-01

Pharmacists must collaborate with other health professionals to promote the optimal use of medications, relying on coordinated, interprofessional communication and care to do so. In 2003, the Institute of Medicine (IOM) recommended “all health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics.”2 At the University of Washington, the Center for Health Sciences Interprofessional Education (CHSIE) was established in 1997 to promote interprofessional curricular and clinical innovation in education, faculty development, and student activities, and to conduct evaluative research regarding the impact of interprofessional innovations. In this manuscript, we will describe the Center for Health Sciences Interprofessional Education, and highlight key projects that serve as examples of pharmacy involvement in interprofessional education, research, and service. PMID:19657496

What's in It for Us? Making the Case for Interprofessional Field Education Experiences for Social Work Students

ERIC Educational Resources Information Center

Charles, Grant; Barring, Vena; Lake, Sarah

2011-01-01

There continues to be resistance amongst the various healthcare professions regarding implementing an interprofessional agenda in practice and education settings. This partly is due to the protection of professional turf. This article describes the experiences of Canadian social work students participating in an interprofessional field education…

Interprofessional Education in Gross Anatomy: Experience with First-Year Medical and Physical Therapy Students at Mayo Clinic

ERIC Educational Resources Information Center

Hamilton, Steven S.; Yuan, Brandon J.; Lachman, Nirusha; Hellyer, Nathan J.; Krause, David A.; Hollman, John H.; Youdas, James W.; Pawlina, Wojciech

2008-01-01

Interprofessional education (IPE) in clinical practice is believed to improve outcomes in health care delivery. Integrating teaching and learning objectives through cross discipline student interaction in basic sciences has the potential to initiate interprofessional collaboration at the early stages of health care education. Student attitudes and…

Promoting Inter-Professional Teamwork and Learning--The Case of a Surgical Operating Theatre

ERIC Educational Resources Information Center

Collin, Kaija; Paloniemi, Susanna; Mecklin, Jukka-Pekka

2010-01-01

Hospitals, and surgical operating theatres (OTs) in particular, are environments in which inter-professional teamwork and learning are essential to secure patient safety and effective practice. However, it has been revealed in many studies that inter-professional collaborative work in hospital organisations faces many challenges and constraints.…

The intraprofessional and interprofessional relations of neurorehabilitation nurses: a negotiated order perspective.

PubMed

Miller, Karen-Lee; Kontos, Pia C

2013-08-01

To report a study of the negotiation practices of neurorehabilitation nurses with one another and with allied health professionals to understand nursing relations. Negotiated order theory offers a promising theoretical lens with which to explore negotiation between nurses and other professionals. This study is the first to apply the perspective to nurse-nurse and nurse-allied health professional relations. The study is a secondary analysis of findings from a multi-site arts-based intervention to improve patient-centred neurorehabilitation practice. Interviews and ethnographic observations were conducted (2008-2011) in two neurorehabilitation units in Ontario, Canada. Participants (n = 31) included registered and practical nurses, nurse leaders, and allied health professionals from physical, occupational, and recreational therapy, speech language pathology, and social work. Neurorehabilitation nursing is characterized by heavy workload, high patient acuity, and poor interprofessional collaboration. This practice context was negotiated by nurses through two strategies: (1) intraprofessional collegialism, accomplished through tactics including task and knowledge sharing, emotional support, coercive threats, and suppression of dissension; and (2) vying for an autonomous essential nursing role in interprofessional practice, accomplished by claiming unique nursing knowledge based on 24/7 nursing proximity, the expansion of the division of professional labour with allied health professionals and modifying physical therapy care plans. The intraprofessional context and negotiations therein were linked in significant ways to interprofessional negotiations. Understanding this complexity has important implications for improving patient safety and interprofessional practice interventions. © 2012 Blackwell Publishing Ltd.

The influence of empowerment, authentic leadership, and professional practice environments on nurses' perceived interprofessional collaboration.

PubMed

Regan, Sandra; Laschinger, Heather K S; Wong, Carol A

2016-01-01

The aim of this study was to examine the influence of structural empowerment, authentic leadership and professional nursing practice environments on experienced nurses' perceptions of interprofessional collaboration. Enhanced interprofessional collaboration (IPC) is seen as one means of transforming the health-care system and addressing concerns about shortages of health-care workers. Organizational supports and resources are suggested as key to promoting IPC. A predictive non-experimental design was used to test the effects of structural empowerment, authentic leadership and professional nursing practice environments on perceived interprofessional collaboration. A random sample of experienced registered nurses (n = 220) in Ontario, Canada completed a mailed questionnaire. Hierarchical multiple regression analysis was used. Higher perceived structural empowerment, authentic leadership, and professional practice environments explained 45% of the variance in perceived IPC (Adj. R² = 0.452, F = 59.40, P < 0.001). Results suggest that structural empowerment, authentic leadership and a professional nursing practice environment may enhance IPC. Nurse leaders who ensure access to resources such as knowledge of IPC, embody authenticity and build trust among nurses, and support the presence of a professional nursing practice environment can contribute to enhanced IPC. © 2015 John Wiley & Sons Ltd.

Understanding the drivers of interprofessional collaborative practice among HIV primary care providers and case managers in HIV care programmes.

PubMed

Mavronicolas, Heather A; Laraque, Fabienne; Shankar, Arti; Campbell, Claudia

2017-05-01

Care coordination programmes are an important aspect of HIV management whose success depends largely on HIV primary care provider (PCP) and case manager collaboration. Factors influencing collaboration among HIV PCPs and case managers remain to be studied. The study objective was to test an existing theoretical model of interprofessional collaborative practice and determine which factors play the most important role in facilitating collaboration. A self-administered, anonymous mail survey was sent to HIV PCPs and case managers in New York City. An adapted survey instrument elicited information on demographic, contextual, and perceived social exchange (trustworthiness, role specification, and relationship initiation) characteristics. The dependent variable, perceived interprofessional practice, was constructed from a validated scale. A sequential block wise regression model specifying variable entry order examined the relative importance of each group of factors and of individual variables. The analysis showed that social exchange factors were the dominant drivers of collaboration. Relationship initiation was the most important predictor of interprofessional collaboration. Additional influential factors included organisational leadership support of collaboration, practice settings, and frequency of interprofessional meetings. Addressing factors influencing collaboration among providers will help public health programmes optimally design their structural, hiring, and training strategies to foster effective social exchanges and promote collaborative working relationships.

Midwife-physician collaboration: a conceptual framework for interprofessional collaborative practice.

PubMed

Smith, Denise Colter

2015-01-01

Since the passage of the Affordable Care Act, collaborative practice has been cited as one method of increasing access to care, decreasing costs, and improving efficiency. How and under what conditions might these goals be achieved? Midwives and physicians have built effective collaborative practice models over a period of 30 years. Empirical study of interprofessional collaboration between midwives and physicians could be useful in guiding professional education, regulation, and health policy in women's health and maternity care. Construction of a conceptual framework for interprofessional collaboration between midwives and physicians was guided by a review of the literature. A theory derivation strategy was used to define dimensions, concepts, and statements of the framework. Midwife-physician interprofessional collaboration can be defined by 4 dimensions (organizational, procedural, relational, and contextual) and 12 concepts (trust, shared power, synergy, commitment, and respect, among others). The constructed framework provides the foundation for further empirical study of the interprofessional collaborative process. The experiences of midwife-physician collaborations provide solid support for a conceptual framework of the collaborative process. A conceptual framework provides a point from which further research can increase knowledge and understanding about how successful outcomes are achieved in collaborative health care practices. Construction of a measurement scale and validation of the model are important next steps. © 2014 by the American College of Nurse-Midwives.

Integrated analysis of isopentenyl pyrophosphate (IPP) toxicity in isoprenoid-producing Escherichia coli

DOE Office of Scientific and Technical Information (OSTI.GOV)

George, Kevin W.; Thompson, Mitchell; Kim, Joonhoon

Isopentenyl pyrophosphate (IPP) toxicity presents a challenge in engineered microbial systems since its formation is unavoidable in terpene biosynthesis. Here in this work, we develop an experimental platform to study IPP toxicity in isoprenol-producing Escherichia coli. We first characterize the physiological response to IPP accumulation, demonstrating that elevated IPP levels are linked to growth inhibition, reduced cell viability, and plasmid instability. We show that IPP toxicity selects for pathway “breakage”, using proteomics to identify a reduction in phosphomevalonate kinase (PMK) as a probable recovery mechanism. Next, using multi-omics data, we demonstrate that endogenous E. coli metabolism is globally impacted bymore » IPP accumulation, which slows nutrient uptake, decreases ATP levels, and perturbs nucleotide metabolism. We also observe the extracellular accumulation of IPP and present preliminary evidence that IPP can be transported by E. coli, findings that might be broadly relevant for the study of isoprenoid biosynthesis. Finally, we discover that IPP accumulation leads to the formation of ApppI, a nucleotide analog of IPP that may contribute to observed toxicity phenotypes. This comprehensive assessment of IPP stress suggests potential strategies for the alleviation of prenyl diphosphate toxicity and highlights possible engineering targets for improved IPP flux and high titer isoprenoid production.« less

Integrated analysis of isopentenyl pyrophosphate (IPP) toxicity in isoprenoid-producing Escherichia coli

DOE PAGES

George, Kevin W.; Thompson, Mitchell; Kim, Joonhoon; ...

2018-03-09

Isopentenyl pyrophosphate (IPP) toxicity presents a challenge in engineered microbial systems since its formation is unavoidable in terpene biosynthesis. Here in this work, we develop an experimental platform to study IPP toxicity in isoprenol-producing Escherichia coli. We first characterize the physiological response to IPP accumulation, demonstrating that elevated IPP levels are linked to growth inhibition, reduced cell viability, and plasmid instability. We show that IPP toxicity selects for pathway “breakage”, using proteomics to identify a reduction in phosphomevalonate kinase (PMK) as a probable recovery mechanism. Next, using multi-omics data, we demonstrate that endogenous E. coli metabolism is globally impacted bymore » IPP accumulation, which slows nutrient uptake, decreases ATP levels, and perturbs nucleotide metabolism. We also observe the extracellular accumulation of IPP and present preliminary evidence that IPP can be transported by E. coli, findings that might be broadly relevant for the study of isoprenoid biosynthesis. Finally, we discover that IPP accumulation leads to the formation of ApppI, a nucleotide analog of IPP that may contribute to observed toxicity phenotypes. This comprehensive assessment of IPP stress suggests potential strategies for the alleviation of prenyl diphosphate toxicity and highlights possible engineering targets for improved IPP flux and high titer isoprenoid production.« less

Assessment of Interprofessional Team Collaboration Scale (AITCS): Development and Testing of the Instrument

ERIC Educational Resources Information Center

Orchard, Carole A.; King, Gillian A.; Khalili, Hossein; Bezzina, Mary Beth

2012-01-01

Introduction: Many health professionals believe they practice collaboratively. Providing insight into their actual level of collaboration requires a means to assess practice within health settings. This chapter reports on the development, testing, and refinement process for the Assessment of Interprofessional Team Collaboration Scale (AITCS).…

Interprofessional Legal Practitioners: The Case of the M.D.-LL.B.

ERIC Educational Resources Information Center

Schneller, Eugene Stewart

1975-01-01

Careers and problems encountered by the large majority of M.D.-LL.B's who practice legal medicine are examined. The author argues that the legal profession must strive to create institutionalized career lines so that interprofessional medical-legal practice is a well-founded career choice. (JT)

Interprofessional collaboration in research, education, and clinical practice: working together for a better future.

PubMed

Green, Bart N; Johnson, Claire D

2015-03-01

Interprofessional collaboration occurs when 2 or more professions work together to achieve common goals and is often used as a means for solving a variety of problems and complex issues. The benefits of collaboration allow participants to achieve together more than they can individually, serve larger groups of people, and grow on individual and organizational levels. This editorial provides an overview of interprofessional collaboration in the areas of clinical practice, education, and research; discusses barriers to collaboration; and suggests potential means to overcome them.

Interprofessional collaboration in research, education, and clinical practice: working together for a better future

PubMed Central

Green, Bart N.; Johnson, Claire D.

2015-01-01

Interprofessional collaboration occurs when 2 or more professions work together to achieve common goals and is often used as a means for solving a variety of problems and complex issues. The benefits of collaboration allow participants to achieve together more than they can individually, serve larger groups of people, and grow on individual and organizational levels. This editorial provides an overview of interprofessional collaboration in the areas of clinical practice, education, and research; discusses barriers to collaboration; and suggests potential means to overcome them. PMID:25594446

Self-efficacy perceptions of interprofessional education and practice in undergraduate healthcare students.

PubMed

Williams, Brett; Beovich, Bronwyn; Ross, Linda; Wright, Caroline; Ilic, Dragan

2017-05-01

Self-efficacy is an individual's perception of their ability to be successful in a given endeavour and it has been shown to have an important role in successful university education and clinical performance of healthcare workers. This article examines the self-efficacy beliefs of undergraduate healthcare students (n = 388) for the skills required for interprofessional education and interprofessional collaboration. The students were enrolled at an Australian university from the disciplines of public health, social work, and paramedic practice. The Self-Efficacy for Interprofessional Experiential Learning (SEIEL) scale, which is a valid and reliable scale, was used to determine the self-reported perceptions of self-efficacy in this cohort. The 16-item scale was developed for use with medicine and other healthcare professional undergraduate students. Student t-tests were used to compare scores between males and females, with one-way ANOVAs used to explore SEIEL scores across disciplines and year level. A significant difference was found between genders for the scores on SEIEL subscale 2 "Interprofessional evaluation and feedback" (p = 0.01) with the male mean being 2.65 units higher (Cohen's d = 0.29). There was also a significant gender difference for the overall SEIEL scale (p = 0.029) with the male mean being 4.1 units higher (Cohen's d = 0.238). No significant gender differences were demonstrated for the subscale "Interprofessional interaction." Neither subscale demonstrated significant differences between healthcare disciplines or course year. Further investigation is required to explore the reasons for the outcomes of this study. With the increasing importance of interprofessional education and practice within healthcare, it would also appear reasonable to consider further research into the development and support of student self-efficacy for the skills required for interprofessional education and interprofessional collaboration within healthcare curricula.

Experiences of Pharmacy Trainees from an Interprofessional Immersion Training.

PubMed

Boland, Daubney; White, Traci; Adams, Eve

2018-04-25

Interprofessional education is essential in that it helps healthcare disciplines better utilize each other and provide team-based collaboration that improves patient care. Many pharmacy training programs struggle to implement interprofessional education. This purpose of the study was to examine the effect of a 30-h interprofessional training that included pharmacy students to determine if the training helped these students build valuable knowledge and skills while working alongside other health care professions. The interprofessional training included graduate-level trainees from pharmacy, behavioral health, nursing, and family medicine programs where the trainees worked within teams to build interprofessional education competencies based on the Interprofessional Education Collaborative core competencies. Sixteen pharmacy trainees participated in the training and completed pre- and post-test measures. Data were collected over a two-year period with participants completing the Team Skills Scale and the Interprofessional Attitudes Scale. Paired sample t -tests indicated that, after this training, pharmacy trainees showed significant increases in feeling better able to work in healthcare teams and valuing interprofessional practice.

Team science as interprofessional collaborative research practice: a systematic review of the science of team science literature

PubMed Central

Little, Meg M; St Hill, Catherine A; Ware, Kenric B; Swanoski, Michael T; Chapman, Scott A; Lutfiyya, M Nawal; Cerra, Frank B

2017-01-01

The National Institute of Health's concept of team science is a means of addressing complex clinical problems by applying conceptual and methodological approaches from multiple disciplines and health professions. The ultimate goal is the improved quality of care of patients with an emphasis on better population health outcomes. Collaborative research practice occurs when researchers from >1 health-related profession engage in scientific inquiry to jointly create and disseminate new knowledge to clinical and research health professionals in order to provide the highest quality of patient care to improve population health outcomes. Training of clinicians and researchers is necessary to produce clinically relevant evidence upon which to base patient care for disease management and empirically guided team-based patient care. In this study, we hypothesized that team science is an example of effective and impactful interprofessional collaborative research practice. To assess this hypothesis, we examined the contemporary literature on the science of team science (SciTS) produced in the past 10 years (2005–2015) and related the SciTS to the overall field of interprofessional collaborative practice, of which collaborative research practice is a subset. A modified preferred reporting items for systematic reviews and meta-analyses (PRISMA) approach was employed to analyze the SciTS literature in light of the general question: Is team science an example of interprofessional collaborative research practice? After completing a systematic review of the SciTS literature, the posed hypothesis was accepted, concluding that team science is a dimension of interprofessional collaborative practice. PMID:27619555

Team science as interprofessional collaborative research practice: a systematic review of the science of team science literature.

PubMed

Little, Meg M; St Hill, Catherine A; Ware, Kenric B; Swanoski, Michael T; Chapman, Scott A; Lutfiyya, M Nawal; Cerra, Frank B

2017-01-01

The National Institute of Health's concept of team science is a means of addressing complex clinical problems by applying conceptual and methodological approaches from multiple disciplines and health professions. The ultimate goal is the improved quality of care of patients with an emphasis on better population health outcomes. Collaborative research practice occurs when researchers from >1 health-related profession engage in scientific inquiry to jointly create and disseminate new knowledge to clinical and research health professionals in order to provide the highest quality of patient care to improve population health outcomes. Training of clinicians and researchers is necessary to produce clinically relevant evidence upon which to base patient care for disease management and empirically guided team-based patient care. In this study, we hypothesized that team science is an example of effective and impactful interprofessional collaborative research practice. To assess this hypothesis, we examined the contemporary literature on the science of team science (SciTS) produced in the past 10 years (2005-2015) and related the SciTS to the overall field of interprofessional collaborative practice, of which collaborative research practice is a subset. A modified preferred reporting items for systematic reviews and meta-analyses (PRISMA) approach was employed to analyze the SciTS literature in light of the general question: Is team science an example of interprofessional collaborative research practice? After completing a systematic review of the SciTS literature, the posed hypothesis was accepted, concluding that team science is a dimension of interprofessional collaborative practice. Copyright © 2016 American Federation for Medical Research.

Interprofessional team management in pediatric critical care: some challenges and possible solutions

PubMed Central

Stocker, Martin; Pilgrim, Sina B; Burmester, Margarita; Allen, Meredith L; Gijselaers, Wim H

2016-01-01

Background Aiming for and ensuring effective patient safety is a major priority in the management and culture of every health care organization. The pediatric intensive care unit (PICU) has become a workplace with a high diversity of multidisciplinary physicians and professionals. Therefore, delivery of high-quality care with optimal patient safety in a PICU is dependent on effective interprofessional team management. Nevertheless, ineffective interprofessional teamwork remains ubiquitous. Methods We based our review on the framework for interprofessional teamwork recently published in association with the UK Centre for Advancement of Interprofessional Education. Articles were selected to achieve better understanding and to include and translate new ideas and concepts. Findings The barrier between autonomous nurses and doctors in the PICU within their silos of specialization, the failure of shared mental models, a culture of disrespect, and the lack of empowering parents as team members preclude interprofessional team management and patient safety. A mindset of individual responsibility and accountability embedded in a network of equivalent partners, including the patient and their family members, is required to achieve optimal interprofessional care. Second, working competently as an interprofessional team is a learning process. Working declared as a learning process, psychological safety, and speaking up are pivotal factors to learning in daily practice. Finally, changes in small steps at the level of the microlevel unit are the bases to improve interprofessional team management and patient safety. Once small things with potential impact can be changed in one’s own unit, engagement of health care professionals occurs and projects become accepted. Conclusion Bottom–up patient safety initiatives encouraging participation of every single care provider by learning effective interprofessional team management within daily practice may be an effective way of fostering patient safety. PMID:26955279

Interprofessional team management in pediatric critical care: some challenges and possible solutions.

PubMed

Stocker, Martin; Pilgrim, Sina B; Burmester, Margarita; Allen, Meredith L; Gijselaers, Wim H

2016-01-01

Aiming for and ensuring effective patient safety is a major priority in the management and culture of every health care organization. The pediatric intensive care unit (PICU) has become a workplace with a high diversity of multidisciplinary physicians and professionals. Therefore, delivery of high-quality care with optimal patient safety in a PICU is dependent on effective interprofessional team management. Nevertheless, ineffective interprofessional teamwork remains ubiquitous. We based our review on the framework for interprofessional teamwork recently published in association with the UK Centre for Advancement of Interprofessional Education. Articles were selected to achieve better understanding and to include and translate new ideas and concepts. The barrier between autonomous nurses and doctors in the PICU within their silos of specialization, the failure of shared mental models, a culture of disrespect, and the lack of empowering parents as team members preclude interprofessional team management and patient safety. A mindset of individual responsibility and accountability embedded in a network of equivalent partners, including the patient and their family members, is required to achieve optimal interprofessional care. Second, working competently as an interprofessional team is a learning process. Working declared as a learning process, psychological safety, and speaking up are pivotal factors to learning in daily practice. Finally, changes in small steps at the level of the microlevel unit are the bases to improve interprofessional team management and patient safety. Once small things with potential impact can be changed in one's own unit, engagement of health care professionals occurs and projects become accepted. Bottom-up patient safety initiatives encouraging participation of every single care provider by learning effective interprofessional team management within daily practice may be an effective way of fostering patient safety.

Interprofessionalism and the Practice of Health Psychology in Hospital and Community: Walking the Bridge Between Here and There.

PubMed

Tovian, Steven M

2016-12-01

Interprofessionalism is a cornerstone for health care reform and is an important dimension for success for the practice of professional psychology in integrated care settings, whether in academic health centers, ambulatory clinics, or in independent practice. This article examines salient skills that have allowed the author to practice in both primary and tertiary health care settings, as well as in academic health centers and independent community practice. The scientist practitioner model of professional psychology has served to guide the author as a "roadmap" for successful collaborative, integrated care in the changing health care environment. The author emphasizes that marketing of health services in professional psychology is crucial for achieving the goals of interprofessionalism, and to secure a role for professional psychology in health care reform. Future challenges to psychology in health care are discussed with implications for training and practice.

Scaffolding Interprofessional Education: Unfolding Case Studies, Virtual World Simulations, and Patient-Centered Care.

PubMed

Zook, Sharon Strang; Hulton, Linda J; Dudding, Carol C; Stewart, Anne L; Graham, Amy C

Fragmentation of health care negatively impacts quality; one of the contributing factors may be ineffective collaboration among health care professionals. This article describes the implementation of an interprofessional education curriculum for graduate students enrolled in nursing, psychology, and speech-language pathology programs. Over 3 semesters, students engaged in interprofessional collaboration modules, unfolding case studies, virtual simulation, and shared case planning experiences. The curriculum's impact on students' attitudes and values toward interprofessional collaborative practice was measured.

Interprofessional Clinical Ethics Education: The Promise of Cross-Disciplinary Problem-Based Learning.

PubMed

Kurtz, Melissa J; Starbird, Laura E

2016-09-01

A review of Lin et al.'s pilot study exploring the effects of an interprofessional, problem-based learning clinical ethics curriculum on Taiwanese medical and nursing students' attitudes towards interprofessional collaboration highlights the benefits of interprofessional collaboration and offers insight into how problem-based learning might be universally applied in ethics education. Interprofessional collaboration is an ideal approach for exploring ethical dilemmas because it involves all relevant professionals in discussions about ethical values that arise in patient care. Interprofessional ethics collaboration is challenging to implement, however, given time constraints and organizational and practice demands. Nevertheless, we suggest that when professionals collaborate, they can collectively express greater commitment to the patient. We also suggest future research avenues that can explore additional benefits of interprofessional collaboration in clinical ethics. © 2016 American Medical Association. All Rights Reserved.

Defining and Understanding the Relationship between Professional Identity and Interprofessional Responsibility: Implications for Educating Health and Social Care Students

ERIC Educational Resources Information Center

Joynes, Viktoria C. T.

2018-01-01

This paper is concerned with exploring the relationship between perceptions of professional identities, interprofessional education (IPE) and collaborative practice. It seeks to introduce the concept of interprofessional responsibility as both a shift in the way in which to conceptualise the professional identity of Health and Social Care…

Activity confrontation methods: A reflexive and metacognitive approach for interprofessional collaboration training.

PubMed

Aiguier, Gregory; Oboeuf, Alexandre; Cobbaut, Jean-Philippe; Vanpee, Dominique

2015-01-01

Integration of interprofessional collaboration into healthcare education and training programmes has become a fundamental issue. Its objective is to learn how to collectively build collaborative care practice that addresses the uniqueness of each context and the specific situation of the patient. It is also about understanding the process of collectively building collaborative care practice in order to be able to apply it in different contexts. This article describes a study that aimed to examine the value of relying on activity confrontation methods to develop training. These methods consist of filming practitioners during an activity and encouraging them to analyse it. It was found that these methods encourage reflexive analysis of the motives for pursuing interprofessional action (identifying constitutive factors) but also a metacognitive approach on the conditions of learning (p < 0.01). In addition to the educational dimensions (methods and leadership positions) and organisational dimensions (frameworks), it was found that the patient's role is essential in developing interprofessional care practice and training (p < 0.01). Given the nature of these findings, this article goes on to suggest that the patient must be considered a "partner" in development and delivery of interprofessional learning and care.

An Interprofessional Collaborative Practice model for preparation of clinical educators.

PubMed

Scarvell, Jennie M; Stone, Judy

2010-07-01

Work-integrated learning is essential to health professional education, but faces increasing academic and industry resource pressures. The aim of this pilot "Professional Practice Project" was to develop and implement an innovative education intervention for clinical educators across several health disciplines. The project used interprofessional collaboration as its underlying philosophy, and a participatory action research methodology in four cycles: Cycle 1: Formation of an interprofessional project executive and working party from academic staff. Data collection of student insights into work integrated learning. Cycle 2: Formation of an interprofessional reference group to inform curriculum development for a series of clinical education workshops. Cycle 3: Delivery of workshops; 174 clinical educators, supervisors and preceptors attended two workshops: "Introduction to experiential learning" and " utilizing available resources for learning". Cycle 4: Seminar discussion of the Professional Practice Project at a national health-education conference. This pilot project demonstrated the advantages of using collaborative synergies to allow innovation around clinical education, free from the constraints of traditional discipline-specific education models. The planning, delivery and evaluation of clinical education workshops describe the benefits of interprofessional collaboration through enhanced creative thinking, sharing of clinical education models and a broadening of experience for both learners and facilitators.

How do interprofessional student teams interact in a primary care clinic? A qualitative analysis using activity theory.

PubMed

Kent, Fiona; Francis-Cracknell, Alison; McDonald, Rachael; Newton, Jennifer M; Keating, Jennifer L; Dodic, Miodrag

2016-10-01

Practice based interprofessional education opportunities are proposed as a mechanism for health professionals to learn teamwork skills and gain an understanding of the roles of others. Primary care is an area of practice that offers a promising option for interprofessional student learning. In this study, we investigated what and how students from differing professions learn together. Our findings inform the design of future interprofessional education initiatives. Using activity theory, we conducted an ethnographic investigation of interprofessional education in primary care. During a 5 months period, we observed 14 clinic sessions involving mixed discipline student teams who interviewed people with chronic disease. Teams were comprised of senior medicine, nursing, occupational therapy, pharmacy and physiotherapy entry level students. Semi-structured interviews were also conducted with seven clinical educators. Data were analysed to ascertain the objectives, tools, rules and division of labour. Two integrated activity systems were identified: (1) student teams gathering information to determine patients' health care needs and (2) patients either as health consumers or student educators. Unwritten rules regarding 'shared contribution', 'patient as key information source' and 'time constraints' were identified. Both the significance of software literacy on team leadership, and a pre-determined structure of enquiry, highlighted the importance of careful consideration of the tools used in interprofessional education, and the way they can influence practice. The systems of practice identified provide evidence of differing priorities and values, and multiple perspectives of how to manage health. The work reinforced the value of the patients' voice in clinical and education processes.

Evaluating an interprofessional disease state and medication management review model.

PubMed

Hoti, Kreshnik; Forman, Dawn; Hughes, Jeffery

2014-03-01

There is lack of literature data reporting an incorporation of medication management reviews in students' interprofessional education (IPE) and practice programs in aged care settings. This pilot study reports how an interprofessional disease state and medication management review program (DSMMR) was established in a residential aged care facility in Perth, Western Australia. Students from the professions of nursing, pharmacy and physiotherapy focused on a wellness check in the areas of cognition, falls and continence while integrating a medication management review. Students' attitudes were explored using a pre- and post-placement questionnaire. Students indicated positive experience with the IPE DSMMR program which also resulted in their positive attitudinal shift towards IPE and practice. These findings indicated that aged care can be a suitable setting for student interprofessional programs focusing on DSMMR.

Interprofessional Learning of Physiotherapists under Conditions of Higher Education in Great Britain

ERIC Educational Resources Information Center

Guk, Svitlana

2014-01-01

The problems of implementing interprofessional training of physiotherapists in universities and at the bases of the practical training of students in Great Britain have been analyzed. The role of physiotherapists in issues of medical education and practical assistance within their own profession has been defined. The list of leading training bases…

Linking Essential Learning Outcomes and Interprofessional Collaborative Practice Competency in Health Science Undergraduates

ERIC Educational Resources Information Center

Reed, Carole-Rae; Garcia, Luis Ivan; Slusser, Margaret M.; Konowitz, Sharon; Yep, Jewelry

2017-01-01

Assessing student learning outcomes and determining achievement of the Interprofessional Collaborative Practice (IPCEP) Core Competency of Values/Ethics in a generic pre-professional Bachelor of Science in Health Science (BSHS) program is challenging. A course level Student Learning Outcome (SLO) is: "….articulate the impact of personal…

Students' perceptions of the interprofessional team in practice through the application of servant leadership principles.

PubMed

Neill, Mark; Hayward, Karen S; Peterson, Teri

2007-08-01

This study examined students' perceptions of interprofessional practice within a framework of servant leadership principles, applied in the care of rural older adults utilizing a service learning model. Mobile wellness services were provided through the Idaho State University Senior Health Mobile project in a collaborative team approach in the community-based setting. Students from varied health professional programs were placed in teams for the provision of wellness care, with communication among team members facilitated by a health professions faculty member serving as field coordinator. The Interdisciplinary Education Perception Scale (IEPS) was used to measure students' perceptions of interprofessional practice using a pretest post-test research design. Multivariate analysis was performed revealing a significant pretest to post-test effect on students' perceptions as measured by factors inherent in the IEPS and deemed essential to effective interprofessional practice. Univariate analysis revealed a significant change in students' perception of professional competence and autonomy, actual cooperation and resource sharing within and across professions, and an understanding of the value and contributions of other professionals from pretest to post-test.

Training in interprofessional collaboration: pedagogic innovation in family medicine units.

PubMed

Paré, Line; Maziade, Jean; Pelletier, Francine; Houle, Nathalie; Iloko-Fundi, Maximilien

2012-04-01

A number of agencies that accredit university health sciences programs recently added standards for the acquisition of knowledge and skills with respect to interprofessional collaboration. Within primary care settings there are no practical training programs that allow students from different disciplines to develop competencies in this area. The training program was developed within family medicine units affiliated with Université Laval in Quebec for family medicine residents and trainees from various disciplines to develop competencies in patient-centred, interprofessional collaborative practice in primary care. Based on adult learning theories, the program was divided into 3 phases--preparing family medicine unit professionals, training preceptors, and training the residents and trainees. The program's pedagogic strategies allowed participants to learn with, from, and about one another while preparing them to engage in contemporary primary care practices. A combination of quantitative and qualitative methods was used to evaluate the implementation process and the immediate results of the training program. The training program had a positive effect on both the clinical settings and the students. Preparation of clinical settings is an important issue that must be considered when planning practical interprofessional training.

The nurse's lived experience of becoming an interprofessional leader.

PubMed

Stiles, Kim A; Horton-Deutsch, Sara L; Andrews, Catherine A

2014-11-01

In the current complex health care environment, nurses in all practice settings are called on to be leaders in advocating for a healthier future. Health care reform, the rise of the evidence-based practice movement, and the proliferation of new educational options are opening opportunities as never before for nurses to expand their leadership capacity to an interprofessional level. This interpretive phenomenological study conducted with eight nurse participants describes their experience of becoming an interprofessional leader. A team of three nurse researchers interpreted the texts individually and collectively. Interview texts were analyzed hermeneutically to uncover the common shared experience of moving toward common ground with interprofessional leadership as a process, one that not only took time, but also called for self-reflection, deliberate actions, and a new mind-set. This study develops the evidence base for leadership preparation at a time when there is a strong need for interprofessional leaders and educators in health care. Copyright 2014, SLACK Incorporated.

Interprofessional collaboration in family health teams

PubMed Central

Goldman, Joanne; Meuser, Jamie; Rogers, Jess; Lawrie, Lynne; Reeves, Scott

2010-01-01

ABSTRACT OBJECTIVE To examine family health team (FHT) members’ perspectives and experiences of interprofessional collaboration and perceived benefits. DESIGN Qualitative case study using semistructured interviews. SETTING Fourteen FHTs in urban and rural Ontario. PARTICIPANTS Purposeful sample of the members of 14 FHTs, including family physicians, nurse practitioners, nurses, dietitians, social workers, pharmacists, and managers. METHODS A multiple case-study approach involving 14 FHTs was employed. Thirty-two semistructured interviews were conducted and data were analyzed by employing an inductive thematic approach. A member-checking technique was also undertaken to enhance the validity of the findings. MAIN FINDINGS Five main themes are reported: rethinking traditional roles and scopes of practice, management and leadership, time and space, interprofessional initiatives, and early perceptions of collaborative care. CONCLUSION This study shows the importance of issues such as roles and scopes of practice, leadership, and space to effective team-based primary care, and provides a framework for understanding different types of interprofessional interventions used to support interprofessional collaboration. PMID:20944025

A new inter-professional course preparing learners for life in rural communities.

PubMed

Medves, Jennifer; Paterson, Margo; Chapman, Christine Y; Young, John H; Tata, Elizabeth; Bowes, Denise; Hobbs, Neil; McAndrews, Brian; O'Riordan, Anne

2008-01-01

The 'Professionals in Rural Practice' course was developed with the aim of preparing students enrolled in professional programs in Canada to become better equipped for the possible eventuality of professional work in a rural setting. To match the reality of living and working in a rural community, which by nature is interprofessional, the course designers were an interprofessional teaching team. In order to promote group cohesiveness the course included the participation of an interprofessional group of students and instructors from the disciplines of medicine, nursing, occupational therapy, physical therapy, teacher education, and theology. The format of the course included three-hour classes over an eight-week period and a two-day field experience in a rural community. The course utilized various experiential and interactive teaching and learning methods, along with a variety of assessment methods. Data were collected from student participants over two iterations of the course using a mixed methods approach. Results demonstrate that students value the interprofessional and experiential approach to learning and viewed this course as indispensable for gaining knowledge of other professions and preparation for rural practice. The data reveal important organizational and pedagogical considerations specific to interprofessional education, community based action research, and the unique interprofessional nature of training for life and work in a rural community. This study also indicates the potential value of further longitudinal study of participants in this course. Key words: Canada, community based action research, education, interdisciplinary, interprofessional.

Interprofessional education and practice guide No. 4: Developing and sustaining interprofessional education at an academic health center.

PubMed

Willgerodt, Mayumi A; Abu-Rish Blakeney, Erin; Brock, Douglas M; Liner, Debra; Murphy, Nanci; Zierler, Brenda

2015-01-01

Increasingly health professions schools and academic health centers are required to include interprofessional education (IPE) as a standard part of their core curricula to maintain accreditation. However, challenges continue to surface as faculty struggle to develop and participate in IPE activities while balancing increasing workloads and limited resources, and also trying to keep current in the changing profession-specific accreditation and standards. This guide shares lessons learned from developing and sustaining IPE activities at the University of Washington (UW) based in the United States. In 2008, the UW Schools of Nursing and Medicine were awarded funds to develop, implement, and evaluate an interprofessional program focused on team communication. This funding supported the creation of two annual large-scale IPE events, provided infrastructure support for the Center for Health Sciences Interprofessional Education, Research and Practice (CHSIERP), and supported numerous interprofessional activities and initiatives in the health professions curricula. Our experiences over the years have yielded several key lessons that are important to consider in any IPE effort. In this guide we report on these lessons learned and provide pragmatic suggestions for designing and implementing IPE in order to maximize long-term success.

Traditional and Accelerated Baccalaureate Nursing Students' Self-Efficacy for Interprofessional Learning.

PubMed

Durkin, Anne E; Feinn, Richard S

The aim of the study was to examine self-efficacy among traditional and accelerated nursing students with regard to interprofessional learning. The World Health Organization and other organizations recognize the need for interprofessional education to prepare health care providers for collaborative practice. Graduates of baccalaureate nursing programs require competence in interprofessional collaboration and communication. Traditional (n = 239) and accelerated (n = 114) nursing students' self-efficacy was measured utilizing Mann et al.'s Self-Efficacy for Interprofessional Experiential Learning Scale. Accelerated students averaged significantly higher than traditional students on the interprofessional team evaluation and feedback subscale (p = .006) and overall self-efficacy (p = .041). Awareness of possible differences between traditional and accelerated nursing students with regard to self-efficacy may help faculty develop effective interprofessional learning experiences for students in each cohort. Although results cannot be generalized, findings from this study provide evidence to guide the selection of learning strategies.

Interprofessional education and practice guide No. 5: Interprofessional teaching for prequalification students in clinical settings.

PubMed

Lie, Désirée A; Forest, Christopher P; Kysh, Lynn; Sinclair, Lynne

2016-05-01

The importance of interprofessional education in health professions training is increasingly recognised through new accreditation guidelines. Clinician teachers from different professions may find themselves being asked to teach or supervise learners from multiple health professions, focusing on interprofessional dynamics, interprofessional communication, role understanding, and the values and ethics of collaboration. Clinician teachers often feel prepared to teach learners from their own profession but may feel ill prepared to teach learners from other professions. In this guide, we draw upon the collective experience from two countries: an institution from the United States with experience in guiding faculty to teach in a student-run interprofessional clinic and an institution from Canada that offers interprofessional experiences to students in community and hospital settings. This guide offers teaching advice to clinician educators in all health professions who plan to or already teach in an interprofessional clinical setting. We anticipate that clinician teachers can learn to fully engage learners from different professions, precept effectively, recognise common pitfalls, increase their confidence, reflect, and become role models to deliver effective teaching in interprofessional settings.

Knowledge Translation of Interprofessional Collaborative Patient-Centred Practice: The Working Together Project Experience

ERIC Educational Resources Information Center

MacDonald, Colla J.; Archibald, Douglas; Stodel, Emma; Chambers, Larry W.; Hall, Pippa

2008-01-01

The Working Together (WT) project involved the design and delivery of an online learning resource for healthcare teams in long-term care (LTC) so that knowledge regarding interprofessional collaborative patient-centred practice (ICPCP) could be readily accessed and then transferred to the workplace. The purpose of this paper is to better…

How to Sustain Interprofessional Learning and Practice: Messages for Higher Education and Health and Social Care Management

ERIC Educational Resources Information Center

Meads, Geoffrey; Jones, Isabel; Harrison, Rachel; Forman, Dawn; Turner, Warren

2009-01-01

The principal aim of this article is to promote the more effective integration of interprofessional learning with practice developments in health and social care. Ten specific recommendations are offered for the successful management of recent central policies for collaboration at the interface of the higher education and service sectors.…

Content validation of an interprofessional learning video peer assessment tool.

PubMed

Nisbet, Gillian; Jorm, Christine; Roberts, Chris; Gordon, Christopher J; Chen, Timothy F

2017-12-16

Large scale models of interprofessional learning (IPL) where outcomes are assessed are rare within health professional curricula. To date, there is sparse research describing robust assessment strategies to support such activities. We describe the development of an IPL assessment task based on peer rating of a student generated video evidencing collaborative interprofessional practice. We provide content validation evidence of an assessment rubric in the context of large scale IPL. Two established approaches to scale development in an educational setting were combined. A literature review was undertaken to develop a conceptual model of the relevant domains and issues pertaining to assessment of student generated videos within IPL. Starting with a prototype rubric developed from the literature, a series of staff and student workshops were undertaken to integrate expert opinion and user perspectives. Participants assessed five-minute videos produced in a prior pilot IPL activity. Outcomes from each workshop informed the next version of the rubric until agreement was reached on anchoring statements and criteria. At this point the rubric was declared fit to be used in the upcoming mandatory large scale IPL activity. The assessment rubric consisted of four domains: patient issues, interprofessional negotiation; interprofessional management plan in action; and effective use of video medium to engage audience. The first three domains reflected topic content relevant to the underlying construct of interprofessional collaborative practice. The fourth domain was consistent with the broader video assessment literature calling for greater emphasis on creativity in education. We have provided evidence for the content validity of a video-based peer assessment task portraying interprofessional collaborative practice in the context of large-scale IPL activities for healthcare professional students. Further research is needed to establish the reliability of such a scale.

Student midwives and paramedic students' experiences of shared learning in pre-hospital childbirth.

PubMed

Feltham, Christina; Foster, Julie; Davidson, Tom; Ralph, Stewart

2016-06-01

To explore the experiences of midwifery and paramedic students undertaking interprofessional learning. A one day interprofessional learning workshop incorporating peer assisted learning for undergraduate pre-registration midwifery and paramedic students was developed based on collaborative practice theory and simulation based learning. Twenty-five student midwives and thirty-one paramedic students participated in one of two identical workshops conducted over separate days. Videoed focus group sessions were held following the workshop sessions in order to obtain qualitative data around student experience. Qualitative data analysis software (ATLAS.ti) was used to collate the transcriptions from the focus group sessions and the video recordings were scrutinised. Thematic analysis was adopted. Four main themes were identified around the understanding of each other's roles and responsibilities, the value of interprofessional learning, organisation and future learning. Students appeared to benefit from a variety of learning opportunities including interprofessional learning and peer assisted learning through the adoption of both formal and informal teaching methods, including simulation based learning. A positive regard for each other's profession including professional practice, professional governing bodies, professional codes and scope of practice was apparent. Students expressed a desire to undertake similar workshops with other professional students. Interprofessional learning workshops were found to be a positive experience for the students involved. Consideration needs to be given to developing interprofessional learning with other student groups aligned with midwifery at appropriate times in relation to stage of education. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Report of the 2016-2017 Professional Affairs Standing Committee: Formally Embracing and Engaging Preceptors in the Academy — The Time Has Come

PubMed Central

Chair, Karen Whalen; Aistrope, Daniel S.; Ausili, Jason; Besinque, Kathleen H.; Cardello, Elizabeth A.; Hritcko, Philip M.; MacKinnon, George E.; Maroyka, Eric; Burke, Elizabeth Sutton; Trent, I. Shane; Bradley-Baker, Lynette R.

2017-01-01

EXECUTIVE SUMMARY The 2016-2017 AACP Professional Affairs Committee (PAC) was charged to examine strategies to include adjunct/affiliate preceptors as AACP members and to determine the value proposition of AACP membership for this group of educators. The PAC defined adjunct/affiliate preceptors as preceptors who are neither full-time employees nor have a primary employment commitment (≥50% of the preceptor’s work salary) at a school/college of pharmacy. Specific charges to the PAC included: recommend an approach to increase the number of adjunct/affiliate preceptors as AACP members, examine AACP membership from an adjunct/affiliate preceptor value perspective, and prepare a concise summary of available literature describing value-added contributions of student pharmacists and pharmacy preceptors to pharmacy practice models, interprofessional education (IPE) and interprofessional practice (IPP). The summary of the plan developed by the PAC to address the charges is presented in the following report, which includes three sections: the value proposition of AACP membership for adjunct/affiliate preceptors, expansion of the presence of adjunct/affiliate preceptors in AACP, and the value of student pharmacists in experiential education settings. The value proposition of AACP membership for adjunct/affiliate preceptors section describes results of surveys and focus groups conducted by the PAC. The PAC surveyed experiential education directors at schools/colleges of pharmacy, adjunct/affiliate preceptors (from a request via the experiential education directors), and new pharmacy practice faculty members in order to determine current resources available for adjunct/affiliate preceptor development, as well as explore potential resources AACP could provide for adjunct/affiliate preceptor development. Focus groups were held with adjunct/affiliate preceptors and experiential education faculty/staff to explore some of the results and concepts generated from the surveys. The PAC developed three recommendations for AACP as a result of the surveys and focus groups. The report also describes various factors that should be considered by AACP in developing a membership category for adjunct/affiliate preceptors, including potential membership models, establishment of an advisory board, and collaboration with other stakeholder groups. The final section of the report provides an executive summary and detailed table, which summarizes available literature on the value of student pharmacists in experiential education. The brief literature review reinforces that there are many different practice settings where student pharmacists add value to patient care and the practice site. This information is significant for experiential education faculty/staff, as well as adjunct/affiliate preceptors, and serves as an example of best practices which document the value experiential education provides to patient care and practice sites. The final section of the report provides a policy statement that was adopted by the 2017 AACP House of Delegates and one suggestion to schools/colleges of pharmacy. The report concludes with a call to action regarding the formal involvement of adjunct/affiliate preceptors by AACP and the academy. PMID:29302095

From the nurses' station to the health team hub: how can design promote interprofessional collaboration?

PubMed

Gum, Lyn Frances; Prideaux, David; Sweet, Linda; Greenhill, Jennene

2012-01-01

Interprofessional practice implies that health professionals are able to contribute patient care in a collaborative environment. In this paper, it is argued that in a hospital the nurses' station is a form of symbolic power. The term could be reframed as a "health team hub," which fosters a place for communication and interprofessional working. Studies have found that design of the Nurses' Station can impact on the walking distance of hospital staff, privacy for patients and staff, jeopardize patient confidentiality and access to resources. However, no studies have explored the implications of nurses' station design on interprofessional practice. A multi-site collective case study of three rural hospitals in South Australia explored the collaborative working culture of each hospital. Of the cultural concepts being studied, the physical design of nurses' stations and the general physical environment were found to have a major influence on an effective collaborative practice. Communication barriers were related to poor design, lack of space, frequent interruptions and a lack of privacy; the name "nurses' station" denotes the space as the primary domain of nurses rather than a workspace for the healthcare team. Immersive work spaces could encourage all members of the healthcare team to communicate more readily with one another to promote interprofessional collaboration.

"It's a funny old game". Football as an educational metaphor within induction to practice-based interprofessional learning.

PubMed

Stephens, John; Abbott-Brailey, Hilary; Pearson, Pauline

2007-08-01

The Common Learning Programme in the North East of England (CLPNE) sought to introduce interprofessional education into the practice setting for pre-registration health and social care students. Students, clinical educators/mentors, and facilitators met within groups over a period of 3 - 6 weeks to explore interprofessional working and learning together. This paper evaluates the use of a game, the Football Stadium, to stimulate participants' exploration of practice-based interprofessional working and learning at CLPNE induction sessions. Data consisting of verbal and written feedback from students and clinical educators/mentors, and field notes from facilitators covering 22 CLPNE pilot sites (February 2003 - July 2005) was supplemented by researcher observation at 12 sites. Two themes emerged from the data: the use of the Football Stadium as an "ice-breaker" at team induction and, the use of the Football Stadium as a vehicle to facilitate reflective learning. Key issues included personal identity and role within a novice--expert continuum, creating and developing the team environment and, enhancing and developing learning communities. Although recognized as requiring careful, sensitive facilitation, the Football Stadium is a simple means to present learning opportunities for interprofessional education within a non-threatening learning environment that facilitates active participation.

A Clinical Nurse Specialist-Led Interprofessional Quality Improvement Project to Reduce Hospital-Acquired Pressure Ulcers.

PubMed

Fabbruzzo-Cota, Christina; Frecea, Monica; Kozell, Kathryn; Pere, Katalin; Thompson, Tamara; Tjan Thomas, Julie; Wong, Angela

2016-01-01

The purpose of this clinical nurse specialist-led interprofessional quality improvement project was to reduce hospital-acquired pressure ulcers (HAPUs) using evidence-based practice. Hospital-acquired pressure ulcers (PUs) have been linked to morbidity, poor quality of life, and increasing costs. Pressure ulcer prevention and management remain a challenge for interprofessional teams in acute care settings. Hospital-acquired PU rate is a critical nursing quality indicator for healthcare organizations and ties directly with Mount Sinai Hospital's (MSH's) mission and vision, which mandates providing the highest quality care to patients and families. This quality improvement project, guided by the Donabedian model, was based on the Registered Nurses' Association of Ontario Best Practice Guideline Risk Assessment & Prevention of Pressure Ulcers. A working group was established to promote evidence-based practice for PU prevention. Initiatives such as documentation standardization, development of staff education and patient and family educational resources, initiation of a hospital-wide inventory for support surfaces, and procurement of equipment were implemented to improve PU prevention and management across the organization. An 80% decrease in HAPUs has been achieved since the implementation of best practices by the Best Practice Guideline Pressure Ulcer working group. The implementation of PU prevention strategies led to a reduction in HAPU rates. The working group will continue to work on building interprofessional awareness and collaboration in order to prevent HAPUs and promote an organizational culture that supports staff development, teamwork and communication. This quality improvement project is a successful example of an interprofessional clinical nurse specialist-led initiative that impacts patient/family and organization outcomes through the identification and implementation of evidence-based nursing practice.

Interprofessional Education Among Student Health Professionals Using Human Patient Simulation

PubMed Central

Chmil, Joyce V.

2014-01-01

Objective. To describe the planning, implementation, and outcomes of an interprofessional education clinical laboratory facilitated through human patient simulation. Design. An interprofessional education clinical laboratory was developed with a patient-care scenario of acute exacerbation of heart failure that incorporated the use of a high-fidelity patient simulator. Pharmacy and nursing students assumed clinical roles in this realistic scenario and collaborated to diagnose and treat the patient. Assessment. Student attitudes toward and readiness to participate in interprofessional education improved following participation in the laboratory. Students reported that the greatest benefit of the experience was in their communication skills. Conclusion. Students’ ability to participate in interprofessional education experiences and their attitudes toward them improved following participation in this curricular initiative. Further evaluation of the impact of interprofessional education on student learning outcomes and changes in practice is warranted. PMID:24954934

Implementing an interprofessional first-year teamwork project: some key reflections.

PubMed

McNaughton, Susan Maree

2013-09-01

Implementing an interprofessional teamwork project for first-year students presents pedagogical and practical challenges. While transferable skills and attributes are important, engagement of students with limited professional experience in teamwork depends on relevance to current learning needs. This report outlines principles learned from planning and implementing a teamwork project for an interprofessional health administration and service development course. Practising interprofessional teamwork as leaders and teachers, aligning with previous, current and future teamwork content and processes and responding to student feedback and achievement have been the key factors in shaping the project over three semesters. Face-to-face and online interprofessional teamwork learning has necessitated developing resources that support self-direction, using familiar technology and providing enabling physical environments. Implications for first-year interprofessional teamwork are that structured well-resourced processes, responsiveness and alignment of learning all improve student outcomes.

A multi-method evaluation of interprofessional education for healthcare professionals caring for women during and after pregnancy.

PubMed

Olander, Ellinor; Coates, Rose; Brook, Judy; Ayers, Susan; Salmon, Debra

2018-02-09

This multi-method evaluation assessed the perceived impact of interprofessional workshops targeting enhanced collaboration between healthcare professionals who care for women during and after pregnancy. Current policy recommends partnership working to improve care for women and babies, however, there is little interprofessional education in this area. Five one-day workshops were delivered to 18 healthcare professionals (47.4% of the 38 healthcare professionals registered). The workshop was evaluated through questionnaires before and after the workshop measuring attitudes and willingness towards collaboration; observations of the workshops by a researcher and follow-up interviews 2 months' post-workshop to explore changes in practice. Workshops were attended by midwives, health visitors (trained nurses specialising in community care for children 0-5 years), dietitians, nurses, a general practitioner and a breastfeeding specialist. Attitudes and willingness to participate in interprofessional collaborative practice improved after the workshop. Observations made at the workshop included engaged participants who reported numerous barriers towards collaboration. Follow-up contact with 12 participants identified several examples of collaboration in practice resulting from workshop attendance. These findings suggest that the workshops influenced attendees to change their practice towards more collaborative working. Future work needs to confirm these results with more participants.

Training in interprofessional collaboration

PubMed Central

Paré, Line; Maziade, Jean; Pelletier, Francine; Houle, Nathalie; Iloko-Fundi, Maximilien

2012-01-01

Abstract Problem addressed A number of agencies that accredit university health sciences programs recently added standards for the acquisition of knowledge and skills with respect to interprofessional collaboration. Within primary care settings there are no practical training programs that allow students from different disciplines to develop competencies in this area. Objective of the program The training program was developed within family medicine units affiliated with Université Laval in Quebec for family medicine residents and trainees from various disciplines to develop competencies in patient-centred, interprofessional collaborative practice in primary care. Program description Based on adult learning theories, the program was divided into 3 phases—preparing family medicine unit professionals, training preceptors, and training the residents and trainees. The program’s pedagogic strategies allowed participants to learn with, from, and about one another while preparing them to engage in contemporary primary care practices. A combination of quantitative and qualitative methods was used to evaluate the implementation process and the immediate results of the training program. Conclusion The training program had a positive effect on both the clinical settings and the students. Preparation of clinical settings is an important issue that must be considered when planning practical interprofessional training. PMID:22611607

Twelve tips for delivering successful interprofessional case conferences.

PubMed

O'Brien, Bridget C; Patel, Shalini R; Pearson, Meg; Eastburn, Abigail P; Earnest, Gillian E; Strewler, Anna; Gager, Krista; Manuel, Jennifer K; Dulay, Maya; Bachhuber, Melissa R; Shunk, Rebecca

2017-12-01

Interprofessional case conferences (ICCs) offer an interactive, practical way to engage members of two or more health professions in discussions that involve learning and working together to improve patient care. Well-orchestrated ICCs provide opportunities to integrate interprofessional (IP) education into routine clinical practice. The authors provide 12 tips to support the conceptualization, planning, implementation, facilitation, evaluation, and sustainability of ICCs. They draw from extensive experience as IP educators and facilitators of ICCs and from literature on IP education, case-based learning, small-group facilitation, peer-assisted learning, and learner engagement - all of which offer insights into ICCs but have not been integrated and applied to this context.

Interprofessional Care and Teamwork in the ICU.

PubMed

Donovan, Anne L; Aldrich, J Matthew; Gross, A Kendall; Barchas, Denise M; Thornton, Kevin C; Schell-Chaple, Hildy M; Gropper, Michael A; Lipshutz, Angela K M

2018-06-01

We describe the importance of interprofessional care in modern critical care medicine. This review highlights the essential roles played by specific members of the interprofessional care team, including patients and family members, and discusses quality improvement initiatives that require interprofessional collaboration for success. Studies were identified through MEDLINE search using a variety of search phrases related to interprofessional care, critical care provider types, and quality improvement initiatives. Additional articles were identified through a review of the reference lists of identified articles. Original articles, review articles, and systematic reviews were considered. Manuscripts were selected for inclusion based on expert opinion of well-designed or key studies and review articles. "Interprofessional care" refers to care provided by a team of healthcare professionals with overlapping expertise and an appreciation for the unique contribution of other team members as partners in achieving a common goal. A robust body of data supports improvement in patient-level outcomes when care is provided by an interprofessional team. Critical care nurses, advanced practice providers, pharmacists, respiratory care practitioners, rehabilitation specialists, dieticians, social workers, case managers, spiritual care providers, intensivists, and nonintensivist physicians each provide unique expertise and perspectives to patient care, and therefore play an important role in a team that must address the diverse needs of patients and families in the ICU. Engaging patients and families as partners in their healthcare is also critical. Many important ICU quality improvement initiatives require an interprofessional approach, including Awakening and Breathing Coordination, Delirium, Early Exercise/Mobility, and Family Empowerment bundle implementation, interprofessional rounding practices, unit-based quality improvement initiatives, Patient and Family Advisory Councils, end-of-life care, coordinated sedation awakening and spontaneous breathing trials, intrahospital transport, and transitions of care. A robust body of evidence supports an interprofessional approach as a key component in the provision of high-quality critical care to patients of increasing complexity and with increasingly diverse needs.

Interprofessional collaborative patient-centred care: a critical exploration of two related discourses.

PubMed

Fox, Ann; Reeves, Scott

2015-03-01

There has been sustained international interest from health care policy makers, practitioners, and researchers in developing interprofessional approaches to delivering patient-centred care. In this paper, we offer a critical exploration of a selection of professional discourses related to these practice paradigms, including interprofessional collaboration, patient-centred care, and the combination of the two. We argue that for some groups of patients, inequalities between different health and social care professions and between professionals and patients challenge the successful realization of the positive aims associated with these discourses. Specifically, we argue that interprofessional and professional-patient hierarchies raise a number of key questions about the nature of professions, their relationships with one another as well as their relationship with patients. We explore how the focus on interprofessional collaboration and patient-centred care have the potential to reinforce a patient compliance model by shifting responsibility to patients to do the "right thing" and by extending the reach of medical power across other groups of professionals. Our goal is to stimulate debate that leads to enhanced practice opportunities for health professionals and improved care for patients.

Outcomes of Introducing Early Learners to Interprofessional Competencies in a Classroom Setting.

PubMed

Lockeman, Kelly S; Lanning, Sharon K; Dow, Alan W; Zorek, Joseph A; DiazGranados, Deborah; Ivey, Carole K; Soper, Shawne

2017-01-01

Although interprofessional practice is important for improving healthcare delivery, there is little evidence describing interprofessional education (IPE) outcomes beyond changes in attitudes and knowledge of prelicensure learners. More rigorous evaluation of early IPE is needed to determine its impact on teaching interprofessional collaborative practice and providing a solid foundation for applying collaborative skills in the clinical environment. First-year students (N = 679) in 7 health professions programs participated in a 4-session series focusing on professional roles and responsibilities, teams and teamwork, and the healthcare system. Interprofessional teams of 5-6 students, from at least 3 professions, were assembled for the duration of the series and created a team charter during their first session to guide their work. Each subsequent session included a brief lecture and interactive exercises. Faculty facilitators from the participating programs provided support to students during the sessions. As a culminating project, each team created a short video depicting a barrier to interprofessional collaboration. Students evaluated the performance of their team members using a web-based peer assessment survey. A course evaluation with an embedded validated attitudinal scale was used to assess changes in student perceptions about IPE. A sample of videos were also scored by 2 faculty using a rubric linked to course expectations. This educational offering took place on the health sciences campus of a large, mid-Atlantic research university with more than 3,200 clinical learners in schools of allied health professions, dentistry, medicine, nursing, and pharmacy. It was the first interprofessional activity for most of the learners. There were 555 students who participated in some or all of the sessions. Comments indicated that students enjoyed interacting with their peers and prefer activities allowing them to apply content to their profession over lectures. The assessment measures revealed a disconnect between student ratings targeting interprofessional socialization and faculty ratings targeting the products of their teamwork. Although students provided positive feedback to their teammates through peer assessment, and the attitudinal scale showed a small but significant increase in positive attitudes toward IPE, the videos they created did not demonstrate a deep understanding of barriers to interprofessional practice. This large-scale IPE activity for early learners supported progress toward interprofessional socialization, but student learning was inconsistently demonstrated in teamwork products. Course planners should augment self- and peer-reported interprofessional socialization measures with faculty-generated behavioral outcome assessments. Such triangulation produces a more robust data set to inform decisions about curricular revisions and development.

Interprofessional Collaborative Practice: How Could Dentistry Participate?

PubMed

Cole, James R; Dodge, William W; Findley, John S; Horn, Bruce D; Kalkwarf, Kenneth L; Martin, Max M; Valachovic, Richard W; Winder, Ronald L; Young, Stephen K

2018-05-01

There is a remarkable phenomenon occurring among health professionals: the development of ongoing, routine collaboration, both in educating the next generation of providers and in delivering care. These new approaches, commonly referred to as interprofessional education and interprofessional collaborative practice, have been introduced into academic health settings and delivery systems throughout the U.S. and the rest of the world; however, the full integration of dentistry in health care teams remains unrealized. In academic settings, dentistry has found ways to collaborate with the other health professions, but most practicing dentists still find themselves on the margins of new models of care delivery. This article provides a perspective on the history and context of the evolution of collaborative approaches to health care and proposes ways in which dentistry can participate more fully in the future.

Interprofessional education as part of becoming a doctor or physiotherapist in a competency-based curriculum

PubMed Central

Sander, Oliver; Schmidt, Regine; Rehkämper, Gerd; Lögters, Tim; Zilkens, Christoph; Schneider, Matthias

2016-01-01

Introduction: Interprofessional learning is a critical pre-requisite for future interprofessional work. Structural adaptations in education offer possibilities to introduce new concepts. Rheumatic and musculoskeletal diseases (RMD) are both prevented and treated by physicians and physiotherapists but the development of interprofessional roles is seldom part of curricula. Project description: A complex, longitudinal interprofessional educational approach for future doctors and physiotherapists was designed and implanted at various stages (anatomy, physical examination, pathology, therapy). Most segments of the RMD curriculum are now based on interprofessional classes. Student satisfaction with learning is continually and comparatively evaluated. Learning success is assessed with practical and written exams. Results: Interprofessional teaching was first introduced in 2013 for 420 first-year and 360 fourth-year medical students, along with 40 first- and third-year physiotherapy majors. The satisfaction with teaching and learning is high and distinctly above average for all teaching areas (satisfaction RMD rated as 2.4; average for all is 3.3). The percentage of those who pass the final exam is 94%. 100% of the students surveyed support the continuation of this interprofessional unit. Conclusion: Interprofessional teaching of RMD can be successfully implemented for future physicians and physiotherapists at different learning levels. PMID:27280126

Interprofessional education as part of becoming a doctor or physiotherapist in a competency-based curriculum.

PubMed

Sander, Oliver; Schmidt, Regine; Rehkämper, Gerd; Lögters, Tim; Zilkens, Christoph; Schneider, Matthias

2016-01-01

Interprofessional learning is a critical pre-requisite for future interprofessional work. Structural adaptations in education offer possibilities to introduce new concepts. Rheumatic and musculoskeletal diseases (RMD) are both prevented and treated by physicians and physiotherapists but the development of interprofessional roles is seldom part of curricula. A complex, longitudinal interprofessional educational approach for future doctors and physiotherapists was designed and implanted at various stages (anatomy, physical examination, pathology, therapy). Most segments of the RMD curriculum are now based on interprofessional classes. Student satisfaction with learning is continually and comparatively evaluated. Learning success is assessed with practical and written exams. Interprofessional teaching was first introduced in 2013 for 420 first-year and 360 fourth-year medical students, along with 40 first- and third-year physiotherapy majors. The satisfaction with teaching and learning is high and distinctly above average for all teaching areas (satisfaction RMD rated as 2.4; average for all is 3.3). The percentage of those who pass the final exam is 94%. 100% of the students surveyed support the continuation of this interprofessional unit. Interprofessional teaching of RMD can be successfully implemented for future physicians and physiotherapists at different learning levels.

The Lead Crack Fatigue Lifting Framework

DTIC Science & Technology

2010-04-01

15000 20000 25000 30000 35000 40000 F-WELD Test Hours C ra ck d ep th (m m ) IPP (1) IPP (2) IPP (3) IPP ( 4 ) IPP (5) IPP ( 6 ) IPP (6_A) FASS 226 (2...FASS 226 ( 4 ) FASS 226 (5) FASS 226 (5L) FASS 226 ( 6 ) FASS 226 (6R) SIH_OBD_SPLICE SIH_FS238/239 (1) SIH_FS238/239 (2) SIH_FS238/239 (3) SIH_FS238/239...conservative. 0.001 0.01 0.1 1 10 0 1 2 3 4 5 6 CB9 RHS CB8 LHS CB12 LHS CB12 RHS CB1 LHS FT55 LHS FT55 RHS ST16 LHS ST16 RHS Log average FLEI Virtual test

Teaching teamwork: an evaluation of an interprofessional training ward placement for health care students

PubMed Central

Morphet, Julia; Hood, Kerry; Cant, Robyn; Baulch, Julie; Gilbee, Alana; Sandry, Kate

2014-01-01

The establishment of interprofessional teamwork training in the preprofessional health care curriculum is a major challenge for teaching faculties. Interprofessional clinical placements offer an opportunity for teamwork education, as students in various professions can work and learn together. In this sequential, mixed-method study, focus group and survey techniques were used to evaluate students’ educational experiences after 2-week ward-based interprofessional clinical placements. Forty-five senior nursing, medicine, and other health care students cared for patients in hospital wards under professional supervision, with nursing-medicine student “teams” leading care. Thirty-six students attended nine exit focus groups. Five central themes that emerged about training were student autonomy and workload, understanding of other professional roles, communication and shared knowledge, interprofessional teamwork/collaboration, and the “inner circle”, or being part of the unit team. The learning environment was described as positive. In a postplacement satisfaction survey (n=38), students likewise rated the educational experience highly. In practicing teamwork and collaboration, students were able to rehearse their future professional role. We suggest that interprofessional clinical placements be regarded as an essential learning experience for senior preprofessional students. More work is needed to fully understand the effect of this interactive program on students’ clinical learning and preparation for practice. PMID:25028569

Teaching teamwork: an evaluation of an interprofessional training ward placement for health care students.

PubMed

Morphet, Julia; Hood, Kerry; Cant, Robyn; Baulch, Julie; Gilbee, Alana; Sandry, Kate

2014-01-01

The establishment of interprofessional teamwork training in the preprofessional health care curriculum is a major challenge for teaching faculties. Interprofessional clinical placements offer an opportunity for teamwork education, as students in various professions can work and learn together. In this sequential, mixed-method study, focus group and survey techniques were used to evaluate students' educational experiences after 2-week ward-based interprofessional clinical placements. Forty-five senior nursing, medicine, and other health care students cared for patients in hospital wards under professional supervision, with nursing-medicine student "teams" leading care. Thirty-six students attended nine exit focus groups. Five central themes that emerged about training were student autonomy and workload, understanding of other professional roles, communication and shared knowledge, interprofessional teamwork/collaboration, and the "inner circle", or being part of the unit team. The learning environment was described as positive. In a postplacement satisfaction survey (n=38), students likewise rated the educational experience highly. In practicing teamwork and collaboration, students were able to rehearse their future professional role. We suggest that interprofessional clinical placements be regarded as an essential learning experience for senior preprofessional students. More work is needed to fully understand the effect of this interactive program on students' clinical learning and preparation for practice.

Online Video Conferencing: A Promising Innovation in Interprofessional Education.

PubMed

Palumbo, Mary V; Bennett, Darcy N

2016-01-01

This pilot project demonstrated using online video conferencing with students from eight disciplines for providing care of a rural elder with multiple chronic conditions. Eighty-three students participated in 12 video case conferences, each led by a nurse-practitioner student. All students were given information on care of elders and the core competencies for interprofessional practice. Nurse-practitioner students were given information and practice on running a team meeting. A survey evaluated the activity in terms of interprofessional competency attainment in four domains (IPEC) by using data aggregated from 14 Likert scale questions. Participants (n=81, 98% response) rated the value of this activity highly (>60% strongly agreed and >25% agreed) across all four competency domains. Differences between disciplines were not found. Open-ended questions confirmed that the students valued the activity but also conveyed a desire for more in-person interprofessional activities to be included in their education.

Interprofessional education day - an evaluation of an introductory experience for first-year students.

PubMed

Singer, Zachary; Fung, Kevin; Lillie, Elaine; McLeod, Jennifer; Scott, Grace; You, Peng; Helleman, Krista

2018-05-01

Interprofessional health care teams have been shown to improve patient safety and reduce medical errors, among other benefits. Introducing interprofessional concepts to students in full day events is an established model that allows students to learn together. Our group developed an academic day for first-year students devoted to an introductory interprofessional education (IPE) experience, 'IPE Day'. In total, 438 students representing medicine, dentistry, pharmacy and optometry gathered together, along with 25 facilitators, for IPE Day. Following the day's program, students completed the evaluation consisting of the Interprofessional Collaborative Competencies Attainment Survey and open-ended questions. Narrative responses were analyzed for content and coded using the Canadian Interprofessional Health Collaborative competency domains. Three hundred and eight evaluations were completed. Students reported increased self-ratings of competency across all 20 items (p < 0.05). Their comments were organized into the six domains: interprofessional communication, collaborative leadership, role clarification, patient-centred care, conflict resolution, and team functioning. Based on these findings, we suggest that this IPE activity may be useful for improving learner perceptions about their interprofessional collaborative practice competence.

Twelve tips for a successful interprofessional team-based high-fidelity simulation education session

PubMed Central

Bould, M. Dylan; Layat Burn, Carine; Reeves, Scott

2014-01-01

Simulation-based education allows experiential learning without risk to patients. Interprofessional education aims to provide opportunities to different professions for learning how to work effectively together. Interprofessional simulation-based education presents many challenges, including the logistics of setting up the session and providing effective feedback to participants with different backgrounds and mental models. This paper aims to provide educators with a series of practical and pedagogical tips for designing, implementing, assessing, and evaluating a successful interprofessional team-based simulation session. The paper is organized in the sequence that an educator might use in developing an interprofessional simulation-based education session. Collectively, this paper provides guidance from determining interprofessional learning objectives and curricular design to program evaluation. With a better understanding of the concepts and pedagogical methods underlying interprofessional education and simulation, educators will be able to create conditions for a unique educational experience where individuals learn with and from other specialties and professions in a controlled, safe environment. PMID:25023765

Collaborative peer review process as an informal interprofessional learning tool: Findings from an exploratory study.

PubMed

Kwon, Jae Yung; Bulk, Laura Yvonne; Giannone, Zarina; Liva, Sarah; Chakraborty, Bubli; Brown, Helen

2018-01-01

Despite numerous studies on formal interprofessional education programes, less attention has been focused on informal interprofessional learning opportunities. To provide such an opportunity, a collaborative peer review process (CPRP) was created as part of a peer-reviewed journal. Replacing the traditional peer review process wherein two or more reviewers review the manuscript separately, the CPRP brings together students from different professions to collaboratively review a manuscript. The aim of this study was to assess whether the CPRP can be used as an informal interprofessional learning tool using an exploratory qualitative approach. Eight students from Counselling Psychology, Occupational and Physical Therapy, Nursing, and Rehabilitation Sciences were invited to participate in interprofessional focus groups. Data were analysed inductively using thematic analysis. Two key themes emerged, revealing that the CPRP created new opportunities for interprofessional learning and gave practice in negotiating feedback. The results reveal that the CPRP has the potential to be a valuable interprofessional learning tool that can also enhance reviewing and constructive feedback skills.

Determining the predictors of innovation implementation in healthcare: a quantitative analysis of implementation effectiveness.

PubMed

Jacobs, Sara R; Weiner, Bryan J; Reeve, Bryce B; Hofmann, David A; Christian, Michael; Weinberger, Morris

2015-01-22

The failure rates for implementing complex innovations in healthcare organizations are high. Estimates range from 30% to 90% depending on the scope of the organizational change involved, the definition of failure, and the criteria to judge it. The innovation implementation framework offers a promising approach to examine the organizational factors that determine effective implementation. To date, the utility of this framework in a healthcare setting has been limited to qualitative studies and/or group level analyses. Therefore, the goal of this study was to quantitatively examine this framework among individual participants in the National Cancer Institute's Community Clinical Oncology Program using structural equation modeling. We examined the innovation implementation framework using structural equation modeling (SEM) among 481 physician participants in the National Cancer Institute's Community Clinical Oncology Program (CCOP). The data sources included the CCOP Annual Progress Reports, surveys of CCOP physician participants and administrators, and the American Medical Association Physician Masterfile. Overall the final model fit well. Our results demonstrated that not only did perceptions of implementation climate have a statistically significant direct effect on implementation effectiveness, but physicians' perceptions of implementation climate also mediated the relationship between organizational implementation policies and practices (IPP) and enrollment (p <0.05). In addition, physician factors such as CCOP PI status, age, radiological oncologists, and non-oncologist specialists significantly influenced enrollment as well as CCOP organizational size and structure, which had indirect effects on implementation effectiveness through IPP and implementation climate. Overall, our results quantitatively confirmed the main relationship postulated in the innovation implementation framework between IPP, implementation climate, and implementation effectiveness among individual physicians. This finding is important, as although the model has been discussed within healthcare organizations before, the studies have been predominately qualitative in nature and/or at the organizational level. In addition, our findings have practical applications. Managers looking to increase implementation effectiveness of an innovation should focus on creating an environment that physicians perceive as encouraging implementation. In addition, managers should consider instituting specific organizational IPP aimed at increasing positive perceptions of implementation climate. For example, IPP should include specific expectations, support, and rewards for innovation use.

An introductory pharmacy practice experience based on a medication therapy management service model.

PubMed

Agness, Chanel F; Huynh, Donna; Brandt, Nicole

2011-06-10

To implement and evaluate an introductory pharmacy practice experience (IPPE) based on the medication therapy management (MTM) service model. Patient Care 2 is an IPPE that introduces third-year pharmacy students to the MTM service model. Students interacted with older adults to identify medication-related problems and develop recommendations using core MTM elements. Course outcome evaluations were based on number of documented medication-related problems, recommendations, and student reviews. Fifty-seven older adults participated in the course. Students identified 52 medication-related problems and 66 medical problems, and documented 233 recommendations relating to health maintenance and wellness, pharmacotherapy, referrals, and education. Students reported having adequate experience performing core MTM elements. Patient Care 2 may serve as an experiential learning model for pharmacy schools to teach the core elements of MTM and provide patient care services to the community.

Implementing and evaluating an interprofessional minority health conference for social work and healthcare professionals.

PubMed

Washington, Tiffany R; Ward, Trina Salm; Young, Henry N; Orpinas, Pamela; Cornelius, Llewellyn J

2017-11-01

Interprofessional education (IPE) is one strategy for addressing health inequities; however, little attention has been paid to continuing IPE for practicing social work and healthcare professionals. This article offers guidance to faculty in social work and health-related academic units on offering continuing IPE on the topic of minority health. An interprofessional group of faculty offered a day-long conference on minority health, ethics, and social justice. The conference goal was to promote interprofessional communication in a co-learning environment and promote dialogue on social determinants of health and health equity in the state. Data were obtained from surveys and analysis of work plans developed during the conference. Workshop participants were majority White (62%), social workers (79%), and practiced for 14 years on average. The most useful topics were dementia and polypharmacy. Takeaway strategies included interprofessional work, being mindful of access to resources, and engagement in continuing education. Lessons learned include plan in advance for all professions; recruit faculty and students from multiple departments to increase interprofessional diversity; offer strategies and incentives to increase student participation; be strategic about conference location and format; and identify a strategic format and theme. IPE is a means of preparing learners for working together in their future careers to provide high-quality patient-centred care and reduce health disparities. Professional development can provide an opportunity to enhance skills to address health disparities, and learning can be significantly enhanced when participants connect with colleagues from different professions, discuss diverse opinions, and share successful practices.

An exploratory study of an assessment tool derived from the competencies of the interprofessional education collaborative.

PubMed

Dow, Alan W; DiazGranados, Deborah; Mazmanian, Paul E; Retchin, Sheldon M

2014-07-01

Linking the outcomes from interprofessional education to improvements in patient care has been hampered by educational assessments that primarily measure the short-term benefits of specific curricular interventions. Competencies, recently published by the Interprofessional Education Collaborative (IPEC), elaborate overarching goals for interprofessional education by specifying desired outcomes for graduating health professions students. The competencies define a transition point between the prescribed and structured educational experience of a professional degree program and the more self-directed, patient-oriented learning associated with professional practice. Drawing on the IPEC competencies for validity, we created a 42-item questionnaire to assess outcomes related to collaborative practice at the degree program level. To establish the usability and psychometric properties of the questionnaire, it was administered to all the students on a health science campus at a large urban university in the mid-Atlantic of the United States. The student responses (n = 481) defined four components aligned in part with the four domains of the IPEC competencies. In addition, the results demonstrated differences in scores by domain that can be used to structure future curricula. These findings suggest a questionnaire based on the IPEC competencies might provide a measure to assess programmatic outcomes related to interprofessional education. We discuss directions for future research, such as a comparison of results within and between institutions, and how these results could provide valuable insights about the effect of different curricular approaches to interprofessional education and the success of various educational programs at preparing students for collaborative practice.

AN EXPLORATORY STUDY OF AN ASSESSMENT TOOL DERIVED FROM THE COMPETENCIES OF THE INTERPROFESSIONAL EDUCATION COLLABORATIVE

PubMed Central

Dow, Alan W.; DiazGranados, Deborah; Mazmanian, Paul E.; Retchin, Sheldon M.

2015-01-01

Linking the outcomes from interprofessional education to improvements in patient care has been hampered by educational assessments that primarily measure the short-term benefits of specific curricular interventions. Competencies, recently published by the Interprofessional Education Collaborative (IPEC), elaborate overarching goals for interprofessional education by specifying desired outcomes for graduating health professions students. The competencies define a transition point between the prescribed and structured educational experience of a professional degree program and the more self-directed, patient-oriented learning associated with professional practice. Drawing on the IPEC competencies for validity, we created a 42-item questionnaire to assess outcomes related to collaborative practice at the degree program level. To establish the usability and psychometric properties of the questionnaire, it was administered to all the students on a health science campus at a large urban university in the mid-Atlantic of the United States. The student responses (n = 481) defined four components aligned in part with the four domains of the IPEC competencies. In addition, the results demonstrated differences in scores by domain that can be used to structure future curricula. These findings suggest a questionnaire based on the IPEC competencies might provide a measure to assess programmatic outcomes related to interprofessional education. We discuss directions for future research, such as a comparison of results within and between institutions, and how these results could provide valuable insights about the effect of different curricular approaches to interprofessional education and the success of various educational programs at preparing students for collaborative practice. PMID:24593327

Interprofessional non-technical skills for surgeons in disaster response: a qualitative study of the Australian perspective.

PubMed

Willems, Anneliese; Waxman, Buce; Bacon, Andrew K; Smith, Julian; Peller, Jennifer; Kitto, Simon

2013-03-01

Interprofessional non-technical skills for surgeons in disaster response have not yet been developed. The aims of this study were to identify the non-technical skills required of surgeons in disaster response and training for disaster response and to explore the barriers and facilitators to interprofessional practice in surgical teams responding to disasters. Twenty health professionals, with prior experience in natural disaster response or education, participated in semi-structured in-depth interviews. A qualitative matrix analysis design was used to thematically analyze the data. Non-technical skills for surgeons in disaster response identified in this study included skills for austere environments, cognitive strategies and interprofessional skills. Skills for austere environments were physical self-care including survival skills, psychological self-care, flexibility, adaptability, innovation and improvisation. Cognitive strategies identified in this study were "big picture" thinking, situational awareness, critical thinking, problem solving and creativity. Interprofessional attributes include communication, team-player, sense of humor, cultural competency and conflict resolution skills. "Interprofessionalism" in disaster teams also emerged as a key factor in this study and incorporated elements of effective teamwork, clear leadership, role adjustment and conflict resolution. The majority of participants held the belief that surgeons needed training in non-technical skills in order to achieve best practice in disaster response. Surgeons considerring becoming involved in disaster management should be trained in these skills, and these skills should be incorporated into disaster preparation courses with an interprofessional focus.

The Role of the Speech-Language Pathologist in Creating a Model for Interprofessional Practice in an Ambulatory Care Clinic.

PubMed

Robinson, Tommie L; Anderson, Debra; Long, Sahira

2018-02-01

There is a need to better coordinate services for children in urban settings who are at risk for communication disorders. This article addresses the barriers to obtaining services and discusses the process for creating a model for interprofessional practice to better serve patients from lower socioeconomic backgrounds. Copyright © 2017 Elsevier Inc. All rights reserved.

The influence of authentic leadership and empowerment on new-graduate nurses' perceptions of interprofessional collaboration.

PubMed

Laschinger, Heather K S; Smith, Lesley Marie

2013-01-01

The aim of this study was to examine new-graduate nurses' perceptions of the influence of authentic leadership and structural empowerment on the quality of interprofessional collaboration in healthcare work environments. Although the challenges associated with true interprofessional collaboration are well documented, new-graduate nurses may feel particularly challenged in becoming contributing members. Little research exists to inform nurse leaders' efforts to facilitate effective collaboration in acute care settings. A predictive nonexperimental design was used to test a model integrating authentic leadership and workplace empowerment as resources that support interprofessional collaboration. Multiple regression analysis revealed that 24% of the variance in perceived interprofessional collaboration was explained by unit-leader authentic leadership and structural empowerment (R = 0.24, F = 29.55, P = .001). Authentic leadership (β = .294) and structural empowerment (β = .288) were significant independent predictors. Results suggest that authentic leadership and structural empowerment may promote interprofessional collaborative practice in new nurses.

Intentional Interprofessional Experiential Education.

PubMed

Grice, Gloria R; Thomason, Angela R; Meny, Lisa M; Pinelli, Nicole R; Martello, Jay L; Zorek, Joseph A

2018-04-01

The experiential component of a doctor of pharmacy curricula is an ideal, yet underutilized vehicle to advance interprofessional education (IPE) initiatives. To date, most experiential-based IPE initiatives occur in a naturally occurring, non-deliberate fashion. The American Association of Colleges of Pharmacy (AACP) Experiential Education Section formed the Task Force on Intentional Interprofessional Education in Experiential Education in academic year 2015-2016 to explore the issue. This commentary describes the work of the task force, including the following elements: defining intentional interprofessional experiential education as "the explicit effort by preceptors and practice sites to create/foster educational opportunities or activities designed specifically to achieve interprofessional educational competencies;" conducting a systematic literature review to identify examples of intentional interprofessional experiential education in the published literature; surveying faculty with oversight of experiential education programs and preceptors within those programs; and generating recommendations to stakeholders including AACP, pharmacy schools, and experiential education administrators.

Differentiating intraprofessional attitudes toward paradigms in health care delivery among chiropractic factions: results from a randomly sampled survey

PubMed Central

2014-01-01

Background As health care has increased in complexity and health care teams have been offered as a solution, so too is there an increased need for stronger interprofessional collaboration. However the intraprofessional factions that exist within every profession challenge interprofessional communication through contrary paradigms. As a contender in the conservative spinal health care market, factions within chiropractic that result in unorthodox practice behaviours may compromise interprofessional relations and that profession’s progress toward institutionalization. The purpose of this investigation was to quantify the professional stratification among Canadian chiropractic practitioners and evaluate the practice perceptions of those factions. Methods A stratified random sample of 740 Canadian chiropractors was surveyed to determine faction membership and how professional stratification could be related to views that could be considered unorthodox to current evidence-based care and guidelines. Stratification in practice behaviours is a stated concern of mainstream medicine when considering interprofessional referrals. Results Of 740 deliverable questionnaires, 503 were returned for a response rate of 68%. Less than 20% of chiropractors (18.8%) were aligned with a predefined unorthodox perspective of the conditions they treat. Prediction models suggest that unorthodox perceptions of health practice related to treatment choices, x-ray use and vaccinations were strongly associated with unorthodox group membership (X2 =13.4, p = 0.0002). Conclusion Chiropractors holding unorthodox views may be identified based on response to specific beliefs that appear to align with unorthodox health practices. Despite continued concerns by mainstream medicine, only a minority of the profession has retained a perspective in contrast to current scientific paradigms. Understanding the profession’s factions is important to the anticipation of care delivery when considering interprofessional referral. PMID:24512507

Differentiating intraprofessional attitudes toward paradigms in health care delivery among chiropractic factions: results from a randomly sampled survey.

PubMed

McGregor, Marion; Puhl, Aaron A; Reinhart, Christine; Injeyan, H Stephen; Soave, David

2014-02-10

As health care has increased in complexity and health care teams have been offered as a solution, so too is there an increased need for stronger interprofessional collaboration. However the intraprofessional factions that exist within every profession challenge interprofessional communication through contrary paradigms. As a contender in the conservative spinal health care market, factions within chiropractic that result in unorthodox practice behaviours may compromise interprofessional relations and that profession's progress toward institutionalization. The purpose of this investigation was to quantify the professional stratification among Canadian chiropractic practitioners and evaluate the practice perceptions of those factions. A stratified random sample of 740 Canadian chiropractors was surveyed to determine faction membership and how professional stratification could be related to views that could be considered unorthodox to current evidence-based care and guidelines. Stratification in practice behaviours is a stated concern of mainstream medicine when considering interprofessional referrals. Of 740 deliverable questionnaires, 503 were returned for a response rate of 68%. Less than 20% of chiropractors (18.8%) were aligned with a predefined unorthodox perspective of the conditions they treat. Prediction models suggest that unorthodox perceptions of health practice related to treatment choices, x-ray use and vaccinations were strongly associated with unorthodox group membership (X(2) =13.4, p = 0.0002). Chiropractors holding unorthodox views may be identified based on response to specific beliefs that appear to align with unorthodox health practices. Despite continued concerns by mainstream medicine, only a minority of the profession has retained a perspective in contrast to current scientific paradigms. Understanding the profession's factions is important to the anticipation of care delivery when considering interprofessional referral.

Interprofessional teamwork innovations for primary health care practices and practitioners: evidence from a comparison of reform in three countries

PubMed Central

Harris, Mark F; Advocat, Jenny; Crabtree, Benjamin F; Levesque, Jean-Frederic; Miller, William L; Gunn, Jane M; Hogg, William; Scott, Cathie M; Chase, Sabrina M; Halma, Lisa; Russell, Grant M

2016-01-01

Context A key aim of reforms to primary health care (PHC) in many countries has been to enhance interprofessional teamwork. However, the impact of these changes on practitioners has not been well understood. Objective To assess the impact of reform policies and interventions that have aimed to create or enhance teamwork on professional communication relationships, roles, and work satisfaction in PHC practices. Design Collaborative synthesis of 12 mixed methods studies. Setting Primary care practices undergoing transformational change in three countries: Australia, Canada, and the USA, including three Canadian provinces (Alberta, Ontario, and Quebec). Methods We conducted a synthesis and secondary analysis of 12 qualitative and quantitative studies conducted by the authors in order to understand the impacts and how they were influenced by local context. Results There was a diverse range of complex reforms seeking to foster interprofessional teamwork in the care of patients with chronic disease. The impact on communication and relationships between different professional groups, the roles of nursing and allied health services, and the expressed satisfaction of PHC providers with their work varied more within than between jurisdictions. These variations were associated with local contextual factors such as the size, power dynamics, leadership, and physical environment of the practice. Unintended consequences included deterioration of the work satisfaction of some team members and conflict between medical and nonmedical professional groups. Conclusion The variation in impacts can be understood to have arisen from the complexity of interprofessional dynamics at the practice level. The same characteristic could have both positive and negative influence on different aspects (eg, larger practice may have less capacity for adoption but more capacity to support interprofessional practice). Thus, the impacts are not entirely predictable and need to be monitored, and so that interventions can be adapted at the local level. PMID:26889085

Cognitive continuum theory in interprofessional healthcare: A critical analysis.

PubMed

Parker-Tomlin, Michelle; Boschen, Mark; Morrissey, Shirley; Glendon, Ian

2017-07-01

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.

Europe, the professions and interprofessional education: an exploration in inter-culture relativity.

PubMed

Lorenz, Walter

2009-09-01

This paper seeks to understand the inter-cultural relationships between the notions of Europe, the professions and interprofessional education (IPE) in developing an argument for the necessity of interprofessional education for meeting the complex challenges for the professions and society in the 21st century. The concept of "strange loops" is used to explore the paradoxes and recursions in understanding what Europe, the professions and interprofessional education really are. After questioning perceptions of the professions in a changing Europe, I challenge interprofessional education to greater heights. IPE has to accompany all professional exchanges across borders as a critical, constructive process that focuses on differences in theory and practice within the different professional fields to overcome their problems of adjustment to changing user needs and cultural requirements.

Global health education programming as a model for inter-institutional collaboration in interprofessional health education.

PubMed

Peluso, Michael J; Hafler, Janet P; Sipsma, Heather; Cherlin, Emily

2014-07-01

While global health (GH) opportunities have expanded at schools of medicine, nursing, and public health, few examples of interprofessional approaches to GH education have been described. The elective GH program at our university serves as an important opportunity for high-quality interprofessional education. We undertook a qualitative study to examine the experience of student, faculty and administrative leaders of the program. We used content analysis to code responses and analyze data. Among the leadership, key themes fell within the categories of interprofessional education, student-faculty collaboration, professional development, and practical considerations for the development of such programs. The principles described could be considered by institutions seeking to develop meaningful partnerships in an effort to develop or refine interprofessional global health education programs.

[Interprofessional education for patient-centred practice: development of outcome-focused competencies for a Bachelor Programme Interprofessional Health Care].

PubMed

Mahler, Cornelia; Karstens, Sven; Roos, Marco; Szecsenyi, Joachim

2012-01-01

Health care systems in Germany and around the world are faced with demographic change and the need of providing health services in increasingly complex health care surroundings. A highly qualified workforce is needed to face the challenges ahead and to coordinate health care. In addition, there is evidence that interprofessional education strengthens interprofessional collaboration which can lead to improved health outcomes. The University of Heidelberg, Medical Faculty, decided to develop a bachelor programme integrating specific health professions and interprofessional qualifications into the curriculum. The manuscript describes the identification process of the outcome-focused competencies for this bachelor degree. The six-step curriculum model by Kern et al. was applied. An expert panel identified major tasks and health care fields for which the students should be qualified for. These results were transferred into a questionnaire and distributed among targeted learners as well as practitioners, experts and employers in different health care fields for relevance ratings. Also, individuals were interviewed to receive additional information and to generate further ideas. Thirteen different practice fields, five tasks and thirteen topics common to all health care professions were collected. The subsequent survey comprising 66 items was completed by 139 targeted learners as well as 82 practitioners and experts. All identified practice fields were rated as relevant for future professional life. Top ratings were "supervising procedures" (targeted learners) and "interprofessional communication and coordination" (practitioners, experts and employers). The results were discussed and consented in the expert panel and learner outcomes/objectives were categorized according to the CanMED roles. A thorough needs assessment was performed setting the foundation for the further development of the curriculum. The identified competencies are in line with the five core competencies defined by the WHO which are necessary for interprofessional collaboration: patient-centred care, partnering, quality improvement, information and communication technology, and public health perspective. The application of the CanMED framework proved to be suitable. It may be used as common terminology to help define interfaces with curricula of other health professions. The interprofessional development of the bachelor programme fostered a deeper understanding between health professionals and can therefore be regarded as a first step in improving interprofessional collaboration. Copyright © 2012. Published by Elsevier GmbH.

An examination of current stroke rehabilitation practice in Peru: Implications for interprofessional education.

PubMed

McDonald, Cody L; Fuhs, Amy K; Kartin, Deborah

2018-05-01

This study aimed to better understand current clinical practice of rehabilitation professionals in Lima, Peru, and to explore the existence of and potential for interprofessional collaboration. A secondary purpose was to assess rehabilitation professionals' agreement with evidence-based stroke rehabilitation statements and confidence performing stroke rehabilitation tasks prior to and following an interprofessional stroke rehabilitation training. Current clinical practice for rehabilitation professionals in Peru differs from high-income counties like the United States, as physical therapists work with dysphagia and feeding, prosthetist orthotists serve a strictly technical role, and nurses have a limited role in rehabilitation. Additionally, while opportunity for future interprofessional collaboration within stroke rehabilitation exists, it appears to be discouraged by current health system policies. Pre- and post-training surveys were conducted with a convenience sample of 107 rehabilitation professionals in Peru. Survey response options included endorsement of professionals for rehabilitation tasks and a Likert scale of agreement and confidence. Training participants largely agreed with evidence-based stroke rehabilitation statements. Differences in opinion remained regarding the prevalence of dysphagia and optimal frequency of therapy post-stroke. Substantially increased agreement post-training was seen in favour of early initiation of stroke rehabilitation and ankle foot orthosis use. Participants were generally confident performing traditional profession-specific interventions and educating patients and families. Substantial increases were seen in respondents' confidence to safely and independently conduct bed to chair transfers and determine physiological stability. Identification of key differences in rehabilitation professionals' clinical practice in Peru is a first step toward strengthening the development of sustainable rehabilitation systems and interprofessional collaboration.

Development and evaluation of a regional, large-scale interprofessional collaborative care summit.

PubMed

Foote, Edward F; Clarke, Virginia; Szarek, John L; Waters, Sharon K; Walline, Vera; Shea, Diane; Goss, Sheryl; Farrell, Marian; Easton, Diana; Dunleavy, Erin; Arscott, Karen

2015-01-01

The Northeastern/Central Pennsylvania Interprofessional Education Coalition (NECPA IPEC) is a coalition of faculty from multiple smaller academic institutions with a mission to promote interprofessional education. An interprofessional learning program was organized, which involved 676 learners from 10 different institutions representing 16 unique professions, and took place at seven different institutions simultaneously. The program was a 3-hour long summit which focused on the management of a patient with ischemic stroke. A questionnaire consisting of the Interprofessional Education Perception Scale (IEPS) questionnaire (pre-post summit), Likert-type questions, and open comment questions explored the learners' perceptions of the session and their attitudes toward interprofessional learning. Responses were analyzed using descriptive statistics and statistical tests for difference and qualitative thematic coding. The attitude of learners toward interprofessional education (as measured by the IEPS) was quite high even prior to the summit, so there were no significant changes after the summit. However, a high percentage of learners and facilitators agreed that the summit met its objective and was effective. In addition, the thematic analysis of the open-ended questions confirmed that students learned from the experience with a sense of the core competencies of interprofessional education and practice. A collaborative approach to delivering interprofessional learning is time and work intensive but beneficial to learners.

Creating the Evidence through Comparative Effectiveness Research for Interprofessional Education and Collaborative Practice by Deploying a National Intervention Network and a National Data Repository

PubMed Central

Pechacek, Judith; Cerra, Frank; Brandt, Barbara; Lutfiyya, May Nawal; Delaney, Connie

2015-01-01

Background: There is currently a resurgence of interest in interprofessional education and collaborative practice (IPECP) and its potential to positively impact health outcomes at both the patient level and population level, healthcare delivery, and health professions education. This resurgence of interest led to the creation of the National Center on Interprofessional Collaborative Practice and Education in October 2012. Methods: This paper describes three intertwined knowledge generation strategies of the National Center on Interprofessional Practice and Education: (1) the development of a Nexus Incubator Network, (2) the undertaking of comparative effectiveness research, and (3) the creation of a National Center Data Repository. Results: As these strategies are implemented over time they will result in the production of empirically grounded knowledge regarding the direction and scope of the impact, if any, of IPECP on well-defined health and healthcare outcomes including the possible improvement of the patient experience of care. Conclusions: Among the motivating factors for the National Center and the three strategies adopted and addressed herein is the need for rigorously produced, scientifically sound evidence regarding IPECP and whether or not it has the capacity to positively affect the patient experience of care, the health of populations, and the per capita cost of healthcare. PMID:27417753

Promoting interprofessional understandings through online learning: a qualitative examination.

PubMed

McKenna, Lisa; Boyle, Malcolm; Palermo, Claire; Molloy, Elizabeth; Williams, Brett; Brown, Ted

2014-09-01

Interprofessional education is increasingly a core component of health professional curricula. It has been suggested that interprofessional education can directly enhance patient care outcomes. However, literature has reported many difficulties in its successful implementation. This study investigated students' perceptions of participating in an online, Web-based module to facilitate interprofessional education. Three focus groups, each with 13-15 students, from emergency health (paramedic), nursing, occupational therapy, physiotherapy, and nutrition and dietetics were conducted with students who participated in an online interprofessional education module at one Australian university. Thematic analysis was employed to analyze interview transcripts. Four themes emerged: professional understanding, patient-centeredness, comparison with other interprofessional education activities, and overcoming geographical boundaries. Students were overwhelmingly positive about their learning experiences and the value of the module in assisting their understandings of the roles of other health professionals. Online approaches to interprofessional education have the potential to enhance learning and overcome geographical and logistical issues inherent in delivering face-to-face interprofessional education. Furthermore, our design approach allowed students to watch how other health professionals worked in a way that they were unable to achieve in clinical practice. © 2014 Wiley Publishing Asia Pty Ltd.

What are private sector physiotherapists' perceptions regarding interprofessional and intraprofessional work for managing low back pain?

PubMed

Perreault, Kadija; Dionne, Clermont E; Rossignol, Michel; Poitras, Stéphane; Morin, Diane

2018-03-28

In the last decades, interactions between health professionals have mostly been discussed in the context of interprofessional teamwork where professionals work closely together and share a team identity. Comparatively, little work has been done to explore interactions that occur between professionals in contexts where traditionally formal structures have been less supporting the implementation of interprofessional teamwork, such as in the private healthcare sector. The objective of this study was to identify private sector physiotherapists' perceptions of interprofessional and intraprofessional work regarding interventions for adults with low back pain. This was a cross-sectional survey of 327 randomly-selected physiotherapists. Data were analysed using descriptive statistics. A majority of physiotherapists reported positive effects of interprofessional work for their clients, themselves and their workplaces. Proximity of physiotherapists with other professionals, clinical workloads, and client's financial situation were perceived as important factors influencing the implementation of interprofessional work. Low back pain is a highly prevalent and disabling condition. The results of this study indicate that integrating interprofessional work in the management of low back pain in the private sector is warranted. Furthermore, the implementation of interprofessional work is viewed by practicing physiotherapists as dependent upon certain client-, professional- and organizational-level factors.

Interprofessional collaboration from nurses and physicians – A triangulation of quantitative and qualitative data

PubMed

Schärli, Marianne; Müller, Rita; Martin, Jacqueline S; Spichiger, Elisabeth; Spirig, Rebecca

2017-01-01

Background: Interprofessional collaboration between nurses and physicians is a recurrent challenge in daily clinical practice. To ameliorate the situation, quantitative or qualitative studies are conducted. However, the results of these studies have often been limited by the methods chosen. Aim: To describe the synthesis of interprofessional collaboration from the nursing perspective by triangulating quantitative and qualitative data. Method: Data triangulation was performed as a sub-project of the interprofessional Sinergia DRG Research program. Initially, quantitative and qualitative data were analyzed separately in a mixed methods design. By means of triangulation a „meta-matrix“ resulted in a four-step process. Results: The „meta-matrix“ displays all relevant quantitative and qualitative results as well as their interrelations on one page. Relevance, influencing factors as well as consequences of interprofessional collaboration for patients, relatives and systems become visible. Conclusion: For the first time, the interprofessional collaboration from the nursing perspective at five Swiss hospitals is shown in a „meta-matrix“. The consequences of insufficient collaboration between nurses and physicians are considerable. This is why it’s necessary to invest in interprofessional concepts. In the „meta-matrix“ the factors which influence the interprofessional collaboration positively or negatively are visible.

Readiness for interprofessional learning: a cross-faculty comparison between architecture and occupational therapy students.

PubMed

Larkin, Helen; Hitch, Danielle; Watchorn, Valerie; Ang, Susan; Stagnitti, Karen

2013-09-01

Health and wellbeing includes a need for built environments to accommodate and be inclusive of the broadest range of people and a corresponding need to ensure graduates are ready to engage in this field of interprofessional and inter-industry practise. All too often, interprofessional education in higher education is neglected with a tendency towards educational silos, particularly at a cross-faculty level. This paper reports on an initiative that embedded universal design practice education into the curricula of first year architecture and third year occupational therapy students and evaluated the impact on students' readiness for interprofessional learning. The Readiness for Interprofessional Learning Scale (RIPLS) was given to students at the beginning and end of the semester during which students participated in a variety of online and face-to-face curriculum initiatives. Results showed that at the beginning of semester, occupational therapy students were significantly more positive about interprofessional learning than their architecture counterparts. Post-results showed that this trend continued but that occupational therapy students became less positive on some items after the interprofessional learning experience. This study provides insights into the interprofessional learning experiences of a group of students who have not previously been studied within the available literature.

Validation of a global scale to assess the quality of interprofessional teamwork in mental health settings.

PubMed

Tomizawa, Ryoko; Yamano, Mayumi; Osako, Mitue; Hirabayashi, Naotugu; Oshima, Nobuo; Sigeta, Masahiro; Reeves, Scott

2017-12-01

Few scales currently exist to assess the quality of interprofessional teamwork through team members' perceptions of working together in mental health settings. The purpose of this study was to revise and validate an interprofessional scale to assess the quality of teamwork in inpatient psychiatric units and to use it multi-nationally. A literature review was undertaken to identify evaluative teamwork tools and develop an additional 12 items to ensure a broad global focus. Focus group discussions considered adaptation to different care systems using subjective judgements from 11 participants in a pre-test of items. Data quality, construct validity, reproducibility, and internal consistency were investigated in the survey using an international comparative design. Exploratory factor analysis yielded five factors with 21 items: 'patient/community centred care', 'collaborative communication', 'interprofessional conflict', 'role clarification', and 'environment'. High overall internal consistency, reproducibility, adequate face validity, and reasonable construct validity were shown in the USA and Japan. The revised Collaborative Practice Assessment Tool (CPAT) is a valid measure to assess the quality of interprofessional teamwork in psychiatry and identifies the best strategies to improve team performance. Furthermore, the revised scale will generate more rigorous evidence for collaborative practice in psychiatry internationally.

Aligning interprofessional education collaborative sub-competencies to a progression of learning.

PubMed

Patel Gunaldo, Tina; Brisolara, Kari Fitzmorris; Davis, Alison H; Moore, Robert

2017-05-01

In the United States, the Interprofessional Education Collaborative (IPEC) developed four core competencies for interprofessional collaborative practice. Even though the IPEC competencies and respective sub-competencies were not created in a hierarchal manner, one might reflect upon a logical progression of learning as well as learners accruing skills allowing them to master one level of learning and building on the aggregate of skills before advancing to the next level. The Louisiana State University Health-New Orleans Center for Interprofessional Education and Collaborative Practice (CIPECP) determined the need to align the sub-competencies with the level of behavioural expectations in order to simplify the process of developing an interprofessional education experience targeted to specific learning levels. In order to determine the most effective alignment, CIPECP discussions revolved around current programmatic expectations across the institution. Faculty recognised the need to align sub-competencies with student learning objectives. Simultaneously, a progression of learning existing within each of the four IPEC domains was noted. Ultimately, the faculty and staff team agreed upon categorising the sub-competencies in a hierarchical manner for the four domains into either a "basic, intermediate, or advanced" level of competency.

Building capacity in Australian interprofessional health education: perspectives from key health and higher education stakeholders.

PubMed

Matthews, Lynda R; Pockett, Rosalie B; Nisbet, Gillian; Thistlethwaite, Jill E; Dunston, Roger; Lee, Alison; White, Jill F

2011-05-01

A substantial literature engaging with the directions and experiences of stakeholders involved in interprofessional health education exists at the international level, yet almost nothing has been published that documents and analyses the Australian experience. Accordingly, this study aimed to scope the experiences of key stakeholders in health and higher education in relation to the development of interprofessional practice capabilities in health graduates in Australia. Twenty-seven semi-structured interviews and two focus groups of key stakeholders involved in the development and delivery of interprofessional health education in Australian higher education were undertaken. Interview data were coded to identify categories that were organised into key themes, according to principles of thematic analysis. Three themes were identified: the need for common ground between health and higher education, constraints and enablers in current practice, and the need for research to establish an evidence base. Five directions for national development were also identified. The study identified a range of interconnected changes that will be required to successfully mainstream interprofessional education within Australia, in particular, the importance of addressing issues of culture change and the need for a nationally coordinated and research informed approach. These findings reiterate those found in the international literature.

Simulated Order Verification and Medication Reconciliation during an Introductory Pharmacy Practice Experience.

PubMed

Metzger, Nicole L; Chesson, Melissa M; Momary, Kathryn M

2015-09-25

Objective. To create, implement, and assess a simulated medication reconciliation and an order verification activity using hospital training software. Design. A simulated patient with medication orders and home medications was built into existing hospital training software. Students in an institutional introductory pharmacy practice experience (IPPE) reconciled the patient's medications and determined whether or not to verify the inpatient orders based on his medical history and laboratory data. After reconciliation, students identified medication discrepancies and documented their rationale for rejecting inpatient orders. Assessment. For a 3-year period, the majority of students agreed the simulation enhanced their learning, taught valuable clinical decision-making skills, integrated material from previous courses, and stimulated their interest in institutional pharmacy. Overall feedback from student evaluations about the IPPE also was favorable. Conclusion. Use of existing hospital training software can affordably simulate the pharmacist's role in order verification and medication reconciliation, as well as improve clinical decision-making.

Impact of hybrid delivery of education on student academic performance and the student experience.

PubMed

Congdon, Heather Brennan; Nutter, Douglas A; Charneski, Lisa; Butko, Peter

2009-11-12

To compare student academic performance and the student experience in the first-year doctor of pharmacy (PharmD) program between the main and newly opened satellite campuses of the University of Maryland. Student performance indicators including graded assessments, course averages, cumulative first-year grade point average (GPA), and introductory pharmacy practice experience (IPPE) evaluations were analyzed retrospectively. Student experience indicators were obtained via an online survey instrument and included involvement in student organizations; time-budgeting practices; and stress levels and their perceived effect on performance. Graded assessments, course averages, GPA, and IPPE evaluations were indistinguishable between campuses. Students' time allocation was not different between campuses, except for time spent attending class and watching lecture videos. There was no difference between students' stress levels at each campus. The implementation of a satellite campus to expand pharmacy education yielded academic performance and student engagement comparable to those from traditional delivery methods.

Identifying the Types of Support Needed by Interprofessional Teams Providing Pediatric End-of-Life Care: A Thematic Analysis.

PubMed

Riotte, Clare O; Kukora, Stephanie K; Keefer, Patricia M; Firn, Janice I

2018-04-01

Despite the number of interprofessional team members caring for children at the end of life, little evidence exists on how institutions can support their staff in providing care in these situations. We sought to evaluate which aspects of the hospital work environment were most helpful for multidisciplinary team members who care for patients at the end of life and identify areas for improvement to better address staff needs. Qualitative thematic analysis was completed of free-text comments from a survey distributed to interprofessional staff members involved in the care of a recently deceased pediatric patient. A total of 2701 surveys were sent; 890 completed. Free-text responses were provided by 306 interprofessional team members. Interprofessional team members involved in the care of a child who died at a 348 bed academic children's hospital in the Midwestern United States. Realist thematic analysis of free-text responses was completed in Dedoose using a deductive and inductive approach with line-by-line coding. Descriptive statistics of demographic information was completed using Excel. Thematic analysis of the 306 free-text responses identified three main support-related themes. Interprofessional team members desire to have (1) support through educational efforts such as workshops, (2) support from colleagues, and (3) support through institutional practices. Providers who participate in end-of-life work benefit from ongoing support through education, interpersonal relationships, and institutional practices. Addressing these areas from an interprofessional perspective enables staff to provide the optimal care for patients, patients' families, and themselves.

Synthesis and Evaluation of Chlorinated Substrate Analogues for Farnesyl Diphosphate Synthase

PubMed Central

Heaps, Nicole A.; Poulter, C. Dale

2011-01-01

Substrate analogues for isopentenyl diphosphate (IPP) and dimethylallyl diphosphate (DMAPP), where the C3 methyl groups were replaced by chlorine, were synthesized and evaluated as substrates for avian farnesyl diphosphate synthase (FPPase). The IPP analogue (3-ClIPP) was a co-substrate when incubated with dimethylallyl diphosphate (DMAPP) or geranyl diphosphate (GPP) to give the corresponding chlorinated analogues of geranyl diphosphate (3-ClGPP) and farnesyl diphosphate (3-ClFPP), respectively. No products were detected in incubations of 3-ClIPP with 3-ClDMAPP. Incubation of IPP with 3-ClDMAPP gave 11-ClFPP as the sole product. Values of KM3-ClIPP (with DMAPP) and KM3-ClDMAPP (with IPP) were similar to those for IPP and DMAPP, however values of kcat for both analogues were substantially lower. These results are consistent with a dissociative electrophilic alkylation mechanism where the rate-limiting step changes from heterolytic cleavage of the carbon-oxygen bond in the allylic substrate to alkylation of the double bond of the homoallylic substrate. PMID:21344952

Anti-fibrotic characteristics of Vγ9+ γδ T cells in systemic sclerosis.

PubMed

Markovits, Noa; Bendersky, Anna; Loebstein, Ronen; Brusel, Marina; Kessler, Efrat; Bank, Ilan

2016-01-01

γδ T cells of the Vγ9Vδ2 subtype secrete anti-fibrotic cytokines upon isopentenyl pyrophosphate (IPP) stimulation. In this study, we sought to compare IPP and Zoledronate, an up-regulator of IPP, effects on proliferation and cytokine secretion of Vγ9+ T cells from systemic sclerosis (SSc) patients and healthy controls (HCs). We also examined the effect of IPP-triggered peripheral blood mononuclear cells (PBMC) on fibroblast procolla- gen secretion. PBMC from SSc patients and HCs were stimulated by increasing concentrations of Zoledronate, with or without IPP, and Vγ9+ T cell percentages were calculated using FACScan analysis. Subsequently, PBMC were cultured with IPP or toxic shock syndrome toxin-1 (TSST-1), and contents of the anti-fibrotic cytokines tumour necrosis factor (TNF)-α and interferon (IFN)-γ were measured by ELISA kits. Finally, supernatants of IPP-triggered Vγ9+ T cells from SSc patients were added to fibroblast cultures, and relative intensities of procollagen α1 chains were determined by densinometry. Higher concentrations of Zoledronate were required for maximal proliferation of Vγ9+ T cells in 9 SSc patients compared to 9 HCs, irrespective of exogenous IPP. When compared to stimulation by TSST-1, a non-Vγ9+ selective reagent, secretion of the anti-fibrotic cytokines TNF-α and IFN-γ in response to IPP was relatively diminished in SSc but not in HCs. Reduction of procollagen secretion by fibroblasts cultured with supernatants of IPP-stimulated PBMC was observed only in some SSc patients. Activated Vγ9+ T cells could act as anti-fibrotic mediators in SSc, although decreased responsiveness to IPP may play a role in the pathological fibrosis of this disease.

[Local groups as a tool for quality assurance of community health services].

PubMed

Mjell, J; Hjortdahl, P

2001-05-30

The aim of this study was to assess the use of local interprofessional or audit groups as a tool of quality enhancement. Fifty-six doctors, physiotherapists and nurses attended nine local interprofessional groups. The aim was to improve the quality of each professional's practice and to improve communication between the professions. The groups had a total of 62 meetings with each professional attending on average 5.7 meetings. All groups initiated quality enhancement projects. Initially the groups were very active and showed great initiative, but there were few final results. However, many groups reported improved communication and cooperation between the participating professionals. The experience from this project may be summarised as follows: The professionals within one and the same group should have more or less the same background and specialty. We recommend caution with organising interprofessional groups unless their participants work in the same practice. Interprofessional groups should spend adequate time for the members to get to know each other, and they should be guided by an experienced leader.

Interprofessional leadership training in MCH social work.

PubMed

Pecukonis, Edward; Doyle, Otima; Acquavita, Shauna; Aparicio, Elizabeth; Gibbons, Maya; Vanidestine, Todd

2013-01-01

The need to train health social workers to practice interprofessionally is an essential goal of social work education. Although most health social workers have exposure to multidisciplinary practice within their field work, few social work education programs incorporate interprofessional learning as an integrated component of both course work and field experiences (McPherson, Headrick, & Moss, 2001; Reeves, Lewin, Espin, & Zwaranstein, 2010; Weinstein, Whittington, & Leiba, 2003). In addition, little is written about the kinds of curricula that would effectively promote interdisciplinary training for social work students. These findings are particularly puzzling since there is increasing and compelling evidence that interdisciplinary training improves health outcomes (IOM, 2001). This article describes a social work education program that incorporates an Interprofessional education and leadership curriculum for Maternal and Child Health Social Work (MCHSW) at the University of Maryland's School of Social Work. The University of Maryland's Interprofesisonal Training Model is described along with the components needed to formulate an interdisciplinary learning experience. Various outcomes and lessons learned are discussed.

Exploring the potential of a capability framework as a vision and "sensemaking" tool for leaders of interprofessional education.

PubMed

Brewer, Margo

2016-09-01

Creating a vision (visioning) and sensemaking have been described as key leadership practices in the leadership literature. A vision provides clarity, motivation, and direction for staff, and is essential particularly in times of significant change. Closely related to visioning is sensemaking (the organisation of stimuli into a framework allowing people to understand, explain, attribute, extrapolate, and predict). The application of these strategies to leadership within the interprofessional field is yet to be scrutinised. This study examines an interprofessional capability framework as a visioning and sensemaking tool for use by leaders within a university health science curriculum. Interviews with 11 faculty members revealed that the framework had been embedded across multiple years and contexts within the curriculum. Furthermore, a range of responses to the framework were evoked in relation to its use to make sense of interprofessional practice and to provide a vision, guide, and focus for faculty. Overall the findings indicate that the framework can function as both a visioning and sensemaking tool.

The future of education and training in dental technology: designing a dental curriculum that facilitates teamwork across the oral health professions.

PubMed

Evans, J; Henderson, A; Johnson, N

2010-03-13

Teamwork is essential for the provision of contemporary, high quality oral health care. Teamwork skills need to be taught and learnt and therefore ought to be one of the core competencies in all dental education programmes: dentistry, oral health therapy, dental technology and dental assisting. Currently, lack of opportunities for collaborative learning and practice within educational establishments, and in the practising professions, hamper the development of effective teamwork. For students across oral health care, learning 'together' requires positive action for teamwork skills to be developed. Interprofessional curricula need to be formally developed, based on evidence from the wider education literature that demonstrates how to maximise the engagements needed for teamwork in practice. Rigorous study of interprofessional education within dentistry and oral health is in its infancy. Anecdotal evidence indicates that dental technology students who experience an interprofessional curriculum are better prepared for collaborative practice. Formalised interprofessional education is posited as an effective strategy to improve interactions among oral health professionals leading to improved patient care. This paper reviews the extant literature and describes the approach currently being trialled at Griffith University.

Measuring the impact of an interprofessional multimedia learning resource on Japanese nurses and nursing students using the Theory of Planned Behavior Medication Safety Questionnaire.

PubMed

Omura, Mieko; Levett-Jones, Tracy; Stone, Teresa Elizabeth; Maguire, Jane; Lapkin, Samuel

2015-12-01

Interprofessional communication and teamwork are essential for medication safety; however, limited educational opportunities for health professionals and students to develop these skills exist in Japan. This study evaluated the impact of an interprofessional multimedia learning resource on registered nurses' and nursing students' intention to practice in a manner promoting medication safety. Using a quasi-experimental design, Japanese registered nurses and nursing students (n = 203) were allocated to an experimental (n = 109) or control group (n = 94). Behavioral intentions of medication safety and the predictor variables of attitudes, perceived behavioral control, and subjective norms were measured using a Japanese version of the Theory of Planned Behavior Medication Safety Questionnaire. Registered nurses in the experimental group demonstrated a greater intention to collaborate and practice in a manner that enhanced medication safety, evidenced by higher scores than the control group on all predictor variables. The results demonstrate the potential for interprofessional multimedia learning resources to positively impact the behaviors of Japanese registered nurses in relation to safe medication practices. Further research in other contexts and with other cohorts is warranted. © 2015 Wiley Publishing Asia Pty Ltd.

Interprofessional learning at work: what spatial theory can tell us about workplace learning in an acute care ward.

PubMed

Gregory, Linda Rosemary; Hopwood, Nick; Boud, David

2014-05-01

It is widely recognized that every workplace potentially provides a rich source of learning. Studies focusing on health care contexts have shown that social interaction within and between professions is crucial in enabling professionals to learn through work, address problems and cope with challenges of clinical practice. While hospital environments are beginning to be understood in spatial terms, the links between space and interprofessional learning at work have not been explored. This paper draws on Lefebvre's tri-partite theoretical framework of perceived, conceived and lived space to enrich understandings of interprofessional learning on an acute care ward in an Australian teaching hospital. Qualitative analysis was undertaken using data from observations of Registered Nurses at work and semi-structured interviews linked to observed events. The paper focuses on a ward round, the medical workroom and the Registrar's room, comparing and contrasting the intended (conceived), practiced (perceived) and pedagogically experienced (lived) spatial dimensions. The paper concludes that spatial theory has much to offer understandings of interprofessional learning in work, and the features of work environments and daily practices that produce spaces that enable or constrain learning.

Innovations in interprofessional education: building collaborative practice skills.

PubMed

Friedrichsen, Steven; Martinez, Timothy S; Hostetler, Josih; Tang, Julie M W

2014-09-01

The Institute of Medicine advocates redesigning the health care system through interprofessional education (IPE) and collaborative practice. These strategies are game changers. Western University embraces this paradigm shift with an IPE curriculum for all students in 13 health care disciplines. Further, the College of Dental Medicine's innovations in community-based dental education and local programs such as the Children's Dental Care Project are preparing students as future interdisciplinary teams to improve patient care.

An Interprofessional Rural Health Education Program

PubMed Central

MacDowell, Martin; Schriever, Allison E.; Glasser, Michael; Schoen, Marieke D.

2012-01-01

Objectives. To develop, implement, and assess an interprofessional rural health professions program for pharmacy and medical students. Design. A recruitment and admissions process was developed that targeted students likely to practice in rural areas. Pharmacy students participated alongside medical students in completing the Rural Health Professions program curriculum, which included monthly lecture sessions and assignments, and a capstone clinical requirement in the final year. Assessment. Fourteen pharmacy students and 33 medical students were accepted into the program during the first 2 years of the Rural Health Professions program. Approximately 90% of the rural health professions students were originally from rural areas. Conclusions. The rural health professions program is an interprofessional approach to preparing healthcare providers to practice in rural communities. PMID:23275664

Challenges Faced by Social Workers as Members of Interprofessional Collaborative Health Care Teams

PubMed Central

Ambrose-Miller, Wayne; Ashcroft, Rachelle

2016-01-01

Interprofessional collaboration is increasingly being seen as an important factor in the work of social workers. A focus group was conducted with Canadian social work educators, practitioners, and students to identify barriers and facilitators to collaboration from the perspective of social work. Participants identified six themes that can act as barriers and facilitators to collaboration: culture, self-identity, role clarification, decision making, communication, and power dynamics. These findings carry important implications for interprofessional collaboration with social workers in health practice. PMID:27263200

Development of an interprofessional competency framework in Japan.

PubMed

Haruta, Junji; Sakai, Ikuko; Otsuka, Mariko; Yoshimoto, Hisashi; Yoshida, Kazue; Goto, Michiko; Shimoi, Toshinori

2016-09-01

This article presents a project that aimed to identify a set of competencies (domains and statements) to prepare Japanese students and healthcare practitioners for collaborative practice. The Japan Association for Interprofessional Education (JAIPE) has started a government-funded project to formulate its interprofessional competency framework, in cooperation with professional organisations (e.g. Japan Society for Medical Education) in healthcare and social sciences. This three-year project is underway as part of the Initiative to Build up the Core Healthcare Personnel programme of Mie University. This project consists of five stages: literature review, data collection, prototype development, consensus formation, and finalisation. Our efforts will culminate in Japan's first interprofessional competency framework, with consensus from relevant academic societies and other stakeholders. We hope that the involvement of stakeholder participation will improve the usability of the final interprofessional competency framework.

Inter-professional collaboration as a health human resources strategy: moving forward with a western provinces research agenda.

PubMed

Mickelson, Grace; Suter, Esther; Deutschlander, Siegrid; Bainbridge, Lesley; Harrison, Liz; Grymonpre, Ruby; Hepp, Shelanne

2012-01-01

The current gap in research on inter-professional collaboration and health human resources outcomes is explored by the Western Canadian Interprofessional Health Collaborative (WCIHC). In a recent research planning workshop with the four western provinces, 82 stakeholders from various sectors including health, provincial governments, research and education engaged with WCIHC to consider aligning their respective research agendas relevant to inter-professional collaboration and health human resources. Key research recommendations from a recent knowledge synthesis on inter-professional collaboration and health human resources as well as current provincial health priorities framed the discussions at the workshop. This knowledge exchange has helped to consolidate a shared current understanding of inter-professional education and practice and health workforce planning and management among the participating stakeholders. Ultimately, through a focused research program, a well-aligned approach between sectors to finding health human resources solutions will result in sustainable health systems reform. Copyright © 2013 Longwoods Publishing.

A virtual patient educational activity to improve interprofessional competencies: A randomized trial.

PubMed

Shoemaker, Michael J; de Voest, Margaret; Booth, Andrew; Meny, Lisa; Victor, Justin

2015-01-01

The purpose of the present study was to determine whether an interprofessional virtual patient educational activity improved interprofessional competencies in pharmacy, physician assistant, and physical therapy graduate students. Seventy-two fifth semester pharmacy (n = 33), fourth semester physician assistant (n = 27) and fourth semester physical therapy (n = 12) graduate students participated in the study. Participants were stratified by discipline and randomized into control (n = 38) and experimental groups (n = 34). At baseline and at study completion, all participants completed an original, investigator-developed survey that measured improvement in selected Interprofessional Education Collaborative (IPEC) competencies and the Readiness for Interprofessional Learning Scale (RIPLS). The experimental group had statistically significantly greater odds of improving on a variety of IPEC competencies and RIPLS items. The use of a single, interprofessional educational activity resulted in having a greater awareness of other professions' scopes of practice, what other professions have to offer a given patient and how different professions can collaborate in patient care.

Participation in interprofessional education: an evaluation of student and staff experiences.

PubMed

Forte, Anna; Fowler, Patricia

2009-01-01

This study investigates the experiences of staff and students involved in an identified Common Learning unit (module) named "Preparation for Practice". The unit was studied by those undertaking pre-registration undergraduate pathways in Physiotherapy, Occupational Therapy, Diagnostic Radiography and Therapeutic Radiography at London South Bank University. The study comprised uni-professional, inter-professional and staff focus groups. The main themes that emerged from the student focus groups were "Interprofessional awareness", "Impact on patient care" and "Positive and negative aspects of unit delivery". These themes were reflected in the staff focus group which also highlighted the impact of different learning and teaching strategies in working with interprofessional groups. Students and staff were able to understand the benefits of interprofessional education but they also identified barriers that detracted from the students' learning. Overall a variety of views were expressed which reflected the diversity of the student group and the challenges that this presented in the delivery of interprofessional education.

Interprofessional supervision in an intercultural context: a qualitative study.

PubMed

Chipchase, Lucy; Allen, Shelley; Eley, Diann; McAllister, Lindy; Strong, Jenny

2012-11-01

Our understanding of the qualities and value of clinical supervision is based on uniprofessional clinical education models. There is little research regarding the role and qualities needed in the supervisor role for supporting interprofessional placements. This paper reports the views and perceptions of medical and allied heath students and supervisors on the characteristics of clinical supervision in an interprofessional, international context. A qualitative case study was used involving semi-structured interviews of eight health professional students and four clinical supervisors before and after an interprofessional, international clinical placement. Our findings suggest that supervision from educators whose profession differs from that of the students can be a beneficial and rewarding experience leading to the use of alternative learning strategies. Although all participants valued interprofessional supervision, there was agreement that profession-specific supervision was required throughout the placement. Further research is required to understand this view as interprofessional education aims to prepare graduates for collaborative practice where they may work in teams supervised by staff whose profession may differ from their own.

An interprofessional service-learning course: uniting students across educational levels and promoting patient-centered care.

PubMed

Dacey, Marie; Murphy, Judy I; Anderson, Delia Castro; McCloskey, William W

2010-12-01

Recognizing the importance of interprofessional education, we developed a pilot interprofessional education course at our institution that included a total of 10 nursing, BS health psychology, premedical, and pharmacy students. Course goals were for students to: 1) learn about, practice, and enhance their skills as members of an interprofessional team, and 2) create and deliver a community-based service-learning program to help prevent or slow the progression of cardiovascular disease in older adults. Teaching methods included lecture, role-play, case studies, peer editing, oral and poster presentation, and discussion. Interprofessional student teams created and delivered two different health promotion programs at an older adult care facility. Despite barriers such as scheduling conflicts and various educational experiences, this course enabled students to gain greater respect for the contributions of other professions and made them more patient centered. In addition, inter-professional student teams positively influenced the health attitudes and behaviors of the older adults whom they encountered. Copyright 2010, SLACK Incorporated.

Teaching interprofessional teamwork skills to health professional students: A scoping review.

PubMed

Fox, Lanae; Onders, Robert; Hermansen-Kobulnicky, Carol J; Nguyen, Thanh-Nga; Myran, Leena; Linn, Becky; Hornecker, Jaime

2018-03-01

An expanding body of literature is examining interprofessional teamwork and its effect in healthcare. To produce capable healthcare professionals prepared to participate in interprofessional roles, teamwork training must begin early in health professional students' training. The focus of this scoping review was to explore interprofessional education (IPE) studies designed to teach and/or assess interprofessional teamwork skills to students from two or more different health professions, to find and describe effective pedagogy and assessment strategies. Using a scoping review methodology, 1,106 abstracts were reviewed by three teams of investigators. Eligibility criteria were inclusion of students in interprofessional teams, an intervention to improve interprofessional teamwork skills and assessment of outcomes related to teamwork. Thirty-three studies met the criteria for inclusion. The literature was varied in terms of study design, teaching methods and assessment measures for interprofessional teamwork. The lack of rigorous, comparable studies in this area makes recommending one teaching method or assessment measure over another difficult. Regardless of teaching method, it appears that most learning activities where interprofessional teams interact result in positive changes in student perceptions and attitudes towards IPE and practice. As health education programs seek to incorporate more interprofessional activities into their respective programs, it is important to review methods and measures that would best fit their individual program. This review highlights the importance of standardising the reporting of methods and outcomes for those who wish to incorporate the studied methods into their curricula.

Interprofessional Care and Collaborative Practice.

ERIC Educational Resources Information Center

Casto, R. Michael; And Others

This book provides materials for those learning about the dynamics, techniques, and potential of interprofessional collaboration in health care and human services professions. Eight case studies thread their way through most chapters to unify and illustrate the text. Part 1 addresses the theoretical framework that forms the basis for…

Exploring how Australian occupational therapists and physiotherapists understand each other's professional values: implications for interprofessional education and practice.

PubMed

Aguilar, Alejandra; Stupans, Ieva; Scutter, Sheila; King, Sharron

2014-01-01

This article provides insight into the values Australian occupational therapists and physiotherapists consider essential for their practice and the values that they perceive as important for each other. Findings from a study that employed the Delphi technique to identify the values occupational therapists and physiotherapists consider essential for their practice were compared with interview results that provide insight into how these professionals perceive one another's values. The results from this comparison indicate that occupational therapy and physiotherapy participants have limited knowledge of each other's values. This is evidenced by participants only identifying a minority of the values considered essential within the other profession and not identifying many of the values that guide daily practice within the other profession. The results hold implications for interprofessional education and practice, where knowledge of the values of other professions in the team is essential. To enable interprofessional collaboration, professions need to make their values explicit and provide their students, practitioners and educators with opportunities to learn about their own values and the values of other professions.

Interprofessionalism: Educating to meet patient needs.

PubMed

Kirch, Darrell G; Ast, Cori

2015-01-01

Interprofessional teams in health care are showing promise in achieving the triple aim-providing better care for the individual patient, reducing costs, and improving population health. To complement current changes in health care delivery in the United States, there is a growing consensus among health professions educators that students should be trained in interprofessional models prior to entering clinical practice. Current interprofessional education (IPE) efforts in anatomy education are producing positive results in enhancing professional respect, collaboration, and teamwork among health professions students. In spite of existing structural and cultural barriers to IPE, health professions educators must continue to lead and grow IPE efforts as a critical component to improving the health of our nation. © 2014 American Association of Anatomists.

"India Population Projects" in Karnataka.

PubMed

Reddy, P H; Badari, V S

1991-12-01

An overview, objectives, implementation, and research and evaluation studies of 2 India Population Projects in Karnataka are presented. The India Population Project I (IPP-I) was conducted in Karnataka and Uttar Pradesh. India Population Project III (IPP-III) took place between 1984-92 in 6 districts of Karnataka: Belgaum, Bijapur, Dharwad, Bidar, Gulbarga, and Raichur, and 4 districts in Kerala. The 6 districts in Karnataka accounted for 36% (13.2 million) of the total national population. The project cost was Rs. 713.1 million which was shared by the World Bank, and the Indian national and regional government. Due to poor past performance, these projects were undertaken to improve health and family welfare status. Specific project objectives are outlined. IPP-I included an urban component, and optimal Government of India program, and an intensive rural initiative. The urban program aimed to improved pre- and postnatal services and facilities, and the family planning (FP) in Bangalore city. The rural program was primarily to provide auxiliary nurse-midwives and hospitals and clinics, and also supplemental feeding program for pregnant and nursing mothers and children up to 2 years. The government program provided FP staff and facilities. IPP-I had 3 units to oversee building construction, to recruit staff and provide supplies and equipment, and to establish a Population Center. IPP-III was concerned with service delivery; information, education, and communication efforts (IEC) and population education; research and evaluation; and project management. Both projects contributed significantly to improving the infrastructure. A brief account of the types and kinds of studies undertaken is given. Studies were grouped into longitudinal studies of fertility, mortality, and FP; management information and evaluation systems for health and family welfare programs; experimental strategies; and other studies. Research and evaluation studies in IPP-III encompassed studies in gaps in knowledge, skills, and practice of health and FP personnel; baseline and endline surveys; and operational evaluation of the management information and evaluation system; factors affecting primary health care in Gulbarga district; evaluation of radio health lessons and the impact of the Kalyana Matha Program; and studies of vaccination and child survival and maternal mortality. Training programs were also undertaken.

The Efficacy of Injury Prevention Programs in Adolescent Team Sports: A Meta-analysis.

PubMed

Soomro, Najeebullah; Sanders, Ross; Hackett, Daniel; Hubka, Tate; Ebrahimi, Saahil; Freeston, Jonathan; Cobley, Stephen

2016-09-01

Intensive sport participation in childhood and adolescence is an established cause of acute and overuse injury. Interventions and programs designed to prevent such injuries are important in reducing individual and societal costs associated with treatment and recovery. Likewise, they help to maintain the accrual of positive outcomes from participation, such as cardiovascular health and skill development. To date, several studies have individually tested the effectiveness of injury prevention programs (IPPs). To determine the overall efficacy of structured multifaceted IPPs containing a combination of warm-up, neuromuscular strength, or proprioception training, targeting injury reduction rates according to risk exposure time in adolescent team sport contexts. Systematic review and meta-analysis. With established inclusion criteria, studies were searched in the following databases: Cochrane Central Register of Controlled Trials, MEDLINE, SPORTDiscus, Web of Science, EMBASE, CINAHL, and AusSportMed. The keyword search terms (including derivations) included the following: adolescents, sports, athletic injuries, prevention/warm-up programs. Eligible studies were then pooled for meta-analysis with an invariance random-effects model, with injury rate ratio (IRR) as the primary outcome. Heterogeneity among studies and publication bias were tested, and subgroup analysis examined heterogeneity sources. Across 10 studies, including 9 randomized controlled trials, a pooled overall point estimate yielded an IRR of 0.60 (95% CI = 0.48-0.75; a 40% reduction) while accounting for hours of risk exposure. Publication bias assessment suggested an 8% reduction in the estimate (IRR = 0.68, 95% CI = 0.54-0.84), and the prediction interval intimated that any study estimate could still fall between 0.33 and 1.48. Subgroup analyses identified no significant moderators, although possible influences may have been masked because of data constraints. Compared with normative practices or control, IPPs significantly reduced IRRs in adolescent team sport contexts. The underlying explanations for IPP efficacy remain to be accurately identified, although they potentially relate to IPP content and improvements in muscular strength, proprioceptive balance, and flexibility. Clinical practitioners (eg, orthopaedics, physical therapists) and sports practitioners (eg, strength and conditioners, coaches) can respectively recommend and implement IPPs similar to those examined to help reduce injury rates in adolescent team sports contexts. © 2015 The Author(s).

Comparison of intravesical prostatic protrusion, prostate volume and serum prostatic-specific antigen in the evaluation of bladder outlet obstruction.

PubMed

Lim, Kok Bin; Ho, Henry; Foo, Keong Tatt; Wong, Michael Yuet Chen; Fook-Chong, Stephanie

2006-12-01

The aims of this study were to define the relationship between intravesical prostatic protrusion (IPP), prostate-specific antigen (PSA) and prostate volume (PV) and to determine which one of them is the best predictor of bladder outlet obstruction (BOO) due to benign prostatic enlargement. A prospective study of 114 male patients older than 50 years examined between November 2001 and 2002 was performed. They were evaluated with digital rectal examination, International Prostate Symptoms Score, PSA, uroflowmetry, postvoid residual urine measurement, IPP and PV using transabdominal ultrasound scan. Statistical analysis included scatter plot with Spearman's correlation coefficients and nominal logistic regression Prostate volume, IPP and PSA showed parallel correlation. Although all three indices had good correlation with BOO index, IPP was the best. The Spearman rho correlation coefficients were 0.314, 0.408 and 0.507 for PV, PSA and IPP, respectively. Using receiver-operator characteristic curves, the areas under the curve for PV, PSA and IPP were 0.637, 0.703 and 0.772, respectively. The positive predictive values of PV, PSA and IPP were 65%, 68% and 72%, respectively. Using a nominal regression model, IPP remained the most significant independent index to determine BOO. All three non-invasive indices correlate with one another. The study showed that IPP is a better predictor for BOO than PSA or PV.

Interprofessional collaborative practice within cancer teams: Translating evidence into action. A mixed methods study protocol

PubMed Central

2010-01-01

Background A regional integrated cancer network has implemented a program (educational workshops, reflective and mentoring activities) designed to support the uptake of evidence-informed interprofessional collaborative practices (referred to in this text as EIPCP) within cancer teams. This research project, which relates to the Registered Nurses' Association of Ontario (RNAO) Best Practice Guidelines and other sources of research evidence, represents a unique opportunity to learn more about the factors and processes involved in the translation of evidence-based recommendations into professional practices. The planned study seeks to address context-specific challenges and the concerns of nurses and other stakeholders regarding the uptake of evidence-based recommendations to effectively promote and support interprofessional collaborative practices. Aim This study aims to examine the uptake of evidence-based recommendations from best practice guidelines intended to enhance interprofessional collaborative practices within cancer teams. Design The planned study constitutes a practical trial, defined as a trial designed to provide comprehensive information that is grounded in real-world healthcare dynamics. An exploratory mixed methods study design will be used. It will involve collecting quantitative data to assess professionals' knowledge and attitudes, as well as practice environment factors associated with effective uptake of evidence-based recommendations. Semi-structured interviews will be conducted concurrently with care providers to gather qualitative data for describing the processes involved in the translation of evidence into action from both the users' (n = 12) and providers' (n = 24) perspectives. The Graham et al. Ottawa Model of Research Use will serve to construct operational definitions of concepts, and to establish the initial coding labels to be used in the thematic analysis of the qualitative data. Quantitative and qualitative results will be merged during interpretation to provide complementary perspectives of interrelated contextual factors that enhance the uptake of EIPCP and changes in professional practices. Discussion The information obtained from the study will produce new knowledge on the interventions and sources of support most conducive to the uptake of evidence and building of capacity to sustain new interprofessional collaborative practice patterns. It will provide new information on strategies for overcoming barriers to evidence-informed interventions. The findings will also pinpoint critical determinants of 'what works and why' taking into account the interplay between evidence, operational, relational micro-processes of care, uniqueness of patients' needs and preferences, and the local context. PMID:20626858

Using an interprofessional competency framework to examine collaborative practice.

PubMed

Hepp, Shelanne L; Suter, Esther; Jackson, Karen; Deutschlander, Siegrid; Makwarimba, Edward; Jennings, Jake; Birmingham, Lisa

2015-03-01

Healthcare organisations are starting to implement collaborative practice to increase the quality of patient care. However, operationalising and measuring progress towards collaborative practice has proven to be difficult. Various interprofessional competency frameworks have been developed that outline essential collaborative practice competencies for healthcare providers. If these competencies were enacted to their fullest, collaborative practice would be at its best. This article examines collaborative practice in six acute care units across Alberta using the Canadian Interprofessional Health Collaborative (CIHC) competency framework (CIHC, 2010 ). The framework entails the six competencies of patient-centred care, communication, role clarification, conflict resolution, team functioning and collaborative leadership (CIHC, 2010 ). We conducted a secondary analysis of interviews with 113 healthcare providers from different professions, which were conducted as part of a quality improvement study. We found positive examples of communication and patient-centred care supported by unit structures and processes (e.g. rapid rounds and collaborative plan of care). Some gaps in collaborative practice were found for role clarification and collaborative leadership. Conflict resolution and team functioning were not well operationalised on these units. Strategies are presented to enhance each competency domain in order to fully enact collaborative practice. Using the CIHC competency framework to examine collaborative practice was useful for identifying strength and areas needing improvement.

Students' Perceptions on an Interprofessional Ward Round Training - A Qualitative Pilot Study.

PubMed

Nikendei, C; Huhn, D; Pittius, G; Trost, Y; Bugaj, T J; Koechel, A; Schultz, J-H

2016-01-01

Ward rounds are an essential activity for interprofessional teams in hospital settings and represent complex tasks requiring not only medical knowledge but also communication skills, clinical technical skills, patient management skills and team-work skills. The present study aimed to analyse final year students', nurses' as well as physiotherapists' views on a simulation-based interprofessional ward round training. In two successive passes a total number of 29 final year students, nursing students and physiotherapy students (16 in the first run, 13 in the second) volunteered to participate in two standardized patient ward round scenarios: (1) patient with myocardial infarction, and (2) patient with poorly controlled diabetes. Views on the interprofessional ward round training were assessed using focus groups. Focus group based feedback contained two main categories (A) ward round training benefits and (B) difficulties. Positive aspects enfolded course preparation, setting of the training, the involvement of the participants during training and the positive learning atmosphere. Difficulties were seen in the flawed atmosphere and realization of ward rounds in the daily clinical setting with respect to inter-professional aspects, and course benefit for the different professional groups. The presented inter-professional ward round training represents a well received and valuable model of interprofessional learning. Further research should assess its effectiveness, processes of interprofessional interplay and transfer into clinical practice.

Interprofessional education in practice: Evaluation of a work integrated aged care program.

PubMed

Lawlis, Tanya; Wicks, Alison; Jamieson, Maggie; Haughey, Amy; Grealish, Laurie

2016-03-01

Health professional clinical education is commonly conducted in single discipline modes, thus limiting student collaboration skills. Aged care residential facilities, due to the chronic and complex health care needs of residents, provide an ideal placement to provide a collaborative experience. Interprofessional education is widely acknowledged as the pedagogical framework through which to facilitate collaboration. The aim of the evaluation was to assess student attitudes towards collaboration after active involvement in an interprofessional education program. Students studying nursing, occupational therapy, and aged care were invited to complete a version of the Readiness for Interprofessional Learning Scale before and after participating in a three-week pilot interprofessional program. A positive change in student attitudes towards other health professionals and the importance of working in interprofessional teams was reported with significant differences between two statements indicated: Learning with health-care students before qualifications would improve relationships after qualifications; and I learned a lot from the students from the other disciplines. The innovative pilot project was found to enhance student learning in interprofessional teams and the aged care environment. Further development of this and similar interprofessional programs is required to develop sustainable student projects that have health benefits for residents in aged care residential facilities. Copyright © 2015 Elsevier Ltd. All rights reserved.

A sociological exploration of the tensions related to interprofessional collaboration in acute-care discharge planning.

PubMed

Goldman, Joanne; Reeves, Scott; Wu, Robert; Silver, Ivan; MacMillan, Kathleen; Kitto, Simon

2016-01-01

Patient discharge is a key concern in hospitals, particularly in acute care, given the multifaceted and challenging nature of patients' healthcare needs. Policies on discharge have identified the importance of interprofessional collaboration, yet research has described its limitations in this clinical context. This study aimed to extend our understanding of interprofessional interactions related to discharge in a general internal medicine setting by using sociological theories to illuminate the existence of, and interplay between, structural factors and microlevel practices. An ethnographic approach was employed to obtain an in-depth insight into healthcare providers' perspectives, behaviours, and interactions regarding discharge. Data collection involved observations, interviews, and document analysis. Approximately 65 hours of observations were undertaken, 23 interviews were conducted with healthcare providers, and government and hospital discharge documents were collected. Data were analysed using a directed content approach. The findings indicate the existence of a medically dominated division of healthcare labour in patient discharge with opportunities for some interprofessional negotiations; the role of organizational routines in facilitating and challenging interprofessional negotiations in patient discharge; and tensions in organizational priorities that impact an interprofessional approach to discharge. The findings provide insight into the various levels at which interventions can be targeted to improve interprofessional collaboration in discharge while recognizing the organizational tensions that challenge an interprofessional approach.

The interprofessional socialization and valuing scale: a tool for evaluating the shift toward collaborative care approaches in health care settings.

PubMed

King, Gillian; Shaw, Lynn; Orchard, Carole A; Miller, Stacy

2010-01-01

There is a need for tools by which to evaluate the beliefs, behaviors, and attitudes that underlie interprofessional socialization and collaborative practice in health care settings. This paper introduces the Interprofessional Socialization and Valuing Scale (ISVS), a 24-item self-report measure based on concepts in the interprofessional literature concerning shifts in beliefs, behaviors, and attitudes that underlie interprofessional socialization. The ISVS was designed to measure the degree to which transformative learning takes place, as evidenced by changed assumptions and worldviews, enhanced knowledge and skills concerning interprofessional collaborative teamwork, and shifts in values and identities. The scales of the ISVS were determined using principal components analysis. The principal components analysis revealed three scales accounting for approximately 49% of the variance in responses: (a) Self-Perceived Ability to Work with Others, (b) Value in Working with Others, and (c) Comfort in Working with Others. These empirically derived scales showed good fit with the conceptual basis of the measure. The ISVS provides insight into the abilities, values, and beliefs underlying socio-cultural aspects of collaborative and authentic interprofessional care in the workplace, and can be used to evaluate the impact of interprofessional education efforts, in house team training, and workshops.

Inter-professional work based learning within an MSc in Advanced Practice: lessons from one UK higher education programme.

PubMed

Gaskell, Lynne; Beaton, Susan

2010-09-01

This paper will describe the implementation of inter-professional work based education (IPE) in one postgraduate Advanced Practitioner programme in the UK. The concept of Advanced Practice has developed as a response of a number of drivers including change in junior doctor training; government policy and increasing demands on the central government funded UK health service (the NHS). The programme was commissioned by the then greater Manchester Strategic Health Authority (now NHS North West) to meet service needs. The educational philosophy underpinning the MSc Advanced Practice (health and social care) provided by the University of Salford is IPE linked to work based learning. The process of work based learning (WBL) and inter-professional learning underpinning the programme will be discussed in relation to feedback from university staff, Advanced Practitioner (AP) students and employer feedback taken from programme and module evaluations. We argue that IPE at this level facilitates a greater understanding of the connectivity between professionals working in the health care system in the UK; a better understanding of the skills and knowledge base of colleagues; more inter-professional working and appropriate referrals in the work place. This has raised the profile of Advanced Practice (AP) in the region and ultimately resulted in better patient care with more effective and efficient use of resources (Acton Shapiro, 2006, 2008). (c) 2009 Elsevier Ltd. All rights reserved.

Examining Interprofessional Education through the Lens of Interdisciplinarity: Power, Knowledge and New Ontological Subjects

ERIC Educational Resources Information Center

Olson, Rebecca E.; Brosnan, Caragh

2017-01-01

Interprofessional education (IPE)--students of different professions learning together, from and about each other--is increasingly common in health professional degrees. Despite its explicit aims of transforming identities, practices and relationships within/across health professions, IPE remains under-theorised sociologically, with most IPE…

Bourdieu and Interprofessional Education: What's the Relevance?

ERIC Educational Resources Information Center

Bonello, Marjorie; Wright, Jon; Morris, Jane; Sadlo, Gaynor

2018-01-01

Interprofessional education (IPE) is perceived to be one strategy to reduce professional compartmentalisation and improve collaborative practices. The unequal power relations existing between the various professions who need to collaborate for IPE remains largely unexamined and it is only in recent years that sociological theories have been…

Designing Simulations for Athletic Training Students through Interprofessional Teaching Collaboration

ERIC Educational Resources Information Center

Tivener, Kristin Ann; Gloe, Donna Sue

2015-01-01

Context: While multidisciplinary team approaches to education and practice have been promoted for decades, literature on collaborative efforts in athletic training and nursing remains sparse. Objective: The goal of this article is to provide an example of an interprofessional teaching collaboration in which a simulation scenario was developed…

An Approach to Integrating Interprofessional Education in Collaborative Mental Health Care

ERIC Educational Resources Information Center

Curran, Vernon; Heath, Olga; Adey, Tanis; Callahan, Terrance; Craig, David; Hearn, Taryn; White, Hubert; Hollett, Ann

2012-01-01

Objective: This article describes an evaluation of a curriculum approach to integrating interprofessional education (IPE) in collaborative mental health practice across the pre- to post-licensure continuum of medical education. Methods: A systematic evaluation of IPE activities was conducted, utilizing a combination of evaluation study designs,…

School Mental Health Professionals' Training, Comfort, and Attitudes toward Interprofessional Collaboration with Pediatric Primary Care Providers

ERIC Educational Resources Information Center

Arora, Prerna G.; Connors, Elizabeth H.; Biscardi, Krystin A.; Hill, Allison M.

2016-01-01

Despite the well-documented need for interprofessional collaboration (IPC) between school mental health (SMH) professionals and pediatric primary care providers (PCPs), research on current collaborative practices of these professionals is limited. Accordingly, using survey methodology, this study investigated SMH professionals' previous training…

Online Interprofessional Health Sciences Education: From Theory to Practice

ERIC Educational Resources Information Center

Luke, Robert; Solomon, Patty; Baptiste, Sue; Hall, Pippa; Orchard, Carole; Rukholm, Ellen; Carter, Lorraine

2009-01-01

Online learning (e-learning) has a nascent but established history. Its application to interprofessional education (IPE), however, is relatively new. Over the past 2 decades the Internet has been used increasingly to mediate education. We have come past the point of ""should" we use the Internet for education" to…

Dissecting through barriers: A follow-up study on the long-term effects of interprofessional education in a dissection course with healthcare professional students.

PubMed

Zheng, Yu Hang Eric; Palombella, Andrew; Salfi, Jenn; Wainman, Bruce

2018-04-16

Several studies have shown significant improvements in the attitudes and perceptions of healthcare professional students toward interprofessional education (IPE) immediately following intervention with IPE courses. However, there remains little evidence on the lasting effects of IPE courses and the long-term influences of these IPE experiences are poorly documented. The purpose of this study is to assess the long-term effects of an intensive, ten-week interprofessional gross anatomy dissection course at McMaster University. Attitudes and perceptions of past participants towards interprofessional learning were evaluated, now that they have started working with other healthcare professionals outside of the IPE course setting. Thirty-four past participants who have clinical experience working in interprofessional settings or are currently working in the healthcare field completed a follow-up questionnaire consisting of a modified Readiness for Interprofessional Learning Scale (RIPLS) and open-ended questions. Quantitative analysis revealed a significant decrease in their attitude towards teamwork and collaboration and respect for other health professions, but a significant improvement in their understanding of roles and responsibilities compared to their results immediately after the IPE intervention. Qualitative analysis of open-ended questions revealed several themes such as developing interprofessional competencies, developing relationships, and remembering the strengths of the IPE dissection course. The results of this study indicate that the IPE experience in anatomy was highly valued by the students and that past participants maintain a clear understanding of their scope of practice, but the reality of clinical practice may have eroded gains made in the program. Anat Sci Educ. © 2018 American Association of Anatomists. © 2018 American Association of Anatomists.

What did first-year students experience during their interprofessional education? A qualitative analysis of e-portfolios.

PubMed

Imafuku, Rintaro; Kataoka, Ryuta; Ogura, Hiroshi; Suzuki, Hisayoshi; Enokida, Megumi; Osakabe, Keitaro

2018-05-01

Interprofessional collaboration is an essential approach to comprehensive patient care. As previous studies have argued, interprofessional education (IPE) must be integrated in a stepwise, systematic manner in undergraduate health profession education programmes. Given this perspective, first-year IPE is a critical opportunity for building the foundation of interprofessional collaborative practice. This study aims to explore the first-year students' learning processes and the longitudinal changes in their perceptions of learning in a year-long IPE programme. Data were collected at a Japanese medical university, in which different pedagogical approaches are adopted in the IPE programme. Some of these approaches include interprofessional problem-based learning, early exposure, and interactive lecture-based teaching. The students are required to submit written reflections as a formative assessment. This study conducted an inductive thematic analysis of 104 written reflections from a series of e-portfolios of 26 first-year students. The themes related to learning outcomes from student perspectives included communication (e.g., active listening and intelligible explanation), teams and teamwork (e.g., mutual engagement and leadership), roles/responsibilities as a group member (e.g., self-directed learning and information literacy), and roles/responsibilities as a health professional (e.g., understanding of the student's own professional and mutual respect in an interprofessional team). The study also indicated three perspectives of students' learning process at different stages of the IPE, i.e., processes by which students became active and responsible learners, emphasised the enhancement of teamwork, and developed their own interprofessional identities. This study revealed the first-year students' learning processes in the year-long IPE programme and clarified the role of the first-year IPE programme within the overall curriculum. The findings suggest that the students' active participation in the IPE programme facilitated their fundamental understanding of communication/teamwork and identity formation as a health professional in interprofessional collaborative practice.

International Classification of Functioning, Disability and Health: Catalyst for interprofessional education and collaborative practice.

PubMed

Snyman, Stefanus; Von Pressentin, Klaus B; Clarke, Marina

2015-01-01

Patient-centred and community-based care is required for promotion of health equity. To enhance patient-centred interprofessional care, the World Health Organization recommends using the framework of the International Classification of Functioning, Disability and Health (ICF). Stellenbosch University's Interprofessional Education and Collaborative Practice (IPECP) strategy has promoted using ICF since 2010. Undergraduate medical students on rural clinical placements are expected to use ICF in approaching and managing patients. Students' ability to develop interprofessional care plans using ICF is assessed by a team of preceptors representing various health professions. This study explored the experiences of medical students and their preceptors using ICF in IPECP, and how patients perceived care received. Associative Group Analysis methodology was used to collect data for this study. In total, 68 study participants were enrolled of which 37 were medical students, 16 preceptors and 15 patients. Students found ICF enabled a patient-centred approach and reinforce the importance of context. Patients felt listened to and cared for. Preceptors, obliged to use ICF, came to appreciate the advantages of interprofessional care, promoting mutually beneficial teamwork and job satisfaction. The value of integrating IPECP as an authentic learning experience was demonstrated as was ICF as a catalyst in pushing boundaries for change.

Merging Social Networking Environments and Formal Learning Environments to Support and Facilitate Interprofessional Instruction

PubMed Central

King, Sharla; Greidanus, Elaine; Carbonaro, Michael; Drummond, Jane; Patterson, Steven

2009-01-01

This study describes the redesign of an interprofessional team development course for health science students. A theoretical model is hypothesized as a framework for the redesign process, consisting of two themes: 1) the increasing trend among post-secondary students to participate in social networking (e.g., Facebook, Second Life) and 2) the need for healthcare educators to provide interprofessional training that results in effective communities of practice and better patient care. The redesign focused on increasing the relevance of the course through the integration of custom-designed technology to facilitate social networking during their interprofessional education. Results suggest that students in an educationally structured social networking environment can be guided to join learning communities quickly and access course materials. More research and implementation work is required to effectively develop interprofessional health sciences communities in a combined face-to-face and on-line social networking context. PMID:20165519

Healthcare students' experiences of an interprofessional, student-led neuro-rehabilitation community-based clinic.

PubMed

Gustafsson, Louise; Hutchinson, Laura; Theodoros, Deborah; Williams, Katrina; Copley, Anna; Fagan, Amy; Desha, Laura

2016-01-01

Student-led clinics are becoming more prominent as educators seek alternate models of clinical education for health professionals. The purpose of this study was to evaluate healthcare students' experiences of an interprofessional student-led clinic for clients with neurological conditions. Thirteen students representing occupational therapy, physiotherapy, and speech pathology were recruited for the study. A sequential mixed-methods evaluation was employed and the results from the Interprofessional Education Scale and focus group revealed that the students experienced positive perceptions of working collaboratively with other professions, forming good relationships with others, as well as an increased respect for the roles of other professions. The findings suggest that providing a capstone opportunity, where students can work as part of an interprofessional team with a real client, in a format they may come across in future clinical practice, may be beneficial in providing them with essential interprofessional skills as new graduate health professionals.

Interprofessional communication and medical error: a reframing of research questions and approaches.

PubMed

Varpio, Lara; Hall, Pippa; Lingard, Lorelei; Schryer, Catherine F

2008-10-01

Progress toward understanding the links between interprofessional communication and issues of medical error has been slow. Recent research proposes that this delay may result from overlooking the complexities involved in interprofessional care. Medical education initiatives in this domain tend to simplify the complexities of team membership fluidity, rotation, and use of communication tools. A new theoretically informed research approach is required to take into account these complexities. To generate such an approach, we review two theories from the social sciences: Activity Theory and Knotworking. Using these perspectives, we propose that research into interprofessional communication and medical error can develop better understandings of (1) how and why medical errors are generated and (2) how and why gaps in team defenses occur. Such complexities will have to be investigated if students and practicing clinicians are to be adequately prepared to work safely in interprofessional teams.

Merging social networking environments and formal learning environments to support and facilitate interprofessional instruction.

PubMed

King, Sharla; Greidanus, Elaine; Carbonaro, Michael; Drummond, Jane; Patterson, Steven

2009-04-28

This study describes the redesign of an interprofessional team development course for health science students. A theoretical model is hypothesized as a framework for the redesign process, consisting of two themes: 1) the increasing trend among post-secondary students to participate in social networking (e.g., Facebook, Second Life) and 2) the need for healthcare educators to provide interprofessional training that results in effective communities of practice and better patient care. The redesign focused on increasing the relevance of the course through the integration of custom-designed technology to facilitate social networking during their interprofessional education. Results suggest that students in an educationally structured social networking environment can be guided to join learning communities quickly and access course materials. More research and implementation work is required to effectively develop interprofessional health sciences communities in a combined face-to-face and on-line social networking context.

Simulated settings; powerful arenas for learning patient safety practices and facilitating transference to clinical practice. A mixed method study.

PubMed

Reime, Marit Hegg; Johnsgaard, Tone; Kvam, Fred Ivan; Aarflot, Morten; Breivik, Marit; Engeberg, Janecke Merethe; Brattebø, Guttorm

2016-11-01

Poor teamwork is an important factor in the occurrence of critical incidents because of a lack of non-technical skills. Team training can be a key to prevent these incidents. The purpose of this study was to explore the experience of nursing and medical students after a simulation-based interprofessional team training (SBITT) course and its impact on professional and patient safety practices, using a concurrent mixed-method design. The participants (n = 262) were organized into 44 interprofessional teams. The results showed that two training sequences the same day improved overall team performance. Making mistakes during SBITT appeared to improve the quality of patient care once the students returned to clinical practice as it made the students more vigilant. Furthermore, the video-assisted oral debriefing provided an opportunity to strengthen interprofessional teamwork and share situational awareness. SBITT gave the students an opportunity to practice clinical reasoning skills and to share professional knowledge. The students conveyed the importance of learning to speak up to ensure safe patient practices. Simulated settings seem to be powerful arenas for learning patient safety practices and facilitating transference of this awareness to clinical practice. Copyright © 2016 Elsevier Ltd. All rights reserved.

Milestones and entrustable professional activities: The key to practically translating competencies for interprofessional education?

PubMed

Wagner, Susan J; Reeves, Scott

2015-01-01

Competency-based education and practice have become foundational for developing interprofessional education (IPE) and interprofessional collaboration. There has been a plethora of competencies developed in these areas recently, both at individual institutions and nationally; however, their effective integration and thus potential has not been fully realized educationally. Milestones and entrustable professional activities (EPAs) are new concepts and assessment approaches from medical education that provide a way to functionally use and maximize competencies to ensure that competency is attained. They are applicable to learning activities both within the classroom and the clinic, as well as to lifelong learning. This paper defines and describes milestones and EPAs, considers the importance of their application to IPE, and summarizes a future research project that will identify EPAs for an IPE curriculum.

Healthcare students as innovative partners in the development of future healthcare services: An action research approach.

PubMed

Norbye, Bente

2016-11-01

Health care systems in Norway and the western world have experienced extensive changes due to patients living longer with complex conditions that require coordinated care. A Norwegian healthcare reform has led to significant restructuring in service delivery as a devolution of services to municipalities. Partners from three rural healthcare services, students from four professional programmes, and one lecturer from each of the professional programmes used a collaborative approach to obtain new knowledge through interprofessional practice. Using an action research design, the research group facilitated democratic processes through dialogues with healthcare services and students. The design is visualised as a cyclical process in which each cycle contributes to improvements, innovations, and increased understanding. A total of 32 students and 3 supervisors were interviewed before and after the clinical practice experiences. Fieldwork was conducted during three clinical periods. Interprofessional student groups formed small healthcare teams and assessed patients with chronic and long-term conditions. Students prepared and negotiated patient follow-up. The teams' responsibilities led to reflective practices that enhanced their professional knowledge. The teams achieved a new understanding of patient situations, which influenced "second opinions" for patients with complex conditions and led to innovative practices. The change in perception of patient needs led to a changed professional approach. The students' perceptions changed as they learned from and about each other and in collaboration with the health service; this led to more coordinated care of patients with complex conditions. Interprofessional learning in community settings provided a platform to improve both healthcare education and rural healthcare services. This research contributes to knowledge of how students' placement in interprofessional teams can enhance students learning from, with and about each other. The student teams promoted new ways of approaching and delivering complex patient treatment and care in community healthcare service. Collaborative partnerships in interprofessional learning have potential in the wider international arena as a means for practice improvement. Copyright © 2016 Elsevier Ltd. All rights reserved.

Challenges of interprofessional team training: a qualitative analysis of residents' perceptions.

PubMed

van Schaik, Sandrijn; Plant, Jennifer; O'Brien, Bridget

2015-01-01

Simulation-based interprofessional team training is thought to improve patient care. Participating teams often consist of both experienced providers and trainees, which likely impacts team dynamics, particularly when a resident leads the team. Although similar team composition is found in real-life, debriefing after simulations puts a spotlight on team interactions and in particular on residents in the role of team leader. The goal of the current study was to explore residents' perceptions of simulation-based interprofessional team training. This was a secondary analysis of a study of residents in the pediatric residency training program at the University of California, San Francisco (United States) leading interprofessional teams in simulated resuscitations, followed by facilitated debriefing. Residents participated in individual, semi-structured, audio-recorded interviews within one month of the simulation. The original study aimed to examine residents' self-assessment of leadership skills, and during analysis we encountered numerous comments regarding the interprofessional nature of the simulation training. We therefore performed a secondary analysis of the interview transcripts. We followed an iterative process to create a coding scheme, and used interprofessional learning and practice as sensitizing concepts to extract relevant themes. 16 residents participated in the study. Residents felt that simulated resuscitations were helpful but anxiety provoking, largely due to interprofessional dynamics. They embraced the interprofessional training opportunity and appreciated hearing other healthcare providers' perspectives, but questioned the value of interprofessional debriefing. They identified the need to maintain positive relationships with colleagues in light of the teams' complex hierarchy as a barrier to candid feedback. Pediatric residents in our study appreciated the opportunity to participate in interprofessional team training but were conflicted about the value of feedback and debriefing in this setting. These data indicate that the optimal approach to such interprofessional education activities deserves further study.

Nurses' Perspectives on Interprofessional Communication in the Prevention of Functional Decline in Hospitalized Older People.

PubMed

Butler, Jeffrey I; Fox, Mary T

2018-03-22

Older people present with complex health issues on admission to hospital and are at high risk for functional decline and related complications. Thus, they require the services of diverse health-care professionals working in concert to support their functioning. Despite nurses' central role in caring for this patient population, and evidence indicating that interprofessional communication is a persistent challenge for nurses in acute-care settings, little is known about nurses' views on interprofessional communication in care preserving functioning in acutely admitted older people. To fill this knowledge gap, we gathered acute-care staff nurses' perspectives on interprofessional communication in a function-focused, interprofessional approach to hospital care for older adults. Thirteen focus groups were conducted with a purposeful, criterion-based sample of 57 nurses working in acute-care hospitals. Thematic analysis revealed two overarching themes capturing nurses' perspectives on key factors shaping interprofessional communication in a function-focused interprofessional approach to care (1) context of direct communication and (2) context of indirect communication. The first theme demonstrates that nurses preferred synchronous modes of communication, but some ascribed greater importance to unstructured forms of direct information-sharing, while others stressed structured direct communication, particularly interprofessional rounds. The second theme also documents divergence in nurses' views on asynchronous communication, with some emphasizing information technology and others analog tools. Perceptions of some modes of interprofessional communication were found to vary by practice setting. Theoretical and pragmatic conclusions are drawn that can be used to optimize interprofessional communication processes supporting hospitalized older people's functioning.

Every team needs a coach: Training for interprofessional clinical placements.

PubMed

Grymonpre, Ruby; Bowman, Susan; Rippin-Sisler, Cathy; Klaasen, Kathleen; Bapuji, Sunita B; Norrie, Ola; Metge, Colleen

2016-09-01

Despite growing awareness of the benefits of interprofessional education and interprofessional collaboration (IPC), understanding how teams successfully transition to IPC is limited. Student exposure to interprofessional teams fosters the learners' integration and application of classroom-based interprofessional theory to practice. A further benefit might be reinforcing the value of IPC to members of the mentoring team and strengthening their IPC. The research question for this study was: Does training in IPC and clinical team facilitation and mentorship of pre-licensure learners during interprofessional clinical placements improve the mentoring teams' collaborative working relationships compared to control teams? Statistical analyses included repeated time analysis multivariate analysis of variance (MANOVA). Teams on four clinical units participated in the project. Impact on intervention teams pre- versus post-interprofessional clinical placement was modest with only the Cost of Team score of the Attitudes Towards Healthcare Team Scale improving relative to controls (p = 0.059) although reflective evaluations by intervention team members noted many perceived benefits of interprofessional clinical placements. The significantly higher group scores for control teams (geriatric and palliative care) on three of four subscales of the Assessment of Interprofessional Team Collaboration Scale underscore our need to better understand the unique features within geriatric and palliative care settings that foster superior IPC and to recognise that the transition to IPC likely requires a more diverse intervention than the interprofessional clinical placement experience implemented in this study. More recently, it is encouraging to see the development of innovative tools that use an evidence-based, multi-dimensional approach to support teams in their transition to IPC.

Does Including Public Health Students on Interprofessional Teams Increase Attainment of Interprofessional Practice Competencies?

PubMed

Duffy, Pamela Ann; Ronnebaum, Julie A; Stumbo, Teri A; Smith, Kari Nies; Reimer, Rachel A

2017-04-01

Interprofessional education (IPE) creates dynamic experiential learning that can address social determinants of health that influence health outcomes. To examine the effects of including public health students on IPE teams on the interprofessional practice domain constructs (values/ethics, roles/responsibilities, interprofessional communication, and teams and teamwork). This single-case, mixed-methods study was performed using a grounded theory approach. Students from 8 graduate health sciences programs participated in an asynchronous, 6-week, online IPE learning activity. Three of the 4 interprofessional practice domain constructs were examined as outcome variables: participants' biomedical vs biopsychosocial patient approach (values/ethics); reported change in attitudes, beliefs, or values about other health professions (roles/responsibilities); and anticipated changes in future professional behaviors/interactions/approaches (teams and teamwork). Predictor variables were having an MPH participant on the IPE team, participants' enrollment in a clinical or nonclinical program, and student perception of the online format (interprofessional communication). Three hundred nineteen students were included, 261 from clinical and 58 from nonclinical programs. A significant association was found between having an MPH participant on the IPE teams and participants' awareness of the influence of social determinants of health (OR, 2.04; 95% CI, 1.13-3.66; P<.05). Program type was also significantly associated with awareness of the influence of social determinants of health, such that participants in nonclinical programs were significantly more likely to report the importance of social determinants of health in the care plan (OR, 3.68; 95% CI, 1.38-9.84; P<.01). Participants were significantly less likely to report future behavior change if they were in clinical programs (OR, 0.44; 95% CI, 0.23-0.86; P<.05) or if they disliked the online format (OR, 0.25; 95% CI, 0.14-0.42; P<.01). The model fit the data well (χ23=30.80; P<.001). Inclusion of MPH students on IPE teams has the potential to increase clinical participants' awareness of the influence of social determinants of health and interest in incorporating a biopsychosocial approach to health care.

The positive impact of interprofessional education: a controlled trial to evaluate a programme for health professional students.

PubMed

Darlow, Ben; Coleman, Karen; McKinlay, Eileen; Donovan, Sarah; Beckingsale, Louise; Gray, Ben; Neser, Hazel; Perry, Meredith; Stanley, James; Pullon, Sue

2015-06-04

Collaborative interprofessional practice is an important means of providing effective care to people with complex health problems. Interprofessional education (IPE) is assumed to enhance interprofessional practice despite challenges to demonstrate its efficacy. This study evaluated whether an IPE programme changed students' attitudes to interprofessional teams and interprofessional learning, students' self-reported effectiveness as a team member, and students' perceived ability to manage long-term conditions. A prospective controlled trial evaluated an eleven-hour IPE programme focused on long-term conditions' management. Pre-registration students from the disciplines of dietetics (n = 9), medicine (n = 36), physiotherapy (n = 12), and radiation therapy (n = 26) were allocated to either an intervention group (n = 41) who received the IPE program or a control group (n = 42) who continued with their usual discipline specific curriculum. Outcome measures were the Attitudes Toward Health Care Teams Scale (ATHCTS), Readiness for Interprofessional Learning Scale (RIPLS), the Team Skills Scale (TSS), and the Long-Term Condition Management Scale (LTCMS). Analysis of covariance compared mean post-intervention scale scores adjusted for baseline scores. Mean post-intervention attitude scores (all on a five-point scale) were significantly higher in the intervention group than the control group for all scales. The mean difference for the ATHCTS was 0.17 (95 %CI 0.05 to 0.30; p = 0.006), for the RIPLS was 0.30 (95 %CI 0.16 to 0.43; p < 0.001), for the TSS was 0.71 (95 %CI 0.49 to 0.92; p < 0.001), and for the LTCMS was 0.75 (95 %CI 0.56 to 0.94; p < 0.001). The mean effect of the intervention was similar for students from the two larger disciplinary sub-groups of medicine and radiation therapy. An eleven-hour IPE programme resulted in improved attitudes towards interprofessional teams and interprofessional learning, as well as self-reported ability to function within an interprofessional team, and self-reported confidence, knowledge, and ability to manage people with long-term conditions. These findings indicate that a brief intervention such as this can have immediate positive effects and contribute to the development of health professionals who are ready to collaborate with others to improve patient outcomes.

Interprofessional practice and decision support: an organizational framework applied to a mental health setting.

PubMed

Campbell, Susan; Stowe, Karen; Ozanne, Elissa M

2011-11-01

Decision support as a means to assist people in making healthcare decisions has been discussed extensively in the medical literature. However, the potential for use of decision support and decision aids with people with psychiatric disabilities in order to promote recovery has only begun to be researched and discussed in the mental health literature. Organizational factors that foster interprofessional practice within a decision support environment focused on mental health issues are examined in this paper.

Interprofessional practice and learning disability nursing.

PubMed

McCray, Janet

Several decades of policy and service change in the field of learning disability have set in place new service boundaries in health and social care, leading to different working relationships for professionals based on interprofessional and interagency collaboration. However, economic pressures may result in agencies offering resource-led rather than needs-led services, resulting in fragmented services and tensions between professional groups faced with tough choices in order to meet the long-term needs of people with learning disabilities. One of the key roles of the registered learning disability nurse (RLDN) is that of facilitator in meeting the healthcare needs of people with learning disabilities, which involves interprofessional working across these new health and social care boundaries. The aim of this article is to present the findings from a small scale research study that was undertaken to explore the views of the RLDN group in relation to interprofessional practice in the long-term support of people with learning disabilities. Set within a grounded theory methodology, this article focuses on one element of the research study, which was a descriptive analysis of individual practitioners' experiences. In documenting the practitioners' accounts, the research begins to identify a series of key roles and significant practice knowledge held by those employed in learning disability nursing positions.

Metabolic routes affecting rubber biosynthesis in Hevea brasiliensis latex

PubMed Central

Chow, Keng-See; Mat-Isa, Mohd.-Noor; Bahari, Azlina; Ghazali, Ahmad-Kamal; Alias, Halimah; Mohd.-Zainuddin, Zainorlina; Hoh, Chee-Choong; Wan, Kiew-Lian

2012-01-01

The cytosolic mevalonate (MVA) pathway in Hevea brasiliensis latex is the conventionally accepted pathway which provides isopentenyl diphosphate (IPP) for cis-polyisoprene (rubber) biosynthesis. However, the plastidic 2-C-methyl-D-erythritol 4-phosphate (MEP) pathway may be an alternative source of IPP since its more recent discovery in plants. Quantitative RT-PCR (qRT-PCR) expression profiles of genes from both pathways in latex showed that subcellular compartmentalization of IPP for cis-polyisoprene synthesis is related to the degree of plastidic carotenoid synthesis. From this, the occurrence of two schemes of IPP partitioning and utilization within one species is proposed whereby the supply of IPP for cis-polyisoprene from the MEP pathway is related to carotenoid production in latex. Subsequently, a set of latex unique gene transcripts was sequenced and assembled and they were then mapped to IPP-requiring pathways. Up to eight such pathways, including cis-polyisoprene biosynthesis, were identified. Our findings on pre- and post-IPP metabolic routes form an important aspect of a pathway knowledge-driven approach to enhancing cis-polyisoprene biosynthesis in transgenic rubber trees. PMID:22162870

Metabolic routes affecting rubber biosynthesis in Hevea brasiliensis latex.

PubMed

Chow, Keng-See; Mat-Isa, Mohd-Noor; Bahari, Azlina; Ghazali, Ahmad-Kamal; Alias, Halimah; Mohd-Zainuddin, Zainorlina; Hoh, Chee-Choong; Wan, Kiew-Lian

2012-03-01

The cytosolic mevalonate (MVA) pathway in Hevea brasiliensis latex is the conventionally accepted pathway which provides isopentenyl diphosphate (IPP) for cis-polyisoprene (rubber) biosynthesis. However, the plastidic 2-C-methyl-D-erythritol 4-phosphate (MEP) pathway may be an alternative source of IPP since its more recent discovery in plants. Quantitative RT-PCR (qRT-PCR) expression profiles of genes from both pathways in latex showed that subcellular compartmentalization of IPP for cis-polyisoprene synthesis is related to the degree of plastidic carotenoid synthesis. From this, the occurrence of two schemes of IPP partitioning and utilization within one species is proposed whereby the supply of IPP for cis-polyisoprene from the MEP pathway is related to carotenoid production in latex. Subsequently, a set of latex unique gene transcripts was sequenced and assembled and they were then mapped to IPP-requiring pathways. Up to eight such pathways, including cis-polyisoprene biosynthesis, were identified. Our findings on pre- and post-IPP metabolic routes form an important aspect of a pathway knowledge-driven approach to enhancing cis-polyisoprene biosynthesis in transgenic rubber trees.

Understanding interprofessional collaboration in the context of chronic disease management for older adults living in communities: a concept analysis.

PubMed

Bookey-Bassett, Sue; Markle-Reid, Maureen; Mckey, Colleen A; Akhtar-Danesh, Noori

2017-01-01

To report a concept analysis of interprofessional collaboration in the context of chronic disease management, for older adults living in communities. Increasing prevalence of chronic disease among older adults is creating significant burden for patients, families and healthcare systems. Managing chronic disease for older adults living in the community requires interprofessional collaboration across different health and other care providers, organizations and sectors. However, there is a lack of consensus about the definition and use of interprofessional collaboration for community-based chronic disease management. Concept analysis. Electronic databases CINAHL, Medline, HealthStar, EMBASE, PsychINFO, Ageline and Cochrane Database were searched from 2000 - 2013. Rodgers' evolutionary method for concept analysis. The most common surrogate term was interdisciplinary collaboration. Related terms were interprofessional team, multidisciplinary team and teamwork. Attributes included: an evolving interpersonal process; shared goals, decision-making and care planning; interdependence; effective and frequent communication; evaluation of team processes; involving older adults and family members in the team; and diverse and flexible team membership. Antecedents comprised: role awareness; interprofessional education; trust between team members; belief that interprofessional collaboration improves care; and organizational support. Consequences included impacts on team composition and function, care planning processes and providers' knowledge, confidence and job satisfaction. Interprofessional collaboration is a complex evolving concept. Key components of interprofessional collaboration in chronic disease management for community-living older adults are identified. Implications for nursing practice, education and research are proposed. © 2016 John Wiley & Sons Ltd.

Knowledge Translation and Interprofessional Collaboration: Where the Rubber of Evidence-Based Care Hits the Road of Teamwork

ERIC Educational Resources Information Center

Zwarenstein, Merrick; Reeves, Scott

2006-01-01

Knowledge-translation interventions and interprofessional education and collaboration interventions all aim at improving health care processes and outcomes. Knowledge-translation interventions attempt to increase evidence-based practice by a single professional group and thus may fail to take into account barriers from difficulties in…

Effective Interprofessional Teams: "Contact Is Not Enough" to Build a Team

ERIC Educational Resources Information Center

Sargeant, Joan; Loney, Elaine; Murphy, Gerard

2008-01-01

Introduction: Teamwork and interprofessional practice and learning are becoming integral to health care. It is anticipated that these approaches can maximize professional resources and optimize patient care. Current research, however, suggests that primary health care teams may lack the capacity to function at a level that enhances the individual…

[Interprofessional collaboration in the Family Health Strategy: implications for the provision of care and work management].

PubMed

Matuda, Caroline Guinoza; Pinto, Nicanor Rodrigues da Silva; Martins, Cleide Lavieri; Frazão, Paulo

2015-08-01

Interprofessional collaboration is seen as a resource for tackling model of care and workforce problems. The scope of this study was to understand the perception about the shared work and interprofessional collaboration of professionals who work in primary health care. A qualitative study was conducted in São Paulo city. In-depth interviews were performed with professionals from distinct categories who worked in the Family Health Strategy and Support Center for Family Health. The results highlighted the empirical 'professional interaction' and 'production goals' categories. The forms of interaction, the role of specialized matrix support and the perspective in which production goals are perceived by the professionals pointed to tensions between traditional professional logic and collaboration logic. It also revealed the tensions between a model based on specialized procedures and a more collaborative model centered on health needs of families and of the community. The sharing of responsibilities and practices, changes in the logic of patient referral to specialized services and inadequate organizational arrangements remain major challenges to the integration of interprofessional collaboration for the development of new care practices.

Occupational therapy students in the process of interprofessional collaborative learning: a grounded theory study.

PubMed

Howell, Dana

2009-01-01

The purpose of this grounded theory study was to generate a theory of the interprofessional collaborative learning process of occupational therapy (OT) students who were engaged in a collaborative learning experience with students from other allied health disciplines. Data consisted of semi-structured interviews with nine OT students from four different interprofessional collaborative learning experiences at three universities. The emergent theory explained OT students' need to build a culture of mutual respect among disciplines in order to facilitate interprofessional collaborative learning. Occupational therapy students went through a progression of learned skills that included learning how to represent the profession of OT, hold their weight within a team situation, solve problems collaboratively, work as a team, and ultimately, to work in an actual team in practice. This learning process occurred simultaneously as students also learned course content. The students had to contend with barriers and facilitators that influenced their participation and the success of their collaboration. Understanding the interprofessional learning process of OT students will help allied health faculty to design more effective, inclusive interprofessional courses.

Attitudes of students in medicine, nursing, occupational therapy, and physical therapy toward interprofessional education.

PubMed

Rose, Molly A; Smith, Kellie; Veloski, J Jon; Lyons, Kevin J; Umland, Elena; Arenson, Christine A

2009-01-01

With the growing interest in interprofessional education and practice, methods to evaluate the effectiveness of related curricular activities are essential. The purpose of this study was twofold: (1) to assess the attitudes of students in medicine, nursing, occupational therapy, and physical therapy toward interprofessional education using the Interdisciplinary Education Perception Scale and Readiness for Interprofessional Learning Scale and (2) to compare data with normative data previously reported. The two instruments were administered to 474 first-year students in medicine, nursing, occupational therapy, and physical therapy who completed the forms in the context of a workshop at the conclusion of the first year of an interprofessional health mentor program. Differences among professions were reported. Students in medicine and physical therapy rated members of their own professions significantly higher in the areas of competence/autonomy and need for cooperation as compared with those in nursing and occupational therapy. Along with reporting similarities and differences, the results provide additional normative data on these tools that can be used when choosing tools to evaluate interprofessional education attitudes.

Phase separation of DMDBS from iPP, and controlled crystalline orientation

NASA Astrophysics Data System (ADS)

Sreenivas, K.; Kumaraswamy, Guruswamy; Basargekar, R. S.

2012-02-01

We report an unexpected dependence of DMDBS phase separation temperature on the molecular weight of the matrix isotactic polypropylene (iPP). DMDBS crystallizes out at lower temperatures for iPP with decreasing molecular weight (and correspondingly lower tacticity). This molecular weight dependence is unique to iPP, and is not observed for either syndiotactic PP or for random ethylene-PP copolymers. We show that thermodynamic Flory-type arguments are unable to rationalize the observed results. We also results on extrusion film casting of iPP containing DMDBS and show that flow-alignment of DMDBS networks template the orientation of PP crystals. The modulus and yield strength increase on addition of DMDBS, relative to the neat iPP. Tensile modulus and yield stress of drawn films increase with the degree of orientation, and we are able to achieve a substantial increase even at relatively low draw ratios.

Experiences and shared meaning of teamwork and interprofessional collaboration among health care professionals in primary health care settings: a systematic review.

PubMed

Sangaleti, Carine; Schveitzer, Mariana Cabral; Peduzzi, Marina; Zoboli, Elma Lourdes Campos Pavone; Soares, Cassia Baldini

2017-11-01

During the last decade, teamwork has been addressed under the rationale of interprofessional practice or collaboration, highlighted by the attributes of this practice such as: interdependence of professional actions, focus on user needs, negotiation between professionals, shared decision making, mutual respect and trust among professionals, and acknowledgment of the role and work of the different professional groups. Teamwork and interprofessional collaboration have been pointed out as astrategy for effective organization of health care services as the complexity of healthcare requires integration of knowledge and practices from differente professional groups. This integration has a qualitative dimension that can be identified through the experiences of health professionals and to the meaning they give to teamwork. The objective of this systematic review was to synthesize the best available evidence on the experiences of health professionals regarding teamwork and interprofessional collaboration in primary health care settings. The populations included were all officially regulated health professionals that work in primary health settings: dentistry, medicine, midwifery, nursing, nutrition, occupational therapy, pharmacy, physical education, physiotherapy, psychology, social work and speech therapy. In addition to these professionals, community health workers, nursing assistants, licensed practical nurses and other allied health workers were also included. The phenomena of interest were experiences of health professionals regarding teamwork and interprofessional collaboration in primary health care settings. The context was primary health care settings that included health care centers, health maintenance organizations, integrative medicine practices, integrative health care, family practices, primary care organizations and family medical clinics. National health surgery as a setting was excluded. The qualitative component of the review considered studies that focused on qualitative data including designs such as phenomenology, grounded theory, ethnography, action research and feminist research. A three-step search strategy was utilized. Ten databases were searched for papers published from 1980 to June 2015. Studies published in English, Portuguese and Spanish were considered. Methodological quality was assessed using the Qualitative Assessment and Review Instrument developed by the Joanna Briggs Institute. All included studies received a score of at least 70% the questions in the instrument, 11 studies did not address the influence of the researcher on the research or vice-versa, and six studies did not present a statement locating the researcher culturally or theoretically. Qualitative findings were extracted using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Qualitative research findings were pooled using a pragmatic meta-aggregative approach and the Joanna Briggs Institute Qualitative Assessment and Review Instrument software. This review included 21 research studies, representing various countries and healthcare settings. There were 223 findings, which were aggregated into 15 categories, and three synthesized findings: CONCLUSIONS: This review shows that health professionals experience teamwork and interprofessional collaboration as a process in primary health care settings; its conditions, consequences (benefits and barriers), and finally shows its determinants. Health providers face enormous ideological, organizational, structural and relational challenges while promoting teamwork and interprofessional collaboration in primary health care settings. This review has identified possible actions that could improve implementation of teamwork and interprofessional collaboration in primary health care.

Infusing informatics into interprofessional education: the iTEAM (Interprofessional Technology Enhanced Advanced practice Model) project.

PubMed

Skiba, Diane J; Barton, Amy J; Knapfel, Sarah; Moore, Gina; Trinkley, Katy

2014-01-01

The iTEAM goal is to prepare advanced practice nurses, physicians and pharmacists with the interprofessional (IP) core competencies (informatics, patient centric, quality-focused, evidence based care) to provide technology enhanced collaborative care by: offering technology enhanced learning opportunities through a required informatics course, advanced practice courses (team based experiences with both standardized and virtual patients) and team based clinical experiences including e-health experiences. The innovative features of iTEAM project will be achieved through use of social media strategies, a web accessible Electronic Health Records (EHRs) system, a Virtual Clinic/Hospital in Second Life, various e-health applications including traditional telehealth tools and consumer oriented tools such as patient portals, social media consumer groups and mobile health (m-health) applications for health and wellness functions. It builds upon the schools' rich history of IP education and includes clinical partners, such as the VA and other clinical sites focused on care for underserved patient populations.

Gathering, strategizing, motivating and celebrating: the team huddle in a teaching general practice.

PubMed

Walsh, Allyn; Moore, Ainsley; Everson, Jennifer; DeCaire, Katharine

2018-03-01

To understand how implementing a daily team huddle affected the function of a complex interprofessional team including learners. A qualitative descriptive study using semi-structured interviews in focus groups. An academic general practice teaching practice. All members of one interprofessional team, including nurses, general practitioners, junior doctors, and support staff. Focus group interviews using semi-structured guidance were transcribed and the results analysed using qualitative content analysis. Four interrelated themes were identified: communication and knowledge sharing; efficiency of care; relationship and team building; and shared responsibility for team function. The implementation of the daily team huddle was seen by participants to enhance the collaboration within the team and to contribute to work life enjoyment. Participants perceived that problems were anticipated and solved quickly. Clinical updates and information about patients benefited the team including learners. Junior doctors quickly understood the scope of practice of other team members, but some felt reluctant to offer clinical opinions. The implementation of a daily team huddle was viewed as worthwhile by this large interprofessional general practice team. The delivery of patient care was more efficient, knowledge was readily distributed, and problem solving was shared across the team, including junior doctors.

Overcoming barriers to interprofessional education in gerontology: the Interprofessional Curriculum for the Care of Older Adults.

PubMed

Schapmire, Tara J; Head, Barbara A; Nash, Whitney A; Yankeelov, Pamela A; Furman, Christian D; Wright, R Brent; Gopalraj, Rangaraj; Gordon, Barbara; Black, Karen P; Jones, Carol; Hall-Faul, Madri; Faul, Anna C

2018-01-01

A fragmented workforce consisting of multiple disciplines with varying levels of training and limited ability to work as a team often provides care to older adults. Interprofessional education (IPE) is essential for preparing practitioners for the effective teamwork required for community-based, holistic, person-centered care of the older adults. Despite numerous programs and offerings to advance education and interdisciplinary patient care, there is an unmet need for geriatric IPE, especially as it relates to community-dwelling older adults and caregivers in medically underserved areas. A core group of university faculty from multiple disciplines received funding from the Health Resources and Services Administration Geriatric Workforce Enhancement Program to collaborate with community-based providers from several Area Agencies on Aging in the creation and implementation of the Interprofessional Curriculum for the Care of Older Adults (iCCOA). This geriatric curriculum is interprofessional, comprehensive, and community-based. Learners include third-year nursing students, nurse practitioner students, third-year medical students, internal medicine and family medicine residents, master's level social work students, third-year pharmacy students, pharmacy residents, third-year dental students, dental hygiene students, community-based organization professionals, practicing community organizers, and community health navigators. This article describes the efforts, successes, and challenges experienced with this endeavor, including securing funding, ensuring equal representation of the disciplines, adding new components to already crowded curricula, building curriculum on best practices, improving faculty expertise in IPE, managing logistics, and ensuring comprehensive evaluation. The results summarize the iCCOA components, as well as the interprofessional domains, knowledge, and competencies.

Overcoming barriers to interprofessional education in gerontology: the Interprofessional Curriculum for the Care of Older Adults

PubMed Central

Head, Barbara A; Nash, Whitney A; Yankeelov, Pamela A; Furman, Christian D; Wright, R Brent; Gopalraj, Rangaraj; Gordon, Barbara; Black, Karen P; Jones, Carol; Hall-Faul, Madri; Faul, Anna C

2018-01-01

A fragmented workforce consisting of multiple disciplines with varying levels of training and limited ability to work as a team often provides care to older adults. Interprofessional education (IPE) is essential for preparing practitioners for the effective teamwork required for community-based, holistic, person-centered care of the older adults. Despite numerous programs and offerings to advance education and interdisciplinary patient care, there is an unmet need for geriatric IPE, especially as it relates to community-dwelling older adults and caregivers in medically underserved areas. A core group of university faculty from multiple disciplines received funding from the Health Resources and Services Administration Geriatric Workforce Enhancement Program to collaborate with community-based providers from several Area Agencies on Aging in the creation and implementation of the Interprofessional Curriculum for the Care of Older Adults (iCCOA). This geriatric curriculum is interprofessional, comprehensive, and community-based. Learners include third-year nursing students, nurse practitioner students, third-year medical students, internal medicine and family medicine residents, master’s level social work students, third-year pharmacy students, pharmacy residents, third-year dental students, dental hygiene students, community-based organization professionals, practicing community organizers, and community health navigators. This article describes the efforts, successes, and challenges experienced with this endeavor, including securing funding, ensuring equal representation of the disciplines, adding new components to already crowded curricula, building curriculum on best practices, improving faculty expertise in IPE, managing logistics, and ensuring comprehensive evaluation. The results summarize the iCCOA components, as well as the interprofessional domains, knowledge, and competencies. PMID:29497345

Interprofessional rhetoric and operational realities: an ethnographic study of rounds in four intensive care units.

PubMed

Paradis, Elise; Leslie, Myles; Gropper, Michael A

2016-10-01

Morning interprofessional rounds (MIRs) are used in critical care medicine to improve team-based care and patient outcomes. Given existing evidence of conflict between and dissatisfaction among rounds participants, this study sought to better understand how the operational realities of care delivery in the intensive care unit (ICU) impact the success of MIRs. We conducted a year-long comparative ethnographic study of interprofessional collaboration and patient and family involvement in four ICUs in tertiary academic hospitals in two American cities. The study included 576 h of observation of team interactions, 47 shadowing sessions and 40 clinician interviews. In line with best practices in ethnographic research, data collection and analysis were done iteratively using the constant comparative method. Member check was conducted regularly throughout the project. MIRs were implemented on all units with the explicit goals of improving team-based and patient-centered care. Operational conditions on the units, despite interprofessional commitment and engagement, appeared to thwart ICU teams from achieving these goals. Specifically, time constraints, struggles over space, and conflicts between MIRs' educational and care-plan-development functions all prevented teams from achieving collaboration and patient-involvement. Moreover, physicians' de facto control of rounds often meant that they resembled medical rounds (their historical predecessors), and sidelined other providers' contributions. This study suggests that the MIRs model, as presently practiced, might not be well suited to the provision of team-based, patient-centered care. In the interest of interprofessional collaboration, of the optimization of clinicians' time, of high-quality medical education and of patient-centered care, further research on interprofessional rounds models is needed.

A three-year reflective writing program as part of introductory pharmacy practice experiences.

PubMed

Nuffer, Wesley; Vaughn, Jessica; Kerr, Kevin; Zielenski, Christopher; Toppel, Brianna; Johnson, Lauren; McCauley, Patrina; Turner, Christopher J

2013-06-12

To implement and evaluate a 3-year reflective writing program incorporated into introductory pharmacy practice experiences (IPPEs) in the first- through third-year of a doctor of pharmacy (PharmD) program. Reflective writing was integrated into 6 IPPE courses to develop students' lifelong learning skills. In their writing, students were required to self-assess their performance in patient care activities, identify and describe how they would incorporate learning opportunities, and then evaluate their progress. Practitioners, faculty members, and fourth-year PharmD students served as writing preceptors. The success of the writing program was assessed by reviewing class performance and surveying writing preceptor's opinions regarding the student's achievement of program objectives. Class pass rates averaged greater than 99% over the 8 years of the program and the large majority of the writing preceptors reported that student learning objectives were met. A support pool of 99 writing preceptors was created. A 3-year reflective writing program improved pharmacy students' reflection and reflective writing skills.

Impact of Hybrid Delivery of Education on Student Academic Performance and the Student Experience

PubMed Central

Nutter, Douglas A.; Charneski, Lisa; Butko, Peter

2009-01-01

Objectives To compare student academic performance and the student experience in the first-year doctor of pharmacy (PharmD) program between the main and newly opened satellite campuses of the University of Maryland. Methods Student performance indicators including graded assessments, course averages, cumulative first-year grade point average (GPA), and introductory pharmacy practice experience (IPPE) evaluations were analyzed retrospectively. Student experience indicators were obtained via an online survey instrument and included involvement in student organizations; time-budgeting practices; and stress levels and their perceived effect on performance. Results Graded assessments, course averages, GPA, and IPPE evaluations were indistinguishable between campuses. Students' time allocation was not different between campuses, except for time spent attending class and watching lecture videos. There was no difference between students' stress levels at each campus. Conclusions The implementation of a satellite campus to expand pharmacy education yielded academic performance and student engagement comparable to those from traditional delivery methods. PMID:19960080

Isopentenyldiphosphate:dimethylallyldiphosphate isomerase: Construction of a high-level heterologous expression system for the gene from Saccharomyces cerevisiae and identification of an active-site nucleophile

DOE Office of Scientific and Technical Information (OSTI.GOV)

Street, I.P.; Poulter, C.D.

1990-08-14

Isopentenyldiphosphate:dimethylallyldiphosphate isomerase (IPP isomerase) is an enzyme in isoprene metabolism which catalyzes the interconversion of the fundamental five-carbon homoallylic and allylic diphosphate building blocks for the pathway. The gene encoding IPP isomerase has recently been isolated from Saccharomyces cerevisiae. A heterologous expression system was constructed for the gene and used to overexpress IPP isomerase in Escherichia coli. In transformants carrying the expression vector, IPP isomerase activity was increased by over 100,000-fold relative to that of the untransformed host strain. The overexpressed enzyme constitutes 30-35% of the total soluble cell protein and can be purified to homogeneity in two steps. Recombinantmore » IPP isomerase was indistinguishable from that purified from yeast. 3-(Fluoromethyl)-3-butenyl diphosphate (FIPP) is a specific active-site-directed inhibitor of IPP isomerase from Claviceps purpurea. Inactivation of yeast IPP isomerase by FIPP was active-site-directed, and inhibition resulted in formation of a stoichiometric enzyme-inhibitor complex. The site of covalent attachment in the enzyme-inhibitor complex was determined by inactivating IPP isomerase with (4-{sup 3}H)FIPP, followed by digestion of the labeled enzyme with trypsin and purification of the resulting radioactive peptides by reversed-phase high-performance liquid chromatography. The primary site of attachment was Cys-139.« less

Discovering eHealth Technology: An Innovative Interprofessional Graduate Student Learning Experience.

PubMed

Estes, Krista; Gilliam, Eric; Knapfel, Sarah; Lee, Chanmi; Skiba, Diane

2016-01-01

The use of eHealth has grown in recent years and is projected to continue to increase exponentially. In order to empower and prepare advanced practice providers to integrate eHealth into their clinical practice, curricular changes need to occur. The iTEAM grant provides a unique opportunity to prepare advanced practice disciplines to provide collaborative care using eHealth. Through the integration of a simulated telehealth using a standardized patient, Doctor of Pharmacy and Advanced Practice Registered Nursing students learned how to apply health information technology and coordinate care in an interprofessional manner. Opportunities and challenges to guide future efforts to integrate eHealth-learning experiences into the curriculum are identified.

Development of an interprofessional competency framework for collaborative practice in Japan.

PubMed

Haruta, Junji; Yoshida, Kazue; Goto, Michiko; Yoshimoto, Hisashi; Ichikawa, Shuhei; Mori, Youhei; Yoshimi, Kenji; Otsuka, Mariko

2018-01-30

Rapid aging of the population necessitates improved collaboration among healthcare professionals. Unfortunately, interprofessional collaboration has yet to be implemented effectively in Japan. Therefore, we aimed to develop an interprofessional competency framework for Japanese healthcare professionals. The project was conducted as a four-step process, starting with initial categorization of potential competency domains,, followed by guiding principle and prototype development, feedback on the prototype, and final consensus. First, authors (JH and MO) collected opinions about competency in interprofessional collaboration at two academic meetings of the Japan Association for Interprofessional Education (JAIPE) and then analyzed the data thematically. Second, a project team consisting of JAIPE and University representatives extracted the domains and statements as prototype 1. Third, seven representatives from professional organizations joined the project team and developed prototype 2. We then called for feedback on the revised prototype 2 at both an open symposium and via public comments. Following revision of prototype 2, a new project team including 20 university, professional organization and health practitioner representatives finally discussed prototype 3, developed the final draft and reached a consensus. In analysis after collecting the data, we extracted 11 themes. We developed four key principles which applied to six domains as prototype 1-3. Finally, our competency framework included two core domains of "Patient-/client-/family-/community-centered" and "Interprofessional communication", and four peripheral domains of "Role contribution", "Facilitation of relationships", "Reflection" and "Understanding of others". We developed an interprofessional competency framework in Japan which consists of two core and four peripheral domains. The interprofessional competency framework is likely to affect the understanding of "high-context" and "relationalism" in Japanese healthcare. We hope that our interprofessional competency framework will encourage the systematic implementation of interprofessional education and collaboration in Japan.

Training future health providers to care for the underserved: a pilot interprofessional experience.

PubMed

Hasnain, Memoona; Koronkowski, Michael J; Kondratowicz, Diane M; Goliak, Kristen L

2012-01-01

Interprofessional teamwork is essential for effective delivery of health care to all patients, particularly the vulnerable and underserved. This brief communication describes a pilot interprofessional learning experience designed to introduce medicine and pharmacy students to critical health issues affecting at-risk, vulnerable patients and helping students learn the value of functioning effectively in interprofessional teams. With reflective practice as an overarching principle, readings, writing assignments, a community-based immersion experience, discussion seminars, and presentations were organized to cultivate students' insights into key issues impacting the health and well-being of vulnerable patients. A written program evaluation form was used to gather students' feedback about this learning experience. Participating students evaluated this learning experience positively. Both quantitative and qualitative input indicated the usefulness of this learning experience in stimulating learners' thinking and helping them learn to work collaboratively with peers from another discipline to understand and address health issues for at-risk, vulnerable patients within their community. This pilot educational activity helped medicine and pharmacy students learn the value of functioning effectively in interprofessional teams. Given the importance of interprofessional teamwork and the increasing need to respond to the health needs of underserved populations, integrating interprofessional learning experiences in health professions training is highly relevant, feasible, and critically needed.

The interprofessional learning experience: Findings from a qualitative study based in an outpatient setting.

PubMed

Jakobsen, Flemming; Mørcke, Anne Mette; Hansen, Torben Bæk

2017-09-01

Clinical interprofessional education has traditionally taken place in hospital wards, but much diagnosis and treatment have shifted to the outpatient setting. The logical consequence is to shift more students' clinical placements from the "bedside" to outpatient settings. However, it is unclear how we ensure that this shift maximises learning. The purpose of this article is to understand the authentic learning experience in an interprofessional outpatient clinic setting. We performed an exploratory case study with interviews of four nursing students, 13 medical students, and six staff members who worked in an interprofessional outpatient orthopaedic clinic from March 2015 to January 2016. The interviews were transcribed and analysed using systematic text condensation. The students' self-reported learning experience in this outpatient clinic was characterised by direct patient contact and by authentic, interprofessional, task-based learning, and a preference for indirect supervision when conducting uncomplicated patient consultations. The supervisors intended to create this interprofessional outpatient clinic experience by having a clear teaching approach based on adult learning principles in a safe and challenging learning environment. The shift to the outpatient setting was strongly and practically supported by the management. This study indicates that student learning can be shifted to the outpatient clinic setting if there is supportive management and dedicated supervisors who establish a challenging yet safe interprofessional learning environment.

The student-run free clinic: an ideal site to teach interprofessional education?

PubMed

Sick, Brian; Sheldon, Lisa; Ajer, Katy; Wang, Qi; Zhang, Lei

2014-09-01

Student-run free clinics (SRFCs) often include an interprofessional group of health professions students and preceptors working together toward the common goal of caring for underserved populations. Therefore, it would seem that these clinics would be an ideal place for students to participate in an interprofessional collaborative practice and for interprofessional education to occur. This article describes a prospective, observational cohort study of interprofessional attitudes and skills including communication and teamwork skills and attitudes about interprofessional learning, relationships and interactions of student volunteers in a SRFC compared to students who applied and were not accepted to the clinic and to students who never applied to the clinic. This study showed a decrease in attitudes and skills after the first year for all groups. Over the next two years, the total score on the survey for the accepted students was higher than the not accepted students. The students who were not accepted also became more similar to students who never applied. This suggests a protective effect against declining interprofessional attitudes and skills for the student volunteers in a SRFC. These findings are likely a function of the design of the clinical and educational experience in the clinic and of the length of contact the students have with other professions.

Interprofessional Collaboration

PubMed Central

Engel, Joyce; Taplay, Karyn; Stobbe, Karl

2015-01-01

In this hermeneutic phenomenological study, we examined the experience of interprofessional collaboration from the perspective of nursing and medical students. Seventeen medical and nursing students from two different universities participated in the study. We used guiding questions in face-to-face, conversational interviews to explore students’ experience and expectations of interprofessional collaboration within learning situations. Three themes emerged from the data: the great divide, learning means content, and breaking the ice. The findings suggest that the experience of interprofessional collaboration within learning events is influenced by the natural clustering of shared interests among students. Furthermore, the carry-forward of impressions about physician–nurse relationships prior to the educational programs and during clinical placements dominate the formation of new relationships and acquisition of new knowledge about roles, which might have implications for future practice. PMID:28462293

Not left to chance: introducing an undergraduate interprofessional education curriculum.

PubMed

Pardue, Karen T

2013-01-01

Teaching diverse health profession students to work in teams, communicate, understand each other's roles and responsibilities, and effectively collaborate is imperative for creating a practice-ready workforce. This short report introduces an innovative undergraduate interprofessional curriculum for students enrolled in the baccalaureate majors of applied exercise science, athletic training, dental hygiene, nursing and pre-occupational therapy. The process of designing this program of study, guided by the method of appreciative inquiry, is highlighted. The format and learning activities created for this novel curriculum are described. Congruence for this endeavor is explored through alignment with the recent national Interprofessional Education Collaborative expert panel report. Preparing graduates to fulfill the dual identity of discipline-specific clinician and interprofessional team member is an essential curricular consideration for contemporary health profession education.

Multidisciplinary Meeting (MDM) Can Provide Education and Reinforcement of Inter-Professional Development

ERIC Educational Resources Information Center

Zafiropoulos, George; Byfield, David

2016-01-01

The introduction of a multidisciplinary meeting (MDM) was analysed through a retrospective empirical study. The question of using it as a valuable tool to reinforce inter-professional development was made. The data was collected from 60 forth year Chiropractic students, who were at the end of their education and who were practicing their…

Long-Term Effect of a Short Interprofessional Education Interaction between Medical and Physical Therapy Students

ERIC Educational Resources Information Center

Sytsma, Terin T.; Haller, Elizabeth P.; Youdas, James W.; Krause, David A.; Hellyer, Nathan J.; Pawlina, Wojciech; Lachman, Nirusha

2015-01-01

Medicine is increasingly focused on team-based practice as interprofessional cooperation leads to better patient care. Thus, it is necessary to teach teamwork and collaboration with other health care professionals in undergraduate medical education to ensure that trainees entering the workforce are prepared to work in teams. Gross anatomy provides…

Infusing Integrated Behavioral Health in an MSW Program: Curricula, Field, and Interprofessional Educational Activities

ERIC Educational Resources Information Center

Zerden, Lisa de Saxe; Jones, Anne; Brigham, Rebecca; Kanfer, Meryl; Zomorodi, Margaret

2017-01-01

An essential aspect of integrated care is the coordination of medical and behavioral health needs concurrently. This has sparked renewed emphasis on interprofessional (IP) education and practice. The impetus for IP efforts was crystalized in large part because of health care reforms, and federal funding to expand the behavioral health work force.…

The Use of PBL in an Interprofessional Education Course for Health Care Professional Students

ERIC Educational Resources Information Center

L'Ecuyer, Kristine; Pole, David; Leander, Sheila A.

2015-01-01

A problem-based learning (PBL) framework was utilized in a series of six interprofessional team seminars (IPTS) for postbaccalaureate students from seven health professions. The goal of IPTS was to develop a collaborative practice-ready workforce prepared to respond to patient care needs through use of concrete examples, skills development,…

Intra-vesical Prostatic Protrusion (IPP) Can Be Reduced by Prostatic Artery Embolization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lin, Yen-Ting, E-mail: ymerically@gmail.com; Amouyal, Grégory, E-mail: gregamouyal@hotmail.com; Thiounn, Nicolas, E-mail: nicolas.thiounn@egp.aphp.fr

BackgroundProstate artery embolization (PAE) is a new approach to improve lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia. PAE results in global reduction of prostate volume (PV). There are no data available on the efficacy of PAE in reducing intra-vesical prostatic protrusion (IPP), an anatomic feature that is clinically related with bladder outlet obstruction and LUTS.ObjectiveTo assess the results of PAE in patients with significant IPP due to median lobe hyperplasia and to compare the IPSS decrease and IPP change.Material and MethodsProspective analysis of 18 consecutive patients with significant IPP (>5 mm) related to median lobe hyperplasia undergoing PAEmore » using 30–500-μm-calibrated trisacryl microspheres. We measured IPP on sagittal T2-weighted images before and 3 months after PAE. IPSS and clinical results were also evaluated at 3 months.ResultsPAE resulted in significant IPP reduction (1.57 cm ± 0.55 before PAE and 1.30 cm ± 0.46 after PAE, p = 0.0005) (Fig. 1) with no complication. IPSS, quality of life (QoL), total prostate-specific antigen (PSA) level, and PV showed significant reduction after PAE, and maximum urinary flow rate (Q{sub max}) showed significant increase after PAE. No significant change of International Index of Erectile Function (IIEF) for clinical evaluation after PAE. A significant correlation was found between the IPP change and the IPSS change (r = 0.636, p = 0.0045).ConclusionPatients had significant IPP reduction as well as significant symptomatic improvement after PAE, and these improvements were positively correlated.« less

Comparison between AMS 700™ CX and Coloplast™ Titan inflatable penile prosthesis for Peyronie's disease treatment and remodeling: clinical outcomes and patient satisfaction.

PubMed

Chung, Eric; Solomon, Matthew; DeYoung, Ling; Brock, Gerald B

2013-11-01

The implantation of inflatable penile prosthesis (IPP) with simultaneous manual penile remodeling allows for men to undergo a single procedure aimed at correcting both the penile deformity/curvature and erectile dysfunction (ED). To evaluate the clinical outcomes and patient satisfaction in men with Peyronie's disease (PD) and ED who underwent AMS 700™ CX and the newer Coloplast™ Titan inflatable penile prosthesis (IPP) implant. Patient demographics, type of IPP, clinical outcomes, post-implant sexual characteristics, and overall patient satisfaction. A single-center retrospective review of clinical database and prospective telephone survey were conducted in all men with PD who underwent IPP between January 2006 and November 2010. A total of 138 patients with an average age of 57.7 (32 to 80) underwent AMS 700 CX (88 patients) and Coloplast Titans (50 patients) IPP implantation during the 5-year period. The majority of patients (91%) had only one IPP implantation. The IPP clinical outcomes include eight (6%) revision surgery for device malfunction and three (2%) device explantation for prosthesis infection. While there was no statistically significance in device survival between the two devices, the trend favored AMS 700 CX over Titan (5-year Kaplan-Meier estimates of mechanical survival were 91% vs. 87%, P>0.05) and both IPPs provided similar penile straightening without the need for revision surgery. Most men (79%) reported great satisfaction following CX or Titan implants with greater than two thirds of men reported greater self-confidence and 82% of patients would undergo the same operation again. AMS 700™ CX and Coloplast™ Titan IPP implantation and penile remodeling appeared to provide permanent penile straightening and high patient satisfaction without an increase risk of revision surgery. © 2012 International Society for Sexual Medicine.

The impact of medication synchronization on quality care criteria in an independent community pharmacy.

PubMed

Hinson, Jessica L; Garofoli, Gretchen K; Elswick, Betsy M

To determine the impact of a comprehensive medication synchronization program in an independent community pharmacy by (1) evaluating changes in Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) scores and (2) examining the change in monthly prescription volume. Independent community pharmacy in Morgantown, WV. Waterfront Family Pharmacy is a single-location independent community pharmacy located in Morgantown, WV. The pharmacy consists of four full-time pharmacists and is the primary practice site for one community pharmacy PGY-1 resident. The pharmacy provides a variety of clinical services, including vaccine administration, medication therapy management, and diabetes education services. In September 2014, Waterfront Family Pharmacy started a comprehensive medication synchronization program. Change in Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) scores and change in monthly prescription volume. At the end of 6 months there was improvement in all targeted EQuIPP scores. There was a 7% improvement in proportion of days covered (PDC) for cholesterol-reducing agents, a 9.5% improvement in PDC for oral glycemic agents, a 1.2% improvement in PDC for renin-angiotensin system antagonists, and a 1.8% reduction in the use of high-risk medications in the elderly. There was also an average increase in monthly prescription volume of 4.8% over the first 6 months after the implementation of the comprehensive medication synchronization program. The implementation of a comprehensive medication synchronization program in an independent community pharmacy may result in benefits including improved EQuIPP scores and increased prescription volume. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Nursing and Dental Students' Reflections on Interprofessional Practice After a Service-Learning Experience in Appalachia.

PubMed

Nierenberg, Susan; Hughes, Linda Paine; Warunek, Molli; Gambacorta, Joseph E; Dickerson, Suzanne S; Campbell-Heider, Nancy

2018-05-01

Nowhere is the discrepancy between good and poor oral health status more pronounced in the U.S. than in the Appalachian region, where there is a high incidence of dental problems related to non-flouridated water, limited access to care, and tooth loss. To address these disparities, in 2016 University at Buffalo dental and nurse practitioner faculty members led a group of dental and nursing students on a two-day service-learning experience in rural Tennessee. The aim of this study was to assess the dental and nursing students' reflections on this interprofessional service-learning experience in Appalachia. After the program, all 36 students who took part in it were invited to complete a survey with open-ended questions about the experience and their attitudes about interprofessional practice. Of the students, 34 (94.4%) returned the surveys, and 23 completed all the questions. Thematic analysis was used to code and analyze the student comments, which were then organized into themes. Five themes emerged: facilitating care through teamwork, gaining mutual respect, gaining confidence, understanding dental role in overall health, and relieving suffering. The overarching pattern was the link among all the themes: that everyone has a part to play in ensuring that patients get the best care. The themes and overarching pattern corresponded to the Interprofessional Education Collaboration (IPEC) competencies and the overall goal of delivering patient-centered care to a population that is underserved. These findings suggest that exposure to patients who lack dental care and have severe oral health problems can impact developing nursing and dental professionals in ways that can increase their appreciation of interprofessional practice and their future willingness to provide care in underserved settings.

What fosters or prevents interprofessional teamworking in primary and community care? A literature review.

PubMed

Xyrichis, Andreas; Lowton, Karen

2008-01-01

The increase in prevalence of long-term conditions in Western societies, with the subsequent need for non-acute quality patient healthcare, has brought the issue of collaboration between health professionals to the fore. Within primary care, it has been suggested that multidisciplinary teamworking is essential to develop an integrated approach to promoting and maintaining the health of the population whilst improving service effectiveness. Although it is becoming widely accepted that no single discipline can provide complete care for patients with a long-term condition, in practice, interprofessional working is not always achieved. This review aimed to explore the factors that inhibit or facilitate interprofessional teamworking in primary and community care settings, in order to inform development of multidisciplinary working at the turn of the century. A comprehensive search of the literature was undertaken using a variety of approaches to identify appropriate literature for inclusion in the study. The selected articles used both qualitative and quantitative research methods. Following a thematic analysis of the literature, two main themes emerged that had an impact on interprofessional teamworking: team structure and team processes. Within these two themes, six categories were identified: team premises; team size and composition; organisational support; team meetings; clear goals and objectives; and audit. The complex nature of interprofessional teamworking in primary care meant that despite teamwork being an efficient and productive way of achieving goals and results, several barriers exist that hinder its potential from becoming fully exploited; implications and recommendations for practice are discussed. These findings can inform development of current best practice, although further research needs to be conducted into multidisciplinary teamworking at both the team and organisation level, to ensure that enhancement and maintenance of teamwork leads to an improved quality of healthcare provision.

Essays on the investment behavior of independent power producers in the United States electricity industry under regulatory restructuring

NASA Astrophysics Data System (ADS)

Yan, Jingming

2002-09-01

In recent years, there have been efforts at both the federal and state level to introduce greater competition and markets into the US electricity industry through regulatory restructuring. A key to the success of such efforts is the ability of the restructuring to attract investment from non-utility, independent power producers (IPPs). The two essays in this dissertation examine empirically the investment behavior of IPPs under the regulatory restructuring between 1996 and 2000. In both essays, the effects of restructuring on a firm's investment decision are decomposed into the effects that work through the investment cost and that through the expected profit from the investment. The first essay studies the entry behavior of IPPs under the restructuring. The main finding of the essay is that the restructuring has done little to lower the entry barrier faced by IPPs-high fixed cost to entry is still a main factor that hinders IPP investment. The second essay studies IPPs' decisions between investing through building new power plants ("make") and investing through acquiring divested plants ("buy"). It finds that the availability of the "buy" option does not "squeeze" out investment on new capacities. IPPs that chose to "buy" did so because they expected a lower return from "make" and hence would not have switched their investment to new capacities even if the "buy" option were not available. Therefore, divestiture is a viable policy tool for state regulators to attract more IPP investment.

Interprofessional practice in health care: an educational project with four learning sequences for students from six study programs.

PubMed

Nowak, Anna Christina; Klimke-Jung, Kathrin; Schäfer, Thorsten; Reif, Karl

2016-01-01

In response to demographic changes and the growing complexity of healthcare demands, national and international organizations are requiring greater cooperation among the health professions. Implementation of interprofessional learning programs within study programs in medicine, midwifery, nursing, and therapy is still rare. The first projects are currently underway in Germany. This paper presents the experience gathered by the organizers as interprofessional courses for six study programs were implemented. As part of the collaborative project "Interprofessional Practice in Health Care" between the Medical School at the Ruhr University in Bochum and the Department for Applied Health Sciences at the Hochschule für Gesundheit, interprofessional curricular units were developed, taught and evaluated with the aim of establishing permanent and joint curricular structures at the two German universities. Imparting communication skills, knowledge of and appreciation for the work performed by the other health professions, as well as having students reflect on their own professional roles and responsibilities, were the focus of four curricular units. Students worked together in small interprofessional groups. A total of 220 students enrolled in occupational therapy, midwifery, speech therapy, medicine, nursing, and physiotherapy participated in small-group seminars. When conducting and implementing the seminars, administrative and methodological challenges became apparent, and this should be taken into consideration in regard to any future development of interprofessional courses. Integration into existing curricula, along with finding time in the various schedules and appropriate classroom space for small groups, were among the challenges faced. For over 86% of the students it was important that students from all six of the degree programs involved participated in the project. A detailed analysis of the content and evaluation will follow. The value of the project's aim to include as many study programs in the health professions and medicine as possible was confirmed by the participating students. However, accomplishing this requires a substantial amount of organizational effort in terms of scheduling, finding classroom space and integration into existing curricula. Careful attention must be given specifically to the coordination of monoprofessional and interprofessional teaching units.

Collaborating in the context of co-location: a grounded theory study.

PubMed

Wener, Pamela; Woodgate, Roberta L

2016-03-10

Most individuals with mental health concerns seek care from their primary care provider, who may lack comfort, knowledge, and time to provide care. Interprofessional collaboration between providers improves access to primary mental health services and increases primary care providers' comfort offering these services. Building and sustaining interprofessional relationships is foundational to collaborative practice in primary care settings. However, little is known about the relationship building process within these collaborative relationships. The purpose of this grounded theory study was to gain a theoretical understanding of the interprofessional collaborative relationship-building process to guide health care providers and leaders as they integrate mental health services into primary care settings. Forty primary and mental health care providers completed a demographic questionnaire and participated in either an individual or group interview. Interviews were audio-recorded and transcribed verbatim. Transcripts were reviewed several times and then individually coded. Codes were reviewed and similar codes were collapsed to form categories using using constant comparison. All codes and categories were discussed amongst the researchers and the final categories and core category was agreed upon using constant comparison and consensus. A four-stage developmental interprofessional collaborative relationship-building model explained the emergent core category of Collaboration in the Context of Co-location. The four stages included 1) Looking for Help, 2) Initiating Co-location, 3) Fitting-in, and 4) Growing Reciprocity. A patient-focus and communication strategies were essential processes throughout the interprofessional collaborative relationship-building process. Building interprofessional collaborative relationships amongst health care providers are essential to delivering mental health services in primary care settings. This developmental model describes the process of how these relationships are co-created and supported by the health care region. Furthermore, the model emphasizes that all providers must develop and sustain a patient-focus and communication strategies that are flexible. Applying this model, health care providers can guide the creation and sustainability of primary care interprofessional collaborative relationships. Moreover, this model may guide health care leaders and policy makers as they initiate interprofessional collaborative practice in other health care settings.

Shifts in nursing and medical student's attitudes, beliefs and behaviours about interprofessional work: An interprofessional placement in ambulatory care.

PubMed

Seaman, Karla; Saunders, Rosemary; Dugmore, Helen; Tobin, Claire; Singer, Rachel; Lake, Fiona

2018-05-12

To examine students' beliefs, behaviours and attitudes in relation to interprofessional socialisation, and their expectations and experience, before and after a two-week clinical placement in ambulatory care. Interprofessional clinical placements for students are important for developing an understanding of interprofessional collaboration and identity, for the benefit of patient care. Ambulatory care environment involves collaborative management of complex chronic problems. This educator supported placement enabled final year nursing and medical students to work together. A descriptive matched pre-post study was conducted. Students' completed an online questionnaire pre and post their clinical placement. The questionnaire comprised of three sections; demographic information, the Interprofessional Socialisation and Valuing Scale and open-ended questions. Descriptive analysis and paired t-tests were conducted for the three subscales and thematic analysis of qualitative responses was conducted. Sixty-two of the 151 students between 2011-2014 completed both surveys. There was a significant increase post placement in the overall Interprofessional Socialisation and Valuing Scale scores. The change was greater for nursing students compared with medical students, although for both groups the change was small. The majority had a good to very good experience learning each other's and their own professions, and identified the Nurse Educator and Teaching Registrar as key to success. A clinical placement in an ambulatory setting for nursing and medical students resulted in an increase in self-perceived ability to work with others and in valuing working with others. Interprofessional clinical placements are essential for students to understand interprofessional practice for better patient outcomes and developing their own perspective of future work within an interprofessional team. Ambulatory care is an ideal environment for nursing and other health professional students to engage in interprofessional clinical placements. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Interprofessional Learning – Development and Implementation of Joint Medical Emergency Team Trainings for Medical and Nursing Students at Universitätsmedizin Greifswald

PubMed Central

Partecke, Maud; Balzer, Claudius; Finkenzeller, Ingmar; Reppenhagen, Christiane; Hess, Ulrike; Hahnenkamp, Klaus; Meissner, Konrad

2016-01-01

Introduction: Interprofessional collaboration is of great importance in clinical practice, particularly in the field of emergency medicine. The professions involved in providing emergency care must work hand in hand, and tasks and routines must be coordinated effectively. However, medical and nursing students have only few opportunities to experience interprofessional cooperation during their formal training. Addressing this situation, the Department of Anesthesiology and the Vocational School of Greifswald University Medical School initiated a project to increase patient safety by integrating interprofessional human factor training into the curriculum of both health professions. This manuscript addresses how an interprofessional course module focusing on clinical emergency medicine can be taught with an emphasis on competency and problem-solving. In addition, it was important to identify suitable instruments for systematic quality development and assurance of this teaching and learning format. Project description: The aim of the project, which took place from October 2013 to September 2015, was the development, implementation and evaluation of a simulation-based, interprofessional course module on clinical emergency medicine. Target groups were medical and nursing students. Modern pedagogical models and methods were applied to the design and teaching of the course content. The project was carried out in separate phases: definition, planning, practical implementation, evaluation and documentation. The project was accompanied by systematic quality development. Established guidelines for quality-centered school development were applied to quality development, assurance and evaluation. Results: Over two years, a 16 credit-hour course module was developed and then taught and evaluated during the 2014 and 2015 summer semesters. A total of 120 medical students and 120 nursing students participated in the course module. Eighteen teachers from medicine and nursing were trained as instructors and assisted by 12 student tutors. Regular evaluations focused on different aspects of the project, using instruments for empirical educational research. Excellent ratings given to the course by the attendees indicate a high degree of satisfaction in both participating professions regarding course design and content, as well as the quality of teaching. Discussion: In a position paper, the GMA committee on Interprofessional Education in Health Professions issued recommendations for interprofessional education. The recommendations given for teaching and quality assurance are drawn upon here, and relevant examples from the course concept presented. Conclusion: The design of the course corresponds to the recommendations of the GMA committee on Interprofessional Education in the Health Professions. Based on these, and considering the satisfactory evaluations, both continuation and further development of this interprofessional teaching format are justified. PMID:27280143

Interprofessional Learning - Development and Implementation of Joint Medical Emergency Team Trainings for Medical and Nursing Students at Universitätsmedizin Greifswald.

PubMed

Partecke, Maud; Balzer, Claudius; Finkenzeller, Ingmar; Reppenhagen, Christiane; Hess, Ulrike; Hahnenkamp, Klaus; Meissner, Konrad

2016-01-01

Interprofessional collaboration is of great importance in clinical practice, particularly in the field of emergency medicine. The professions involved in providing emergency care must work hand in hand, and tasks and routines must be coordinated effectively. However, medical and nursing students have only few opportunities to experience interprofessional cooperation during their formal training. Addressing this situation, the Department of Anesthesiology and the Vocational School of Greifswald University Medical School initiated a project to increase patient safety by integrating interprofessional human factor training into the curriculum of both health professions. This manuscript addresses how an interprofessional course module focusing on clinical emergency medicine can be taught with an emphasis on competency and problem-solving. In addition, it was important to identify suitable instruments for systematic quality development and assurance of this teaching and learning format. The aim of the project, which took place from October 2013 to September 2015, was the development, implementation and evaluation of a simulation-based, interprofessional course module on clinical emergency medicine. Target groups were medical and nursing students. Modern pedagogical models and methods were applied to the design and teaching of the course content. The project was carried out in separate phases: definition, planning, practical implementation, evaluation and documentation. The project was accompanied by systematic quality development. Established guidelines for quality-centered school development were applied to quality development, assurance and evaluation. Over two years, a 16 credit-hour course module was developed and then taught and evaluated during the 2014 and 2015 summer semesters. A total of 120 medical students and 120 nursing students participated in the course module. Eighteen teachers from medicine and nursing were trained as instructors and assisted by 12 student tutors. Regular evaluations focused on different aspects of the project, using instruments for empirical educational research. Excellent ratings given to the course by the attendees indicate a high degree of satisfaction in both participating professions regarding course design and content, as well as the quality of teaching. In a position paper, the GMA committee on Interprofessional Education in Health Professions issued recommendations for interprofessional education. The recommendations given for teaching and quality assurance are drawn upon here, and relevant examples from the course concept presented. The design of the course corresponds to the recommendations of the GMA committee on Interprofessional Education in the Health Professions. Based on these, and considering the satisfactory evaluations, both continuation and further development of this interprofessional teaching format are justified.

Racial Differences in Communication Apprehension and Interprofessional Socialization in Fourth-Year Doctor of Pharmacy Students

PubMed Central

Karpinski, Aryn C.

2016-01-01

Objective. To examine racial differences in communication apprehension and interprofessional socialization in fourth-year PharmD students and to investigate the relationship between the two constructs. Methods. Two measures with reliability and validity psychometric evidence were administered to fourth-year pharmacy students at a single historically black university with a large racial minority population. The Personal Report of Communication Apprehension (PRCA-24) measures level of fear or anxiety associated with communication. The Interprofessional Socialization and Valuing Scale (ISVS) measures beliefs, attitudes, and behaviors towards interprofessional collaborative practice. Results. One hundred fourteen students completed the survey. This produced a 77.4% response rate and 45.6% of the participants were African American. There were significant differences between races (ie, White, African-American, and Asian) on both measures. The PCRA-24 and ISVS were significantly correlated in each racial group. Conclusion. As pharmacy education moves to more interprofessional collaborations, the racial differences need to be considered and further explored. Pharmacy curricula can be structured to promote students’ comfort when communicating interprofessionally across racial groups. Understanding of culture and early education in cultural competence may need to be emphasized to navigate racial or cultural differences. PMID:26941434

Learning collaborative teamwork: an argument for incorporating the humanities.

PubMed

Hall, Pippa; Brajtman, Susan; Weaver, Lynda; Grassau, Pamela Anne; Varpio, Lara

2014-11-01

A holistic, collaborative interprofessional team approach, which includes patients and families as significant decision-making members, has been proposed to address the increasing burden being placed on the health-care system. This project hypothesized that learning activities related to the humanities during clinical placements could enhance interprofessional teamwork. Through an interprofessional team of faculty, clinical staff, students, and patient representatives, we developed and piloted the self-learning module, "interprofessional education for collaborative person-centred practice through the humanities". The module was designed to provide learners from different professions and educational levels with a clinical placement/residency experience that would enable them, through a lens of the humanities, to better understand interprofessional collaborative person-centred care without structured interprofessional placement activities. Learners reported the self-paced and self-directed module to be a satisfactory learning experience in all four areas of care at our institution, and certain attitudes and knowledge were significantly and positively affected. The module's evaluation resulted in a revised edition providing improved structure and instruction for students with no experience in self-directed learning. The module was recently adapted into an interactive bilingual (French and English) online e-learning module to facilitate its integration into the pre-licensure curriculum at colleges and universities.

Pre-registration interprofessional clinical education in the workplace: a realist review.

PubMed

Kent, Fiona; Hayes, Jacinta; Glass, Sharon; Rees, Charlotte E

2017-09-01

The inclusion of interprofessional education opportunities in clinical placements for pre-registration learners has recently been proposed as a strategy to enhance graduates' skills in collaborative practice. A realist review was undertaken to ascertain the contexts, mechanisms and outcomes of formal interprofessional clinical workplace learning. Initial scoping was carried out, after which Ovid MEDLINE, CINAHL and EMBASE were searched from 2005 to April 2016 to identify formal interprofessional workplace educational interventions involving pre-registration learners. Papers reporting studies conducted in dedicated training wards were excluded, leaving a total of 30 papers to be included in the review. Several educational formats that combined students from medicine, nursing, pharmacy and allied health professions were identified. These included: the use of engagement by student teams with a real patient through interview as the basis for discussion and reflection; the use of case studies through which student teams work to promote discussion; structured workshops; ward rounds, and shadowing. Meaningful interprofessional student discussion and reflection comprised the mechanism by which the outcome of learners acquiring knowledge of the roles of other professions and teamwork skills was achieved. The mechanism of dialogue during an interaction with a real patient allowed the patient to provide his or her perspective and contributed to an awareness of the patient's perspective in health care practice. Medication- or safety-focused interprofessional tasks contributed to improved safety awareness. In the absence of trained facilitators or in the context of negative role-modelling, programmes were less successful. In the design of workplace education initiatives, curriculum decisions should take into consideration the contexts of the initiatives and the mechanisms for achieving the education-related outcomes of interest. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

Measuring Knowledge, Acceptance, and Perceptions of Telehealth in an Interprofessional Curriculum for Student Nurse Practitioners, Occupational Therapists, and Physical Therapists

ERIC Educational Resources Information Center

Randall, Ken; Steinheider, Brigitte; Isaacson, Mary; Shortridge, Ann; Bird, Stephanie; Crio, Carrie; Ross, Heather; Loving, Gary

2016-01-01

Introduction: The use of telehealth in service delivery is both challenging and beneficial. This paper describes the results of a three semester-long interprofessional education program in team-based care using telehealth technology. The study assessed telehealth knowledge acquisition, practice in a structured environment with a simulated patient,…

Promoting interprofessional learning with medical students in home care settings.

PubMed

Solomon, Patricia; Risdon, Cathy

2011-01-01

The home care setting is ideal for medical students to learn about the importance of interprofessional collaboration in the community. This project examined the impact of a unique program designed to facilitate medical students' knowledge and awareness of the challenges of interprofessional care in the home. In pairs, medical students participated in two community visits with preceptors from different professions. Students completed a structured personal reflection after their first visit. Students and preceptors participated in focus groups or interviews to identify strengths and challenges of the experiences. The structured reflections and the focus group and interview transcripts were analyzed qualitatively. 164 medical students and 36 preceptors participated in 326 visits. There were high ratings of satisfaction from students and preceptors. Students developed unexpected insights into peoples' lives, developed a greater understanding of the patient's perspective and determinants of health, learned about others' scope of practice, and developed an appreciation of the limitations of their own scope of practice. Preceptors had high expectations for student performance and engagement and enjoyed the opportunity to impart their knowledge to future physicians. Although organizationally complex, the program evaluation suggestions that students and preceptors benefit from interprofessional experiences in the home.

Reflections and unprompted observations by healthcare students of an interprofessional shadowing visit.

PubMed

Wright, Anna; Hawkes, Gillian; Baker, Becky; Lindqvist, Susanne Marie

2012-07-01

This paper reports work from a Centre for Interprofessional Practice in a higher education institution in the UK that offers four levels of interprofessional learning (IPL) to all healthcare students. The second level (IPL2) integrates professional practice into the learning process, requiring students to shadow a qualified healthcare professional (from a different profession) for half a day. Students complete a reflective statement upon their learning experience on their return. A study was undertaken to analyse students' reflective statements in depth to see their observations and reflections on the shadowing visit. Using frame analysis, 160 reflective statements were analyzed, identifying common words and phrases used by students, which were then grouped together under six themes. Three of these related directly to the assignment: communication styles and techniques; communication between healthcare professionals and comparison of students' own and other healthcare professionals' roles. Three themes emerged from student's own interpretation of observations and reflections made during the shadowing of a different professional: attitudes toward other professions; power structures between professionals and patients and between professionals and impact of communication on patient care. Interprofessional shadowing gives students an opportunity to observe communication between healthcare professionals and patients and to reflect on broader issues surrounding collaborative working.

Evaluation of medical and veterinary students' attitudes toward a one health interprofessional curricular exercise.

PubMed

Winer, Jenna Nicole; Nakagawa, Keisuke; Conrad, Patricia A; Brown, Lauren; Wilkes, Michael

2015-01-01

This study evaluates whether medical and veterinary students' attitudes toward "One Health" and interprofessional education changed after participating in a joint small group learning exercise focused on risk factors associated with zoonotic disease. A survey was distributed to third-year medical students (n = 98) and second-year veterinary students (n = 140), each with a 95% response rate. Overall, 92% of veterinary students and 73% of medical students agreed or strongly agreed that "One Health" was relevant to their desired specialty. Students from both schools largely agreed that interprofessional education should be a goal of the curriculum for their school, and that interprofessional approaches strengthen their overall education. Students reported increased confidence in their communication skills and improved ability to contribute to One Health collaborative teams. This educational intervention, built around a patient case, focused on a variety of learning objectives including skills (such as communication), knowledge (of zoonotic toxoplasmosis) and attitudes (toward collaborative learning and practice). By sparking an interest in One Health during their early professional education, we sought to encourage a new generation of physicians and veterinarians to adopt a more collaborative spirit to their clinical practice, which will ultimately benefit human, animal and environmental health.

Self-efficacy and self-esteem in third-year pharmacy students.

PubMed

Yorra, Mark L

2014-09-15

To identify the experiential and demographic factors affecting the self-efficacy and self-esteem of third-year pharmacy (P3) students. A 25-item survey that included the Rosenberg Self-Esteem Scale and the General Self-Efficacy Scale, as well as types and length of pharmacy practice experiences and demographic information was administered to doctor of pharmacy (PharmD) students from 5 schools of pharmacy in New England at the completion of their P3 year. The survey response rate was approximately 50% of the total target population (399/820). Students with a grade point average (GPA)≥3.0 demonstrated a higher significant effect from unpaid introductory pharmacy practice experiences (IPPEs) on their self-efficacy scores (p<0.05) compared to students with lower GPAs. Students who had completed more than the required amount of pharmacy experiences had higher levels of self-efficacy and self-esteem (p<0.05). Ethnicity also was related to students' levels of self-efficacy and self-esteem. Self-efficacy and self-esteem are two important factors in pharmacy practice. Colleges and schools of pharmacy should ensure that students complete enough practice experiences, beyond the minimum of 300 IPPE hours, as one way to improve their self-efficacy and self-esteem.

Self-Efficacy and Self-Esteem in Third-Year Pharmacy Students

PubMed Central

2014-01-01

Objective. To identify the experiential and demographic factors affecting the self-efficacy and self-esteem of third-year pharmacy (P3) students. Methods. A 25-item survey that included the Rosenberg Self-Esteem Scale and the General Self-Efficacy Scale, as well as types and length of pharmacy practice experiences and demographic information was administered to doctor of pharmacy (PharmD) students from 5 schools of pharmacy in New England at the completion of their P3 year. Results. The survey response rate was approximately 50% of the total target population (399/820). Students with a grade point average (GPA)≥3.0 demonstrated a higher significant effect from unpaid introductory pharmacy practice experiences (IPPEs) on their self-efficacy scores (p<0.05) compared to students with lower GPAs. Students who had completed more than the required amount of pharmacy experiences had higher levels of self-efficacy and self-esteem (p<0.05). Ethnicity also was related to students’ levels of self-efficacy and self-esteem. Conclusion. Self-efficacy and self-esteem are two important factors in pharmacy practice. Colleges and schools of pharmacy should ensure that students complete enough practice experiences, beyond the minimum of 300 IPPE hours, as one way to improve their self-efficacy and self-esteem. PMID:25258439

The struggle for inter-professional teamwork and collaboration in maternity care: Austrian health professionals' perspectives on the implementation of the Baby-Friendly Hospital Initiative.

PubMed

Wieczorek, Christina C; Marent, Benjamin; Dorner, Thomas E; Dür, Wolfgang

2016-03-14

The health benefits of breastfeeding for mothers and babies are well documented in the scientific literature. Research suggests that support of breastfeeding during pre- and postnatal maternity care is an important determinant of breastfeeding initiation and duration. To support and promote breastfeeding on maternity units, the Baby-Friendly Hospital Initiative (BFHI) was launched in 1991. In Austria, however, less than one fifth of hospitals with a maternity unit are currently BFHI-certified. Implementation of BFHI and adjunct changes in work practices seem to represent a major challenge to maternity units. This article builds upon previous research that has identified a number of facilitators of and barriers to BFHI implementation in Austria. A major barrier has been the lack of intra- and inter-professional collaboration. Therefore, this article investigates the ways in which different healthcare professionals struggle to work together to successfully integrate the BFHI into practice. In this study, a qualitative research approach was used. Thirty-six semi-structured interviews with 11 midwives, 11 nurses, 13 physicians, and one quality manager, working across three maternity units, were interviewed on-site. Data analysis followed thematic analysis. Midwives, nurses, and physicians had diverse approaches to childbirth and breastfeeding (medicalization vs. naturalness) and worked along different jurisdictions that became manifest in strict spatial divisions of maternity units. In their engagement within the BFHI, midwives, nurses, and physicians pursued different strategies (safeguarding vs. circumvention strategies). These differences hindered inter-professional teamwork and collaboration and, therefore, the integration of BFHI into practice. Differing approaches to childbirth and breastfeeding, deep seated professional jurisdictions, as well as spatial constraints, challenge inter-professional teamwork and collaboration on maternity units. Inter-professional teamwork and collaboration are widely espoused goals of contemporary healthcare improvement strategies. Yet, critical debate on how these goals can be integrated into practice is needed. To enable collaboration and facilitate the implementation of programs such as BFHI, the different perspectives of health professionals should be brought together and the potential for integrating different forms of knowledge and practices should be considered.

[Interprofessional education: training for healthcare professionals for teamwork focusing on users].

PubMed

Peduzzi, Marina; Norman, Ian James; Germani, Ana Claudia Camargo Gonçalves; da Silva, Jaqueline Alcântara Marcelino; de Souza, Geisa Colebrusco

2013-08-01

The theoretical constructs of interprofessional education (IPE) are analyzed based on two reviews of the literature, taking the context of training for healthcare professionals in Brazil into consideration. Three types of training are identified: uniprofessional, multiprofessional and interprofessional, with predominance of the first type. The first occurs among students of the same profession, in isolation; the second occurs among students of two or more professions, in parallel without interaction; and the third involves shared learning, with interaction between students and/or professionals from different fields. The distinction between interprofessionalism and interdisciplinarity is highlighted: these refer to integration, respectively, of professional practices and disciplines or fields of knowledge. Through the analysis presented, it is concluded that in the Brazilian context, IPE (the basis for collaborative teamwork) is still limited to some recent initiatives, which deserve to be investigated.

Modeling best practices in chronic disease management: the Arthritis Program at Southlake Regional Health Centre.

PubMed

Bain, Lorna; Mierdel, Sandra; Thorne, Carter

2012-01-01

Researchers, hospital administrators and governments are striving to define competencies in interprofessional care and education, as well as to identify effective models in chronic disease management. For more than 25 years The Arthritis Program (TAP) at Southlake Regional Health Centre in Newmarket, Ontario, has actively practiced within these two interrelated priorities, which are now at the top of the healthcare agenda in Ontario and Canada. The approximately 135 different rheumatic conditions are the primary cause of long-term disability in Canada, affecting those from youth to the senior years, with an economic burden estimated at $4.4 billion (CAD$) annually, and growing. For the benefit of healthcare managers and their clients with chronic conditions, this article discusses TAP's history and demonstrable success, predicated on an educational model of patient self-management and self-efficacy. Also outlined are TAP's contributions in supporting evidence-based best practices in interprofessional collaboration and chronic disease management; approaches that are arguably understudied and under-practiced. Next steps for TAP include a larger role in empirical research in chronic-disease management and integration of a formal training program to benefit health professionals launching or expanding their interprofessional programs using TAP as the dynamic clinical example.

An evaluation of a training placement in general practice for paramedic practitioner students: improving patient-centred care through greater interprofessional understanding and supporting the development of autonomous practitioners.

PubMed

Ruston, Annmarie; Tavabie, Abdol

2011-01-01

To report the extent to which the placement of paramedic practitioner students (PPSs) in accredited general practice (GP) training practices supported their development as autonomous, patient-centred practitioners and fostered interprofessional learning. A case study method was used. Sources of data included semi-structured telephone interviews (eight PPSs, eight GP trainers), an online end of placement survey and placement and assessment documentation. Interview data were transcribed and analysed using the constant comparative method. Accredited training practices in South East England. All respondents were positive that the placement provided a high-quality interprofessional learning environment which provided PPSs with learning opportunities based on assessed need, the support of experienced trainers and access to a wide range of patients and learning situations. The placement enabled PPSs to acquire the appropriate skills, knowledge and understanding to act as autonomous, patient-centred practitioners. The placement provides a sound model for expanding the skills of paramedic practitioners in order to meet the increasing demands for patient-centred, community based health care. It provided them with the skills to treat patients closer to home rather than automatically transporting them to hospital.

Interprofessional education in the clinical setting: A qualitative look at the preceptor's perspective in training advanced practice nursing students.

PubMed

Chen, Angel K; Rivera, Josette; Rotter, Nicole; Green, Emily; Kools, Susan

2016-11-01

With the shift towards interprofessional education to promote collaborative practice, clinical preceptors are increasingly working with trainees from various professions to provide patient care. It is unclear whether and how preceptors modify their existing precepting approach when working with trainees from other professions. There is little information on strategies for this type of precepting, and how preceptors may foster or impede interprofessional collaboration. The purpose of this qualitative description pilot study was to identify current methods preceptors use to teach trainees from other professions in the clinical setting, particularly advanced practice nursing and medical trainees, and to identify factors that support or impede this type of precepting. Data collected through observations and interviews were analyzed by the research team using thematic analysis procedures. Three major themes were identified: 1) a variety of teaching approaches and levels of engagement with trainees of different professions, 2) preceptor knowledge gaps related to curricula, goals, and scope of practice of trainees from other professions, and 3) administrative, structural and logistical elements that impact the success of precepting trainees from different professions in the clinical setting. This study has implications for faculty development and evaluation of current precepting practices in clinical settings. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

The use of interprofessional learning and simulation in undergraduate nursing programs to address interprofessional communication and collaboration: An integrative review of the literature.

PubMed

Granheim, Benedikte M; Shaw, Julie M; Mansah, Martha

2018-03-01

To identify how simulation and interprofessional learning are used together in undergraduate nursing programs and undertaken in schools of nursing to address interprofessional communication and collaboration. An integrative literature review. The databases CINAHL, ProQuest, PubMed, Scopus, PsycInfo and Science Direct were searched to identify articles from 2006 to 2016 that reported on the use of IPL and simulation together in undergraduate nursing education. Whittemore and Knafl's five step process was used to guide the integrative review of quantitative and qualitative literature. Only peer reviewed articles written in English that addressed undergraduate nursing studies, were included in the review. Articles that did not aim to improve communication and collaboration were excluded. All articles selected were examined to determine their contribution to interprofessional learning and simulation in undergraduate nursing knowledge. The faculties of nursing used interprofessional learning and simulation in undergraduate nursing programs that in some cases were connected to a specific course. A total of nine articles, eight research papers and one narrative report, that focused on collaboration and communication were selected for this review. Studies predominantly used nursing and medical student participants. None of the included studies identified prior student experience with interprofessional learning and simulation. Four key themes were identified: communication, collaboration/teamwork, learning in practice and understanding of roles, and communication. This review highlights the identified research relating to the combined teaching strategy of interprofessional learning and simulation that addressed communication and collaboration in undergraduate nursing programs. Further research into the implementation of interprofessional learning and simulation may benefit the emergent challenges. Information drawn from this review can be used in informing education and educational development in the future. Copyright © 2017 Elsevier Ltd. All rights reserved.

Interprofessional care in intensive care settings and the factors that impact it: results from a scoping review of ethnographic studies.

PubMed

Paradis, Elise; Leslie, Myles; Gropper, Michael A; Aboumatar, Hanan J; Kitto, Simon; Reeves, Scott

2013-12-01

At the heart of safe cultures are effective interactions within and between interprofessional teams. Critical care clinicians see severely ill patients who require coordinated interprofessional care. In this scoping review, we asked: "What do we know about processes, relationships, organizational and contextual factors that shape the ability of clinicians to deliver interprofessional care in adult ICUs?" Using the 5-stage process established by Levac et al. (2010), we reviewed 981 abstracts to identify ethnographic articles that shed light on interprofessional care in the intensive care unit. The quality of selected articles is assessed using best practices in ethnographic research; their main insights evaluated in light of an interprofessional framework developed by Reeves et al (Interprofessional Teamwork for Health and Social Care. San Francisco, CA: Wiley-Blackwell; 2010). Overall, studies were of mixed quality, with an average (SD) score of 5.8 out of 10 (1.77). Insights into intensive care unit cultures include the importance of paying attention to workflow, the nefarious impact of hierarchical relationships, the mixed responses to protocols imposed from the top down, and a general undertheorization of sex and race. This review highlights several lessons for safe cultures and argues that more needs to be known about the context of critical care if quality and safety interventions are to succeed. Copyright © 2013 Elsevier Inc. All rights reserved.

Synergistic Effects of Ethanol and Isopentenyl Pyrophosphate on Expansion of γδ T Cells in Synovial Fluid from Patients with Arthritis

PubMed Central

Laurent, Agneta J.; Bindslev, Niels; Johansson, Björn; Berg, Louise

2014-01-01

Low to moderate ethanol consumption has been associated with protective effects in autoimmune diseases such as rheumatoid arthritis, RA. An expansion of γδ T cells induced by isopentenyl pyrophosphate, IPP, likewise seems to have a protective role in arthritis. The aim of this project was to test the hypothesis that low doses of ethanol can enhance IPP-induced expansion of synovial fluid γδ T cells from patients with arthritis and may thereby potentially account for the beneficial effects of ethanol on symptoms of the arthritic process. Thus, mononuclear cells from synovial fluid (SF) from 15 patients with arthritis and from peripheral blood (PB) from 15 healthy donors were stimulated with low concentrations of ethanol and IPP for 7 days in vitro. IPP in combination with ethanol 0.015%, 2.5 mM, equivalent to the decrease per hour in blood ethanol concentration due to metabolism, gave a significantly higher fractional expansion of SF γδ T cells compared with IPP alone after 7 days (ratio 10.1+/−4.0, p<0.0008, n = 12) in patients with arthritis. Similar results were obtained for PB γδ T cells from healthy controls (ratio 2.0+/−0.4, p<0.011, n = 15). The augmented expansion of γδ T cells in SF is explained by a higher proliferation (p = 0.0034, n = 11) and an increased survival (p<0.005, n = 11) in SF cultures stimulated with IPP plus ethanol compared to IPP alone. The synergistic effects of IPP and ethanol indicate a possible allosteric effect of ethanol. Similar effects could be seen when stimulating PB with ethanol in presence of risedronate, which has the ability to increase endogenous levels of IPP. We conclude that expansion of γδ T cells by combinatorial drug effects, possibly in fixed-dose combination, FDC, of ethanol in the presence of IPP might give a protective role in diseases such as arthritis. PMID:25090614

The impact of an interprofessional problem-based learning curriculum of clinical ethics on medical and nursing students' attitudes and ability of interprofessional collaboration: a pilot study.

PubMed

Lin, Yu-Chih; Chan, Te-Fu; Lai, Chung-Sheng; Chin, Chi-Chun; Chou, Fan-Hao; Lin, Hui-Ju

2013-09-01

Clinical ethic situations in modern multiprofessional healthcare systems may involve different healthcare professions who work together for patient care. The undergraduate interprofessional education of clinical ethics would help to incubate healthcare students' ability of interprofessional collaboration in solving ethical problems. However, the impact from an interprofessional educational model on student's attitudes and confidence of interprofessional collaboration should be carefully evaluated during the process of curricular development. This study aimed to conduct a pilot interprofessional PBL curriculum of clinical ethics and evaluate the curricular impact on interprofessional students' attitude and confidence of collaborative teamwork. Thirty-six medical and nursing students volunteered to participate in this study and were divided into three groups (medical group, nursing group, and mixed group). Tutors were recruited from the Medical School and the College of Nursing. The pilot curriculum included one lecture of clinical ethics, one PBL case study with two tutorial sessions, and one session of group discussion and feedback. A narrative story with multiple story lines and a multiperspective problem analysis tool were used in the PBL tutorials. The students' self-evaluation of learning questionnaire was used to evaluate students' learning of clinical ethics and interprofessional collaborative skills and attitude. The internal consistency of the questionnaire was measured by Cronbach α, and the criterion-related validity of the questionnaire was evaluated through associations between the dimension scores with the student group by one-way analysis of variance test (ANOVA) test and Tukey-Kramer honestly significant difference (HSD) comparison. There was significant difference among different groups in students' ability and attitudes about "interprofessional communication and collaboration" (p = 0.0184). The scores in the mixed group (37.58 ± 3.26) were higher than the medical group (32.10 ± 4.98). In conclusion, our model for the interprofessional PBL curriculum of clinical ethics is practicable and will produce positive impacts on students' attitudes and confidence of interprofessional collaboration. Copyright © 2013. Published by Elsevier B.V.

Exploring individual adaptations to an anterior cruciate ligament injury prevention programme.

PubMed

Fox, Aaron S; Bonacci, Jason; McLean, Scott G; Saunders, Natalie

2018-01-01

Individual responses to anterior cruciate ligament injury prevention programmes (ACL IPPs) have received little attention. This study examined the effects of an ACL IPP on neuromuscular control and lower limb biomechanics during landing at the group and individual levels. Sixteen female athletes were randomly allocated to training (n=8) or control (n=8) groups. Electromyography, and three-dimensional kinematic and kinetic data were collected during landing at two testing sessions. Repeated measures ANOVA and effect sizes (Cohen's d) examined the effect of the IPP at the group and individual levels. A sub-group analysis comparing the effect of the IPP on 'high-' (i.e. large peak knee abduction moment at baseline) versus 'low-risk' individuals was also conducted. At the group level; the IPP increased activation of the medial hamstrings prior to landing (p<0.001; d=0.264) and the medial gastrocnemius at landing (p<0.001; d=0.426), and increased hip external rotation early after initial contact (p<0.001; d=0.476). Variable adaptations were seen across individuals within the training group for all variables (p<0.001). The IPP had a large effect in reducing frontal plane knee moments for 'high-risk' individuals (d>0.91), however these results did not reach statistical significance (p>0.05). The IPP induced adaptations during landing, however, individual data revealed dissimilar responses to the programme. Individuals displaying a pre-existing high-risk strategy may incur greater benefits from IPPs, yet only if the programme targets the relevant high-risk strategy. Copyright © 2017 Elsevier B.V. All rights reserved.

Asymmetrical intrapleural pressure distribution: a cause for scoliosis? A computational analysis.

PubMed

Schlager, Benedikt; Niemeyer, Frank; Galbusera, Fabio; Wilke, Hans-Joachim

2018-04-13

The mechanical link between the pleural physiology and the development of scoliosis is still unresolved. The intrapleural pressure (IPP) which is distributed across the inner chest wall has yet been widely neglected in etiology debates. With this study, we attempted to investigate the mechanical influence of the IPP distribution on the shape of the spinal curvature. A finite element model of pleura, chest and spine was created based on CT data of a patient with no visual deformities. Different IPP distributions at a static end of expiration condition were investigated, such as the influence of an asymmetry in the IPP distribution between the left and right hemithorax. The results were then compared to clinical data. The application of the IPP resulted in a compressive force of 22.3 N and a flexion moment of 2.8 N m at S1. An asymmetrical pressure between the left and right hemithorax resulted in lateral deviation of the spine towards the side of the reduced negative pressure. In particular, the pressure within the dorsal section of the rib cage had a strong influence on the vertebral rotation, while the pressure in medial and ventral region affected the lateral displacement. An asymmetrical IPP caused spinal deformation patterns which were comparable to deformation patterns seen in scoliotic spines. The calculated reaction forces suggest that the IPP contributes in counterbalancing the weight of the intrathoracic organs. The study confirms the potential relevance of the IPP for spinal biomechanics and pathologies, such as adolescent idiopathic scoliosis.

Ultrasound image features of intravesical prostatic protrusion indicated failure of medication therapy of finasteride and doxazosin in patients with benign prostatic hyperplasia (LUTS/BPH).

PubMed

Liu, Qiang; Zhu, Yunkai; Liu, Jianping; Qi, Jun; Kang, Jian

2017-03-01

Intravesical prostatic protrusion (IPP) is a type of benign prostatic hyperplasia (BPH) adenoma, and it plays a critical role in the pathogenesis of bladder outlet obstruction in patients with lower urinary tract syndromes (LUTS/BPH). The goal of this study was to investigate the effect of a combination therapy with finasteride and doxazosin on IPP in BPU/LUTS patients. A total of 322 BPH patients with enlarged prostatic volume as well as moderate to severe symptom scores were enrolled and divided into four groups according to the degree of IPP (IPP > 10 mm, 5-10 mm, <5 mm and no IPP) in this study. Aggravated International Prostatic Symptom Score (IPSS), acute urinary retention or relevant urinary complications were considered as failure of the therapy. The degrees of IPP were recorded before and after 6 months of treatment. Student's t test and χ 2 were performed between the baseline and endpoint of the therapy. The results showed that the total prostate volume (TPV) and transition zone volume (TZV) of the prostate decreased significantly after 6-month combination therapy (P < 0.05), while no significant changes in IPP were observed at that point (P > 0.05). Failure rates of the medication differed significantly among the four groups. The study indicated that the combination therapy using finasteride and doxazosin could not reduce the degree of IPP. LUTS/BPH patients with IPP which contributes to the failure of medication tend to have a higher risk of progression.

Implementing a collaborative coaching intervention for professionals providing care to children and their families: An exploratory study.

PubMed

Tatla, Sandy K; Howard, Dori; Antunes Silvestre, Alda; Burnes, Stacey; Husson, Meghan; Jarus, Tal

2017-09-01

The growing complexity of healthcare requires family and interprofessional partnerships to deliver effective care. Interprofessional coaching can enhance family-centred practice and collaboration. The purpose of this study was to explore the acceptability and feasibility of collaborative coaching training to improve family centredness within acute paediatric rehabilitation. Using a participatory action design, service providers (SPs; n = 36) underwent a 6-month coaching programme involving coaching workshops, learning triads, and tailored sessions with a licensed coach. The feasibility and acceptability of coaching on SPs' family interactions and care was explored. Measure of Processes of Care (MPOC) and MPOC-SP, a coaching skills questionnaire, and focus groups were used to evaluate the acceptability of coaching training. We found that structured coaching training was feasible and SPs reported significant improvements in their coaching skills; however, MPOC and MPOC-SP scores did not reveal significant differences. Qualitative themes indicated that clinicians are developing coaching competencies and applying these skills in clinical practice. Participants perceived that the coaching approach strengthened relationships amongst colleagues, and they valued the opportunity for interprofessional learning. Findings suggest that coaching offers promise as an approach to facilitate successful patient outcomes and improve processes of care. Preliminary findings indicate that interprofessional coaching training is acceptable, feasible, and can significantly improve SP coaching skills and improve team cohesion. Further research to study the effects of coaching on interprofessional care using validated outcome measures and to assess the impact on service delivery is recommended.

Five challenges to ethical communication for interprofessional paediatric practice: A social work perspective.

PubMed

Delany, Clare; Richards, Angela; Stewart, Helen; Kosta, Lauren

2017-07-01

In paediatric clinical care, what is said to a parent or carer as well as when, where, and how it is said, directly advances or diminishes parents' capacities to understand available options and to contribute to decisions about treatment for their child. This makes interprofessional and patient communication an ethical endeavour. Social workers are uniquely situated to observe, participate in, and provide an active link in the communication between families and other health team members. This article reports phenomenological research exploring ethical issues encountered by social workers in their everyday practice communicating with families and other health professionals in a paediatric hospital context in Australia. Data were collected via semi-structured interviews with nine social workers and analysed thematically. Participants described two main communication-based roles: to support families through information provision and to contribute collaboratively to the interprofessional team involved in caring for a child and family. We grouped participants' descriptions of conflict between these roles into five main "communication challenges": (1) holding troublesome knowledge; (2) the need for diplomacy; (3) conciliation; (4) every man and his dog in family meetings; and (5) systems and processes presenting a brick wall. The five communication challenges provide empirically derived examples of how communication occurring within interprofessional health teams and between individual clinicians and parents can act to diminish or enhance parents' experience of care for their hospitalised child. Identifying these challenges may help to inform how communication within interprofessional teams and between clinicians and patients can benefit children and their parents.

76 FR 5580 - Black Hills Colorado IPP, LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-01

... proceeding Black Hills Colorado IPP, LLC's application for market-based rate authority, with an accompanying... DEPARTMENT OF ENERGY Federal Energy Regulatory Commission [Docket No. ER11-2724-000] Black Hills Colorado IPP, LLC; Supplemental Notice That Initial Market-Based Rate Filing Includes Request for Blanket...

Polarimetric imaging of biological tissues based on the indices of polarimetric purity.

PubMed

Van Eeckhout, Albert; Lizana, Angel; Garcia-Caurel, Enric; Gil, José J; Sansa, Adrià; Rodríguez, Carla; Estévez, Irene; González, Emilio; Escalera, Juan C; Moreno, Ignacio; Campos, Juan

2018-04-01

We highlight the interest of using the indices of polarimetric purity (IPPs) to the inspection of biological tissues. The IPPs were recently proposed in the literature and they result in a further synthetization of the depolarizing properties of samples. Compared with standard polarimetric images of biological samples, IPP-based images lead to larger image contrast of some biological structures and to a further physical interpretation of the depolarizing mechanisms inherent to the samples. In addition, unlike other methods, their calculation do not require advanced algebraic operations (as is the case of polar decompositions), and they result in 3 indicators of easy implementation. We also propose a pseudo-colored encoding of the IPP information that leads to an improved visualization of samples. This last technique opens the possibility of tailored adjustment of tissues contrast by using customized pseudo-colored images. The potential of the IPP approach is experimentally highlighted along the manuscript by studying 3 different ex-vivo samples. A significant image contrast enhancement is obtained by using the IPP-based methods, compared to standard polarimetric images. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The ATP-binding cassette transporter A1 regulates phosphoantigen release and Vγ9Vδ2 T cell activation by dendritic cells

PubMed Central

Castella, Barbara; Kopecka, Joanna; Sciancalepore, Patrizia; Mandili, Giorgia; Foglietta, Myriam; Mitro, Nico; Caruso, Donatella; Novelli, Francesco; Riganti, Chiara; Massaia, Massimo

2017-01-01

Vγ9Vδ2 T cells are activated by phosphoantigens, such as isopentenyl pyrophosphate (IPP), which is generated in the mevalonate pathway of antigen-presenting cells. IPP is released in the extracellular microenvironment via unknown mechanisms. Here we show that the ATP-binding cassette transporter A1 (ABCA1) mediates extracellular IPP release from dendritic cells (DC) in cooperation with apolipoprotein A-I (apoA-I) and butyrophilin-3A1. IPP concentrations in the supernatants are sufficient to induce Vγ9Vδ2 T cell proliferation after DC mevalonate pathway inhibition with zoledronic acid (ZA). ZA treatment increases ABCA1 and apoA-I expression via IPP-dependent LXRα nuclear translocation and PI3K/Akt/mTOR pathway inhibition. These results close the mechanistic gap in our understanding of extracellular IPP release from DC and provide a framework to fine-tune Vγ9Vδ2 T cell activation via mevalonate and PI3K/Akt/mTOR pathway modulation. PMID:28580927

The Effects of Injury Prevention Programs on the Biomechanics of Landing Tasks: A Systematic Review With Meta-analysis.

PubMed

Lopes, Thiago Jambo Alves; Simic, Milena; Myer, Gregory D; Ford, Kevin R; Hewett, Timothy E; Pappas, Evangelos

2018-05-01

Anterior cruciate ligament (ACL) tear is a common injury in sports and often occurs during landing from a jump. To synthesize the evidence on the effects of injury prevention programs (IPPs) on landing biomechanics as they relate to the ligament, quadriceps, trunk, and leg dominance theories associated with ACL injury risk. Meta-analysis. Six electronic databases were searched for studies that investigated the effect of IPPs on landing task biomechanics. Prospective studies that reported landing biomechanics at baseline and post-IPP were included. Results from trunk, hip, and knee kinematics and kinetics related to the ACL injury theories were extracted, and meta-analyses were performed when possible. The criteria were met by 28 studies with a total of 466 participants. Most studies evaluated young females, bilateral landing tasks, and recreational athletes, while most variables were related to the ligament and quadriceps dominance theories. An important predictor of ACL injury, peak knee abduction moment, decreased ( P = .01) after the IPPs while other variables related to the ligament dominance theory did not change. Regarding the quadriceps dominance theory, after the IPPs, angles of hip flexion at initial contact ( P = .009), peak hip flexion ( P = .002), and peak knee flexion ( P = .007) increased, while knee flexion at initial contact did not change ( P = .18). Moreover, peak knee flexion moment decreased ( P = .005) and peak vertical ground-reaction force did not change ( P = .10). The exercises used in IPPs might have the potential to improve landing task biomechanics related to the quadriceps dominance theory, especially increasing peak knee and hip flexion angles. Importantly, peak knee abduction moment decreased, which indicates that IPPs influence a desired movement strategy to help athletes overcome dangerous ligament dominance loads arising from lack of frontal plane control during dynamic tasks. The lack of findings for some biomechanical variables suggests that future IPPs may be enhanced by targeting participants' baseline profile deficits, highlighting the need to deliver an individualized and task-specific IPP.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Z Xu; C Chen; Y Wang

Combined effects of graphene nanosheets (GNSs) and shear flow on the crystallization behavior of isotactic polypropylene (iPP) were investigated by in-situ synchrotron wide-angle X-ray diffraction (WAXD) and small-angle X-ray scattering (SAXS) techniques. For crystallization under quiescent condition (at 145 C), the half-crystallization time (t{sub 1/2}) of nanocomposites containing 0.05 and 0.1 wt % GNSs was reduced to at least 50% compared to that of neat iPP, indicating the high nucleation ability of GNSs. The crystallization rate of iPP was directly proportional to the GNS content. Under a relatively weak shear flow (at a rate of 20 s{sup -1} for 5more » s duration) and a low degree of supercooling, the neat iPP exhibited an isotropic structure due to the relaxation of row nuclei. However, visible antisotropic crystals appeared in sheared iPP/GNSs nanocomposites, indicating that GNSs induced a network structure hindering the mobility of iPP chains and allowing the survival of oriented row nuclei for a long period of time. The presence of GNSs clearly enhanced the effects of shear-induced nucleation as well as orientation of iPP crystals. Two kinds of nucleating origins coexisted in the sheared nanocomposite melt: heterogeneous nucleating sites initiated by GNSs and homogeneous nucleating sites (row nuclei) induced by shear. The difference of t{sub 1/2} of nanocomposites with and without shear was significantly larger than that of neat iPP. The presence of GNSs and shear flow exhibited a synergistic interaction on promoting crystallization kinetics of iPP, although the effect of GNS concentration was not apparent. From WAXD results of isothermal and nonisothermal crystallization of sheared iPP, it was found that the appearance of {beta}-crystals depended on the preservation of row nuclei, where the {alpha}-crystals were predominant in the iPP/GNSs nanocomposites, indicating that GNSs could directly induce {alpha}-crystals of iPP.« less

Prospective evaluation of postoperative penile rehabilitation: penile length/girth maintenance 1 year following Coloplast Titan inflatable penile prosthesis.

PubMed

Henry, Gerard D; Carrion, Rafael; Jennermann, Caroline; Wang, Run

2015-05-01

The most prevalent long-term complaint after successful inflatable penile prosthesis (IPP) surgery is reduction of penile length. The purpose of this study was to evaluate penile measurements in patients whose implantation experience included the aggressive new length measurement technique (NLMT) coupled with postoperative IPP rehabilitation (daily inflation) of the implant for 1 year. Moreover, we aimed to document objective data concerning dimensional changes of the phallus over time. Postoperative IPP rehabilitation has been discussed and presented at meetings, but no multi-institutional prospective data have been published. Our goal was to assess results using the Coloplast Titan IPP, with NLMT, and postoperative rehabilitation. After IRB approval, we conducted a prospective, three-center study of 40 patients who underwent IPP placement, with NLMT for end organ failure erectile dysfunction with the Coloplast Titan IPP. The patient was instructed to inflate daily for 6 months and then inflate maximally for 1-2 hours daily for 6-12 months. Fifteen penile measurements were taken before and immediately after surgery and at follow-up visits. Penile length measurements after implantation compared with 12 months postimplantation. Penile measurement changes were statistically significantly improved at 12 months as compared with immediately postoperative and at 6 months. A total of 64.5% of subjects were satisfied with their length at 1 year, and 74.2% had perceived penile length that was longer (29%) or the same (45.2%) as prior to the surgery; 61.3% and 16.1% of subjects had increased and unchanged satisfaction, respectively, with penile length as compared with prior to IPP surgery. All but two subjects (93.4%) were satisfied with the overall function and dimensions of their IPP. This study suggests using the Coloplast Titan IPP with aggressive cylinder sizing, and a postoperative penile rehabilitation inflation protocol may help optimize patient satisfaction and erectile penile measurements. © 2015 International Society for Sexual Medicine.

"May I Please Tell You a Little Anecdote?" Inter-Professional Decision-Making about Inclusion in the Borderland between General and Special Schooling

ERIC Educational Resources Information Center

Røn Larsen, Maja

2016-01-01

This article addresses inter-professional work and decision-making around inclusion in school, using an approach inspired by social practice theory. Based on a case analysis, the article presents analytical examples of the ways in which knowledge from children's everyday life tends to be considered anecdotal and disregarded in the decision-making…

Interprofessional education and working in mental health: in search of the evidence base.

PubMed

Priest, Helena M; Roberts, Paula; Dent, Helen; Blincoe, Christine; Lawton, Diana; Armstrong, Christine

2008-05-01

To explore interprofessional attitudes arising from shared learning in mental health. Inter-professional education in healthcare is a priority area for improving team-working and communication. Many studies have attempted to evaluate its benefits and challenges, although few emanate from the mental health arena. However, producing evidence to link educational input with clinical outcomes is notoriously difficult. This project attempted to produce evidence for changes in interprofessional attitudes and stereotypes. Mental health nursing students and clinical psychology trainees participated in inter-professional education. An evaluation tool was designed to evaluate the experience and outcomes, and to consider implications for interprofessional working. There was an increase in clarity regarding roles, approaches and resources, and how to collaborate in practice. There was no significant change in professional identity. Many challenges were identified, including differences in academic level, previous experience, expectations, assessment, motivation and effort. Despite the challenges, it remains important to offer collaboration with future mental health colleagues as a foundation for effective team-working. Recommendations are made for creating inter-professional education opportunities for diverse student groups. Mental health professionals need to work effectively in multidisciplinary teams. Drawing on available guidance, managers should encourage and support team members to undertake shared learning where possible, both within clinical settings and through more formal educational provision. In this way, managers can facilitate collaborative relationships which will pay dividends for the provision of effective mental health care. This project adds to the limited knowledge currently available on interprofessional learning and attitudes within a mental health context.

Implementation of an interprofessional communication and collaboration intervention to improve care capacity for heart failure management in long-term care.

PubMed

Boscart, Veronique M; Heckman, George A; Huson, Kelsey; Brohman, Lisa; Harkness, Karen I; Hirdes, John; McKelvie, Robert S; Stolee, Paul

2017-09-01

Heart failure affects up to 20% of nursing home residents and is associated with high morbidity, mortality, and transfers to acute care. A major barrier to heart failure management in nursing home settings is limited interprofessional communication. Guideline-based heart failure management programs in nursing homes can reduce hospitalisation rates, though sustainability is limited when interprofessional communication is not addressed. A pilot intervention, 'Enhancing Knowledge and Interprofessional Care for Heart Failure', was implemented on two units in two conveniently selected nursing homes to optimise interprofessional care processes amongst the care team. A core heart team was established, and participants received tailored education focused on heart failure management principles and communication processes, as well as weekly mentoring. Our previous work provided evidence for this intervention's acceptability and implementation fidelity. This paper focuses on the preliminary impact of the intervention on staff heart failure knowledge, communication, and interprofessional collaboration. To determine the initial impact of the intervention on selected staff outcomes, we employed a qualitative design, using a social constructivist interpretive framework. Findings indicated a perceived increase in team engagement, interprofessional collaboration, communication, knowledge about heart failure, and improved clinical outcomes. Individual interviews with staff revealed innovative ways to enhance communication, supporting one another with knowledge and engagement in collaborative practices with residents and families. Engaging teams, through the establishment of core heart teams, was successful to develop interprofessional communication processes for heart failure management. Further steps to be undertaken include assessing the sustainability and effectiveness of this approach with a larger sample.

Capturing readiness to learn and collaboration as explored with an interprofessional simulation scenario: A mixed-methods research study.

PubMed

Rossler, Kelly L; Kimble, Laura P

2016-01-01

Didactic lecture does not lend itself to teaching interprofessional collaboration. High-fidelity human patient simulation with a focus on clinical situations/scenarios is highly conducive to interprofessional education. Consequently, a need for research supporting the incorporation of interprofessional education with high-fidelity patient simulation based technology exists. The purpose of this study was to explore readiness for interprofessional learning and collaboration among pre-licensure health professions students participating in an interprofessional education human patient simulation experience. Using a mixed methods convergent parallel design, a sample of 53 pre-licensure health professions students enrolled in nursing, respiratory therapy, health administration, and physical therapy programs within a college of health professions participated in high-fidelity human patient simulation experiences. Perceptions of interprofessional learning and collaboration were measured with the revised Readiness for Interprofessional Learning Scale (RIPLS) and the Health Professional Collaboration Scale (HPCS). Focus groups were conducted during the simulation post-briefing to obtain qualitative data. Statistical analysis included non-parametric, inferential statistics. Qualitative data were analyzed using a phenomenological approach. Pre- and post-RIPLS demonstrated pre-licensure health professions students reported significantly more positive attitudes about readiness for interprofessional learning post-simulation in the areas of team work and collaboration, negative professional identity, and positive professional identity. Post-simulation HPCS revealed pre-licensure nursing and health administration groups reported greater health collaboration during simulation than physical therapy students. Qualitative analysis yielded three themes: "exposure to experiential learning," "acquisition of interactional relationships," and "presence of chronology in role preparation." Quantitative and qualitative data converged around the finding that physical therapy students had less positive perceptions of the experience because they viewed physical therapy practice as occurring one-on-one rather than in groups. Findings support that pre-licensure students are ready to engage in interprofessional education through exposure to an experiential format such as high-fidelity human patient simulation. Copyright © 2015 Elsevier Ltd. All rights reserved.

Interprofessional approach for teaching functional knee joint anatomy.

PubMed

Meyer, Jakob J; Obmann, Markus M; Gießler, Marianne; Schuldis, Dominik; Brückner, Ann-Kathrin; Strohm, Peter C; Sandeck, Florian; Spittau, Björn

2017-03-01

Profound knowledge in functional and clinical anatomy is a prerequisite for efficient diagnosis in medical practice. However, anatomy teaching does not always consider functional and clinical aspects. Here we introduce a new interprofessional approach to effectively teach the anatomy of the knee joint. The presented teaching approach involves anatomists, orthopaedists and physical therapists to teach anatomy of the knee joint in small groups under functional and clinical aspects. The knee joint courses were implemented during early stages of the medical curriculum and medical students were grouped with students of physical therapy to sensitize students to the importance of interprofessional work. Evaluation results clearly demonstrate that medical students and physical therapy students appreciated this teaching approach. First evaluations of following curricular anatomy exams suggest a benefit of course participants in knee-related multiple choice questions. Together, the interprofessional approach presented here proves to be a suitable approach to teach functional and clinical anatomy of the knee joint and further trains interprofessional work between prospective physicians and physical therapists as a basis for successful healthcare management. Copyright © 2016 The Authors. Published by Elsevier GmbH.. All rights reserved.

The impact of an online interprofessional course in disaster management competency and attitude towards interprofessional learning.

PubMed

Atack, Lynda; Parker, Kathryn; Rocchi, Marie; Maher, Janet; Dryden, Trish

2009-11-01

A recent national assessment of emergency planning in Canada suggests that health care professionals are not properly prepared for disasters. In response to this gap, an interprofessional course in disaster management was developed, implemented and evaluated in Toronto, Canada from 2007 to 2008. Undergraduate students from five educational institutions in nursing, medicine, paramedicine, police, media and health administration programs took an eight-week online course. The course was highly interactive and included video, a discussion forum, an online board game and opportunity to participate in a high fidelity disaster simulation with professional staff. Curriculum developers set interprofessional competency as a major course outcome and this concept guided every aspect of content and activity development. A study was conducted to examine change in students' perceptions of disaster management competency and interprofessional attitudes after the course was completed. Results indicate that the course helped students master basic disaster management content and raised their awareness of, and appreciation for, other members of the interdisciplinary team. The undergraduate curriculum must support the development of collaborative competencies and ensure learners are prepared to work in collaborative practice.

Impact of a collaborative interprofessional learning experience upon medical and social work students in geriatric health care.

PubMed

Gould, Paul Robert; Lee, Youjung; Berkowitz, Shawn; Bronstein, Laura

2015-01-01

Interprofessional collaborative practice is increasingly recognized as an essential model in health care. This study lends preliminary support to the notion that medical students (including residents) and social work students develop a broader understanding of one another's roles and contributions to enhancing community-dwelling geriatric patients' health, and develop a more thorough understanding of the inherent complexities and unique aspects of geriatric health care. Wilcoxon Signed Rank Tests of participants' scores on the Index of Interdisciplinary Collaboration (IIC) indicated the training made significant changes to the students' perception of interprofessional collaboration. Qualitative analysis of participants' statements illustrated (1) benefits of the IPE experience, including complementary roles in holistic interventions; and (2) challenges to collaboration. The findings suggest that interprofessional educational experiences have a positive impact upon students' learning and strategies for enhanced care of geriatric patients.

Interprofessional communication in healthcare: An integrative review.

PubMed

Foronda, Cynthia; MacWilliams, Brent; McArthur, Erin

2016-07-01

The link between miscommunication and poor patient outcomes has been well documented. To understand the current state of knowledge regarding interprofessional communication, an integrative review was performed. The review suggested that nurses and physicians are trained differently and they exhibit differences in communication styles. The distinct frustrations that nurses and physicians expressed with each other were discussed. Egos, lack of confidence, lack of organization and structural hierarchies hindered relationships and communications. Research suggested that training programs with the use of standardized tools and simulation are effective in improving interprofessional communication skills. Recommendations include education beyond communication techniques to address the broader related constructs of patient safety, valuing diversity, team science, and cultural humility. Future directions in education are to add courses in patient safety to the curriculum, use handover tools that are interprofessional in nature, practice in simulation hospitals for training, and use virtual simulation to unite the professions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Fostering the development of effective person-centered healthcare communication skills: an interprofessional shared learning model.

PubMed

Cavanaugh, James T; Konrad, Shelley Cohen

2012-01-01

To describe the implementation of an interprofessional shared learning model designed to promote the development of person-centered healthcare communication skills. Master of social work (MSW) and doctor of physical therapy (DPT) degree students. The model used evidence-based principles of effective healthcare communication and shared learning methods; it was aligned with student learning outcomes contained in MSW and DPT curricula. Students engaged in 3 learning sessions over 2 days. Sessions involved interactive reflective learning, simulated role-modeling with peer assessment, and context-specific practice of communication skills. The perspective of patients/clients was included in each learning activity. Activities were evaluated through narrative feedback. Students valued opportunities to learn directly from each other and from healthcare consumers. Important insights and directions for future interprofessional learning experiences were gleaned from model implementation. The interprofessional shared learning model shows promise as an effective method for developing person-centered communication skills.

Interprofessional education: the inclusion of dental hygiene in health care within the United States - a call to action.

PubMed

Vanderbilt, Allison A; Isringhausen, Kim T; Bonwell, Patricia Brown

2013-01-01

There is a lack of access to oral health care in the United States for rural, underserved, uninsured, and low-income populations. There are widely recognized problems with the US health care system, including rapidly increasing costs and access to oral health. During the last decade, there has been a huge influx and push toward interprofessional education programs; however, these programs conveniently leave out dental hygiene. Interprofessional education can bring forth the collaboration, communication, and teamwork necessary to provide a comprehensive health care plan to treat oral health care needs in patients. As the advanced practice for dental hygiene emerges, it is imperative that the educational qualifications of dental hygienists are sufficient to enable them to safely provide the scope of services and care encompassed in these new expanded roles and to effectively participate as an interprofessional team member.

Attitudes of nursing staff toward interprofessional in-patient-centered rounding.

PubMed

Sharma, Umesh; Klocke, David

2014-09-01

Historically, medicine and nursing has had a hierarchical and patriarchal relationship, with physicians holding monopoly over knowledge-based practice of medical care, thus impeding interprofessional collaboration. Power gradient prevents nurses from demanding cooperative patient rounding. We surveyed attitudes of nursing staff at our tertiary care community hospital, before and after implementation of a patient-centered interprofessional (hospitalist-nurse) rounding process for patients. There was a substantial improvement in nursing staff satisfaction related to the improved communication (7%-54%, p < 0.001) and rounding (3%-49%, p < 0.001) by hospitalist providers. Patient-centered rounding also positively impacted nursing workflow (5%-56%, p < 0.001), nurses' perceptions of value as a team member (26%-56%, p = 0.018) and their job satisfaction (43%-59%, p = 0.010). Patient-centered rounding positively contributed to transforming the hospitalist-nurse hierarchical model to a team-based collaborative model, thus enhancing interprofessional relationships.

The Long Way Toward Cooperation

PubMed Central

Block, Karen; Stamer, Maren; Schmacke, Norbert

2015-01-01

To better understand why cooperation between health care professionals is still often problematic, we carried out 25 semistructured face-to-face expert interviews with physicians and nurses in different rural and urban areas in northern Germany. Using Mayring’s qualitative content analysis method to analyze the data collected, we found that doctors and nurses interpreted interprofessional conflicts differently. Nursing seems to be caught in a paradoxical situation: An increasing emphasis is placed on achieving interprofessional cooperation but the core areas of nursing practice are subject to increasing rationalization in the current climate of health care marketization. The subsequent and systematic devaluation of nursing work makes it difficult for physicians to acknowledge nurses’ expertise. We suggest that to ameliorate interprofessional cooperation, nursing must insist on its own logic of action thereby promoting its professionalization; interprofessional cooperation cannot take place until nursing work is valued by all members of the health care system. PMID:28462297

Past, present, and future trends of master's education in nursing.

PubMed

Gerard, Sally O; Kazer, Meredith W; Babington, Lynn; Quell, Theresa T

2014-01-01

Nurses interested in pursuing careers in advanced practice are now being educated at the doctoral level through new doctorate of nursing practice degree programs. In light of this shift, master's programs for advanced practice nurses are in a tenuous position, and it is questionable whether the remaining master's level educational programs are meeting the needs of consumers, health care institutions, and students. Given the great need for clinical leadership in health care, it is essential to reexamine master's nursing education to ensure that educational institutions are meeting the needs of graduate nursing students, consumers, and health care systems. Research supports that the master's-prepared nurse of the future must be proficient in the development and management of accountable care systems using state-of-the-art technology. In addition, interprofessional models show improvement in health care delivery and health outcomes. The current demands in health care that impact nursing education will be discussed, including the movement toward interprofessional education and the broadened expertise, required of master's-prepared nurses working in an era of health care reform. While academic medical centers are actively advancing toward an interprofessional model, the majority of nurses in this country are educated in private and community settings. This article will examine the move toward interprofessional education at a private university, utilizing clinical partnerships to revise the master's program. The goal of this revision is to empower students with the expertise required in today's health care environment to improve the delivery of care. Copyright © 2014 Elsevier Inc. All rights reserved.

Interdisciplinary Practice Models for Older Adults With Back Pain: A Qualitative Evaluation.

PubMed

Salsbury, Stacie A; Goertz, Christine M; Vining, Robert D; Hondras, Maria A; Andresen, Andrew A; Long, Cynthia R; Lyons, Kevin J; Killinger, Lisa Z; Wallace, Robert B

2018-03-19

Older adults seek health care for low back pain from multiple providers who may not coordinate their treatments. This study evaluated the perceived feasibility of a patient-centered practice model for back pain, including facilitators for interprofessional collaboration between family medicine physicians and doctors of chiropractic. This qualitative evaluation was a component of a randomized controlled trial of 3 interdisciplinary models for back pain management: usual medical care; concurrent medical and chiropractic care; and collaborative medical and chiropractic care with interprofessional education, clinical record exchange, and team-based case management. Data collection included clinician interviews, chart abstractions, and fieldnotes analyzed with qualitative content analysis. An organizational-level framework for dissemination of health care interventions identified norms/attitudes, organizational structures and processes, resources, networks-linkages, and change agents that supported model implementation. Clinicians interviewed included 13 family medicine residents and 6 chiropractors. Clinicians were receptive to interprofessional education, noting the experience introduced them to new colleagues and the treatment approaches of the cooperating profession. Clinicians exchanged high volumes of clinical records, but found the logistics cumbersome. Team-based case management enhanced information flow, social support, and interaction between individual patients and the collaborating providers. Older patients were viewed positively as change agents for interprofessional collaboration between these provider groups. Family medicine residents and doctors of chiropractic viewed collaborative care as a useful practice model for older adults with back pain. Health care organizations adopting medical and chiropractic collaboration can tailor this general model to their specific setting to support implementation.

Exploring healthcare professionals' perceptions of the anesthesia assistant role and its impact on patients and interprofessional collaboration.

PubMed

Lam, Phoebe; Lopez Filici, Ana; Middleton, Claire; McGillicuddy, Patricia

2018-01-01

To practice interprofessional collaboration (IPC), understanding the roles of each profession in the team is key. Anesthesia assistants (AAs) are a relatively new addition to the Canadian healthcare system. As a result, its role in the delivery of anesthesia care can be misunderstood by other healthcare professionals. Using an exploratory multiple case study design, this article explores healthcare professionals' perceptions of the AA role and its impact on patients and IPC. Sixteen semi-structured, in-depth interviews were conducted with a purposive sample of nine healthcare professions from inside and outside the peri-operative care unit in two urban, acute care, university-affiliated teaching research hospitals in Ontario. A thematic analysis of the interview transcripts identified five overarching themes: limited understanding of the AA role, improved patient-centred care, improve IPC and interprofessional education, ongoing challenges, and the future direction for professional growth. Results indicated that despite regular clinical practice collaboration, participants have a limited understanding of AAs in terms of their educational prerequisites, scope of practice, and roles. One reason for this lack of understanding is that there is a high variability of titles and clinical duties for non-physician anesthesia providers. The diverse range of anesthesia services provided by AAs can also become a barrier to the full understanding of their scope of practice and roles. The limited understanding of the AA role was reported as one of AAs' ongoing challenges. It prevents AAs from realising their full scope of practice. Participants suggested that AAs' professional growth should focus on promoting and expanding their role. Understanding other healthcare professionals' perceptions of AAs will assist them to become better ambassadors for their role, and to more effectively promote and practice IPC. Ultimately, this will result in improved interprofessional teamwork to deliver effective and efficient patient care.

A Three-Year Reflective Writing Program as Part of Introductory Pharmacy Practice Experiences

PubMed Central

Vaughn, Jessica; Kerr, Kevin; Zielenski, Christopher; Toppel, Brianna; Johnson, Lauren; McCauley, Patrina; Turner, Christopher J.

2013-01-01

Objectives. To implement and evaluate a 3-year reflective writing program incorporated into introductory pharmacy practice experiences (IPPEs) in the first- through third-year of a doctor of pharmacy (PharmD) program. Design. Reflective writing was integrated into 6 IPPE courses to develop students’ lifelong learning skills. In their writing, students were required to self-assess their performance in patient care activities, identify and describe how they would incorporate learning opportunities, and then evaluate their progress. Practitioners, faculty members, and fourth-year PharmD students served as writing preceptors. Assessment. The success of the writing program was assessed by reviewing class performance and surveying writing preceptor’s opinions regarding the student’s achievement of program objectives. Class pass rates averaged greater than 99% over the 8 years of the program and the large majority of the writing preceptors reported that student learning objectives were met. A support pool of 99 writing preceptors was created. Conclusions. A 3-year reflective writing program improved pharmacy students’ reflection and reflective writing skills. PMID:23788811

GP and pharmacist inter-professional learning - a grounded theory study.

PubMed

Cunningham, David E; Ferguson, Julie; Wakeling, Judy; Zlotos, Leon; Power, Ailsa

2016-05-01

Practice Based Small Group Learning (PBSGL) is an established learning resource for primary care clinicians in Scotland and is used by one-third of general practitioners (GPs). Scottish Government and UK professional bodies have called for GPs and pharmacists to work more closely together to improve care. To gain GPs' and pharmacists' perceptions and experiences of learning together in an inter-professional PBSGL pilot. Qualitative research methods involving established GP PBSGL groups in NHS Scotland recruiting one or two pharmacists to join them. A grounded theory method was used. GPs were interviewed in focus groups by a fellow GP, and pharmacists were interviewed individually by two researchers, neither being a GP or a pharmacist. Interviews were audio-recorded, transcribed and analysed using grounded theory methods. Data saturation was achieved and confirmed. Three themes were identified: GPs' and pharmacists' perceptions and experiences of inter-professional learning; Inter-professional relationships and team-working; Group identity and purpose of existing GP groups. Pharmacists were welcomed into GP groups and both professions valued inter-professional PBSGL learning. Participants learned from each other and both professions gained a wider perspective of the NHS and of each others' roles in the organisation. Inter-professional relationships, communication and team-working were strengthened and professionals regarded each other as peers and friends.

Interprofessional teamwork skills as predictors of clinical outcomes in a simulated healthcare setting.

PubMed

Shrader, Sarah; Kern, Donna; Zoller, James; Blue, Amy

2013-01-01

Teaching interprofessional (IP) teamwork skills is a goal of interprofessional education. The purpose of this study was to examine the relationship between IP teamwork skills, attitudes and clinical outcomes in a simulated clinical setting. One hundred-twenty health professions students (medicine, pharmacy, physician assistant) worked in interprofessional teams to manage a "patient" in a health care simulation setting. Students completed the Interdisciplinary Education Perception Scale (IEPS) attitudinal survey instrument. Students' responses were averaged by team to create an IEPS attitudes score. Teamwork skills for each team were rated by trained observers using a checklist to calculate a teamwork score (TWS). Clinical outcome scores (COS) were determined by summation of completed clinical tasks performed by the team based on an expert developed checklist. Regression analyses were conducted to determine the relationship of IEPS and TWS with COS. IEPS score was not a significant predictor of COS (p=0.054), but TWS was a significant predictor (p<0.001) of COS. Results suggest that in a simulated clinical setting, students' interprofessional teamwork skills are significant predictors of positive clinical outcomes. Interprofessional curricular models that produce effective teamwork skills can improve student performance in clinical environments and likely improve teamwork practice to positively affect patient care outcomes.

The Evolution of an Interprofessional Shared Decision-Making Research Program: Reflective Case Study of an Emerging Paradigm

PubMed Central

Menear, Matthew; Stacey, Dawn; Brière, Nathalie; Légaré, France

2016-01-01

Introduction: Healthcare research increasingly focuses on interprofessional collaboration and on shared decision making, but knowledge gaps remain about effective strategies for implementing interprofessional collaboration and shared decision-making together in clinical practice. We used Kuhn’s theory of scientific revolutions to reflect on how an integrated interprofessional shared decision-making approach was developed and implemented over time. Methods: In 2007, an interdisciplinary team initiated a new research program to promote the implementation of an interprofessional shared decision-making approach in clinical settings. For this reflective case study, two new team members analyzed the team’s four projects, six research publications, one unpublished and two published protocols and organized them into recognizable phases according to Kuhn’s theory. Results: The merging of two young disciplines led to challenges characteristic of emerging paradigms. Implementation of interprofessional shared-decision making was hindered by a lack of conceptual clarity, a dearth of theories and models, little methodological guidance, and insufficient evaluation instruments. The team developed a new model, identified new tools, and engaged knowledge users in a theory-based approach to implementation. However, several unresolved challenges remain. Discussion: This reflective case study sheds light on the evolution of interdisciplinary team science. It offers new approaches to implementing emerging knowledge in the clinical context. PMID:28435417

The historical social positioning of nursing and medicine: implications for career choice, early socialization and interprofessional collaboration.

PubMed

Price, Sheri; Doucet, Shelley; Hall, Linda McGillis

2014-03-01

For almost half a century, research has identified that effective teamwork is essential in order to enhance care provision and health outcomes for patients. Although the value of teamwork is well-recognized in healthcare, the historically rooted dynamics of workplace relationships create a myriad of challenges to creating collaborative teams. Understanding the history of interpersonal dynamics between health professionals can provide direction for future interprofessional education and collaboration strategies. The aim of this paper is to provide a historical overview of the social positioning of nursing and medicine in the context of interprofessional collaboration. Few professions work as closely as nursing and medicine. Despite the well-recognized benefits of interprofessional collaboration, these two professions are often socially positioned in opposition to one another and depicted as adversarial. This analysis will seek to advance our understanding of the historical roots between these two professions and their relationships with and among each other in relation to career choice, early socialization and patient care delivery. An exploration of the historical social positioning of nursing and medicine can provide an enhanced understanding of the barriers to interprofessional collaboration and inform future successes in interprofessional education and practice among all health and social care professions.

The Evolution of an Interprofessional Shared Decision-Making Research Program: Reflective Case Study of an Emerging Paradigm.

PubMed

Dogba, Maman Joyce; Menear, Matthew; Stacey, Dawn; Brière, Nathalie; Légaré, France

2016-07-19

Healthcare research increasingly focuses on interprofessional collaboration and on shared decision making, but knowledge gaps remain about effective strategies for implementing interprofessional collaboration and shared decision-making together in clinical practice. We used Kuhn's theory of scientific revolutions to reflect on how an integrated interprofessional shared decision-making approach was developed and implemented over time. In 2007, an interdisciplinary team initiated a new research program to promote the implementation of an interprofessional shared decision-making approach in clinical settings. For this reflective case study, two new team members analyzed the team's four projects, six research publications, one unpublished and two published protocols and organized them into recognizable phases according to Kuhn's theory. The merging of two young disciplines led to challenges characteristic of emerging paradigms. Implementation of interprofessional shared-decision making was hindered by a lack of conceptual clarity, a dearth of theories and models, little methodological guidance, and insufficient evaluation instruments. The team developed a new model, identified new tools, and engaged knowledge users in a theory-based approach to implementation. However, several unresolved challenges remain. This reflective case study sheds light on the evolution of interdisciplinary team science. It offers new approaches to implementing emerging knowledge in the clinical context.

Idiopathic precocious puberty in girls: Psychosexual development.

PubMed

Meyer-Bahlburg, H F; Ehrhardt, A A; Bell, J J; Cohen, S F; Healey, J M; Feldman, J F; Morishima, A; Baker, S W; New, M I

1985-08-01

A promising model syndrome for the examination of the role of physical maturation in the development of female sexuality is idiopathic precocious puberty (IPP). In this first controlled study of psychosexual development in IPP females, 16 females between 13 and 20 years of age with a history of IPP were compared to 16 control subjects with a history of normal puberty pair-matched to the index subjects on the basis of sex, race, age, socioeconomic level, and menarcheal status. The psychosexual history and the current psychosexual status were assessed by a systematic half-structured interview. The IPP females on average passed the psychosexual milestones at an earlier age than their normal maturing peers, with a particularly early onset of masturbation. Those who were sociosexually active tended to report a higher total orgasmic outlet and a higher sex drive. There was no increase in homosexuality among IPP girls. The timing of puberty has a (modest) influence on psychosexual development in females.

Development and Construct Validation of the Interprofessional Attitudes Scale

PubMed Central

Norris, Jeffrey; Carpenter, Joan G.; Eaton, Jacqueline; Guo, Jia-Wen; Lassche, Madeline; Pett, Marjorie A.; Blumenthal, Donald K.

2015-01-01

Purpose Training of health professionals requires development of interprofessional competencies and assessment of these competencies. No validated tools exist to assess all four competency domains described in the 2011 Core Competencies for Interprofessional Collaborative Practice (the IPEC Report). The purpose of this study was to develop and validate a scale based on the IPEC competency domains that assesses interprofessional attitudes of students in the health professions. Method In 2012, a survey tool was developed and administered to 1,549 students from the University of Utah Health Science Center, an academic health center composed of four schools and colleges (Health, Medicine, Nursing, and Pharmacy). Exploratory and confirmatory factor analyses (EFA and CFA) were performed to validate the assessment tool, eliminate redundant questions, and to identify subscales. Results The EFA and CFA focused on aligning subscales with IPEC core competencies, and demonstrating good construct validity and internal consistency reliability. A response rate of 45% (n = 701) was obtained. Responses with complete data (n=678) were randomly split into two datasets which were independently analyzed using EFA and CFA. The EFA produced a 27-item scale, with five subscales (Cronbach’s alpha coefficients: 0.62 to 0.92). CFA indicated the content of the five subscales was consistent with the EFA model. Conclusions The Interprofessional Attitudes Scale (IPAS) is a novel tool that, compared to previous tools, better reflects current trends in interprofessional competencies. The IPAS should be useful to health sciences educational institutions and others training people to work collaboratively in interprofessional teams. PMID:25993280

The Oral Health Care Manager in a Patient-Centered Health Facility.

PubMed

Theile, Cheryl Westphal; Strauss, Shiela M; Northridge, Mary Evelyn; Birenz, Shirley

2016-06-01

The dental hygienist team member has an opportunity to coordinate care within an interprofessional practice as an oral health care manager. Although dental hygienists are currently practicing within interprofessional teams in settings such as pediatric offices, hospitals, nursing homes, schools, and federally qualified health centers, they often still assume traditional responsibilities rather than practicing to the full extent of their training and licenses. This article explains the opportunity for the dental hygiene professional to embrace patient-centered care as an oral health care manager who can facilitate integration of oral and primary care in a variety of health care settings. Based on an innovative model of collaboration between a college of dentistry and a college of nursing, an idea emerged among several faculty members for a new management method for realizing continuity and coordination of comprehensive patient care. Involved faculty members began working on the development of an approach to interprofessional practice with the dental hygienist serving as an oral health care manager who would address both oral health care and a patient's related primary care issues through appropriate referrals and follow-up. This approach is explained in this article, along with the results of several pilot studies that begin to evaluate the feasibility of a dental hygienist as an oral health care manager. A health care provider with management skills and leadership qualities is required to coordinate the interprofessional provision of comprehensive health care. The dental hygienist has the opportunity to lead closer integration of oral and primary care as an oral health care manager, by coordinating the team of providers needed to implement comprehensive, patient-centered care. Copyright © 2016 Elsevier Inc. All rights reserved.

Prevention and health promotion from theory to practice: The interprofessional MeMPE Summer University for students of Medicine, Master of Public Health and Epidemiology.

PubMed

Idler, Nadja; Huber, Johanna; von Mutius, Sabine; Welbergen, Lena; Fischer, Martin R

2016-01-01

Objective: During the 2015 summer semester of Munich's Ludwig Maximilian University (LMU) medical school, the pilot project "MeMPE Summer University - An Interprofessional Seminar on Prevention and Health Promotion" was implemented as a compulsory elective subject. In 90 teaching units of 45 minutes each, 20 students from the degree programs of Medicine, Master of Public Health and Master of Science Epidemiology (MeMPE) completed modules in theoretical introduction, scientific project work as well as practical assignments and conference attendance. Methods: The project was evaluated by students using pre- and post-project questionnaires (26 and 57 items, evaluated on a Five-level Likert scale of 1="fully agree" to 5="fully disagree"). The evaluation interviews of the instruction participants were recorded, transcribed and analyzed according to Mayring's qualitative content analysis. Results: Questionnaire response rate was 100 %. In pre/post comparison, the students reported an improvement in factual knowledge (pre median=3.0; post median=2.0; p<0.0001), in scientific work (pre median=3.0; post median=1.0; p<0.0001) and in interprofessional work (pre median=2.0; post median=1.0; p=0.024). In 18 interviews, the instructors largely expressed their motivation to participate in the project again. Conclusion: The MeMPE Summer University can serve as an example of best practice for interprofessional communication of prevention and health-promotion topics in theory and practice. The evaluation results show that the project enjoyed a high level of acceptance among students and instructors, and that it should be conducted in a revised version again in 2016.

IMMR Phase 1 Prototyping Plan Inputs

NASA Technical Reports Server (NTRS)

Vowell, C. W.; Johnson-Throop, Kathy; Smith, Bryon; Darcy, Jeannette

2006-01-01

This viewgraph presentation reviews the phase I plan of the prototype of the IMMR by the Multilateral Medical Operations Panel (MMOP) Medical Informatics & Technology (MIT) Working Group. It reviews the Purpose of IMMR Prototype Phase 1 (IPP1); the IPP1 Plan Overview, the IMMR Prototype Phase 1 Plan for PDDs and MIC and MIC-DDs, Plan for MICs, a nd the IPP1 objectives

An Examination of Interprofessional Team Functioning in a BScN Blended Learning Program: Implications for Accessible Distance-Based Nursing Education Programs

ERIC Educational Resources Information Center

Carter, Lorraine Mary; Beattie, Bev; Caswell, Wenda; Fitzgerald, Scott; Nowrouzi, Behdin

2016-01-01

In this study, the perceptions and experiences of an interprofessional team responsible for the development and delivery of the Registered Practical Nurse (RPN) to Bachelor of Science in Nursing (BScN) Blended Learning Program at Nipissing University were examined. In this program, RPNs can acquire a BScN through distance-based part-time study,…

Using the HEADSSS guide to teach students diagnostic skills in adolescent health Views from students participating in interprofessional courses.

PubMed

Parisi, Vanessa; De Stadelhofen, Léo Meyer; Péchère, Benoit; Steimer, Sylvain; De Watteville, Aude; Haller, Dagmar M; Navarro, Carol; Szynalski-Morel, Murielle; Meynard, Anne

Over the past few years, an interprofessional team of lecturers in Geneva has developed courses entitled « adolescent health and development ». These courses are open to students in medicine, nursing and nutrition, as well as to other interested health professionals. Using vignettes, students who participated in the courses present their thoughts on the use of the HEADSSS interview guide in the diagnostic approach with adolescents. These optional courses provide an opportunity to explore infrequently taught domains of the curriculum in a creative way. They give students the chance to develop common practice skills providing the basis for improved inter-professional collaborations in the future.

Interprofessional management of concussion in sport.

PubMed

Pabian, Patrick S; Oliveira, Leonardo; Tucker, Jennifer; Beato, Morris; Gual, Carlos

2017-01-01

Due to the high incidence of sports concussion, various health and medical providers are likely to encounter athletes who have sustained such an injury. Management of concussion necessitates coordinated care by the members of the sports medicine team due to its pathophysiology and complexity of management during recovery. All members of the sports medicine team must possess contemporary knowledge of concussion management as well as strong interprofessional communication skills to ensure effective care and safe return to sports participation. Therefore, the aim of this manuscript is to review the current best practices in interdisciplinary management of sports concussion with a special emphasis on the required interprofessional communication among the sports medicine team. Copyright © 2016 Elsevier Ltd. All rights reserved.

Understanding interprofessional education as an intergroup encounter: The use of contact theory in programme planning.

PubMed

Carpenter, John; Dickinson, Claire

2016-01-01

A key underlying assumption of interprofessional education (IPE) is that if the professions are brought together they have the opportunity to learn about each other and dispel the negative stereotypes which are presumed to hamper interprofessional collaboration in practice. This article explores the application of contact theory in IPE with reference to eight evaluation studies (1995-2012) which adopted this theoretical perspective. It proposes that educators should pay explicit attention to an intergroup perspective in designing IPE programmes and specifically to the "contact variables" identified by social psychologists studying intergroup encounters. This would increase the chances of the planned contact having a positive effect on attitude change.

Setting a research agenda for interprofessional education and collaborative practice in the context of United States health system reform

PubMed Central

Lutfiyya, May Nawal; Brandt, Barbara; Delaney, Connie; Pechacek, Judith; Cerra, Frank

2016-01-01

ABSTRACT Interprofessional education (IPE) and collaborative practice (CP) have been prolific areas of inquiry exploring research questions mostly concerned with local program and project assessment. The actual sphere of influence of this research has been limited. Often discussed separately, this article places IPE and CP in the same conceptual space. The interface of these form a nexus where new knowledge creation may be facilitated. Rigorous research on IPE in relation to CP that is relevant to and framed by health system reform in the U.S. is the ultimate research goal of the National Center for Interprofessional Practice and Education at the University of Minnesota. This paper describes the direction and scope for a focused and purposive IPECP research agenda linked to improvement in health outcomes, contextualized by health care reform in the U.S. that has provided a revitalizing energy for this area of inquiry. A research agenda articulates a focus, meaningful and robust questions, and a theory of change within which intervention outcomes are examined. Further, a research agenda identifies the practices the area of inquiry is interested in informing, and the types of study designs and analytic approaches amenable to carrying out the proposed work. PMID:26230379

Setting a research agenda for interprofessional education and collaborative practice in the context of United States health system reform.

PubMed

Lutfiyya, May Nawal; Brandt, Barbara; Delaney, Connie; Pechacek, Judith; Cerra, Frank

2016-01-01

Interprofessional education (IPE) and collaborative practice (CP) have been prolific areas of inquiry exploring research questions mostly concerned with local program and project assessment. The actual sphere of influence of this research has been limited. Often discussed separately, this article places IPE and CP in the same conceptual space. The interface of these form a nexus where new knowledge creation may be facilitated. Rigorous research on IPE in relation to CP that is relevant to and framed by health system reform in the U.S. is the ultimate research goal of the National Center for Interprofessional Practice and Education at the University of Minnesota. This paper describes the direction and scope for a focused and purposive IPECP research agenda linked to improvement in health outcomes, contextualized by health care reform in the U.S. that has provided a revitalizing energy for this area of inquiry. A research agenda articulates a focus, meaningful and robust questions, and a theory of change within which intervention outcomes are examined. Further, a research agenda identifies the practices the area of inquiry is interested in informing, and the types of study designs and analytic approaches amenable to carrying out the proposed work.

From school to work: promoting the application of pre-qualification interprofessional education in the clinical workplace.

PubMed

Murray-Davis, Beth; Marshall, Michelle; Gordon, Frances

2012-09-01

The rationale for Interprofessional Education (IPE) is based on the assumption it will improve practice. Despite evidence that it may modify attitudes and provide knowledge and skills for collaboration, there is little evidence about whether these skills can be transferred to practice. The aim of this research was to explore how midwifery students apply pre-qualification IPE learning to practice and to understand the factors in the clinical workplace that facilitate or hinder this application. A purposive sample of students, educators, Heads of Midwifery and new midwives from four universities throughout the United Kingdom participated in semi-structured interviews and focus groups. Emerging themes were developed using the principles of Grounded Theory. Participants articulated ways in which the clinical environment either promoted or prevented IPE in practice. The extent to which the clinical institution promoted IPE was made visible through the support for students during placements; the support for new midwives; and the evolution of professional roles. Buy-in for the IPE agenda in the workplace influences the ability of new midwives to apply IPE competencies to professional practice. The benefits of a theoretical foundation in interprofessional skills may be lost if students and new midwives find themselves working in contexts that do not make collaboration a priority. Copyright © 2011 Elsevier Ltd. All rights reserved.

CE: Original Research: Exploring Clinicians' Perceptions About Sustaining an Evidence-Based Fall Prevention Program.

PubMed

Porter, Rebecca B; Cullen, Laura; Farrington, Michele; Matthews, Grace; Tucker, Sharon

2018-05-01

: Purpose: This study aimed to address the knowledge gap between implementing and sustaining evidence-based fall prevention practices for hospitalized patients by exploring perspectives of the interprofessional health care team. A qualitative design was used to capture insights from clinicians across disciplines in a large midwestern academic medical center. Four homogenous semistructured focus groups and three individual interviews involving a total of 20 clinicians were conducted between October 2013 and March 2014. Audio-recorded data were transcribed and analyzed using inductive qualitative analysis. Two primary themes emerged from participants regarding the sustainability of an evidence-based fall prevention program: communication patterns within the interprofessional health care team and influences of hospital organizational practices and elements. Several subthemes also emerged. Participants gave nursing staff primary responsibility for fall risk assessment and prevention. Individual professional perceptions and practices, as well as organizational characteristics, affect the sustainability of evidence-based fall prevention practices. While all team members recognized patient falls as a significant quality and safety issue, most believed that direct care nurses hold primary responsibility for leading fall prevention efforts. The data support the importance of effective interprofessional team communication and organizational practices in sustaining an evidence-based fall prevention program across inpatient units. Furthermore, the data call into question the wisdom in labeling quality indicators as "nursing sensitive"; the evidence indicates that a team approach is best.

Chronic Obstructive Pulmonary Disease and Heart Failure Self-Management Kits for Outpatient Transitions of Care.

PubMed

Boylan, Paul; Joseph, Tina; Hale, Genevieve; Moreau, Cynthia; Seamon, Matthew; Jones, Renee

2018-03-01

To develop heart failure (HF) and chronic obstructive pulmonary disease (COPD) self-management kits in an accountable care organization (ACO) to facilitate patients' self-care and prevent hospital readmissions. Pharmacists practice in an outpatient-based ACO. They participate in interprofessional office visits with providers and independently manage maintenance pharmacotherapies. Pharmacists collaborate with an interprofessional team within the ACO including physicians, nurses, case managers, and paramedics. Two commonly encountered diseases are chronic COPD and HF. Reducing preventable readmissions for these conditions are important quality benchmarks and cost-saving strategies. Pharmacists were responsible for developing HF and COPD self-management kits containing patient education materials and prescriptions to facilitate self-care. Prior to kit development, pharmacists performed a literature review to determine the presence of previously published findings on these topics. The interprofessional team continually evaluates the successes and limitations of this initiative. Pharmacists developed training and instructions for ACO allied health professionals in an effort to incorporate the self-management kits in clinical practice. The initial literature search revealed no studies describing the intervention of interest. Innovative programs designed to help reduce preventable readmissions are lacking in primary care. Implementation of the self-management kits was accepted by interprofessional ACO leadership and is currently being integrated into allied health workflow. Patients at risk for having an exacerbation of COPD or HF should receive self-management strategies. Prompt therapy prior to exacerbations reduces hospital admissions and readmissions, speeds recovery, and slows disease progression. Pharmacist-facilitated implementation of self-management kits may be developed by interprofessional health care teams.

Training and Assessing Interprofessional Virtual Teams Using a Web-Based Case System.

PubMed

Dow, Alan W; Boling, Peter A; Lockeman, Kelly S; Mazmanian, Paul E; Feldman, Moshe; DiazGranados, Deborah; Browning, Joel; Coe, Antoinette; Selby-Penczak, Rachel; Hobgood, Sarah; Abbey, Linda; Parsons, Pamela; Delafuente, Jeffrey; Taylor, Suzanne F

2016-01-01

Today, clinical care is often provided by interprofessional virtual teams-groups of practitioners who work asynchronously and use technology to communicate. Members of such teams must be competent in interprofessional practice and the use of information technology, two targets for health professions education reform. The authors created a Web-based case system to teach and assess these competencies in health professions students. They created a four-module, six-week geriatric learning experience using a Web-based case system. Health professions students were divided into interprofessional virtual teams. Team members received profession-specific information, entered a summary of this information into the case system's electronic health record, answered knowledge questions about the case individually, then collaborated asynchronously to answer the same questions as a team. Individual and team knowledge scores and case activity measures--number of logins, message board posts/replies, views of message board posts--were tracked. During academic year 2012-2013, 80 teams composed of 522 students from medicine, nursing, pharmacy, and social work participated. Knowledge scores varied by profession and within professions. Team scores were higher than individual scores (P < .001). Students and teams with higher knowledge scores had higher case activity measures. Team score was most highly correlated with number of message board posts/replies and was not correlated with number of views of message board posts. This Web-based case system provided a novel approach to teach and assess the competencies needed for virtual teams. This approach may be a valuable new tool for measuring competency in interprofessional practice.

The Future of Interprofessional Education and Practice for Dentists and Dental Education.

PubMed

Andrews, Elizabeth A

2017-08-01

In the ever-changing landscape of education, health professions programs must be adaptable and forward-thinking. Programs need to understand the services students should be educated to provide over the next 25 years. The movement to increase collaboration among health professionals to improve health care outcomes is a significant priority for all health professions. Complex medical issues frequently seen in patients can best be addressed with interprofessional health care teams. Training future health care providers to work in such teams facilitates collaborative care and can result in improved outcomes for patients. What skills will dental students need in 2040 to practice as part of these interprofessional teams? Important skills needed for success are collaboration, communication, professionalism, and the ability to manage medically complex patients. These abilities are in alignment with the four Interprofessional Education Collaborative (IPEC) core competency domains and will continue to be key skills necessary in the future. Transitioning to a one university approach for preclinical and clinical training along with development of an all-inclusive electronic health record will drive this model forward. Faculty training and continuing education for clinicians, residents, and allied health providers will be necessary for comprehensive adoption of a team-based collaborative care system. With the health care delivery system moving towards more patient-centered, team-based care, interprofessional education helps future clinicians develop into confident team members who will lead health care into the future and produce better patient outcomes. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

Comprehensive Literacy Instruction, Interprofessional Collaborative Practice, and Students With Severe Disabilities.

PubMed

Erickson, Karen A

2017-05-17

The purpose of this clinical focus article is to briefly describe comprehensive emergent and conventional literacy instruction for students with severe disabilities. Specific attention is given to interprofessional collaborative practice and the roles of team members in planning and delivering instruction. A rationale for the delivery of comprehensive instruction that balances skill and meaning emphases is provided with reference to new college and career readiness standards, the literature on literacy acquisition for students without disabilities, and, when possible, the literature on literacy acquisition for students with severe disabilities. Specific instructional approaches are presented to demonstrate how teams can actively engage students with severe disabilities in instruction that is collaborative, participatory, and interactive. Successful provision of comprehensive literacy instruction that allows students with severe disabilities to achieve conventional literacy takes time and the efforts of a collaborative interprofessional team. Speech-language pathologists play a critical role on these teams as they ensure that students with severe disabilities have the language and communication supports they need to be successful.

Evaluation of an interprofessional educational curriculum pilot course for practitioners working with post-stroke patients.

PubMed

Olaisen, Rho Henry; Mariscal-Hergert, Cheryl; Shaw, Alissa; Macchiavelli, Cecilia; Marsheck, Joanna

2014-03-01

This report describes the design and evaluation of an interprofessional pilot training course aimed at pre-licensure practitioners working with post-stroke patients in community-based settings. The course was developed by community-based practitioners from nine health professions. Course learning activities included traditional methods (lectures) and interactive modules (problem-based learning and exchange-based learning). The study's aim was to assess the program's effectiveness in adapting and incorporating knowledge, skills and self-confidence when delivering tertiary care in therapeutic pool environments; gauge adoption of course principles into practice, and assess overall course satisfaction. Methods of evaluation included conceptual mapping of course format, pre- and post-questionnaires, daily reflection questionnaires, course satisfaction survey and adoption survey, 10 weeks follow-up. Overall, the findings indicate students' knowledge, skills and self-confidence in delivering effective post-stroke care increased following the training. Students reported adopting clinical practices in 10 weeks follow-up. Implications for designing interprofessional curricula are discussed.

A Typology of Interprofessional Teamwork in Acute Geriatric Care: A Study in 55 units in Belgium.

PubMed

Piers, Ruth D; Versluys, Karen J J; Devoghel, Johan; Lambrecht, Sophie; Vyt, André; Van Den Noortgate, Nele J

2017-09-01

To explore the quality of interprofessional teamwork in acute geriatric care and to build a model of team types. Cross-sectional multicenter study. Acute geriatric units in Belgium. Team members of different professional backgrounds. Perceptions of interprofessional teamwork among team members of 55 acute geriatric units in Belgium were measured using a survey covering collaborative practice and experience, managerial coaching and open team culture, shared reflection and decision-making, patient files facilitating teamwork, members' belief in the power of teamwork, and members' comfort in reporting incidents. Cluster analysis was used to determine types of interprofessional teamwork. Professions and clusters were compared using analysis of variance. The overall response rate was 60%. Of the 890 respondents, 71% were nursing professionals, 20% other allied health professionals, 5% physicians, and 4% logistic and administrative staff. More than 70% of respondents scored highly on interprofessional teamwork competencies, consultation, experiences, meetings, management, and results. Fewer than 55% scored highly on items about shared reflection and decision-making, reporting incidents from a colleague, and patient files facilitating interprofessional teamwork. Nurses in this study rated shared reflection and decision-making lower than physicians on the same acute geriatric units (P < .001). Using the mean score on each of the six areas, four clusters that differed significantly in all areas were identified using hierarchical cluster analysis and scree plot analysis (P < .001). Interprofessional teamwork in acute geriatric units is satisfactory, but shared reflection and decision-making needs improvement. Four types of interprofessional teamwork are identified and can be used to benchmark the teamwork of individual teams. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Midwives' and health visitors' collaborative relationships: A systematic review of qualitative and quantitative studies.

PubMed

Aquino, Maria Raisa Jessica Ryc V; Olander, Ellinor K; Needle, Justin J; Bryar, Rosamund M

2016-10-01

Interprofessional collaboration between midwives and health visitors working in maternal and child health services is widely encouraged. This systematic review aimed to identify existing and potential areas for collaboration between midwives and health visitors; explore the methods through which collaboration is and can be achieved; assess the effectiveness of this relationship between these groups, and ascertain whether the identified examples of collaboration are in line with clinical guidelines and policy. A narrative synthesis of qualitative and quantitative studies. Fourteen electronic databases, research mailing lists, recommendations from key authors and reference lists and citations of included papers. Papers were included if they explored one or a combination of: the areas of practice in which midwives and health visitors worked collaboratively; the methods that midwives and health visitors employed when communicating and collaborating with each other; the effectiveness of collaboration between midwives and health visitors; and whether collaborative practice between midwives and health visitors meet clinical guidelines. Papers were assessed for study quality. Eighteen papers (sixteen studies) met the inclusion criteria. The studies found that midwives and health visitors reported valuing interprofessional collaboration, however this was rare in practice. Findings show that collaboration could be useful across the service continuum, from antenatal care, transition of care/handover, to postnatal care. Evidence for the effectiveness of collaboration between these two groups was equivocal and based on self-reported data. In relation, multiple enablers and barriers to collaboration were identified. Communication was reportedly key to interprofessional collaboration. Interprofessional collaboration was valuable according to both midwives and health visitors, however, this was made challenging by several barriers such as poor communication, limited resources, and poor understanding of each other's role. Structural barriers such as physical distance also featured as a challenge to interprofessional collaboration. Although the findings are limited by variable methodological quality, these were consistent across time, geographical locations, and health settings, indicating transferability and reliability. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Internal Medicine Residents' Perceptions of Team-Based Care and its Educational Value in the Continuity Clinic: A Qualitative Study.

PubMed

Soones, Tacara N; O'Brien, Bridget C; Julian, Katherine A

2015-09-01

In order to teach residents how to work in interprofessional teams, educators in graduate medical education are implementing team-based care models in resident continuity clinics. However, little is known about the impact of interprofessional teams on residents' education in the ambulatory setting. To identify factors affecting residents' experience of team-based care within continuity clinics and the impact of these teams on residents' education. This was a qualitative study of focus groups with internal medicine residents. Seventy-seven internal medicine residents at the University of California San Francisco at three continuity clinic sites participated in the study. Qualitative interviews were audiotaped and transcribed. The authors used a general inductive approach with sensitizing concepts in four frames (structural, human resources, political and symbolic) to develop codes and identify themes. Residents believed that team-based care improves continuity and quality of care. Factors in four frames affected their ability to achieve these goals. Structural factors included communication through the electronic medical record, consistent schedules and regular team meetings. Human resources factors included the presence of stable teams and clear roles. Political and symbolic factors negatively impacted team-based care, and included low staffing ratios and a culture of ultimate resident responsibility, respectively. Regardless of the presence of these factors or resident perceptions of their teams, residents did not see the practice of interprofessional team-based care as intrinsically educational. Residents' experiences practicing team-based care are influenced by many principles described in the interprofessional teamwork literature, including understanding team members' roles, good communication and sufficient staffing. However, these attributes are not correlated with residents' perceptions of the educational value of team-based care. Including residents in interprofessional teams in their clinic may not be sufficient to teach residents how team-based care can enhance their overall learning and future practice.

Using Standardized Patients to Teach Interprofessional Competencies to Dental Students.

PubMed

Anders, Patrick L; Scherer, Yvonne Krall; Hatton, Michael; Antonson, Donald; Austin-Ketch, Tammy; Campbell-Heider, Nancy

2016-01-01

The aims of this study were to develop, implement, and evaluate a novel interprofessional standardized patient exercise (ISPE) with oral-systemic and interprofessional collaborative practice (IPCP) components. Dental students and doctor of nursing practice (DNP) students at one U.S. university participated in the simulation, which was primarily designed to test their teamwork skills. In spring 2014, DNP students worked in the dental clinics with dental students under the supervision of nursing and dental faculty members. To test the teamwork outcomes for both groups of students, a standardized patient (SP) scenario was designed to include multiple chronic medical diagnoses and an oral-systemic component. The exercise was filmed for later review. Outcomes measures included SP and student self-evaluations and faculty evaluation of student documentation. The primary outcome of interest from a dental standpoint was faculty evaluation of IPCP competencies derived from the Core Competencies of Interprofessional Collaborative Practice and were deemed to be observable by faculty when viewing the videotaped scenario. Eight teams of students participated with an SP trained in the scenario. Each team consisted of a DNP student, a fourth-year dental student, and a second-year dental student. All eligible students in the DNP class (n=20) and eight students from each dental class (approximately 110 each) participated. The results showed that the teams scored highest on the role/responsibilities subscale, indicating students were respectful of each other's roles and expertise and effectively engaged each other to develop strategies to meet the patient's needs. Scores on the three other subscales (values/ethics, interprofessional communication, and teams/teamwork) were also high. These findings appeared to support IPCP as a method to foster knowledge and respect for other roles and responsibilities, improve appreciation of teamwork, and encourage better communication among health care providers. The ISPE scenario provided an effective way to evaluate IPCP competencies.

The steps to forming a joint venture IPP in Poland

DOE Office of Scientific and Technical Information (OSTI.GOV)

Allen, Z.; Colligan, M.J.

Poland represents the largest market in Central Europe with 38 million people and an installed electrical generating capacity of about 32 gigawatts. Since 1989, when the process of governmental restructuring along free market principals began, the allure to IPP developers has been evident, but is of yet unrealized. The natural model for IPP development in Poland would seem to be joint ventures with Polish generating companies. These enterprises already have sites, franchises, and a going business to contribute to a joint company. There are a number of reasons why so few deals have been concluded in Poland to date, andmore » a number of barriers still exist that tend to hamper the realization of project finance funded power joint ventures. But, these barriers are not insurmountable. Overcoming them in the context of a joint venture relationship with a domestic partner requires patience, work, and an ability to bridge the gaps between the realities of working in a post-Communist environment and the practicalities of structuring projects that can be financed in the international capital markets. The new Energy Law in Poland establishes a framework for a viable private sector power generation business. But the enabling regulations are yet to be published or approved. There is still effective political risk on account of the uncertainty this creates. Pressure is mounting on the Polish Government, especially due to its expressed interest in joining the EU, to get the power sector to operate on private sector terms, if not in private hands. The trends are pointing in the direction of increased market driven policies and practices. The conclusion is that, despite the delays of the past, independent power projects will start to happen in Poland on a joint venture basis, with increasing frequency in the next years.« less

Competencies for optimal practice in integrated environments: examining attributes of a consensus interprofessional practice document from the licensed integrative health disciplines.

PubMed

Goldblatt, Elizabeth; Wiles, Michael; Schwartz, Jan; Weeks, John

2013-01-01

The Academic Consortium for Complementary and Alternative Health Care (ACCAHC) is committed to advancing human health through the advancement and integration of the complementary and alternative medicine (CAM) professions within the American healthcare system. This will involve the maturation and integration of the licensed CAM professions into conventional healthcare delivery, and in turn, it will involve the development of competency in integrative healthcare and interprofessional education within the CAM professions. In 2010, ACCAHC resolved to identify the competencies necessary for this transformation, and in the process, discovered a parallel process of competency development within conventional healthcare, the Interprofessional Education Collaborative (IPEC), representing the six major conventional healthcare professions. The ACCAHC competency document, its development, and its similarity to the IPEC document are discussed. The ACCAHC competency document identified two domains of competence that were not present in the IPEC document: evidence-informed practice and institutional healthcare practices. These two domains of competency are discussed with respect to their significance in both CAM and conventional healthcare practices. ACCAHC's goal is to foster collaboration among its member professions and with conventional healthcare professions, and to use these competency documents to improve and optimize healthcare delivery, practices, and outcomes in America. It is hoped that ACCAHC's competency document will catalyze interaction with IPEC leading to the adoption of a single shared competency document that will meet the needs of all healthcare providers and educators. © 2013 Elsevier Inc. All rights reserved.

Innovations in oral health: A toolkit for interprofessional education.

PubMed

Dolce, Maria C; Parker, Jessica L; Werrlein, Debra T

2017-05-01

The integration of oral health competencies into non-dental health professions curricula can serve as an effective driver for interprofessional education (IPE). The purpose of this report is to describe a replicable oral-health-driven IPE model and corresponding online toolkit, both of which were developed as part of the Innovations in Oral Health (IOH): Technology, Instruction, Practice, and Service programme at Bouvé College of Health Sciences, Northeastern University, USA. Tooth decay is a largely preventable disease that is connected to overall health and wellness, and it affects the majority of adults and a fifth of children in the United States. To prepare all health professionals to address this problem, the IOH model couples programming from the online resource Smiles for Life: A National Oral Health Curriculum with experiential learning opportunities designed for undergraduate and graduate students that include simulation-learning (technology), hands-on workshops and didactic sessions (instruction), and opportunities for both cooperative education (practice) and community-based learning (service). The IOH Toolkit provides the means for others to replicate portions of the IOH model or to establish a large-scale IPE initiative that will support the creation of an interprofessional workforce-one equipped with oral health competencies and ready for collaborative practice.

Precision medicine in oncology: New practice models and roles for oncology pharmacists.

PubMed

Walko, Christine; Kiel, Patrick J; Kolesar, Jill

2016-12-01

Three different precision medicine practice models developed by oncology pharmacists are described, including strategies for implementation and recommendations for educating the next generation of oncology pharmacy practitioners. Oncology is unique in that somatic mutations can both drive the development of a tumor and serve as a therapeutic target for treating the cancer. Precision medicine practice models are a forum through which interprofessional teams, including pharmacists, discuss tumor somatic mutations to guide patient-specific treatment. The University of Wisconsin, Indiana University, and Moffit Cancer Center have implemented precision medicine practice models developed and led by oncology pharmacists. Different practice models, including a clinic, a clinical consultation service, and a molecular tumor board (MTB), were adopted to enhance integration into health systems and payment structures. Although the practice models vary, commonalities of three models include leadership by the clinical pharmacist, specific therapeutic recommendations, procurement of medications for off-label use, and a research component. These three practice models function as interprofessional training sites for pharmacy and medical students and residents, providing an important training resource at these institutions. Key implementation strategies include interprofessional involvement, institutional support, integration into clinical workflow, and selection of model by payer mix. MTBs are a pathway for clinical implementation of genomic medicine in oncology and are an emerging practice model for oncology pharmacists. Because pharmacists must be prepared to participate fully in contemporary practice, oncology pharmacy residents must be trained in genomic oncology, schools of pharmacy should expand precision medicine and genomics education, and opportunities for continuing education in precision medicine should be made available to practicing pharmacists. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Structuring Communication Relationships for Interprofessional Teamwork (SCRIPT): a cluster randomized controlled trial.

PubMed

Zwarenstein, Merrick; Reeves, Scott; Russell, Ann; Kenaszchuk, Chris; Conn, Lesley Gotlib; Miller, Karen-Lee; Lingard, Lorelei; Thorpe, Kevin E

2007-09-18

Despite a burgeoning interest in using interprofessional approaches to promote effective collaboration in health care, systematic reviews find scant evidence of benefit. This protocol describes the first cluster randomized controlled trial (RCT) to design and evaluate an intervention intended to improve interprofessional collaborative communication and patient-centred care. The objective is to evaluate the effects of a four-component, hospital-based staff communication protocol designed to promote collaborative communication between healthcare professionals and enhance patient-centred care. The study is a multi-centre mixed-methods cluster randomized controlled trial involving twenty clinical teaching teams (CTTs) in general internal medicine (GIM) divisions of five Toronto tertiary-care hospitals. CTTs will be randomly assigned either to receive an intervention designed to improve interprofessional collaborative communication, or to continue usual communication practices. Non-participant naturalistic observation, shadowing, and semi-structured, qualitative interviews were conducted to explore existing patterns of interprofessional collaboration in the CTTs, and to support intervention development. Interviews and shadowing will continue during intervention delivery in order to document interactions between the intervention settings and adopters, and changes in interprofessional communication. The primary outcome is the rate of unplanned hospital readmission. Secondary outcomes are length of stay (LOS); adherence to evidence-based prescription drug therapy; patients' satisfaction with care; self-report surveys of CTT staff perceptions of interprofessional collaboration; and frequency of calls to paging devices. Outcomes will be compared on an intention-to-treat basis using adjustment methods appropriate for data from a cluster randomized design. Pre-intervention qualitative analysis revealed that a substantial amount of interprofessional interaction lacks key core elements of collaborative communication such as self-introduction, description of professional role, and solicitation of other professional perspectives. Incorporating these findings, a four-component intervention was designed with a goal of creating a culture of communication in which the fundamentals of collaboration become a routine part of interprofessional interactions during unstructured work periods on GIM wards. Registered with National Institutes of Health as NCT00466297.

Interprofessional collaboration in the ICU: how to define?

PubMed

Rose, Louise

2011-01-01

The intensive care unit (ICU) is a dynamic, complex and, at times, highly stressful work environment that involves ongoing exposure to the complexities of interprofessional team functioning. Failures of communication, considered examples of poor collaboration among health care professionals, are the leading cause of inadvertent harm across all health care settings. Evidence suggests effective interprofessional collaboration results in improved outcomes for critically ill patients. One recent study demonstrated a link between low standardized mortality ratios and self-identified levels of collaboration. The aim of this paper is to discuss determinants and complexities of interprofessional collaboration, the evidence supporting its impact on outcomes in the ICU, and interventions designed to foster better interprofessional team functioning. Elements of effective interprofessional collaboration include shared goals and partnerships including explicit, complementary and interdependent roles; mutual respect; and power sharing. In the ICU setting, teams continually alter due to large staff numbers, shift work and staff rotations through the institution. Therefore, the ideal 'unified' team working together to provide better care and improve patient outcomes may be difficult to sustain. Power sharing is one of the most complex aspects of interprofessional collaboration. Ownership of specialized knowledge, technical skills, clinical territory, or even the patient, may produce interprofessional conflict when ownership is not acknowledged. Collaboration by definition implies interdependency as opposed to autonomy. Yet, much nursing literature focuses on achievement of autonomy in clinical decision-making, cited to improve job satisfaction, retention and patient outcomes. Autonomy of health care professionals may be an inappropriate goal when striving to foster interprofessional collaboration. Tools such as checklists, guidelines and protocols are advocated, by some, as ways for nurses to gain influence and autonomy in clinical decision-making. Protocols to guide ICU practices such as sedation and weaning reduce the duration of mechanical ventilation in some studies, while others have failed to demonstrate this advantage. Existing organizational strategies that facilitate effective collaboration between health care professionals may contribute to this lack of effect.

Incorporating Nurse-Midwifery Students into Graduate Medical Education: Lessons Learned in Interprofessional Education.

PubMed

Kaplan, Rebekah; Shaw-Battista, Jenna; Stotland, Naomi Ellen

2015-01-01

There is a current emphasis on interprofessional education in health care with the aim to improve teamwork and ultimately the quality and safety of care. As part of a Health Resources and Services Administration Advanced Nursing Education project, an interprofessional faculty and student team planned and implemented the first didactic coursework for nurse-midwifery and medical students at the University of California, San Francisco and responded to formative feedback in order to create a more meaningful educational experience for future combined cohorts. This article describes the process of including advanced nurse-midwifery students into 2 classes previously offered solely to medical students: 1) an elective in which students are matched with a pregnant woman to observe care that she receives before, during, and after giving birth; and 2) a required course on basic clinical care across the human lifespan. The development of these interprofessional courses, obstacles to success, feedback from students, and responses to course evaluations are reviewed. Themes identified in student course evaluations included uncertainty about interprofessional roles, disparity in clinical knowledge among learners, scheduling difficulties, and desire for more interprofessional education opportunities and additional time for facilitated interprofessional discussion. As a result of this feedback, more class time was designated for interprofessional exchange; less experienced rather than advanced midwifery students were included in both classes; and more interdisciplinary panel presentations were provided, along with clearer communication about student and clinician roles. Early project activities indicated nurse-midwifery students can be effectively included in existing medical student courses with revised curriculum and highlighted challenges that should be considered in the planning phase of similar projects in the future. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health. © 2015 by the American College of Nurse-Midwives.

An Interprofessional Learning Workshop for Mammography and Sonography Students Focusing on Breast Cancer Care and Management Via Simulation: A Pilot Study.

PubMed

Giles, Eileen M; Parange, Nayana; Knight, Bronwyn

2017-08-01

The literature surrounding interprofessional education claims that students who learn with, from, and about one another in well-designed interprofessional programs will practice together collaboratively upon graduation, given the skills to do so. The objective of this study was to examine attitudes to interprofessional practice before and after an interprofessional learning (IPL) activity. A total of 35 postgraduate medical imaging students attended a week-long mammography workshop. The sessions provided a range of didactic sessions related to diagnosis and management of breast cancer. An IPL session was incorporated on completion of the workshop to consolidate learning. Props and authentic resources were used to increase the fidelity of the simulation. Participants completed pre- and post-workshop questionnaires comprising an interprofessional education and collaboration scale and a quiz to gauge knowledge of specific content related to professional roles. Responses to each statement in the scale and quiz score, pre or post workshop, were compared, whereas responses to open-ended questions in post-workshop survey were thematically analyzed. Seventeen paired surveys were received. There was a significant total improvement of 10.66% (P = .036). After simulation, there was a statistically significant improvement in participants' understanding (P < .05) that IPL offers holistic care to the patient and that teamwork is useful for reducing errors in patient care. Simulation helped participants develop more awareness of their role within the profession, improve their understanding of other professionals, and gain more realistic expectations of team members. This pilot study confirmed learning within an IPL simulation improved attitudes toward shared learning, teamwork, and communication. Simulation provides opportunities for learning in a safe environment, and technology can be used in diverse ways to provide authentic learning. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Enacting 'team' and 'teamwork': using Goffman's theory of impression management to illuminate interprofessional practice on hospital wards.

PubMed

Lewin, Simon; Reeves, Scott

2011-05-01

Interprofessional teamwork is widely advocated in health and social care policies. However, the theoretical literature is rarely employed to help understand the nature of collaborative relations in action or to critique normative discourses of teamworking. This paper draws upon Goffman's (1963) theory of impression management, modified by Sinclair (1997), to explore how professionals 'present' themselves when interacting on hospital wards and also how they employ front stage and backstage settings in their collaborative work. The study was undertaken in the general medicine directorate of a large NHS teaching hospital in England. An ethnographic approach was used, including interviews with 49 different health and social care staff and participant observation of ward-based work. These observations focused on both verbal and non-verbal interprofessional interactions. Thematic analysis of the data was undertaken. The study findings suggest that doctor-nurse relationships were characterised by 'parallel working', with limited information sharing or effective joint working. Interprofessional working was based less on planned, 'front stage' activities, such as wards rounds, than on ad hoc backstage opportunistic strategies. These backstage interactions, including corridor conversations, allowed the appearance of collaborative 'teamwork' to be maintained as a form of impression management. These interactions also helped to overcome the limitations of planned front stage work. Our data also highlight the shifting 'ownership' of space by different professional groups and the ways in which front and backstage activities are structured by physical space. We argue that the use of Sinclair's model helps to illuminate the nature of collaborative interprofessional relations within an acute care setting. In such settings, the notion of teamwork, as a form of regular interaction and with a shared team identity, appears to have little relevance. This suggests that interventions to change interprofessional practice need to include a focus on ad hoc as well as planned forms of communication. Copyright © 2011 Elsevier Ltd. All rights reserved.

Interprofessional teamwork in the trauma setting: a scoping review

PubMed Central

2013-01-01

Approximately 70 to 80% of healthcare errors are due to poor team communication and understanding. High-risk environments such as the trauma setting (which covers a broad spectrum of departments in acute services) are where the majority of these errors occur. Despite the emphasis on interprofessional collaborative practice and patient safety, interprofessional teamworking in the trauma setting has received little attention. This paper presents the findings of a scoping review designed to identify the extent and nature of this literature in this setting. The MEDLINE (via OVID, using keywords and MeSH in OVID), and PubMed (via NCBI using MeSH), and CINAHL databases were searched from January 2000 to April 2013 for results of interprofessional teamworking in the trauma setting. A hand search was conducted by reviewing the reference lists of relevant articles. In total, 24 published articles were identified for inclusion in the review. Studies could be categorized into three main areas, and within each area were a number of themes: 1) descriptions of the organization of trauma teams (themes included interaction between team members, and leadership); 2) descriptions of team composition and structure (themes included maintaining team stability and core team members); and 3) evaluation of team work interventions (themes included activities in practice and activities in the classroom setting). Descriptive studies highlighted the fluid nature of team processes, the shared mental models, and the need for teamwork and communication. Evaluative studies placed a greater emphasis on specialized roles and individual tasks and activities. This reflects a multiprofessional as opposed to an interprofessional model of teamwork. Some of the characteristics of high-performing interprofessional teams described in this review are also evident in effective teams in the community rehabilitation and intermediate care setting. These characteristics may well be pertinent to other settings, and so provide a useful foundation for future investigations. PMID:24188523

Preparing Teachers to Work with "Everybody": A Curricular Approach to the Reform of Teacher Education

ERIC Educational Resources Information Center

Florian, Lani

2013-01-01

This article reports on a curricular approach to teacher education using the ideas in "Learning without Limits" to prepare teachers to enter a profession in which they take responsibility for the learning and achievement of all learners. Key aspects of Scotland's Inclusive Practice Project (IPP) are described and the role of…

Interprofessional Education for Collaboration: Learning How to Improve Health from Interprofessional Models across the Continuum of Education to Practice--Workshop Summary

ERIC Educational Resources Information Center

Cuff, Patricia A.

2013-01-01

Every year, the Global Forum undertakes two workshops whose topics are selected by the more than 55 members of the Forum. It was decided in this first year of the Forum's existence that the workshops should lay the foundation for future work of the Forum and the topic that could best provide this base of understanding was…

A framework for the design, implementation, and evaluation of interprofessional education.

PubMed

Pardue, Karen T

2015-01-01

The growing emphasis on teamwork and care coordination within health care delivery is sparking interest in interprofessional education (IPE) among nursing and health profession faculty. Faculty often lack firsthand IPE experience, which hinders pedagogical reform. This article proposes a theoretically grounded framework for the design, implementation, and evaluation of IPE. Supporting literature and practical advice are interwoven. The proposed framework guides faculty in the successful creation and evaluation of collaborative learning experiences.

And deregulation shall lead me to lie down in green pastures

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weidinger, G.

1995-06-01

This presentation briefly reviews the history of the IPP industry, the current state of competition, and potential opportunities for IPPs in a deregulated environment. Since the beginning of the PURPA created IPP industry, we have experienced many market phases. These began with {open_quotes}beat avoided cost,{close_quotes} followed by {open_quotes}find a need and fill it,{close_quotes} followed by {open_quotes}the bid fest,{close_quotes} to today`s {open_quotes}anything goes.{close_quotes} During this time, market clearing prices have declined from over 80/KwHr to 2-40/KwHr. Today`s partially deregulated electric market includes fierce competition and several new players in the game. Where surplus capacity exists, IPPs must compete with subsidized power.more » Long-term contracts are no longer widely available. Access to markets is constrained by less than open transmission. Even with these challenges, opportunities remain for the IPP supplier. Opportunities for advanced coal-fired power systems will be explored.« less

Isoprenoid biosynthesis in higher plants and in Escherichia coli: on the branching in the methylerythritol phosphate pathway and the independent biosynthesis of isopentenyl diphosphate and dimethylallyl diphosphate.

PubMed Central

Hoeffler, Jean-François; Hemmerlin, Andréa; Grosdemange-Billiard, Catherine; Bach, Thomas J; Rohmer, Michel

2002-01-01

In the bacterium Escherichia coli, the mevalonic-acid (MVA)-independent 2-C-methyl-d-erythritol 4-phosphate (MEP) pathway is characterized by two branches leading separately to isopentenyl diphosphate (IPP) and dimethylallyl diphosphate (DMAPP). The signature of this branching is the retention of deuterium in DMAPP and the deuterium loss in IPP after incorporation of 1-[4-(2)H]deoxy-d-xylulose ([4-(2)H]DX). Feeding tobacco BY-2 cell-suspension cultures with [4-(2)H]DX resulted in deuterium retention in the isoprene units derived from DMAPP, as well as from IPP in the plastidial isoprenoids, phytoene and plastoquinone, synthesized via the MEP pathway. This labelling pattern represents direct evidence for the presence of the DMAPP branch of the MEP pathway in a higher plant, and shows that IPP can be synthesized from DMAPP in plant plastids, most probably via a plastidial IPP isomerase. PMID:12010124

Teaching evidence-based practice principles to prepare health professions students for an interprofessional learning experience.

PubMed

Aronoff, Nell; Stellrecht, Elizabeth; Lyons, Amy G; Zafron, Michelle L; Glogowski, Maryruth; Grabowski, Jeremiah; Ohtake, Patricia J

2017-10-01

The research assessed online learning modules designed to teach health professions students evidence-based practice (EBP) principles in an interprofessional context across two institutions. Students from nine health professions at two institutions were recruited to participate in this pilot project consisting of two online learning modules designed to prepare students for an in-person case-based interprofessional activity. Librarians and an instructional designer created two EBP modules. Students' competence in EBP was assessed before and after the modules as well as after the in-person activity. Students evaluated the online learning modules and their impact on the students' learning after the in-person session. A total of 39 students from 8 health professions programs participated in the project. Average quiz scores for online EBP module 1 and module 2 were 83% and 76%, respectively. Following completion of the learning modules, adapted Fresno test of competence in EBP scores increased ( p =0.001), indicating that the modules improved EBP skill competence. Student evaluations of the learning modules were positive. Students indicated that they acquired new information skills that contributed to their ability to develop a patient care plan and that they would use these information skills in their future clinical practice. Online EBP learning modules were effective in developing EBP knowledge and skills for health professions students. Using the same modules ensured that students from different health professions at different stages of their professional programs had consistent knowledge and enabled each student to fully engage in an interprofessional evidence-based activity. Student feedback indicated the modules were valued and beneficial.

A 'RIPPER' Project: advancing rural inter-professional health education at the University of Tasmania.

PubMed

Whelan, Jessica J; Spencer, Judy F; Rooney, Kim

2008-01-01

Attending to the shortage and sustainability of health care professionals and resources in rural areas in Australia is a continuing challenge. In response, there is a heightened focus on new models of healthcare delivery and collaboration that optimise the quality of patient care, respond to complex health needs and increase professional job satisfaction. Interprofessional rural health education within universities has been proposed as one way of addressing these challenges. This article reports on the development, design, implementation and evaluation of the RIPPER initiative (Rural Interprofessional Program Education Retreat). RIPPER is an interprofessional rural health education initiative developed by a team at the University of Tasmania's Faculty of Health Science. The objective of the program was to develop a rural interprofessional learning module for final year undergraduate health science students at the University of Tasmania. The program was first piloted in a rural Tasmanian community in 2006, with a second iteration in 2007. Participants in the program included approximately 60 students from the disciplines of Medicine, Nursing and Pharmacy. The format and educational design of the RIPPER program was focussed on a multi-station learning circuit using interprofessional case-based scenarios. Each learning station employed experiential and interactive educational strategies that included high and low fidelity simulation, role play and reflection. The learning stations required students to work collaboratively in small interprofessional teams to respond to a series of rural emergency healthcare scenarios. Qualitative and quantitative evaluation data was collected from student participants over two years utilising a pre- and post-test quasi experimental design. Results demonstrated a positive shift in students' understanding of interprofessional practice and the roles and skills of other health professions. There was also an increase in the value ascribed by students to collaboration and team work as a way of problem solving and improving patient outcomes. The project evaluation indicated the importance of developing a sustainable and embedded interprofessional rural module within the undergraduate health science curriculum. The project evaluation findings also point to some of the strengths and limitations of implementing interprofessional education activities in a rural setting.

Scheduling of eccentric lower limb injury prevention exercises during the soccer micro-cycle: Which day of the week?

PubMed

Lovell, R; Whalan, M; Marshall, P W M; Sampson, J A; Siegler, J C; Buchheit, M

2018-05-24

Scheduling eccentric-based injury prevention programs (IPP) during the common 6-day micro-cycle in soccer is challenged by recovery and tapering phases. This study profiled muscle damage, neuromuscular performance, and perceptual responses to a lower limb eccentric-based IPP administered 1 (MD+1) vs 3 days (MD+3) postmatch. A total of 18 semi-professional players were monitored daily during 3 in-season 6-day micro-cycles, including weekly competitive fixtures. Capillary creatine kinase concentration (CK), posterior lower limb isometric peak force (PF), counter-movement jump (CMJ) performance, and muscle soreness were assessed 24 hours prior to match-day (baseline), and every 24 hours up to 120 hours postmatch. The IPP consisted of lunges, single stiff leg dead-lifts, single leg-squats, and Nordic hamstring exercises. Performing the IPP on MD+1 attenuated the decline in CK normally observed following match play (CON: 142%; MD+3: 166%; small differences). When IPP was delivered on MD+3, CK was higher vs CON and MD+1 trials on both MD+4 (MD+3: 260%; CON: 146%; MD+1: 151%; moderate differences) and MD+5 (MD+3: 209%; CON: 125%; MD+1: 127%; small differences). Soreness ratings were not exacerbated when the IPP was delivered on MD+1, but when prescribed on MD+3, hamstring soreness ratings remained higher on MD+4 and MD+5 (small differences). No between-trial differences were observed for PF and CMJ. Administering the IPP in the middle of the micro-cycle (MD+3) increased measures of muscle damage and soreness, which remained elevated on the day prior to the next match (MD+5). Accordingly, IPP should be scheduled early in the micro-cycle, to avoid compromising preparation for the following match. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Preoperative clinical and diagnostic characteristics of patients who require delayed IPP after primary Peyronies repair.

PubMed

Alphs, Hannah H; Navai, Neema; Köhler, Tobias S; McVary, Kevin T

2010-03-01

Penile vascular abnormalities occur in a high proportion of patients with Peyronie's disease (PD). Penile duplex ultrasonography (PDU) and dynamic infusion cavernosometry and cavernosography (DICC) are tools that can be used to help tailor individualized treatment for patients undergoing surgical intervention for their PD. However, precisely which parameters can be used to predict those patients with PD at risk for developing erectile dysfunction (ED) after intervention without inflatable penile prosthesis (IPP) has not been previously elucidated. To evaluate preoperative vascular parameters that predispose PD patients for developing ED after intervention without IPP. Twenty-six patients receiving surgical intervention for their PD at a single center were retrospectively identified. Of these, 11 (42.3%) opted for primary repair without placement of an IPP. Three (27.2%) of these 11 patients went on to develop ED postoperatively. We compared various demographic, PDU, and DICC parameters between patients who did and did not fail primary repair of their PD. Mean age and follow-up of patients who went on to develop ED after repair of PD without IPP were not significantly different (P < 0.05). Resistive index (RI) and end diastolic volume were significantly different between these two groups (P < 0.05), while peak systolic volume, flow to maintain, and pressure decay were not significantly different. An RI cutoff of <0.80 was found to identify all patients who would later develop ED and fail primary repair without IPP. Penile vascular assessment can aid in counseling patients about their risk of developing delayed ED after primary repair of PD. In our cohort of patients, PDU provided preoperative risk stratification for postoperative erectile dysfunction in men undergoing Peyronie's repair without IPP. We propose the prospective study of an RI cutoff to identify patients at risk of failing primary PD repair without IPP.

Advance Care Planning: Understanding Clinical Routines and Experiences of Interprofessional Team Members in Diverse Health Care Settings.

PubMed

Arnett, Kelly; Sudore, Rebecca L; Nowels, David; Feng, Cindy X; Levy, Cari R; Lum, Hillary D

2017-12-01

Interprofessional health care team members consider advance care planning (ACP) to be important, yet gaps remain in systematic clinical routines to support ACP. A clearer understanding of the interprofessional team members' perspectives on ACP clinical routines in diverse settings is needed. One hundred eighteen health care team members from community-based clinics, long-term care facilities, academic clinics, federally qualified health centers, and hospitals participated in a 35-question, cross-sectional online survey to assess clinical routines, workflow processes, and policies relating to ACP. Respondents were 53% physicians, 18% advanced practice nurses, 11% nurses, and 18% other interprofessional team members including administrators, chaplains, social workers, and others. Regarding clinical routines, respondents reported that several interprofessional team members play a role in facilitating ACP (ie, physician, social worker, nurse, others). Most (62%) settings did not have, or did not know of, policies related to ACP documentation. Only 14% of settings had a patient education program. Two-thirds of the respondents said that addressing ACP is a high priority and 85% felt that nonphysicians could have ACP conversations with appropriate training. The clinical resources needed to improve clinical routines included training for providers and staff, dedicated staff to facilitate ACP, and availability of patient/family educational materials. Although interprofessional health care team members consider ACP a priority and several team members may be involved, clinical settings lack systematic clinical routines to support ACP. Patient educational materials, interprofessional team training, and policies to support ACP clinical workflows that do not rely solely on physicians could improve ACP across diverse clinical settings.

Interprofessional Communities of Practice in Continuing Medical Education for Promoting and Sustaining Practice Change: A Prospective Cohort Study.

PubMed

Barker, Megan; Lecce, Julia; Ivanova, Anna; Zawertailo, Laurie; Dragonetti, Rosa; Selby, Peter

2018-01-01

Standard knowledge delivery formats for CME may have limited impact on long-term practice change. A community of practice (CoP) is one tool that may enhance competencies and support practice change. This study explores the utility of an interprofessional CoP as an adjunct to a CME program in tobacco addiction treatment (Training Enhancement in Applied Counselling and Health [TEACH] Project) to promote and sustain practice change. A prospective cohort design was utilized to examine the long-term impact of the TEACH CoP on practice change. An online survey was administered to TEACH-trained practitioners to assess perceived feasibility, importance, and confidence related to course competencies, involvement in TEACH CoP activities, engagement in knowledge transfer (KT), and implementation of new programming. Chi-square tests were used to detect differences in KT and program development associated with CoP participation. Course competency scores from immediate postcourse surveys and long-term follow-up surveys were compared. No significant differences in participant characteristics were found between those who did (n = 300) and did not (n = 122) participate in the TEACH CoP. Mean self-perceived competency scores were greater immediately after course than at long-term follow-up; however, self-ratings of competency in pharmacological interventions and motivational interviewing were higher at follow-up. TEACH CoP participation was associated with significantly greater engagement in KT and implementation of new programming after training. The findings from this evaluation suggest the value of interprofessional CoPs offered posttraining as a mechanism to enhance practice. CME providers should consider offering CoPs as a component of training programs to promote and sustain practice change.

Confronting human papilloma virus/oropharyngeal cancer: a model for interprofessional collaboration.

PubMed

Fried, Jacquelyn L

2014-06-01

A collaborative practice model related to Human Papilloma Virus (HPV) associated oropharyngeal cancer highlights the role of the dental hygienist in addressing this condition. The incidence of HPV associated head and neck cancer is rising. Multiple professionals including the dental hygienist can work collaboratively to confront this growing public health concern. A critical review applies the growth and utilization of interprofessional education (IPE) and interprofessional collaboration (IPC) to multi-disciplinary models addressing the human papilloma virus and oropharyngeal cancers. A model related to HPV associated oropharyngeal cancer addresses an oral systemic condition that supports the inclusion of a dental hygienist on collaborative teams addressing prevention, detection, treatment and cure of OPC. Copyright © 2014 Elsevier Inc. All rights reserved.

Critical Care Interprofessional Education: Exploring Conflict and Power-Lessons Learned.

PubMed

Friend, Mary Louanne; Friend, Richard D; Ford, Cassandra; Ewell, Patrick J

2016-12-01

The purpose of this mixed-methods study was to evaluate the effects of an innovative critical care interprofessional education intervention on prelicensure nursing and medical students at a large public university. The class provided opportunities for students to (a) explore stereotypes about each respective profession, (b) examine the occurrence and effects of interprofessional conflict in high-acuity areas, and (c) explore conflict resolution techniques while learning how to perform critical care procedures as a team. A nonequivalent control group design with pretest, posttest, and focus group interviews were used. Data analyses indicated no subscales and total scores were significantly different across time or between groups. However, focus group analyses indicated that changes did occur. The findings suggest that students experience interprofessional conflict in clinical settings, yet lack the confidence and skills to effectively mitigate these behaviors. Ongoing studies to measure student empowerment and their intentions to practice collaboratively before and after graduation are recommended. [J Nurs Educ. 2016;55(12):696-700.]. Copyright 2016, SLACK Incorporated.

Experiences in disaster-related mental health relief work: An exploratory model for the interprofessional training of psychological relief workers.

PubMed

Ren, ZhengJia; Wang, HongTao; Zhang, Wei

2017-01-01

The purpose of this study was to begin to generate an exploratory model of the disaster-related mental health education process associated with the training experiences of psychological relief workers active during the Sichuan earthquake in China. The data consisted of semi-structured interviews with 20 psychological relief workers from four different professions (social workers, psychiatric nurses, psychiatrists, and counsellors) regarding their experiences in training and ideas for improvement. The model explains the need to use a people-centred community interprofessional education approach, which focuses on role-modelling of the trainer, caring for relief workers, paying attention to the needs of the trainee, and building systematic interprofessional education strategies. The proposed model identifies areas for the comprehensive training of relief workers and aims to address the importance of people-centred mental health service provisions, ensure intentional and strategic training of relief workers using interprofessional concepts and strategies, and use culturally attuned and community-informed strategies in mental health training practices.

Reality Check: Are We Truly Preparing Our Students for Interprofessional Collaborative Practice?

PubMed

Salfi, Jenn; Mohaupt, Jennifer; Patterson, Christine; Allen, Dianne

2015-06-01

Many academic settings offer interprofessional education (IPE) experiences that are of short duration and situated in safe, controlled environments such as classrooms or simulation labs. The purpose of this study was to examine the effects of a 10-week IPE strategy that was incorporated into the final clinical practicum of a BScN program. A mixed methods design was chosen, in the belief that qualitative data would help explain quantitative data from pre-test/post-test design (n = 268). Quantitative results revealed that participants disagreed more with statements on interprofessional collaboration (IPC) after completion of the strategy (p = 0.00). Qualitative findings reinforced these results, revealing a theme of common sense is not so common when it comes to IPC in the health-care setting. When student nurses are being prepared for IPC, IPE strategies should be as "real" as possible, with exposure to some of the realities of interprofessional team functioning. Copyright© by Ingram School of Nursing, McGill University.

Integrated Personnel and Pay System-Army Increment 2 (IPPS-A Inc 2)

DTIC Science & Technology

2016-03-01

2016 Major Automated Information System Annual Report Integrated Personnel and Pay System-Army Increment 2 (IPPS-A Inc 2) Defense Acquisition...703-325-3747 DSN Phone: 865-2915 DSN Fax: 221-3747 Date Assigned: May 2, 2014 Program Information Program Name Integrated Personnel and Pay System...Program Description The Integrated Personnel and Pay System-Army (IPPS-A) will provide the Army with an integrated, multi-Component (Active, National

Towards defining interprofessional competencies for global health education: drawing on educational frameworks and the experience of the UW-Madison Global Health Institute.

PubMed

Brown, Lori DiPrete

2014-12-01

The experience and lessons to date from the University of Wisconsin-Madison Global Health Institute's global health programs, considered together with more recently published competency frameworks related to global health practice, can provide important insights into the development of a core set of interprofessional competencies for global health that can be used across disciplines and professions. © 2014 American Society of Law, Medicine & Ethics, Inc.

Using video-reflexive ethnography to capture the complexity of leadership enactment in the healthcare workplace.

PubMed

Gordon, Lisi; Rees, Charlotte; Ker, Jean; Cleland, Jennifer

2017-12-01

Current theoretical thinking asserts that leadership should be distributed across many levels of healthcare organisations to improve the patient experience and staff morale. However, much healthcare leadership education focusses on the training and competence of individuals and little attention is paid to the interprofessional workplace and how its inherent complexities might contribute to the emergence of leadership. Underpinned by complexity theory, this research aimed to explore how interprofessional healthcare teams enact leadership at a micro-level through influential acts of organising. A whole (interprofessional) team workplace-based study utilising video-reflexive ethnography occurred in two UK clinical sites. Thematic framework analyses of the video data (video-observation and video-reflexivity sessions) were undertaken, followed by in-depth analyses of human-human and human-material interactions. Data analysis revealed a complex interprofessional environment where leadership is a dynamic process, negotiated and renegotiated in various ways throughout interactions (both formal and informal). Being able to "see" themselves at work gave participants the opportunity to discuss and analyse their everyday leadership practices and challenge some of their sometimes deeply entrenched values, beliefs, practices and assumptions about healthcare leadership. These study findings therefore indicate a need to redefine the way that medical and healthcare educators facilitate leadership development and argue for new approaches to research which shifts the focus from leaders to leadership.

Defining and understanding the relationship between professional identity and interprofessional responsibility: implications for educating health and social care students.

PubMed

Joynes, Viktoria C T

2018-03-01

This paper is concerned with exploring the relationship between perceptions of professional identities, interprofessional education (IPE) and collaborative practice. It seeks to introduce the concept of interprofessional responsibility as both a shift in the way in which to conceptualise the professional identity of Health and Social Care (H&SC) staff and as a new set of practices that help to inform the way in which students are prepared for collaborative working. The presented research, undertaken as part of a Ph.D. study, is based upon semi-structured interviews (n = 33) with H&SC staff who were recruited from both the United Kingdom (UK) Health Service and UK universities. Drawing upon thematic analysis of the data, the results of the research identified that previous conceptualisations of professional identity aligned to a whole profession do not relate to the way in which professionals perceive their identities. Senior professionals claimed to be more comfortable with their own professional identity, and with working across professional boundaries, than junior colleagues. Academic staff also identified that much IPE currently taught in universities serves the purpose of box-ticking rather than being delivered in meaningful way. It is proposed that the findings have implications for the way in which IPE is currently taught, and that adoption of the proposed concept of 'interprofessional responsibility' may help address some of the concerns these findings raise.

From struggles to resource gains in interprofessional service networks: Key findings from a multiple case study.

PubMed

Toiviainen, Hanna; Kira, Mari

2017-07-01

In interprofessional service networks, employees cross professional boundaries to collaborate with colleagues and clients with expertise and values different from their own. It can be a struggle to adopt shared work practices and deal with "multivoicedness." At the same time, networks allow members to engage in meaningful service provision, gain a broader understanding of the service provided, and obtain social support. Intertwined network struggles and resource gains have received limited attention in the interprofessional care literature to date. The aim of the study was to investigate the learning potential of the co-existing struggles and resource gains. This article reports findings from two interprofessional networks. Interviews were conducted with 19 employees and thematically analysed. Three types of struggles and six types of resource gains of networking were identified. The struggles relate, first, to the assumptions of networking following similar practices to those in a home organisation; second, to the challenges of dealing with the multivoicedness of networking; and, third, to the experienced gap between the networking ideals and the reality of cooperation. At the same time, the network members experience gains in emotional resources (e.g., stronger sense of meaningfulness at work), cognitive resources (e.g., understanding the customer needs from alternative perspectives), and social resources (e.g., being able to rely on other professionals' competence). Learning potential emerged from the dynamics between coexisting struggles and resource gains.

A qualitative, interprofessional analysis of barriers to and facilitators of implementation of the Department of Veterans Affairs' Clostridium difficile prevention bundle using a human factors engineering approach.

PubMed

Yanke, Eric; Moriarty, Helene; Carayon, Pascale; Safdar, Nasia

2018-03-01

Clostridium difficile infection (CDI) is increasingly prevalent, severe, and costly. Adherence to infection prevention practices remains suboptimal. More effective strategies to implement guidelines and evidence are needed. Interprofessional focus groups consisting of physicians, resident physicians, nurses, and health technicians were conducted for a quality improvement project evaluating adherence to the Department of Veterans Affairs' (VA) nationally mandated C difficile prevention bundle. Qualitative analysis with a visual matrix display identified barrier and facilitator themes guided by the Systems Engineering Initiative for Patient Safety model, a human factors engineering approach. Several themes, encompassing both barriers and facilitators to bundle adherence, emerged. Rapid turnaround time of C difficile polymerase chain reaction testing was a facilitator of timely diagnosis. Too few, poorly located, and cluttered sinks were barriers to appropriate hand hygiene. Patient care workload and the time-consuming process of contact isolation precautions were also barriers to adherence. Multiple work system components serve as barriers to and facilitators of adherence to the VA CDI prevention bundle among an interprofessional group of health care workers. Organizational factors appear to significantly influence bundle adherence. Interprofessional perspectives are needed to identify barriers to and facilitators of bundle implementation, which is a necessary first step to address adherence to bundled infection prevention practices. Published by Elsevier Inc.

Investigation into health science students' awareness of occupational therapy: implications for interprofessional education.

PubMed

Alotaibi, Naser; Shayea, Abdulaziz; Nadar, Mohammed; Abu Tariah, Hashem

2015-01-01

To investigate the level of awareness of the occupational therapy profession among final-year health sciences students at Kuwait University. This study utilized a survey targeting final-year students in the Health Sciences Center at Kuwait University schools of medicine, pharmacy, dentistry, and allied health sciences. The survey addressed awareness of occupational therapy, its scope of practice, work environments, and preference for learning more about the profession. Of the 244 surveys distributed, 132 were returned, for a 54% response rate. The proportion of those who knew about occupational therapy ranged from 94% (radiologic science) to a low of 17% (medicine). Most respondents learned about occupational therapy from colleagues (77.1%), rather than from their academic programs (28.1%). RESULTS indicated that about one fifth of students (21.4%) were unsure about the role of occupational therapists as members of the health care team. Preferences for learning more about the profession were consistent with interprofessional opportunities, such as observing an occupational therapy session (64.5%) and attending a workshop (63.6%) or presentation (59.8%). Although most respondents had some awareness of occupational therapy, specifics about its scope of practice and relevance to the health care team were lacking. Preferences for learning more about occupational therapy were consistent with the current trend for interprofessional education in health care. Implications for interprofessional education are presented.

An Interprofessional Approach to Reducing the Risk of Falls Through Enhanced Collaborative Practice.

PubMed

Eckstrom, Elizabeth; Neal, Margaret B; Cotrell, Vicki; Casey, Colleen M; McKenzie, Glenise; Morgove, Megan W; DeLander, Gary E; Simonson, William; Lasater, Kathie

2016-08-01

Falls are the leading cause of accidental deaths in older adults and are a growing public health concern. The American Geriatrics Society (AGS) and British Geriatrics Society (BGS) published guidelines for falls screening and risk reduction, yet few primary care providers report following any guidelines for falls prevention. This article describes a project that engaged an interprofessional teaching team to support interprofessional clinical teams to reduce fall risk in older adults by implementing the AGS/BGS guidelines. Twenty-five interprofessional clinical teams with representatives from medicine, nursing, pharmacy, and social work were recruited from ambulatory, long-term care, hospital, and home health settings for a structured intervention: a 4-hour training workshop plus coaching for implementation for 1 year. The workshop focused on evidence-based strategies to decrease the risk of falls, including screening for falls; assessing gait, balance, orthostatic blood pressure, and other medical conditions; exercise including tai chi; vitamin D supplementation; medication review and reduction; and environmental assessment. Quantitative and qualitative data were collected using chart reviews, coaching plans and field notes, and postintervention structured interviews of participants. Site visits and coaching field notes confirmed uptake of the strategies. Chart reviews showed significant improvement in adoption of all falls prevention strategies except vitamin D supplementation. Long-term care facilities were more likely to address environmental concerns and add tai chi classes, and ambulatory settings were more likely to initiate falls screening. The intervention demonstrated that interprofessional practice change to target falls prevention can be incorporated into primary care and long-term care settings. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Improving collaborative care in managing eating disorders: a pilot study.

PubMed

Heath, Olga; English, Denise; Simms, Joanne; Ward, Pamela; Hollett, Ann; Dominic, Anna

2013-01-01

The purpose of this pilot study was to evaluate the impact of a continuing interprofessional educational workshop focused on eating disorders in a rural area in Newfoundland and Labrador (NL), Canada. The pilot study helped determine if the eating disorder workshop was feasible for implementation to a broader audience. A conceptual model developed by our eating disorder team and described in the article guided this innovative program. The intensive 2-day workshop was piloted in one community with 41 health and education professionals in attendance. A key element was the focus on creating and sustaining collaborative care for eating disorders. Participants completed pre-post workshop measures of interprofessional attitudes and skills, self-reported knowledge, confidence, and intention to change practice (post questionnaire only). A 6-month follow-up survey measured self-reported practice change. There were significant positive changes in interprofessional attitudes and skills as well as knowledge and confidence in collaborative management of eating disorders. Post-workshop, 69% (n = 24/35) of participants indicated intention to change practice, and on follow-up, 7 of 10 respondents reported implementing changes in practice as a result of the workshop. Low response rate at follow-up was a limitation. Results support the impact of the workshop in improving knowledge, confidence, and attitudes toward collaboration and changing practice and the value of implementing the program province-wide. Copyright © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

Collaboration Between Academia and Practice: Interprofessional Crises Leadership and Disaster Management.

PubMed

Hoying, Cheryl; Farra, Sharon; Mainous, Rosalie; Baute, Rebecca; Gneuhs, Matthew

2017-02-01

An innovative interprofessional disaster preparedness program was designed and implemented through an academic-practice partnership between a large midwestern children's hospital and a community-based state university. This course was part of a constellation of courses developed in response to Presidential Directive (HSPD) 8, a mandate to standardize disaster response training that was issued after the inefficiencies following Hurricane Katrina. A hybrid immersive and didactic approach was used to train senior leadership and frontline clinicians. Included were simulated experiences at the National Center for Medical Readiness, a workshop, and online modules. The program that focused on crisis leadership and disaster management was developed and implemented to serve patient-centered organizations.

High-throughput enzyme screening platform for the IPP-bypass mevalonate pathway for isopentenol production

DOE PAGES

Kang, Aram; Meadows, Corey W.; Canu, Nicolas; ...

2017-04-05

Isopentenol (or isoprenol, 3-methyl-3-buten-1-ol) is a drop-in biofuel and a precursor for commodity chemicals such as isoprene. Biological production of isopentenol via the mevalonate pathway has been optimized extensively in Escherichia coli, yielding 70% of its theoretical maximum. However, high ATP requirements and isopentenyl diphosphate (IPP) toxicity pose immediate challenges for engineering bacterial strains to overproduce commodities utilizing IPP as an intermediate. To overcome these limitations, we developed an “IPP-bypass” isopentenol pathway using the promiscuous activity of a mevalonate diphosphate decarboxylase (PMD) and demonstrated improved performance under aeration-limited conditions. However, relatively low activity of PMD toward the non-native substrate (mevalonatemore » monophosphate, MVAP) was shown to limit flux through this new pathway. By inhibiting all IPP production from the endogenous non-mevalonate pathway, we developed a high-throughput screening platform that correlated promiscuous PMD activity toward MVAP with cellular growth. Successful identification of mutants that altered PMD activity demonstrated the sensitivity and specificity of the screening platform. Strains with evolved PMD mutants and the novel IPP-bypass pathway increased titers up to 2.4-fold. Further enzymatic characterization of the evolved PMD variants suggested that higher isopentenol titers could be achieved either by altering residues directly interacting with substrate and cofactor or by altering residues on nearby α-helices. These altered residues could facilitate the production of isopentenol by tuning either k cat or K i of PMD for the non-native substrate. The synergistic modification made on PMD for the IPP-bypass mevalonate pathway is expected to significantly facilitate the industrial scale production of isopentenol.« less

High-throughput enzyme screening platform for the IPP-bypass mevalonate pathway for isopentenol production

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kang, Aram; Meadows, Corey W.; Canu, Nicolas

Isopentenol (or isoprenol, 3-methyl-3-buten-1-ol) is a drop-in biofuel and a precursor for commodity chemicals such as isoprene. Biological production of isopentenol via the mevalonate pathway has been optimized extensively in Escherichia coli, yielding 70% of its theoretical maximum. However, high ATP requirements and isopentenyl diphosphate (IPP) toxicity pose immediate challenges for engineering bacterial strains to overproduce commodities utilizing IPP as an intermediate. To overcome these limitations, we developed an “IPP-bypass” isopentenol pathway using the promiscuous activity of a mevalonate diphosphate decarboxylase (PMD) and demonstrated improved performance under aeration-limited conditions. However, relatively low activity of PMD toward the non-native substrate (mevalonatemore » monophosphate, MVAP) was shown to limit flux through this new pathway. By inhibiting all IPP production from the endogenous non-mevalonate pathway, we developed a high-throughput screening platform that correlated promiscuous PMD activity toward MVAP with cellular growth. Successful identification of mutants that altered PMD activity demonstrated the sensitivity and specificity of the screening platform. Strains with evolved PMD mutants and the novel IPP-bypass pathway increased titers up to 2.4-fold. Further enzymatic characterization of the evolved PMD variants suggested that higher isopentenol titers could be achieved either by altering residues directly interacting with substrate and cofactor or by altering residues on nearby α-helices. These altered residues could facilitate the production of isopentenol by tuning either k cat or K i of PMD for the non-native substrate. The synergistic modification made on PMD for the IPP-bypass mevalonate pathway is expected to significantly facilitate the industrial scale production of isopentenol.« less

Effects of elevated artificial pneumoperitoneum pressure on invasive blood pressure and levels of blood gases.

PubMed

Hypolito, Octavio; Azevedo, João Luiz; Gama, Fernanda; Azevedo, Otavio; Miyahira, Susana Abe; Pires, Oscar César; Caldeira, Fabiana Alvarenga; Silva, Thamiris

2014-01-01

to evaluate the clinical, hemodynamic, gas analysis and metabolic repercussions of high transient pressures of pneumoperitoneum for a short period of time to ensure greater security for introduction of the first trocar. sixty-seven patients undergoing laparoscopic procedures were studied and randomly distributed in P12 group: n=30 (intraperitoneal pressure [IPP] 12mmHg) and P20 group: n=37 (IPP of 20mmHg). Mean arterial pressure (MAP) was evaluated by catheterization of the radial artery; and through gas analysis, pH, partial pressure of oxygen (PaO2), partial pressure of CO2 (PaCO2), bicarbonate (HCO3) and alkalinity (BE) were evaluated. These parameters were measured in both groups at time zero before pneumoperitoneum (TP0); at time 1 (TP1) when IPP reaches 12mmHg in both groups; at time 2 (TP2) after five min with IPP=12mmHg in P12 and after 5min with IPP=20mmHg at P20; and at time 3 (TP3) after 10min with IPP=12mmHg in P12 and with return of IPP from 20 to 12mmHg, starting 10min after TP1 in P20. Different values from those considered normal for all parameters assessed, or the appearance of atypical organic phenomena, were considered as clinical changes. there were statistically significant differences in P20 group in MAP, pH, HCO3 and BE, but within normal limits. No clinical and pathological changes were observed. high and transient intra-abdominal pressure causes changes in MAP, pH, HCO3 and BE, but without any clinical impact on the patient. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

Psychological abuse, substance abuse distress, dissatisfaction with friendships, and incident psychiatric problems.

PubMed

Sheikh, Mashhood Ahmed

2018-05-01

The aim of this study was to assess the mediating role of dissatisfaction with friendships in adulthood in the associations between psychological abuse in childhood, substance abuse distress in childhood, and incident psychiatric problems (IPPs) in adulthood over 13 years of follow-up. We used data collected from 1994 to 2008 within the framework of the Tromsø Study (N = 9502), a representative, longitudinal, prospective cohort study. Poisson regression analysis was used to assess the associations between psychological abuse, substance abuse distress, dissatisfaction with friendships in adulthood, and IPPs in adulthood. Indirect effects and proportion mediated (%) were assessed with the difference-in-coefficients method. Psychological abuse (relative risk [RR] = 1.66, 95% confidence interval [CI]: 1.45-1.89) and substance abuse distress in childhood (RR = 1.38, 95% CI: 1.18-1.62) were associated with an increased risk of dissatisfaction with friendships in adulthood. Dissatisfaction with friendships in adulthood was associated with an increased risk of IPPs in adulthood (RR = 1.71, 95% CI: 1.33-2.20). Moreover, dissatisfaction with friendships in adulthood mediated 9.31% (95% CI: 4.25-14.57) of the association between psychological abuse in childhood and IPPs in adulthood, and 9.17% (95% CI: 4.35-16.33) of the association between substance abuse distress in childhood and IPPs in adulthood. Dissatisfaction with friendships in adulthood mediates a minor proportion of the associations between psychological abuse, substance abuse distress, and IPPs in adulthood. Interventions aimed at decreasing dissatisfaction with friendships may dampen some of the effect of psychological abuse and substance abuse distress in childhood on IPPs in adulthood. Copyright © 2018 Elsevier Inc. All rights reserved.

Can interventions improve health services from informal private providers in low and middle-income countries?: a comprehensive review of the literature.

PubMed

Shah, Nirali M; Brieger, William R; Peters, David H

2011-07-01

BACKGROUND There is a growing interest in the role of private health providers in low- and middle-income countries (LMICs). Informal private providers (IPPs) provide a significant portion of health care in many LMICs, but they have not received training in allopathic medicine. Interventions have been developed to take advantage of their potential to expand access to essential health services, although their success is not well measured. This paper addresses this information gap through a review of interventions designed to improve the quality, coverage, or costs of health services provided by IPPs in LMICs. METHODS A search for published literature in the last 15 years for any intervention dealing with IPPs in a LMIC, where at least one outcome was measured, was conducted through electronic databases PubMed and Global Health, as well as Google for grey literature from the Internet. RESULTS A total of 1272 articles were retrieved, of which 70 separate studies met inclusion criteria. The majority (70%) of outcomes measured proximate indicators such as provider knowledge (61% were positive) and behaviour (56% positive). Training IPPs was the most common intervention tested (77% of studies), but the more effective strategies did not involve training alone. Interventions that changed the institutional relationships and contributed to changing the incentives and accountability environment were most successful, and often required combinations of interventions. CONCLUSION Although there are documented interventions among IPPs, there are few good quality studies. Strategies that change the market conditions for IPPs-by changing incentives and accountability-appear more likely to succeed than those that depend on building individual capacities of IPPs. Understanding the effectiveness of these and other strategies will also require more rigorous research designs that assess contextual factors and document outcomes over longer periods.

A novel approach to reducing admissions for children with sickle cell disease in pain crisis through individualization and standardization in the emergency department.

PubMed

Schefft, Matthew R; Swaffar, Caitlan; Newlin, Jennifer; Noda, Cady; Sisler, India

2018-06-01

Vaso-occlusive crisis (VOC) is frequent in children with sickle cell disease (SCD) creating significant burden on patients, families, and emergency departments (ED). The objective of the project was to reduce the admission rate for children with SCD presenting to our ED with VOC by >20% within 6 months of initiating individualized pain plans (IPP). A multi-disciplinary quality improvement team was assembled. A Plan-Do-Study-Act (PDSA) format was employed. The IPP document was created in a unique folder within the electronic medical record. IPPs were created through retrospective chart review for our 80 highest resource users. Pediatric residents, ED residents, and ED attending physicians were instructed on use of the IPPs. Our study measured the presence of an IPP, adherence to the IPP, and time to opiate administration. Our primary outcome was admission rate. Length of stay and 72-hr return to the ED were assessed as balancing measures. Overall, admission rate decreased by 24% following implementation compared with the previous 5 years (P = 0.046). IPPs were created for 78% of patients and followed by ED staff in 86% of visits. Admission rate was significantly lower for patients receiving a second opiate dose within 45 min of the first dose (P < 0.01). There was no difference in readmission rate or 72-hr return rate to ED. This study presents an effective strategy to reduce admission rate for children with SCD presenting with VOC. Shorter time to second opiate dosing was also associated with reduced risk of admission. © 2018 Wiley Periodicals, Inc.

DOD Business Systems Modernization: Additional Action Needed to Achieve Intended Outcomes

DTIC Science & Technology

2015-07-01

including greater operational efficiencies and cost savings. View GAO-15-627. For more information, contact Carol R. Cha at (202) 512-4456 or chac @gao.gov...report, please contact me at (202) 512-4456 or chac @gao.gov. Contact points for our Offices of Congressional Relations and Public Affairs may be found...Personnel and Pay System - Army (IPPS-A), Integrated Personnel and Pay System - Navy (IPPS- N ), Air Force Integrated Personnel and Pay System (AF-IPPS

Indices of polarimetric purity for biological tissues inspection

NASA Astrophysics Data System (ADS)

Van Eeckhout, Albert; Lizana, Angel; Garcia-Caurel, Enric; Gil, José J.; Sansa, Adrià; Rodríguez, Carla; Estévez, Irene; González, Emilio; Escalera, Juan C.; Moreno, Ignacio; Campos, Juan

2018-02-01

We highlight the interest of using the Indices of Polarimetric Purity (IPPs) for the biological tissue inspection. These are three polarimetric metrics focused on the study of the depolarizing behaviour of the sample. The IPPs have been recently proposed in the literature and provide different and synthetized information than the commonly used depolarizing indices, as depolarization index (PΔ) or depolarization power (Δ). Compared with the standard polarimetric images of biological samples, IPPs enhance the contrast between different tissues of the sample and show differences between similar tissues which are not observed using the other standard techniques. Moreover, they present further physical information related to the depolarization mechanisms inherent to different tissues. In addition, the algorithm does not require advanced calculations (as in the case of polar decompositions), being the indices of polarimetric purity fast and easy to implement. We also propose a pseudo-coloured image method which encodes the sample information as a function of the different indices weights. These images allow us to customize the visualization of samples and to highlight certain of their constitutive structures. The interest and potential of the IPP approach are experimentally illustrated throughout the manuscript by comparing polarimetric images of different ex-vivo samples obtained with standard polarimetric methods with those obtained from the IPPs analysis. Enhanced contrast and retrieval of new information are experimentally obtained from the different IPP based images.

Enzymatic protein hydrolysates from high pressure-pretreated isolated pea proteins have better antioxidant properties than similar hydrolysates produced from heat pretreatment.

PubMed

Girgih, Abraham T; Chao, Dongfang; Lin, Lin; He, Rong; Jung, Stephanie; Aluko, Rotimi E

2015-12-01

Isolated pea protein (IPP) dispersions (1%, w/v) were pretreated with high pressure (HP) of 200, 400, or 600 MPa for 5 min at 24 °C or high temperature (HT) for 30 min at 100 °C prior to hydrolysis with 1% (w/w) Alcalase. HP pretreatment of IPP at 400 and 600 MPa levels led to significantly (P<0.05) improved (>40%) oxygen radical absorption capacity (ORAC) of hydrolysates. 2,2-Diphenyl-1-picrylhydrazyl, superoxide radical and hydroxyl radical scavenging activities of pea protein hydrolysates were also significantly (P<0.05) improved (25%, 20%, and 40%, respectively) by HP pretreatment of IPP. Protein hydrolysates from HT IPP showed no ORAC, superoxide or hydroxyl scavenging activity but had significantly (P<0.05) improved (80%) ferric reducing antioxidant power. The protein hydrolysates had weaker antioxidant properties than glutathione but overall, the HP pretreatment was superior to HT pretreatment in facilitating enzymatic release of antioxidant peptides from IPP. Copyright © 2015 Elsevier Ltd. All rights reserved.

Novel polypropylene/inorganic fullerene-like WS2 nanocomposites containing a β-nucleating agent: isothermal crystallization and melting behavior.

PubMed

Naffakh, Mohammed; Marco, Carlos; Ellis, Gary

2012-02-16

The isothermal crystallization and subsequent melting behavior of isotactic polypropylene (iPP) nucleated with different nucleating agents (NAs) are investigated. Tungsten disulfide (IF-WS(2)) and N,N'-dicyclohexyl-2,6-naphthalene (NJ) and dual-additive mixtures are introduced into an iPP matrix to generate new materials that exhibit variable α- and β-polymorphism. As shown in previous work, small amounts of IF-WS(2) or NJ have a nucleating effect during the crystallization of iPP. However, the isothermal crystallization and melting behavior of iPP nucleated by dual α(IF-WS(2))/β(NJ) additive systems are dependent on both the NA composition balance and the crystallization temperature. In particular, our results demonstrate that it is possible to obtain any α-phase to β-phase content ratio by controlling the composition of NAs under appropriate isothermal crystallization conditions. The nucleating behavior of the additives can be illustrated by competitive nucleation, and the correlation between crystallization and melting temperatures and relative α- and β-crystals content in iPP in the nanocomposites is discussed.

Why are you here? Needs analysis of an interprofessional health-education graduate degree program

PubMed Central

Cable, Christian; Knab, Mary; Tham, Kum Ying; Navedo, Deborah D; Armstrong, Elizabeth

2014-01-01

Little is known about the nature of faculty development that is needed to meet calls for a focus on quality and safety with particular attention to the power of interprofessional collaborative practice. Through grounded-theory methodology, the authors describe the motivation and needs of 20 educator/clinicians in multiple disciplines who chose to enroll in an explicitly interprofessional master’s program in health profession education. The results, derived from axial coding described by Strauss and Corbin, revealed that faculty pursue such postprofessional master’s degrees out of a desire to be better prepared for their roles as educators. A hybrid-delivery model on campus and online provided access to graduate degrees while protecting the ability of participants to remain in current positions. The added benefit of a community of practice related to evidence-based and innovative models of education was valued by participants. Authentic, project-based learning and assessment supported their advancement in home institutions and systems. The experience was described by participants as a disruptive innovation that helped them attain their goal of leadership in health profession education. PMID:24748830

The Association Between Daytime Intensivist Physician Staffing and Mortality in the Context of Other ICU Organizational Practices: A Multicenter Cohort Study.

PubMed

Costa, Deena Kelly; Wallace, David J; Kahn, Jeremy M

2015-11-01

Daytime intensivist physician staffing is associated with improved outcomes in the ICU. However, it is unclear whether this association persists in the era of interprofessional, protocol-directed critical care. We sought to reexamine the association between daytime intensivist physician staffing and ICU mortality and determine if interprofessional rounding and protocols for mechanical ventilation in part mediate this relationship. Retrospective cohort study of ICUs in the Acute Physiology and Chronic Health Evaluation clinical information system from 2009 to 2010. Forty-nine ICUs in 25 U.S. hospitals. Adults (17 yr and older) admitted to a study ICU. None. We defined high-intensity daytime intensivist staffing as either a mandatory consult or closed ICU model; interprofessional rounds as rounds that included a respiratory therapist, pharmacist, physician and nurse; and protocol use as having protocols for liberation from mechanical ventilation and lung protective mechanical ventilation. Using multivariable logistic regression, we estimated the independent effect of daytime intensivist physician staffing on in-hospital mortality controlling for interprofessional rounds and protocols for mechanical ventilation, as well as other patient and hospital characteristics. Twenty-seven ICUs (55%) reported high-intensity daytime physician staffing, 42 ICUs (85%) reported daily interprofessional rounds, and 31 (63%) reported having protocols for mechanical ventilation. There was no association between daytime intensivist physician staffing and in-hospital mortality (adjusted odds ratio, 0.86; 95% CI, 0.65-1.14). After adjusting for interprofessional rounds and protocols for mechanical ventilation, the effect of daytime intensivist physician staffing remained nonsignificant (adjusted odds ratio, 0.90; 95% CI, 0.70-1.17). High-intensity daytime physician staffing in the ICU was not significantly associated with lower mortality in a modern cohort. This association was not affected by interprofessional rounds or protocols for mechanical ventilation.

Interprofessional team debriefings with or without an instructor after a simulated crisis scenario: An exploratory case study.

PubMed

Boet, Sylvain; Pigford, Ashlee-Ann; Fitzsimmons, Amber; Reeves, Scott; Triby, Emmanuel; Bould, M Dylan

2016-11-01

The value of debriefing after an interprofessional simulated crisis is widely recognised; however, little is known about the content of debriefings and topics that prompt reflection. This study aimed to describe the content and topics that facilitate reflection among learners in two types of interprofessional team debriefings (with or without an instructor) following simulated practice. Interprofessional operating room (OR) teams (one anaesthesia trainee, one surgical trainee, and one staff circulating OR nurse) managed a simulated crisis scenario and were randomised to one of two debriefing groups. Within-team groups used low-level facilitation (i.e., no instructor but a one-page debriefing form based on the Ottawa Global Rating Scale). The instructor-led group used high-level facilitation (i.e., gold standard instructor-led debriefing). All debriefings were recorded, transcribed, and thematically analysed using the inductive qualitative methodology. Thirty-seven interprofessional team-debriefing sessions were included in the analysis. Regardless of group allocation (within-team or instructor-led), the debriefings centred on targeted crisis resource management (CRM) content (i.e., communication, leadership, situation awareness, roles, and responsibilities). In both types of debriefings, three themes emerged as topics for entry points into reflection: (1) the process of the debriefing itself, (2) experience of the simulation model, including simulation fidelity, and (3) perceived performance, including the assessment of CRM. Either with or without an instructor, interprofessional teams focused their debriefing discussion on targeted CRM content. We report topics that allowed learners to enter reflection. This is important for understanding how to maximise learning opportunities when creating education activities for healthcare providers that work in interprofessional settings.

Transcultural healthcare immersion: a unique interprofessional experience poised to influence collaborative practice in cultural settings.

PubMed

Morton, Jennifer

2012-01-01

This paper describes a model for interprofessional and transcultural learning established by the author and supported by the University of New England and Ghana Health Mission, Inc. The model for interprofessional immersion in cultural settings represents a guiding framework predicated on a conceptual "brick and mortar" process for building cultural proficiency among individuals and within teams. It encompasses social, clinical and behavioral components (brick) and personal desire, cultural humility and values (mortar). The ``bounty'' aspect of the model is achieved by way of successful student learning outcomes, positive interprofessional and community-based collaborations, and finally, and to be measured over time, favorable patient and population (programmatic) outcomes. In partnership with the Ghana Health Mission, Inc and local community health workers, students and faculty from a range of health professions took part in a cultural-clinical experience known as Transcultural Immersion in Healthcare. The goal of the experience was to advance cultural proficiency and knowledge through intensive cultural immersion. An urban setting in Ghana, located in West Africa served as the setting for this unique experience. The transcultural immersion in healthcare experience achieved its ``bounty'' as seen in the enhanced cultural proficiency of students and faculty, seamless interprofessional communication and collaboration, and provision of primary care and related services to patients and the Ghanaian community. Future research is in development to test the Model for Interprofessional Immersion in Cultural Settings (MIICS) in a variety of other settings and with a cross section of health disciplines.

Undergraduate interprofessional education using high-fidelity paediatric simulation.

PubMed

Stewart, Moira; Kennedy, Neil; Cuene-Grandidier, Hazel

2010-06-01

High-fidelity simulation is becoming increasingly important in the delivery of teaching and learning to health care professionals within a safe environment. Its use in an interprofessional context and at undergraduate level has the potential to facilitate the learning of good communication and teamworking, in addition to clinical knowledge and skills. Interprofessional teaching and learning workshops using high-fidelity paediatric simulation were developed and delivered to undergraduate medical and nursing students at Queen's University Belfast. Learning outcomes common to both professions, and essential in the clinical management of sick children, included basic competencies, communication and teamworking skills. Quantitative and qualitative evaluation was undertaken using published questionnaires. Quantitative results - the 32-item questionnaire was analysed for reliability using spss. Responses were positive for both groups of students across four domains - acquisition of knowledge and skills, communication and teamworking, professional identity and role awareness, and attitudes to shared learning. Qualitative results - thematic content analysis was used to analyse open-ended responses. Students from both groups commented that an interprofessional education (IPE) approach to paediatric simulation improved clinical and practice-based skills, and provided a safe learning environment. Students commented that there should be more interprofessional and simulation learning opportunities. High-fidelity paediatric simulation, used in an interprofessional context, has the potential to meet the requirements of undergraduate medical and nursing curricula. Further research is needed into the long-term benefits for patient care, and its generalisability to other areas within health care teaching and learning. © Blackwell Publishing Ltd 2010.

Teaching evidence-based practice principles to prepare health professions students for an interprofessional learning experience

PubMed Central

Aronoff, Nell; Stellrecht, Elizabeth; Lyons, Amy G.; Zafron, Michelle L.; Glogowski, Maryruth; Grabowski, Jeremiah; Ohtake, Patricia J.

2017-01-01

Objective: The research assessed online learning modules designed to teach health professions students evidence-based practice (EBP) principles in an interprofessional context across two institutions. Methods: Students from nine health professions at two institutions were recruited to participate in this pilot project consisting of two online learning modules designed to prepare students for an in-person case-based interprofessional activity. Librarians and an instructional designer created two EBP modules. Students’ competence in EBP was assessed before and after the modules as well as after the in-person activity. Students evaluated the online learning modules and their impact on the students’ learning after the in-person session. Results: A total of 39 students from 8 health professions programs participated in the project. Average quiz scores for online EBP module 1 and module 2 were 83% and 76%, respectively. Following completion of the learning modules, adapted Fresno test of competence in EBP scores increased (p=0.001), indicating that the modules improved EBP skill competence. Student evaluations of the learning modules were positive. Students indicated that they acquired new information skills that contributed to their ability to develop a patient care plan and that they would use these information skills in their future clinical practice. Conclusions: Online EBP learning modules were effective in developing EBP knowledge and skills for health professions students. Using the same modules ensured that students from different health professions at different stages of their professional programs had consistent knowledge and enabled each student to fully engage in an interprofessional evidence-based activity. Student feedback indicated the modules were valued and beneficial. PMID:28983201

Interprofessional educator ambassadors: An empirical study of motivation and added value.

PubMed

Anderson, Elizabeth Susan; Thorpe, Lucy Nicola

2010-01-01

Interprofessional education (IPE) is being led by a driving force of teaches who advocate for the importance of this learning within health and social care professional curriculum. Many of these leaders have additional uni professional teaching responsibilities. This study aimed to explore the impact of leading an IPE curriculum on teachers, who were at the forefront of establishing a new IPE curriculum in the east midlands, UK. The prospective study used the principles of grounded theory to analyse the educator's experiences. The study included teachers who work from academic university posts and those who teach from within practice. These IPE leaders were identified through their involvement in the design and delivery of the local IPE initiatives. They were invited to share their experiences at either a mixed-discipline focus group, a one-to-one interview or by completing a postal/e questionnaire. During analysis the views from each data set were triangulated. A total of 58 educators shared their experiences. All benefitted from being part of the planning and teaching teams. They were driven by a strong belief that IPE had the potential to improve patient care and that future healthcare practice would remain team based. Engagement had brought additional benefits to their teaching and career development in particular through forming new relationships with colleagues from other caring professions. They were concerned about educators teaching interprofessional student groups with little prior experience of IPE. The data suggest educators who take on a leading developmental role in designing and delivering an interprofessional curriculum benefit personally and professionally through working relationships with colleagues in other professions and through teaching wider networks of students. These new insights strengthen personal practice and research and in turn have the potential to influence and improve the quality of faculty teaching.

An exploration of experts' perceptions on the use of interprofessional education to support collaborative practice in the care of community-living older adults.

PubMed

Ploeg, Jenny; Markle-Reid, Maureen; Fisher, Anita; Bookey-Bassett, Sue; Chambers, Tracey; Kennedy, Laurie; Morsy, Mona; Dufour, Sinéad

2017-09-01

Globally, as older adults are living longer and with more chronic conditions, there is a need to support their ability to age optimally in their homes and communities. Community-based interprofessional teams working closely with these older adults, their families, and informal caregivers will be instrumental in achieving this goal. Interprofessional education (IPE) is the means through which these teams can develop expertise in collaboratively working together with older adults. However, most IPE occurs in academic settings, and acute and long-term care sectors and little is known about IPE in the context of home and community care of older adults. The purpose of this study was to describe perceptions of academic and practice experts related to the current state of IPE in home and community care of older adults and the changes that are necessary to meet the future needs of practitioners and older adults. Using a qualitative descriptive design, interviews were conducted with 32 national and international key informants representing practitioners, educators, researchers, and health system decision-makers in the field of IPE. Thematic analysis of the data identified six themes: (a) client and family-centred care at the core of IPE, (b) the community as a unique learning setting across the learning continuum; (c) an aging-relevant IPE curriculum; (d) faculty commitment and resources for IPE; (e) technological innovation to support IPE; and (f) comprehensive IPE programme evaluation and research. These findings are explored through the lens of an interprofessional learning continuum model. The article concludes with a discussion of the study implications for IPE practice and research specifically in the care of community-living older adults.

An Evaluation of the Decision-Making Capacity Assessment Model.

PubMed

Brémault-Phillips, Suzette C; Parmar, Jasneet; Friesen, Steven; Rogers, Laura G; Pike, Ashley; Sluggett, Bryan

2016-09-01

The Decision-Making Capacity Assessment (DMCA) Model includes a best-practice process and tools to assess DMCA, and implementation strategies at the organizational and assessor levels to support provision of DMCAs across the care continuum. A Developmental Evaluation of the DMCA Model was conducted. A mixed methods approach was used. Survey ( N = 126) and focus group ( N = 49) data were collected from practitioners utilizing the Model. Strengths of the Model include its best-practice and implementation approach, applicability to independent practitioners and inter-professional teams, focus on training/mentoring to enhance knowledge/skills, and provision of tools/processes. Post-training, participants agreed that they followed the Model's guiding principles (90%), used problem-solving (92%), understood discipline-specific roles (87%), were confident in their knowledge of DMCAs (75%) and pertinent legislation (72%), accessed consultative services (88%), and received management support (64%). Model implementation is impeded when role clarity, physician engagement, inter-professional buy-in, accountability, dedicated resources, information sharing systems, and remuneration are lacking. Dedicated resources, job descriptions inclusive of DMCAs, ongoing education/mentoring supports, access to consultative services, and appropriate remuneration would support implementation. The DMCA Model offers practitioners, inter-professional teams, and organizations a best-practice and implementation approach to DMCAs. Addressing barriers and further contextualizing the Model would be warranted.

An Evaluation of the Decision-Making Capacity Assessment Model

PubMed Central

Brémault-Phillips, Suzette C.; Parmar, Jasneet; Friesen, Steven; Rogers, Laura G.; Pike, Ashley; Sluggett, Bryan

2016-01-01

Background The Decision-Making Capacity Assessment (DMCA) Model includes a best-practice process and tools to assess DMCA, and implementation strategies at the organizational and assessor levels to support provision of DMCAs across the care continuum. A Developmental Evaluation of the DMCA Model was conducted. Methods A mixed methods approach was used. Survey (N = 126) and focus group (N = 49) data were collected from practitioners utilizing the Model. Results Strengths of the Model include its best-practice and implementation approach, applicability to independent practitioners and inter-professional teams, focus on training/mentoring to enhance knowledge/skills, and provision of tools/processes. Post-training, participants agreed that they followed the Model’s guiding principles (90%), used problem-solving (92%), understood discipline-specific roles (87%), were confident in their knowledge of DMCAs (75%) and pertinent legislation (72%), accessed consultative services (88%), and received management support (64%). Model implementation is impeded when role clarity, physician engagement, inter-professional buy-in, accountability, dedicated resources, information sharing systems, and remuneration are lacking. Dedicated resources, job descriptions inclusive of DMCAs, ongoing education/mentoring supports, access to consultative services, and appropriate remuneration would support implementation. Conclusions The DMCA Model offers practitioners, inter-professional teams, and organizations a best-practice and implementation approach to DMCAs. Addressing barriers and further contextualizing the Model would be warranted. PMID:27729947

Reducing Length of Stay, Direct Cost, and Readmissions in Total Joint Arthroplasty Patients With an Outcomes Manager-Led Interprofessional Team.

PubMed

Arana, Melissa; Harper, Licia; Qin, Huanying; Mabrey, Jay

The purpose of this quality improvement project was to determine whether an outcomes manager-led interprofessional team could reduce length of stay and direct cost without increasing 30-day readmission rates in the total joint arthroplasty patient population. The goal was to promote interprofessional relationships combined with collaborative practice to promote coordinated care with improved outcomes. Results from this project showed that length of stay (total hip arthroplasty [THA] reduced by 0.4 days and total knee arthroplasty [TKA] reduced by 0.6 days) and direct cost (THA reduced by $1,020 per case and TKA reduced by $539 per case) were significantly decreased whereas 30-day readmission rates of both populations were not significantly increased.

The effect of an interprofessional simulation-based education program on perceptions and stereotypes of nursing and medical students: A quasi-experimental study.

PubMed

Lockeman, Kelly S; Appelbaum, Nital P; Dow, Alan W; Orr, Shelly; Huff, Tanya A; Hogan, Christopher J; Queen, Brenda A

2017-11-01

Interprofessional education is intended to train practitioners to collaboratively address challenges in healthcare delivery, and interprofessional simulation-based education (IPSE) provides realistic, contextual learning experiences in which roles, responsibilities, and professional identity can be learned, developed, and assessed. Reducing negative stereotypes within interprofessional relationships is a prime target for IPSE. We sought to understand whether perceptions of interprofessional education and provider stereotypes change among nursing and medical students after participating in IPSE. We also sought to determine whether changes differed based on the student's discipline. This was a quasi-experimental pretest-posttest study. The study took place at a large mid-Atlantic public university with a comprehensive health science campus. 147 senior Bachelors of Science in Nursing students and 163 fourth-year medical students participated. Students were grouped into interprofessional teams for a two-week period and participated in three two-hour simulations focused on collaboration around acutely ill patients. At the beginning of the first session, they completed a pretest survey with demographic items and measures of their perceptions of interprofessional clinical education, stereotypes about doctors, and stereotypes about nurses. They completed a posttest with the same measures after the third session. 251 students completed both the pretest and posttest surveys. On all three measures, students showed an overall increase in scores after the IPSE experience. In comparing the change by student discipline, medical students showed little change from pretest to posttest on stereotypes of doctors, while nursing students had a significant increase in positive perceptions about doctors. No differences were noted between disciplines on changes in stereotypes of nurses. This study demonstrated that a short series of IPSE experiences resulted in improved perceptions of interprofessional practice and changes in stereotypical views of each profession even when the experience was not directly designed to address these issues. Differences observed between nursing and medical students should be explored further. Copyright © 2017 Elsevier Ltd. All rights reserved.

Preschool Teachers' Endorsement of Instructional Practices: An Interprofessional Exploration

ERIC Educational Resources Information Center

Koutsoftas, Anthony D.; Dubasik, Virginia L.; Moss DiDonato, Alicia

2017-01-01

Background: Preschool teacher's instructional practices are one component of high-quality early education classrooms that have the potential to directly influence young children's school readiness and success; therefore, the type and quality of instructional practices used by preschool teachers should be explored. Purpose: The purpose of this…

Interprofessional Practice and Education in Health Care: Their Relevance to School Psychology

ERIC Educational Resources Information Center

Margison, Judith A.; Shore, Bruce M.

2009-01-01

Calls for increased collaborative practices in school psychology parallel similar advances in the realm of health care. This article overviews the concepts associated with collaborative practice in school psychology and in health care (e.g., interaction, teamwork, and collaboration) and discusses how the literature emerging from interprofessional…

Increasing patient safety with neonates via handoff communication during delivery: a call for interprofessional health care team training across GME and CME.

PubMed

Vanderbilt, Allison A; Pappada, Scott M; Stein, Howard; Harper, David; Papadimos, Thomas J

2017-01-01

Hospitals have struggled for years regarding the handoff process of communicating patient information from one health care professional to another. Ineffective handoff communication is recognized as a serious patient safety risk within the health care community. It is essential to take communication into consideration when examining the safety of neonates who require immediate medical attention after birth; effective communication is vital for positive patient outcomes, especially with neonates in a delivery room setting. Teamwork and effective communication across the health care continuum are essential for providing efficient, quality care that leads to favorable patient outcomes. Interprofessional simulation and team training can benefit health care professionals by improving interprofessional competence, defined as one's knowledge of other professionals including an understanding of their training and skillsets, and role clarity. Interprofessional teams that include members with specialization in obstetrics, gynecology, and neonatology have the potential to considerably benefit from training effective handoff and communication practices that would ensure the safety of the neonate upon birth. We must strive to provide the most comprehensive systematic, standardized, interprofessional handoff communication training sessions for such teams, through Graduate Medical Education and Continuing Medical Education that will meet the needs across the educational continuum.

Interprofessional teamwork in stroke care: Is it visible or important to patients and carers?

PubMed

Hewitt, Gillian; Sims, Sarah; Greenwood, Nan; Jones, Fiona; Ross, Fiona; Harris, Ruth

2015-01-01

Interprofessional teamwork is seen in healthcare policy and practice as a key strategy for providing safe, efficient and holistic healthcare and is an accepted part of evidence-based stroke care. The impact of interprofessional teamwork on patient and carer experience(s) of care is unknown, although some research suggests a relationship might exist. This study aimed to explore patient and carer perceptions of good and poor teamwork and its impact on experiences of care. Critical incident interviews were conducted with 50 patients and 33 carers in acute, inpatient rehabilitation and community phases of care within two UK stroke care pathways. An analytical framework, derived from a realist synthesis of 13 'mechanisms' (processes) of interprofessional teamwork, was used to identify positive and negative 'indicators' of teamwork. Participants identified several mechanisms of teamwork, but it was not a subject most talked about readily. This suggests that interprofessional teamwork is not a concept that is particularly important to stroke patients and carers; they do not readily perceive any impacts of teamwork on their experiences. These findings are a salient reminder that what might be expected by healthcare professionals to be important influences on experience may not be perceived to be so by patients and carers.

Views of the United States healthcare system: Findings from documentary analysis of an interprofessional education course.

PubMed

Bultas, Margaret W; Ruebling, Irma; Breitbach, Anthony; Carlson, Judy

2016-11-01

As the healthcare system of the United States becomes more complex, collaboration among health professionals is becoming an essential aspect in improving the health of individuals and populations. An interprofessional education course entitled "Health Care System and Health Promotion" was developed to allow health profession students to work and learn together about issues related to healthcare delivery, health promotion, and the effect of policy issues on key stakeholders in the system. A qualitative document analysis research design was used to evaluate the effect of this interprofessional course on students' views of the current healthcare system of the United States. Fifty-nine student articles were analysed using document analysis. Health professions represented in the sample included occupational therapy, physical therapy, athletic training, nursing, and radiation therapy, nuclear medicine technology, and magnetic resonance imaging. Eight themes were identified including: increased personal awareness, the need for a system change, concern for access, affordability of healthcare, vision for future practice role, need for quality care, the value of interprofessional collaboration (IPC), and the importance of disease prevention. The results of the study suggest that healthcare education can benefit from the integration of Interprofessional Education (IPE) courses into their curriculum especially when teaching content common to all healthcare professions such as healthcare systems and health promotion.

Changing Health Professionals' Attitudes and Practice Behaviors Through Interprofessional Continuing Education in Oral-Systemic Health.

PubMed

Mowat, Stephanie; Hein, Casey; Walsh, Tanya; MacDonald, Laura; Grymonpre, Ruby; Sisler, Jeffrey

2017-12-01

Integration of oral-systemic science into clinical care holds promise for improving patient outcomes and presenting opportunities for individuals in various health care professions to learn with, from, and about each other. The aim of this study was to examine whether an interprofessional continuing education program dedicated to oral-systemic health improved participants' attitudes toward interprofessional education and collaboration between dental and non-dental health care professionals and whether it influenced the physicians' practice of screening for debilitating oral diseases. The study took place in 2014 and used a mixed-methods approach, consisting of Readiness for Interprofessional Learning Scale (RIPLS) surveys conducted before, immediately after, and six months after the intervention, as well as surveys of self-reported practice behaviors and semi-structured interviews. A total of 231 health care professionals participated in the lectures and roundtable discussions. Of those, 134 responded to the pre-program survey (58% response rate), 110 responded to the post-program survey (48% response rate), and 58 responded to the survey six months after the program (25% response rate). The participants' median total RIPLS score at baseline was 76.5, which increased significantly immediately following the program (81.0) but returned to baseline six months later (76.5). Participants' RIPLS domain scores also increased significantly by profession from before to after the event, with effects returning to baseline after six months. Significantly more physicians reported screening for caries and periodontal disease after the intervention. An overall theme of "learning with, from, and about each other" was drawn from the interviews with 15 participants. The physicians took away a message of "just look in the mouth," while the dental professionals reported feeling valued as members of the health care team. Although reported improvements in oral-systemic health practice immediately after the intervention were encouraging, further research is necessary to understand why collaborative behaviors were not sustained.

Interprofessional Obstetric Ultrasound Education: Successful Development of Online Learning Modules; Case-Based Seminars; and Skills Labs for Registered and Advanced Practice Nurses, Midwives, Physicians, and Trainees.

PubMed

Shaw-Battista, Jenna; Young-Lin, Nichole; Bearman, Sage; Dau, Kim; Vargas, Juan

2015-01-01

Ultrasound is an important aid in the clinical diagnosis and management of normal and complicated pregnancy and childbirth. The technology is widely applied to maternity care in the United States, where comprehensive standard ultrasound examinations are routine. Targeted scans are common and used for an increasing number of clinical indications due to emerging research and a greater availability of equipment with better image resolution at lower cost. These factors contribute to an increased demand for obstetric ultrasound education among students and providers of maternity care, despite a paucity of data to inform education program design and evaluation. To meet this demand, from 2012 to 2015 the University of California, San Francisco nurse-midwifery education program developed and implemented an interprofessional obstetric ultrasound course focused on clinical applications commonly managed by maternity care providers from different professions and disciplines. The course included matriculating students in nursing and medicine, as well as licensed practitioners such as registered and advanced practice nurses, midwives, and physicians and residents in obstetrics and gynecology and family medicine. After completing 10 online modules with a pre- and posttest of knowledge and interprofessional competencies related to teamwork and communication, trainees attended a case-based seminar and hands-on skills practicum with pregnant volunteers. The course aimed to establish a foundation for further supervised clinical training prior to independent practice of obstetric ultrasound. Course development was informed by professional guidelines and clinical and education research literature. This article describes the foundations, with a review of the challenges and solutions encountered in obstetric ultrasound education development and implementation. Our experience will inform educators who wish to facilitate obstetric ultrasound competency development among new and experienced maternity care providers in academic and clinical settings. This article is part of a special series of articles that address midwifery innovations in clinical practice, education, interprofessional collaboration, health policy, and global health. © 2015 by the American College of Nurse-Midwives.

Interprofessional training for final year healthcare students: a mixed methods evaluation of the impact on ward staff and students of a two-week placement and of factors affecting sustainability.

PubMed

McGettigan, Patricia; McKendree, Jean

2015-10-26

Multiple care failings in hospitals have led to calls for increased interprofessional training in medical education to improve multi-disciplinary teamwork. Providing practical interprofessional training has many challenges and remains uncommon in medical schools in the UK. Unlike most previous research, this evaluation of an interprofessional training placement takes a multi-faceted approach focusing not only on the impact on students, but also on clinical staff delivering the training and on outcomes for patients. We used mixed methods to examine the impact of a two-week interprofessional training placement undertaken on a medical rehabilitation ward by three cohorts of final year medical, nursing and therapy students. We determined the effects on staff, ward functioning and participating students. Impact on staff was evaluated using the Questionnaire for Psychological and Social factors at work (QPSNordic) and focus groups. Ward functioning was inferred from standard measures of care including length of stay, complaints, and adverse events. Impact on students was evaluated using the Readiness for Interprofessional Learning Survey (RIPLS) among all students plus a placement survey among medical students. Between 2007 and 2010, 362 medical students and 26 nursing and therapy students completed placements working alongside the ward staff to deliver patient care. Staff identified benefits including skills recognition and expertise sharing. Ward functioning was stable. Students showed significant improvements in the RIPLS measures of Teamwork, Professional Identity and Patient-Centred Care. Despite small numbers of students from other professions, medical students' rated the placement highly. Increasing student numbers and budgetary constraints led to the cessation of the placement after three years. Interprofessional training placements can be delivered in a clinical setting without detriment to care and with benefits for all participants. While financial support is a necessity, it appears that having students from multiple professions is not critical for a valuable training experience; staff from different professions and students from a single profession can work successfully together. Difficulty in aligning the schedules of different student professions is commonly cited as a barrier to interprofessional training. Our experience challenges this and should encourage provision of authentic interprofessional training experience.

Structuring communication relationships for interprofessional teamwork (SCRIPT): a cluster randomized controlled trial

PubMed Central

Zwarenstein, Merrick; Reeves, Scott; Russell, Ann; Kenaszchuk, Chris; Conn, Lesley Gotlib; Miller, Karen-Lee; Lingard, Lorelei; Thorpe, Kevin E

2007-01-01

Background Despite a burgeoning interest in using interprofessional approaches to promote effective collaboration in health care, systematic reviews find scant evidence of benefit. This protocol describes the first cluster randomized controlled trial (RCT) to design and evaluate an intervention intended to improve interprofessional collaborative communication and patient-centred care. Objectives The objective is to evaluate the effects of a four-component, hospital-based staff communication protocol designed to promote collaborative communication between healthcare professionals and enhance patient-centred care. Methods The study is a multi-centre mixed-methods cluster randomized controlled trial involving twenty clinical teaching teams (CTTs) in general internal medicine (GIM) divisions of five Toronto tertiary-care hospitals. CTTs will be randomly assigned either to receive an intervention designed to improve interprofessional collaborative communication, or to continue usual communication practices. Non-participant naturalistic observation, shadowing, and semi-structured, qualitative interviews were conducted to explore existing patterns of interprofessional collaboration in the CTTs, and to support intervention development. Interviews and shadowing will continue during intervention delivery in order to document interactions between the intervention settings and adopters, and changes in interprofessional communication. The primary outcome is the rate of unplanned hospital readmission. Secondary outcomes are length of stay (LOS); adherence to evidence-based prescription drug therapy; patients' satisfaction with care; self-report surveys of CTT staff perceptions of interprofessional collaboration; and frequency of calls to paging devices. Outcomes will be compared on an intention-to-treat basis using adjustment methods appropriate for data from a cluster randomized design. Discussion Pre-intervention qualitative analysis revealed that a substantial amount of interprofessional interaction lacks key core elements of collaborative communication such as self-introduction, description of professional role, and solicitation of other professional perspectives. Incorporating these findings, a four-component intervention was designed with a goal of creating a culture of communication in which the fundamentals of collaboration become a routine part of interprofessional interactions during unstructured work periods on GIM wards. Trial registration Registered with National Institutes of Health as NCT00466297. PMID:17877830

Landing Technique and Performance in Youth Athletes After a Single Injury-Prevention Program Session

PubMed Central

Root, Hayley; Trojian, Thomas; Martinez, Jessica; Kraemer, William; DiStefano, Lindsay J.

2015-01-01

Context Injury-prevention programs (IPPs) performed as season-long warm-ups improve injury rates, performance outcomes, and jump-landing technique. However, concerns regarding program adoption exist. Identifying the acute benefits of using an IPP compared with other warm-ups may encourage IPP adoption. Objective To examine the immediate effects of 3 warm-up protocols (IPP, static warm-up [SWU], or dynamic warm-up [DWU]) on jump-landing technique and performance measures in youth athletes. Design Randomized controlled clinical trial. Setting Gymnasiums. Patients or Other Participants Sixty male and 29 female athletes (age = 13 ± 2 years, height = 162.8 ± 12.6 cm, mass = 37.1 ± 13.5 kg) volunteered to participate in a single session. Intervention(s) Participants were stratified by age, sex, and sport and then were randomized into 1 protocol: IPP, SWU, or DWU. The IPP consisted of dynamic flexibility, strengthening, plyometric, and balance exercises and emphasized proper technique. The SWU consisted of jogging and lower extremity static stretching. The DWU consisted of dynamic lower extremity flexibility exercises. Participants were assessed for landing technique and performance measures immediately before (PRE) and after (POST) completing their warm-ups. Main Outcome Measure(s) One rater graded each jump-landing trial using the Landing Error Scoring System. Participants performed a vertical jump, long jump, shuttle run, and jump-landing task in randomized order. The averages of all jump-landing trials and performance variables were used to calculate 1 composite score for each variable at PRE and POST. Change scores were calculated (POST − PRE) for all measures. Separate 1-way (group) analyses of variance were conducted for each dependent variable (α < .05). Results No differences were observed among groups for any performance measures (P > .05). The Landing Error Scoring System scores improved after the IPP (change = −0.40 ± 1.24 errors) compared with the DWU (0.27 ± 1.09 errors) and SWU (0.43 ± 1.35 errors; P = .04). Conclusions An IPP did not impair sport performance and may have reduced injury risk, which supports the use of these programs before sport activity. PMID:26523663

Comparison of Infrapubic vs Penoscrotal Approaches for 3-Piece Inflatable Penile Prosthesis Placement: Do We Have a Winner?

PubMed

Palmisano, Franco; Boeri, Luca; Cristini, Cristiano; Antonini, Gabriele; Spinelli, Matteo Giulio; Franco, Giorgio; Longo, Fabrizio; Gadda, Franco; Colombo, Fulvio; Montanari, Emanuele

2018-05-02

The 3-piece inflatable penile prosthesis (IPP) is the gold standard treatment for male erectile dysfunction when other less invasive approaches are contra-indicated or unacceptable for the patient. There are currently 2 surgical approaches for IPP implantation: the penoscrotal (PS) and the infrapubic (IP) incision. To assess the most recent evidence on the impact of surgical approach for 3-piece IPP implantation in patients with erectile dysfunction. A systematic literature review was performed using the MEDLINE (PubMed) and Cochrane Libraries databases in November 2017 to identify all studies investigating 3-piece IPP with a specified surgical access. The following key words were used in combination: "infrapubic," "transcrotal," "penoscrotal," "peno-scrotal," and "penile prosthesis." Additional references were obtained from the reference lists of full-text manuscripts. We used a narrative synthesis for the analyses of the studies. 22 Studies reporting data on 3-piece IPP implantation with a specified surgical approach were found in the literature. While IPPs are most commonly positioned through a PS incision, the IP approach is a faster procedure. No cases of glans hypoesthesia after IPP placement with an IP approach were reported, and the overall peri-prosthetic infection rate was 3.3% or less. Patient satisfaction rates were higher than 80% in both groups. Both the IP and PS approaches are viable and effective strategies for a 3-piece IPP placement, and result in high satisfaction rates. To date there is no evidence that an incision strategy may reduce infection rates. Penile sensory loss following an IP approach remains a virtual risk. It is recommended that the surgeon executing the implant have knowledge of both accesses and be capable of tailoring the incision strategy for complex cases. The chosen method should be based on the patient's specific anatomy, surgical history, and surgeon experience. Palmisano F, Boeri L, Cristini C, et al. Comparison of Infrapubic vs Penoscrotal Approaches for 3-Piece Inflatable Penile Prosthesis Placement: Do We Have a Winner? Sex Med Rev 2018;XX:XXX-XXX. Copyright © 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Using complexity theory to develop a student-directed interprofessional learning activity for 1220 healthcare students.

PubMed

Jorm, Christine; Nisbet, Gillian; Roberts, Chris; Gordon, Christopher; Gentilcore, Stacey; Chen, Timothy F

2016-08-08

More and better interprofessional practice is predicated to be necessary to deliver good care to the patients of the future. However, universities struggle to create authentic learning activities that enable students to experience the dynamic interprofessional interactions common in healthcare and that can accommodate large interprofessional student cohorts. We investigated a large-scale mandatory interprofessional learning (IPL) activity for health professional students designed to promote social learning. A mixed methods research approach determined feasibility, acceptability and the extent to which student IPL outcomes were met. We developed an IPL activity founded in complexity theory to prepare students for future practice by engaging them in a self-directed (self-organised) learning activity with a diverse team, whose assessable products would be emergent creations. Complicated but authentic clinical cases (n = 12) were developed to challenge student teams (n = 5 or 6). Assessment consisted of a written management plan (academically marked) and a five-minute video (peer marked) designed to assess creative collaboration as well as provide evidence of integrated collective knowledge; the cohesive patient-centred management plan. All students (including the disciplines of diagnostic radiology, exercise physiology, medicine, nursing, occupational therapy, pharmacy, physiotherapy and speech pathology), completed all tasks successfully. Of the 26 % of students who completed the evaluation survey, 70 % agreed or strongly agreed that the IPL activity was worthwhile, and 87 % agreed or strongly agreed that their case study was relevant. Thematic analysis found overarching themes of engagement and collaboration-in-action suggesting that the IPL activity enabled students to achieve the intended learning objectives. Students recognised the contribution of others and described negotiation, collaboration and creation of new collective knowledge after working together on the complicated patient case studies. The novel video assessment was challenging to many students and contextual issues limited engagement for some disciplines. We demonstrated the feasibility and acceptability of a large scale IPL activity where design of cases, format and assessment tasks was founded in complexity theory. This theoretically based design enabled students to achieve complex IPL outcomes relevant to future practice. Future research could establish the psychometric properties of assessments of student performance in large-scale IPL events.

Peer teacher training (PTT) program for health professional students: interprofessional and flipped learning.

PubMed

Burgess, Annette; Roberts, Chris; van Diggele, Christie; Mellis, Craig

2017-12-04

The need for developing healthcare professional students' peer teaching skills is widely acknowledged, and a number of discipline-based peer teacher training programs have been previously reported. However, a consensus on what a student peer teaching skills program across the health professions should entail, and the associated benefits and challenges, has not been previously described. The purpose of this study was to demonstrate the design and implementation of an interprofessional Peer Teacher Training (PTT) program, and explore outcomes and participant perceptions, using Experience-Based Learning (ExBL) theory. In 2016, an interprofessional team of academics from across three healthcare faculties: Medicine, Pharmacy and Health Sciences, developed and implemented a six module, flipped learning, interprofessional PTT program. Pre- and post questionnaires, using a Likert scale of 1-5, as well as open ended questions, were distributed to students. Descriptive statistics were used to analyse quantitative data, and thematic analysis was used to analyse qualitative data. Ninety senior students from across the three faculties participated. Eighty nine percent of participants completed a pre- and post-course questionnaire. Students felt the required pre-class preparation, including online pre-reading, discussion board, videos, and teaching activities enhanced their face-to-face learning experience. In class, students valued the small-group activities, and the opportunities to practice their teaching skills with provision of feedback. Students reported increased confidence to plan and deliver peer teaching activities, and an increased awareness of the roles and responsibilities of health professionals outside of their own discipline, and use of different terminology and communication methods. Students' suggestions for improving the PTT, included; less large group teaching; more online delivery of theory; and inclusion of a wider range of health professional disciplines. The PTT program provided a theoretically informed framework where students could develop and practice their teaching skills, helping to shape students' professional values as they assume peer teaching responsibilities and move towards healthcare practice. The flipped learning, interprofessional format was successful in developing students' skills, competence and confidence in teaching, assessment, communication and feedback. Importantly, participation increased students' awareness and understanding of the various roles of health professionals.

Innovation and design of a web-based pain education interprofessional resource.

PubMed

Lax, Leila; Watt-Watson, Judy; Lui, Michelle; Dubrowski, Adam; McGillion, Michael; Hunter, Judith; Maclennan, Cameron; Knickle, Kerry; Robb, Anja; Lapeyre, Jaime

2011-01-01

The present article describes educational innovation processes and design of a web-based pain interprofessional resource for prelicensure health science students in universities across Canada. Operationalization of educational theory in design coupled with formative evaluation of design are discussed, along with strategies that support collaborative innovation. Educational design was driven by content, theory and evaluation. Pain misbeliefs and teaching points along the continuum from acute to persistent pain were identified. Knowledge-building theory, situated learning, reflection and novel designs for cognitive scaffolding were then employed. Design research principles were incorporated to inform iterative and ongoing design. An authentic patient case was constructed, situated in interprofessional complex care to highlight learning objectives related to pre-operative, postoperative and treatment up to one year, for a surgical cancer patient. Pain mechanisms, assessment and management framed content creation. Knowledge building scaffolds were used, which included video simulations, embedded resources, concurrent feedback, practice-based reflective exercises and commentaries. Scaffolds were refined to specifically support knowledge translation. Illustrative commentaries were designed to explicate pain misbeliefs and best practices. Architecture of the resource was mapped; a multimedia, interactive prototype was created. This pain education resource was developed primarily for individual use, with extensions for interprofessional collective discourse. Translation of curricular content scripts into representation maps supported the collaborative design process by establishing a common visual language. The web-based prototype will be formatively and summatively evaluated to assess pedagogic design, knowledge-translation scaffolds, pain knowledge gains, relevance, feasibility and fidelity of this educational innovation.

Exploring interprofessional collaboration during the integration of diabetes teams into primary care.

PubMed

Gucciardi, Enza; Espin, Sherry; Morganti, Antonia; Dorado, Linda

2016-02-01

Specialised diabetes teams, specifically certified nurse and dietitian diabetes educator teams, are being integrated part-time into primary care to provide better care and support for Canadians living with diabetes. This practice model is being implemented throughout Canada in an effort to increase patient access to diabetes education, self-management training, and support. Interprofessional collaboration can have positive effects on both health processes and patient health outcomes, but few studies have explored how health professionals are introduced to and transition into this kind of interprofessional work. Data from 18 interviews with diabetes educators, 16 primary care physicians, 23 educators' reflective journals, and 10 quarterly debriefing sessions were coded and analysed using a directed content analysis approach, facilitated by NVIVO software. Four major themes emerged related to challenges faced, strategies adopted, and benefits observed during this transition into interprofessional collaboration between diabetes educators and primary care physicians: (a) negotiating space, place, and role; (b) fostering working relationships; (c) performing collectively; and (d) enhancing knowledge exchange. Our findings provide insight into how healthcare professionals who have not traditionally worked together in primary care are collaborating to integrate health services essential for diabetes management. Based on the experiences and personal reflections of participants, establishing new ways of working requires negotiating space and place to practice, role clarification, and frequent and effective modes of formal and informal communication to nurture the development of trust and mutual respect, which are vital to success.

Bridging the training-practice gap in interprofessional student supervision.

PubMed

Martin, Priya; Kumar, Saravana; Abernathy, LuJuana

2017-04-01

Workforce recruitment and retention issues are common in highly dispersed regions such as Queensland in Australia. Provision of student placements in these non-metropolitan areas is one way of promoting staff recruitment. However, healthcare professionals in these areas face a number of challenges in accessing training opportunities including student supervision training. Funding was made available to develop and run a series of targeted, evidence-based, interprofessional student supervision workshops in non-metropolitan Queensland. Workshop participants were health professionals from both public and private health service providers in Queensland. Using a pre-post design, anonymous data were collected through surveys administered before and after workshop participation. Descriptive statistics were used to analyze participant information. Free text responses were categorized using an iterative process to identify prevalent themes. A total of 147 participants attended nine face-to-face workshops and provided data. Allied health participants represented 70% of the population, with the remainder largely from nursing, medicine and dentistry. There was a positive shift in self-reported level of confidence in student supervision following training. Of the participants 143 (97%) reported that they acquired new skills and knowledge from training. A number of enablers of and barriers to translation of learning to practice following interprofessional student supervision training were identified. Targeted interprofessional student supervision training is valuable and can increase participants' self-reported level of confidence in student supervision. It is recommended that health organizations promote a culture of providing positive student placement experiences in order to maximize future workforce opportunities.

Designing learning spaces for interprofessional education in the anatomical sciences.

PubMed

Cleveland, Benjamin; Kvan, Thomas

2015-01-01

This article explores connections between interprofessional education (IPE) models and the design of learning spaces for undergraduate and graduate education in the anatomical sciences and other professional preparation. The authors argue that for IPE models to be successful and sustained they must be embodied in the environment in which interprofessional learning occurs. To elaborate these arguments, two exemplar tertiary education facilities are discussed: the Charles Perkins Centre at the University of Sydney for science education and research, and Victoria University's Interprofessional Clinic in Wyndham for undergraduate IPE in health care. Backed by well-conceived curriculum and pedagogical models, the architectures of these facilities embody the educational visions, methods, and practices they were designed to support. Subsequently, the article discusses the spatial implications of curriculum and pedagogical change in the teaching of the anatomical sciences and explores how architecture might further the development of IPE models in the field. In conclusion, it is argued that learning spaces should be designed and developed (socially) with the expressed intention of supporting collaborative IPE models in health education settings, including those in the anatomical sciences. © 2015 American Association of Anatomists.

Mapping the interprofessional education landscape for students on rural clinical placements: an integrative literature review.

PubMed

Walker, Lorraine; Cross, Merylin; Barnett, Tony

2018-05-01

Interprofessional collaboration and effective teamwork are core to optimising rural health outcomes; however, little is known about the opportunities available for interprofessional education (IPE) in rural clinical learning environments. This integrative literature review addresses this deficit by identifying, analysing and synthesising the research available about the nature of and potential for IPE provided to undergraduate students undertaking rural placements, the settings and disciplines involved and the outcomes achieved. An integrative review method was adopted to capture the breadth of evidence available about IPE in the rural context. This integrative review is based on a search of nine electronic databases: CINAHL, Cochrane Library, EMBASE, MEDLINE, ProQuest, PubMed, SCOPUS, Web of Science and Google Scholar. Search terms were adapted to suit those used by different disciplines and each database and included key words related to IPE, rurality, undergraduate students and clinical placement. The inclusion criteria included primary research and reports of IPE in rural settings, peer reviewed, and published in English between 2000 and mid-2016. This review integrates the results of 27 primary research studies undertaken in seven countries: Australia, Canada, USA, New Zealand, the Philippines, South Africa and Tanzania. Despite geographical, cultural and health system differences, all of the studies reviewed were concerned with developing collaborative, interprofessional practice-ready graduates and adopted a similar mix of research methods. Overall, the 27 studies involved more than 3800 students (range 3-1360) from 36 disciplinary areas, including some not commonly associated with interprofessional education, such as theology. Interprofessional education was provided in a combination of university and rural placement settings including hospitals, community health services and other rural venues. The education activities most frequently utilised were seminars, tutorial discussion groups (n=21, 84%), case presentations (n=11, 44%) and community projects (n=11, 44%) augmented by preliminary orientation and ongoing interaction with clinicians during placement. The studies reviewed demonstrate that rural clinical learning environments provide rich and varied IPE opportunities for students that increase their interprofessional understanding, professional respect for other roles, and awareness of the collaborative and interprofessional nature of rural practice. This review addresses the lack of attention given to understanding IPE in the rural context, provides Australian and international evidence that initiatives are being offered to diverse student groups undertaking placements in rural settings and proposes a research agenda to develop a relevant framework to support rural IPE. Rural clinical learning environments afford a rich resource whereby health professionals can conceptualise IPE creatively and holistically to construct transformative learning experiences for students. This review develops a case for supporting the development, trialling, evaluation and translation of IPE initiatives that harness the opportunities afforded by rural placements. Further research is required to examine the ways to optimise IPE opportunities in the rural clinical context, including the potential for simulation-based activities, the challenges to achieving sustainable programs, and to evaluate the impact of interprofessional education on collaboration and health outcomes.

Team meetings in specialist palliative care: asking questions as a strategy within interprofessional interaction.

PubMed

Arber, Anne

2008-10-01

In this article, I explore what happens when specialist palliative care staff meet together to discuss patients under their care. Many studies (e.g., Atkinson) have discussed how health care practitioners in various settings use rhetorical strategies when presenting cases in situations such as ward rounds and team meetings. Strategies for arguing and persuading are central to medical practice in the interprofessional context. The context of specialist palliative care is an interesting place for research, as there is a history of patient-centered holistic approaches to care, within a multidisciplinary context, that is interdisciplinary in its focus, structure, and practice (e.g., Saunders). This article examines the rhetorical accomplishment of teamwork in specialist palliative care settings.

Collaborative Leadership, Part 2: The Role of the Nurse Leader in Interprofessional Team-Based Practice - Shifting from Task- to Collaborative Patient-/Family-Focused Care.

PubMed

Orchard, Carole A; Sonibare, Olubukola; Morse, Adam; Collins, Jennifer; Al-Hamad, Areej

2017-01-01

This paper presents a discussion on the key role that nurses assume with their patients and also with other health providers. We will argue that a change is needed to provide "space" for nurses to re-engage with their patients and to return to their key coordinating role between their patients, their family members and other health providers in interprofessional patient and family-centred collaborative practice. Furthermore, we will discuss the important role of nurse leaders to present the nurses' unique role and importance to health system administrators and policy makers to improve health outcomes of patients and how their role can concomitantly reduce healthcare costs. Copyright © 2017 Longwoods Publishing.

Educational role of nurse practitioners in a family practice centre: perspectives of learners and nurses.

PubMed

Walsh, Allyn; Moore, Ainsley; Barber, Anne; Opsteen, Joanne

2014-06-01

To examine the role of nurse practitioners (NPs) as educators of family medicine residents in order to better understand the interprofessional educational dynamics in a clinical teaching setting. A qualitative descriptive approach, using purposive sampling. A family practice centre that is associated with an academic department of family medicine and is based in an urban area in southern Ontario. First-year (8 of 9) and second-year (9 of 10) family medicine residents whose training program was based at the family practice centre, and all NPs (4 of 4) who worked at the centre. Semistructured interviews were conducted, which were audiotaped and transcribed. An iterative approach was used for coding and analysis. Data management software guided organization and analysis of the data. Four interconnected themes were identified: role clarification, professional identity formation, factors that enhance the educational role of NPs, and factors that limit the educational role of NPs. Although residents recognized NPs' value in team functioning and areas of specialized knowledge, they were unclear about NPs' scope of practice. Depending on residents' level of training, residents tended to respond differently to teaching by NPs. More of the senior residents believed they needed to think like physicians and preferred clinical teaching from physician teachers. Junior residents valued the step-by-step instructional approach used by NPs, and they had a decreased sense of vulnerability when being taught by NPs. Training in teaching skills was helpful for NPs. Barriers to providing optimal education included opportunity, time, and physician attitudes. The lack of an intentional orientation of family medicine residents to NPs' scope of practice and educational role can lead to difficulties in interprofessional education. More explicit recognition of the evolving professional identity of family medicine residents might decrease resistance to teaching by NPs and ensure that interprofessional teaching and learning strategies are effective. Faculty development opportunities for all educators are required to manage these issues, both to ensure teaching competencies and to reinforce positive interprofessional collaboration. Copyright© the College of Family Physicians of Canada.

Surgeon-Therapist Communication: Do All Members See Eye-to-Eye?

PubMed

Longstaffe, Robert; Slade Shantz, Jesse; Leiter, Jeff; Peeler, Jason

2015-11-01

Poor interprofessional collaboration has been shown to negatively affect patient care within many fields of medicine. Growing evidence is suggesting that improved interprofessional collaboration can positively affect patient care. Postoperative rehabilitation of many orthopedic conditions necessitates the combined efforts of surgeons, and therapists. There is a paucity of literature examining collaboration among orthopedic surgeons and therapists regarding postoperative rehabilitation. The following study examines the perceived quality of communications between orthopedic surgeons and therapists employing an online survey. We hypothesized that collaborative practice patterns result in improved perceptions of communication. Ethics board approval was obtained. Subjects consisted of orthopedic surgeons, licensed physiotherapists and certified athletic therapists. The online survey was distributed through the Canadian Orthopaedic Association (COA), the Canadian Physiotherapy Association (CPA) and the Canadian Athletic Therapists Association (CATA). Data analysis was performed using Stata/IC 12.1 (Stata Corp, College Station, TX, USA). Descriptive statistics were calculated to determine the median responses and ranges. Median responses were compared using the Kruskal-Wallis one-way analysis of variance. Qualitative analysis regarding text responses was performed by three reviewers. Responses were received from all specialties (COA 164, CPA 524, CATA 163). There were significant differences in the perceived quality of communication by quantitative and qualitative analysis (p < 0.001). Analysis of communication within practice patterns of stand-alone versus collaborative revealed improved perception of communication quality with increased contact. 65.6% of responders that practiced as stand-alone had a negative view of interprofessional communication. 48.4% of responders in a collaborative practice had a positive view of interprofessional communication. Analysis of the preferred form of communication found that orthopedic surgeons felt the most useful referral information was a pre-printed consult sheet (odds ratio [OR] = 1.56, p < 0.001), whereas therapists were more likely to rank consult notes (OR = 1.27, p < 0.042) and operative reports (OR = 1.20, p < 0.092) as a more useful form of communication. Collaborative practice shows improved perceptions of communication between specialties. Orthopedic surgeons perceive a higher quality of communication than therapists. Therapists and orthopedic surgeons also do not agree on the information that should be relayed between the specialties regarding postoperative rehabilitation.

Usefulness of Interprofessional Education (Tsurumai-Meijo IPE) in Program Collaborating with Simulated Patients.

PubMed

Goto, Aya; Hanya, Manako; Yoshimi, Akira; Uchida, Mizuki; Takeuchi, Saori; Aida, Nobuko; Suematsu, Mina; Abe, Keiko; Yasui, Hiroki; Kamei, Hiroyuki; Noda, Yukihiro

2017-01-01

Collaboration with multiple healthcare professionals is important to provide safer and higher quality care. Interprofessional education (IPE) promotes the practice of team-based care. The establishment of Tsurumai-Meijo IPE, including interprofessional education and practice (IPEP) and video-teaching materials, was conducted in collaboration with school of medicine/nursing in Nagoya University and Fujita Health University, because Meijo University does not have its own clinical settings and faculties except for pharmacy. In the established Tsurumai-Meijo IPE, pharmacy, medicine, and nursing students interviewed simulated patients (SP) together or separately and practiced team-based care through Tsurumai-Meijo IPEP. Students could learn in advance and on their own about each professional's knowledge related to patient care by using video-teaching materials from the Meijo IPE homepage. Using a questionnaire survey at the end of program, this study was examined whether Tsurumai-Meijo IPEP, and video-teaching materials were useful for understanding importance of team-based care. More than 83% of students indicated that Tsurumai-Meijo IPE is useful on future clinical practice. This suggests that the program and materials are beneficial to the medical student education. In the optional survey of some clinical pharmacists, who had participated in Tsurumai-Meijo IPE before graduation, they utilized it in their work and it facilitated their work related to team-based care. Tsurumai-Meijo IPE collaborating with SP is likely to contribute to provide high quality and safe team-based care by taking advantage of specialized professional ability of healthcare professionals.

Content and cultural validity in the development of the Indigenous Play Partner Scale.

PubMed

Dender, Alma M; Stagnitti, Karen E

2017-08-01

Culturally relevant assessments of Australian Indigenous children's social pretend play do not exist. This study investigated the content validity and cultural validity of the Indigenous Play Partner Scale (I-PPS). Six pairs of children (i.e. 12 children) aged four-six years from a remote Australian town were videoed playing in pairs, and 14 community elders and mothers participated across three focus groups. The social interactions between the children were transcribed from the videos. Nineteen verbs, grouped into five categories of social interaction, described the social interactions between the pairs of children. The descriptions of the social interaction verbs were presented to the community elders and mothers in a focus group. The themes from the focus groups were 'background of Indigenous understanding of play' and 'proposed social interaction verbs'. The first theme reflected community collaboration, children playing in multi-aged groups and the role of older children within the play. Guided by the focus group discussion, the videos were re-analysed and 20 social interaction verbs were described that reflected the cultural context of play. The content and cultural validity of the I-PPS was established through community consultation. Twenty social interaction verbs, which form the basis of the items of the I-PPS, reflected Indigenous cultural values of being non-judgemental of Indigenous children's social interactions during pretend play. Culturally relevant assessments for Australian Indigenous children do not disadvantage this population group and are essential for practice in occupational therapy. © 2017 Occupational Therapy Australia.

Bridging the gap: enhancing interprofessional education using simulation.

PubMed

Robertson, James; Bandali, Karim

2008-10-01

Simulated learning and interprofessional education (IPE) are increasingly becoming more prevalent in health care curriculum. As the focus shifts to patient-centred care, health professionals will need to learn with, from and about one another in real-life settings in order to facilitate teamwork and collaboration. The provision of simulated learning in an interprofessional environment helps replicate these settings thereby providing the traditional medical education model with opportunities for growth and innovation. Learning in context is an essential psychological and cognitive aspect of education.This paper offers a conceptual analysis of the salient issues related to IPE and medical simulation. In addition, the paper argues for the integration of simulation into IPE in order to develop innovative approaches for the delivery of education and improved clinical practice that may benefit students and all members of the health care team.

Disseminating Comparative Effectiveness Research Through Community-based Experiential Learning.

PubMed

Hansen, Richard A; Williamson, Margaret; Stevenson, Lynn; Davis, Brandy R; Evans, R Lee

2017-02-25

Objectives. To launch and evaluate a comparative effectiveness research education and dissemination program as part of an introductory pharmacy practice experience (IPPE). Methods. First- through third-year PharmD students received training on comparative effectiveness research and disseminated printed educational materials to patients in the community who they were monitoring longitudinally (n=314). Students completed an assessment and initial visit documentation form at the first visit, and a follow-up assessment and documentation form at a subsequent visit. Results. Twenty-three diabetes patients, 29 acid-reflux patients, 30 osteoarthritis patients, and 50 hypertension patients received materials. Aside from the patient asking questions, which was the most common outcome (n=44), the program resulted in 38 additional actions, which included stopping, starting, or changing treatments or health behaviors, or having additional follow-up or diagnostic testing. Small but positive improvements in patient understanding, confidence, and self-efficacy were observed. Conclusions. Dissemination of comparative effectiveness research materials in an IPPE program demonstrated a positive trend in markers of informed decision-making.

Evaluating students' perceptions of an interprofessional problem-based pilot learning project.

PubMed

Eccott, Lynda; Greig, Alison; Hall, Wendy; Lee, Michael; Newton, Christie; Wood, Victoria

2012-01-01

Interprofessional teams provide the promise of effective, comprehensive and reliable care. Interprofessional education (IPE) promotes students' knowledge and attitudes to support interprofessional teamwork, and problem-based learning formats enable students to gain valuable teamwork experience. To design, implement, and evaluate an interprofessional problem-based learning module in a large Canadian university focusing on the effects of this format on students' knowledge, attitudes, and perceptions. A pre-post mixed-methods research design was used, with a convenience sample of 24 students from medicine, pharmacy, nursing, physical therapy, and occupational therapy. Participants in the module were divided into 5 teams composed of one member from each discipline. Pre-tests were delivered just prior to module participation and post-tests directly followed. Students also participated in focus groups to provide feedback about module content, process, outcomes, and practical considerations. Students' attitudes toward interprofessional teamwork improved from baseline to post-intervention. Mean differences were significant using paired t-tests on confidence in professional role (p <0.001), communication (p = 0.02), understanding roles of others (p = 0.002), identification with the team (p = 0.002), comfort with members (p = 0.047), cooperation with team members (p = 0.004), team perceptions (p = 0.04), decision-making (p <0.001), team efficiency (p <0.001), minimal conflict (p = 0.04), and group contributions (p = 0.03). Focus group themes indicated students were satisfied with the module, perceived increased knowledge about roles and perspectives, greater confidence to collaborate, and increased motivation to engage in intra-curricular IPE. The timing of their exposure within their respective educational programs was identified as important.

Exercise physiologists: essential players in interdisciplinary teams for noncommunicable chronic disease management.

PubMed

Soan, Esme J; Street, Steven J; Brownie, Sharon M; Hills, Andrew P

2014-01-01

Noncommunicable diseases (NCDs), such as obesity and type 2 diabetes mellitus, are a growing public health challenge in Australia, accounting for a significant and increasing cost to the health care system. Management of these chronic conditions is aided by interprofessional practice, but models of care require updating to incorporate the latest evidence-based practice. Increasing research evidence reports the benefits of physical activity and exercise on health status and the risk of inactivity to chronic disease development, yet physical activity advice is often the least comprehensive component of care. An essential but as yet underutilized player in NCD prevention and management is the "accredited exercise physiologist," a specialist in the delivery of clinical exercise prescriptions for the prevention or management of chronic and complex conditions. In this article, the existing role of accredited exercise physiologists in interprofessional practice is examined, and an extension of their role proposed in primary health care settings.

Hot topic: Changes in angiotensin-converting enzyme inhibition and concentrations of the tripeptides Val-Pro-Pro and Ile-Pro-Pro during ripening of different Swiss cheese varieties.

PubMed

Meyer, J; Bütikofer, U; Walther, B; Wechsler, D; Sieber, R

2009-03-01

The angiotensin-converting enzyme (ACE) inhibitory activity and the concentration of the 2 ACE-inhibiting tripeptides Val-Pro-Pro (VPP) and Ile-Pro-Pro (IPP) were studied during cheese ripening in 7 Swiss cheese varieties. The semi-hard cheeses Tilsiter, Appenzeller 1/4 fat, Tête de Moine, and Vacherin fribourgeois and the extra-hard and hard cheeses Berner Hobelkäse, Le Gruyère, and Emmentaler were investigated. Three loaves of each variety manufactured in different cheese factories were purchased at the beginning of commercial ripeness and investigated at constant intervals until the end of the usual sale period. Good agreement was found between ACE-inhibitory activity and the total concentration of VPP and IPP at advanced ripening stages. In most of the investigated varieties ACE-inhibitory activity and the concentration of the 2 tripeptides initially increased during the study period. A decline in the concentration of VPP and IPP was obtained toward the end of the investigated period for Tilsiter and Gruyère. The ratio of VPP/IPP decreased during ripening in all varieties with the exception of Emmentaler. However, large variations were observed among the cheese varieties as well as the individual loaves of the same variety. Chemical characterization of the investigated cheeses revealed that qualitative differences in the proteolysis pattern, not quantitative differences in the degree of proteolysis, are responsible for the observed variations in the concentrations of VPP and IPP. The presence of Lactobacillus helveticus in the starter culture was associated with elevated concentrations of VPP and IPP. The results of the present study show that concentrations of VPP and IPP above 100 mg/kg are attainable in semi-hard cheese varieties after ripening periods of about 4 to 7 mo and that stable concentrations of the 2 antihypertensive tripeptides can be expected over several weeks of cheese ripening.

Evidence for the Involvement of Acid/Base Chemistry in the Reaction Catalyzed by the Type II Isopentenyl Diphosphate/Dimethylallyl Diphosphate Isomerase from Staphylococcus aureus†

PubMed Central

Thibodeaux, Christopher J.; Mansoorabadi, Steven O.; Kittleman, William; Chang, Wei-chen; Liu, Hung-wen

2011-01-01

The type II isopentenyl diphosphate/dimethylallyl diphosphate isomerase (IDI-2) is a flavin mononucleotide (FMN)-dependent enzyme that catalyzes the reversible isomerization of isopentenyl pyrophosphate (IPP) to dimethylallyl pyrophosphate (DMAPP), a reaction with no net change in redox state of the coenzyme or substrate. Here, UV-vis spectral analysis of the IDI-2 reaction revealed the accumulation of a reduced neutral dihydroflavin intermediate when the reduced enzyme was incubated with IPP or DMAPP. When IDI-2 was reconstituted with 1-deazaFMN and 5-deazaFMN, similar reduced neutral forms of the deazaflavin analogues were observed in the presence of IPP. Single turnover stopped-flow absorbance experiments indicated that this flavin intermediate formed and decayed at kinetically competent rates in the pre-steady-state and, thus, most likely represents a true intermediate in the catalytic cycle. UV-vis spectra of the reaction mixtures reveal trace amounts of a neutral semiquinone, but evidence for the presence of IPP-based radicals could not be obtained by EPR spectroscopy. Rapid-mix chemical quench experiments show no burst in DMAPP formation, suggesting that the rate determining step in the forward direction (IPP to DMAPP) occurs prior to DMAPP formation. A solvent deuterium kinetic isotope effect (D2OVmax = 1.5) was measured on vo in steady-state kinetic experiments at saturating substrate concentrations. A substrate deuterium kinetic isotope effect was also measured on the initital velocity (DVmax = 1.8) and on the decay rate of the flavin intermediate (Dks = 2.3) in single-turnover stopped-flow experiments using (R)-[2-2H]-IPP. Taken together, these data suggest that the C2–H bond of IPP is cleaved in the rate determining step and that general acid/base catalysis may be involved during turnover. Possible mechanisms for the IDI-2 catalyzed reaction are presented and discussed in terms of the available X-ray crystal structures. PMID:18229948

Influence of Ice-phase of Hydrometeors on Moist-Convection

NASA Technical Reports Server (NTRS)

Sud, Y. C.; Walker, G. K.

2003-01-01

Climate models often ignore the influence of ice-phase physics (IPP) of hydrometeors as a second order effect. This has also been true for McRAS (Microphysics of clouds with Relaxed Arakawa Schubert Scheme) developed by the authors. Recognizing that the temperature sounding is critical for moist-convection, and, that IPP would modify it, we investigated the influence of introducing IPP into McRAS coupled to FvGCM (finite volume General Circulation Model with NCAR physics). We analyzed three 3-yr long simulations; the first called Control Case, CC and had no IPP; the other two called Experiments El and E2 had IPP introduced with two different in-cloud freezing assumptions. Simulation El assumed that all hydrometeors remain liquid in the updraft and freeze upon detrainment. Simulation E2 invoked the in-cloud freezing of new condensate generated at subfreezing temperatures in the updraft while old cloud water continued to ascend as liquid. Upon detrainment, this cloud water also froze like in E1. With these assumptions, about 50% of hydrometeors froze in the tower and the rest froze in the anvil. However, in both El and E2, the frozen hydrometeors melted during fall at the first encounter of above freezing ambient temperature. Comparative analysis revealed that El simulated far more mid-level and far less deep clouds while E2 had modified deep and more mid-level clouds as compared to CC along with some major changes around the melt-level. We infer that IPP produced a more realistic response in E2. At the basic level, the results show that ice-phase processes influence convective detrainment at mid- and deep levels in accord with TOGAGOARE observations. The results suggest that IPP can help to mitigate less-than-observed mid-level and over-abundance of deep convective clouds in McRAS.

The melt-recrystallization behavior of highly oriented α-iPP fibers embedded in a HIPS matrix.

PubMed

Ye, Liwei; Li, Huihui; Qiu, Zhaobin; Yan, Shouke

2015-03-21

The melt-recrystallization behavior of α-iPP fibers embedded in an amorphous HIPS matrix has been studied by means of optical microscopy. The amorphous HIPS serving as a supporter of iPP fibers does not become involved in the nucleation and crystallization process of the molten highly oriented iPP fibers. It also does not provide any birefringence under the optical microscope with crossed polarizers. This enables the study of orientation-induced β-iPP crystallization through a control of the melting status of the fibers. Through melting the fibers at different temperatures above 175 °C and subsequent recrystallization, some β-iPP crystals were always produced. The content of the β-iPP crystal depends strongly on the melting temperature and melting time of the iPP fibers. It was confirmed that melting the iPP fibers at relatively lower temperature, e.g. 176 °C, less amount of β-iPP crystals were observed. The content of β-iPP crystal enhances first with increasing melting temperature and then decreases with further increase of the fiber melting temperature. The β-iPP crystallization is found to be most favorable upon melting the fibers at 178 °C for 2 min. This demonstrates the requirement of a certain chain or chain segment orientation for generating β-iPP crystallization on the one hand, while higher orientation of the iPP chains or chain segments encourages the growth of iPP crystals in the α-form on the other hand. This has been further confirmed by varying the melting time of the fiber at different temperatures, since relaxation of the iPP molecular chains at a fixed temperature is time dependent. Moreover, the complete transformation of α-iPP fibers in some local places into β-iPP crystals implies that the αβ-transition may not be required for the orientation-induced β-iPP crystallization.

Association between metabolic syndrome and intravesical prostatic protrusion in patients with benign prostatic enlargement and lower urinary tract symptoms (MIPS Study).

PubMed

Russo, Giorgio I; Regis, Federica; Spatafora, Pietro; Frizzi, Jacopo; Urzì, Daniele; Cimino, Sebastiano; Serni, Sergio; Carini, Marco; Gacci, Mauro; Morgia, Giuseppe

2018-05-01

To investigate the association between metabolic syndrome (MetS) and morphological features of benign prostatic enlargement (BPE), including total prostate volume (TPV), transitional zone volume (TZV) and intravesical prostatic protrusion (IPP). Between January 2015 and January 2017, 224 consecutive men aged >50 years presenting with lower urinary tract symptoms (LUTS) suggestive of BPE were recruited to this multicentre cross-sectional study. MetS was defined according to International Diabetes Federation criteria. Multivariate linear and logistic regression models were performed to verify factors associated with IPP, TZV and TPV. Patients with MetS were observed to have a significant increase in IPP (P < 0.01), TPV (P < 0.01) and TZV (P = 0.02). On linear regression analysis, adjusted for age and metabolic factors of MetS, we found that high-density lipoprotein (HDL) cholesterol was negatively associated with IPP (r = -0.17), TPV (r = -0.19) and TZV (r = -0.17), while hypertension was positively associated with IPP (r = 0.16), TPV (r = 0.19) and TZV (r = 0.16). On multivariate logistic regression analysis adjusted for age and factors of MetS, hypertension (categorical; odds ratio [OR] 2.95), HDL cholesterol (OR 0.94) and triglycerides (OR 1.01) were independent predictors of TPV ≥ 40 mL. We also found that HDL cholesterol (OR 0.86), hypertension (OR 2.0) and waist circumference (OR 1.09) were significantly associated with TZV ≥ 20 mL. On age-adjusted logistic regression analysis, MetS was significantly associated with IPP ≥ 10 mm (OR 34.0; P < 0.01), TZV ≥ 20 mL (OR 4.40; P < 0.01) and TPV ≥ 40 mL (OR 5.89; P = 0.03). We found an association between MetS and BPE, demonstrating a relationship with IPP. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

Inter-professional education of prospective speech-language therapists and primary school teachers through shared professional practice placements.

PubMed

Wilson, Leanne; McNeill, Brigid; Gillon, Gail T

2017-07-01

Preliminary studies of inter-professional education (IPE) among student speech-language therapists (SLTs) and student teachers suggest that workshop-based applications are beneficial in preparing participants for elements of collaborative practice. Situating IPE within the students' professional practice placements may provide another useful avenue to develop attitudes, knowledge and skills for inter-professional collaboration. Research examining the impact of different approaches to IPE is required to advance our understanding of effective design and evaluation of such initiatives. To understand how student SLTs and student teachers develop competency for collaborative practice when co-working during professional practice placements to support children's speech and literacy development. A case study design was used to monitor the impact of the IPE. Student SLTs (n = 4) were paired with student teachers (n = 4) to participate in shared professional practice placements in junior school classrooms. An inductive thematic analysis of interviews conducted with participants after the IPE was employed to explore the development of competencies in collaborative practice. Change in inter-disciplinary knowledge and perceptions over the IPE was evaluated via survey to further explore the development of collaborative competencies. Integration of qualitative and quantitative findings suggested that participants began to develop four broad areas of collaborative competency: understanding of professional roles and expertise, communication skills to support shared decision-making, inter-dependency in supporting children's learning, and flexibility to implement alternative instructional practices. Interview analysis also revealed factors related to the facilitators and learning contexts that supported and/or limited the collaboration between participants. Shared placement experiences between student SLTs and student teachers may be an effective method for building participants' competencies in multiple aspects of collaborative practice. Active facilitation by both SLT and classroom teacher supervisors alongside careful consideration of learning contexts (e.g., classroom structure) will help to ensure that learning is maximized for prospective professionals. © 2016 Royal College of Speech and Language Therapists.

Nursing practice and work environment issues in the 21st century: a leadership challenge.

PubMed

Manojlovich, Milisa; Barnsteiner, Jane; Bolton, Linda Burnes; Disch, Joanne; Saint, Sanjay

2008-01-01

A leadership conference titled "Have Patient Safety and the Workforce Shortage Created the Perfect Storm?" was held in honor of Dr. Ada Sue Hinshaw, who was ending her tenure as dean of the University of Michigan School of Nursing. A morning panel on the preferred future for practice featured plenary speaker Dr. Linda Burnes Bolton and participating panelists Dr. Sanjay Saint, Dr. Jane Barnsteiner, and Dr. Joanne Disch. Each speaker presented a unique yet complementary perspective, with several common themes permeating the morning's presentations. For example, all of the speakers mentioned how important interprofessional collaboration is to promoting patient safety. The themes can be categorized broadly as nursing practice and work environment issues, with subthemes of interprofessional communication and collaboration, systems solutions to patient safety problems, and future directions in nursing education. A synopsis of comments made during the morning practice panel and empirical support for the themes and subthemes identified by panelists are provided in this article.

Education of advanced practice nurses in Canada.

PubMed

Martin-Misener, Ruth; Bryant-Lukosius, Denise; Harbman, Patricia; Donald, Faith; Kaasalainen, Sharon; Carter, Nancy; Kilpatrick, Kelley; DiCenso, Alba

2010-12-01

In Canada, education programs for the clinical nurse specialist (CNS) and nurse practitioner (NP) roles began 40 years ago. NP programs are offered in almost all provinces. Education for the CNS role has occurred through graduate nursing programs generically defined as providing preparation for advanced nursing practice. For this paper, we drew on pertinent sections of a scoping review of the literature and key informant interviews conducted for a decision support synthesis on advanced practice nursing to describe the following: (1) history of advanced practice nursing education in Canada, (2) current status of advanced practice nursing education in Canada, (3) curriculum issues, (4) interprofessional education, (5) resources for education and (6) continuing education. Although national frameworks defining advanced nursing practice and NP competencies provide some direction for education programs, Canada does not have countrywide standards of education for either the NP or CNS role. Inconsistency in the educational requirements for primary healthcare NPs continues to cause significant problems and interferes with inter-jurisdictional licensing portability. For both CNSs and NPs, there can be a mismatch between a generalized education and specialized practice. The value of interprofessional education in facilitating effective teamwork is emphasized. Recommendations for future directions for advanced practice nursing education are offered.

Role of isopentenyl-diphosphate isomerase in heterologous cyanobacterial (Synechocystis) isoprene production.

PubMed

Chaves, Julie E; Romero, Paloma Rueda; Kirst, Henning; Melis, Anastasios

2016-12-01

Heterologous production of isoprene (C 5 H 8 ) hydrocarbons in cyanobacteria, emanating from sunlight, CO 2 , and water, is now attracting increasing attention. The concept entails application of an isoprene synthase transgene from terrestrial plants, heterologously expressed in cyanobacteria, aiming to reprogram carbon flux in the terpenoid biosynthetic pathway toward formation and spontaneous release of this volatile chemical from the cell and liquid culture. However, flux manipulations and carbon-partitioning reactions between isoprene (the product) and native terpenoid biosynthesis for cellular needs are not yet optimized for isoprene yield. The primary reactant for isoprene biosynthesis is dimethylallyl diphosphate (DMAPP), whereas both DMAPP and its isopentenyl diphosphate (IPP) isomer are needed for cellular terpenoid biosynthesis. The present work addressed the function of an isopentenyl diphosphate (IPP) isomerase in cyanobacteria and its role in carbon partitioning between IPP and DMAPP, both of which serve, in variable ratios, as reactants for the synthesis of different cellular terpenoids. The work was approached upon the heterologous expression in Synechocystis of the "isopentenyl diphosphate isomerase" gene (FNI) from Streptococcus pneumoniae, using isoprene production as a "reporter process" for substrate partitioning between DMAPP and IPP. It is shown that transgenic expression of the FNI gene in Synechocystis resulted in a 250 % increase in the "reporter isoprene" rate and yield, suggesting that the FNI isomerase shifted the endogenous DMAPP-IPP steady-state pool size toward DMAPP, thereby enhancing rates and yield of isoprene production. The work provides insight into the significance and functional role of the IPP isomerase in these photosynthetic microorganisms.

Professional groups driving change toward patient-centred care: interprofessional working in stroke rehabilitation in Denmark.

PubMed

Burau, Viola; Carstensen, Kathrine; Lou, Stina; Kuhlmann, Ellen

2017-09-16

Patient-centred care based on needs has been gaining momentum in health policy and the workforce. This creates new demand for interprofessional teams and redefining roles and tasks of professionals, yet little is known on how to implement new health policies more effectively. Our aim was to analyse the role and capacity of health professions in driving organisational change in interprofessional working and patient-centred care. A case study of the introduction of interprofessional, early discharge teams in stroke rehabilitation in Denmark was conducted with focus on day-to-day coordination of care tasks and the professional groups' interests and strategies. The study included 5 stroke teams and 17 interviews with different health professionals conducted in 2015. Professional groups expressed highly positive professional interest in reorganised stroke rehabilitation concerning patients, professional practice and intersectoral relations; individual professional and collective interprofessional interests strongly coincided. The corresponding strategies were driven by a shared goal of providing needs-based care for patients. Individual professionals worked independently and on behalf of the team. There was also a degree of skills transfer as individual team members screened patients on behalf of other professional groups. The study identified supportive factors and contexts of patient-centred care. This highlights capacity to improve health workforce governance through professional participation, which should be explored more systematically in a wider range of healthcare services.

The perceived quality of interprofessional teamwork in an intensive care unit: A single centre intervention study.

PubMed

Van den Bulcke, Bo; Vyt, Andre; Vanheule, Stijn; Hoste, Eric; Decruyenaere, Johan; Benoit, Dominique

2016-05-01

This article describes a study that evaluated the quality of teamwork in a surgical intensive care unit and assessed whether teamwork could be improved significantly through a tailor-made intervention. The quality of teamwork prior to and after the intervention was assessed using the Interprofessional Practice and Education Quality Scales (IPEQS) using the PROSE online diagnostics and documenting system, which assesses three domains of teamwork: organisational factors, care processes, and team members' attitudes and beliefs. Furthermore, team members evaluated strengths and weaknesses of the teamwork through open-ended questions. Information gathered by means of the open questions was used to design a tailor-made 12-week intervention consisting of (1) optimising the existing weekly interdisciplinary meetings with collaborative decision-making and clear communication of goal-oriented actions, including the psychosocial aspects of care; and (2) organising and supporting the effective exchange of information over time between all professions involved. It was found that the intervention had a significant impact on organisational factors and care processes related to interprofessional teamwork for the total group and within all subgroups, despite baseline differences between the subgroups in interprofessional teamwork. In conclusion, teamwork, and more particularly the organisational aspects of interprofessional collaboration and processes of care, can be improved by a tailor-made intervention that takes into account the professional needs of healthcare workers.

The Application of Informatics in Delineating the Proof of Concept for Creating Knowledge of the Value Added by Interprofessional Practice and Education

PubMed Central

Cerra, Frank; Pacala, James; Brandt, Barbara F.; Lutfiyya, May Nawal

2015-01-01

The resurgence of interest in the promise of interprofessional education and collaborative practice (IPECP) to positively impact health outcomes, requires the collection of appropriate data that can be analyzed and from which information and knowledge linking IPECP interventions to improved health outcomes might be produced and reported to stakeholders such as health systems, policy makers and regulators, payers, and accreditation agencies. To generate such knowledge the National Center for Interprofessional Practice and Education at the University of Minnesota has developed three strategies, the first two of which are: (1) creating an IPECP research agenda, and (2) a national Nexus Innovation Network (NIN) of intervention projects that are generating data that are being input and housed in a National Center Data Repository (NCDR). In this paper, the informatics platform supporting the work of these first two strategies is presented as the third interconnected strategy for knowledge generation. The proof of concept for the informatics strategy is developed in this paper by describing: data input from the NIN into the NCDR, the linking and merging of those data to produce analyzable data files that incorporate institutional and individual level data, and the production of meaningful analyses to create and provide relevant information and knowledge. This paper is organized around the concepts of data, information and knowledge—the three conceptual foundations of informatics. PMID:27417818

Fostering interprofessional learning in a rehabilitation setting: development of an interprofessional clinical learning unit.

PubMed

Vanderzalm, Jeanne; Hall, Mark D; McFarlane, Lu-Anne; Rutherford, Laurie; Patterson, Steven K

2013-01-01

The development and implementation of interprofessional (IP) clinical learning units as a method to enhance IP clinical education and improve patient care in a rehabilitation setting are described. Using a community-based participatory research approach, academia and healthcare delivery agencies formed a partnership to create an IP clinical learning unit in a rehabilitation setting. Preimplementation data from surveys and focus group data identified areas for improvement to enhance IP understanding and collaboration. A working group developed and implemented initiatives to enhance IP practice. Preimplementation, eight themes emerged from which the working group identified goals and implemented strategies to strengthen IP learning. Goals included Creation of an IP Learning Environment, Increased Awareness of IP Practice, Role Clarification, Enhanced IP Communication, and Reflection and Evaluation. Postimplementation data revealed six themes: Communication, Informal IP Learning, Role Awareness, Positive Learning Environment, Logistics, and Challenges. The development of the IP clinical learning unit was successful and rewarding, but not without its challenges. Formal IP education was necessary to enhance collaborative practice, even in a multidisciplinary environment. Commitment and support from all participants, particularly managers and administrators from the healthcare agency, were critical to success. The focus of this unit was on a stroke rehabilitation unit; however, the development and implementation principles identified may be applicable to any team-based clinical setting. © 2013 Association of Rehabilitation Nurses.

Identifying facilitators and barriers for implementation of interprofessional education: Perspectives from medical educators in the Netherlands.

PubMed

de Vries-Erich, Joy; Reuchlin, Kirsten; de Maaijer, Paul; van de Ridder, J M Monica

2017-03-01

Patient care and patient safety can be compromised by the lack of interprofessional collaboration and communication between healthcare providers. Interprofessional education (IPE) should therefore start during medical training and not be postponed until after graduation. This case study explored the current situation in the Dutch context and interviewed experts within medical education and with pioneers of successful best practices to learn more about their experiences with IPE. Data analysis started while new data were still collected, resulting in an iterative, constant comparative process. Using a strengths, weaknesses, opportunities, and threats (SWOT) analysis framework, we identified barriers and facilitators such as lack of a collective professional language, insufficient time or budget, stakeholders' resistance, and hierarchy. Opportunities and strengths identified were developing a collective vision, more attention for patient safety, and commitment of teachers. The facilitators and barriers relate to the organisational level of IPE and the educational content and practice. In particular, communication, cohesiveness, and support are influenced by these facilitators. An adequate identification of the SWOT elements in the current situation could prove beneficial for a successful implementation of IPE within the healthcare educational system.

New national curricula guidelines that support the use of interprofessional education in the Brazilian context: An analysis of key documents.

PubMed

Freire Filho, José Rodrigues; Viana Da Costa, Marcelo; Forster, Aldaísa Cassanho; Reeves, Scott

2017-11-01

The National Curricular Guidelines (NCGs) are important documents for understanding the history of academic health professions education in Brazil. Key policies within the NCGs have helped to reorient health professions education and have stimulated curricular changes, including active learning methodologies and more integrated teaching-service environments, and, more recently, have introduced interprofessional education (IPE) in both undergraduate and postgraduate sectors. This article presents the findings of a study that examined the NCGs for nursing, dentistry, and medicine courses as juridical foundations for adopting strategies that promote IPE across higher education institutions in Brazil. We employed a comparative and exploratory documentary analysis to understand the role of IPE and collaborative practices in NCGs for the three largest professions in Brazil. Following a thematic analysis of these texts, four key themes emerged: faculty development; competencies for teamwork; curricular structure; and learning metrics. Key findings related to each of these themes are presented and discussed in relation to the wider interprofessional literature. The article goes on to argue that the statements contained in the NCGs about adoption of IPE and collaborative practices will have an important influence in shaping the future of health professions education in Brazil.

Impact of an interprofessional rural health care practice education experience on students and communities.

PubMed

Charles, Grant; Bainbridge, Lesley; Copeman-Stewart, Kathy; Kassam, Rosemin; Tiffin, Shelly

2008-01-01

The Interprofessional Rural Program of British Columbia (IRPBC) was established in 2003 as a pilot program aimed at supporting the recruitment of health and human service professionals to rural communities in British Columbia, Canada. The program was designed to expose students in the health and human service professions to rural communities and to assess whether this exposure increased the likelihood of their return to work in nonurban settings once they completed their studies. The initial qualitative evaluation of IRPBC was conducted via individual interviews in the first year and written questionnaires in the second year. In general, IRPBC was perceived by the participants to have had a significant impact on the students and communities. The students who participated in it benefited not only from the chance to engage in rural practice but also from the opportunity to interact within an interprofessional context; and the communities participating in the program profited from enhanced health care and the possibility of attracting new practitioners from these students. Exposure to new ways of providing service and the impact that the introduction of teams of passionate students can have on both practitioners and small communities have greatly enriched the broader communities.