Role construction and boundaries in interprofessional primary health care teams: a qualitative study.

PubMed

MacNaughton, Kate; Chreim, Samia; Bourgeault, Ivy Lynn

2013-11-24

The move towards enhancing teamwork and interprofessional collaboration in health care raises issues regarding the management of professional boundaries and the relationship among health care providers. This qualitative study explores how roles are constructed within interprofessional health care teams. It focuses on elucidating the different types of role boundaries, the influences on role construction and the implications for professionals and patients. A comparative case study was conducted to examine the dynamics of role construction on two interprofessional primary health care teams. The data collection included interviews and non-participant observation of team meetings. Thematic content analysis was used to code and analyze the data and a conceptual model was developed to represent the emergent findings. The findings indicate that role boundaries can be organized around interprofessional interactions (giving rise to autonomous or collaborative roles) as well as the distribution of tasks (giving rise to interchangeable or differentiated roles). Different influences on role construction were identified. They are categorized as structural (characteristics of the workplace), interpersonal (dynamics between team members such as trust and leadership) and individual dynamics (personal attributes). The implications of role construction were found to include professional satisfaction and more favourable wait times for patients. A model that integrates these different elements was developed. Based on the results of this study, we argue that autonomy may be an important element of interprofessional team functioning. Counter-intuitive as this may sound, we found that empowering team members to develop autonomy can enhance collaborative interactions. We also argue that while more interchangeable roles could help to lessen the workloads of team members, they could also increase the potential for power struggles because the roles of various professions would become less differentiated. We consider the conceptual and practical implications of our findings and we address the transferability of our model to other interprofessional teams.

Role construction and boundaries in interprofessional primary health care teams: a qualitative study

PubMed Central

2013-01-01

Background The move towards enhancing teamwork and interprofessional collaboration in health care raises issues regarding the management of professional boundaries and the relationship among health care providers. This qualitative study explores how roles are constructed within interprofessional health care teams. It focuses on elucidating the different types of role boundaries, the influences on role construction and the implications for professionals and patients. Methods A comparative case study was conducted to examine the dynamics of role construction on two interprofessional primary health care teams. The data collection included interviews and non-participant observation of team meetings. Thematic content analysis was used to code and analyze the data and a conceptual model was developed to represent the emergent findings. Results The findings indicate that role boundaries can be organized around interprofessional interactions (giving rise to autonomous or collaborative roles) as well as the distribution of tasks (giving rise to interchangeable or differentiated roles). Different influences on role construction were identified. They are categorized as structural (characteristics of the workplace), interpersonal (dynamics between team members such as trust and leadership) and individual dynamics (personal attributes). The implications of role construction were found to include professional satisfaction and more favourable wait times for patients. A model that integrates these different elements was developed. Conclusions Based on the results of this study, we argue that autonomy may be an important element of interprofessional team functioning. Counter-intuitive as this may sound, we found that empowering team members to develop autonomy can enhance collaborative interactions. We also argue that while more interchangeable roles could help to lessen the workloads of team members, they could also increase the potential for power struggles because the roles of various professions would become less differentiated. We consider the conceptual and practical implications of our findings and we address the transferability of our model to other interprofessional teams. PMID:24267663

Student Perceptions of an Interprofessional Educational Experience: The Importance of Goal Articulation

ERIC Educational Resources Information Center

McBride, Jennifer M.; Drake, Richard L.

2015-01-01

The education of future health care professionals must involve activities where interprofessional collaboration and the functioning of interdisciplinary teams are the goals and not the exceptions. This type of interprofessional education (IPE) will benefit students as they will be better able to communicate with and mobilize the skills of other…

Realizing Enhanced Student Interprofessional Education through Clinical Teamwork (RESPECT): An Interprofessional Education Project

ERIC Educational Resources Information Center

Infante, Taline Dadian

2012-01-01

Health professions students have limited exposure to each other during their education and training, yet there are many expectations for their interaction in the workplace as part of functioning health-care teams. Interprofessional education is a mechanism to facilitate teamwork and relationships between health-care professionals by encouraging…

Evidence of collaboration, pooling of resources, learning and role blurring in interprofessional healthcare teams: a realist synthesis.

PubMed

Sims, Sarah; Hewitt, Gillian; Harris, Ruth

2015-01-01

Interprofessional teamwork has become an integral feature of healthcare delivery in a wide range of conditions and services in many countries. Many assumptions are made in healthcare literature and policy about how interprofessional teams function and about the outcomes of interprofessional teamwork. Realist synthesis is an approach to reviewing research evidence on complex interventions which seeks to explore these assumptions. It does this by unpacking the mechanisms of an intervention, exploring the contexts which trigger or deactivate them and connecting these contexts and mechanisms to their subsequent outcomes. This is the second in a series of four papers reporting a realist synthesis of interprofessional teamworking. The paper discusses four of the 13 mechanisms identified in the synthesis: collaboration and coordination; pooling of resources; individual learning; and role blurring. These mechanisms together capture the day-to-day functioning of teams and the dependence of that on members' understanding each others' skills and knowledge and learning from them. This synthesis found empirical evidence to support all four mechanisms, which tentatively suggests that collaboration, pooling, learning, and role blurring are all underlying processes of interprofessional teamwork. However, the supporting evidence for individual learning was relatively weak, therefore there may be assumptions made about learning within healthcare literature and policy that are not founded upon strong empirical evidence. There is a need for more robust research on individual learning to further understand its relationship with interprofessional teamworking in healthcare.

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.

Interprofessional team building in the palliative home care setting: Use of a conceptual framework to inform a pilot evaluation.

PubMed

Shaw, James; Kearney, Colleen; Glenns, Brenda; McKay, Sandra

2016-01-01

Home-based palliative care is increasingly dependent on interprofessional teams to deliver collaborative care that more adequately meets the needs of clients and families. The purpose of this pilot evaluation was to qualitatively explore the views of an interprofessional group of home care providers (occupational therapists, nurses, personal support work supervisors, community care coordinators, and a team coordinator) regarding a pilot project encouraging teamwork in interprofessional palliative home care services. We used qualitative methods, informed by an interprofessional conceptual framework, to analyse participants' accounts and provide recommendations regarding strategies for interprofessional team building in palliative home health care. Findings suggest that encouraging practitioners to share past experiences and foster common goals for palliative care are important elements of team building in interprofessional palliative care. Also, establishing a team leader who emphasises sharing power among team members and addressing the need for mutual emotional support may help to maximise interprofessional teamwork in palliative home care. These findings may be used to develop and test more comprehensive efforts to promote stronger interprofessional teamwork in palliative home health care delivery.

Team Development Measure in Interprofessional Graduate Education: A Pilot Study.

PubMed

Beebe, Lora Humphrey; Roman, Marian; Skolits, Gary; Raynor, Hollie; Thompson, Dixie; Franks, Andrea

2018-04-01

A faculty team developed the 4-week Recovery-Based Interprofessional Distance Education (RIDE) rotation for graduate students in their disciplines. The evaluation team identified the Team Development Measure (TDM) as a potential alternative to reflect team development during the RIDE rotation. The TDM, completed anonymously online, was piloted on the second student cohort (N = 18) to complete the RIDE rotation. The overall pretest mean was 60.73 points (SD = 11.85) of a possible 100 points, indicating that students anticipated their RIDE team would function at a moderately high level during the 4-week rotation. The overall posttest mean, indicating student perceptions of actual team functioning, was 72.71 points (SD = 23.31), an average increase of 11.98 points. Although not statistically significant, Cohen's effect size (d = 0.43) indicates an observed difference of large magnitude. No other published work has used the TDM as a pre-/posttest measure of team development. The authors believe the TDM has several advantages as a measure of student response to interprofessional education offerings, particularly in graduate students with prior experience on health care teams. Further work is needed to validate and extend the findings of this pilot study. [Journal of Psychosocial Nursing and Mental Health Services, 56(4), 18-22.]. Copyright 2018, SLACK Incorporated.

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.

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.

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.

Interprofessional Care and Role of Team Leaders.

PubMed

Kaini, B K

2015-01-01

Interprofessional care is an essential part of the health service delivery system. It helps to achieve improved care and to deliver the optimal and desired health outcomes by working together, sharing and learning skills. Health care organisation is a collective sum of many leaders and followers. Successful delivery of interprofessional care relies on the contribution of interprofessional care team leaders and health care professionals from all groups. The role of the interprofessional care team leader is vital to ensuring continuity and consistency of care and to mobilise and motivate health care professionals for the effective delivery of health services. Medical professionals usually lead interprofessional care teams. Interprofessional care leaders require various skills and competencies for the successful delivery of interprofessional care.

Designing and Evaluating an Interprofessional Experiential Course Series Involving Medical and Pharmacy Students

PubMed Central

Dueñas, Gladys G.; Zanoni, Aileen; Grover, Anisha B.

2016-01-01

Objective. To prepare first-year and second-year pharmacy and medical students to build effective collaborative health care teams by participating in an interprofessional experiential 6-semester course series. Design. An interprofessional experiential course series was designed using a variety of teaching methods to achieve both interprofessional and experiential learning outcomes. A standardized objective behavioral assessment was developed to measure team performance of interprofessional communication and teamwork. In addition, student perceptions were measured using a validated instrument. Assessment. A majority of teams demonstrated appropriate competence with respect to interprofessional communication and teamwork. Additionally, a majority of students expressed positive perceptions of interprofessional collaboration with respect to teamwork, roles and responsibilities, and patient outcomes. Conclusion. An interprofessional experiential course series can be successfully implemented to achieve both interprofessional and experiential learning outcomes. Highly collaborative teams and positive student perceptions provide evidence of achievement of interprofessional education learning outcomes. PMID:27402988

Using interprofessional simulation to improve collaborative competences for nursing, physiotherapy, and respiratory therapy students.

PubMed

King, Judy; Beanlands, Sarah; Fiset, Valerie; Chartrand, Louise; Clarke, Shelley; Findlay, Tarra; Morley, Michelle; Summers, Ian

2016-09-01

Within the care of people living with respiratory conditions, nursing, physiotherapy, and respiratory therapy healthcare professionals routinely work in interprofessional teams. To help students prepare for their future professional roles, there is a need for them to be involved in interprofessional education. The purpose of this project was to compare two different methods of patient simulation in improving interprofessional competencies for students in nursing, physiotherapy, and respiratory therapy programmes. The Canadian Interprofessional Health Collaborative competencies of communication, collaboration, conflict resolution patient/family-centred care, roles and responsibilities, and team functioning were measured. Using a quasi-experimental pre-post intervention approach two different interprofessional workshops were compared: the combination of standardised and simulated patients, and exclusively standardised patients. Students from nursing, physiotherapy, and respiratory therapy programmes worked together in these simulation-based activities to plan and implement care for a patient with a respiratory condition. Key results were that participants in both years improved in their self-reported interprofessional competencies as measured by the Interprofessional Collaborative Competencies Attainment Survey (ICCAS). Participants indicated that they found their interprofessional teams did well with communication and collaboration. But the participants felt they could have better involved the patients and their family members in the patient's care. Regardless of method of patient simulation used, mannequin or standardised patients, students found the experience beneficial and appreciated the opportunity to better understand the roles of other healthcare professionals in working together to help patients living with respiratory conditions.

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.

Perspective: a business school view of medical interprofessional rounds: transforming rounding groups into rounding teams.

PubMed

Bharwani, Aleem M; Harris, G Chad; Southwick, Frederick S

2012-12-01

An effective interprofessional medical team can efficiently coordinate health care providers to achieve the collective outcome of improving each patient's health. To determine how current teams function, four groups of business students independently observed interprofessional work rounds on four different internal medicine services in a typical academic hospital and also interviewed the participants. In all instances, caregivers had formed working groups rather than working teams. Participants consistently exhibited parallel interdependence (individuals working alone and assuming their work would be coordinated with other caregivers) rather than reciprocal interdependence (individuals working together to actively coordinate patient care), the hallmark of effective teams. With one exception, the organization was hierarchical, with the senior attending physician possessing the authority. The interns exclusively communicated with the attending physician in one-on-one conversations that excluded all other members of the team. Although nurses and pharmacists were often present, they never contributed their ideas and rarely spoke.The authors draw on these observations to form recommendations for enhancing interprofessional rounding teams. These are to include the bedside nurse, pharmacist, and case manager as team members, begin with a formal team launch that encourages active participation by all team members, use succinct communication protocols, conduct work rounds in a quiet, distraction-free environment, have teams remain together for longer durations, and receive teamwork training and periodic coaching. High-performing businesses have effectively used teams for decades to achieve their goals, and health care professionals should follow this example.

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.

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,…

Building and expanding interprofessional teaching teams.

PubMed

Darlow, Ben; McKinlay, Eileen; Gallagher, Peter; Beckingsale, Louise; Coleman, Karen; Perry, Meredith; Pullon, Sue

2017-03-01

INTRODUCTION Interprofessional education (IPE) aims to prepare learners to work in collaborative health-care teams. The University of Otago, Wellington has piloted, developed and expanded an IPE programme since 2011. An interprofessional teaching team has developed alongside this programme. AIMS This study aimed to understand the development of a university-based interprofessional teaching team over a 4-year period and generate insights to aid the development of such teams elsewhere. METHODS Two semi-structured audio-recorded educator focus groups were conducted at key times in the development of the IPE programme in 2011 and 2014. The programme focused on long-term condition management and involved students from dietetics, medicine, physiotherapy and radiation therapy. Focus group transcripts were independently analysed by two researchers using Thematic Analysis to identify broad themes. Initial themes were compared, discussed and combined to form a thematic framework. The thematic framework was verified by the education team and subsequently updated and reorganised. RESULTS Three key themes emerged: (i) development as an interprofessional educator; (ii) developing a team; and (iii) risk and reward. Teaching in an interprofessional environment was initially daunting but confidence increased with experience. Team teaching highlighted educators' disciplinary roles and skill sets and exposed educators to different teaching approaches. Educators perceived they modelled team development processes to students through their own development as a team. Interprofessional teaching was challenging to organise but participation was rewarding. Programme expansion increased the risks and complexity, but also acted as a stimulus for development and energised the teaching team. DISCUSSION Interprofessional teaching is initially challenging but ultimately enriching. Interprofessional teaching skills take time to develop and perspectives of role change over time. Educator team development is aided by commitment, understanding, enthusiasm, leadership and trust.

Nurse Perceptions of Artists as Collaborators in Interprofessional Care Teams

PubMed Central

Pesata, Virginia; Lee, Jenny Baxley; Graham-Pole, John

2017-01-01

Increased attention is being given to interprofessional collaboration in healthcare, which has been shown to improve patient satisfaction, patient safety, healthcare processes, and health outcomes. As the arts and artists are being more widely incorporated into healthcare settings throughout the world, professional artists are contributing to interprofessional care teams. A secondary directed content analysis of interviews with 31 nurses on a medical-surgical care unit investigated the roles and impacts of professional artists on the interprofessional care team. The investigation utilized established domains of interprofessional care, including values and ethics, roles and responsibilities, interprofessional communication, and teams and teamwork, and created the domain of quality of care. Findings suggest that artists are valued by nurses as members of the interprofessional care team, that they enhance the provision of patient-centered care, and that they improve quality of care by providing holistic dimensions of caring, including cognitive and social engagement, and meaningful interaction. The presence of artists on interprofessional teams provides a cost-effective and welcome resource for clinical staff and builds a culture in which creativity and interdisciplinary collaboration are more highly valued and activated. PMID:28867778

The rehabilitation team: staff perceptions of the hospital environment, the interdisciplinary team environment, and interprofessional relations.

PubMed

Strasser, D C; Falconer, J A; Martino-Saltzmann, D

1994-02-01

Although inpatient rehabilitation is an interdisciplinary activity organized around a treatment team, there is a limited understanding of the workings of the interdisciplinary process. To elucidate staff perceptions of key aspects of the rehabilitation treatment process, we surveyed staff (n = 113) from selected inpatient teams. The staff completed social psychological instruments that measure perceptions of the hospital environment (The Ward Atmosphere Scale [WAS]), the team's environment (the Group Environment Scale [GES]), and interprofessional relations (Interprofessional Perception Scale [IPS]). Rehabilitation staff generally endorse the team approach, but express concerns over professional boundaries. Interprofessional difficulties seemed to be independent of team membership or professional training. Compared with published data from other settings, rehabilitation teams resembled task-oriented groups, but showed significant differences across teams in their perceptions of the team and hospital environments. The task-oriented character of rehabilitation teams, team-specific characteristics, and discord in interprofessional relationships may need to be considered in studies of rehabilitation teams effectiveness.

Interprofessional Education: A Summary of Reports and Barriers to Recommendations.

PubMed

Meleis, Afaf I

2016-01-01

Effective, quality care to achieve the newly developed sustainable development goals requires the development of collaborative teams and is predicated on implementing transformative interprofessional education and on team members who are equally empowered. This is a report on The Lancet commission on transformative education for health professionals and the National Academy of Medicine's dialogues on developing and implementing innovations to enhance collaborations and to facilitate the effectiveness of healthcare teams. Using postcolonial feminist theory for critical analysis and integrations of findings from both reports, as well as for identification of barriers to achieving equity in team functioning. The global Lancet commission and the National Academy of Medicine/Institute of Medicine forum developed frameworks that could be used to educate the next generation of professionals based on identifying the local needs of communities within a global context. Recommendations included breaking down silos that exists between schools and using an equity and justice framework in developing educational programs; utilizing contemporary innovations in teaching that correspond with innovations in healthcare systems; and insuring investments in time, energy, and resources in interprofessional education. However, without addressing the silos created through professional identities and power differentials, goals of interprofessional education and collaborative practice may not be achieved. While a great deal has been written about interprofessional education, it is imperative for faculty in the different professional schools and for members of healthcare teams to engage in dialogues that address the fundamental and most obstinate barriers to forming equitable teams, which is the consistent narrative of medical privilege and centrism. The dialogues about medical privilege and physician centrism in education and health care could drive the development of programmatic approaches to enhancing interprofessional education and teamwork based on justice and equity frameworks. © 2015 Sigma Theta Tau International.

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.

What and how do students learn in an interprofessional student-run clinic? An educational framework for team-based care

PubMed Central

Lie, Désirée A.; Forest, Christopher P.; Walsh, Anne; Banzali, Yvonne; Lohenry, Kevin

2016-01-01

Background The student-run clinic (SRC) has the potential to address interprofessional learning among health professions students. Purpose To derive a framework for understanding student learning during team-based care provided in an interprofessional SRC serving underserved patients. Methods The authors recruited students for a focus group study by purposive sampling and snowballing. They constructed two sets of semi-structured questions for uniprofessional and multiprofessional groups. Sessions were audiotaped, and transcripts were independently coded and adjudicated. Major themes about learning content and processes were extracted. Grounded theory was followed after data synthesis and interpretation to establish a framework for interprofessional learning. Results Thirty-six students from four professions (medicine, physician assistant, occupational therapy, and pharmacy) participated in eight uniprofessional groups; 14 students participated in three multiprofessional groups (N = 50). Theme saturation was achieved. Six common themes about learning content from uniprofessional groups were role recognition, team-based care appreciation, patient experience, advocacy-/systems-based models, personal skills, and career choices. Occupational therapy students expressed self-advocacy, and medical students expressed humility and self-discovery. Synthesis of themes from all groups suggests a learning continuum that begins with the team huddle and continues with shared patient care and social interactions. Opportunity to observe and interact with other professions in action is key to the learning process. Discussion Interprofessional SRC participation promotes learning ‘with, from, and about’ each other. Participation challenges misconceptions and sensitizes students to patient experiences, health systems, advocacy, and social responsibility. Learning involves interprofessional interactions in the patient encounter, reinforced by formal and informal communications. Participation is associated with interest in serving the underserved and in primary care careers. The authors proposed a framework for interprofessional learning with implications for optimal learning environments to promote team-based care. Future research is suggested to identify core faculty functions and best settings to advance and enhance student preparation for future collaborative team practice. PMID:27499364

What and how do students learn in an interprofessional student-run clinic? An educational framework for team-based care.

PubMed

Lie, Désirée A; Forest, Christopher P; Walsh, Anne; Banzali, Yvonne; Lohenry, Kevin

2016-01-01

Background The student-run clinic (SRC) has the potential to address interprofessional learning among health professions students. Purpose To derive a framework for understanding student learning during team-based care provided in an interprofessional SRC serving underserved patients. Methods The authors recruited students for a focus group study by purposive sampling and snowballing. They constructed two sets of semi-structured questions for uniprofessional and multiprofessional groups. Sessions were audiotaped, and transcripts were independently coded and adjudicated. Major themes about learning content and processes were extracted. Grounded theory was followed after data synthesis and interpretation to establish a framework for interprofessional learning. Results Thirty-six students from four professions (medicine, physician assistant, occupational therapy, and pharmacy) participated in eight uniprofessional groups; 14 students participated in three multiprofessional groups (N = 50). Theme saturation was achieved. Six common themes about learning content from uniprofessional groups were role recognition, team-based care appreciation, patient experience, advocacy-/systems-based models, personal skills, and career choices. Occupational therapy students expressed self-advocacy, and medical students expressed humility and self-discovery. Synthesis of themes from all groups suggests a learning continuum that begins with the team huddle and continues with shared patient care and social interactions. Opportunity to observe and interact with other professions in action is key to the learning process. Discussion Interprofessional SRC participation promotes learning 'with, from, and about' each other. Participation challenges misconceptions and sensitizes students to patient experiences, health systems, advocacy, and social responsibility. Learning involves interprofessional interactions in the patient encounter, reinforced by formal and informal communications. Participation is associated with interest in serving the underserved and in primary care careers. The authors proposed a framework for interprofessional learning with implications for optimal learning environments to promote team-based care. Future research is suggested to identify core faculty functions and best settings to advance and enhance student preparation for future collaborative team practice.

What and how do students learn in an interprofessional student-run clinic? An educational framework for team-based care.

PubMed

Lie, Désirée A; Forest, Christopher P; Walsh, Anne; Banzali, Yvonne; Lohenry, Kevin

2016-01-01

The student-run clinic (SRC) has the potential to address interprofessional learning among health professions students. To derive a framework for understanding student learning during team-based care provided in an interprofessional SRC serving underserved patients. The authors recruited students for a focus group study by purposive sampling and snowballing. They constructed two sets of semi-structured questions for uniprofessional and multiprofessional groups. Sessions were audiotaped, and transcripts were independently coded and adjudicated. Major themes about learning content and processes were extracted. Grounded theory was followed after data synthesis and interpretation to establish a framework for interprofessional learning. Thirty-six students from four professions (medicine, physician assistant, occupational therapy, and pharmacy) participated in eight uniprofessional groups; 14 students participated in three multiprofessional groups (N = 50). Theme saturation was achieved. Six common themes about learning content from uniprofessional groups were role recognition, team-based care appreciation, patient experience, advocacy-/systems-based models, personal skills, and career choices. Occupational therapy students expressed self-advocacy, and medical students expressed humility and self-discovery. Synthesis of themes from all groups suggests a learning continuum that begins with the team huddle and continues with shared patient care and social interactions. Opportunity to observe and interact with other professions in action is key to the learning process. Interprofessional SRC participation promotes learning 'with, from, and about' each other. Participation challenges misconceptions and sensitizes students to patient experiences, health systems, advocacy, and social responsibility. Learning involves interprofessional interactions in the patient encounter, reinforced by formal and informal communications. Participation is associated with interest in serving the underserved and in primary care careers. The authors proposed a framework for interprofessional learning with implications for optimal learning environments to promote team-based care. Future research is suggested to identify core faculty functions and best settings to advance and enhance student preparation for future collaborative team practice.

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.

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.

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.

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.

Interprofessional Teamwork and Collaboration Between Community Health Workers and Healthcare Teams: An Integrative Review.

PubMed

Franklin, Catherine M; Bernhardt, Jean M; Lopez, Ruth Palan; Long-Middleton, Ellen R; Davis, Sheila

2015-01-01

Community Health Workers (CHWs) serve as a means of improving outcomes for underserved populations. However, their relationship within health care teams is not well studied. The purpose of this integrative review was to examine published research reports that demonstrated positive health outcomes as a result of CHW intervention to identify interprofessional teamwork and collaboration between CHWs and health care teams. A total of 47 studies spanning 33 years were reviewed using an integrative literature review methodology for evidence to support the following assumptions of effective interprofessional teamwork between CHWs and health care teams: (1) shared understanding of roles, norms, values, and goals of the team; (2) egalitarianism; (3) cooperation; (4) interdependence; and(5) synergy. Of the 47 studies, 12 reported at least one assumption of effective interprofessional teamwork. Four studies demonstrated all 5 assumptions of interprofessional teamwork. Four studies identified in this integrative review serve as exemplars for effective interprofessional teamwork between CHWs and health care teams. Further study is needed to describe the nature of interprofessional teamwork and collaboration in relation to patient health outcomes.

Interprofessional Teamwork and Collaboration Between Community Health Workers and Healthcare Teams

PubMed Central

Bernhardt, Jean M.; Lopez, Ruth Palan; Long-Middleton, Ellen R.; Davis, Sheila

2015-01-01

Objectives: Community Health Workers (CHWs) serve as a means of improving outcomes for underserved populations. However, their relationship within health care teams is not well studied. The purpose of this integrative review was to examine published research reports that demonstrated positive health outcomes as a result of CHW intervention to identify interprofessional teamwork and collaboration between CHWs and health care teams. Methods: A total of 47 studies spanning 33 years were reviewed using an integrative literature review methodology for evidence to support the following assumptions of effective interprofessional teamwork between CHWs and health care teams: (1) shared understanding of roles, norms, values, and goals of the team; (2) egalitarianism; (3) cooperation; (4) interdependence; and(5) synergy. Results: Of the 47 studies, 12 reported at least one assumption of effective interprofessional teamwork. Four studies demonstrated all 5 assumptions of interprofessional teamwork. Conclusions: Four studies identified in this integrative review serve as exemplars for effective interprofessional teamwork between CHWs and health care teams. Further study is needed to describe the nature of interprofessional teamwork and collaboration in relation to patient health outcomes. PMID:28462254

Evaluation of an interprofessional education program for advanced practice nursing and dental students: The oral-systemic health connection.

PubMed

Nash, Whitney A; Hall, Lynne A; Lee Ridner, S; Hayden, Dedra; Mayfield, Theresa; Firriolo, John; Hupp, Wendy; Weathers, Chandra; Crawford, Timothy N

2018-07-01

In response to the growing body of evidence supporting the need for expanded interprofessional education among health professions, an interprofessional education program, based on the Interprofessional Education Collaborative Core Competencies, was piloted with nurse practitioner and dental students. The purpose of this pilot study was to evaluate a technology enhanced interprofessional education program focused on the oral-systemic health connection for nurse practitioner and dental students. A two-group comparative study using cross-sectional data and a quasi-experimental one-group pre-test/post-test design were used to evaluate students' knowledge of IPE core competencies, attitudes toward interprofessional education and interdisciplinary teamwork, and self-efficacy in functioning as a member of an interdisciplinary team. This program was implemented with master of science in nursing students pursuing a primary care nurse practitioner (NP) degree and dental students at a large urban academic health sciences center. Cohort 1 (N = 75) consisted of NP (n = 34) and dental students (n = 41) at the end of their degree program who participated in a one-time survey. Cohort 2 (N = 116) was comprised of second-year NP students (n = 22) and first-year dental students (n = 94) who participated in the IPE program. Students participated in a multi-faceted educational program consisting of technology- enhanced delivery as well as interactive exercises in the joint health assessment course. Data were collected prior to the initiation and at the conclusion of the program. Nurse practitioner and dental students who participated in the program had better self-efficacy in functioning as a member of an interdisciplinary team than graduating students who did not participate. Students from both nursing and dentistry who participated in the program had significantly improved self-efficacy in functioning in interprofessional teams from pre- to post-test. An interprofessional education program can be a valuable addition to the health professions curriculum of nurse practitioner and dental students. Care must be taken to address logistical issues when working with students in different academic programs. Copyright © 2018. Published by Elsevier Ltd.

Trying on the professional self: nursing students' perceptions of learning about roles, identity and teamwork in an interprofessional clinical placement.

PubMed

Hood, Kerry; Cant, Robyn; Leech, Michelle; Baulch, Julie; Gilbee, Alana

2014-05-01

This study aims to describe how senior nursing students viewed the clinical learning environment and matured their professional identity through interprofessional learning in a student-led hospital 'ward'. Undergraduate nursing and medical student teams participated in a trial of ward-based interprofessional clinical learning, managing patients over 2 weeks in a rehabilitation ward. Qualitative and quantitative program evaluation was conducted using exit student focus groups and a satisfaction survey. Twenty-three nursing and medical students in three placement rounds provided positive feedback. Five main themes emerged describing their engagement in 'trying on' a professional role: 'experiencing independence and autonomy'; 'seeing clearly what nursing's all about'; 'altered images of other professions'; 'ways of communicating and collaborating' and 'becoming a functioning team'. Ward-based interprofessional clinical placements offer senior students authentic ideal clinical experiences. We consider this essential learning for future interprofessional collaboration which should be included in senior nursing students' education. © 2014.

Sustainable interprofessional teamwork needs a team-friendly healthcare system: Experiences from a collaborative Dutch programme.

PubMed

van Dijk-de Vries, Anneke; van Dongen, Jerôme Jean Jacques; van Bokhoven, Marloes Amantia

2017-03-01

The significance of effective interprofessional teamwork to improve the quality of care has been widely recognised. Effective interprofessional teamwork calls on good collaboration between professionals and patients, coordination between professionals, and the development of teamwork over time. Effective development of teams also requires support from the wider organisational context. In a Dutch village, healthcare professionals work closely together, and mutual consultations as well as interprofessional meetings take place on a regular basis. The network was created as a precondition for sustainable interprofessional teamwork in elderly care. However, several external barriers were experienced regarding the supportive structure and cooperative attitude of the healthcare insurer and municipality. The aim of the article is to examine these experience-based issues regarding internal organisation, perspective, and definition of effective teamwork. Complicating factors refer to finding the right key figures, and the different perspectives on team development and team effectiveness. Our conclusion is that the organisation of healthcare insurance companies needs to implement fundamental changes to facilitate an interprofessional care approach. Furthermore, municipalities should work on their vision of the needs and benefits of a fruitful collaboration with interprofessional healthcare teams. The challenge for healthcare teams is to learn to speak the language of external partners. To support the development of interprofessional teams, external parties need to recognise and trust in a shared aim to provide quality of care in an efficient and effective way.

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.

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.

An interprofessional team approach to tracheostomy care: a mixed-method investigation into the mechanisms explaining tracheostomy team effectiveness.

PubMed

Mitchell, Rebecca; Parker, Vicki; Giles, Michelle

2013-04-01

In an effort to reduce tracheostomy-related complications, many acute care facilities have implemented specialist tracheostomy teams. Some studies, however, generate only mixed support for the connection between tracheostomy teams and patient outcomes. This suggests that the effect of collaborative teamwork in tracheostomy care is still not well understood. The aim of this paper is to investigate the mechanisms through which an interprofessional team approach can improve the management of patients with a tracheostomy. The achievement of this research objective requires the collection of rich empirical data, which indicates the use of a qualitative methodology. A case study approach provided an opportunity to collect a wealth of data on tracheostomy team activities and dynamics. Data were collected on an interprofessional tracheostomy team in a large tertiary referral hospital in Australia. The team was composed of clinical nurse consultants, a physiotherapist, a speech pathologist, a dietician, a social worker and medical officers. Data were collected through a focus group and one-to-one, semi-structured in-depth interviews, and thematic analysis was used to analyse experiences of tracheostomy team members. Qualitative analysis resulted in two main themes: interprofessional protocol development and implementation; and interprofessional decision-making. Our findings suggest that tracheostomy teams enhance consistency of care through the development and implementation of interprofessional protocol. In addition, such team allow more efficient and effective communication and decision-making consequent to the collocation of diverse professionals. These findings provide new insight into the role of tracheostomy teams in successfully implementing complex protocol and the explanatory mechanisms through which interprofessional teams may generate positive outcomes for tracheostomy patients. Copyright © 2012. Published by Elsevier Ltd.

Exploring the importance of team psychological safety in the development of two interprofessional teams.

PubMed

O'Leary, Denise Fiona

2016-01-01

It has been previously demonstrated that interactions within interprofessional teams are characterised by effective communication, shared decision-making, and knowledge sharing. This article outlines aspects of an action research study examining the emergence of these characteristics within change management teams made up of nurses, general practitioners, physiotherapists, care assistants, a health and safety officer, and a client at two residential care facilities for older people in Ireland. The theoretical concept of team psychological safety (TPS) is utilised in presenting these characteristics. TPS has been defined as an atmosphere within a team where individuals feel comfortable engaging in discussion and reflection without fear of censure. Study results suggest that TPS was an important catalyst in enhancing understanding and power sharing across professional boundaries and thus in the development of interprofessional teamwork. There were differences between the teams. In one facility, the team developed many characteristics of interprofessional teamwork while at the other there was only a limited shift. Stability in team membership and organisational norms relating to shared decision-making emerged as particularly important in accounting for differences in the development of TPS and interprofessional teamwork.

Interprofessional education and social interaction: The use of automated external defibrillators in team-based basic life support.

PubMed

Onan, Arif; Simsek, Nurettin

2017-04-01

Automated external defibrillators are pervasive computing devices designed for the treatment and management of acute sudden cardiac arrest. This study aims to explain users' actual use behavior in teams formed by different professions taken after a short time span of interaction with automated external defibrillator. Before the intervention, all the participants were certified with the American Heart Association Basic Life Support for healthcare providers. A statistically significant difference was revealed in mean individual automated external defibrillator technical skills between uniprofessional and interprofessional groups. The technical automated external defibrillator team scores were greater for groups with interprofessional than for those with uniprofessional education. The nontechnical automated external defibrillator skills of interprofessional and uniprofessional teams revealed differences in advantage of interprofessional teams. Students positively accept automated external defibrillators if well-defined and validated training opportunities to use them expertly are available. Uniprofessional teams were successfully supported by their members and, thereby, used automated external defibrillator effectively. Furthermore, the interprofessional approach resulted in as much effective teamwork as the uniprofessional approach.

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.

Interprofessional education in team communication: working together to improve patient safety.

PubMed

Brock, Douglas; Abu-Rish, Erin; Chiu, Chia-Ru; Hammer, Dana; Wilson, Sharon; Vorvick, Linda; Blondon, Katherine; Schaad, Douglas; Liner, Debra; Zierler, Brenda

2013-05-01

Communication failures in healthcare teams are associated with medical errors and negative health outcomes. These findings have increased emphasis on training future health professionals to work effectively within teams. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) communication training model, widely employed to train healthcare teams, has been less commonly used to train student interprofessional teams. The present study reports the effectiveness of a simulation-based interprofessional TeamSTEPPS training in impacting student attitudes, knowledge and skills around interprofessional communication. Three hundred and six fourth-year medical, third-year nursing, second-year pharmacy and second-year physician assistant students took part in a 4 h training that included a 1 h TeamSTEPPS didactic session and three 1 h team simulation and feedback sessions. Students worked in groups balanced by a professional programme in a self-selected focal area (adult acute, paediatric, obstetrics). Preassessments and postassessments were used for examining attitudes, beliefs and reported opportunities to observe or participate in team communication behaviours. One hundred and forty-nine students (48.7%) completed the preassessments and postassessments. Significant differences were found for attitudes toward team communication (p<0.001), motivation (p<0.001), utility of training (p<0.001) and self-efficacy (p=0.005). Significant attitudinal shifts for TeamSTEPPS skills included, team structure (p=0.002), situation monitoring (p<0.001), mutual support (p=0.003) and communication (p=0.002). Significant shifts were reported for knowledge of TeamSTEPPS (p<0.001), advocating for patients (p<0.001) and communicating in interprofessional teams (p<0.001). Effective team communication is important in patient safety. We demonstrate positive attitudinal and knowledge effects in a large-scale interprofessional TeamSTEPPS-based training involving four student professions.

Interprofessional education in team communication: working together to improve patient safety.

PubMed

Brock, Douglas; Abu-Rish, Erin; Chiu, Chia-Ru; Hammer, Dana; Wilson, Sharon; Vorvick, Linda; Blondon, Katherine; Schaad, Douglas; Liner, Debra; Zierler, Brenda

2013-11-01

Communication failures in healthcare teams are associated with medical errors and negative health outcomes. These findings have increased emphasis on training future health professionals to work effectively within teams. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) communication training model, widely employed to train healthcare teams, has been less commonly used to train student interprofessional teams. The present study reports the effectiveness of a simulation-based interprofessional TeamSTEPPS training in impacting student attitudes, knowledge and skills around interprofessional communication. Three hundred and six fourth-year medical, third-year nursing, second-year pharmacy and second-year physician assistant students took part in a 4 h training that included a 1 h TeamSTEPPS didactic session and three 1 h team simulation and feedback sessions. Students worked in groups balanced by a professional programme in a self-selected focal area (adult acute, paediatric, obstetrics). Preassessments and postassessments were used for examining attitudes, beliefs and reported opportunities to observe or participate in team communication behaviours. One hundred and forty-nine students (48.7%) completed the preassessments and postassessments. Significant differences were found for attitudes toward team communication (p<0.001), motivation (p<0.001), utility of training (p<0.001) and self-efficacy (p=0.005). Significant attitudinal shifts for TeamSTEPPS skills included, team structure (p=0.002), situation monitoring (p<0.001), mutual support (p=0.003) and communication (p=0.002). Significant shifts were reported for knowledge of TeamSTEPPS (p<0.001), advocating for patients (p<0.001) and communicating in interprofessional teams (p<0.001). Effective team communication is important in patient safety. We demonstrate positive attitudinal and knowledge effects in a large-scale interprofessional TeamSTEPPS-based training involving four student professions.

Physicians' attitudes about interprofessional treatment of chronic pain: family physicians are considered the most important collaborators.

PubMed

Klinar, Ivana; Ferhatovic, Lejla; Banozic, Adriana; Raguz, Marija; Kostic, Sandra; Sapunar, Damir; Puljak, Livia

2013-06-01

Interprofessional collaboration is the process in which different professional groups work together to positively impact health care. We aimed to explore physicians' attitudes toward interprofessional collaboration in the context of chronic pain management with the implication that if attitudes are not positive, appropriate interventions could be developed. A quantitative attitudes study. The ethical committee approved the study. A web-based survey about interprofessional treatment of chronic pain was administered to physicians. Outcome measures were as follows: physicians' demographic and workplace information, previous experience of working within an interprofessional team, and attitudes towards interprofessional collaboration in chronic pain management. There were 90 physicians who responded to the survey. Physicians had positive attitudes towards team work in the context of chronic pain, but they were undecided about sharing their role within an interprofessional team. The family physician was singled out as the most important as well as the most common collaborator in chronic pain treatment. Interprofessional educational seminars and workshops were suggested as methods for improving interprofessional collaboration. Interprofessional collaboration may be enhanced with continuing medical education that will bring together different healthcare professionals, enable them to exchange experiences and learn about their potential roles within a team. © 2012 Nordic College of Caring Science.

"Let's stick together"--a grounded theory exploration of interprofessional working used to provide person centered chronic back pain services.

PubMed

Howarth, Michelle; Warne, Tony; Haigh, Carol

2012-11-01

Chronic back pain is a global phenomenon and a common reason why patients seek help from health professionals. Person-centered interprofessional working is acknowledged as the main strategy for chronic back pain management; however, the complexity of chronic pain can present significant challenges for teams. Although methods used by interprofessional teams to collaborate have been previously explored, how they work together to deliver person-centered chronic back pain care has received limited attention. The aim of this study was to explore person-centered care from the perspectives of people with chronic back pain and the interprofessional teams who cared for them. A grounded theory methodology was used to capture the interprofessional team's perspectives of person-centered working. A purposive sample of four chronic back pain management teams participated in semi-structured face-to-face interviews and focus groups. Data were thematically analyzed using a constant comparative method. Three categories emerged, collective efficacy, negotiated space and team maturity, which illustrated the attributes of interprofessional teams that influenced person-centered working. The findings suggest that collective efficacy matures over time within a negotiated coalesced space and re-enforces the need for teams to stick together to ensure effective person-centered care.

An interprofessional training course in crises and human factors for perioperative teams.

PubMed

Stephens, Tim; Hunningher, Annie; Mills, Helen; Freeth, Della

2016-09-01

Improving patient safety and the culture of care are health service priorities that coexist with financial pressures on organisations. Research suggests team training and better team processes can improve team culture, safety, performance, and clinical outcomes, yet opportunities for interprofessional learning remain scarce. Perioperative practitioners work in a high pressure, high-risk environment without the benefits of stable team membership: this limits opportunities and momentum for team-initiated collaborative improvements. This article describes an interprofessional course focused on crises and human factors which comprised a 1-day event and a multifaceted sustainment programme for perioperative practitioners, grouped by surgical specialty. Participants reported increased understanding and confidence to enact processes and behaviours that support patient safety, including: team behaviours (communication, coordination, cooperation and back-up, leadership, situational awareness); recognising different perspectives and expectations within the team; briefing and debriefing; after action review; and using specialty-specific incident reports to generate specialty-specific interprofessional improvement plans. Participants valued working with specialty colleagues away from normal work pressures. In the high-pressure arena of front-line healthcare delivery, improving patient safety and theatre efficiency can often be erroneously considered conflicting agendas. Interprofessional collaboration amongst staff participating in this initiative enabled general and specialty-specific interprofessional learning that transcended this conflict.

RN Job Satisfaction and Retention After an Interprofessional Team Intervention.

PubMed

Baik, Dawon; Zierler, Brenda

2018-04-01

Despite continuing interest in interprofessional teamwork to improve nurse outcomes and quality of care, there is little research that focuses on nurse job satisfaction and retention after an interprofessional team intervention. This study explored registered nurse (RN) job satisfaction and retention after a purposeful interprofessional team training and structured interprofessional bedside rounds were implemented. As part of a larger study, in this comparative cross-sectional study, pre- and post-intervention data on RN job satisfaction and turnover rate were collected and analyzed. It was found that RNs had significantly higher job satisfaction after the interprofessional team intervention. The 6-month period turnover rate in the post-intervention period was slightly lower than the 6-month period turnover rate in pre-intervention period; however, the rate was too low to provide statistical evidence. Ongoing coaching and supportive work environments to improve RN outcomes should be considered to enhance quality of care and patient safety in healthcare.

Perception of Interprofessional Collaboration and Co-Location of Specialists and Primary Care Teams in Youth Mental Health

PubMed Central

Rousseau, Cécile; Pontbriand, Annie; Nadeau, Lucie; Johnson-Lafleur, Janique

2017-01-01

Objectives Interprofessional collaboration is a cornerstone of youth mental health collaborative care models. This article presents quantitative results from a mixed-methods study. It analyses the organizational predictors of the perception of interprofessional collaboration of professionals comparing two models of services within recently constituted youth mental health collaborative care teams. Methods Professionals (n=104) belonging to six health and social services institutions completed an online survey measuring their perceptions of interprofessional collaboration through a validated questionnaire, the PINCOM-Q. Results Results suggest that the integrated model of collaborative care in which specialized resources are co-located with the primary care teams is the main significant predictor of positive perception of interprofessional collaborations in the youth mental health team. Conclusion More research on the relation between service delivery models and interprofessional relations could help support the successful implementation of collaborative care in youth mental health. PMID:29056982

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.

A team-based interprofessional education course for first-year health professions students.

PubMed

Peeters, Michael J; Sexton, Martha; Metz, Alexia E; Hasbrouck, Carol S

2017-11-01

Interprofessional education (IPE) is required within pharmacy education, and should include classroom-based education along with experiential interprofessional collaboration. For classroom-based education, small-group learning environments may create a better platform for engaging students in the essential domain of interprofessional collaboration towards meaningful learning within IPE sub-domains (interprofessional communication, teams and teamwork, roles and responsibilities, and values and ethics). Faculty envisioned creating a small-group learning environment that was inviting, interactive, and flexible using situated learning theory. This report describes an introductory, team-based, IPE course for first-year health-professions students; it used small-group methods for health-professions students' learning of interprofessional collaboration. The University of Toledo implemented a 14-week required course involving 554 first-year health-sciences students from eight professions. The course focused on the Interprofessional Education Collaborative's (IPEC) Core Competencies for Interprofessional Collaboration. Students were placed within interprofessional teams of 11-12 students each and engaged in simulations, standardized-patient interviews, case-based communications exercises, vital signs training, and patient safety rotations. Outcomes measured were students' self-ratings of attaining learning objectives, perceptions of other professions (from word cloud), and satisfaction through end-of-course evaluations. This introductory, team-based IPE course with 554 students improved students' self-assessed competency in learning objectives (p < 0.01, Cohen's d = 0.9), changed students' perceptions of other professions (via word clouds), and met students' satisfaction through course evaluations. Through triangulation of our various assessment methods, we considered this course offering a success. This interprofessional, team-based, small-group strategy to teaching and learning IPE appeared helpful within this interactive, classroom-based course. Copyright © 2017 Elsevier Inc. All rights reserved.

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.

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.

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.

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.

Comparison of language used and patterns of communication in interprofessional and multidisciplinary teams.

PubMed

Sheehan, D; Robertson, L; Ormond, T

2007-02-01

Can the language used and the patterns of communication differentiate a multidisciplinary team from an interprofessional team? This research question arose from an unexpected outcome of a study that investigated clinical reasoning of health professional team members in the elder care wards of two different hospitals. The issue at stake was the apparent disparity in the way in which the two teams communicated. To further explore this, the original transcribed interview data was analysed from a symbolic interactionist perspective in order that the language and communication patterns between the two teams could be identified and compared. Differences appeared to parallel the distinctions between multidisciplinary and interprofessional teams as reported in the literature. Our observations were that an interprofessional team was characterized by its use of inclusive language, continual sharing of information between team members and a collaborative working approach. In the multidisciplinary team, the members worked in parallel, drawing information from one another but did not have a common understanding of issues that could influence intervention. The implications of these communication differences for team members, team leaders and future research are then discussed.

Assessment of student interprofessional education (IPE) training for team-based geriatric home care: does IPE training change students' knowledge and attitudes?

PubMed

Reilly, Jo Marie; Aranda, María P; Segal-Gidan, Freddi; Halle, Ashley; Han, Phuu Pwint; Harris, Patricia; Jordan, Katie; Mulligan, Roseann; Resnik, Cheryl; Tsai, Kai-Ya; Williams, Brad; Cousineau, Michael R

2014-01-01

Our study assesses changes in students' knowledge and attitudes after participation in an interprofessional, team-based, geriatric home training program. Second-year medical, physician assistant, occupational therapy, social work, and physical therapy students; third-year pharmacy students; and fourth-year dental students were led by interprofessional faculty teams. Student participants were assessed before and after the curriculum using an interprofessional attitudes learning scale. Significant differences and positive data trends were noted at year-end. Our study suggests that early implementation, assessment, and standardization of years of student training is needed for optimal interprofessional geriatric learning. Additionally, alternative student assessment tools should be considered for future studies.

Evaluation of interprofessional education: lessons learned through the development and implementation of an interprofessional seminar on team communication for undergraduate health care students in Heidelberg – a project report

PubMed Central

Berger, Sarah; Mahler, Cornelia; Krug, Katja; Szecsenyi, Joachim; Schultz, Jobst-Hendrik

2016-01-01

Introduction: This project report describes the development, “piloting” and evaluation of an interprofessional seminar on team communication bringing together medical students and Interprofessional Health Care B.Sc. students at the Medical Faculty of Heidelberg University, Germany. Project Description: A five-member interprofessional team collaborated together on this project. Kolb’s experiential learning concept formed the theoretical foundation for the seminar, which explored three interprofessional competency areas: team work, communication and values/ethics. Evaluation for the purposes of quality assurance and future curricula development was conducted using two quantitative measures: descriptive analysis of a standardized course evaluation tool (EvaSys) ANOVA analysis of the German translation of the University of the West of England Interprofessional Questionnaire (UWE-IP-D). Results: The key finding from the standardized course evaluation was that the interprofessional seminars were rated more positively [M=2.11 (1 most positive and 5 most negative), SD=1, n=27] than the monoprofessional seminars [M=2.55, SD=0.98, n=90]. The key finding from the UWE-IP-D survey, comparing pre and post scores of the interprofessional (IP) (n=40) and monoprofessional (MP) groups (n=34), was that significant positive changes in mean scores for both groups towards communication, teamwork and interprofessional learning occurred. Conclusions: Lessons learnt included: a) recognising the benefit of being pragmatic when introducing interprofessional education initiatives, which enabled various logistical and attitudinal barriers to be overcome; b) quantitative evaluation of learning outcomes alone could not explain positive responses or potential influences of interprofessional aspects, which highlighted the need for a mixed methods approach, including qualitative methods, to enrich judgment formation on interprofessional educational outcomes. PMID:27280133

Evaluation of interprofessional education: lessons learned through the development and implementation of an interprofessional seminar on team communication for undergraduate health care students in Heidelberg - a project report.

PubMed

Berger, Sarah; Mahler, Cornelia; Krug, Katja; Szecsenyi, Joachim; Schultz, Jobst-Hendrik

2016-01-01

This project report describes the development, "piloting" and evaluation of an interprofessional seminar on team communication bringing together medical students and Interprofessional Health Care B.Sc. students at the Medical Faculty of Heidelberg University, Germany. A five-member interprofessional team collaborated together on this project. Kolb's experiential learning concept formed the theoretical foundation for the seminar, which explored three interprofessional competency areas: team work, communication and values/ethics. Evaluation for the purposes of quality assurance and future curricula development was conducted using two quantitative measures: descriptive analysis of a standardized course evaluation tool (EvaSys) ANOVA analysis of the German translation of the University of the West of England Interprofessional Questionnaire (UWE-IP-D). The key finding from the standardized course evaluation was that the interprofessional seminars were rated more positively [M=2.11 (1 most positive and 5 most negative), SD=1, n=27] than the monoprofessional seminars [M=2.55, SD=0.98, n=90]. The key finding from the UWE-IP-D survey, comparing pre and post scores of the interprofessional (IP) (n=40) and monoprofessional (MP) groups (n=34), was that significant positive changes in mean scores for both groups towards communication, teamwork and interprofessional learning occurred. Lessons learnt included: a) recognising the benefit of being pragmatic when introducing interprofessional education initiatives, which enabled various logistical and attitudinal barriers to be overcome; b) quantitative evaluation of learning outcomes alone could not explain positive responses or potential influences of interprofessional aspects, which highlighted the need for a mixed methods approach, including qualitative methods, to enrich judgment formation on interprofessional educational outcomes.

Education and Communication in an Interprofessional Antimicrobial Stewardship Program.

PubMed

Foral, Pamela A; Anthone, Jennifer M; Destache, Christopher J; Vivekanandan, Renuga; Preheim, Laurel C; Gorby, Gary L; Horne, John M; Dobronski, Leo A; Syed, Javeria J; Mindru, Cezarina; Ali, Mir A; Ali, Karim F; Neemann, Kari A; Bittner, Marvin J

2016-09-01

Interprofessional education/interprofessional practice (IPE/IPP) is an essential component in medical education and training. A collaborative interprofessional team environment ensures optimal patient-centered care. To describe the implementation of 2 interprofessional antimicrobial stewardship program (ASP) teams using IPE/IPP and to assess the acceptance rate by the primary medical and surgical teams of ASP recommendations for antimicrobial interventions. A business plan for the ASP was approved at 2 academic medical centers used for the present study. During a 3-year study period, 2 interprofessional ASP teams included an attending physician specializing in infectious disease (ID), an ID physician fellow, an ASP pharmacist, physician residents, medical students, pharmacy residents, and pharmacy students. Educational seminars were presented for all adult-admitting physicians to discuss the need for the ASP and the prospective audit and feedback process. Cases were presented for discussion during ASP/ID rounds and recommendations were agreed upon by the ASP team. A motivational interviewing face-to-face technique was frequently used to convey the ASP team recommendation to the primary medical or surgical team in a noncoercive and educational manner. The ASP team recommendations for ASP interventions were documented in the medical records. The overall acceptance rate of recommendations by the primary medical and surgical teams were greater than 90% (2051 of 2266). The most frequent interventions provided were streamline therapy (601), route of administration change (452), bug-drug mismatch (190), and discontinuation of therapy (179). Route of administration change was also the most frequently accepted intervention (96%). The motivational face-to-face communication technique was particularly useful in conveying ASP team member recommendations to the primary medical or surgical teams. Communicating recommendations as a multidisciplinary team in an educational manner seems to have resulted in to greater acceptance of recommendations.

Military Interprofessional Health Care Teams: How USU is Working to Harness the Power of Collaboration.

PubMed

D'Angelo, Matthew R; Saperstein, Adam K; Seibert, Diane C; Durning, Steven J; Varpio, Lara

2016-11-01

Despite efforts to increase patient safety, hundreds of thousands of lives are lost each year to preventable health care errors. The Institute of Medicine and other organizations have recommended that facilitating effective interprofessional health care team work can help address this problem. While the concept of interprofessional health care teams is known, understanding and organizing effective team performance have proven to be elusive goals. Although considerable research has been conducted in the civilian sector, scholars have yet to extend research to the military context. Indeed, delivering the highest caliber of health care to our service men and women is vitally important. This commentary describes a new initiative as the Uniformed Services University of the Health Sciences aimed at researching the characteristics of successful military interprofessional teams and why those characteristics are important. It also describes the interprofessional education initiative that Uniformed Services University is launching to help optimize U.S. military health care. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Development of a Customizable Programme for Improving Interprofessional Team Meetings: An Action Research Approach

PubMed Central

van Bokhoven, Marloes Amantia; Goossens, Wilhelmus Nicolaas Marie; Daniëls, Ramon; van der Weijden, Trudy; Beurskens, Anna

2018-01-01

Introduction: Interprofessional teamwork is increasingly necessary in primary care to meet the needs of people with complex care demands. Needs assessment shows that this requires efficient interprofessional team meetings, focusing on patients’ personal goals. The aim of this study was to develop a programme to improve the efficiency and patient-centredness of such meetings. Methods: Action research approach: a first draft of the programme was developed, and iteratively used and evaluated by three primary care teams. Data were collected using observations, interviews and a focus group, and analysed using directed content analysis. Results: The final programme comprises a framework to reflect on team functioning, and training activities supplemented by a toolbox. Training is intended for the chairperson and a co-chair, and aims at organizing and structuring meetings, and enhancing patient-centredness. Our findings emphasize the essential role of the team’s chairperson, who, in addition to technically structuring meetings, should act as a change agent guiding team development. Conclusion: Findings show that the programme should be customizable to each individual team’s context and participants’ learning objectives. Becoming acquainted with new structures can be considered a growth process, in which teams have to find their way, with the chairperson as change agent. PMID:29632457

Interprofessional stroke rehabilitation for stroke survivors using home care.

PubMed

Markle-Reid, Maureen; Orridge, Camille; Weir, Robin; Browne, Gina; Gafni, Amiram; Lewis, Mary; Walsh, Marian; Levy, Charissa; Daub, Stacey; Brien, Heather; Roberts, Jacqueline; Thabane, Lehana

2011-03-01

To compare a specialized interprofessional team approach to community-based stroke rehabilitation with usual home care for stroke survivors using home care services. Randomized controlled trial of 101 community-living stroke survivors (<18 months post-stroke) using home care services. Subjects were randomized to intervention (n=52) or control (n=49) groups. The intervention was a 12-month specialized, evidence-based rehabilitation strategy involving an interprofessional team. The primary outcome was change in health-related quality of life and functioning (SF-36) from baseline to 12 months. Secondary outcomes were number of strokes during the 12-month follow-up, and changes in community reintegration (RNLI), perceived social support (PRQ85-Part 2), anxiety and depressive symptoms (Kessler-10), cognitive function (SPMSQ), and costs of use of health services from baseline to 12 months. A total of 82 subjects completed the 12-month follow-up. Compared with the usual care group, stroke survivors in the intervention group showed clinically important (although not statistically significant) greater improvements from baseline in mean SF-36 physical functioning score (5.87, 95% CI -3.98 to 15.7; p=0.24) and social functioning score (9.03, CI-7.50 to 25.6; p=0.28). The groups did not differ for any of the secondary effectiveness outcomes. There was a higher total per-person costs of use of health services in the intervention group compared to usual home care although the difference was not statistically significant (p=0.76). A 12-month specialized, interprofessional team is a feasible and acceptable approach to community-based stroke rehabilitation that produced greater improvements in quality of life compared to usual home care. Clinicaltrials.gov identifier: NCT00463229.

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.

Walking the Walk in Team-Based Education: The Crimson Care Collaborative Clinic in Family Medicine.

PubMed

Meisinger, Kirsten; Wohler, Diana

2016-09-01

Effective implementation of robust team-based care in the United States requires significant training for all team members. This education is integral to creating a culture of collaboration and respect among interprofessional members of the health care team. The lack of interprofessional clinical educational experiences contributes to a "hidden curriculum" that reinforces the problematic view that medicine is at the top of a hierarchy among health professions. However, learners themselves have started resisting this view by integrating cross-disciplinary team-based training into their own education. One example of learner-based leadership in interprofessional team care is the Crimson Care Collaborative at Cambridge Health Alliance, a student-faculty collaborative family medicine clinic. This successful clinic demonstrates that high-quality interprofessional clinical education can be accomplished through partnerships between educational institutions and existing patient-centered medical homes. © 2016 American Medical Association. All Rights Reserved.

The interprofessional team as a small group.

PubMed

Kane, R A

1975-01-01

Conflicts in interprofessional teamwork may be as much explained by group process considerations as by the interaction of professional roles and statuses. This paper examines the interprofessional team as a small group, using a synthesis of sources from social psychology, social group work, T-group literature, management theory, and health team research. Eight issues are considered in relation to the team as a small group, namely, (a) the individual in the group, (b) team size, (c) group norms, (d) democracy, (e) decision making and conflict resolution, (f) communication and structure, (g) leadership, and (h) group harmony and its relationship to group productivity.

A patient-centred team-coaching concept for medical rehabilitation.

PubMed

Körner, M; Becker, S; Dinius, J; Müller, C; Zimmermann, L; Rundel, M

2018-01-01

Team coaching enhances teamwork and subsequently improves patient-centredness in medical rehabilitation clinics. Even though interprofessional teamwork is regarded as a crucial factor in medical rehabilitation, to date no evaluated team-coaching approaches are available for improving interprofessional teamwork in medical rehabilitation in Germany. Based on a systematic literature search and interviews with staff, managers, and patients of rehabilitation clinics, we developed a team-coaching approach that is standardized in its process but based on the individual needs and requests of each clinic. It takes a systemic perspective and is goal-oriented and solution-focused. The approach mainly serves to provide impulses to make use of resources within the team and to support a self-directed organisational learning process. It is manualized and can, therefore, be used by professionals aiming to improve interprofessional teamwork in their clinic. A multi-centre, cluster-randomized controlled study that was conducted to evaluate the team-coaching approach showed positive results. Team organization, knowledge integration, and responsibility can be improved, and, therefore, the implementation of the patient-centred team-coaching approach in interprofessional rehabilitation teams can be recommended.

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…

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.

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.

Interprofessional collaboration and integration as experienced by social workers in health care.

PubMed

Glaser, Brooklyn; Suter, Esther

2016-01-01

Interprofessional collaboration in health care is gaining popularity. This secondary analysis focuses on social workers' experiences on interprofessional teams. The data revealed that social workers perceived overall collaboration as positive. However, concerns were made apparent regarding not having the opportunity to work to full scope and a lack of understanding of social work ideology from other professionals. Both factors seem to impede integration of and collaboration with social workers on health care teams. This study confirms the need to encourage and support health care providers to more fully understand the foundation, role, and efficacy of social work on interprofessional teams.

Web-based versus face-to-face interprofessional team encounters with standardized patients.

PubMed

Lempicki, Kelly A; Holland, Christine S

2018-03-01

Challenges exist in developing interprofessional education (IPE) activities including coordinating schedules and obtaining appropriate space for teams to work. Virtual worlds have been explored as a means to overcome some of these challenges. We sought to develop a web-based interprofessional team interaction with a standardized patient (SP), as compared to a face-to-face SP interaction, focusing on the competency area of interprofessional communication. Interprofessional teams of students were randomized to complete a web-based or face-to-face SP encounter. The web-based encounter was conducted via video conference that students accessed using their own electronic device. Interprofessional communication was evaluated by faculty observers and the SPs. Participants of the web-based encounter also completed a perceptions questionnaire. Interprofessional communication was rated as average/above average by the authors and SPs. Perceptions of the web-based encounter were mixed with not all students willing to complete such an encounter again despite finding it enjoyable and a positive learning experience. The need for adequate preparation was identified, including the opportunity to review the patient case before the encounter. The web-based SP encounter afforded students the opportunity to utilize communication technology to provide patient-centered care while collaborating as an interprofessional team. Video conferencing presents an opportunity to bypass some logistical challenges in scheduling IPE experiences and can be implemented as a co-curricular activity, avoiding course revisions. Additional studies are needed to further explore student and patient perspectives and clarify when, and with what level of trainees, the experiences are most valuable. Copyright © 2017 Elsevier Inc. All rights reserved.

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.

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.

Modelling the effect of perceived interdependence among mental healthcare professionals on their work role performance.

PubMed

Markon, Marie-Pierre; Chiocchio, François; Fleury, Marie-Josée

2017-07-01

The purpose of mental healthcare system reform was to enhance service efficiency by strengthening primary mental healthcare and increasing service integration in communities. Reinforcing interprofessional teamwork also intended to address the extensive and multidimensional needs of patients with mental disorders by bringing together a broader array of expertise. In this context, mental healthcare professionals (MHCPs) from various health and social care professions are more interdependent in many aspects of their work (tasks, resources, and goals). We wanted to examine the effect of perceived interdependence among MHCPs on their work role performance in the context of mental healthcare. For this purpose, we developed and tested a model coherent with the Input-Mediator-Outcome-Input (IMOI) framework of team effectiveness. Data from questionnaires administered to 315 MHCPs from four local health service networks in Quebec, Canada were analysed through structural equation modelling and mediation analysis. The structural equation model provided a good fit for the data and explained 51% of the variance of work role performance. Perceived collaboration, confidence in the advantages of interprofessional collaboration, involvement in the decision process, knowledge sharing, and satisfaction with the nature of the work partially mediated the effect of perceived interdependence among team members on work role performance. Therefore, perceived interdependence among team members had a positive impact on the work role performance of MHCPs mostly through its effect on favourable team functioning features. This implies, in practice, that increased interdependence of MHCPs would be more likely to truly enhance work role performance if team-based interventions to promote collaborative work and interprofessional teaching and training programs to support work within interprofessional teams were jointly implemented. Participation in the decision process and knowledge sharing should also be fostered, for instance, by adopting knowledge management best practices.

An Introductory Interprofessional Exercise for Healthcare Students

PubMed Central

Rege, Saumitra V.; Misto, Kara; Dollase, Richard; George, Paul

2012-01-01

Objective. To evaluate healthcare students’ perceptions of an introductory interprofessional exercise and their team dynamics. Design. A workshop was developed, combining second-year medical students, fourth-year nursing students, and third-year pharmacy students to work as an interdisciplinary team. The teams alternated between working together on patient cases focusing on chronic obstructive pulmonary disease and asthma, and on the evaluation of standardized pneumonia patients. Teams were given the patients' health information and no other instructions. A faculty member and the standardized patient evaluated the students using a teamwork global rating scale. Assessment. Student survey results showed a positive response to interprofessional teamwork. The faculty members and standardized patients reported that the students worked as a cohesive unit and demonstrated good team communication. Conclusions. This introductory interprofessional experience had a positive impact on the students’ understanding of collaboration and teamwork. This type of experience will help students foster future collaborations as healthcare providers. PMID:23129853

Balancing cognitive diversity and mutual understanding in multidisciplinary teams.

PubMed

Mitchell, Rebecca; Boyle, Brendan; O'Brien, Rachael; Malik, Ashish; Tian, Karen; Parker, Vicki; Giles, Michelle; Joyce, Pauline; Chiang, Vico

Interprofessional health care teams are increasingly utilized in health care organizations. Although there is support for their capacity to solve complex problems, there is also evidence that such teams are not always successful. In an effort to understand the capacity of interprofessional teams to innovate successfully, we investigate the role of cognitive diversity to establish whether and how knowledge differences lead to innovation. The aim of this study was to construct and investigate a model of team innovation predicted by cognitive diversity. In addition to investigating the direct impact of cognitive diversity in interprofessional health care teams, we develop a model incorporating mediated and moderated effects. In this study, we explore the role of debate as a mediating factor capable of explaining the impact of cognitive diversity on innovation. We further propose that the link between cognitive diversity and innovation through debate is contingent upon trans-specialist knowledge, knowledge shared by health care professionals, spanning specialist divides and enabling mutual understanding. The hypotheses were investigated using a cross-sectional, correlational design. Survey data received from 75 interprofessional teams employed in an acute care setting, representing a 36% response rate, were used to investigate our model. Analysis supports a significant relationship between cognitive diversity and debate, which is stronger when teams rate highly for trans-specialist knowledge. Results also support a positive relationship between debate and innovation and our full moderated mediated pathway. A range of strategies are indicated by our results to increase innovation in interprofessional teams. In particular, interventions such as interprofessional education and training, which have been shown to facilitate the development of shared language and meaning, are recommended by our findings.

A network model of communication in an interprofessional team of healthcare professionals: A cross-sectional study of a burn unit.

PubMed

Shoham, David A; Harris, Jenine K; Mundt, Marlon; McGaghie, William

2016-09-01

Healthcare teams consist of individuals communicating with one another during patient care delivery. Coordination of multiple specialties is critical for patients with complex health conditions, and requires interprofessional and intraprofessional communication. We examined a communication network of 71 health professionals in four professional roles: physician, nurse, health management, and support personnel (dietitian, pharmacist, or social worker), or other health professionals (including physical, respiratory, and occupational therapists, and medical students) working in a burn unit. Data for this cross-sectional study were collected by surveying members of a healthcare team. Ties were defined by asking team members whom they discussed patient care matters with on the shift. We built an exponential random graph model to determine: (1) does professional role influence the likelihood of a tie; (2) are ties more likely between team members from different professions compared to between team members from the same profession; and (3) which professions are more likely to form interprofessional ties. Health management and support personnel ties were 94% interprofessional while ties among nurses were 60% interprofessional. Nurses and other health professionals were significantly less likely than physicians to form ties. Nurses were 1.64 times more likely to communicate with nurses than non-nurses (OR = 1.64, 95% CI: 1.01-2.66); there was no significant role homophily for physicians, other health professionals, or health management and support personnel. Understanding communication networks in healthcare teams is an early step in understanding how teams work together to provide care; future work should evaluate the types and quality of interactions between members of interprofessional healthcare teams.

Interprofessional intensive care unit team interactions and medical crises: a qualitative study.

PubMed

Piquette, Dominique; Reeves, Scott; Leblanc, Vicki R

2009-05-01

Research has suggested that interprofessional collaboration could improve patient outcomes in the intensive care unit (ICU). Maintaining optimal interprofessional interactions in a setting where unpredictable medical crises occur periodically is however challenging. Our study aimed to investigate the perceptions of ICU health care professionals regarding how acute medical crises affect their team interactions. We conducted 25 semi-structured interviews of ICU nurses, staff physicians, and respiratory therapists. All interviews were audio-taped and transcribed, and the analysis was undertaken using an inductive thematic approach. Our data indicated that the nature of interprofessional interactions changed as teams passed through three key temporal periods around medical crises. During the "pre-crisis period", interactions were based on the mutual respect of each other's expertise. During the "crisis period", hierarchical interactions were expected and a certain lack of civility was tolerated. During the "post-crisis period", divergent perceptions emerged amongst health professionals. Post-crisis team dispersion left the nurses with questions and emotions not expressed by other team members. Nurses believed that systematic interprofessional feedback sessions held immediately after a crisis could address some of their needs. Further research is needed to establish the possible benefits of strategies addressing ICU health care professionals' specific needs for interprofessional feedback after a medical crisis.

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.

Impact of crisis resource management simulation-based training for interprofessional and interdisciplinary teams: A systematic review.

PubMed

Fung, Lillia; Boet, Sylvain; Bould, M Dylan; Qosa, Haytham; Perrier, Laure; Tricco, Andrea; Tavares, Walter; Reeves, Scott

2015-01-01

Crisis resource management (CRM) abilities are important for different healthcare providers to effectively manage critical clinical events. This study aims to review the effectiveness of simulation-based CRM training for interprofessional and interdisciplinary teams compared to other instructional methods (e.g., didactics). Interprofessional teams are composed of several professions (e.g., nurse, physician, midwife) while interdisciplinary teams are composed of several disciplines from the same profession (e.g., cardiologist, anaesthesiologist, orthopaedist). Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were searched using terms related to CRM, crisis management, crew resource management, teamwork, and simulation. Trials comparing simulation-based CRM team training versus any other methods of education were included. The educational interventions involved interprofessional or interdisciplinary healthcare teams. The initial search identified 7456 publications; 12 studies were included. Simulation-based CRM team training was associated with significant improvements in CRM skill acquisition in all but two studies when compared to didactic case-based CRM training or simulation without CRM training. Of the 12 included studies, one showed significant improvements in team behaviours in the workplace, while two studies demonstrated sustained reductions in adverse patient outcomes after a single simulation-based CRM team intervention. In conclusion, CRM simulation-based training for interprofessional and interdisciplinary teams show promise in teaching CRM in the simulator when compared to didactic case-based CRM education or simulation without CRM teaching. More research, however, is required to demonstrate transfer of learning to workplaces and potential impact on patient outcomes.

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…

The art and science of interprofessional education.

PubMed

Graybeal, Clay; Long, Richard; Scalise-Smith, Dale; Zeibig, Elizabeth

2010-01-01

Interprofessional education (IPE) is increasingly accepted as a core element of health professions education. Its primary function is to prepare health professions students to engage in and deliver interprofessional, team-based healthcare, with the ultimate goal of improving the health and well-being of patients and clients. This paper summarizes findings from 10 interviews with institutional leaders in the field. The goal was to discover core themes than contribute to the art and science of IPE. Thematic challenges and successes are reviewed, and recommendations are provided for further research and for those interested in developing or improving IPE in their own institutions.

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.

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.

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.

When less is more: validating a brief scale to rate interprofessional team competencies.

PubMed

Lie, Désirée A; Richter-Lagha, Regina; Forest, Christopher P; Walsh, Anne; Lohenry, Kevin

2017-01-01

There is a need for validated and easy-to-apply behavior-based tools for assessing interprofessional team competencies in clinical settings. The seven-item observer-based Modified McMaster-Ottawa scale was developed for the Team Objective Structured Clinical Encounter (TOSCE) to assess individual and team performance in interprofessional patient encounters. We aimed to improve scale usability for clinical settings by reducing item numbers while maintaining generalizability; and to explore the minimum number of observed cases required to achieve modest generalizability for giving feedback. We administered a two-station TOSCE in April 2016 to 63 students split into 16 newly-formed teams, each consisting of four professions. The stations were of similar difficulty. We trained sixteen faculty to rate two teams each. We examined individual and team performance scores using generalizability (G) theory and principal component analysis (PCA). The seven-item scale shows modest generalizability (.75) with individual scores. PCA revealed multicollinearity and singularity among scale items and we identified three potential items for removal. Reducing items for individual scores from seven to four (measuring Collaboration, Roles, Patient/Family-centeredness, and Conflict Management) changed scale generalizability from .75 to .73. Performance assessment with two cases is associated with reasonable generalizability (.73). Students in newly-formed interprofessional teams show a learning curve after one patient encounter. Team scores from a two-station TOSCE demonstrate low generalizability whether the scale consisted of four (.53) or seven items (.55). The four-item Modified McMaster-Ottawa scale for assessing individual performance in interprofessional teams retains the generalizability and validity of the seven-item scale. Observation of students in teams interacting with two different patients provides reasonably reliable ratings for giving feedback. The four-item scale has potential for assessing individual student skills and the impact of IPE curricula in clinical practice settings. IPE: Interprofessional education; SP: Standardized patient; TOSCE: Team objective structured clinical encounter.

Learning Outcome Measurement in Nurse Participants After Disaster Training.

PubMed

Farra, Sharon L; Smith, Sherrill; Bashaw, Marie A

2016-10-01

The National Disaster Health Consortium is an interprofessional disaster training program. Using the Hierarchical Learning Framework of Competency Sets in Disaster Medicine and Public Health, this program educates nurses and other professionals to provide competent care and leadership within the interprofessional team. This study examined outcomes of this training. Training consisted of a combination of online and on-site training. Learning outcomes were measured by using the Emergency Preparedness Information Questionnaire (EPIQ) pre/post training and participant performance during live functional exercises with the use of rubrics based on Homeland Security Exercise and Evaluation principles. A total of 64 participants completed the EPIQ before and after training. The mean EPIQ pre-training score of 154 and mean post-training score of 81 (reverse-scored) was found to be statistically significant by paired t-test (P<0.001). Performance was evaluated in the areas of triage, re-triage, surge response, and sheltering. Greater than 90% of the exercise criteria were either met or partially met. Participants successfully achieved overall objectives in all scenarios. Disaster response requires nurses and other providers to function in interprofessional teams. Educational projects, like the National Disaster Health Consortium program, offer the potential to address the need for a standardized, interprofessional disaster training curriculum to promote positive outcomes. (Disaster Med Public Health Preparedness. 2016;page 1 of 6).

Using Simulation in Interprofessional Education.

PubMed

Paige, John T; Garbee, Deborah D; Brown, Kimberly M; Rojas, Jose D

2015-08-01

Simulation-based training (SBT) is a powerful educational tool permitting the acquisition of surgical knowledge, skills, and attitudes at both the individual- and team-based level in a safe, nonthreatening learning environment at no risk to a patient. Interprofessional education (IPE), in which participants from 2 or more health or social care professions learn interactively, can help improve patient care through the promotion of efficient coordination, dissemination of advances in care across specialties and professions, and optimization of individual- and team-based function. Nonetheless, conducting SBT IPE sessions poses several tactical and strategic challenges that must be effectively overcome to reap IPE's benefits. Copyright © 2015 Elsevier Inc. 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.

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

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.

Planning for interprofessional change in primary health care: exploring the use of the Interprofessional Resource Centre

PubMed Central

Patterson, Christine; Arthur, Heather; Peachey, Gladys; Vohra, Julie; Price, David; Pearson, Dave; Mariani, Rob

2013-01-01

Importance Resources to support change are needed for solo practitioners who are transitioning to family health teams (FHTs) which involve multiple health disciplines working together to provide team-based care. Objective The purpose of this project was: (1) to explore the use of an online resource, the Interprofessional Resource Centre (IRC), when planning for interprofessional change and; (2) to explore the experience of planning interprofessional change. Design and setting Six FHTs organized under the structure of one Local Health Integrated Network (LHIN) in Ontario, Canada. Intervention Participants in six FHTs were directed to the IRC to support planning interprofessional change. In addition, two of the six FHTs participated in pilot site meetings with investigators where they received in-person support to apply the information from the IRC to an interprofessional activity. Results Pilot site participants reported the IRC was useful for planning, but they cited lack of time to use it as a key barrier. When planning for interprofessional change, providers experienced challenges with physician buy-in and team dynamics. As a strategy for change, providers would like to learn from other FHTs who have experienced success with interprofessional change; at the LHIN level, they saw a need for more educational opportunities. Participation was found to be low among those only receiving online support. Conclusion and relevance Based on the results of the study, it appears that online resource centers do have some value in knowledge translation when combined with in-person meetings. In exploring the planning of interprofessional change in primary health care teams, it was found that buy-in with physicians is a key challenge. PMID:23901309

The relationship between team climate and interprofessional collaboration: Preliminary results of a mixed methods study.

PubMed

Agreli, Heloise F; Peduzzi, Marina; Bailey, Christopher

2017-03-01

Relational and organisational factors are key elements of interprofessional collaboration (IPC) and team climate. Few studies have explored the relationship between IPC and team climate. This article presents a study that aimed to explore IPC in primary healthcare teams and understand how the assessment of team climate may provide insights into IPC. A mixed methods study design was adopted. In Stage 1 of the study, team climate was assessed using the Team Climate Inventory with 159 professionals in 18 interprofessional teams based in São Paulo, Brazil. In Stage 2, data were collected through in-depth interviews with a sample of team members who participated in the first stage of the study. Results from Stage 1 provided an overview of factors relevant to teamwork, which in turn informed our exploration of the relationship between team climate and IPC. Preliminary findings from Stage 2 indicated that teams with a more positive team climate (in particular, greater participative safety) also reported more effective communication and mutual support. In conclusion, team climate provided insights into IPC, especially regarding aspects of communication and interaction in teams. Further research will provide a better understanding of differences and areas of overlap between team climate and IPC. It will potentially contribute for an innovative theoretical approach to explore interprofessional work in primary care settings.

An interprofessional communication training using simulation to enhance safe care for a deteriorating patient.

PubMed

Liaw, Sok Ying; Zhou, Wen Tao; Lau, Tang Ching; Siau, Chiang; Chan, Sally Wai-Chi

2014-02-01

Communication and teamwork between doctors and nurses are critical for optimal patient care. Simulation and interprofessional team learning are emerging as significant learning strategies to promote teamwork and communication between different health professionals. The aim of the study is to describe the development, implementation and evaluation of a simulation-based interprofessional educational (Sim-IPE) program, using a presage-process-product (3P) model, for improving medical and nursing students' communication skills in caring of a patient with physiological deterioration. The program was conducted using full-scale simulation and communication strategies adapted from Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS). 127 medical and nursing students participated in a 3-hour small group interprofessional learning that incorporated simulation scenarios of deteriorating patients. Pre and post-tests were conducted to assess the students' self-confidence in interprofessional communication and perception in interprofessional learning. After the training, the students completed a satisfaction questionnaire. Both medicine and nursing groups demonstrated a significant improvement on post-test score from pre-test score for self-confidence (p<.0001) and perception (p<.0001) with no significant differences detected between the two groups. The participants were highly satisfied with their simulation learning. The Sim-IPE has better prepared the medical and nursing students in communicating with one another in providing safe care for deteriorating patient. In addition, it has improved their perception towards interprofessional learning. This pre-registration interprofessional education could prepare them for more comprehensive interprofessional team learning at post-registration level. Copyright © 2014 Elsevier Ltd. All rights reserved.

A mixed-methods study of interprofessional learning of resuscitation skills.

PubMed

Bradley, Paul; Cooper, Simon; Duncan, Fiona

2009-09-01

This study aimed to identify the effects of interprofessional resuscitation skills teaching on medical and nursing students' attitudes, leadership, team-working and performance skills. Year 2 medical and nursing students learned resuscitation skills in uniprofessional or interprofessional settings, prior to undergoing observational ratings of video-recorded leadership, teamwork and skills performance and subsequent focus group interviews. The Readiness for Interprofessional Learning Scale (RIPLS) was administered pre- and post-intervention and again 3-4 months later. There was no significant difference between interprofessional and uniprofessional teams for leadership, team dynamics or resuscitation tasks performance. Gender, previous interprofessional learning experience, professional background and previous leadership experience had no significant effect. Interview analysis showed broad support for interprofessional education (IPE) matched to clinical reality with perceived benefits for teamwork, communication and improved understanding of roles and perspectives. Concerns included inappropriate role adoption, hierarchy issues, professional identity and the timing of IPE episodes. The RIPLS subscales for professional identity and team-working increased significantly post-intervention for interprofessional groups but returned to pre-test levels by 3-4 months. However, interviews showed interprofessional groups retained a 'residual positivity' towards IPE, more so than uniprofessional groups. An intervention based on common, relevant, shared learning outcomes set in a realistic educational context can work with students who have differing levels of previous IPE and skills training experience. Qualitatively, positive attitudes outlast quantitative changes measured using the RIPLS. Further quantitative and qualitative work is required to examine other domains of learning, the timing of interventions and impact on attitudes towards IPE.

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.

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.

Examining the effects of an experiential interprofessional education activity with older adults.

PubMed

Conti, Gerry; Bowers, Cassandra; O'Connell, Mary Beth; Bruer, Stephen; Bugdalski-Stutrud, Carol; Smith, Geralynn; Bickes, Joan; Mendez, Jennifer

2016-01-01

The need for experienced healthcare professionals to work with older adults is great, yet educational training is limited. In this interprofessional education (IPE) study, 861 students from five professions made 293 visits in the homes or preferred community settings of 208 older adults. Surveys with quantitative and open-text feedback assessed attitudes towards older adults, IPE team functioning, and the value of home visits. Survey results showed strongly positive attitudes towards ageing and older adults. Students from all professions expressed surprise and admiration for the active lives led by these healthier older adults, lives clearly in contrast to stereotypes of ageing. They further acknowledged the value of collaborative team functioning in meeting older adult needs, learned more about the roles and responsibilities of other professions, and identified strengths of the home as a site for care. Students positively valued the experience as part of their professional training, with 82% of all students stating they would welcome additional IPE opportunities. Results suggest that an experiential IPE activity can positively shape student attitudes towards older adults, IPE, and interprofessional collaboration.

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.

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.

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

Cognitive Aids for Role Definition (CARD) to improve interprofessional team crisis resource management: An exploratory study.

PubMed

Renna, Tania Di; Crooks, Simone; Pigford, Ashlee-Ann; Clarkin, Chantalle; Fraser, Amy B; Bunting, Alexandra C; Bould, M Dylan; Boet, Sylvain

2016-09-01

This study aimed to assess the perceived value of the Cognitive Aids for Role Definition (CARD) protocol for simulated intraoperative cardiac arrests. Sixteen interprofessional operating room teams completed three consecutive simulated intraoperative cardiac arrest scenarios: current standard, no CARD; CARD, no CARD teaching; and CARD, didactic teaching. Each team participated in a focus group interview immediately following the third scenario; data were transcribed verbatim and qualitatively analysed. After 6 months, participants formed eight new teams randomised to two groups (CARD or no CARD) and completed a retention intraoperative cardiac arrest simulation scenario. All simulation sessions were video recorded and expert raters assessed team performance. Qualitative analysis of the 16 focus group interviews revealed 3 thematic dimensions: role definition in crisis management; logistical issues; and the "real life" applicability of CARD. Members of the interprofessional team perceived CARD very positively. Exploratory quantitative analysis found no significant differences in team performance with or without CARD (p > 0.05). In conclusion, qualitative data suggest that the CARD protocol clarifies roles and team coordination during interprofessional crisis management and has the potential to improve the team performance. The concept of a self-organising team with defined roles is promising for patient safety.

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.

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.

All the World's a Stage: Integrating Theater and Medicine for Interprofessional Team Building in Physician and Nurse Residency Programs.

PubMed

Salam, Tabassum; Collins, Michelle; Baker, Ann-Marie

2012-01-01

To facilitate the delivery of excellent patient care, physician-nurse teams must work in a collaborative manner. We found that venues for the joint training of physician-nurse teams to foster collaboration are insufficient. We developed a novel interprofessional experience in which resident physicians and nurse residents practiced communication and collaboration skills involving a simulated alcohol withdrawal patient care scenario. Theater students portrayed the patients experiencing withdrawal. The team cared for each patient in a fully equipped and functioning hospital room in a simulation center. Together, they collaborated on interventions and a patient plan of care. After the 10-minute bedside scenario, physician and nurse educators facilitated a joint debriefing session for the physician-nurse learning team. Learners noted an improvement in their ability to identify alcohol withdrawal (44% of participants preencounter to 94% of participants postencounter) and to communicate with team members (55% of participants preencounter to 81% of participants postencounter). The learners felt the physician-nurse team training experience was exceptionally valuable for its authenticity.

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.

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.

Building social capital with interprofessional student teams in rural settings: A service-learning model.

PubMed

Craig, Pippa L; Phillips, Christine; Hall, Sally

2016-08-01

To describe outcomes of a model of service learning in interprofessional learning (IPL) aimed at developing a sustainable model of training that also contributed to service strengthening. A total of 57 semi-structured interviews with key informants and document review exploring the impacts of interprofessional student teams engaged in locally relevant IPL activities. Six rural towns in South East New South Wales. Local facilitators, staff of local health and other services, health professionals who supervised the 89 students in 37 IPL teams, and academic and administrative staff. Perceived benefits as a consequence of interprofessional, service-learning interventions in these rural towns. Reported outcomes included increased local awareness of a particular issue addressed by the team; improved communication between different health professions; continued use of the team's product or a changed procedure in response to the teams' work; and evidence of improved use of a particular local health service. Given the limited workforce available in rural areas to supervise clinical IPL placements, a service-learning IPL model that aims to build social capital may be a useful educational model. © 2015 National Rural Health Alliance Inc.

Healthcare provider perceptions of the role of interprofessional care in access to and outcomes of primary care in an underserved area.

PubMed

Wan, Shaowei; Teichman, Peter G; Latif, David; Boyd, Jennifer; Gupta, Rahul

2018-03-01

To meet the needs of an aging population who often have multiple chronic conditions, interprofessional care is increasingly adopted by patient-centred medical homes and Accountable Care Organisations to improve patient care coordination and decrease costs in the United States, especially in underserved areas with primary care workforce shortages. In this cross-sectional survey across multiple clinical settings in an underserved area, healthcare providers perceived overall outcomes associated with interprofessional care teams as positive. This included healthcare providers' beliefs that interprofessional care teams improved patient outcomes, increased clinic efficiency, and enhanced care coordination and patient follow-up. Teams with primary care physician available each day were perceived as better able to coordinate care and follow up with patients (p = .031), while teams that included clinical pharmacists were perceived as preventing medication-associated problems (p < .0001). Healthcare providers perceived the interprofessional care model as a useful strategy to improve various outcomes across different clinical settings in the context of a shortage of primary care physicians.

An Interprofessional Learning Module on Asthma Health Promotion

PubMed Central

Shah, Smita; Kearey, Phoebe; Bosnic-Anticevich, Sinthia; Grootjans, John; Armour, Carol

2011-01-01

Objective To develop, implement, and evaluate a new interprofessional learning module that focused on asthma health promotion called Taking Action Together for Asthma. Design Faculty members in medicine, nursing, and pharmacy courses recruited 10 students each to participate in a 3-day interprofessional learning module. Students received extensive materials including a workbook to document their expectations and experience; completed a 1-day interprofessional workshop; received training in the Triple A (Adolescent Asthma Action) program; and went into high schools and taught the Triple A program to students in interprofessional teams. Assessment Before and after participating in the module, students completed a questionnaire consisting of 3 previously validated instruments: the Asthma Knowledge for Health Professionals Scale, Attitudes Toward Health Care Teams Scale, and Readiness for Interprofessional Learning Scale (RIPLS). Seventeen students completed both the pre- and post-module scales and significant changes were seen only in means scores for the Attitude Toward Healthcare Teams (81.0 ± 4.7 to 85.2 ± 5.9) and the Teamwork and Collaboration subscale of the RIPLS (41.4 ± 2.7 to 43.2 ± 2.7). Conclusion Health promotion activities offer a viable mechanism for fostering interprofessional learning among health professions students. PMID:21519420

An interprofessional learning module on asthma health promotion.

PubMed

Saini, Bandana; Shah, Smita; Kearey, Phoebe; Bosnic-Anticevich, Sinthia; Grootjans, John; Armour, Carol

2011-03-10

To develop, implement, and evaluate a new interprofessional learning module that focused on asthma health promotion called Taking Action Together for Asthma. Faculty members in medicine, nursing, and pharmacy courses recruited 10 students each to participate in a 3-day interprofessional learning module. Students received extensive materials including a workbook to document their expectations and experience; completed a 1-day interprofessional workshop; received training in the Triple A (Adolescent Asthma Action) program; and went into high schools and taught the Triple A program to students in interprofessional teams. Before and after participating in the module, students completed a questionnaire consisting of 3 previously validated instruments: the Asthma Knowledge for Health Professionals Scale, Attitudes Toward Health Care Teams Scale, and Readiness for Interprofessional Learning Scale (RIPLS). Seventeen students completed both the pre- and post-module scales and significant changes were seen only in means scores for the Attitude Toward Healthcare Teams (81.0 ± 4.7 to 85.2 ± 5.9) and the Teamwork and Collaboration subscale of the RIPLS (41.4 ± 2.7 to 43.2 ± 2.7). Health promotion activities offer a viable mechanism for fostering interprofessional learning among health professions students.

Working together: Using a unique approach to evaluate an interactive and clinic-based longitudinal interprofessional education experience with 13 professions.

PubMed

Thompson, Britta M; Bratzler, Dale W; Fisher, Mark J; Torres, Amie; Faculty, Epic; Sparks, Rhonda A

2016-11-01

Interprofessional education (IPE) involving an interactive and longitudinal clinic experience at an inner-city charitable clinic from September to May 2013/2014 was evaluated. Pre-, mid-, and post-intervention data were collected from students in 13 different professions including medicine (medical and physician assistant), dentistry (dental and dental hygiene), nursing (undergraduate and clinical nurse specialist), public health, pharmacy, physical therapy, occupational therapy, nutritional sciences, speech and language pathology, and social work. To evaluate their interprofessional attitudes, students completed the TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ) and Readiness for Interprofessional Learning Scale (RIPLS). They also completed a unique measure, healthcare professionals circles diagrams (HPCDs), that indicated student conceptualisation of a healthcare team caring for a complex patient, along with perception of their team's progress towards meeting patient goals. Results from the T-TAQ and RIPLS scores indicated small but significant increases from pre- to post-intervention (p = 0.005 and 0.012, respectively). Analysis of the HPCDs revealed significant increases in students' perceptions of the types of interprofessional team members, relationships, and communication between professions to provide medical care to patients (p < 0.01). Most HPCDs included pharmacists, nurses, and physicians as part of the care team at all time points. Students significantly increased their inclusion of dentistry, public health, social work, and physician assistants as members of the healthcare team from pre- to post-intervention. Implications of our data indicated the importance of IPE interventions that include not only classroom-based sessions, but actual patient care experiences within interprofessional teams. It also reinforced the importance of new and unique methods to assess IPE.

Using the International Classification of Functioning, Disability and Health Framework to Achieve Interprofessional Functional Outcomes for Young Children: A Speech-Language Pathology Perspective.

PubMed

McNeilly, Lemmietta G

2018-02-01

The International Classification of Functioning, Disability and Health (ICF) framework is an excellent tool to facilitate the writing of functional goals for children who exhibit communication disorders and other developmental problems that require services from professionals in multiple therapeutic areas. The holistic view of children provides each professional with an approach that integrates how one's specific health conditions and contextual factors influence a child's functioning and participation in daily activities. This allows the interprofessional team to view the child as a person, recognizing how one need influences another within his or her environment. Copyright © 2017 Elsevier Inc. All rights reserved.

[Implementing Inter-Professional Education (IPE): Challenges and Strategies].

PubMed

Lee, Chia-Lun; Hung, Chich-Hsiu

2017-12-01

Inter-professional practice (IPP), necessary in today's healthcare environment, should be guided and practiced through inter-professional education (IPE). Within the context of an effective IPE program, collaborative medical professionals must be cognizant of the demands of patients' integrated care, organize a collaborative inter-professional team, and achieve the objectives of patient-centered care. However, the many challenges of IPE include insufficient understanding of inter-professional care, occupational culture-related boundary issues, lack of a college education, and insufficient support from academic and medical institutions. This article suggests adopting effective strategies to promote inter-professional recognition, create a harmonious medical culture, eliminate barriers to education, and enhance support for academic and medical institutions. Inter-professional collaboration between academic and clinical institutions must provide resources and substantive professional training. Effectively implementing IPE and IPP is expected to elicit trust, respect, and efficient communication from team members.

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.

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.

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.

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

Assessment of a Statewide Palliative Care Team Training Course: COMFORT Communication for Palliative Care Teams.

PubMed

Wittenberg, Elaine; Ferrell, Betty; Goldsmith, Joy; Ragan, Sandra L; Paice, Judith

2016-07-01

Despite increased attention to communication skill training in palliative care, few interprofessional training programs are available and little is known about the impact of such training. This study evaluated a communication curriculum offered to interprofessional palliative care teams and examined the longitudinal impact of training. Interprofessional, hospital-based palliative care team members were competitively selected to participate in a two-day training using the COMFORT(TM SM) (Communication, Orientation and options, Mindful communication, Family, Openings, Relating, Team) Communication for Palliative Care Teams curriculum. Course evaluation and goal assessment were tracked at six and nine months postcourse. Interprofessional palliative care team members (n = 58) representing 29 teams attended the course and completed course goals. Participants included 28 nurses, 16 social workers, 8 physicians, 5 chaplains, and one psychologist. Precourse surveys assessed participants' perceptions of institution-wide communication performance across the continuum of care and resources supporting optimum communication. Postcourse evaluations and goal progress monitoring were used to assess training effectiveness. Participants reported moderate communication effectiveness in their institutions, with the weakest areas being during bereavement and survivorship care. Mean response to course evaluation across all participants was greater than 4 (scale of 1 = low to 5 = high). Participants taught an additional 962 providers and initiated institution-wide training for clinical staff, new hires, and volunteers. Team member training improved communication processes and increased attention to communication with family caregivers. Barriers to goal implementation included a lack of institutional support as evidenced in clinical caseloads and an absence of leadership and funding. The COMFORT(TM SM) communication curriculum is effective palliative care communication training for interprofessional teams.

Getting a head start: high-fidelity, simulation-based operating room team training of interprofessional students.

PubMed

Paige, John T; Garbee, Deborah D; Kozmenko, Valeriy; Yu, Qingzhao; Kozmenko, Lyubov; Yang, Tong; Bonanno, Laura; Swartz, William

2014-01-01

Effective teamwork in the operating room (OR) is often undermined by the "silo mentality" of the differing professions. Such thinking is formed early in one's professional experience and is fostered by undergraduate medical and nursing curricula lacking interprofessional education. We investigated the immediate impact of conducting interprofessional student OR team training using high-fidelity simulation (HFS) on students' team-related attitudes and behaviors. Ten HFS OR interprofessional student team training sessions were conducted involving 2 standardized HFS scenarios, each of which was followed by a structured debriefing that targeted team-based competencies. Pre- and post-session mean scores were calculated and analyzed for 15 Likert-type items measuring self-efficacy in teamwork competencies using the t-test. Additionally, mean scores of observer ratings of team performance after each scenario and participant ratings after the second scenario for an 11-item Likert-type teamwork scale were calculated and analyzed using one-way ANOVA and t-test. Eighteen nursing students, 20 nurse anesthetist students, and 28 medical students participated in the training. Statistically significant gains from mean pre- to post-training scores occurred on 11 of the 15 self-efficacy items. Statistically significant gains in mean observer performance scores were present on all 3 subscales of the teamwork scale from the first scenario to the second. A statistically significant difference was found in comparisons of mean observer scores with mean participant scores for the team-based behaviors subscale. High-fidelity simulation OR interprofessional student team training improves students' team-based attitudes and behaviors. Students tend to overestimate their team-based behaviors. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Assessing Interprofessional Education Collaborative Competencies in Service-Learning Course

PubMed Central

Hale, Kenneth M.; Brown, Nicole V.; McAuley, James W.

2016-01-01

Objective. To investigate the effect of an interprofessional service-learning course on health professions students’ self-assessment of Interprofessional Education Collaborative (IPEC) competencies. Design. The semester-long elective course consisted of two components: a service component where students provided patient care in an interprofessional student-run free clinic and bi-weekly workshops in which students reflected on their experiences and discussed roles, team dynamics, communication skills, and challenges with underserved patient populations. Assessment. All fifteen students enrolled in the course completed a validated 42-question survey in a retrospective post-then-pre design. The survey instrument assessed IPEC competencies in four domains: Values and Ethics, Roles and Responsibilities, Interprofessional Communication, and Teams and Teamwork. Students’ self-assessment of IPEC competencies significantly improved in all four domains after completion of the course. Conclusion. Completing an interprofessional service-learning course had a positive effect on students’ self-assessment of interprofessional competencies, suggesting service-learning is an effective pedagogical platform for interprofessional education. PMID:27073285

Assessing Interprofessional Education Collaborative Competencies in Service-Learning Course.

PubMed

Sevin, Alexa M; Hale, Kenneth M; Brown, Nicole V; McAuley, James W

2016-03-25

Objective. To investigate the effect of an interprofessional service-learning course on health professions students' self-assessment of Interprofessional Education Collaborative (IPEC) competencies. Design. The semester-long elective course consisted of two components: a service component where students provided patient care in an interprofessional student-run free clinic and bi-weekly workshops in which students reflected on their experiences and discussed roles, team dynamics, communication skills, and challenges with underserved patient populations. Assessment. All fifteen students enrolled in the course completed a validated 42-question survey in a retrospective post-then-pre design. The survey instrument assessed IPEC competencies in four domains: Values and Ethics, Roles and Responsibilities, Interprofessional Communication, and Teams and Teamwork. Students' self-assessment of IPEC competencies significantly improved in all four domains after completion of the course. Conclusion. Completing an interprofessional service-learning course had a positive effect on students' self-assessment of interprofessional competencies, suggesting service-learning is an effective pedagogical platform for interprofessional education.

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.

Family physicians' perspectives on interprofessional teamwork: Findings from a qualitative study.

PubMed

Szafran, Olga; Torti, Jacqueline M I; Kennett, Sandra L; Bell, Neil R

2018-03-01

The aim of this study was to describe family physicians' perspectives of their role in the primary care team and factors that facilitate and hinder teamwork. A qualitative study was conducted employing individual interviews with 19 academic/community-based family physicians who were part of interprofessional primary care teams in Edmonton, Alberta, Canada. Professional responsibilities and roles of physicians within the team and the facilitators and barriers to teamwork were investigated. Interviews were audiotaped, transcribed and analysed for emerging themes. The study findings revealed that family physicians consistently perceived themselves as having the leadership role on in the primary care team. Facilitators of teamwork included: communication; trust and respect; defined roles/responsibilities of team members; co-location; task shifting to other health professionals; and appropriate payment mechanisms. Barriers to teamwork included: undefined roles/responsibilities; lack of space; frequent staff turnover; network boundaries; and a culture of power and control. The findings suggest that moving family physicians toward more integrative and interdependent functioning within the primary care team will require overcoming the culture of traditional professional roles, addressing facilitators and barriers to teamwork, and providing training in teamwork.

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.

Trauma Non-Technical Training (TNT-2): the development, piloting and multilevel assessment of a simulation-based, interprofessional curriculum for team-based trauma resuscitation.

PubMed

Doumouras, Aristithes G; Keshet, Itay; Nathens, Avery B; Ahmed, Najma; Hicks, Christopher M

2014-10-01

Medical error is common during trauma resuscitations. Most errors are nontechnical, stemming from ineffective team leadership, nonstandardized communication among team members, lack of global situational awareness, poor use of resources and inappropriate triage and prioritization. We developed an interprofessional, simulation-based trauma team training curriculum for Canadian surgical trainees. Here we discuss its piloting and evaluation.

Interprofessional Healthcare Teams in the Military: A Scoping Literature Review.

PubMed

Varpio, Lara; Bader, Karlen S; Meyer, Holly S; Durning, Steven J; Artino, Anthony R; Hamwey, Meghan K

2018-05-08

Research into healthcare delivered via interprofessional healthcare teams (IHTs) has uncovered that IHT can improve patient satisfaction, enhance collaborative behaviors, reduce clinical error rates, and streamline management of care delivery. Importantly, these achievements are attained by IHTs that have been trained via interprofessional education (IPE). Research indicates that interprofessional healthcare team training must be contextualized to suit the demands of each care context. However, research into the unique demands required of military IHTs has yet to be explored. For any form of IPE to be successfully implemented in the military, we need a clear understanding of how interprofessional healthcare team competencies must be tailored to suit military care contexts. Specifically, we must know: (1) What evidence is currently available regarding IHTs in the military?; and (2) What gaps in the evidence need to be addressed for IPE to be customized to meet the needs of military healthcare delivery? We conducted a scoping review of the literature was conducted to identify the breadth of knowledge currently available regarding MIHTs. A search of PubMed, EMBASE, PsycInfo, ERIC, DTIC.mil, and NYAM Gray Literature databases was conducted without date restrictions. The search terms were: (interprofessional* OR interprofessional*) AND (military OR Army OR Navy OR Navy OR Marines OR "Air Force" OR "Public Health Service") AND (health OR medicine). Of the 675 articles identified via the initial search, only 21 articles met inclusion criteria (i.e., involved military personnel, teams were medically focused, comprised at least two professional disciplines, and at least two people). The manuscripts included: seven original research studies, six commentaries, five reviews, one letter, one annual report, and one innovation report. Analyses identified three themes (i.e., effective communication, supportive team environments, members) related to successful MIHT collaborations and five related to unsuccessful MIHT collaborations (i.e., inability to develop team cohesion, lack of trust, ineffective communication and communication breakdowns, unaddressed or unresolved conflicts, rank conflicts). These manuscripts highlighted contextual factors that shape MIHTs. For example, MIHTs often work and live together for extended periods of time when deployed. Also, military rank can facilitate collaboration by establishing clear lines of reporting, but can problematize collaboration when inexperienced care providers (e.g., early career physicians) outrank other team members (e.g., medics) who have more experience providing care in deployment contexts. Given the experiences of military personnel can be perilous and unpredictable, the military has an obligation to study the unique contexts of care where interprofessional healthcare teams are employed. In doing so, better interprofessional education interventions can be tailored to better aid our service men, women, and their families.

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 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.

Changing stress while stressing change: the role of interprofessional education in mediating stress in the introduction of a transformative technology.

PubMed

Gillan, Caitlin; Wiljer, David; Harnett, Nicole; Briggs, Kaleigh; Catton, Pamela

2010-11-01

The introduction of a transformative technology into practice settings can affect the functioning of interprofessional teams, placing stress on interprofessional relationships, thus slowing adoption and change. This study explored the potential of an interprofessional education (IPE) approach to mediate this stress and facilitate the adoption of a transformative technology- Image Guided Radiation Therapy (IGRT). Oncologists, physicists, and therapists in radiation medicine who attended an interprofessional IGRT Education Course were interviewed about perceived benefits and stressors to IPE and to interprofessional practice (IPP) in the IGRT context. A modified grounded theory approach was used to conduct 14 interviews, with 200 minutes of interview time recorded. In introducing IGRT, participants noted interprofessional stress in understanding and adopting new technology. IPE offered common terminology, appreciation for others' knowledge, and a holistic framework for practice. Outcomes were thought to foster collaboration, efficiency, and improved professional role definition. Time constraints and power relations were noted to be residual stressors exacerbated by IPE, but were thought to be transient. IPE can thus be of benefit in the implementation of transformative technologies such as IGRT, through mediation of interprofessional stress inherent in change. Interprofessional knowledge, collaboration, and efficiency in practice facilitate the development and adoption of a new practice model.

Implementation of a novel population panel management curriculum among interprofessional health care trainees.

PubMed

Kaminetzky, Catherine P; Beste, Lauren A; Poppe, Anne P; Doan, Daniel B; Mun, Howard K; Woods, Nancy Fugate; Wipf, Joyce E

2017-12-22

Gaps in chronic disease management have led to calls for novel methods of interprofessional, team-based care. Population panel management (PPM), the process of continuous quality improvement across groups of patients, is rarely included in health professions training for physicians, nurses, or pharmacists. The feasibility and acceptance of such training across different healthcare professions is unknown. We developed and implemented a novel, interprofessional PPM curriculum targeted to diverse health professions trainees. The curriculum was implemented annually among internal medicine residents, nurse practitioner students and residents, and pharmacy residents co-located in a large, academic primary care site. Small groups of interprofessional trainees participated in supervised quarterly seminars focusing on chronic disease management (e.g., diabetes mellitus, hypertension, or chronic obstructive pulmonary disease) or processes of care (e.g., emergency department utilization for nonacute conditions or chronic opioid management). Following brief didactic presentations, trainees self-assessed their clinic performance using patient-level chart review, presented individual cases to interprofessional staff and faculty, and implemented subsequent feedback with their clinic team. We report data from 2011 to 2015. Program evaluation included post-session participant surveys regarding attitudes, knowledge and confidence towards PPM, ability to identify patients for referral to interprofessional team members, and major learning points from the session. Directed content analysis was performed on an open-ended survey question. Trainees (n = 168) completed 122 evaluation assessments. Trainees overwhelmingly reported increased confidence in using PPM and increased knowledge about managing their patient panel. Trainees reported improved ability to identify patients who would benefit from multidisciplinary care or referral to another team member. Directed content analysis revealed that trainees viewed team members as important system resources (n = 82). Structured interprofessional training in PPM is both feasible and acceptable to trainees across multiple professions. Curriculum participants reported improved panel management skills, increased confidence in using PPM, and increased confidence in identifying candidates for interprofessional care. The curriculum could be readily exported to other programs and contexts.

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

'Who is on your health-care team?' Asking individuals with heart failure about care team membership and roles.

PubMed

LaDonna, Kori A; Bates, Joanna; Tait, Glendon R; McDougall, Allan; Schulz, Valerie; Lingard, Lorelei

2017-04-01

Complex, chronically ill patients require interprofessional teams to address their multiple health needs; heart failure (HF) is an iconic example of this growing problem. While patients are the common denominator in interprofessional care teams, patients have not explicitly informed our understanding of team composition and function. Their perspectives are crucial for improving quality, patient-centred care. To explore how individuals with HF conceptualize their care team, and perceive team members' roles. Individuals with advanced HF were recruited from five cities in three Canadian provinces. Individuals were asked to identify their HF care team during semi-structured interviews. Team members' titles and roles, quotes pertaining to team composition and function, and frailty criteria were extracted and analysed using descriptive statistics and content analysis. A total of 62 individuals with HF identified 2-19 team members. Caregivers, nurses, family physicians and cardiologists were frequently identified; teams also included dentists, foot care specialists, drivers, housekeepers and spiritual advisors. Most individuals met frailty criteria and described participating in self-management. Individuals with HF perceived being active participants, not passive recipients, of care. They identified teams that were larger and more diverse than traditional biomedical conceptualizations. However, the nature and importance of team members' roles varied according to needs, relationships and context. Patients' degree of agency was negotiated within this context, causing multiple, sometimes conflicting, responses. Ignoring the patient's role on the care team may contribute to fragmented care. However, understanding the team through the patient's lens - and collaborating meaningfully among identified team members - may improve health-care delivery. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Leading team learning: what makes interprofessional teams learn to work well?

PubMed

Chatalalsingh, Carole; Reeves, Scott

2014-11-01

This article describes an ethnographic study focused on exploring leaders of team learning in well-established nephrology teams in an academic healthcare organization in Canada. Employing situational theory of leadership, the article provides details on how well established team members advance as "learning leaders". Data were gathered by ethnographic methods over a 9-month period with the members of two nephrology teams. These learning to care for the sick teams involved over 30 regulated health professionals, such as physicians, nurses, social workers, pharmacists, dietitians and other healthcare practitioners, staff, students and trainees, all of whom were collectively managing obstacles and coordinating efforts. Analysis involved an inductive thematic analysis of observations, reflections, and interview transcripts. The study indicated how well established members progress as team-learning leaders, and how they adapt to an interprofessional culture through the activities they employ to enable day-to-day learning. The article uses situational theory of leadership to generate a detailed illumination of the nature of leaders' interactions within an interprofessional context.

Piloting a Dispersed and Inter-Professional Lesson Study Using Technology to Link Team Members at a Distance

ERIC Educational Resources Information Center

Koutsouris, George; Norwich, Brahm; Fujita, Taro; Ralph, Thomas; Adlam, Anna; Milton, Fraser

2017-01-01

This article presents an evaluation of distance technology used in a novel Lesson Study (LS) approach involving a dispersed LS team for inter-professional purposes. A typical LS model with only school teachers as team members was modified by including university-based lecturers with the school-based teachers, using video-conferencing and online…

There is no "i" in teamwork in the patient-centered medical home: defining teamwork competencies for academic practice.

PubMed

Leasure, Emily L; Jones, Ronald R; Meade, Lauren B; Sanger, Marla I; Thomas, Kris G; Tilden, Virginia P; Bowen, Judith L; Warm, Eric J

2013-05-01

Evidence suggests that teamwork is essential for safe, reliable practice. Creating health care teams able to function effectively in patient-centered medical homes (PCMHs), practices that organize care around the patient and demonstrate achievement of defined quality care standards, remains challenging. Preparing trainees for practice in interprofessional teams is particularly challenging in academic health centers where health professions curricula are largely siloed. Here, the authors review a well-delineated set of teamwork competencies that are important for high-functioning teams and suggest how these competencies might be useful for interprofessional team training and achievement of PCMH standards. The five competencies are (1) team leadership, the ability to coordinate team members' activities, ensure appropriate task distribution, evaluate effectiveness, and inspire high-level performance, (2) mutual performance monitoring, the ability to develop a shared understanding among team members regarding intentions, roles, and responsibilities so as to accurately monitor one another's performance for collective success, (3) backup behavior, the ability to anticipate the needs of other team members and shift responsibilities during times of variable workload, (4) adaptability, the capability of team members to adjust their strategy for completing tasks on the basis of feedback from the work environment, and (5) team orientation, the tendency to prioritize team goals over individual goals, encourage alternative perspectives, and show respect and regard for each team member. Relating each competency to a vignette from an academic primary care clinic, the authors describe potential strategies for improving teamwork learning and applying the teamwork competences to academic PCMH practices.

The Mangle of Interprofessional Health Care Teams

PubMed Central

2015-01-01

The aim of this study was to explore dimensions of relational work in interprofessional health care teams. Practitioners from a variety of disciplines came together to examine teamwork and cocreate knowledge about interprofessionalism using forum theater. Interviews held prior to the workshop to explore teamwork were foundational to structuring the workshop. The forum theater processes offered participants the opportunity to enact and challenge behaviors and attitudes they experienced in health care teams. Throughout the workshop, aspects of professional identity, power, trust, communication, system structures, and motivation were explored. The activities of the workshop were analyzed using Pickering’s theory, identifying three mangle strands found in being a team: organizational influences, accomplishing tasks, and an orientation to care. Performativity was identified as having a bearing on how teams perform and how teamwork is enacted. Practice components were seen as strands within a mangling of human and nonhuman forces that shape team performativity. PMID:28462298

The value of inter-professional education: a comparative study of dental technology students' perceptions across four countries.

PubMed

Evans, J; Henderson, A J; Sun, J; Haugen, H; Myhrer, T; Maryan, C; Ivanow, K N; Cameron, A; Johnson, N W

2015-04-24

The ability to function as an effective member of a dental care team is a highly desirable--frequently mandated--attribute of dental technology (DT) graduates. Currently, there is little rigorous examination of how the learning of team-working skills might best be structured in a DT curriculum. This research compares DT curricula, and students' attitudes and perceptions regarding collaboration in practice, from four countries. Students (n=376) were invited to complete an education profile questionnaire, and the standardised measure--the shared learning scale. There were 196 (52%) responses. Students given opportunities to engage with others had better perceptions of inter-professional learning (IPL). Most believed that team-work and collaborative skills were best acquired by learning together with other dental care professionals, preferably sharing cases for real patients. Curricula should maximise opportunities for dental technology students to experience authentic IPL. Collaboration and team-work needs to be embedded through the whole undergraduate programme.

Improving interprofessional collaboration: The effect of training in nonviolent communication.

PubMed

Museux, Anne-Claire; Dumont, Serge; Careau, Emmanuelle; Milot, Élise

2016-07-01

This article examines the effects of nonviolent communication (NVC) training on the interprofessional collaboration (IPC) of two health and social services sector care teams. The study was conducted in 2013 with two interprofessional teams (N = 9) using a mixed method research design to measure the effects of the training. Individual IPC competency was measured using the Team Observed Structured Clinical Encounter tool, and group competency using the Observed Interprofessional Collaboration tool. A focus group was held to collect participant perceptions of what they learned in the training. Results revealed improvements in individual competency in client/family-centered collaboration and role clarification. Improvements in group competency were also found with respect to teams' ability to develop a shared plan of action. Data suggests that participants accepted and adopted training content. After the training, they appeared better able to identify the effects of spontaneous communication, more understanding of the mechanisms of empathy, and in a better position to foster collective leadership.

Evidence of a shared purpose, critical reflection, innovation and leadership in interprofessional healthcare teams: a realist synthesis.

PubMed

Sims, Sarah; Hewitt, Gillian; Harris, Ruth

2015-05-01

Realist synthesis is a theory-driven approach for evaluating complex interventions using empirical evidence, which seeks an explanatory analysis of who a complex intervention works for, how, why, and in what circumstances. Interprofessional teamworking in healthcare is one such complex intervention, as teams are influenced by social and organizational factors, which makes them highly variable and context dependent. This article concludes a series of four articles that report on a realist synthesis of interprofessional teamworking. The synthesis identified 13 mechanisms that are reported in the literature to be the underlying processes through which interprofessional teamworking produces its effects. This article explores four of these mechanisms: a shared purpose; critical reflection; innovation; and leadership. These mechanisms together explain how a team sets and maintains its focus and direction. This article highlights that whilst many assumptions are made within the healthcare literature about how these mechanisms operate within teams, these assumptions are not always founded upon strong empirical evidence.

Interprofessional collaborative reasoning by residents and nurses in internal medicine: Evidence from a simulation study.

PubMed

Blondon, K S; Maître, F; Muller-Juge, V; Bochatay, N; Cullati, S; Hudelson, P; Vu, N V; Savoldelli, G L; Nendaz, M R

2017-04-01

Clinical reasoning has been studied in residents or nurses, using interviews or patient-provider encounters. Despite a growing interest in interprofessional collaboration, the notion of collaborative reasoning has not been well studied in clinical settings. Our study aims at exploring resident-nurse collaborative reasoning in a simulation setting. We enrolled 14 resident-nurse teams from a general internal medicine division in a mixed methods study. Teams each managed one of four acute case scenarios, followed by a stimulated-recall session. A qualitative, inductive analysis of the transcripts identified five dimensions of collaborative reasoning: diagnostic reasoning, patient management, patient monitoring, communication with the patient, and team communication. Three investigators (two senior physicians, one nurse) assessed individual and team performances using a five-point Likert scale, and further extracted elements supporting the collaborative reasoning process. Global assessment of the resident-nurse team was not simply an average of individual performances. Qualitative results underlined the need to improve situational awareness, particularly for task overload. Team communication helped team members stay abreast of each other's thoughts and improve their efficiency. Residents and nurses differed in their reasoning processes, and awareness of this difference may contribute to improving interprofessional collaboration. Understanding collaborative reasoning can provide an additional dimension to interprofessional education.

The effects on team emotions and team effectiveness of coaching in interprofessional health and social care teams.

PubMed

Dimas, Isabel Dórdio; Renato Lourenço, Paulo; Rebelo, Teresa

2016-07-01

The purpose of this study was to examine the effects of coaching behaviours provided by peers and by the leader on the emotions experienced by interprofessional health and social care teams and on members' satisfaction with the team, as well as on team performance. Data were obtained from a survey among 344 employees working in 52 interprofessional health and social care teams from nine Portuguese organizations. The results show that leader coaching and peer coaching have a positive effect on the level of team members' satisfaction with the team and on positive emotions, and a negative effect on negative emotions. Furthermore, coaching provided by peers presents a positive effect on team performance as assessed by the leader of the team. Our findings put forward the importance of engaging in coaching behaviours to promote quality of the team experience, as well as the achievement of team performance objectives. Further studies should explore how coaching behaviours impact the patient, whose well-being is the ultimate objective of a team in the health and social care system, namely in terms of the patient's perception of quality care or patient outcomes.

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

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.

Integration of e-learning technologies in an interprofessional health science course.

PubMed

Carbonaro, Mike; King, Sharla; Taylor, Elizabeth; Satzinger, Franziska; Snart, Fern; Drummond, Jane

2008-02-01

Advances in information and communication technology are influencing instructional formats and delivery modes for post secondary teaching and learning. The purpose of this study was to determine whether interprofessional team process skills traditionally taught in a small group face-to-face classroom setting could be taught in a blended learning environment; without compromising the pedagogical approach and collaborative Group Investigation Model (Sharan & Sharan 1992) used in the course. A required interprofessional team development course designed to teach health science students (Medicine, Nursing, Pharmacy, Occupational Therapy, Physical Therapy, Dentistry, Dental Hygiene, Medical Laboratory Science, and Nutrition) team process skills was redesigned from a 100% face-to-face delivery format to a blended learning format where 70% of the instruction was delivered using a new synchronous virtual classroom technology (Elluminate www.elluminate.com) in conjunction with asynchronous technology (WebCT). It was hypothesized there would be no significant difference between the blended learning format and the traditional face-to-face format in the development of interprofessional team knowledge, skills and attitudes. The two formats were evaluated on demographic information, computer experience, and interprofessional team attitudes, knowledge and skills. The three main findings are: (a) no significant differences between student groups on achieving team process skills, (b) an observation of differences between the groups on team dynamics, and (c) a more positive achievement of course learning objectives perceived by students in the blended learning class. The results provide evidence to support our blended learning format without compromising pedagogy. They also suggest that this format enhances students' perceptions of their learning.

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.

Short-term service trips and the interprofessional team: a perspective from Honduras.

PubMed

VanderWielen, Lynn M; Halder, Gabriela E; Enurah, Alexander S; Pearson, Catherine; Stevens, Michael P; Crossman, Steven H

2015-03-01

Short-term service trips from the USA annually spend over $250 million dollars to provide healthcare to individuals in developing nations. These trips often uniquely define goals as related to changes in the host population and overlook the valuable benefits potentially incurred by the trip volunteers. The Honduras Outreach Medical Brigada Relief Effort utilizes an interprofessional team approach to develop the dual goals of improving health and quality of life in host communities and improving interprofessional teamwork values and skills among participants. This article outlines details of this program, describes on-going evaluation work and discusses the interprofessional implications from this project.

Strategies for interprofessional education: the Interprofessional Team Objective Structured Clinical Examination for midwifery and medical students.

PubMed

Cullen, Lindsay; Fraser, Diane; Symonds, Ian

2003-08-01

This paper provides an overview of the processes involved in implementing an interprofessional education (IPE) strategy in a recently established School of Human Development at the University of Nottingham. The merger of the academic divisions of child health, midwifery, obstetrics and gynaecology was a deliberate initiative to create an organisational infrastructure intended to enhance opportunities for interprofessional collaborations in research and education. As a first step, a small group of academic midwives and obstetricians formed a project group to find the best way of facilitating IPE for medical and midwifery students at undergraduate level. A discussion is provided of the work the project group undertook to: determine an agreed definition of IPE; decide an action research approach was needed; determine the ways in which teaching and learning strategies were to be implemented, evaluated and compared; and identify the factors inhibiting and enhancing developments. Evaluations have demonstrated that the Interprofessional Team Objective Structured Clinical Examination (ITOSCE) focusing on intrapartum scenarios is effective in promoting interprofessional learning. Both medical and midwifery students and facilitators agree that team working and understanding each other's roles has been enhanced and that although resource intensive, IPE is worth the time and effort involved.

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.

Fostering successful interprofessional teamwork through an undergraduate student placement in a secondary school.

PubMed

Fortugno, Mariella; Chandra, Smriti; Espin, Sherry; Gucciardi, Enza

2013-07-01

This exploratory case study examined an interprofessional placement of undergraduate students from nutrition, nursing, early childhood education, and child and youth care who collaborated to develop and deliver four healthy-living modules to secondary school students in Canada. An inductive thematic analysis was used to describe the teamwork that occurred between students. Data collected included focus groups with undergraduate students and preceptors, undergraduate students' reflections and secondary school students' evaluations of the modules delivered. Two major themes that emerged from all data sources were "team functioning" and "shift in perspectives". The undergraduate students identified several ways that facilitated their successful and positive teamwork with one another and also expressed how the placement experience improved their interprofessional skills. Findings from this study are discussed in relation to contact theory (Allport, 1954) and self-presentation theory (Goffman, 1963). This study suggests that providing undergraduate students with interprofessional placements in an educational setting can enhance interprofessional teamwork opportunities for students of various disciplines.

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.

Developing a grounded theory for interprofessional collaboration acquisition using facilitator and actor perspectives in simulated wilderness medical emergencies.

PubMed

Smith, Heather A; Reade, Maurianne; Marr, Marion; Jeeves, Nicholas

2017-01-01

Interprofessional collaboration is a complex process that has the potential to transform patient care for the better in urban, rural and remote healthcare settings. Simulation has been found to improve participants' interprofessional competencies, but the mechanisms by which interprofessionalism is learned have yet to be understood. A rural wilderness medicine conference (WildER Med) in northern Ontario, Canada with simulated medical scenarios has been demonstrated to be effective in improving participants' collaboration without formal interprofessional education (IPE) curriculum. Interprofessionalism may be taught through rural and remote medical simulation, as done in WildER Med where participants' interprofessional competencies improved without any formal IPE curriculum. This learning may be attributed to the informal and hidden curriculum. Understanding the mechanism by which this rural educational experience contributed to participants' learning to collaborate requires insight into the events before, during and after the simulations. The authors drew upon feedback from facilitators and patient actors in one-on-one interviews to develop a grounded theory for how collaboration is taught and learned. Sharing emerged as the core concept of a grounded theory to explain how team members acquired interprofessional collaboration competencies. Sharing was enacted through the strategies of developing common goals, sharing leadership, and developing mutual respect and understanding. Further analysis of the data and literature suggests that the social wilderness environment was foundational in enabling sharing to occur. Medical simulations in other rural and remote settings may offer an environment conducive to collaboration and be effective in teaching collaboration. When designing interprofessional education, health educators should consider using emergency response teams or rural community health teams to optimize the informal and hidden curriculum contributing to interprofessional learning.

Roles, processes, and outcomes of interprofessional shared decision-making in a neonatal intensive care unit: A qualitative study.

PubMed

Dunn, Sandra I; Cragg, Betty; Graham, Ian D; Medves, Jennifer; Gaboury, Isabelle

2018-05-01

Shared decision-making provides an opportunity for the knowledge and skills of care providers to synergistically influence patient care. Little is known about interprofessional shared decision-making processes in critical care settings. The aim of this study was to explore interprofessional team members' perspectives about the nature of interprofessional shared decision-making in a neonatal intensive care unit (NICU) and to determine if there are any differences in perspectives across professional groups. An exploratory qualitative approach was used consisting of semi-structured interviews with 22 members of an interprofessional team working in a tertiary care NICU in Canada. Participants identified four key roles involved in interprofessional shared decision-making: leader, clinical experts, parents, and synthesizer. Participants perceived that interprofessional shared decision-making happens through collaboration, sharing, and weighing the options, the evidence and the credibility of opinions put forward. The process of interprofessional shared decision-making leads to a well-informed decision and participants feeling valued. Findings from this study identified key concepts of interprofessional shared decision-making, increased awareness of differing professional perspectives about this process of shared decision-making, and clarified understanding of the different roles involved in the decision-making process in an NICU.

Interprofessional Health Team Communication About Hospital Discharge: An Implementation Science Evaluation Study.

PubMed

Bahr, Sarah J; Siclovan, Danielle M; Opper, Kristi; Beiler, Joseph; Bobay, Kathleen L; Weiss, Marianne E

The Consolidated Framework for Implementation Research guided formative evaluation of the implementation of a redesigned interprofessional team rounding process. The purpose of the redesigned process was to improve health team communication about hospital discharge. Themes emerging from interviews of patients, nurses, and providers revealed the inherent value and positive characteristics of the new process, but also workflow, team hierarchy, and process challenges to successful implementation. The evaluation identified actionable recommendations for modifying the implementation process.

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.

Enhancing Interprofessional Education With Team-Based Learning.

PubMed

Buhse, Marijean; Della Ratta, Carol

Interprofessional education (IPE) has gained momentum across health profession schools in simulation and clinical settings. Exploring interprofessional experiences in the classroom setting may further enhance collaborative skills while advancing clinical knowledge. The authors describe an innovative approach to IPE to teach chronic care concepts to graduate nursing, physician assistant, and public health students. Enhancing IPE with a team-based learning approach resulted in improved knowledge of chronic care management, student perceptions of mutual respect, and perceived development of communication and teamwork skills.

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.

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).…

A Video Analysis of Intra- and Interprofessional Leadership Behaviors Within "The Burns Suite": Identifying Key Leadership Models.

PubMed

Sadideen, Hazim; Weldon, Sharon-Marie; Saadeddin, Munir; Loon, Mark; Kneebone, Roger

2016-01-01

Leadership is particularly important in complex highly interprofessional health care contexts involving a number of staff, some from the same specialty (intraprofessional), and others from different specialties (interprofessional). The authors recently published the concept of "The Burns Suite" (TBS) as a novel simulation tool to deliver interprofessional and teamwork training. It is unclear which leadership behaviors are the most important in an interprofessional burns resuscitation scenario, and whether they can be modeled on to current leadership theory. The purpose of this study was to perform a comprehensive video analysis of leadership behaviors within TBS. A total of 3 burns resuscitation simulations within TBS were recorded. The video analysis was grounded-theory inspired. Using predefined criteria, actions/interactions deemed as leadership behaviors were identified. Using an inductive iterative process, 8 main leadership behaviors were identified. Cohen's κ coefficient was used to measure inter-rater agreement and calculated as κ = 0.7 (substantial agreement). Each video was watched 4 times, focusing on 1 of the 4 team members per viewing (senior surgeon, senior nurse, trainee surgeon, and trainee nurse). The frequency and types of leadership behavior of each of the 4 team members were recorded. Statistical significance to assess any differences was assessed using analysis of variance, whereby a p < 0.05 was taken to be significant. Leadership behaviors were triangulated with verbal cues and actions from the videos. All 3 scenarios were successfully completed. The mean scenario length was 22 minutes. A total of 362 leadership behaviors were recorded from the 12 participants. The most evident leadership behaviors of all team members were adhering to guidelines (which effectively equates to following Advanced Trauma and Life Support/Emergency Management of Severe Burns resuscitation guidelines and hence "maintaining standards"), followed by making decisions. Although in terms of total frequency the senior surgeon engaged in more leadership behaviors compared with the entire team, statistically there was no significant difference between all 4 members within the 8 leadership categories. This analysis highlights that "distributed leadership" was predominant, whereby leadership was "distributed" or "shared" among team members. The leadership behaviors within TBS also seemed to fall in line with the "direction, alignment, and commitment" ontology. Effective leadership is essential for successful functioning of work teams and accomplishment of task goals. As the resuscitation of a patient with major burns is a dynamic event, team leaders require flexibility in their leadership behaviors to effectively adapt to changing situations. Understanding leadership behaviors of different team members within an authentic simulation can identify important behaviors required to optimize nontechnical skills in a major resuscitation. Furthermore, attempting to map these behaviors on to leadership models can help further our understanding of leadership theory. Collectively this can aid the development of refined simulation scenarios for team members, and can be extrapolated into other areas of simulation-based team training and interprofessional education. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Interprofessional Online Global Health Course

PubMed Central

Devraj, Radhika; Blankson, Faustina; Xin, Huaibo

2016-01-01

Objective. The design and evaluation of an online global health course targeted for pharmacy and other undergraduates is presented. Design. Enrolled students represented nursing, health education, pharmacy and a variety of other disciplines. The course was designed as an entirely online one with no class meetings. The course consisted of eight modules addressing global health competencies and interprofessional education competencies. Readings, quizzes, study question and team projects were tailored to the goals of each module. Students worked in interprofessional teams for their team projects. Assessment. Assessments consisted of pre and post course perceptions and course evaluation. Rubrics were designed to evaluate team assignments and peer assessment of team participation. Conclusion. Course was successful in enhancing perceptions of global health knowledge and understanding of roles and responsibilities of various health disciplines in addressing challenges of global health. No changes in teamwork perceptions were documented after completing the course. The overall course structure was successful in meeting course goals. PMID:28090104

Conceptualizing Interprofessional Teams as Multi-Team Systems-Implications for Assessment and Training.

PubMed

West, Courtney; Landry, Karen; Graham, Anna; Graham, Lori; Cianciolo, Anna T; Kalet, Adina; Rosen, Michael; Sherman, Deborah Witt

2015-01-01

SGEA 2015 CONFERENCE ABSTRACT (EDITED). Evaluating Interprofessional Teamwork During a Large-Scale Simulation. Courtney West, Karen Landry, Anna Graham, and Lori Graham. CONSTRUCT: This study investigated the multidimensional measurement of interprofessional (IPE) teamwork as part of large-scale simulation training. Healthcare team function has a direct impact on patient safety and quality of care. However, IPE team training has not been the norm. Recognizing the importance of developing team-based collaborative care, our College of Nursing implemented an IPE simulation activity called Disaster Day and invited other professions to participate. The exercise consists of two sessions: one in the morning and another in the afternoon. The disaster scenario is announced just prior to each session, which consists of team building, a 90-minute simulation, and debriefing. Approximately 300 Nursing, Medicine, Pharmacy, Emergency Medical Technicians, and Radiology students and over 500 standardized and volunteer patients participated in the Disaster Day event. To improve student learning outcomes, we created 3 competency-based instruments to evaluate collaborative practice in multidimensional fashion during this exercise. A 20-item IPE Team Observation Instrument designed to assess interprofessional team's attainment of Interprofessional Education Collaborative (IPEC) competencies was completed by 20 faculty and staff observing the Disaster Day simulation. One hundred sixty-six standardized patients completed a 10-item Standardized Patient IPE Team Evaluation Instrument developed from the IPEC competencies and adapted items from the 2014 Henry et al. PIVOT Questionnaire. This instrument assessed the standardized or volunteer patient's perception of the team's collaborative performance. A 29-item IPE Team's Perception of Collaborative Care Questionnaire, also created from the IPEC competencies and divided into 5 categories of Values/Ethics, Roles and Responsibilities, Communication, Teamwork, and Self-Evaluation, was completed by 188 students including 99 from Nursing, 43 from Medicine, 6 from Pharmacy, and 40 participants who belonged to more than one component, were students at another institution, or did not indicate their institution. The team instrument was designed to assess each team member's perception of how well the team and him- or herself met the competencies. Five of the items on the team perceptions questionnaire mirrored items on the standardized patient evaluation: demonstrated leadership practices that led to effective teamwork, discussed care and decisions about that care with patient, described roles and responsibilities clearly, worked well together to coordinate care, and good/effective communication. Internal consistency reliability of the IPE Team Observation Instrument was 0.80. In 18 of the 20 items, more than 50% of observers indicated the item was demonstrated. Of those, 6 of the items were observed by 50% to 75% of the observers, and the remaining 12 were observed by more than 80% of the observers. Internal consistency reliability of the IPE Team's Perception of Collaborative Care Instrument was 0.95. The mean response score-1 (strongly disagree) to 4 (strongly agree)-was calculated for each section of the instrument. The overall mean score was 3.57 (SD = .11). Internal consistency reliability of the Standardized Patient IPE Team Evaluation Instrument was 0.87. The overall mean score was 3.28 (SD = .17). The ratings for the 5 items shared by the standardized patient and team perception instruments were compared using independent sample t tests. Statistically significant differences (p < .05) were present in each case, with the students rating themselves higher on average than the standardized patients did (mean differences between 0.2 and 0.6 on a scale of 1-4). Multidimensional, competency-based instruments appear to provide a robust view of IPE teamwork; however, challenges remain. Due to the large scale of the simulation exercise, observation-based assessment did not function as well as self- and standardized patient-based assessment. To promote greater variation in observer assessments during future Disaster Day simulations, we plan to adjust the rating scale from "not observed," "observed," and "not applicable" to a 4-point scale and reexamine interrater reliability.

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.

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.

Attitudes of clinician educators towards interprofessional education and collaboration: Insights from two interprofessional scales.

PubMed

Ong, Sik Yin; Tan, Nigel C K; Knab, Mary S; Farrell, Susan E; Lim, Wee Shiong

2017-09-01

The increasing complexity of healthcare needs underlines the growing importance of interprofessional education and collaborative practice (IPECP) in enhancing quality of patient care. In particular, clinician educators play an influential role in advocating IPECP. The primary goal of our exploratory pilot study is to explore 34 clinician educators' attitudes towards IPECP by using the adapted 14-item Attitudes Toward Health Care Teams Scale (ATHCTS) and 15-item Readiness for Interprofessional Learning Scale (RIPLS). Mean scores of ATHCTS and RIPLS were 3.81 (SD = 0.90) and 4.02 (SD = 0.79), respectively. Using exploratory factor analysis, we identified four factors: team value (ATHCTS), team efficiency (ATHCTS), teamwork and collaboration (RIPLS), and professional socialisation (RIPLS). The "team efficiency" factor on the ATHCTS scored lowest (factor mean = 3.49) compared with other factors (factor means = 3.87-4.08). Correlation analyses revealed that the "team efficiency" factor had small correlations with other factors (r = -0.05-0.37). Our clinician educators valued IPECP in promoting teamwork and professional socialisation but they perceived IPECP to compromise efficiency. The issue of perceived inefficiency by clinician educators merits attention in order to promote wider implementation of IPECP.

Relationship of organizational culture, teamwork and job satisfaction in interprofessional teams.

PubMed

Körner, Mirjam; Wirtz, Markus A; Bengel, Jürgen; Göritz, Anja S

2015-06-23

Team effectiveness is often explained on the basis of input-process-output (IPO) models. According to these models a relationship between organizational culture (input = I), interprofessional teamwork (process = P) and job satisfaction (output = O) is postulated. The aim of this study was to examine the relationship between these three aspects using structural analysis. A multi-center cross-sectional study with a survey of 272 employees was conducted in fifteen rehabilitation clinics with different indication fields in Germany. Structural equation modeling (SEM) was carried out using AMOS software version 20.0 (maximum-likelihood method). Of 661 questionnaires sent out to members of the health care teams in the medical rehabilitation clinics, 275 were returned (41.6%). Three questionnaires were excluded (missing data greater than 30%), yielding a total of 272 employees that could be analyzed. The confirmatory models were supported by the data. The results showed that 35% of job satisfaction is predicted by a structural equation model that includes both organizational culture and teamwork. The comparison of this predictive IPO model (organizational culture (I), interprofessional teamwork (P), job satisfaction (O)) and the predictive IO model (organizational culture (I), job satisfaction (O)) showed that the effect of organizational culture is completely mediated by interprofessional teamwork. The global fit indices are a little better for the IO model (TLI: .967, CFI: .972, RMSEA .052) than for the IPO model (TLI: .934, CFI: .943, RMSEA: .61), but the prediction of job satisfaction is better in the IPO model (R(2) = 35%) than in the IO model (R(2) = 24%). Our study results underpin the importance of interprofessional teamwork in health care organizations. To enhance interprofessional teamwork, team interventions can be recommended and should be supported. Further studies investigating the organizational culture and its impact on interprofessional teamwork and team effectiveness in health care are important.

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.

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."

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.

Attitudes of pharmacy and nutrition students towards team-based care after first exposure to interprofessional education in Qatar.

PubMed

Wilby, Kyle John; Al-Abdi, Tamara; Hassan, Abdelmonem; Brown, Marian Amanda; Paravattil, Bridget; Khalifa, Sherief Ibrahim

2015-01-01

Little is known regarding attitudes of healthcare professional students towards team-based care in the Middle East. As modernization of health systems is rapidly occurring across the Gulf Cooperation Council countries, it is important for students to engage in interprofessional education (IPE) activities. The objective of this study was to assess pre-clinical students' attitudes towards interprofessional healthcare teams after completion of their first IPE activity. A previously validated questionnaire was distributed to 25 pharmacy and 17 nutrition students at Qatar University after participation in an IPE event. Questions related to quality of team-based care and physician centricity. Results showed high agreement regarding high quality care provided by teams yet students were unsure of the value of team-based care when considering required time for implementation. Results provide baseline data for future studies to assess student attitudes throughout the professional programs and give valuable insight for future IPE program design in the Middle East.

Human Simulators and Standardized Patients to Teach Difficult Conversations to Interprofessional Health Care Teams

PubMed Central

Zimmerman, Christine; Kennedy, Christopher; Schremmer, Robert; Smith, Katharine V.

2010-01-01

Objective To design and implement a demonstration project to teach interprofessional teams how to recognize and engage in difficult conversations with patients. Design Interdisciplinary teams consisting of pharmacy students and residents, student nurses, and medical residents responded to preliminary questions regarding difficult conversations, listened to a brief discussion on difficult conversations; formed ad hoc teams and interacted with a standardized patient (mother) and a human simulator (child), discussing the infant's health issues, intimate partner violence, and suicidal thinking; and underwent debriefing. Assessment Participants evaluated the learning methods positively and a majority demonstrated knowledge gains. The project team also learned lessons that will help better design future programs, including an emphasis on simulations over lecture and the importance of debriefing on student learning. Drawbacks included the major time commitment for design and implementation, sustainability, and the lack of resources to replicate the program for all students. Conclusion Simulation is an effective technique to teach interprofessional teams how to engage in difficult conversations with patients. PMID:21088725

Development and Validation of Performance Assessment Tools for Interprofessional Communication and Teamwork (PACT)

ERIC Educational Resources Information Center

Chiu, Chia-Ju

2014-01-01

Background: Medical errors caused by breakdowns in teamwork and interprofessional communication contribute to many deaths in the United States each year. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) is an evidence-based teamwork system developed to improve communication and teamwork skills among health care…

Developing a University-Based Interprofessional Education Diagnostic Team to Identify Children with Possible Autism Spectrum Disorder

ERIC Educational Resources Information Center

Self, Trisha L.; Mitchell, Linda M.; Hess, Sean; Marble, Karissa J.; Swails, Jeffrey

2017-01-01

Upon entering the workplace, speech-language pathologists (SLPs) are required to work on interprofessional teams, yet many of these professionals have not received adequate preservice instruction on how to collaborate. Furthermore, collaborating to provide services for children with autism spectrum disorder (ASD) has been found to improve…

Promoting Collaboration in Health Care Teams through Interprofessional Education: A Simulation Case Study

ERIC Educational Resources Information Center

Ekmekci, Ozgur

2013-01-01

This simulation study explores how the integration of interprofessional components into health care curriculum may impact professional stereotyping and collaborative behavior in care delivery teams comprised of a physician, a registered nurse, a physician's assistant, a physical therapist, and a radiation therapist. As part of the agent-based…

Facilitating Interprofessional Collaboration through ePortfolio: A Pilot Study

ERIC Educational Resources Information Center

Karsten, Kathleen; McMillan Coddington, Deborah; Lehman, Regina M.; Pierce, Cynthia; Tom, May; Gallo-Silver, Les

2015-01-01

Each member of the healthcare team has been trained with specific knowledge and skills. Quality patient care is dependent on the collaboration of the various healthcare professionals and their ability to work as a team. In order to be effective, interprofessional collaboration should be included in the academic preparation of each of the various…

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.

Individual versus interprofessional team performance in formulating care transition plans: A randomised study of trainees from five professional groups.

PubMed

Farrell, Timothy W; Supiano, Katherine P; Wong, Bob; Luptak, Marilyn K; Luther, Brenda; Andersen, Troy C; Wilson, Rebecca; Wilby, Frances; Yang, Rumei; Pepper, Ginette A; Brunker, Cherie P

2018-05-01

Health professions trainees' performance in teams is rarely evaluated, but increasingly important as the healthcare delivery systems in which they will practice move towards team-based care. Effective management of care transitions is an important aspect of interprofessional teamwork. This mixed-methods study used a crossover design to randomise health professions trainees to work as individuals and as teams to formulate written care transition plans. Experienced external raters assessed the quality of the written care transition plans as well as both the quality of team process and overall team performance. Written care transition plan quality did not vary between individuals and teams (21.8 vs. 24.4, respectively, p = 0.42). The quality of team process did not correlate with the quality of the team-generated written care transition plans (r = -0.172, p = 0.659). However, there was a significant correlation between the quality of team process and overall team performance (r = 0.692, p = 0.039). Teams with highly engaged recorders, performing an internal team debrief, had higher-quality care transition plans. These results suggest that high-quality interprofessional care transition plans may require advance instruction as well as teamwork in finalising the plan.

An Interprofessional Course Using Human Patient Simulation to Teach Patient Safety and Teamwork Skills

PubMed Central

McCulloh, Russell; Dyer, Carla; Gregory, Gretchen; Higbee, Dena

2012-01-01

Objectives. To assess the effectiveness of human patient simulation to teach patient safety, team-building skills, and the value of interprofessional collaboration to pharmacy students. Design. Five scenarios simulating semi-urgent situations that required interprofessional collaboration were developed. Groups of 10 to 12 health professions students that included 1 to 2 pharmacy students evaluated patients while addressing patient safety hazards. Assessment. Pharmacy students’ scores on 8 of 30 items on a post-simulation survey of knowledge, skills, and attitudes improved over pre-simulation scores. Students’ scores on 3 of 10 items on a team building and interprofessional communications survey also improved after participating in the simulation exercise. Over 90% of students reported that simulation increased their understanding of professional roles and the importance of interprofessional communication. Conclusions. Simulation training provided an opportunity to improve pharmacy students’ ability to recognize and react to patient safety concerns and enhanced their interprofessional collaboration and communication skills. PMID:22611280

Together We Learn: Analyzing the Interprofessional Internal Medicine Residents' and Master of Public Health Students' Quality Improvement Education Experience.

PubMed

Gupte, Gouri; Noronha, Craig; Horný, Michal; Sloan, Karin; Suen, Winnie

2016-11-01

Although the value of interprofessional collaborative education has been promoted, it is unclear how teams of clinical and nonclinical learners perceive this experience. The authors studied an interprofessional quality improvement (QI) curriculum implemented in 2013 integrating internal medicine residents (n = 90) and Master of Public Health (MPH) students (n = 33) at an urban safety net academic medical center. Pre and post curriculum surveys assessed attitudes toward QI and interprofessional education and team performance. Resident attitudes toward learning and engaging in QI work improved at the end of the curriculum. Overall, MPH students demonstrated significantly more positive attitudes about interprofessional learning and work than residents. They also agreed more strongly than residents that patients would benefit if residents and public health students worked together. As health care organizations evolve to become more integrated, it is crucial that interprofessional educational opportunities be developed and evaluated to help encourage a culture of collaboration among health care providers. © The Author(s) 2015.

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.

An exploration of teaching presence in online interprofessional education facilitation.

PubMed

Evans, Sherryn Maree; Ward, Catherine; Reeves, Scott

2017-07-01

Although the prevalence of online asynchronous interprofessional education (IPE) has increased in the last decade, little is known about the processes of facilitation in this environment. The teaching presence element of the Community of Inquiry Framework offers an approach to analyze the contributions of online facilitators, however, to date it has only been used on a limited basis in health professions education literature. Using an exploratory case study design, we explored the types of contributions made by IPE facilitators to asynchronous interprofessional team discussions by applying the notion of teaching presence. Using a purposeful sampling approach, we analyzed 14 facilitators' contributions to asynchronous team discussion boards in an online IPE course. We analyzed data using directed content analysis based on the key indicators of teaching presence. The online IPE facilitators undertook the three critical pedagogical functions identified in teaching presence: facilitating discourse, direct instruction, and instructional design and organization. While our data fitted well with a number of key activities embedded in these three functions, further modification of the teaching presence concept was needed to describe our facilitators' teaching presence. This study provides an initial insight into the key elements of online asynchronous IPE facilitation. Further research is required to continue to illuminate the complexity of online asynchronous IPE facilitation.

Perceptions of interprofessional teamwork in low-acuity settings: a qualitative analysis.

PubMed

van Schaik, Sandrijn M; O'Brien, Bridget C; Almeida, Sandra A; Adler, Shelley R

2014-06-01

Working effectively in interprofessional teams is a core competency for all health care professionals, yet there is a paucity of instruments with which to assess the associated skills. Published medical teamwork skills assessment tools focus primarily on high-acuity situations, such as cardiopulmonary arrests and crisis events in operating rooms, and may not generalise to non-high-acuity environments, such as in-patient wards and out-patient clinics. We undertook the current study to explore the constructs underlying interprofessional teamwork in non-high-acuity settings and team members' perspectives of essential teamwork attributes. We used an ethnographic approach to study four interprofessional teams in two different low-acuity settings: women's HIV (human immunodeficiency virus) clinics and in-patient paediatric wards. Over a period of 17 months, we collected qualitative data through direct observations, focus groups and individual interviews. We analysed the data using qualitative thematic analysis, following an iterative process: data from our observations (20 hours in total) informed the focus group guide and focus group data informed the interview guide. To enhance the integrity of our analysis, we triangulated data sources and verified themes through member checking. We conducted seven focus groups and 27 individual interviews with a total of 39 study participants representing eight professions. Participants emphasised shared leadership and collaborative decision making, mutual respect, recognition of one's own and others' limitations and strengths, and the need to nurture relationships. Team members also discussed tensions around hierarchy and questioned whether doctor leadership is appropriate for interprofessional teams. Our findings indicate that there are differences in teamwork between low-acuity and high-acuity settings, and also provide insights into potential barriers to effective interprofessional teamwork. Our study delineates essential elements of teamwork in low-acuity settings, including desirable attributes of team members, thus laying the foundation for the development of an individual teamwork skills assessment tool. © 2014 John Wiley & Sons Ltd.

Macrocognition in the Healthcare Built Environment (mHCBE): A Focused Ethnographic Study of "Neighborhoods" in a Pediatric Intensive Care Unit.

PubMed

O'Hara, Susan; Klar, Robin Toft; Patterson, Emily S; Morris, Nancy S; Ascenzi, Judy; Fackler, James C; Perry, Donna J

2018-04-01

The objectives of this research were to describe the interactions (formal and informal), in which macrocognitive functions occur and their location on a pediatric intensive care unit, to describe challenges and facilitators of macrocognition using space syntax constructs (openness, connectivity, and visibility), and to analyze the healthcare built environment (HCBE) using those constructs to explicate influences on macrocognition. In high reliability, complex industries, macrocognition is an approach to develop new knowledge among interprofessional team members. Although macrocognitive functions have been analyzed in multiple healthcare settings, the effect of the HCBE on those functions has not been directly studied. The theoretical framework, "macrocognition in the healthcare built environment" (mHCBE) addresses this relationship. A focused ethnographic study was conducted including observation and focus groups. Architectural drawing files used to create distance matrices and isovist field view analyses were compared to panoramic photographs and ethnographic data. Neighborhoods comprised of corner configurations with maximized visibility enhanced team interactions as well as observation of patients, offering the greatest opportunity for informal situated macrocognitive interactions (SMIs). Results from this study support the intricate link between macrocognitive interactions and space syntax constructs within the HCBE. These findings help increase understanding of how use of the framework of Macrocognition in the HCBE can improve design and support adaptation of interprofessional team practices, maximizing macrocognitive interaction opportunities for patient, family, and team safety and quality.

Dimensions and intensity of inter-professional teamwork in primary care: evidence from five international jurisdictions.

PubMed

Levesque, Jean-Frederic; Harris, Mark F; Scott, Cathie; Crabtree, Benjamin; Miller, William; Halma, Lisa M; Hogg, William E; Weenink, Jan-Willem; Advocat, Jenny R; Gunn, Jane; Russell, Grant

2017-10-23

Inter-professional teamwork in primary care settings offers potential benefits for responding to the increasing complexity of patients' needs. While it is a central element in many reforms to primary care delivery, implementing inter-professional teamwork has proven to be more challenging than anticipated. The objective of this study was to better understand the dimensions and intensity of teamwork and the developmental process involved in creating fully integrated teams. Secondary analyses of qualitative and quantitative data from completed studies conducted in Australia, Canada and USA. Case studies and matrices were used, along with face-to-face group retreats, using a Collaborative Reflexive Deliberative Approach. Four dimensions of teamwork were identified. The structural dimension relates to human resources and mechanisms implemented to create the foundations for teamwork. The operational dimension relates to the activities and programs conducted as part of the team's production of services. The relational dimension relates to the relationships and interactions occurring in the team. Finally, the functional dimension relates to definitions of roles and responsibilities aimed at coordinating the team's activities as well as to the shared vision, objectives and developmental activities aimed at ensuring the long-term cohesion of the team. There was a high degree of variation in the way the dimensions were addressed by reforms across the national contexts. The framework enables a clearer understanding of the incremental and iterative aspects that relate to higher achievement of teamwork. Future reforms of primary care need to address higher-level dimensions of teamwork to achieve its expected outcomes. © The Author 2017. Published by Oxford University Press.

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.

Applying interprofessional Team-Based Learning in patient safety: a pilot evaluation study.

PubMed

Lochner, Lukas; Girardi, Sandra; Pavcovich, Alessandra; Meier, Horand; Mantovan, Franco; Ausserhofer, Dietmar

2018-03-27

Interprofessional education (IPE) interventions are not always successful in achieving learning outcomes. Team-Based Learning (TBL) would appear to be a suitable pedagogical method for IPE, as it focuses on team performance; however, little is known about interprofessional TBL as an instructional framework for patient safety. In this pilot-study, we aimed to (1) describe participants' reactions to TBL, (2) observe their achievement with respect to interprofessional education learning objectives, and (3) document their attitudinal shifts with regard to patient safety behaviours. We developed and implemented a three-day course for pre-qualifying, non-medical healthcare students to give instruction on non-technical skills related to 'learning from errors'. The course consisted of three sequential modules: 'Recognizing Errors', 'Analysing Errors', and 'Reporting Errors'. The evaluation took place within a quasi-experimental pre-test-post-test study design. Participants completed self-assessments through valid and reliable instruments such as the Mennenga's TBL Student Assessment Instrument and the University of the West of England's Interprofessional Questionnaire. The mean scores of the individual readiness assurance tests were compared with the scores of the group readiness assurance test in order to explore if students learned from each other during group discussions. Data was analysed using descriptive (i.e. mean, standard deviation), parametric (i.e. paired t-test), and non-parametric (i.e. Wilcoxon signed-rank test) methods. Thirty-nine students from five different bachelor's programs attended the course. The participants positively rated TBL as an instructional approach. All teams outperformed the mean score of their individual members during the readiness assurance process. We observed significant improvements in 'communication and teamwork' and 'interprofessional learning' but not in 'interprofessional interaction' and 'interprofessional relationships.' Findings on safety attitudes and behaviours were mixed. TBL was well received by the students. Our first findings indicate that interprofessional TBL seems to be a promising pedagogical method to achieve patient safety learning objectives. It is crucial to develop relevant clinical cases that involve all professions. Further research with larger sample sizes (e.g. including medical students) and more rigorous study designs (e.g. pre-test post-test with a control group) is needed to confirm our preliminary findings.

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.

Interprofessional student teams augmenting service provision in residential aged care.

PubMed

Kent, Fiona; Lai, Francis; Beovich, Bronwyn; Dodic, Miodrag

2016-09-01

The aim of this study was to determine the usefulness of student-led interprofessional consultations within residential aged care in augmenting patient care and enhancing student education. Volunteer fourth and final year health-care students conducted interprofessional consultations. In a mixed methods design, residents' health-care changes and perspectives were collected prospectively, and student and educator perceptions were measured by survey and interview. Sixteen aged care residents were consulted by interprofessional teams. Students identified two new health issues and proposed 17 recommendations for referrals and five changes to medication management. At six-weeks follow-up, two recommendations had been acted upon clinically, and two medication changes had been implemented. Reasons for the low uptake of recommendations were determined. Residents, students and educators reported high levels of satisfaction. Residential care facilities offer a useful interprofessional learning environment. Student consultations are positively regarded by patients, students and educators and may augment existing health services. © 2016 AJA Inc.

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…

Interprofessional communication with hospitalist and consultant physicians in general internal medicine: a qualitative study

PubMed Central

2012-01-01

Background Studies in General Internal Medicine [GIM] settings have shown that optimizing interprofessional communication is important, yet complex and challenging. While the physician is integral to interprofessional work in GIM there are often communication barriers in place that impact perceptions and experiences with the quality and quantity of their communication with other team members. This study aims to understand how team members’ perceptions and experiences with the communication styles and strategies of either hospitalist or consultant physicians in their units influence the quality and effectiveness of interprofessional relations and work. Methods A multiple case study methodology was used. Thirty-one semi-structured interviews were conducted with physicians, nurses and other health care providers [e.g. physiotherapist, social worker, etc.] working across 5 interprofessional GIM programs. Questions explored participants’ experiences with communication with all other health care providers in their units, probing for barriers and enablers to effective interprofessional work, as well as the use of communication tools or strategies. Observations in GIM wards were also conducted. Results Three main themes emerged from the data: [1] availability for interprofessional communication, [2] relationship-building for effective communication, and [3] physician vs. team-based approaches. Findings suggest a significant contrast in participants’ experiences with the quantity and quality of interprofessional relationships and work when comparing the communication styles and strategies of hospitalist and consultant physicians. Hospitalist staffed GIM units were believed to have more frequent and higher caliber interprofessional communication and collaboration, resulting in more positive experiences among all health care providers in a given unit. Conclusions This study helps to improve our understanding of the collaborative environment in GIM, comparing the communication styles and strategies of hospitalist and consultant physicians, as well as the experiences of providers working with them. The implications of this research are globally important for understanding how to create opportunities for physicians and their colleagues to meaningfully and consistently participate in interprofessional communication which has been shown to improve patient, provider, and organizational outcomes. PMID:23198855

A review of instruments to measure interprofessional team-based primary care.

PubMed

Shoemaker, Sarah J; Parchman, Michael L; Fuda, Kathleen Kerwin; Schaefer, Judith; Levin, Jessica; Hunt, Meaghan; Ricciardi, Richard

2016-07-01

Interprofessional team-based care is increasingly regarded as an important feature of delivery systems redesigned to provide more efficient and higher quality care, including primary care. Measurement of the functioning of such teams might enable improvement of team effectiveness and could facilitate research on team-based primary care. Our aims were to develop a conceptual framework of high-functioning primary care teams to identify and review instruments that measure the constructs identified in the framework, and to create a searchable, web-based atlas of such instruments (available at: http://primarycaremeasures.ahrq.gov/team-based-care/ ). Our conceptual framework was developed from existing frameworks, the teamwork literature, and expert input. The framework is based on an Input-Mediator-Output model and includes 12 constructs to which we mapped both instruments as a whole, and individual instrument items. Instruments were also reviewed for relevance to measuring team-based care, and characterized. Instruments were identified from peer-reviewed and grey literature, measure databases, and expert input. From nearly 200 instruments initially identified, we found 48 to be relevant to measuring team-based primary care. The majority of instruments were surveys (n = 44), and the remainder (n = 4) were observational checklists. Most instruments had been developed/tested in healthcare settings (n = 30) and addressed multiple constructs, most commonly communication (n = 42), heedful interrelating (n = 42), respectful interactions (n = 40), and shared explicit goals (n = 37). The majority of instruments had some reliability testing (n = 39) and over half included validity testing (n = 29). Currently available instruments offer promise to researchers and practitioners to assess teams' performance, but additional work is needed to adapt these instruments for primary care 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.

A pilot study of interprofessional palliative care education of medical students in the UK and USA.

PubMed

Gadoud, Amy; Lu, Wei-Hsin; Strano-Paul, Lisa; Lane, Susan; Boland, Jason W

2018-03-01

Educating medical students to care for patients at the end-of-life is increasingly recognised as an essential component of training. Traditionally, medical student programmes are run by doctors, but patient care is delivered by an interprofessional team. Our programmes in the UK and USA independently developed a teaching experience led by an interprofessional team of palliative care health professionals. This study explores the palliative care health professionals' perceptions, regarding their unique role in medical student palliative care education. This is the first study to ascertain views of an interprofessional team delivering palliative care education to medical students. Focus groups enable interaction between members of the group as well as the generation of consensus of comments among group members. Two major themes were identified: perceived benefits and value of the experience, and the challenges and lessons learnt from the experiences. Despite different structures and settings, this experiential learning in palliative care provided a rewarding interprofessional experience that has historically been difficult to achieve. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The Emerging Role of Social Work in Primary Health Care: A Survey of Social Workers in Ontario Family Health Teams.

PubMed

Ashcroft, Rachelle; McMillan, Colleen; Ambrose-Miller, Wayne; McKee, Ryan; Brown, Judith Belle

2018-05-01

Primary health care systems are increasingly integrating interprofessional team-based approaches to care delivery. As members of these interprofessional primary health care teams, it is important for social workers to explore our experiences of integration into these newly emerging teams to help strengthen patient care. Despite the expansion of social work within primary health care settings, few studies have examined the integration of social work's role into this expanding area of the health care system. A survey was conducted with Canadian social work practitioners who were employed within Family Health Teams (FHTs), an interprofessional model of primary health care in Ontario emerging from a period of health care reform. One hundred and twenty-eight (N = 128) respondents completed the online survey. Key barriers to social work integration in FHTs included difficulties associated with a medical model environment, confusion about social work role, and organizational barriers. Facilitators for integration of social work in FHTs included adequate education and competencies, collaborative engagement, and organizational structures.

Interprofessional simulation of birth in a non-maternity setting for pre-professional students.

PubMed

McLelland, Gayle; Perera, Chantal; Morphet, Julia; McKenna, Lisa; Hall, Helen; Williams, Brett; Cant, Robyn; Stow, Jill

2017-11-01

Simulation-based learning is an approach recommended for teaching undergraduate health professionals. There is a scarcity of research around interprofessional simulation training for pre-professional students in obstetric emergencies that occur prior to arrival at the maternity ward. The primary aims of the study were to examine whether an interprofessional team-based simulated birth scenario would improve undergraduate paramedic, nursing, and midwifery students' self-efficacy scores and clinical knowledge when managing birth in an unplanned location. The secondary aim was to assess students' satisfaction with the newly developed interprofessional simulation. Quasi-experimental descriptive study with repeated measures. Simulated hospital emergency department. Final year undergraduate paramedic, nursing, and midwifery students. Interprofessional teams of five students managed a simulated unplanned vaginal birth, followed by debriefing. Students completed a satisfaction with simulation survey. Serial surveys of clinical knowledge and self-efficacy were conducted at three time points. Twenty-four students participated in one of five simulation scenarios. Overall, students' self-efficacy and confidence in ability to achieve a successful birth outcome was significantly improved at one month (p<0.001) with a magnitude of increase (effect) of 40% (r=0.71) and remained so after a further three months. Clinical knowledge was significantly increased in only one of three student groups: nursing (p=0.04; r=0.311). Students' satisfaction with the simulation experience was high (M=4.65/5). Results from this study indicate that an interprofessional simulation of a birth in an unplanned setting can improve undergraduate paramedic, nursing and midwifery students' confidence working in an interprofessional team. There was a significant improvement in clinical knowledge of the nursing students (who had least content about managing birth in their program). All students were highly satisfied with the interprofessional simulation experience simulation. Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

Transformation of an Online Multidisciplinary Course into a Live Interprofessional Experience.

PubMed

Sincak, Carrie; Gunn, James; Conroy, Christine; Komperda, Kathy; Van Kanegan, Kevin; Krumdick, Nathaniel; Lee, Michelle; Kanjirath, Preetha; Lempicki, Kelly; Heinking, Kurt; Spiegel, Jacqueline

2017-06-01

Objective. To design, implement, and assess an interprofessional education (IPE) course in the first professional year of students enrolled in eight different health professions programs. Design. An interprofessional faculty committee created a 1-credit hour required IPE course to not only teach students about the roles and responsibilities of each discipline and how they may contribute to an interprofessional team, but to also improve collaboration and team-based communication skills among health care professions students. Students were placed in interprofessional groups and met weekly to participate in didactic lectures, discussion sessions, and a standardized patient encounter. Assessment. Seven hundred and eighty-three health professions students were enrolled in the course, of which 130 students completed questionnaires at all three time points. Students were neutral about the course and found it moderately valuable (Mean 6.23 [on a scale from 1 to 10], interesting (Mean 5.61), and enjoyable (Mean 5.57). Written feedback from the course indicated that the majority of students enjoyed the standardized patient encounter and thought the course provided a valuable opportunity to interact with other students in other health professions programs. Conclusion. This required course served as an introductory interprofessional approach in preparing health professions students to learn from each other about their various roles and responsibilities and how each can contribute to the health care team.

Transformation of an Online Multidisciplinary Course into a Live Interprofessional Experience

PubMed Central

Gunn, James; Conroy, Christine; Komperda, Kathy; Van Kanegan, Kevin; Krumdick, Nathaniel; Lee, Michelle; Kanjirath, Preetha; Lempicki, Kelly; Heinking, Kurt; Spiegel, Jacqueline

2017-01-01

Objective. To design, implement, and assess an interprofessional education (IPE) course in the first professional year of students enrolled in eight different health professions programs. Design. An interprofessional faculty committee created a 1-credit hour required IPE course to not only teach students about the roles and responsibilities of each discipline and how they may contribute to an interprofessional team, but to also improve collaboration and team-based communication skills among health care professions students. Students were placed in interprofessional groups and met weekly to participate in didactic lectures, discussion sessions, and a standardized patient encounter. Assessment. Seven hundred and eighty-three health professions students were enrolled in the course, of which 130 students completed questionnaires at all three time points. Students were neutral about the course and found it moderately valuable (Mean 6.23 [on a scale from 1 to 10], interesting (Mean 5.61), and enjoyable (Mean 5.57). Written feedback from the course indicated that the majority of students enjoyed the standardized patient encounter and thought the course provided a valuable opportunity to interact with other students in other health professions programs. Conclusion. This required course served as an introductory interprofessional approach in preparing health professions students to learn from each other about their various roles and responsibilities and how each can contribute to the health care team. PMID:28720922

Measuring team-based interprofessional education outcomes in clinical dentistry: psychometric evaluation of a new scale at an Australian dental school.

PubMed

Storrs, Mark J; Alexander, Heather; Sun, Jing; Kroon, Jeroen; Evans, Jane L

2015-03-01

Previous research on interprofessional education (IPE) assessment has shown the need to evaluate the influence of team-based processes on the quality of clinical education. This study aimed to develop a valid and reliable instrument to evaluate the effectiveness of interprofessional team-based treatment planning (TBTP) on the quality of clinical education at the Griffith University School of Dentistry and Oral Health, Queensland, Australia. A scale was developed and evaluated to measure interprofessional student team processes and their effect on the quality of clinical education for dental, oral health therapy, and dental technology students (known more frequently as intraprofessional education). A face validity analysis by IPE experts confirmed that items on the scale reflected the meaning of relevant concepts. After piloting, 158 students (61% response rate) involved with TBTP participated in a survey. An exploratory factor analysis using the principal component method retained 23 items with a total variance of 64.6%, suggesting high content validity. Three subscales accounted for 45.7%, 11.4%, and 7.5% of the variance. Internal consistency of the scale (α=0.943) and subscales 1 (α=0.953), 2 (α=0.897), and 3 (α=0.813) was high. A reliability analysis yielded moderate (rs=0.43) to high correlations (0.81) with the remaining scale items. Confirmatory factor analyses verified convergent validity and confirmed that this structure had a good model fit. This study suggests that the instrument might be useful in evaluating interprofessional or intraprofessional team-based processes and their influence on the quality of clinical education in academic dental institutions.

Interprofessional clinical education for occupational therapy and psychology students: a social skills training program for children with autism spectrum disorders.

PubMed

Howell, Dana M; Wittman, Peggy; Bundy, Myra Beth

2012-01-01

An interprofessional clinical learning experience was developed for pre-licensure occupational therapy (OT) and psychology graduate students. Students worked in interprofessional teams to plan and implement a social skills training program for children with autism spectrum disorders (ASD). The objectives were to provide a hands-on, student-led clinical experience; facilitate interprofessional collaborative learning through leadership partnerships and teach children with ASD to engage in appropriate social skill behaviors. Concurrently, faculty performed qualitative research to explore how the students worked together to provide intervention to the children. Data were collected via interview, direct observation of student planning sessions and student interprofessional interactions, and collection of posts from an online social network site used for session planning. There were six student participants and two faculty participants. Four themes emerged: learning who I am as a professional, learning to appreciate our professional differences, learning to communicate with each other and figuring it out, for the benefit of the kids. This interprofessional clinical learning experience and research helps ensure that students are adequately prepared to represent their profession as part of a diverse interprofessional health care team.

Interprofessional education for delirium care: a systematic review.

PubMed

Sockalingam, Sanjeev; Tan, Adrienne; Hawa, Raed; Pollex, Heather; Abbey, Susan; Hodges, Brian David

2014-07-01

Recent delirium prevention and treatment guidelines recommend the use of an interprofessional team trained and competent in delirium care. We conducted a systematic review to identify the evidence for the value of interprofessional delirium education programs on learning outcomes. We searched several databases and the grey literature. Studies describing an education intervention, involving two or more healthcare professions and reporting on at least one learning outcome as classified by Kirkpatrick's evaluation framework were included in this review. Ten out of 633 abstracts reviewed met the study inclusion criteria. Several studies reported on more than one learning outcome. Two studies focused on learner reactions to interprofessional delirium education; three studies focused on learning outcomes (e.g. delirium knowledge); six studies focused on learner behavior in practice; and six studies reported on learning results (e.g. patient outcomes), mainly changes in delirium rates post-intervention. Studies reporting changes in patient outcomes following the delirium education intervention used an interprofessional practice (IPP) intervention in combination with interprofessional education (IPE). Our review of the limited evidence suggests that IPE programs may influence team and patient outcomes in delirium care. More systematic studies of the effectiveness of interprofessional delirium education interventions are needed.

An Interprofessional Model for Serving Youth at Risk for Substance Abuse: The Team Case Study.

ERIC Educational Resources Information Center

Cobia, Debra C.; And Others

1995-01-01

Three models of interprofessional education appropriate for serving youth at risk for substance abuse are described. The evaluation of the team case study model indicated that the participants were more sensitive to the needs of the youths, experienced increased comfort in consulting other agents, and were more confident in their ability to select…

Team OSCE: A Teaching Modality for Promotion of Multidisciplinary Work in Mental Health Settings.

PubMed

Sharma, Manoj Kumar; Chandra, Prabha S; Chaturvedi, Santosh K

2015-01-01

The objective structured clinical examination has been in use both as an assessment and a teaching modality within the mental health profession. It focuses on individual skill enhancement, the inter-professional understanding of role obligation is helpful in promoting competence as a team as well as role of other team members. The Team OSCE (TOSCE) is an effective way in promoting inter-professional learning. The present work assesses the trainee experience with TOSCE and its utility in clinical care. Twenty-two mental health trainees (17 male and 5 female from psychiatry, clinical psychology and psychiatric social work) got exposure to weekly OSCAF training as well as 2-3 Team OSCAFS on various aspects of clinical work as a part of their clinical training for 3 months. Rating from the trainees were taken on TOSCE feedback checklist. TOSCE was helpful in promoting the understanding role of other team members; shared decision-making, problem-solving, handling unexpected events, giving feedback and closure. The TOSCE may be introduced as a way to work on clinical performance, shared decision-making and inter-professional understanding.

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.

Social Work and Interprofessional Education in Health Care: A Call for Continued Leadership

ERIC Educational Resources Information Center

Jones, Barbara; Phillips, Farya

2016-01-01

A report from the Interprofessional Education Collaborative and another from the Institute of Medicine cite working as part of interdisciplinary teams as a core proficiency area for improving health care. This article discusses the core competencies of interprofessional education and the essential role for social workers as leaders and…

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.

Effectiveness of interprofessional education in renal physiology curricula for health sciences graduate students.

PubMed

Harrison-Bernard, Lisa M; Naljayan, Mihran V; Eason, Jane M; Mercante, Donald E; Gunaldo, Tina P

2017-12-01

The primary purpose of conducting an interprofessional education (IPE) experience during the renal physiology block of a graduate-level course was to provide basic science, physical therapy, and physician assistant graduate students with an opportunity to work as a team in the diagnosis, treatment, and collaborative care of a patient with acute kidney injury. The secondary purpose was to enhance the understanding of basic renal physiology principles with a patient case presentation of renal pathophysiology. The overall purpose was to assess the value of IPE integration within a basic science course by examining student perceptions and program evaluation. Graduate-level students operated in interprofessional teams while working through an acute kidney injury patient case. The following Interprofessional Education Collaborative subcompetencies were targeted: Roles/Responsibilities (RR) Behavioral Expectations (RR1, RR4) and Interprofessional Communication (CC) Behavioral Expectations (CC4). Clinical and IPE stimulus questions were discussed both within and between teams with assistance provided by faculty facilitators. Students were given a pre- and postsurvey to determine their knowledge of IPE. There were statistically significant increases from pre- to postsurvey scores for all six IPE questions for all students. Physical therapy and physician assistant students had a statistically significant increase in pre- to postsurvey scores, indicating a more favorable perception of their interprofessional competence for RR1, RR4, and CC4. No changes were noted in pre- to postsurvey scores for basic science graduate students. Incorporating planned IPE experiences into multidisciplinary health science courses represents an appropriate venue to have students learn and apply interprofessional competencies. Copyright © 2017 the American Physiological Society.

Making an "Attitude Adjustment": Using a Simulation-Enhanced Interprofessional Education Strategy to Improve Attitudes Toward Teamwork and Communication.

PubMed

Wong, Ambrose Hon-Wai; Gang, Maureen; Szyld, Demian; Mahoney, Heather

2016-04-01

Health care providers must effectively function in highly skilled teams in a collaborative manner, but there are few interprofessional training strategies in place. Interprofessional education (IPE) using simulation technology has gained popularity to address this need because of its inherent ability to impact learners' cognitive frames and promote peer-to-peer dialog. Provider attitudes toward teamwork have been directly linked to the quality of patient care. Investigators implemented a simulation-enhanced IPE intervention to improve staff attitudes toward teamwork and interprofessional communication in the emergency department setting. The 3-hour course consisted of a didactic session highlighting teamwork and communication strategies, 2 simulation scenarios on septic shock and cardiac arrest, and structured debriefing directed at impacting participant attitudes to teamwork and communication. This was a survey-based observational study. We used the TeamSTEPPS Teamwork Attitudes Questionnaire immediately before and after the session as a measurement of attitude change as well as the Hospital Survey on Patient Safety Culture before the session and 1 year after the intervention for program impact at the behavior level. Seventy-two emergency department nurses and resident physicians participated in the course from July to September 2012. Of the 5 constructs in TeamSTEPPS Teamwork Attitudes Questionnaire, 4 had a significant improvement in scores-6.4%, 2.8%, 4.0%, and 4.0% for team structure, leadership, situation monitoring, and mutual support, respectively (P < 0.0001, P = 0.029, P = 0.014, and P = 0.003, respectively). For Hospital Survey on Patient Safety Culture, 3 of 6 composites directly related to teamwork and communication showed a significant improvement-20.6%, 20.5%, and 23.9%, for frequency of event reporting, teamwork within hospital units, and hospital handoffs and transitions, respectively (P = 0.028, P = 0.035, and P = 0.024, respectively). A simulation-enhanced IPE curriculum was successful in improving participant attitudes toward teamwork and components of patient safety culture related to teamwork and communication.

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.

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.

A model for training medical student innovators: the Harvard Medical School Center for Primary Care Abundance Agents of Change program

PubMed Central

Duong, David B.; Sullivan, Erin E.; Minter-Jordan, Myechia; Giesen, Lindsay; Ellner, Andrew L.

2016-01-01

Background In 2013, the Harvard Medical School Center for Primary Care established the Abundance Agents of Change (AoC) program to promote interprofessional learning and innovation, increase partnership between 15 academic and community health centers (CHCs) in Boston's most under-served communities, and increase medical student interest in primary care careers. Methods The AoC is modeled in the form of a ‘grants challenge’, offering $20,000 to interprofessional student teams to develop an innovative solution that addresses a healthcare delivery need identified by CHCs. The program's initial two years were characterized by a four-stage process which included working with CHCs and crafting a request for proposals, forming interprofessional 20 student teams comprising students from across and outside of Harvard University, training students using a systems-based innovation curriculum, and performing program evaluation. Results Our evaluation data from cohorts 1 and 2 of the AoC program demonstrate that we succeeded in training students as innovators and members of interprofessional teams. We also learned valuable lessons regarding creating better alignment with CHC priorities, extending the program cycle from 12 to 18 months, and changing the way funding is disbursed to 25 students, which will be incorporated in later versions of the program. Conclusions Based on our experience and evaluation data, we believe that this program is a replicable way to train students as innovators and members of interprofessional teams to address the current complex healthcare environment. PMID:27306994

A model for training medical student innovators: the Harvard Medical School Center for Primary Care Abundance Agents of Change program.

PubMed

Duong, David B; Sullivan, Erin E; Minter-Jordan, Myechia; Giesen, Lindsay; Ellner, Andrew L

2016-01-01

Background In 2013, the Harvard Medical School Center for Primary Care established the Abundance Agents of Change (AoC) program to promote interprofessional learning and innovation, increase partnership between 15 academic and community health centers (CHCs) in Boston's most under-served communities, and increase medical student interest in primary care careers. Methods The AoC is modeled in the form of a 'grants challenge', offering $20,000 to interprofessional student teams to develop an innovative solution that addresses a healthcare delivery need identified by CHCs. The program's initial two years were characterized by a four-stage process which included working with CHCs and crafting a request for proposals, forming interprofessional 20 student teams comprising students from across and outside of Harvard University, training students using a systems-based innovation curriculum, and performing program evaluation. Results Our evaluation data from cohorts 1 and 2 of the AoC program demonstrate that we succeeded in training students as innovators and members of interprofessional teams. We also learned valuable lessons regarding creating better alignment with CHC priorities, extending the program cycle from 12 to 18 months, and changing the way funding is disbursed to 25 students, which will be incorporated in later versions of the program. Conclusions Based on our experience and evaluation data, we believe that this program is a replicable way to train students as innovators and members of interprofessional teams to address the current complex healthcare environment.

A model for training medical student innovators: the Harvard Medical School Center for Primary Care Abundance Agents of Change program.

PubMed

Duong, David B; Sullivan, Erin E; Minter-Jordan, Myechia; Giesen, Lindsay; Ellner, Andrew L

2016-01-01

In 2013, the Harvard Medical School Center for Primary Care established the Abundance Agents of Change (AoC) program to promote interprofessional learning and innovation, increase partnership between 15 academic and community health centers (CHCs) in Boston's most under-served communities, and increase medical student interest in primary care careers. The AoC is modeled in the form of a 'grants challenge', offering $20,000 to interprofessional student teams to develop an innovative solution that addresses a healthcare delivery need identified by CHCs. The program's initial two years were characterized by a four-stage process which included working with CHCs and crafting a request for proposals, forming interprofessional 20 student teams comprising students from across and outside of Harvard University, training students using a systems-based innovation curriculum, and performing program evaluation. Our evaluation data from cohorts 1 and 2 of the AoC program demonstrate that we succeeded in training students as innovators and members of interprofessional teams. We also learned valuable lessons regarding creating better alignment with CHC priorities, extending the program cycle from 12 to 18 months, and changing the way funding is disbursed to 25 students, which will be incorporated in later versions of the program. Based on our experience and evaluation data, we believe that this program is a replicable way to train students as innovators and members of interprofessional teams to address the current complex healthcare environment.

A longitudinal interprofessional simulation curriculum for critical care teams: Exploring successes and challenges.

PubMed

Leclair, Laurie W; Dawson, Mary; Howe, Alison; Hale, Sue; Zelman, Eric; Clouser, Ryan; Garrison, Garth; Allen, Gilman

2018-05-01

Interprofessional care teams are the backbone of intensive care units (ICUs) where severity of illness is high and care requires varied skills and experience. Despite this care model, longitudinal educational programmes for such workplace teams rarely include all professions. In this article, we report findings on the initial assessment and evaluation of an ongoing, longitudinal simulation-based curriculum for interprofessional workplace critical care teams. The study had two independent components, quantitative learner assessment and qualitative curricular evaluation. To assess curriculum effectiveness at meeting learning objectives, participant-reported key learning points identified using a self-assessment tool administered immediately following curricular participation were mapped to session learning objectives. To evaluate the curriculum, we conducted a qualitative study using a phenomenology approach involving purposeful sampling of nine curricular participants undergoing recorded semi-structured interviews. Verbatim transcripts were reviewed by two independent readers to derive themes further subdivided into successes and barriers. Learner self-assessment demonstrated that the majority of learners, across all professions, achieved at least one intended learning objective with senior learners more likely to report team-based objectives and junior learners more likely to report knowledge/practice objectives. Successes identified by curricular evaluation included authentic critical care curricular content, safe learning environment, and team comradery from shared experience. Barriers included unfamiliarity with the simulation environment and clinical coverage for curricular participation. This study suggests that a sustainable interprofessional curriculum for workplace ICU critical care teams can achieve the desired educational impact and effectively deliver authentic simulated work experiences if barriers to educational engagement and participation can be overcome.

Examining participant perceptions of an interprofessional simulation-based trauma team training for medical and nursing students.

PubMed

Jakobsen, Rune Bruhn; Gran, Sarah Frandsen; Grimsmo, Bergsvein; Arntzen, Kari; Fosse, Erik; Frich, Jan C; Hjortdahl, Per

2018-01-01

High quality care relies on interprofessional teamwork. We developed a short simulation-based course for final year medical, nursing and nursing anaesthesia students, using scenarios from emergency medicine. The aim of this paper is to describe the adaptation of an interprofessional simulation course in an undergraduate setting and to report participants' experiences with the course and students' learning outcomes. We evaluated the course collecting responses from students through questionnaires with both closed-ended and open-ended questions, supplemented by the facilitators' assessment of students' performance. Our data is based on responses from 310 students and 16 facilitators who contributed through three evaluation phases. In the analysis, we found that students reported emotional activation and learning outcomes within the domains self-insight and stress management, understanding of the leadership role, insight into teamwork, and skills in team communication. In subsequent questionnaire studies students reported having gained insights about communication, teamwork and leadership, and they believed they would be better leaders of teams and/or team members after having completed the course. Facilitators' observations suggested a progress in students' non-technical skills during the course. The facilitators observed that nursing anaesthesia students seemed to be more comfortable in finding their role in the team than the two other groups. In conclusion, we found that an interprofessional simulation-based emergency team training course with a focus on leadership, communication and teamwork, was feasible to run on a regular basis for large groups of students. The course improved the students' team skills and received a favourable evaluation from both students and faculty.

Interprofessional care co-ordinators: the benefits and tensions associated with a new role in UK acute health care.

PubMed

Bridges, Jackie; Meyer, Julienne; Glynn, Michael; Bentley, Jane; Reeves, Scott

2003-08-01

While more flexible models of service delivery are being introduced in UK health and social care, little is known about the impact of new roles, particularly support worker roles, on the work of existing practitioners. This action research study aimed to explore the impact of one such new role, that of interprofessional care co-ordinators (IPCCs). The general (internal) medical service of a UK hospital uses IPCCs to provide support to the interprofessional team and, in doing so, promote efficiency of acute bed use. Using a range of methods, mainly qualitative, this action research study sought to explore the characteristics and impact of the role on interprofessional team working. While the role's flexibility, autonomy and informality contributed to success in meeting its intended objectives, these characteristics also caused some tensions with interprofessional colleagues. These benefits and tensions mirror wider issues associated with the current modernisation agenda in UK health care.

Changes in Perceptions and Attitudes of Healthcare Profession Students Pre and Post Academic Course Experience of Team-Based 'Care for the Critically Ill'.

PubMed

Clark, Karen; Congdon, Heather Brennan; Macmillan, Kelley; Gonzales, Jeffrey P; Guerra, Adriana

2015-01-01

The aim of this study was to describe the development and outcomes of an interprofessional course "Interprofessional Care of the Critically Ill," involving pharmacy, nursing, social work, and respiratory therapy students from two universities. An institutional review board-approved survey was adapted from the TeamSTEPPS surveys investigating clinical practitioners' attitudes and perceptions regarding teamwork, collaboration, and interprofessional engagement. Items applicable to an academic setting were revised and resulted in a 28-statement survey and comments section. Participation was voluntary, and students were requested to participate in the survey on the first and last day of class. There was a significant increase in the perceived understanding of scope of practice of other disciplines from the beginning to end of class (24.4 to 60%, strongly agreed/agreed). Furthermore, students gained appreciation for the complexities associated with working in an interprofessional team with a significant increase in the percent agreeing and strongly agreeing that working on an interdisciplinary team is challenging (66.7 to 81%). Students and faculty gained a greater understanding and appreciation for other disciplines represented in the class and are therefore better prepared to engage in health care teams upon graduation. IPE should be embedded in curriculums and not just an add-on. Copyright © 2015 Elsevier Inc. All rights reserved.

Inter-Professional Working and Learning: Instructional Actions and Boundary Crossing or Boundary Making in Oral Healthcare

ERIC Educational Resources Information Center

Teräs, Marianne

2016-01-01

Inter-professional teams are typical in health care, and inter-professional education has thus become more common. This empirical study explores the instruction-related challenges when students of dentistry and oral hygiene collaborate during their internship in caring for the oral health of patients. The conceptual framework of the study stems…

Developing Memory Clinics in Primary Care: An Evidence-Based Interprofessional Program of Continuing Professional Development

ERIC Educational Resources Information Center

Lee, Linda; Weston, W. Wayne; Hillier, Loretta M.

2013-01-01

Introduction: Primary care is challenged to meet the needs of patients with dementia. A training program was developed to increase capacity for dementia care through the development of Family Health Team (FHT)-based interprofessional memory clinics. The interprofessional training program consisted of a 2-day workshop, 1-day observership, and 2-day…

Team-Based Interprofessional Competency Training for Dementia Screening and Management.

PubMed

Tan, Zaldy S; Damron-Rodriguez, JoAnn; Cadogan, Mary; Gans, Daphna; Price, Rachel M; Merkin, Sharon S; Jennings, Lee; Schickedanz, Heather; Shimomura, Sam; Osterweil, Dan; Chodosh, Joshua

2017-01-01

As many as 50% of people satisfying diagnostic criteria for dementia are undiagnosed. A team-based training program for dementia screening and management was developed targeting four professions (medicine, nursing, pharmacy, social work) whose scope of practice involves dementia care. An interprofessional group of 10 faculty members was trained to facilitate four interactive competency stations on dementia screening, differential diagnoses, dementia management and team care planning, and screening for and managing caregiver stress. Registrants were organized into teams of five members, with at least one member of each profession per team. The teams rotated through all stations, completing assigned tasks through interprofessional collaboration. A total of 117 professionals (51 physicians, 11 nurses, 20 pharmacists, 24 social workers, 11 others) successfully completed the program. Change scores showed significant improvements in overall competence in dementia assessment and intervention (very low = 1; very high = 5; average change 1.12, P < .001), awareness of importance of dementia screening (average change 0.85, P < .001), and confidence in managing medication (average change 0.86, P < .001). Eighty-seven participants (82.9%) reported feeling confident or very confident using the dementia toolkit at their home institution. In a survey administered 3 months after the session, 48 respondents reported that they had changed their approach to administering the Mini-Cog test (78%), differential diagnosis (49%), assessment of caregiver stress (74%), and accessing community support and services (69%). In conclusion, team-based interprofessional competency training is a team teaching model that can be used to enhance competency in dementia screening and management in medical, nursing, pharmacy, and social work practitioners. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Pharmacy students' attitudes towards physician-pharmacist collaboration: Intervention effect of integrating cooperative learning into an interprofessional team-based community service.

PubMed

Wang, Jun; Hu, Xiamin; Liu, Juan; Li, Lei

2016-09-01

The aim of this study was to evaluate the attitudes towards physician-pharmacist collaboration among pharmacy students in order to develop an interprofessional education (IPE) opportunity through integrating cooperative learning (CL) into a team-based student-supported community service event. The study also aimed to assess the change in students' attitudes towards interprofessional collaboration after participation in the event. A bilingual version of the Scale of Attitudes Toward Physician-Pharmacist Collaboration (SATP(2)C) in English and Chinese was completed by pharmacy students enrolled in Wuhan University of Science and Technology, China. Sixty-four students (32 pharmacy students and 32 medical students) in the third year of their degree volunteered to participate in the IPE opportunity for community-based diabetes and hypertension self-management education. We found the mean score of SATP(2)C among 235 Chinese pharmacy students was 51.44. Cronbach's alpha coefficient was 0.90. Our key finding was a significant increase in positive attitudes towards interprofessional collaboration after participation in the IPE activity. These data suggest that there is an opportunity to deliver IPE in Chinese pharmacy education. It appears that the integration of CL into an interprofessional team-based community service offers a useful approach for IPE.

Interprofessional experiences of recent healthcare graduates: A social psychology perspective on the barriers to effective communication, teamwork, and patient-centred care.

PubMed

Thomson, Krist; Outram, Sue; Gilligan, Conor; Levett-Jones, Tracy

2015-01-01

Achieving safe, quality health care is highly dependent on effective communication between all members of the healthcare team. This study explored the attitudes and experiences of recent healthcare graduates regarding interprofessional teamwork and communication within a clinical setting. A total of 68 pharmacy, nursing, and medicine graduates participated in 12 semi-structured focus group discussions in clinical workplaces across three Australian states. Discussion focussed on graduates' experiences of interprofessional education and its impact on their capacity for interprofessional teamwork and communication. The Social Identity and Realistic Conflict theories were used as a framework for qualitative data analysis. A consistent pattern of profession-focussed, rather than patient- or team-focussed goals was revealed along with reports of negative stereotyping, hierarchical communication, and competition for time with the patient. Graduates acknowledged the importance of communication, teamwork, and patient-centred care and felt a better understanding of the roles of other health professionals would assist them to work together for patients' wellbeing. Identifying workplace identities and differential goals has uncovered possible motivations underlying health professionals' behaviour. These insights may help improve interprofessional collaboration by focusing attention on common team goals, increasing feelings of worth and being valued among different professionals, and decreasing the need for competition.

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.

Addressing Dual Patient and Staff Safety Through A Team-Based Standardized Patient Simulation for Agitation Management in the Emergency Department.

PubMed

Wong, Ambrose H; Auerbach, Marc A; Ruppel, Halley; Crispino, Lauren J; Rosenberg, Alana; Iennaco, Joanne D; Vaca, Federico E

2018-06-01

Emergency departments (EDs) have seen harm rise for both patients and health workers from an increasing rate of agitation events. Team effectiveness during care of this population is particularly challenging because fear of physical harm leads to competing interests. Simulation is frequently employed to improve teamwork in medical resuscitations but has not yet been reported to address team-based behavioral emergency care. As part of a larger investigation of agitated patient care, we designed this secondary study to examine the impact of an interprofessional standardized patient simulation for ED agitation management. We used a mixed-methods approach with emergency medicine resident and attending physicians, Physician Assistants (PAs) and Advanced Practice Registered Nurses (APRNs), ED nurses, technicians, and security officers at two hospital sites. After a simulated agitated patient encounter, we conducted uniprofessional and interprofessional focus groups. We undertook structured thematic analysis using a grounded theory approach. Quantitative data consisted of responses to the KidSIM Questionnaire addressing teamwork and simulation-based learning attitudes before and after each session. We reached data saturation with 57 participants. KidSIM scores revealed significant improvements in attitudes toward relevance of simulation, opportunities for interprofessional education, and situation awareness, as well as four of six questions for roles/responsibilities. Two broad themes emerged from the focus groups: (1) a team-based agitated patient simulation addressed dual safety of staff and patients simultaneously and (2) the experience fostered interprofessional discovery and cooperation in agitation management. A team-based simulated agitated patient encounter highlighted the need to consider the dual safety of staff and patients while facilitating interprofessional dialog and learning. Our findings suggest that simulation may be effective to enhance teamwork in behavioral emergency care.

Preliminary investigation into sport and exercise psychology consultants' views and experiences of an interprofessional care team approach to sport injury rehabilitation.

PubMed

Arvinen-Barrow, Monna; Clement, Damien

2017-01-01

Sport injury rehabilitation has moved from predominately physical treatment to a more holistic care. However, limited research has explored the views and experiences of those involved in such an approach. The purpose of this study was to preliminarily investigate sport psychology consultants' (SPCs') views and experiences of an interprofessional team approach to sport injury rehabilitation. A cross-sectional online survey previously used with athletic trainers was distributed via a US-based sport/exercise psychology list-serve (N = 1245). A total of 62 (27 men, 35 women, M age 38.2 years, age range: 22-73 years) participants with 10.6 (SD = 9.8) years of experience as an SPC were included in the final analyses. On average, SPCs felt that it was very important (M = 6.6; SD = 0.6) for athletes to have access to an interprofessional care team. Of the sample, 64.5% (n = 40) typically worked as part of an interprofessional care team 44.7% of the time. The SPCs (n = 28; 45.2%) also indicated that the primary treatment providers (e.g., athletic trainer, physical therapist) were typically serving as the primary point person for such teams. Since gaining entry to sport medicine can be an area SPCs struggle with, building effective working relationships with treatment providers can help promote and increase SPCs involvement in providing holistic, interprofessional care to athletes with injuries. To ensure athletes' successful biopsychosocial return to sport, different individuals and professionals should work together for the benefit of the athlete by adopting holistic care during sports injury rehabilitation.

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.

Knowledge translation: An interprofessional approach to integrating a pain consult team within an acute care unit.

PubMed

Feldman, Kira; Berall, Anna; Karuza, Jurgis; Senderovich, Helen; Perri, Giulia-Anna; Grossman, Daphna

2016-11-01

Management of pain in the frail elderly presents many challenges in both assessment and treatment, due to the presence of multiple co-morbidities, polypharmacy, and cognitive impairment. At Baycrest Health Sciences, a geriatric care centre, pain in its acute care unit had been managed through consultations with the pain team on a case-by-case basis. In an intervention informed by knowledge translation (KT), the pain specialists integrated within the social network of the acute care team for 6 months to disseminate their expertise. A survey was administered to staff on the unit before and after the intervention of the pain team to understand staff perceptions of pain management. Pre- and post-comparisons of the survey responses were analysed by using t-tests. This study provided some evidence for the success of this interprofessional education initiative through changes in staff confidence with respect to pain management. It also showed that embedding the pain team into the acute care team supported the KT process as an effective method of interprofessional team building. Incorporating the pain team into the acute care unit to provide training and ongoing decision support was a feasible strategy for KT and could be replicated in other clinical settings.

Healthcare students interprofessional critical event/disaster response course.

PubMed

Kim, Tae Eung; Shankel, Tamara; Reibling, Ellen T; Paik, Jacqueline; Wright, Dolores; Buckman, Michelle; Wild, Kathi; Ngo, Ehren; Hayatshahi, Alireza; Nguyen, Lee H; Denmark, T Kent; Thomas, Tamara L

2017-01-01

Numerous disasters confirm the need for critical event training in healthcare professions. However, no single discipline works in isolation and interprofessional learning is recognized as a necessary component. An interprofessional faculty group designed a learning curriculum crossing professional schools. Faculty members from four healthcare schools within the university (nursing, pharmacy, allied health, and medicine) developed an interdisciplinary course merging both published cross-cutting competencies for critical event response and interprofessional education competencies. Students completed a discipline-specific online didactic course. Interdisciplinary groups then participated in a 4-hour synchronous experience. This live course featured high-fidelity medical simulations focused on resuscitation, as well as hands-on modules on decontamination and a mass casualty triage incorporating moulaged standardized patients in an active shooter scenario. Participants were senior students from allied health, medicine, nursing, and pharmacy. Precourse and postcourse assessments were conducted online to assess course impact on learning performance, leadership and team development, and course satisfaction. Students participated were 402. Precourse and postcourse evaluations showed improvement in team participation values, critical event knowledge, and 94 percent of participants reported learning useful skills. Qualitative responses evidenced positive response; most frequent recurring comments concerned value of interprofessional experiences in team communication and desire to incorporate this kind of education earlier in their curriculum. Students demonstrated improvement in both knowledge and attitudes in a critical event response course that includes interprofessional instruction and collaboration. Further study is required to demonstrate sustained improvement as well as benefit to clinical outcomes.

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.

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.

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.

Interprofessional collaboration regarding patients' care plans in primary care: a focus group study into influential factors.

PubMed

van Dongen, Jerôme Jean Jacques; Lenzen, Stephanie Anna; van Bokhoven, Marloes Amantia; Daniëls, Ramon; van der Weijden, Trudy; Beurskens, Anna

2016-05-28

The number of people with multiple chronic conditions demanding primary care services is increasing. To deal with the complex health care demands of these people, professionals from different disciplines collaborate. This study aims to explore influential factors regarding interprofessional collaboration related to care plan development in primary care. A qualitative study, including four semi-structured focus group interviews (n = 4). In total, a heterogeneous group of experts (n = 16) and health care professionals (n = 15) participated. Participants discussed viewpoints, barriers, and facilitators regarding interprofessional collaboration related to care plan development. The data were analysed by means of inductive content analysis. The findings show a variety of factors influencing the interprofessional collaboration in developing a care plan. Factors can be divided into 5 key categories: (1) patient-related factors: active role, self-management, goals and wishes, membership of the team; (2) professional-related factors: individual competences, domain thinking, motivation; (3) interpersonal factors: language differences, knowing each other, trust and respect, and motivation; (4) organisational factors: structure, composition, time, shared vision, leadership and administrative support; and (5) external factors: education, culture, hierarchy, domain thinking, law and regulations, finance, technology and ICT. Improving interprofessional collaboration regarding care plan development calls for an integral approach including patient- and professional related factors, interpersonal, organisational, and external factors. Further, the leader of the team seems to play a key role in watching the patient perspective, organising and coordinating interprofessional collaborations, and guiding the team through developments. The results of this study can be used as input for developing tools and interventions targeted at executing and improving interprofessional collaboration related to care plan development.

The implementation of multiple interprofessional integrated modules by health sciences faculty in Chile.

PubMed

Castillo-Parra, Silvana; Oyarzo Torres, Sandra; Espinoza Barrios, Mónica; Rojas-Serey, Ana María; Maya, Juan Diego; Sabaj Diez, Valeria; Aliaga Castillo, Verónica; Castillo Niño, Manuel; Romero Romero, Luis; Foster, Jennifer; Hawes Barrios, Gustavo

2017-11-01

Multiple interprofessional integrated modules (MIIM) 1 and 2 are two required, cross-curricular courses developed by a team of health professions faculty, as well as experts in education, within the Faculty of Medicine of the University of Chile. MIIM 1 focused on virtual cases requiring team decision-making in real time. MIIM 2 focused on a team-based community project. The evaluation of MIIM included student, teacher, and coordinator perspectives. To explore the perceptions of this interprofessional experience quantitative data in the form of standardised course evaluations regarding teaching methodology, interpersonal relations and the course organisation and logistics were gathered. In addition, qualitative perceptions were collected from student focus groups and meetings with tutors and coordinators. Between 2010 and 2014, 881 students enrolled in MIIM. Their evaluation scores rated interpersonal relations most highly, followed by organisation and logistics, and then teaching methodology. A key result was the learning related to interprofessional team work by the teaching coordinators, as well as the participating faculty. The strengths of this experience included student integration and construction of new knowledge, skill development in making decisions, and collective self-learning. Challenges included additional time management and tutors' role. This work requires valuation of an alternative way of learning, which is critical for the performance of future health professionals.

Narrative in interprofessional education and practice: implications for professional identity, provider-patient communication and teamwork.

PubMed

Clark, Phillip G

2014-01-01

Health and social care professionals increasingly use narrative approaches to focus on the patient and to communicate with each other. Both effective interprofessional education (IPE) and practice (IPP) require recognizing the various values and voices of different professions, how they relate to the patient's life story, and how they interact with each other at the level of the healthcare team. This article analyzes and integrates the literature on narrative to explore: self-narrative as an expression of one's professional identity; the co-creation of the patient's narrative by the professional and the patient; and the interprofessional multi-vocal narrative discourse as co-constructed by members of the healthcare team. Using a narrative approach to thinking about professional identity, provider-patient communication, and interprofessional teamwork expands our thinking about both IPE and IPP by providing new insights into the nature of professional practice based on relationships to oneself, the patient, and others on the team. How professionals define themselves, gather and present information from the patient, and communicate as members of a clinical team all have important dimensions that can be revealed by a narrative approach. Implications and conclusions for the further development of the narrative approach in IPE and IPP are offered.

The effectiveness of a nurse practitioner-led pain management team in long-term care: A mixed methods study.

PubMed

Kaasalainen, Sharon; Wickson-Griffiths, Abigail; Akhtar-Danesh, Noori; Brazil, Kevin; Donald, Faith; Martin-Misener, Ruth; DiCenso, Alba; Hadjistavropoulos, Thomas; Dolovich, Lisa

2016-10-01

Considering the high rates of pain as well as its under-management in long-term care (LTC) settings, research is needed to explore innovations in pain management that take into account limited resource realities. It has been suggested that nurse practitioners, working within an inter-professional model, could potentially address the under-management of pain in LTC. This study evaluated the effectiveness of implementing a nurse practitioner-led, inter-professional pain management team in LTC in improving (a) pain-related resident outcomes; (b) clinical practice behaviours (e.g., documentation of pain assessments, use of non-pharmacological and pharmacological interventions); and, (c) quality of pain medication prescribing practices. A mixed method design was used to evaluate a nurse practitioner-led pain management team, including both a quantitative and qualitative component. Using a controlled before-after study, six LTC homes were allocated to one of three groups: 1) a nurse practitioner-led pain team (full intervention); 2) nurse practitioner but no pain management team (partial intervention); or, 3) no nurse practitioner, no pain management team (control group). In total, 345 LTC residents were recruited to participate in the study; 139 residents for the full intervention group, 108 for the partial intervention group, and 98 residents for the control group. Data was collected in Canada from 2010 to 2012. Implementing a nurse practitioner-led pain team in LTC significantly reduced residents' pain and improved functional status compared to usual care without access to a nurse practitioner. Positive changes in clinical practice behaviours (e.g., assessing pain, developing care plans related to pain management, documenting effectiveness of pain interventions) occurred over the intervention period for both the nurse practitioner-led pain team and nurse practitioner-only groups; these changes did not occur to the same extent, if at all, in the control group. Qualitative analysis highlighted the perceived benefits of LTC staff about having access to a nurse practitioner and benefits of the pain team, along with barriers to managing pain in LTC. The findings from this study showed that implementing a nurse practitioner-led pain team can significantly improve resident pain and functional status as well as clinical practice behaviours of LTC staff. LTC homes should employ a nurse practitioner, ideally located onsite as opposed to an offsite consultative role, to enhance inter-professional collaboration and facilitate more consistent and timely access to pain management. Copyright © 2016 Elsevier Ltd. All rights reserved.

Shared leadership and group identification in healthcare: The leadership beliefs of clinicians working in interprofessional teams.

PubMed

Forsyth, Craig; Mason, Barbara

2017-05-01

Despite the proposed benefits of applying shared and distributed leadership models in healthcare, few studies have explored the leadership beliefs of clinicians and ascertained whether differences exist between professions. The current article aims to address these gaps and, additionally, examine whether clinicians' leadership beliefs are associated with the strength of their professional and team identifications. An online survey was responded to by 229 healthcare workers from community interprofessional teams in mental health settings across the East of England. No differences emerged between professional groups in their leadership beliefs; all professions reported a high level of agreement with shared leadership. A positive association emerged between professional identification and shared leadership in that participants who expressed the strongest level of profession identification also reported the greatest agreement with shared leadership. The same association was demonstrated for team identification and shared leadership. The findings highlight the important link between group identification and leadership beliefs, suggesting that strategies that promote strong professional and team identifications in interprofessional teams are likely to be conducive to clinicians supporting principles of shared leadership. Future research is needed to strengthen this link and examine the leadership practices of healthcare workers.

Role Clarification Processes for Better Integration of Nurse Practitioners into Primary Healthcare Teams: A Multiple-Case Study

PubMed Central

D'Amour, Danielle; Contandriopoulos, Damien; Chouinard, Véronique; Dubois, Carl-Ardy

2014-01-01

Role clarity is a crucial issue for effective interprofessional collaboration. Poorly defined roles can become a source of conflict in clinical teams and reduce the effectiveness of care and services delivered to the population. Our objective in this paper is to outline processes for clarifying professional roles when a new role is introduced into clinical teams, that of the primary healthcare nurse practitioner (PHCNP). To support our empirical analysis we used the Canadian National Interprofessional Competency Framework, which defines the essential components for role clarification among professionals. A qualitative multiple-case study was conducted on six cases in which the PHCNP role was introduced into primary care teams. Data collection included 34 semistructured interviews with key informants involved in the implementation of the PHCNP role. Our results revealed that the best performing primary care teams were those that used a variety of organizational and individual strategies to carry out role clarification processes. From this study, we conclude that role clarification is both an organizational process to be developed and a competency that each member of the primary care team must mobilize to ensure effective interprofessional collaboration. PMID:25692039

Role clarification processes for better integration of nurse practitioners into primary healthcare teams: a multiple-case study.

PubMed

Brault, Isabelle; Kilpatrick, Kelley; D'Amour, Danielle; Contandriopoulos, Damien; Chouinard, Véronique; Dubois, Carl-Ardy; Perroux, Mélanie; Beaulieu, Marie-Dominique

2014-01-01

Role clarity is a crucial issue for effective interprofessional collaboration. Poorly defined roles can become a source of conflict in clinical teams and reduce the effectiveness of care and services delivered to the population. Our objective in this paper is to outline processes for clarifying professional roles when a new role is introduced into clinical teams, that of the primary healthcare nurse practitioner (PHCNP). To support our empirical analysis we used the Canadian National Interprofessional Competency Framework, which defines the essential components for role clarification among professionals. A qualitative multiple-case study was conducted on six cases in which the PHCNP role was introduced into primary care teams. Data collection included 34 semistructured interviews with key informants involved in the implementation of the PHCNP role. Our results revealed that the best performing primary care teams were those that used a variety of organizational and individual strategies to carry out role clarification processes. From this study, we conclude that role clarification is both an organizational process to be developed and a competency that each member of the primary care team must mobilize to ensure effective interprofessional collaboration.

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 Workplace Learning in Primary Care: Students from Different Health Professions Work in Teams in Real-Life Settings

ERIC Educational Resources Information Center

Bondevik, Gunnar Tschudi; Holst, Lone; Haugland, Mildrid; Baerheim, Anders; Raaheim, Arild

2015-01-01

Interprofessional education may be defined as an occasion when two or more professions learn with, from, and about each other in order to improve collaboration and quality of care. We studied the self-reported experiences from Norwegian health care students participating in interprofessional workplace learning in primary care. We discuss the…

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.

Jefferson Teamwork Observation Guide (JTOG): An Instrument to Observe Teamwork Behaviors.

PubMed

Lyons, Kevin J; Giordano, Carolyn; Speakman, Elizabeth; Smith, Kellie; Horowitz, June A

2016-01-01

Interprofessional education (IPE) is becoming an integral part of the education of health professions students. However, teaching students to become successful members of interprofessional teams is complex, and it is important for students to learn the combinations of skills necessary for teams to function effectively. There are many instruments available to measure many features related to IPE. However, these instruments are often too cumbersome to use in an observational situation since they tend to be lengthy and contain many abstract characteristics that are difficult to identify. The Jefferson Teamwork Observation Guide (JTOG) is a short tool that was created for students early in their educational program to observe teams in action with a set of guidelines to help them focus their observation on behaviors indicative of good teamwork. The JTOG was developed over a 2-year period based on student and clinician feedback and the input of experts in IPE. While initially developed as a purely educational tool for prelicensure students, it is becoming clear that it is an easy-to-use instrument that assesses the behavior of clinicians in practice.

Teamwork: relevance and interdependence of interprofessional education

PubMed Central

Tamayo, M; Besoaín-Saldaña, A; Aguirre, M; Leiva, J

2017-01-01

ABSTRACT OBJECTIVE Determine the perception of university students regarding interprofessional and interdependent work between team members in their inclusion in primary care. METHODS Analytical cross-sectional study. The sampling had a probabilistic, stratified random type with 95% confidence and 5% margin of error. Seven-hundred and four students of Public Universities in Santiago (Chile) answered self-administered questionnaire. RESULTS Ninety-seven point eight of students say that interprofessional work is important; 27.1% of them declare that their university did not seem to show that their study plans were important. The professionals listed as most important in teams are physicians and nurses. CONCLUSIONS Spaces for development and institutional support are key elements to promote interprofessional work. If this competence can involve each academic unit in their different formative spaces there will be a significant contribution to said promotion. Teamwork is a pending task. PMID:28489187

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.

Interprofessional education in a primary care teaching clinic: findings from a study involving pharmacy and medical students.

PubMed

Sicat, Brigitte Luong; Huynh, Christine; Willett, Rita; Polich, Susan; Mayer, Sallie

2014-01-01

Interprofessional education (IPE) can be hindered by the lack of infrastructure required to support it. We developed a clinical IPE experience for medical and pharmacy students built upon an existing infrastructure. We created tools to orient students to IPE and had students participate in pharmacist-led and physician-led IPE clinics. Results from the surveys indicated that after participating in the IPE experience, there were no significant changes in attitudes toward interprofessional teamwork or attitudes toward different members of the healthcare team. Students found less value in tools outlining roles and responsibilities of team members, on-line modules about the other profession, and IPE group discussion. They placed more value on the actual clinical experience. Themes derived from analysis of open-ended survey questions reflected the value that students placed on interprofessional interaction in the setting of direct patient care.

Students' reflections on shadowing interprofessional teamwork: a Norwegian case study.

PubMed

Fougner, M; Horntvedt, T

2011-01-01

This article reports the students' reflections on interprofessional teamwork during brief exposures to real-life experiences in hospitals or home-based rehabilitation service. Each of the 10 interprofessional groups, comprising three students, followed a rehabilitation team for a day. The composition of each student group correlated with the rehabilitation team. Data were collected from interviews with the student groups and subjected to a thematic analysis. The following four main themes were identified for which the students seemed to affect collaboration: sharing knowledge; team setting and position within the organisation; patient centred focus; and challenges in crossing professional borders when performing tasks. Each of these themes is presented and discussed in relation to the educational literature. In conclusion, the data suggest that a well organized, one-day observation-based learning experience helped to motivate students and helped to enable them to relate theory and practice.

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

Adapting the McMaster-Ottawa scale and developing behavioral anchors for assessing performance in an interprofessional Team Observed Structured Clinical Encounter.

PubMed

Lie, Désirée; May, Win; Richter-Lagha, Regina; Forest, Christopher; Banzali, Yvonne; Lohenry, Kevin

2015-01-01

Current scales for interprofessional team performance do not provide adequate behavioral anchors for performance evaluation. The Team Observed Structured Clinical Encounter (TOSCE) provides an opportunity to adapt and develop an existing scale for this purpose. We aimed to test the feasibility of using a retooled scale to rate performance in a standardized patient encounter and to assess faculty ability to accurately rate both individual students and teams. The 9-point McMaster-Ottawa Scale developed for a TOSCE was converted to a 3-point scale with behavioral anchors. Students from four professions were trained a priori to perform in teams of four at three different levels as individuals and teams. Blinded faculty raters were trained to use the scale to evaluate individual and team performances. G-theory was used to analyze ability of faculty to accurately rate individual students and teams using the retooled scale. Sixteen faculty, in groups of four, rated four student teams, each participating in the same TOSCE station. Faculty expressed comfort rating up to four students in a team within a 35-min timeframe. Accuracy of faculty raters varied (38-81% individuals, 50-100% teams), with errors in the direction of over-rating individual, but not team performance. There was no consistent pattern of error for raters. The TOSCE can be administered as an evaluation method for interprofessional teams. However, faculty demonstrate a 'leniency error' in rating students, even with prior training using behavioral anchors. To improve consistency, we recommend two trained faculty raters per station.

Organizational structure, team process, and future directions of interprofessional health care teams.

PubMed

Cole, Kenneth D; Waite, Martha S; Nichols, Linda O

2003-01-01

For a nationwide Geriatric Interdisciplinary Team Training (GITT) program evaluation of 8 sites and 26 teams, team evaluators developed a quantitative and qualitative team observation scale (TOS), examining structure, process, and outcome, with specific focus on the training function. Qualitative data provided an important expansion of quantitative data, highlighting positive effects that were not statistically significant, such as role modeling and training occurring within the clinical team. Qualitative data could also identify "too much" of a coded variable, such as time spent in individual team members' assessments and treatment plans. As healthcare organizations have increasing demands for productivity and changing reimbursement, traditional models of teamwork, with large teams and structured meetings, may no longer be as functional as they once were. To meet these constraints and to train students in teamwork, teams of the future will have to make choices, from developing and setting specific models to increasing the use of information technology to create virtual teams. Both quantitative and qualitative data will be needed to evaluate these new types of teams and the important outcomes they produce.

The resident physician as leader within the healthcare team.

PubMed

Sonnenberg, Lyn Kathryn; Pritchard-Wiart, Lesley; Busari, Jamiu

2018-05-08

Purpose The purpose of this study was to explore inter-professional clinicians' perspectives on resident leadership in the context of inter-professional teams and to identify a definition for leadership in the clinical context. In 2015, CanMEDS changed the title of one of the core competencies from manager to leader. The shift in language was perceived by some as returning to traditional hierarchical and physician-dominant structures. The resulting uncertainty has resulted in a call to action to not only determine what physician leadership is but to also determine how to teach and assess it. Design/methodology/approach Focus groups and follow-up individual interviews were conducted with 23 inter-professional clinicians from three pediatric clinical service teams at a large, Canadian tertiary-level rehabilitation hospital. Qualitative thematic analysis was used to inductively analyze the data. Findings Data analysis resulted in one overarching theme: leadership is collaborative - and three related subthemes: leadership is shared; leadership is summative; and conceptualizations of leadership are shifting. Research limitations/implications Not all members of the three inter-professional teams were able to attend the focus group sessions because of scheduling conflicts. Participation of additional clinicians could have, therefore, affected the results of this study. The study was conducted locally at a single rehabilitation hospital, among Canadian pediatric clinicians, which highlights the need to explore conceptualization of leadership across different contexts. Practical implications There is an evident need to prepare physicians to be leaders in both their daily clinical and academic practices. Therefore, more concerted efforts are required to develop leadership skills among residents. The authors postulate that continued integration of various inter-professional disciplines during the early phases of training is essential to foster collaborative leadership and trust. Originality/value The results of this study suggest that inter-professional clinicians view clinical leadership as collaborative and fluid and determined by the fit between tasks and team member expertise. Mentorship is important for increasing the ability of resident physicians to develop collaborative leadership roles within teams. The authors propose a collaborative definition of clinical leadership based on the results of this study: a shared responsibility that involves facilitation of dialog; the integration of perspectives and expertise; and collaborative planning for the purpose of exceptional patient care.

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 resuscitation rounds: a teamwork approach to ACLS education.

PubMed

Dagnone, Jeffrey Damon; McGraw, Robert C; Pulling, Cheryl A; Patteson, Ann K

2008-01-01

We developed and implemented a series of interprofessional resuscitation rounds targeting fourth year nursing and medical students, and junior residents from a variety of specialty programs. Each two hour session was conducted in our patient simulation lab, and was held weekly during the academic year. Students were given specific instruction on the roles and responsibilities of resuscitation team members, and then teams of five worked through pre-defined Advanced Cardiac Life Support (ACLS) scenarios on a high fidelity patient simulator. At the end of each session students completed an anonymous evaluation of the program via a standardized questionnaire using Likert rating scales. A total of 222 evaluations (101 nursing students, 42 medical students, and 79 junior residents) were submitted from October 2005 to April 2006. Mean scores reflected a strong consensus that these rounds were valuable for their training, provided a vehicle for understanding team roles in resuscitation, and that these rounds should be mandatory for all medical and nursing trainees. Participants also expressed a desire for additional interprofessional training. Despite challenges inherent in teaching a diverse group of learners, these interprofessional resuscitation rounds were rated highly by nursing and medical trainees as valuable learning experiences.

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.

Learning by viewing versus learning by doing: A comparative study of observer and participant experiences during an interprofessional simulation training.

PubMed

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

2017-01-01

Larger student groups and pressure on limited faculty time have raised the question of the learning value of merely observing simulation training in emergency medicine, instead of active team participation. The purpose of this study was to examine observers and hands-on participants' self-reported learning outcomes during simulation-based interprofessional team training regarding non-technical skills. In addition, we compared the learning outcomes for different professions and investigated team performance relative to the number of simulations in which they participated. A concurrent mixed-method design was chosen to evaluate the study, using questionnaires, observations, and focus group interviews. Participants included a total of 262 postgraduate and bachelor nursing students and medical students, organised into 44 interprofessional teams. The quantitative data showed that observers and participants had similar results in three of six predefined learning outcomes. The qualitative data emphasised the importance of participating in different roles, training several times, and training interprofessionally to enhance realism. Observing simulation training can be a valuable learning experience, but the students' preferred hands-on participation and learning by doing. For this reason, one can legitimise the observer role, given the large student groups and limited faculty time, as long as the students are also given some opportunity for hands-on participation in order to become more confident in their professional roles.

Leadership of interprofessional health and social care teams: a socio-historical analysis.

PubMed

Reeves, Scott; Macmillan, Kathleen; van Soeren, Mary

2010-04-01

The aim of this paper is to explore some of the key socio-historical issues related to the leadership of interprofessional teams. Over the past quarter of a century, there have been repeated calls for collaboration to help improve the delivery of care. Interprofessional teamwork is regarded as a key approach to delivering high-quality, safe care. We draw upon historical documents to understand how modern health and social care professions emerged from 16th-century crafts guilds. We employ sociological theories to help analyse the nature of these professional developments for team leadership. As the forerunners of professions, crafts guilds were established on the basis of protection and promotion of their members. Such traits have been emphasized during the evolution of professions, which have resulted in strains for teamwork and leadership. Understanding a problem through a socio-historical analysis can assist management to understand the barriers to collaboration and team leadership. Nursing management is in a unique role to observe and broker team conflict. It is rare to examine these phenomena through a humanities/social sciences lens. This paper provides a rare perspective to foster understanding - an essential precursor to effective change management.

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.

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.

Beyond the Team: Understanding Interprofessional Work in Two North American ICUs.

PubMed

Alexanian, Janet A; Kitto, Simon; Rak, Kim J; Reeves, Scott

2015-09-01

To examine the ways in which healthcare professionals work together in the ICU setting, through a consideration of the contextual, organizational, processual, and relational factors that impact their interprofessional collaboration. Data from over 350 hours of ethnographic observation and 35 semistructured interviews with clinicians in two ICUs were collected by two medical anthropologists over a period of 6 months. Medical surgical ICUs in two urban research hospitals in Canada and the United States. Although the concept of teamwork is often central to interventions to improve patient safety in the ICU, our observations suggest that this concept does not fully describe how interprofessional work actually occurs in this setting. With the exception of crisis situations, most interprofessional interactions in the two ICUs we studied could be better described as forms of interprofessional work other than teamwork, which include collaboration, coordination, and networking. A singular notion of team is too reductive to account for the ways in which work happens in the ICU and therefore cannot be taken for granted in quality improvement initiatives or among healthcare professionals in this setting. Adapting interventions to the complex nature of interprofessional work and each ICUs unique local context is an important and necessary step to ensure the delivery of safe and effective patient care.

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.

Health care interprofessional education: encouraging technology, teamwork, and team performance.

PubMed

2014-04-01

It is critical to prepare nurses for future practice to work in teams by engaging students in interprofessional education (IPE) that fosters positive attitudes toward teamwork. The purpose of this study was to examine the effects of computer-supported IPE on students’ attitudes and perceptions toward health care teamwork and team performance. A hybrid approach to IPE was used to provide students with an educational experience that combined the benefits of traditional face-to-face communication methodology with a computer-mediated platform that focused on reflection and team building. A statistically significant difference was found in students’ perceptions of team performance after engaging in computer-supported IPE. No statistically significant difference in students’ pretest–posttest composite attitude toward teamwork scores was noted; however, there was a positive trend toward improved scores.

Attitudes of Physician Assistant Educators Toward Interprofessional Education and Collaborative Care.

PubMed

Levy, Laura A; Mathieson, Kathleen

2017-06-01

Interprofessional education (IPE) has been shown to improve collaboration in the workforce, ultimately improving patient care. The purpose of this study was to evaluate physician assistant (PA) educators' attitudes toward IPE and interprofessional (IP) health care teams. An online survey was sent to 1198 PA educators. The survey assessed 3 domains: attitudes toward IPE, attitudes toward IP health care teams, and attitudes toward IP learning in the academic setting. Most participants were involved in some form of IPE. Faculty attitudes were positive in all 3 domains but were more favorable toward IPE. The positive attitudes held by PA faculty members may change the way in which curricula are conceived and delivered, influencing IP collaboration of future health care providers.

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.

Forming a new clinical team for frail older people: can a group development model help?

PubMed

Anderson, Elizabeth Susan; Pollard, Lorraine; Conroy, Simon; Clague-Baker, Nicola

2014-03-01

Integrated services which utilise the expertise of team members along care pathways are evolving. Changes in service structure and subsequent team working arrangements can be a challenge for practitioners expected to redefine how they work with one another. These services are particularly important for the care of frail older people. This exploratory study of one newly forming team presents the views of staff involved in establishing an interprofessional healthcare advisory team for older people within an acute hospital admissions unit. Staff experiences of forming a new service are aligned to a model of team development. The findings are presented as themes relating to the stages of team development and identify the challenges of setting up an integrated service alongside existing services. In particular, team process issues relating to the clarity of goals, role clarification, leadership, team culture and identity. Managers must allow time to ensure new services evolve before setting up evaluation studies for efficiency and effectiveness which might prove against the potential for interprofessional teamworking.

Effective Team Practices: Interprofessional Contributions to Communication Issues With a Parent's Perspective.

PubMed

Cooper-Duffy, Karena; Eaker, Kerri

2017-05-17

This clinical focus article contains a detailed description of how to build effective teams that use interprofessional collaborative practice (IPCP) with special-education professionals, speech-language pathologists, and families of children with severe disabilities. This clinical focus article provides information on using the essential elements of team building and IPCP to provide quality care to families who have children with severe disabilities. The 6 essential elements for team building are described, with suggestions for including families in each: goal-setting, roles and responsibilities, effective and efficient process, communication and interpersonal relationships, collaborative problem solving, and evaluation. The 4 competency domains of IPCP are embedded into each of the team-building elements to demonstrate how teams can implement IPCP. A case study illustrates the difficulty one parent experienced working with a team across the 6 essential team-building elements when seeking communication services for her child with severe disabilities. Building teams with IPCP can be effective for including families and creating high-quality outcomes for individuals with severe disabilities.

Inter-professional in-situ simulated team and resuscitation training for patient safety: Description and impact of a programmatic approach.

PubMed

Zimmermann, Katja; Holzinger, Iris Bachmann; Ganassi, Lorena; Esslinger, Peter; Pilgrim, Sina; Allen, Meredith; Burmester, Margarita; Stocker, Martin

2015-10-29

Inter-professional teamwork is key for patient safety and team training is an effective strategy to improve patient outcome. In-situ simulation is a relatively new strategy with emerging efficacy, but best practices for the design, delivery and implementation have yet to be evaluated. Our aim is to describe and evaluate the implementation of an inter-professional in-situ simulated team and resuscitation training in a teaching hospital with a programmatic approach. We designed and implemented a team and resuscitation training program according to Kern's six steps approach for curriculum development. General and specific needs assessments were conducted as independent cross-sectional surveys. Teamwork, technical skills and detection of latent safety threats were defined as specific objectives. Inter-professional in-situ simulation was used as educational strategy. The training was embedded within the workdays of participants and implemented in our highest acuity wards (emergency department, intensive care unit, intermediate care unit). Self-perceived impact and self-efficacy were sampled with an anonymous evaluation questionnaire after every simulated training session. Assessment of team performance was done with the team-based self-assessment tool TeamMonitor applying Van der Vleuten's conceptual framework of longitudinal evaluation after experienced real events. Latent safety threats were reported during training sessions and after experienced real events. The general and specific needs assessments clearly identified the problems, revealed specific training needs and assisted with stakeholder engagement. Ninety-five interdisciplinary staff members of the Children's Hospital participated in 20 in-situ simulated training sessions within 2 years. Participant feedback showed a high effect and acceptance of training with reference to self-perceived impact and self-efficacy. Thirty-five team members experiencing 8 real critical events assessed team performance with TeamMonitor. Team performance assessment with TeamMonitor was feasible and identified specific areas to target future team training sessions. Training sessions as well as experienced real events revealed important latent safety threats that directed system changes. The programmatic approach of Kern's six steps for curriculum development helped to overcome barriers of design, implementation and assessment of an in-situ team and resuscitation training program. This approach may help improve effectiveness and impact of an in-situ simulated training program.

Collaborative Falls Prevention: Interprofessional Team Formation, Implementation, and Evaluation.

PubMed

Lasater, Kathie; Cotrell, Victoria; McKenzie, Glenise; Simonson, William; Morgove, Megan W; Long, Emily E; Eckstrom, Elizabeth

2016-12-01

As health care rapidly evolves to promote person-centered care, evidence-based practice, and team-structured environments, nurses must lead interprofessional (IP) teams to collaborate for optimal health of the populations and more cost-effective health care. Four professions-nursing, medicine, social work, and pharmacy-formed a teaching team to address fall prevention among older adults in Oregon using an IP approach. The teaching team developed training sessions that included interactive, evidence-based sessions, followed by individualized team coaching. This article describes how the IP teaching team came together to use a unique cross-training approach to teach each other. They then taught and coached IP teams from a variety of community practice settings to foster their integration of team-based falls-prevention strategies into practice. After coaching 25 teams for a year each, the authors present the lessons learned from the teaching team's formation and experiences, as well as feedback from practice team participants that can provide direction for other IP teams. J Contin Educ Nurs. 2016;47(12):545-550. Copyright 2016, SLACK Incorporated.

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.

Understanding Pain and Pain Management in Elderly Nursing Home Patients Applying an Interprofessional Learning Activity in Health Care Students: A Norwegian Pilot Study.

PubMed

Damsgård, Elin; Solgård, Hege; Johannessen, Karin; Wennevold, Katrine; Kvarstein, Gunnvald; Pettersen, Gunn; Garcia, Beate

2018-05-17

Pain is common among elderly patients in nursing homes. However, pain assessment and treatment are inadequate. Interprofessional treatment is recommended, and consequently interprofessional education in pain management is necessary. This pilot project aimed to describe how two interprofessional groups of students approached pain management in two nursing home patients. We formed two teams comprising one student from the nursing, physical therapy, pharmacy, and medical educations. Each team spent one day examining a patient with chronic pain at a nursing home and they developed pain management plans. We collected data through video recordings during teamwork before and after examining the patients and field notes during the patient examination. We analysed the video-recordings applying the seven-step model including 1) viewing the video data, 2) describing the video data, 3) identifying critical events, 4) transcribing, 5) coding, 6) constructing storyline and 7) composing a narrative. Field notes supplied the transcripts. Both teams succeeded in making a pain management plan for their patient. The common examination of the patient was crucial for the students' approaches to pain management and changed their pre-assumptions about the patients' pain. By sharing knowledge and reflecting together, the students reached a common consensus on suggestions for management of the patients' problems. Interprofessional collaboration fostered enthusiasm and a more holistic pain management approach. However,students' lack of knowledge limited their understanding of pain. Knowledge of pain management in nursing home patients and the practice of interprofessional cooperation should be included in pain curricula for health care professionals. Copyright © 2018 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Hotspotting: Development of an Interprofessional Education and Service Learning Program for Care Management in Home Care Patients.

PubMed

Zomorodi, Meg; Odom, Trish; Askew, Naomi C; Leonard, Christina R; Sanders, Kimberly A; Thompson, Daniel

2018-03-28

The purpose of this article is to describe a service learning opportunity where interprofessional teams of students worked together to address patients' social determinants of health through home visits. This article describes this process, known as "hotspotting," and presents the development of this project, including collaboration with a local home health agency, recruiting of students, and weekly team meetings for debriefing. Evaluation data, barriers with implementation, and next steps for sustainability are also discussed.

Team-Based Learning for Nursing and Medical Students: Focus Group Results From an Interprofessional Education Project.

PubMed

Feather, Rebecca A; Carr, Doug E; Reising, Deanna L; Garletts, Derrick M

2016-01-01

Past research indicates that inadequacies in health care delivery create substantial preventable quality issues that can be addressed through improving relationships among clinicians to decrease the negative effects on patient outcomes. The purpose of this article is to describe the implementation of an interprofessional education project with senior nursing and third-year medical students working in teams in a clinical setting. Results include data from focus groups conducted at the conclusion of the project.

Interprofessional primary care team meetings: a qualitative approach comparing observations with personal opinions.

PubMed

van Dongen, Jerôme Jean Jacques; van Bokhoven, Marloes Amantia; Daniëls, Ramon; Lenzen, Stephanie Anna; van der Weijden, Trudy; Beurskens, Anna

2017-02-01

The number of people with multiple chronic conditions requiring primary care services increases. Professionals from different disciplines collaborate and coordinate care to deal with the complex health care needs. There is lack of information on current practices regarding interprofessional team (IPT) meetings. This study aimed to improve our understanding of the process of interprofessional collaboration in primary care team meetings in the Netherlands by observing the current practice and exploring personal opinions. Qualitative study involving observations of team meetings and interviews with participants. Eight different IPT meetings (n = 8) in different primary care practices were observed by means of video recordings. Experiences were explored by conducting individual semi-structured interviews (n = 60) with participants (i.e. health care professionals from different disciplines) of the observed team meetings. The data were analysed by means of content analysis. Most participants expressed favourable opinions about their team meetings. However, observations showed that team meetings were more or less hectic, and lacked a clear structure and team coordinator or leader. There appears to be a discrepancy between findings from observations and interviews. From the interviews, four main themes were extracted: (1) Team structure and composition, (2) Patient-centredness, (3) Interaction and (4) Attitude and motivation. IPT meetings could benefit from improvements in structure, patient-centredness and leadership by the chairpersons. Given the discrepancy between observations and interviews, it would appear useful to improve team members' awareness of aspects that could be improved before training them in dealing with specific challenges. © The Author 2016. Published by Oxford University Press.

Exploring Healthcare Simulation as a Platform for Interprofessional Education

ERIC Educational Resources Information Center

Palaganas, Janice Christine

2012-01-01

Interprofessional education (IPE) is gradually recognized as essential to patient safety and implemented as a standard for healthcare education through professional organization recommendations and accrediting bodies. Given the increasing adoption of experiential and team-based learning, healthcare simulation (HCS) has become a preferred vehicle…

Interprofessional academic health center leadership development: the case of the University of Alabama at Birmingham's Healthcare Leadership Academy.

PubMed

Savage, Grant T; Duncan, W Jack; Knowles, Kathy L; Nelson, Kathleen; Rogers, David A; Kennedy, Karen N

2014-05-01

The study describes the genesis of the University of Alabama at Birmingham's Healthcare Leadership Academy (HLA), highlights the HLA's outcomes, discloses how the HLA has changed, and delineates future directions for academic health center (AHC) interprofessional leadership training. While interprofessional training is recognized as an important component of the professional education for health professionals, AHCs have not focused on interprofessional leadership training to prepare future AHC leaders. As professional bureaucracies, AHCs require leadership distributed across different professions; these leaders not only should be technical experts, but also skilled at interprofessional teamwork and collaborative governance. The HLA is examined using the case method, which is supplemented with a descriptive analysis of program evaluation data and outcomes. The HLA has created a networked community of AHC leaders; the HLA's interprofessional team projects foster innovative problem solving. Interprofessional leadership training expands individuals' networks and has multiple organizational benefits. © 2014.

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.

[Team Development in Medical Rehabilitation: Concept and Evaluation of a Team Intervention].

PubMed

Körner, M; Luzay, L; Becker, S; Rundel, M; Müller, C; Zimmermann, L

2016-04-01

Interprofessional collaboration is a main precondition of successful treatment in rehabilitation. In order to improve interprofessional collaboration, a clinic-specific, goal- and solution-oriented and systemic team development approach was designed. The aim of the study is the evaluation of this approach. A multi-centre cluster-randomized controlled study with staff questionnaires. The team development could be implemented successfully in 4 of 5 clinics and led to significant improvements in team organisation, willingness to accept responsibility and knowledge integration. The effects are small and are caused by the opposed development of intervention and control group. The team development approach can be recommended for rehabilitation practice. A train-the-trainer approach will be developed and further studies are planned in order to disseminate the approach and to investigate the conditions of implementation. © Georg Thieme Verlag KG Stuttgart · New York.

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.

Interprofessional education in primary health care for entry level students--A systematic literature review.

PubMed

Kent, Fiona; Keating, Jennifer L

2015-12-01

This systematic review investigated student learning and patient outcomes associated with interprofessional education in outpatient, primary care clinics. Medline, Cinahl and Embase databases were searched to March 2014. A mixed method evaluation framework was applied to investigate the participants, interventions and effects on student learning and patient outcomes. 26 studies met the inclusion criteria; 13 were quantitative, predominately pre-post-survey design, 6 qualitative and 7 mixed methods design. Studies most commonly investigated student volunteers from medicine, nursing and allied health working in interprofessional clinics that were established to address gaps in community health care. Students appeared to learn teamwork skills and increase their knowledge of the roles of other disciplines. We found no convincing evidence that participation results in changes in attitudes towards other disciplines compared to single discipline education. We also found insufficient evidence to estimate the effectiveness of patient care delivered by interprofessional student teams in this setting compared to single discipline or no care. Given the logistical challenges associated with coordinating clinic attendance for interprofessional teams, high quality studies are needed to assess the effects of clinics on student learning and patient health outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

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.

Contributions of team climate in the study of interprofessional collaboration: A conceptual analysis.

PubMed

Agreli, Heloise F; Peduzzi, Marina; Bailey, Christopher

2017-11-01

The concept of team climate is widely used to understand and evaluate working environments. It shares some important features with Interprofessional Collaboration (IPC). The four-factor theory of climate for work group innovation, which underpins team climate, could provide a better basis for understanding both teamwork and IPC. This article examines in detail the common ground between team climate and IPC, and assesses the relevance of team climate as a theoretical approach to understanding IPC. There are important potential areas of overlap between team climate and IPC that we have grouped under four headings: (1) interaction and communication between team members; (2) common objectives around which collective work is organised; (3) responsibility for performing work to a high standard; and (4) promoting innovation in working practices. These overlapping areas suggest common characteristics that could provide elements of a framework for considering the contribution of team climate to collaborative working, both from a conceptual perspective and, potentially, in operational terms as, for example, a diagnostic tool.

Successful participation of patients in interprofessional team meetings: A qualitative study.

PubMed

van Dongen, Jerôme Jean Jacques; Habets, Iris Gerarda Josephine; Beurskens, Anna; van Bokhoven, Marloes Amantia

2017-08-01

The number of people with multiple chronic conditions increases as a result of ageing. To deal with the complex health-care needs of these patients, it is important that health-care professionals collaborate in interprofessional teams. To deliver patient-centred care, it is often recommended to include the patient as a member of the team. To gain more insight into how health-care professionals and patients, who are used to participate in interprofessional team meetings, experience and organize patient participation in the team meetings. A qualitative study including observations of meetings (n=8), followed by semi-structured interviews with participating health-care professionals (n=8), patients and/or relatives (n=11). Professionals and patients were asked about their experiences of patient participation immediately after the team meetings. Results from both observations and interviews were analysed using content analysis. The findings show a variety of influencing factors related to patient participation that can be divided into five categories: (i) structure and task distribution, (ii) group composition, (iii) relationship between professionals and patients or relatives, (iv) patients' characteristics and (v) the purpose of the meeting. Patient participation during team meetings was appreciated by professionals and patients. A tailored approach to patient involvement during team meetings is preferable. When considering the presence of patients in team meetings, it is recommended to pay attention to patients' willingness and ability to participate, and the necessary information shared before the meeting. Participating patients seem to appreciate support and preparation for the meeting. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

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.

Health Mentor-Reported Outcomes and Perceptions of Student Team Performance in a Longitudinal Interprofessional Education Program.

PubMed

Umland, Elena; Collins, Lauren; Baronner, Ashley; Lim, Edwin; Giordano, Carolyn

2016-01-01

The need to evaluate the impact of interprofessional education (IPE) on learner outcomes is clear, but assessment of IPE's impact on patient health and well-being is lacking. This mixed-methods study evaluated perspectives of community volunteers, health mentors (HMs) who have at least one chronic condition, who participated in an IPE curriculum. In May 2014, 93 HMs concluding the Health Mentors Program completed a survey evaluating their student teams according to the Interprofessional Education Collaborative core competencies' four domains and program impact on health/wellbeing using a 4-point Likert scale (1=strongly disagree; 4=strongly agree). The average response to statements regarding the four domains of values/ethics, roles/responsibilities, communication, and teamwork statements were all >3.0. HMs rated program satisfaction on a 10-point scale (1=least satisfied, 10=most satisfied) and answered open-ended outcome questions. The average program satisfaction score was 9.13±1.43; increased motivation to make and maintain healthy behaviors was reported. In a follow-up focus group with 10 mentors, high satisfaction levels from working with interprofessional student teams were reported, and substantial improvements in managing health conditions and improving overall health status were relayed. Further studies will determine if the patient-reported outcomes of the mentors correlate with objective health measures.

Acceptability and feasibility of an interprofessional end-of-life/palliative care educational intervention in the intensive care unit: A mixed-methods study.

PubMed

Graham, Robyn; Lepage, Carolan; Boitor, Madalina; Petizian, Stephanie; Fillion, Lise; Gélinas, Céline

2018-06-21

This study aimed to describe a seven hour End-of-Life/Palliative Care educational intervention including online content related to symptom management, communication and decision-making capacity and an in-person group integration activity, from the perspective of the interprofessional team in terms of its acceptability and feasibility. A mixed-methods study design was used. The study was conducted in a medical-surgical Intensive Care Unit in Montreal, Canada. The sample consisted of 27 clinicians of the Intensive Care Unit interprofessional team who completed the End-of-Life/Palliative Care educational intervention, and participated in focus groups and completed a self-administered questionnaire. The main outcomes were the acceptability and feasibility of the educational intervention. The intervention was perceived to be appropriate and suitable in providing clinicians with knowledge and skills in symptom management and communication through self-reflection and self-evaluation, provision of assessment tools and promotion of interprofessional teamwork. The online format was more feasible, but the in-person group activity was key for the integration of knowledge and the promotion of interprofessional discussions. Findings suggest that an interprofessional educational intervention integrating on-line content with in-person training has the potential to support clinicians in providing quality End-of-Life/Palliative Care in the Intensive Care Unit. Copyright © 2018. Published by Elsevier Ltd.

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.

Comparing interprofessional and interorganizational collaboration in healthcare: A systematic review of the qualitative research.

PubMed

Karam, Marlène; Brault, Isabelle; Van Durme, Thérèse; Macq, Jean

2018-03-01

Interprofessional and interorganizational collaboration have become important components of a well-functioning healthcare system, all the more so given limited financial resources, aging populations, and comorbid chronic diseases. The nursing role in working alongside other healthcare professionals is critical. By their leadership, nurses can create a culture that encourages values and role models that favour collaborative work within a team context. To clarify the specific features of conceptual frameworks of interprofessional and interorganizational collaboration in the healthcare field. This review, accordingly, offers insights into the key challenges facing policymakers, managers, healthcare professionals, and nurse leaders in planning, implementing, or evaluating interprofessional collaboration. This systematic review of qualitative research is based on the Joanna Briggs Institute's methodology for conducting synthesis. Cochrane, JBI, CINAHL, Embase, Medline, Scopus, Academic Search Premier, Sociological Abstract, PsycInfo, and ProQuest were searched, using terms such as professionals, organizations, collaboration, and frameworks. Qualitative studies of all research design types describing a conceptual framework of interprofessional or interorganizational collaboration in the healthcare field were included. They had to be written in French or English and published in the ten years between 2004 and 2014. Sixteen qualitative articles were included in the synthesis. Several concepts were found to be common to interprofessional and interorganizational collaboration, such as communication, trust, respect, mutual acquaintanceship, power, patient-centredness, task characteristics, and environment. Other concepts are of particular importance either to interorganizational collaboration, such as the need for formalization and the need for professional role clarification, or to interprofessional collaboration, such as the role of individuals and team identity. Promoting interorganizational collaboration was found to face greater challenges, such as achieving a sense of belonging among professionals when differences exist between corporate cultures, geographical distance, the multitude of processes, and formal paths of communication. This review sets a direction to follow for implementing changes that meet the challenge of a changing healthcare system and the transition towards non-institutional care. It also shows that collaboration between nurses and healthcare professionals from different healthcare organizations is still poorly explored. This is a major limitation in the existing scientific literature, especially given the potential role that could be played by nurses in enhancing interorganizational collaboration. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Infusing an Inter-Professional and Inter-University Perspective into Healthcare Education

ERIC Educational Resources Information Center

Goldberg, Lynette R.; Koontz, Jennifer Scott; Downs, David; Uhlig, Paul; Kumar, Neil G.; Shah, Sapna; Clark, Paige E.; Coiner, Christina; Crumrine, Daiquirie

2010-01-01

A national (USA) student-led, case-based CLinician/Administrator Relationship Improvement OrganizatioN (CLARION) competition focuses students in medical and related healthcare programs on the provision of healthcare that is safe, timely, equitable, patient-centred, effective and efficient. Students work in four-person, inter-professional teams to…

Psychology Student Experience of a Brief, Interprofessional Team Training

ERIC Educational Resources Information Center

Zucchero, Reneé A.

2017-01-01

Healthcare providers, including psychologists who work as health service providers and with older adults, must be able to work effectively with professionals from other disciplines. Interprofessional education (IPE) engages students from two or more professions to learn collaboratively. To date, only a few studies have examined psychology student…

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…

Interprofessionalism: Educating to Meet Patient Needs

ERIC Educational Resources Information Center

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…

Multidisciplinary Obstetric Simulated Emergency Scenarios (MOSES): Promoting Patient Safety in Obstetrics with Teamwork-Focused Interprofessional Simulations

ERIC Educational Resources Information Center

Freeth, Della; Ayida, Gubby; Berridge, Emma Jane; Mackintosh, Nicola; Norris, Beverley; Sadler, Chris; Strachan, Alasdair

2009-01-01

Introduction: We describe an example of simulation-based interprofessional continuing education, the multidisciplinary obstetric simulated emergency scenarios (MOSES) course, which was designed to enhance nontechnical skills among obstetric teams and, hence, improve patient safety. Participants' perceptions of MOSES courses, their learning, and…

Building Collaborative Learning Opportunities between Future Veterinary and Design Professionals

ERIC Educational Resources Information Center

Magallanes, Fernando; Stoskopf, Michael K.; Royal, Kenneth D.

2015-01-01

Positive inter-professional collaborations and interactions facilitate the effectiveness of veterinarians working on professional teams addressing a wide range of societal challenges. The need for these interactions extend far beyond the different medical professions, which is the limit of many discussions of inter-professional relations for…

Nurse's perceptions of physiotherapists in critical care team: Report of a qualitative study.

PubMed

Gupte, Pranati; Swaminathan, Narasimman

2016-03-01

Interprofessional relationship plays a major role in effective patient care. Specialized units such as critical care require multidisciplinary care where perception about every members role may affect the delivery of patient care. The objective of this study was to find out nurses' perceptions of the role of physiotherapists in the critical care team. Qualitative study by using semi-structured interview was conducted among the qualified nurses working in the Intensive Care Unit of a tertiary care hospital. The interview consisted of 19 questions divided into 3 sections. Interviews were audio recorded and transcribed. In-depth content analysis was carried out to identify major themes in relation to the research question. Analysis identified five major issues which included role and image of a physiotherapist, effectiveness of treatment, communications, teamwork, and interprofessional relations. Physiotherapists were perceived to be an important member of the critical team with the role of mobilizing the patients. The respondents admitted that there existed limitations in interprofessional relationship. Nurses perceived the role of physiotherapist in the critical care unit as an integral part and agreed on the need for inclusion of therapist multidisciplinary critical care team.

Telehealth by an Interprofessional Team in Patients With CKD: A Randomized Controlled Trial.

PubMed

Ishani, Areef; Christopher, Juleen; Palmer, Deirdre; Otterness, Sara; Clothier, Barbara; Nugent, Sean; Nelson, David; Rosenberg, Mark E

2016-07-01

Telehealth and interprofessional case management are newer strategies of care within chronic disease management. We investigated whether an interprofessional team using telehealth was a feasible care delivery strategy and whether this strategy could affect health outcomes in patients with chronic kidney disease (CKD). Randomized clinical trial. Minneapolis Veterans Affairs Health Care System (VAHCS), St. Cloud VAHCS, and affiliated clinics March 2012 to November 2013 in patients with CKD (estimated glomerular filtration rate < 60mL/min/1.73m(2)). Patients were randomly assigned to receive an intervention (n=451) consisting of care by an interprofessional team (nephrologist, nurse practitioner, nurses, clinical pharmacy specialist, psychologist, social worker, and dietician) using a telehealth device (touch screen computer with peripherals) or to usual care (n=150). The primary end point was a composite of death, hospitalization, emergency department visits, or admission to skilled nursing facilities, compared to usual care. Baseline characteristics of the overall study group: mean age, 75.1±8.1 (SD) years; men, 98.5%; white, 97.3%; and mean estimated glomerular filtration rate, 37±9mL/min/1.73m(2). Telehealth and interprofessional care were successfully implemented with meaningful engagement with the care system. One year after randomization, 208 (46.2%) patients in the intervention group versus 70 (46.7%) in the usual-care group had the primary composite outcome (HR, 0.98; 95% CI, 0.75-1.29; P=0.9). There was no difference between groups for any component of the primary outcome: all-cause mortality (HR, 1.46; 95% CI, 0.42-5.11), hospitalization (HR, 1.15; 95% CI, 0.80-1.63), emergency department visits (HR, 0.92; 95% CI, 0.68-1.24), or nursing home admission (HR, 3.07; 95% CI, 0.71-13.24). Older population, mostly men, potentially underpowered/wide CIs. Telehealth by an interprofessional team is a feasible care delivery strategy in patients with CKD. There was no statistically significant evidence of superiority of this intervention on health outcomes compared to usual care. Published by Elsevier Inc.

Using Interprofessional Learning for Continuing Education: Development and Evaluation of the Graduate Certificate Program in Health Professional Education for Clinicians.

PubMed

Henderson, Saras; Dalton, Megan; Cartmel, Jennifer

2016-01-01

Health professionals may be expert clinicians but do not automatically make effective teachers and need educational development. In response, a team of health academics at an Australian university developed and evaluated the continuing education Graduate Certificate in Health Professional Education Program using an interprofessional learning model. The model was informed by Collins interactional expertise and Knowles adult learning theories. The team collaboratively developed and taught four courses in the program. Blended learning methods such as web-based learning, face-to-face workshops, and online discussion forums were used. Twenty-seven multidisciplinary participants enrolled in the inaugural program. Focus group interview, self-report questionnaires, and teacher observations were used to evaluate the program. Online learning motivated participants to learn in a collaborative virtual environment. The workshops conducted in an interprofessional environment promoted knowledge sharing and helped participants to better understand other discipline roles, so they could conduct clinical education within a broader health care team context. Work-integrated assessments supported learning relevance. The teachers, however, observed that some participants struggled because of lack of computer skills. Although the interprofessional learning model promoted collaboration and flexibility, it is important to note that consideration be given to participants who are not computer literate. We therefore conducted a library and computer literacy workshop in orientation week which helped. An interprofessional learning environment can assist health professionals to operate outside their "traditional silos" leading to a more collaborative approach to the provision of care. Our experience may assist other organizations in developing similar programs.

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.

Interprofessional collaboration within Canadian integrative healthcare clinics: Key components.

PubMed

Gaboury, Isabelle; Bujold, Mathieu; Boon, Heather; Moher, David

2009-09-01

Research shows that interprofessional collaboration has become an important factor in the implementation of effective healthcare models. To date, the literature has not focused on the collaboration between medical doctors and complementary and alternative medicine (CAM) healthcare practitioners, an example of interdisciplinary collaboration called integrative healthcare (IHC). Drawing on in-depth, semi-standardized interviews conducted with 21 practitioners working in Canadian IHC clinics, this paper explored and interpreted how IHC is experienced by those working in Canadian IHC clinics. The interview questions and analysis were guided by the Input, Process, Output conceptual framework drawn from the organizational management theory (McGrath, J. E. (1964). Social psychology: A brief introduction. New York: Holt, Rinehart and Winston.) to study collaboration within teams. We found that constructs contributing to collaboration included practitioners' attitudes and educational background, as well as external factors such as the healthcare system and financial pressures. Major processes affecting collaboration included communication, patient referral and power relationships. These determinants of collaboration were found to result in learning opportunities for practitioners, modified burden of work and ultimately, higher affective commitment toward the clinic. These constructs serve as a guide for further investigation of interprofessional collaboration within an IHC clinic. This exploration of interprofessional collaboration in IHC identified a broad array of key factors associated with interprofessional collaboration. These factors are critical to better understand the functioning of IHC clinics, and provide guidance for creation or maintenance of successful clinics.

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

Self-perceived attitudes toward interprofessional collaboration and interprofessional education among different health care professionals in pediatrics.

PubMed

Bode, Sebastian Felix Nepomuk; Giesler, Marianne; Heinzmann, Andrea; Krüger, Marcus; Straub, Christine

2016-01-01

Interprofessional education (IPE) is the basis for interprofessional collaboration (IPC) in health care systems. It has beneficial effects for both patients and health care professionals. IPC is paramount for adequate care of patients and their families, especially in pediatrics. To determine the attitudes of medical doctors (n=121), nurses (n=15), psychologists (n=14), and social workers (n=19) toward IPE and IPC in a tertiary pediatric university teaching hospital, as well as the inpatient and outpatient settings in pediatrics, we developed a questionnaire with 21 items in four categories based on established questionnaires. All participants worked as part of interprofessional teams, and the overwhelming majority valued IPC highly. Most competencies important for IPC were acquired on the job. There was a substantial lack of interprofessional education, especially for medical doctors and psychologists. IPE still needs to be established as part of the undergraduate curriculum at German universities.

A qualitative analysis of interprofessional healthcare team members' perceptions of patient barriers to healthcare engagement.

PubMed

Powell, Rhea E; Doty, Amanda; Casten, Robin J; Rovner, Barry W; Rising, Kristin L

2016-09-20

Healthcare systems increasingly engage interprofessional healthcare team members such as case managers, social workers, and community health workers to work directly with patients and improve population health. This study elicited perspectives of interprofessional healthcare team members regarding patient barriers to health and suggestions to address these barriers. This is a qualitative study employing focus groups and semi-structured interviews with 39 interprofessional healthcare team members in Philadelphia to elicit perceptions of patients' needs and experiences with the health system, and suggestions for positioning health care systems to better serve patients. Themes were identified using a content analysis approach. Three focus groups and 21 interviews were conducted with 26 hospital-based and 13 ambulatory-based participants. Three domains emerged to characterize barriers to care: social determinants, health system factors, and patient trust in the health system. Social determinants included insurance and financial shortcomings, mental health and substance abuse issues, housing and transportation-related limitations, and unpredictability associated with living in poverty. Suggestions for addressing these barriers included increased financial assistance from the health system, and building a workforce to address these determinants directly. Health care system factors included poor care coordination, inadequate communication of hospital discharge instructions, and difficulty navigating complex systems. Suggestions for addressing these barriers included enhanced communication between care sites, patient-centered scheduling, and improved patient education especially in discharge planning. Finally, factors related to patient trust of the health system emerged. Participants reported that patients are often intimidated by the health system, mistrusting of physicians, and fearful of receiving a serious diagnosis or prognosis. A suggestion for mitigating these issues was increased visibility of the health system within communities to foster trust and help providers gain a better understanding of unique community needs. This work explored interprofessional healthcare team members' perceptions of patient barriers to healthcare engagement. Participants identified barriers related to social determinants of health, complex system organization, and patient mistrust of the health system. Participants offered concrete suggestions to address these barriers, with suggestions supporting current healthcare reform efforts that aim at addressing social determinants and improving health system coordination and adding new insight into how systems might work to improve patient and community trust.

"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.

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.

Academic Developers as Change Agents Improving Quality in a Large Interprofessional Undergraduate Subject

ERIC Educational Resources Information Center

Cordiner, Moira

2014-01-01

Much has been written about academic developers as change agents but not in an interprofessional education (IPE) context. IPE involves teaching students in different health professions how to work effectively in teams across professional boundaries to improve the quality of patient care. Extensive evidence reveals that implementing sustainable IPE…

Evaluating the Types of Pharmacy Student Interventions Made During an Interprofessional 6-Week Adult Internal Medicine Rotation.

PubMed

Vinluan, Celeste M; Jabalie, Melanie M; Navarrete, Jacquelyn P; Padilla, Margie E

2018-06-01

The new standards for pharmacy education require that pharmacy students are involved in direct and interprofessional team-based care in multiple practice settings, which include "real-time" interactions with physician prescribers and medical students. From April 2014 to December 2015, fourth-year Doctor of Pharmacy (PharmD) students at University Medical Center of El Paso, Texas were assigned to an interprofessional team that was comprised of physician prescribers, medical students, and a pharmacist faculty. They recorded their interventions that were analyzed for type, number, physician acceptance, clinical importance, and time requirements for intervention recommendation. Interventions were divided into 5 main types and further divided into specific categories. Twelve PharmD students contributed 531 interventions, resulting in an average of 44 interventions per student with a physician acceptance rate of 87%. The most common types of interventions performed by PharmD students were under the categories of Therapy Needed (29.8%), Too Low Dose/Frequency (21.1%), Too High Dose/Frequency (8.3%), Therapeutic Level Monitoring (6.8%), and IV to PO Conversion (4.9%). A majority of interventions were of moderate clinical importance (56.1%) and took approximately 15 minutes to complete (92.5%). PharmD students under the supervision of clinical faculty on an interprofessional internal medicine team are valuable collaborators and contributors in decreasing the number of drug-related problems that can negatively impact patient care.

Development and pilot testing of an interprofessional patient-centered team training programme in medical rehabilitation clinics in Germany: a process evaluation.

PubMed

Becker, Sonja; Körner, Mirjam; Müller, Christian; Lippenberger, Corinna; Rundel, Manfred; Zimmermann, Linda

2017-07-14

Interprofessional teamwork is considered to be a key component of patient-centred treatment in healthcare, and especially in the rehabilitation sector. To date, however, no interventions exist for improving teamwork in rehabilitation clinics in Germany. A team training programme was therefore designed that is individualised in content but standardised regarding methods and process. It is clinic specific, task related, solution focused and context oriented. The aim of the study was to implement and evaluate this training for interprofessional teams in rehabilitation clinics in Germany. The measure consists of a training of a varying number of sessions with rehabilitation teams that consists of four distinct phases. Those are undergone chronologically, each with clinic-specific contents. It was implemented between 2013 and 2014 in five rehabilitation clinics in Germany and evaluated by the participants via questionnaire (n = 52). Staff in three clinics evaluated the programme as helpful, in particular rating moderation, discussions and communication during the training positively. Staff in the remaining two clinics rated it as not very or not helpful and mentioned long-term structural problems or a lack of need for team training as a reason for this. The team training is applicable and accepted by staff. It should, however, be tested in a greater sample and compared with a control group. Processes should be studied in more detail in order to determine what differentiates successful from non-successful interventions and the different requirements each of these might have.

Multidisciplinary obstetric simulated emergency scenarios (MOSES): promoting patient safety in obstetrics with teamwork-focused interprofessional simulations.

PubMed

Freeth, Della; Ayida, Gubby; Berridge, Emma Jane; Mackintosh, Nicola; Norris, Beverley; Sadler, Chris; Strachan, Alasdair

2009-01-01

We describe an example of simulation-based interprofessional continuing education, the multidisciplinary obstetric simulated emergency scenarios (MOSES) course, which was designed to enhance nontechnical skills among obstetric teams and, hence, improve patient safety. Participants' perceptions of MOSES courses, their learning, and the transfer of learning to clinical practice were examined. Participants included senior midwives, obstetricians, and obstetric anesthetists, including course faculty from 4 purposively selected delivery suites in England. Telephone or e-mail interviews with MOSES course participants and facilitators were conducted, and video-recorded debriefings that formed integral parts of this 1-day course were analyzed. The team training was well received. Participants were able to check out assumptions and expectations of others and develop respect for different roles within the delivery suite (DS) team. Skillful facilitation of debriefing after each scenario was central to learning. Participants reported acquiring new knowledge or insights, particularly concerning the role of communication and leadership in crisis situations, and they rehearsed unfamiliar skills. Observing peers working in the simulations increased participants' learning by highlighting alternative strategies. The learning achieved by individuals and groups was noticeably dependent on their starting points. Some participants identified limited changes in their behavior in the workplace following the MOSES course. Mechanisms to manage the transfer of learning to the wider team were weakly developed, although 2 DS teams made changes to their regular update training. Interprofessional, team-based simulations promote new learning.

ROLE CONFUSION AND SELF ASSESSMENT IN INTERPROFESSIONAL TRAUMA TEAMS

PubMed Central

Steinemann, Susan; Kurosawa, Gene; Wei, Alexander; Ho, Nina; Lim, Eunjung; Suares, Gregory; Bhatt, Ajay; Berg, Benjamin

2015-01-01

Background Trauma care requires coordinating an interprofessional team, with formative feedback on teamwork skills. We hypothesized nurses and surgeons have different perceptions regarding roles during resuscitation; that nurses’ teamwork self-assessment differs from experts’, and that video debriefing might improve accuracy of self-assessment. Methods Trauma nurses and surgeons were surveyed regarding resuscitation responsibilities. Subsequently, nurses joined interprofessional teams in simulated trauma resuscitations. Following each resuscitation, nurses and teamwork experts independently scored teamwork (T-NOTECHS). After video debriefing, nurses repeated T-NOTECHS self-assessment. Results Nurses and surgeons assumed significantly more responsibility by their own profession for 71% of resuscitation tasks. Nurses’ overall T-NOTECHS ratings were slightly higher than experts’. This was evident in all T-NOTECHS subdomains except “leadership,” but despite statistical significance the difference was small and clinically irrelevant. Video debriefing did not improve the accuracy of self-assessment. Conclusions Nurses and physicians demonstrated discordant perceptions of responsibilities. Nurses’ self-assessment of teamwork was statistically, but not clinically significantly, higher than experts’ in all domains except physician leadership. PMID:26801092

The public health leadership certificate: a public health and primary care interprofessional training opportunity.

PubMed

Matson, Christine C; Lake, Jeffrey L; Bradshaw, R Dana; Matson, David O

2014-03-01

This article describes a public health leadership certificate curriculum developed by the Commonwealth Public Health Training Center for employees in public health and medical trainees in primary care to share didactic and experiential learning. As part of the program, trainees are involved in improving the health of their communities and thus gain a blended perspective on the effectiveness of interprofessional teams in improving population health. The certificate curriculum includes eight one-credit-hour didactic courses offered through an MPH program and a two-credit-hour, community-based participatory research project conducted by teams of trainees under the mentorship of health district directors. Fiscal sustainability is achieved by sharing didactic courses with MPH degree students, thereby enabling trainees to take advantage of a reduced, continuing education tuition rate. Public health employee and primary care trainees jointly learn knowledge and skills required for community health improvement in interprofessional teams and gain an integrated perspective through opportunities to question assumptions and broaden disciplinary approaches. At the same time, the required community projects have benefited public health in Virginia.

Norwegian nursing and medical students’ perception of interprofessional teamwork: a qualitative study

PubMed Central

2014-01-01

Background Little is known about the ways in which nursing and medical students perceive and understand their roles in interprofessional teamwork. A 2010 report by the World Health Organization highlights the importance of students’ understanding of teamwork in healthcare, and their ability to be effective team players. This study aims at describing nursing and medical students’ perceptions of interprofessional teamwork, focusing on experiences and recommendations that can be used to guide future educational efforts. Methods The study uses a qualitative research design. Data were collected from four focus group interviews: two homogenous groups (one with medical students, one with nursing students) and two mixed groups (medical and nursing students). Results The results show that traditional patterns of professional role perception still prevail and strongly influence students’ professional attitudes about taking responsibility and sharing responsibility across disciplinary and professional boundaries. It was found that many students had experienced group cultures detrimental to team work. Focusing on clinical training, the study found a substantial variation in perception with regard to the different arenas for interprofessional teamwork, ranging from arenas with collaborative learning to arenas characterized by distrust, confrontation, disrespect and hierarchical structure. Conclusions This study underlines the importance of a stronger focus on interprofessional teamwork in health care education, particularly in clinical training. The study results suggest that the daily rounds and pre-visit “huddles,” or alternatively psychiatric wards, offer arenas suitable for interprofessional training, in keeping with the students’ assessments and criteria proposed in previous studies. PMID:25124090

Norwegian nursing and medical students' perception of interprofessional teamwork: a qualitative study.

PubMed

Aase, Ingunn; Hansen, Britt Sæthre; Aase, Karina

2014-08-14

Little is known about the ways in which nursing and medical students perceive and understand their roles in interprofessional teamwork. A 2010 report by the World Health Organization highlights the importance of students' understanding of teamwork in healthcare, and their ability to be effective team players. This study aims at describing nursing and medical students' perceptions of interprofessional teamwork, focusing on experiences and recommendations that can be used to guide future educational efforts. The study uses a qualitative research design. Data were collected from four focus group interviews: two homogenous groups (one with medical students, one with nursing students) and two mixed groups (medical and nursing students). The results show that traditional patterns of professional role perception still prevail and strongly influence students' professional attitudes about taking responsibility and sharing responsibility across disciplinary and professional boundaries. It was found that many students had experienced group cultures detrimental to team work. Focusing on clinical training, the study found a substantial variation in perception with regard to the different arenas for interprofessional teamwork, ranging from arenas with collaborative learning to arenas characterized by distrust, confrontation, disrespect and hierarchical structure. This study underlines the importance of a stronger focus on interprofessional teamwork in health care education, particularly in clinical training. The study results suggest that the daily rounds and pre-visit "huddles," or alternatively psychiatric wards, offer arenas suitable for interprofessional training, in keeping with the students' assessments and criteria proposed in previous studies.

Interprofessional Curbside Consults to Develop Team Communication and Improve Student Achievement of Learning Outcomes

PubMed Central

Greenwood, Kristin Curry; Rico, Janet; Nalliah, Romesh; DiVall, Margarita

2017-01-01

Objective. To design and implement a series of activities focused on developing interprofessional communication skills and to assess the impact of the activities on students’ attitudes and achievement of educational goals. Design. Prior to the first pharmacy practice skills laboratory session, pharmacy students listened to a classroom lecture about team communication and viewed short videos describing the roles, responsibilities, and usual work environments of four types of health care professionals. In each of four subsequent laboratory sessions, students interacted with a different standardized health care professional role-played by a pharmacy faculty member who asked them a medication-related question. Students responded in verbal and written formats. Assessment. Student performance was assessed with a three-part rubric. The impact of the exercise was assessed by conducting pre- and post-intervention surveys and analyzing students’ performance on relevant Center for the Advancement of Pharmacy Education (CAPE) outcomes. Survey results showed improvement in student attitudes related to team-delivered care. Students’ performance on the problem solver and collaborator CAPE outcomes improved, while performance on the educator outcome worsened. Conclusions. The addition of an interprofessional communication activity with standardized health care professionals provided the opportunity for students to develop skills related to team communication. Students felt the activity was valuable and realistic; however, analysis of outcome achievement from the exercise revealed a need for more exposure to team communication skills. PMID:28289305

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.

Interprofessional Curbside Consults to Develop Team Communication and Improve Student Achievement of Learning Outcomes.

PubMed

Kirwin, Jennifer; Greenwood, Kristin Curry; Rico, Janet; Nalliah, Romesh; DiVall, Margarita

2017-02-25

Objective. To design and implement a series of activities focused on developing interprofessional communication skills and to assess the impact of the activities on students' attitudes and achievement of educational goals. Design. Prior to the first pharmacy practice skills laboratory session, pharmacy students listened to a classroom lecture about team communication and viewed short videos describing the roles, responsibilities, and usual work environments of four types of health care professionals. In each of four subsequent laboratory sessions, students interacted with a different standardized health care professional role-played by a pharmacy faculty member who asked them a medication-related question. Students responded in verbal and written formats. Assessment. Student performance was assessed with a three-part rubric. The impact of the exercise was assessed by conducting pre- and post-intervention surveys and analyzing students' performance on relevant Center for the Advancement of Pharmacy Education (CAPE) outcomes. Survey results showed improvement in student attitudes related to team-delivered care. Students' performance on the problem solver and collaborator CAPE outcomes improved, while performance on the educator outcome worsened. Conclusions. The addition of an interprofessional communication activity with standardized health care professionals provided the opportunity for students to develop skills related to team communication. Students felt the activity was valuable and realistic; however, analysis of outcome achievement from the exercise revealed a need for more exposure to team communication skills.

Mindfulness Meditation and Interprofessional Cardiopulmonary Resuscitation: A Mixed-Methods Pilot Study.

PubMed

Kelm, Diana J; Ridgeway, Jennifer L; Gas, Becca L; Mohan, Monali; Cook, David A; Nelson, Darlene R; Benzo, Roberto P

2018-05-18

Mindfulness training includes mindfulness meditation, which has been shown to improve both attention and self-awareness. Medical providers in the intensive care unit often deal with difficult situations with strong emotions, life-and-death decisions, and both interpersonal and interprofessional conflicts. The effect of mindfulness meditation training on healthcare providers during acute care tasks such as cardiopulmonary resuscitation remains unknown. Mindfulness meditation has the potential to improve provider well-being and reduce stress in individuals involved in resuscitation teams, which could then translate into better team communication and delivery of care under stress. A better understanding of this process could lead to more effective training approaches, improved team performance, and better patient outcomes. All participants were instructed to use a mindfulness meditation device (Muse™ headband) at home for 7 min twice a day or 14 min daily over the 4-week training period. This device uses brainwave sensors to monitor active versus relaxing brain activity and provides real-time feedback. We conducted a single-group pretest-posttest convergent mixed-methods study. We enrolled 24 healthcare providers, comprising 4 interprofessional code teams, including physicians, nurses, respiratory therapists, and pharmacists. Each team participated in a simulation session immediately before and after the mindfulness training period. Each session consisted of two simulated cardiopulmonary arrest scenarios. Both quantitative and qualitative outcomes were assessed. The median proportion of participants who used the device as prescribed was 85%. Emotional balance, as measured by the critical positivity ratio, improved significantly from pretraining to posttraining (p = .02). Qualitative findings showed that mindfulness meditation changed how participants responded to work-related stress, including stress in real-code situations. Participants described the value of time for self-guided practice with feedback from the device, which then helped them develop individual approaches to meditation not reliant on the technology. Time measures during the simulated scenarios improved, specifically, time to epinephrine in Scenario 1 (p = .03) and time to defibrillation in Scenario 2 (p = .02), improved. In addition, team performance, such as teamwork (p = .04), task management (p = .01), and overall performance (p = .04), improved significantly after mindfulness meditation training. Physiologic stress (skin conductance) improved but did not reach statistical significance (p = .11). Mindfulness meditation practice may improve individual well-being and team function in high-stress clinical environments. Our results may represent a foundation to design larger confirmatory studies.

Coaching interprofessional health care improvement teams: the coachee, the coach and the leader perspectives.

PubMed

Godfrey, Marjorie M; Andersson-Gare, Boel; Nelson, Eugene C; Nilsson, Mats; Ahlstrom, Gerd

2014-05-01

To investigate health care improvement team coaching activities from the perspectives of coachees, coaches and unit leaders in two national improvement collaboratives. Despite numerous methods to improve health care, inconsistencies in success have been attributed to factors that include unengaged staff, absence of supportive improvement resources and organisational inertia. Mixed methods sequential exploratory study design, including quantitative and qualitative data from interprofessional improvement teams who received team coaching. The coachees (n = 382), coaches (n = 9) and leaders (n = 30) completed three different data collection tools identifying coaching actions perceived to support improvement activities. Coachees, coaches and unit leaders in both collaboratives reported generally positive perceptions about team coaching. Four categories of coaching actions were perceived to support improvement work: context, relationships, helping and technical support. All participants agreed that regardless of who the coach is, emphasis should include the four categories of team coaching actions. Leaders should reflect on their efforts to support improvement teams and consider the four categories of team coaching actions. A structured team coaching model that offers needed encouragement to keep the team energized, seems to support health care improvement. © 2013 John Wiley & Sons Ltd.

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.

Development and pilot testing the Family Conference Rating Scale: A tool aimed to assess interprofessional patient-centred communication and collaboration competencies.

PubMed

Dojeiji, Sue; Byszewski, Anna; Wood, Tim

2015-01-01

There is a paucity of evidence-based literature on the essential communication and collaboration skills to guide health care teams in conducting and assessing their performance in the Family Conference (FC). The authors developed and collected validity evidence for a rating scale of team FC performance, the Family Conference Rating Scale (FCRS). In phase 1, essential FC communication and collaboration skills were identified through a review of existing communication tools and literature on team functioning; a draft 34-item scale was developed. In phase 2, the scale was narrowed to a 6-category, 9-point scale with descriptors of expected behaviours through an iterative process: testing of the scale on 10 FC transcripts by two experts, soliciting feedback from a focus group of seven health care providers, and testing by non-experts on 49 live FCs. In phase 3, scores on the revised scale were validated by 10 health care providers from different disciplines by rating three videos of FCs of variable quality. Raters were able to detect inter-video variation in FC quality. The reliability of the FCRS was 0.95 and the inter-rater reliability, 0.68. The FCRS may enhance the ability of health professions educators to teach and assess interprofessional patient-centred communication and collaboration competencies.

A qualitative study of hospital pharmacists and antibiotic governance: negotiating interprofessional responsibilities, expertise and resource constraints.

PubMed

Broom, Alex; Plage, Stefanie; Broom, Jennifer; Kirby, Emma; Adams, Jon

2016-02-06

Antibiotic treatment options for common infections are diminishing due to the proliferation of antimicrobial resistance (AMR). The impact of Antimicrobial Stewardship (AMS) programs seeking to preserve viable antibiotic drugs by governing their use in hospitals has hitherto been limited. Pharmacists have been delegated a critical role in antibiotic governance in AMS teams within hospitals but the experience of pharmacists in influencing antibiotic use has received limited attention. In this study we explore the experiences of pharmacists in antibiotic decision-making in two Australian hospitals. We conducted 19 semi-structured interviews to explore hospital-based pharmacists' perceptions and experiences of antibiotic use and governance. The analysis was conducted with NVivo10 software, utilising the framework approach. Three major themes emerged in the pharmacist interviews including (1) the responsibilities of pharmacy in optimising antibiotic use and the interprofessional challenges therein; (2) the importance of antibiotic streamlining and the constraints placed on pharmacists in achieving this; and (3) the potential, but often under-utilised expertise, pharmacists bring to antibiotic optimisation. Pharmacists have a critical role in AMS teams but their capacity to enact change is limited by entrenched interprofessional dynamics. Identifying how hospital pharmacy's antibiotic gatekeeping is embedded in the interprofessional nature of clinical decision-making and limited by organisational environment has important implications for the implementation of hospital policies seeking to streamline antibiotic use. Resource constraints (i.e. time limitation and task prioritisation) in particular limit the capacity of pharmacists to overcome the interprofessional barriers through development of stronger collaborative relationships. The results of this study suggest that to enact change in antibiotic use in hospitals, pharmacists must be supported in their negotiations with doctors, have increased presence on hospital wards, and must be given opportunities to pass on specialist knowledge within multidisciplinary clinical teams.

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.

Using realist synthesis to understand the mechanisms of interprofessional teamwork in health and social care.

PubMed

Hewitt, Gillian; Sims, Sarah; Harris, Ruth

2014-11-01

Realist synthesis offers a novel and innovative way to interrogate the large literature on interprofessional teamwork in health and social care teams. This article introduces realist synthesis and its approach to identifying and testing the underpinning processes (or "mechanisms") that make an intervention work, the contexts that trigger those mechanisms and their subsequent outcomes. A realist synthesis of the evidence on interprofessional teamwork is described. Thirteen mechanisms were identified in the synthesis and findings for one mechanism, called "Support and value" are presented in this paper. The evidence for the other twelve mechanisms ("collaboration and coordination", "pooling of resources", "individual learning", "role blurring", "efficient, open and equitable communication", "tactical communication", "shared responsibility and influence", "team behavioural norms", "shared responsibility and influence", "critically reviewing performance and decisions", "generating and implementing new ideas" and "leadership") are reported in a further three papers in this series. The "support and value" mechanism referred to the ways in which team members supported one another, respected other's skills and abilities and valued each other's contributions. "Support and value" was present in some, but far from all, teams and a number of contexts that explained this variation were identified. The article concludes with a discussion of the challenges and benefits of undertaking this realist synthesis.

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.

Design and evaluation of a prelicensure interprofessional course on improving care transitions.

PubMed

Heflin, Mitchell T; Pinheiro, Sandro O; Konrad, Thomas R; Egerton, Emily O; Thornlow, Deirdre K; White, Heidi K; McConnell, Eleanor J

2014-01-01

Effective management of care transitions for older adults require the coordinated expertise of an interprofessional team. Unfortunately, different health care professions are rarely educated together or trained in teamwork skills. To address this issue, a team of professionally diverse faculty from the Duke University Geriatric Education Center designed an interprofessional course focused on improving transitions of care for older adults. This innovative prelicensure course provided interactive teaching sessions designed to promote critical thinking and foster effective communication among health care professionals, caregivers, and patients. Students were assessed by in-class and online participation, performance on individual assignments, and team-based proposals to improve care transitions for older patients with congestive heart failure. Twenty students representing six professions completed the course; 18 completed all self-efficacy and course evaluation surveys. Students rated their self-efficacy in several domains before and after the course and reported gains in teamwork skills (p < .001), transitions of care (p < .001), quality improvement (p < .001) and cultural competence (p < .001). Learner feedback emphasized the importance of enthusiastic and well-prepared faculty, interactive learning experiences, and engagement in relevant work. This course offers a promising approach to shifting the paradigm of health professions education to empower graduates to promote quality improvement through team-based care.

Interprofessional Collaboration between General Physicians and Emergency Department Teams in Belgium: A Qualitative Study

PubMed Central

Tricas-Sauras, Sandra; Darras, Elisabeth; Macq, Jean

2017-01-01

This study aimed to assess interprofessional collaboration between general physicians and emergency departments in the French speaking regions of Belgium. Eight group interviews were conducted both in rural and urban areas, including in Brussels. Findings showed that the relational components of collaboration, which are highly valued by individuals involved, comprise mutual acquaintanceship and trust, shared power and objectives. The organizational components of collaboration included out-of-hours services, role clarification, leadership and overall environment. Communication and patient’s role were also found to be key elements in enhancing or hindering collaboration across these two levels of care. Relationships between general physicians and emergency departments’ teams were tightly linked to organizational factors and the general macro-environment. Health system regulation did not appear to play a significant role in promoting collaboration between actors. A better role clarification is needed in order to foster multidisciplinary team coordination for a more efficient patient management. Finally, economic power and private practice impeded interprofessional collaboration between the care teams. In conclusion, many challenges need to be addressed for achievement of a better collaboration and more efficient integration. Not only should integration policies aim at reinforcing the role of general physicians as gatekeepers, also they should target patients’ awareness and empowerment. PMID:29588632

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…

Reframing Interdisciplinary and Interprofessional Collaboration through the Lens of Collective and Sociomaterial Theories of Learning

ERIC Educational Resources Information Center

McMurtry, Angus

2013-01-01

The purpose of this article is to begin to explore how collective and sociomaterial theories of learning might be applied within interdisciplinary and interprofessional contexts--in particular the team-based collaboration that is playing an ever larger role in both fields. It ?? articulates several key features of interdisciplinary and…

Interprofessional Rhetoric and Operational Realities: An Ethnographic Study of Rounds in Four Intensive Care Units

ERIC Educational Resources Information Center

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

2016-01-01

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…

The Longitudinal Elderly Person Shadowing Program: Outcomes from an Interprofessional Senior Partner Mentoring Program

ERIC Educational Resources Information Center

Basran, Jenny F. S.; Dal Bello-Haas, Vanina; Walker, Doreen; MacLeod, Peggy; Allen, Bev; D'Eon, Marcel; McKague, Meredith; Chopin, Nicola S.; Trinder, Krista

2012-01-01

The University of Saskatchewan's Longitudinal Elderly Person Shadowing (LEPS) is an interprofessional senior mentors program (SMP) where teams of undergraduate students in their first year of medicine, pharmacy, and physiotherapy; 2nd year of nutrition; 3rd year nursing; and 4th year social work partner with community-dwelling older adults.…

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,…

Facilitating Collaborative Capabilities for Future Work: What Can Be Learnt from Interprofessional Fieldwork in Health

ERIC Educational Resources Information Center

Brewer, Margo; Flavell, Helen

2018-01-01

There is growing pressure in higher education to develop graduates with the capabilities to work effectively in collaborative, interdisciplinary teams to solve the key issues facing humankind. For many years, health has been pioneering interprofessional education as the means to deliver professionals with capacity to work together to deliver high…

Evaluating Student Attitudes: Perceptions of Interprofessional Experiences Following Participation in a Student-Run Free Clinic.

PubMed

Kovalskiy, Aleksandr; Ismail, Rahim; Tran, Kelvin; Desai, Anand; Imran, Amna; Hernandez, Caridad

2017-02-23

It is increasingly evident that patient health outcomes are improved when they are treated by an effective interdisciplinary healthcare team. Many also endorse that learning to function collaboratively in interdisciplinary settings should start at the onset of one's medical education. Student-run free clinics, such as the University of Central Florida College of Medicine's (UCF COM) KNIGHTS (Keeping Neighbors In Good Health Through Service) Clinic, provide opportunities for students to work in concert with other healthcare professionals. This study aimed to discern whether volunteering in this setting had a positive impact on medical students' perception of working within an interdisciplinary team. A single survey was distributed via Qualtrics to all first and second-year medical students (N = 248) at the UCF COM. The items of interest examined in this study were part of a larger study described elsewhere. The mean responses on a 5-point Likert-like scale to these survey items were recorded and compared between two cohorts: KNIGHTS volunteers and non-volunteers. One hundred twenty-three (49.6%) students responded to the survey and most items showed no statistically significant difference between the two groups (p-value > 0.05). However, there were a few items of interest that did show a significant difference. These included KNIGHTS volunteers being much more likely to have worked with other healthcare professionals (p < 0.001) as well as believing themselves to have a better understanding of the role of medicine within an interprofessional team (p = 0.016). Additionally, KNIGHTS volunteers were more likely to feel like they understood the role of patient education (p = 0.031) and pharmacy (p = 0.040) within an interprofessional team. Interestingly, KNIGHTS volunteers were also more likely to believe that problem-solving skills should be learned with students within their own discipline (p = 0.009) as well as that there is little overlap between the roles of medical students and students from other healthcare disciplines (p = 0.044). Still, overall results showed that both volunteers and non-volunteers had an overall positive perception of interdisciplinary teams and working with other healthcare professionals.

Interprofessional education in pharmacology using high-fidelity simulation.

PubMed

Meyer, Brittney A; Seefeldt, Teresa M; Ngorsuraches, Surachat; Hendrickx, Lori D; Lubeck, Paula M; Farver, Debra K; Heins, Jodi R

2017-11-01

This study examined the feasibility of an interprofessional high-fidelity pharmacology simulation and its impact on pharmacy and nursing students' perceptions of interprofessionalism and pharmacology knowledge. Pharmacy and nursing students participated in a pharmacology simulation using a high-fidelity patient simulator. Faculty-facilitated debriefing included discussion of the case and collaboration. To determine the impact of the activity on students' perceptions of interprofessionalism and their ability to apply pharmacology knowledge, surveys were administered to students before and after the simulation. Attitudes Toward Health Care Teams scale (ATHCT) scores improved from 4.55 to 4.72 on a scale of 1-6 (p = 0.005). Almost all (over 90%) of the students stated their pharmacology knowledge and their ability to apply that knowledge improved following the simulation. A simulation in pharmacology is feasible and favorably affected students' interprofessionalism and pharmacology knowledge perceptions. Pharmacology is a core science course required by multiple health professions in early program curricula, making it favorable for incorporation of interprofessional learning experiences. However, reports of high-fidelity interprofessional simulation in pharmacology courses are limited. This manuscript contributes to the literature in the field of interprofessional education by demonstrating that an interprofessional simulation in pharmacology is feasible and can favorably affect students' perceptions of interprofessionalism. This manuscript provides an example of a pharmacology interprofessional simulation that faculty in other programs can use to build similar educational activities. Copyright © 2017 Elsevier Inc. All rights reserved.

Improved Clinical Performance and Teamwork of Pediatric Interprofessional Resuscitation Teams With a Simulation-Based Educational Intervention.

PubMed

Gilfoyle, Elaine; Koot, Deanna A; Annear, John C; Bhanji, Farhan; Cheng, Adam; Duff, Jonathan P; Grant, Vincent J; St George-Hyslop, Cecilia E; Delaloye, Nicole J; Kotsakis, Afrothite; McCoy, Carolyn D; Ramsay, Christa E; Weiss, Matthew J; Gottesman, Ronald D

2017-02-01

To measure the effect of a 1-day team training course for pediatric interprofessional resuscitation team members on adherence to Pediatric Advanced Life Support guidelines, team efficiency, and teamwork in a simulated clinical environment. Multicenter prospective interventional study. Four tertiary-care children's hospitals in Canada from June 2011 to January 2015. Interprofessional pediatric resuscitation teams including resident physicians, ICU nurse practitioners, registered nurses, and registered respiratory therapists (n = 300; 51 teams). A 1-day simulation-based team training course was delivered, involving an interactive lecture, group discussions, and four simulated resuscitation scenarios, each followed by a debriefing. The first scenario of the day (PRE) was conducted prior to any team training. The final scenario of the day (POST) was the same scenario, with a slightly modified patient history. All scenarios included standardized distractors designed to elicit and challenge specific teamwork behaviors. Primary outcome measure was change (before and after training) in adherence to Pediatric Advanced Life Support guidelines, as measured by the Clinical Performance Tool. Secondary outcome measures were as follows: 1) change in times to initiation of chest compressions and defibrillation and 2) teamwork performance, as measured by the Clinical Teamwork Scale. Correlation between Clinical Performance Tool and Clinical Teamwork Scale scores was also analyzed. Teams significantly improved Clinical Performance Tool scores (67.3-79.6%; p < 0.0001), time to initiation of chest compressions (60.8-27.1 s; p < 0.0001), time to defibrillation (164.8-122.0 s; p < 0.0001), and Clinical Teamwork Scale scores (56.0-71.8%; p < 0.0001). A positive correlation was found between Clinical Performance Tool and Clinical Teamwork Scale (R = 0.281; p < 0.0001). Participation in a simulation-based team training educational intervention significantly improved surrogate measures of clinical performance, time to initiation of key clinical tasks, and teamwork during simulated pediatric resuscitation. A positive correlation between clinical and teamwork performance suggests that effective teamwork improves clinical performance of resuscitation teams.

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.

Coordinating a Team Response to Behavioral Emergencies in the Emergency Department: A Simulation-Enhanced Interprofessional Curriculum

PubMed Central

Wong, Ambrose H.; Wing, Lisa; Weiss, Brenda; Gang, Maureen

2015-01-01

Introduction While treating potentially violent patients in the emergency department (ED), both patients and staff may be subject to unintentional injury. Emergency healthcare providers are at the greatest risk of experiencing physical and verbal assault from patients. Preliminary studies have shown that a team-based approach with targeted staff training has significant positive outcomes in mitigating violence in healthcare settings. Staff attitudes toward patient aggression have also been linked to workplace safety, but current literature suggests that providers experience fear and anxiety while caring for potentially violent patients. The objectives of the study were (1) to develop an interprofessional curriculum focusing on improving teamwork and staff attitudes toward patient violence using simulation-enhanced education for ED staff, and (2) to assess attitudes towards patient aggression both at pre- and post-curriculum implementation stages using a survey-based study design. Methods Formal roles and responsibilities for each member of the care team, including positioning during restraint placement, were predefined in conjunction with ED leadership. Emergency medicine residents, nurses and hospital police officers were assigned to interprofessional teams. The curriculum started with an introductory lecture discussing de-escalation techniques and restraint placement as well as core tenets of interprofessional collaboration. Next, we conducted two simulation scenarios using standardized participants (SPs) and structured debriefing. The study consisted of a survey-based design comparing pre- and post-intervention responses via a paired Student t-test to assess changes in staff attitudes. We used the validated Management of Aggression and Violence Attitude Scale (MAVAS) consisting of 30 Likert-scale questions grouped into four themed constructs. Results One hundred sixty-two ED staff members completed the course with >95% staff participation, generating a total of 106 paired surveys. Constructs for internal/biomedical factors, external/staff factors and situational/interactional perspectives on patient aggression significantly improved (p<0.0001, p<0.002, p<0.0001 respectively). Staff attitudes toward management of patient aggression did not significantly change (p=0.542). Multiple quality improvement initiatives were successfully implemented, including the creation of an interprofessional crisis management alert and response protocol. Staff members described appreciation for our simulation-based curriculum and welcomed the interaction with SPs during their training. Conclusion A structured simulation-enhanced interprofessional intervention was successful in improving multiple facets of ED staff attitudes toward behavioral emergency care. PMID:26594279

The evaluation of a multifaceted intervention to promote "speaking up" and strengthen interprofessional teamwork climate perceptions.

PubMed

Ginsburg, Liane; Bain, Lorna

2017-03-01

Communication failure is a leading cause of error and is often due to inhibition of individuals to speak up in interprofessional healthcare environments. The present study sought to evaluate the impact of a multifaceted intervention designed to promote speaking up on teamwork climate in one clinical department of a large community hospital based in Canada. The multifaceted intervention included a role-playing simulation workshop, teamwork climate data feedback and facilitated discussion with the interprofessional team (discussion briefings), and other department-led initiatives to promote trust, teamwork, and speaking up among interprofessional team members. A quasi-experiment (pretest-posttest control group design, using two posttests several months apart) was used to evaluate the impact of the complete intervention on individual teamwork climate perceptions. The intervention was implemented with an intact interprofessional team (the Emergency Department-ED) in 2014. The intensive care unit (ICU) was used as the control unit. Survey response rates were the highest at time 1 (83/102 = 81% for the ED and 29/31 = 94% for the ICU) and the lowest at time 3 (38/105 = 36% for the ED and 14/30 = 47% for the ICU). The results obtained from paired and unpaired analyses suggest that this type of multifaceted approach can improve staff perceptions of teamwork climate. The teamwork climate score in the ED was significantly higher at follow-up (Mt2 = 3.42, SD = 0.66) compared to baseline (Mt1 = 3.13, SD = 0.72), (F(1, 34) = 12.2, p = .001, eta 2 p = .263), while baseline and follow-up scores were not significantly different between baseline and follow-up for the ICU group (Mt1 = 4.12, SD = 0.60; Mt2 = 4.15, SD = 0.56; F(1, 34) = 0.06, p = .806, eta 2 p = .002). Sustaining high levels of participation in interprofessional initiatives and engaging physicians remain challenging when interventions are used in context. Improving team communication is a broad and challenging area that continues to require attention.

Coordinating a Team Response to Behavioral Emergencies in the Emergency Department: A Simulation-Enhanced Interprofessional Curriculum.

PubMed

Wong, Ambrose H; Wing, Lisa; Weiss, Brenda; Gang, Maureen

2015-11-01

While treating potentially violent patients in the emergency department (ED), both patients and staff may be subject to unintentional injury. Emergency healthcare providers are at the greatest risk of experiencing physical and verbal assault from patients. Preliminary studies have shown that a team-based approach with targeted staff training has significant positive outcomes in mitigating violence in healthcare settings. Staff attitudes toward patient aggression have also been linked to workplace safety, but current literature suggests that providers experience fear and anxiety while caring for potentially violent patients. The objectives of the study were (1) to develop an interprofessional curriculum focusing on improving teamwork and staff attitudes toward patient violence using simulation-enhanced education for ED staff, and (2) to assess attitudes towards patient aggression both at pre- and post-curriculum implementation stages using a survey-based study design. Formal roles and responsibilities for each member of the care team, including positioning during restraint placement, were predefined in conjunction with ED leadership. Emergency medicine residents, nurses and hospital police officers were assigned to interprofessional teams. The curriculum started with an introductory lecture discussing de-escalation techniques and restraint placement as well as core tenets of interprofessional collaboration. Next, we conducted two simulation scenarios using standardized participants (SPs) and structured debriefing. The study consisted of a survey-based design comparing pre- and post-intervention responses via a paired Student t-test to assess changes in staff attitudes. We used the validated Management of Aggression and Violence Attitude Scale (MAVAS) consisting of 30 Likert-scale questions grouped into four themed constructs. One hundred sixty-two ED staff members completed the course with >95% staff participation, generating a total of 106 paired surveys. Constructs for internal/biomedical factors, external/staff factors and situational/interactional perspectives on patient aggression significantly improved (p<0.0001, p<0.002, p<0.0001 respectively). Staff attitudes toward management of patient aggression did not significantly change (p=0.542). Multiple quality improvement initiatives were successfully implemented, including the creation of an interprofessional crisis management alert and response protocol. Staff members described appreciation for our simulation-based curriculum and welcomed the interaction with SPs during their training. A structured simulation-enhanced interprofessional intervention was successful in improving multiple facets of ED staff attitudes toward behavioral emergency care.

The Effect of Interprofessional Student-Led Reproductive Health Education on Youths in Juvenile Detention.

PubMed

Son, Ji; Miller, Willa M; Tossone, Krystel; Butcher, Fredrick; Kuo, Kelly

2017-06-01

To assess the effects of an interprofessional student-led comprehensive sexual education curriculum in improving the reproductive health literacy among at-risk youths in detention. We performed a prospective cohort study involving 134 incarcerated youth and an interprofessional team of 23 medical, nursing, and social work students, who participated in a comprehensive reproductive health curriculum over the course of 3 days. Basic reproductive health knowledge, confidence in condom use with a new partner, and self-efficacy with regard to contraception use and sexual autonomy were assessed before and after completion of the curriculum. We also assessed the student teachers' level of comfort with teaching reproductive health to adolescents and their perception of interprofessionalism. Incarcerated youth showed a statistically significant increase in knowledge regarding sexually transmitted infections as well as self-reported confidence in condom use (P = .002). Self-efficacy in contraception use and sexual autonomy did not show significant improvement. Qualitative analysis of student teachers' surveys revealed theme categories regarding perception of youth, perception of self in teaching youth, perception of interacting with youth, and perception of working in interprofessional teams. Our program might represent a mutually beneficial community relationship to improve reproductive health literacy in this high-risk youth population. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

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.

Scottish healthcare student's perceptions of an interprofessional ward simulation: An exploratory, descriptive study.

PubMed

Roberts, Fiona E; Goodhand, Kate

2018-03-01

The most memorable learning occurs during placement. Simulated interprofessional learning is a logical learning opportunity to help healthcare professionals work beyond their professional silos. In this qualitative study, we investigated the perceived learning of students from six health professions (adult nursing, diagnostic radiography, occupational therapy, physiotherapy, dietetics, and pharmacy) from their participation in a 45 min interprofessional ward simulation. Semistructured focus groups were undertaken, and data were analyzed using framework analysis. Two overarching themes were evident, each of which had subthemes: (i) the ward simulation as an interprofessional education opportunity (subthemes: reality of situations and interactions); and (ii) the perceived learning achieved (subthemes: professional roles, priorities, respect, communication, teamwork, and quality of care). The results indicated that a short interprofessional ward simulation, unsupported by additional learning opportunities or directed study, is a useful and engaging interprofessional learning opportunity. Students appear to have learnt important key messages central to the interprofessional education curricula to help develop practitioners who can effectively work together as an interprofessional team, and that this learning is partly due to simulation allowing things to go wrong. © 2017 John Wiley & Sons Australia, Ltd.

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.

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.

Advancing interprofessional patient safety education for medical, nursing, and pharmacy learners during clinical rotations.

PubMed

Thom, Kerri A; Heil, Emily L; Croft, Lindsay D; Duffy, Alison; Morgan, Daniel J; Johantgen, Mary

2016-11-01

Clinical errors are common and can lead to adverse events and patient death. Health professionals must work within interprofessional teams to provide safe and effective care to patients, yet current curricula is lacking with regards to interprofessional education and patient safety. We describe the development and implementation of an interprofessional course aimed at medical, nursing, and pharmacy learners during their clinical training at a large academic medical centre. The course objectives were based on core competencies for interprofessional education and patient safety. The course was offered as recurring three 1-hour sessions, including case-based discussions and a mock root cause analysis. Forty-three students attended at least one session over a 7-month period. We performed a cross-sectional survey of participants to assess readiness for interprofessional learning and a before and after comparison of patient safety knowledge. All students reported a high level of readiness for interprofessional learning, indicating an interest in interprofessional opportunities. In general, understanding and knowledge of the four competency domains in patient safety was low before the course and 100% of students reported an increase in knowledge in these domains after participating in the course.

The development of clinical reasoning and interprofessional behaviors: service-learning at a student-run free clinic.

PubMed

Seif, Gretchen; Coker-Bolt, Patty; Kraft, Sara; Gonsalves, Wanda; Simpson, Kit; Johnson, Emily

2014-11-01

This article examines the benefits of a student run free clinic (SRFC) as a service learning experience for students in medicine, pharmacy, occupational therapy, physical therapy and physician assistant programs. We hypothesized that students who participate in an interprofessional service learning course and volunteer at a SRFC would demonstrate significant increases in perceptions and attitudes for working in interprofessional health care teams and clinical reasoning skills compared to students who did not participate. Three assessments were administered to an experimental and control group of pre-clinical students from medical, occupational therapy, physical therapy, pharmacy and physician assistant programs before and after participation in an interprofessional service-learning course and volunteering at the SRFC. The tools were the Interdisciplinary Education Perception Scale (IEPS), Readiness for Interprofessional Learning Scale (RIPLS) and the Self-Assessment of Clinical Reflection and Reasoning (SACRR). Students who completed the course had improvements in interprofessional perceptions and attitudes (p = 0.03) and perceptions of clinical reasoning skills when compared to the control group (p = 0.002). This study is novel as it examined students' perceptions of interprofessional attitudes and clinical reasoning following participation in an interprofessional service-learning course and participation in a SRFC.

Evaluation of an Interdisciplinary Curriculum Teaching Team-based Palliative Care Integration in Oncology

PubMed Central

Head, Barbara A.; Schapmire, Tara; Earnshaw, Lori; Faul, Anna; Hermann, Carla; Jones, Carol; Martin, Amy; Shaw, Monica Ann; Woggon, Frank; Ziegler, Craig; Pfeifer, Mark

2015-01-01

For students of the health care professions to succeed in today's healthcare environment, they must be prepared to collaborate with other professionals and practice on interdisciplinary teams. As most will care for patients with cancer, they must also understand the principles of palliative care and its integration into oncology. This article reports the success of one university's effort to design and implement an interdisciplinary curriculum teaching team-based palliative care in oncology which was mandatory for medical, nursing, social work and chaplaincy students. Quantitative evaluation indicated that students made significant improvements related to palliative care knowledge and skills and readiness for interprofessional education. Qualitative feedback revealed that students appreciated the experiential aspects of the curriculum most, especially the opportunity to observe palliative teams at work and practice team-based skills with other learners. While there exist many obstacles to interprofessional education and hands-on learning, the value of such experiences to the learners justifies efforts to initiate and continue similar programs in the health sciences. PMID:25708910

Evaluation of an Interdisciplinary Curriculum Teaching Team-Based Palliative Care Integration in Oncology.

PubMed

Head, Barbara A; Schapmire, Tara; Earnshaw, Lori; Faul, Anna; Hermann, Carla; Jones, Carol; Martin, Amy; Shaw, Monica Ann; Woggon, Frank; Ziegler, Craig; Pfeiffer, Mark

2016-06-01

For students of the health care professions to succeed in today's health care environment, they must be prepared to collaborate with other professionals and practice on interdisciplinary teams. As most will care for patients with cancer, they must also understand the principles of palliative care and its integration into oncology. This article reports the success of one university's effort to design and implement an interdisciplinary curriculum teaching team-based palliative care in oncology which was mandatory for medical, nursing, social work, and chaplaincy students. Quantitative evaluation indicated that students made significant improvements related to palliative care knowledge and skills and readiness for interprofessional education. Qualitative feedback revealed that students appreciated the experiential aspects of the curriculum most, especially the opportunity to observe palliative teams at work and practice team-based skills with other learners. While there exist many obstacles to interprofessional education and hands-on learning, the value of such experiences to the learners justifies efforts to initiate and continue similar programs in the health sciences.

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.

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.

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.

Dissecting through Barriers: A Mixed-Methods Study on the Effect of Interprofessional Education in a Dissection Course with Healthcare Professional Students

ERIC Educational Resources Information Center

Fernandes, Alisha Rebecca; Palombella, Andrew; Salfi, Jenn; Wainman, Bruce

2015-01-01

Healthcare delivery is reliant on a team-based approach, and interprofessional education (IPE) provides a means by which such collaboration skills can be fostered prior to entering the workplace. IPE within healthcare programs has been associated with improved collaborative behavior, patient care and satisfaction, reduced clinical error, and…

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,…

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.

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.

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.

Playing interprofessional games: reflections on using the Interprofessional Education Game (iPEG).

PubMed

Joseph, Sundari; Diack, Lesley

2015-05-01

This report explores the relevance of gaming in IPE curriculum design with the use of the Interprofessional Education Game (iPEG) as an activity aimed to achieve positive interprofessional learning outcomes for students. It was designed to enable the understanding of professional roles and responsibilities in patient/client care settings. We provide a description of its implementation and evaluation with first year student cohorts (900+ per cohort) over a 3-year period within an established interprofessional education (IPE) programme. The game encapsulates fun and memorable learning styles to explore professional stereotypes and team approaches to care delivery. It can be a valuable teaching tool for those designing IPE curriculum. Evaluation data from students and staff were mainly positive. We discuss the use of the game and its potential to be adapted in flexible and creative ways to assist educators in consider incorporating gaming within their own IPE programmes.

A review of interprofessional dissemination and education interventions for recognizing and managing dementia

PubMed Central

Galvin, James E.

2014-01-01

The number of individuals with dementia is expected to increase dramatically over the next 20 years. Given the complicated clinical, sociobehavioral, and caregiving skills that are needed to comprehensively assess and manage individuals with dementia, the gold standard of care requires involvement of an interprofessional team. This systematic review examined 4,023 abstracts, finding 18 papers from 16 studies where an interprofessional dissemination program was performed. Most studies found some improvement in clinician knowledge or confidence, or patient outcomes, though methods and patient and clinician populations were disparate. While a significant evidence base for assessing and managing individuals with dementia has been developed, few studies have examined how to disseminate this research, and even fewer in an interprofessional manner. These findings suggest that greater emphasis needs to be placed on disseminating existing evidence-based care and ensuring that programs are interprofessional in nature so that excellent, patient-centered care is provided. PMID:23879387

Interprofessional collaboration: if not now, when?

PubMed

Fried, Jackie

2013-01-01

Interprofessional collaboration (IPC) is a driving force behind state-of-the art health care delivery. Health care experts, governmental bodies, health professions organizations and academicians support the need for collaborative models. Dental hygienists possess unique qualities that can enhance a collaborative team. As preventive therapists, health educators and holistic providers, they are positioned to contribute richly and meaningfully to team models. Health care reform, overwhelming oral health needs and growing associations between oral and systemic wellness add to the dental hygienist's relevance in collaborative arrangements. Dental hygiene clinical and educational models that speak to collaboration are operational in many U.S. states and the future bodes well for their continued growth.

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.

Applying organizational science to health care: a framework for collaborative practice.

PubMed

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

2013-07-01

Developing interprofessional education (IPE) curricula that improve collaborative practice across professions has proven challenging. A theoretical basis for understanding collaborative practice in health care settings is needed to guide the education and evaluation of health professions trainees and practitioners and support the team-based delivery of care. IPE should incorporate theory-driven, evidence-based methods and build competency toward effective collaboration.In this article, the authors review several concepts from the organizational science literature and propose using these as a framework for understanding how health care teams function. Specifically, they outline the team process model of action and planning phases in collaborative work; discuss leadership and followership, including how locus (a leader's integration into a team's usual work) and formality (a leader's responsibility conferred by the traditional hierarchy) affect team functions; and describe dynamic delegation, an approach to conceptualizing escalation and delegation within health care teams. For each concept, they identify competencies for knowledge, attitudes, and behaviors to aid in the development of innovative curricula to improve collaborative practice. They suggest that gaining an understanding of these principles will prepare health care trainees, whether team leaders or members, to analyze team performance, adapt behaviors that improve collaboration, and create team-based health care delivery processes that lead to improved clinical outcomes.

The integration of occupational therapy into primary care: a multiple case study design

PubMed Central

2013-01-01

Background For over two decades occupational therapists have been encouraged to enhance their roles within primary care and focus on health promotion and prevention activities. While there is a clear fit between occupational therapy and primary care, there have been few practice examples, despite a growing body of evidence to support the role. In 2010, the province of Ontario, Canada provided funding to include occupational therapists as members of Family Health Teams, an interprofessional model of primary care. The integration of occupational therapists into this model of primary care is one of the first large scale initiatives of its kind in North America. The objective of the study was to examine how occupational therapy services are being integrated into primary care teams and understand the structures supporting the integration. Methods A multiple case study design was used to provide an in-depth description of the integration of occupational therapy. Four Family Health Teams with occupational therapists as part of the team were identified. Data collection included in-depth interviews, document analyses, and questionnaires. Results Each Family Health Team had a unique organizational structure that contributed to the integration of occupational therapy. Communication, trust and understanding of occupational therapy were key elements in the integration of occupational therapy into Family Health Teams, and were supported by a number of strategies including co-location, electronic medical records and team meetings. An understanding of occupational therapy was critical for integration into the team and physicians were less likely to understand the occupational therapy role than other health providers. Conclusion With an increased emphasis on interprofessional primary care, new professions will be integrated into primary healthcare teams. The study found that explicit strategies and structures are required to facilitate the integration of a new professional group. An understanding of professional roles, trust and communication are foundations for interprofessional collaborative practice. PMID:23679667

Alignment of an interprofessional student learning experience with a hospital quality improvement initiative.

PubMed

Fowler, Terri O; Wise, Holly H; Mauldin, Mary P; Ragucci, Kelly R; Scheurer, Danielle B; Su, Zemin; Mauldin, Patrick D; Bailey, Jennifer R; Borckardt, Jeffrey J

2018-04-11

Assessment of interprofessional education (IPE) frequently focuses on students' learning outcomes including changes in knowledge, skills, and/or attitudes. While a foundational education in the values and information of their chosen profession is critical, interprofessional learning follows a continuum from formal education to practice. The continuum increases in significance and complexity as learning becomes more relationship based and dependent upon the ability to navigate complex interactions with patients, families, communities, co-workers, and others. Integrating IPE into collaborative practice is critical to enhancing students' experiential learning, developing teamwork competencies, and understanding the complexity of teams. This article describes a project that linked students with a hospital-based quality-improvement effort to focus on the acquisition and practice of teamwork skills and to determine the impact of teamwork on patient and quality outcome measures. A hospital unit was identified with an opportunity for improvement related to quality care, patient satisfaction, employee engagement, and team behaviours. One hundred and thirty-seven students from six health profession colleges at the Medical University of South Carolina underwent TeamSTEPPS® training and demonstrated proficiency of their teamwork-rating skills with the TeamSTEPPS® Team Performance Observation Tool (T-TPO). Students observed real-time team behaviours of unit staff before and after staff attended formal TeamSTEPPS® training. The students collected a total of 778 observations using the T-TPO. Teamwork performance on the unit improved significantly across all T-TPO domains (team structure, communication, leadership, situation monitoring, and mutual support). Significant improvement in each domain continued post-intervention and at 15-month follow-up, improvement remained significant compared to baseline. Student engagement in TeamSTEPPS® training and demonstration of their reliability as teamwork-observers was a valuable learning experience and also yielded an opportunity to gather unique, and otherwise difficult to attain, data from a hospital unit for use by quality managers and administrators.

Shared responsibility: school nurses' experience of collaborating in school-based interprofessional teams.

PubMed

Reuterswärd, Marina; Hylander, Ingrid

2017-06-01

The Swedish Education Act (2011) mandated a new combination of services to boost students' physical health, their mental health and special education through interprofessional pupil health and well-being (PH) teams. For Swedish school nurses, providing these services presents new challenges. To describe how Swedish school nurses experience their work and collaboration within the interprofessional PH teams. Twenty-five school nurses (SNs) were interviewed in five focus groups. Content analysis was used to examine the data and to explore SNs' workplace characteristics by using the components of the sense of coherence (SOC) framework. SNs' experiences of work and collaboration within PH teams can be described using three domains: the expectations of others regarding SNs' roles, SNs' contributions to pupils' health and well-being, and collaboration among SNs within PH teams. The results indicate a discrepancy between SNs' own experiences of their contribution and their experiences of other professionals' expectations regarding those contributions. Some duties were perceived as expected, comprehensible, manageable and meaningful, while other duties - though expected - were perceived as less meaningful, taking time away from school-related matters. Other duties that were not explicitly expected - promoting general health and creating safety zones for pupils, teachers and parents, for example - were nonetheless perceived as meaningful. Collaboration within PH teams was considered meaningful, comprehensible and manageable only if the objectives of the team meetings were clear, if other professionals were available and if professional roles on the team were clearly communicated. The SNs reported a lack of clarity regarding their role in PH and its implementation in schools, indicating that professionals in PH teams need to discuss collaboration so as to find their niche given the new conditions. SOC theory emerged as a useful framework for discussing concrete work-related factors in the school environment. © 2016 Nordic College of Caring Science.

Strengthening Interprofessional Requirements Engineering Through Action Sheets: A Pilot Study.

PubMed

Kunz, Aline; Pohlmann, Sabrina; Heinze, Oliver; Brandner, Antje; Reiß, Christina; Kamradt, Martina; Szecsenyi, Joachim; Ose, Dominik

2016-10-18

The importance of information and communication technology for healthcare is steadily growing. Newly developed tools are addressing different user groups: physicians, other health care professionals, social workers, patients, and family members. Since often many different actors with different expertise and perspectives are involved in the development process it can be a challenge to integrate the user-reported requirements of those heterogeneous user groups. Nevertheless, the understanding and consideration of user requirements is the prerequisite of building a feasible technical solution. In the course of the presented project it proved to be difficult to gain clear action steps and priorities for the development process out of the primary requirements compilation. Even if a regular exchange between involved teams took place there was a lack of a common language. The objective of this paper is to show how the already existing requirements catalog was subdivided into specific, prioritized, and coherent working packages and the cooperation of multiple interprofessional teams within one development project was reorganized at the same time. In the case presented, the manner of cooperation was reorganized and a new instrument called an Action Sheet was implemented. This paper introduces the newly developed methodology which was meant to smooth the development of a user-centered software product and to restructure interprofessional cooperation. There were 10 focus groups in which views of patients with colorectal cancer, physicians, and other health care professionals were collected in order to create a requirements catalog for developing a personal electronic health record. Data were audio- and videotaped, transcribed verbatim, and thematically analyzed. Afterwards, the requirements catalog was reorganized in the form of Action Sheets which supported the interprofessional cooperation referring to the development process of a personal electronic health record for the Rhine-Neckar region. In order to improve the interprofessional cooperation the idea arose to align the requirements arising from the implementation project with the method of software development applied by the technical development team. This was realized by restructuring the original requirements set in a standardized way and under continuous adjustment between both teams. As a result not only the way of displaying the user demands but also of interprofessional cooperation was steered in a new direction. User demands must be taken into account from the very beginning of the development process, but it is not always obvious how to bring them together with IT knowhow and knowledge of the contextual factors of the health care system. Action Sheets seem to be an effective tool for making the software development process more tangible and convertible for all connected disciplines. Furthermore, the working method turned out to support interprofessional ideas exchange.

Strengthening Interprofessional Requirements Engineering Through Action Sheets: A Pilot Study

PubMed Central

Pohlmann, Sabrina; Heinze, Oliver; Brandner, Antje; Reiß, Christina; Kamradt, Martina; Szecsenyi, Joachim; Ose, Dominik

2016-01-01

Background The importance of information and communication technology for healthcare is steadily growing. Newly developed tools are addressing different user groups: physicians, other health care professionals, social workers, patients, and family members. Since often many different actors with different expertise and perspectives are involved in the development process it can be a challenge to integrate the user-reported requirements of those heterogeneous user groups. Nevertheless, the understanding and consideration of user requirements is the prerequisite of building a feasible technical solution. In the course of the presented project it proved to be difficult to gain clear action steps and priorities for the development process out of the primary requirements compilation. Even if a regular exchange between involved teams took place there was a lack of a common language. Objective The objective of this paper is to show how the already existing requirements catalog was subdivided into specific, prioritized, and coherent working packages and the cooperation of multiple interprofessional teams within one development project was reorganized at the same time. In the case presented, the manner of cooperation was reorganized and a new instrument called an Action Sheet was implemented. This paper introduces the newly developed methodology which was meant to smooth the development of a user-centered software product and to restructure interprofessional cooperation. Methods There were 10 focus groups in which views of patients with colorectal cancer, physicians, and other health care professionals were collected in order to create a requirements catalog for developing a personal electronic health record. Data were audio- and videotaped, transcribed verbatim, and thematically analyzed. Afterwards, the requirements catalog was reorganized in the form of Action Sheets which supported the interprofessional cooperation referring to the development process of a personal electronic health record for the Rhine-Neckar region. Results In order to improve the interprofessional cooperation the idea arose to align the requirements arising from the implementation project with the method of software development applied by the technical development team. This was realized by restructuring the original requirements set in a standardized way and under continuous adjustment between both teams. As a result not only the way of displaying the user demands but also of interprofessional cooperation was steered in a new direction. Conclusions User demands must be taken into account from the very beginning of the development process, but it is not always obvious how to bring them together with IT knowhow and knowledge of the contextual factors of the health care system. Action Sheets seem to be an effective tool for making the software development process more tangible and convertible for all connected disciplines. Furthermore, the working method turned out to support interprofessional ideas exchange. PMID:27756716

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.

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.

Interprofessional training for nursing and medical students in Norway: Exploring different professional perspectives.

PubMed

Aase, Ingunn; Hansen, Britt Sætre; Aase, Karina; Reeves, Scott

2016-01-01

This article presents an explorative case study focusing on interprofessional training for medical and nursing students in Norway. Based on interviews with, and observations of, multiple stakeholder groups--students, university faculty, and hospital staff--content analysis was applied to investigate their perspectives regarding the design of such educational training. The findings revealed a positive perspective amongst stakeholders while voicing some concerns related to how communication issues, collaboration, workflow, and professional role patterns should be reflected in such training. Based on our data analysis we derive three themes that must be considered for successful interprofessional training of nursing and medical students: clinical professionalism, team performance, and patient-centered perspective. These themes must be balanced contingent on the students' background and the learning objectives of future interprofessional training efforts.

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.

Exploring the value of technology to stimulate interprofessional discussion and education: a needs assessment of emergency medicine professionals.

PubMed

Riley, Jennifer; McGowan, Melissa; Rozmovits, Linda

2014-06-30

The emergency department (ED) is an environment fraught with increasing patient volumes, competing priorities, fluctuating information, and ad hoc interprofessional clinical teams. Limited time is available to reflect on and discuss clinical experiences, policies, or research with others on the involved team. Online resources, such as webcasts and blogs, offer an accessible platform for emergency shift workers to engage in interprofessional discussion and education. Our objective was to explore the current opportunities for shared learning and discussion and to discover the potential of online resources to foster and facilitate interprofessional education within an academic tertiary emergency department community. A qualitative study using semistructured interviews was conducted to solicit participants' views of the current culture of IPE in the ED, the potential value of introducing new online resources and technology in support of IPE, and possible barriers to uptake. Participation was voluntary and participants provided verbal informed consent. Online resources discussed included webcasts, interactive discussion forums, websites, and dashboard with links to central repositories. Identified barriers to uptake of new online resources were an unwillingness to "work" off-shift, a dislike of static one-directional communication, concerns with confidentiality, and the suggestion that new resources would be used by only a select few. Owing to the sensitive dynamics of emergency medicine-and the preference among its professional staff to foster interprofessional discussion and education through personal engagement, in an unhurried, non-stressful environment-introducing and investing in online resources should be undertaken with caution.

Connecting the dots: interprofessional health education and delivery system redesign at the Veterans Health Administration.

PubMed

Gilman, Stuart C; Chokshi, Dave A; Bowen, Judith L; Rugen, Kathryn Wirtz; Cox, Malcolm

2014-08-01

Health systems around the United States are embracing new models of primary care using interprofessional team-based approaches in pursuit of better patient outcomes, higher levels of satisfaction among patients and providers, and improved overall value. Less often discussed are the implications of new models of care for health professions education, including education for physicians, nurse practitioners, physician assistants, and other professions engaged in primary care. Described here is the interaction between care transformation and redesign of health professions education at the largest integrated delivery system in the United States: the Veterans Health Administration (VA). Challenges and lessons learned are discussed in the context of a demonstration initiative, the VA Centers of Excellence in Primary Care Education. Five sites, involving VA medical centers and their academic affiliates in Boise, Cleveland, San Francisco, Seattle, and West Haven, introduced interprofessional primary care curricula for resident physicians and nurse practitioner students beginning in 2011. Implementation struggles largely revolved around the operational logistics and cultural disruption of integrating educational redesign for medicine and nursing and facilitating the interface between educational and clinical activities. To realize new models for interprofessional teaching, faculty, staff, and trainees must understand the histories, traditions, and program requirements across professions and experiment with new approaches to achieving a common goal. Key recommendations for redesign of health professions education revolve around strengthening the union between interprofessional learning, team-based practice, and high-value care.

Refinement of the Interprofessional Socialization and Valuing Scale (ISVS-21) and Development of 9-Item Equivalent Versions.

PubMed

King, Gillian; Orchard, Carole; Khalili, Hossein; Avery, Lisa

2016-01-01

Measures of interprofessional (IP) socialization are needed to capture the role of interprofessional education in preparing students and health practitioners to function as part of IP health care teams. The aims of this study were to refine a previously published version of the Interprofessional Socialization and Valuing Scale (the ISVS-24) and create two shorter equivalent forms to be used in pre-post studies. A graded response model was used to identify ISVS items in a practitioner data set (n = 345), with validation (measure invariance) conducted using a separate student sample (n = 341). Analyses indicated a unidimensional 21-item version with excellent measurement properties, Cronbach alpha of 0.988, 95% confidence interval (CI) 0.985-0.991. There was evidence of measure invariance, as there was excellent agreement of the factor scores for the practitioner and student data, intraclass correlation coefficient = 0.993, 95% CI 0.991-0.994. This indicates that the ISVS-21 measures IP socialization consistently across groups. Two 9-item equivalent versions for pre-post use were developed, with excellent agreement between the two forms. The student score agreement for the two item sets was excellent: intraclass correlation coefficient = 0.970, 95% CI 0.963-0.976. The ISVS-21 is a refined measure to assess existing levels of IP socialization in practitioners and students, and relate IP socialization to other important constructs such as IP collaboration and the development of an IP identity. The equivalent versions can be used to assess change in IP socialization as a result of interprofessional education.

Applying Organizational Science to Health Care: A Framework for Collaborative Practice

PubMed Central

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

2013-01-01

Developing interprofessional education (IPE) curricula that improve collaborative practice across professions has proven challenging. A theoretical basis for understanding collaborative practice in health care settings is needed to guide the education and evaluation of health professions trainees and practitioners and support the team-based delivery of care. IPE should incorporate theory-driven, evidence-based methods and build competency toward effective collaboration. In this article, the authors review several concepts from the organizational science literature and propose using these as a framework for understanding how health care teams function. Specifically, they outline the team process model of action and planning phases in collaborative work; discuss leadership and followership, including how locus (a leader’s integration into a team’s usual work) and formality (a leader’s responsibility conferred by the traditional hierarchy) affect team functions; and describe dynamic delegation, an approach to conceptualizing escalation and delegation within health care teams. For each concept, they identify competencies for knowledge, attitudes, and behaviors to aid in the development of innovative curricula to improve collaborative practice. They suggest that gaining an understanding of these principles will prepare health care trainees, whether team leaders or members, to analyze team performance, adapt behaviors that improve collaboration, and create team-based health care delivery processes that lead to improved clinical outcomes. PMID:23702530

A safe place with space for learning: Experiences from an interprofessional training ward.

PubMed

Hallin, Karin; Kiessling, Anna

2016-01-01

Interprofessional learning in a real ward context effectively increases collaborative and professional competence among students. However, less is known on the processes behind this. The aim of this study was to explore medical, nurse, physiotherapy, and occupational therapy students' perspectives on the process of their own learning at an interprofessional training ward (IPTW). We performed a qualitative content analysis on free-text answers of 333 student questionnaires from the years 2004 to 2011. Two main themes emerged: first, students found that the IPTW provided an enriching learning environment--a safe place with space. It included authentic and relevant patients, well-composed and functioning student teams, competent and supportive supervisors, and adjusted ward structures to support learning. Second, they developed an awareness of their own development with faith in the future--from chaos to clarity. It included personal, professional, and interprofessional development towards a comprehensive view of practice and a faith in their ability to work as professionals in the future. Our findings are discussed with a social constructivist perspective. This study suggests that when an IPTW provides a supportive and permissive learning environment with possibilities to interact with one another--a safe place with space--it enables students to move from insecurity to faith in their abilities--from chaos to clarity. However, if the learning environment is impaired, the students' development could be halted.

The doctor dilemma in interprofessional education and care: how and why will physicians collaborate?

PubMed

Whitehead, Cynthia

2007-10-01

Interprofessional educational (IPE) initiatives are seen as a means to engage health care professionals in collaborative patient-centred care. Given the hierarchical nature of many clinical settings, it is important to examine how the aims of formal IPE courses intersect with the socialisation of medical students into roles of responsibility and authority. This article aims to provide an overview of doctor barriers to collaboration and describe aspects of medical education and socialisation that may limit doctor engagement in the goals of interprofessional education. Additionally, the paper examines the nature of team function in the health care system, reviewing different conceptual models to propose a spectrum of collaborative possibilities. Finally, specific suggestions are offered to increase the impact of interprofessional education programmes in medical education. An acknowledgement of power differentials between health care providers is necessary in the development of models for shared responsibility between professions. Conceptual models of teamwork and collaboration must articulate the desired nature of interaction between professionals with different degrees of responsibility and authority. Educational programmes in areas such as professionalism and ethics have shown limited success when formal and informal curricula significantly diverge. The socialisation of medical students into the role of a responsible doctor must be balanced with training to share responsibility appropriately. Doctor collaborative capacity may be enhanced by programmes designed to develop particular skills for which there is evidence of improved patient outcomes.

Multidisciplinary teams of case managers in the implementation of an innovative integrated services delivery for the elderly in France.

PubMed

de Stampa, Matthieu; Vedel, Isabelle; Trouvé, Hélène; Ankri, Joël; Saint Jean, Olivier; Somme, Dominique

2014-04-07

The case management process is now well defined, and teams of case managers have been implemented in integrated services delivery. However, little is known about the role played by the team of case managers and the value in having multidisciplinary case management teams. The objectives were to develop a fuller understanding of the role played by the case manager team and identify the value of inter-professional collaboration in multidisciplinary teams during the implementation of an innovative integrated service in France. We conducted a qualitative study with focus groups comprising 14 multidisciplinary teams for a total of 59 case managers, six months after their recruitment to the MAIA program (Maison Autonomie Integration Alzheimer). Most of the case managers saw themselves as being part of a team of case managers (91.5%). Case management teams help case managers develop a comprehensive understanding of the integration concept, meet the complex needs of elderly people and change their professional practices. Multidisciplinary case management teams add value by helping case managers move from theory to practice, by encouraging them develop a comprehensive clinical vision, and by initiating the interdisciplinary approach. The multidisciplinary team of case managers is central to the implementation of case management and helps case managers develop their new role and a core inter-professional competency.

Creation of a virtual triage exercise: an interprofessional communication strategy.

PubMed

Farra, Sharon; Nicely, Stephanie; Hodgson, Eric

2014-10-01

Virtual reality simulation as a teaching method is gaining increased acceptance and presence in institutions of higher learning. This study presents an innovative strategy using the interdisciplinary development of a nonimmersive virtual reality simulation to facilitate interprofessional communication. The purpose of this pilot project was to describe nursing students' attitudes related to interprofessional communication following the collaborative development of a disaster triage virtual reality simulation. Collaboration between and among professionals is integral in enhancing patient outcomes. In addition, ineffective communication is linked to detrimental patient outcomes, especially during times of high stress. Poor communication has been identified as the root cause of the majority of negative sentinel events occurring in hospitals. The simulation-development teaching model proved useful in fostering interprofessional communication and mastering course content. Mean scores on the KidSIM Attitudes Towards Teamwork in Training Undergoing Designed Educational Simulation survey demonstrated that nursing students, after simulation experience,had agreement to strong agreement inall areas surveyed including interprofessional education, communication, roles and responsibilities of team members, and situational awareness. The findings indicate that students value interprofessional teamwork and the opportunity to work with other disciplines.

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.

Using "The Burns Suite" as a Novel High Fidelity Simulation Tool for Interprofessional and Teamwork Training.

PubMed

Sadideen, Hazim; Wilson, David; Moiemen, Naiem; Kneebone, Roger

2016-01-01

Educational theory highlights the importance of contextualized simulation for effective learning. The authors recently published the concept of "The Burns Suite" (TBS) as a novel tool to advance the delivery of burns education for residents/clinicians. Effectively, TBS represents a low-cost, high-fidelity, portable, immersive simulation environment. Recently, simulation-based team training (SBTT) has been advocated as a means to improve interprofessional practice. The authors aimed to explore the role of TBS in SBTT. A realistic pediatric burn resuscitation scenario was designed based on "advanced trauma and life support" and "emergency management of severe burns" principles, refined utilizing expert opinion through cognitive task analysis. The focus of this analysis was on nontechnical and interpersonal skills of clinicians and nurses within the scenario, mirroring what happens in real life. Five-point Likert-type questionnaires were developed for face and content validity. Cronbach's alpha was calculated for scale reliability. Semistructured interviews captured responses for qualitative thematic analysis allowing for data triangulation. Twenty-two participants completed TBS resuscitation scenario. Mean face and content validity ratings were high (4.4 and 4.7 respectively; range 4-5). The internal consistency of questions was high. Qualitative data analysis revealed two new themes. Participants reported that the experience felt particularly authentic because the simulation had high psychological and social fidelity, and there was a demand for such a facility to be made available to improve nontechnical skills and interprofessional relations. TBS provides a realistic, novel tool for SBTT, addressing both nontechnical and interprofessional team skills. Recreating clinical challenge is crucial to optimize SBTT. With a better understanding of the theories underpinning simulation and interprofessional education, future simulation scenarios can be designed to provide unique educational experiences whereby team members will learn with and from other specialties and professions in a safe, controlled environment.

Straddling care and education: Developing interprofessional collaboration through a hotspotting service learning project.

PubMed

Jones, Anne C; Li, Trudy; Zomorodi, Meg; Broadhurst, Rob; Weil, Amy B

2018-06-01

Interprofessional (IP) team work has been shown to decrease burnout and improve care and decrease costs. However, institutional barriers have challenged adoption in practice and education. Faculty and students are turning to IP service-learning projects to help students gain experience and provide needed services. This paper highlights a "hotspotting" program where students from different health professions work collaboratively to improve high utilizing patients' health. Benefits, challenges and preliminary results including cost savings and student efficacy are shared. Institutions should surmount barriers that make hotspotting service-learning challenging as IP team-based experiences prepare students for the workplace and can help mitigate burnout. Copyright © 2018 Elsevier Inc. All rights reserved.

Perceived performance and impact of a non-physician-led interprofessional team in a trauma clinic setting.

PubMed

Driessen, Julia; Bellon, Johanna E; Stevans, Joel; Forsythe, Raquel M; Reynolds, Benjamin R; James, A Everette

2017-01-01

Faced with the challenge of meeting the wide degree of post-discharge needs in their trauma population, the University of Pittsburgh Medical Center (UPMC) developed a non-physician-led interprofessional team to provide follow-up care at its UPMC Falk Trauma Clinic. We assessed this model of care using a survey to gauge team member perceptions of this model, and used clinic visit documentation to apply a novel approach to assessing how this model improves the care received by clinic patients. The high level of perceived team performance and cohesion suggests that this model has been successful thus far from a provider perspective. Patients are seen most frequently by audiologists, while approximately half of physical therapy and speech language therapy consults generate a new therapy referral, which is interpreted as a potential change in the patient's care trajectory. The broader message of this analysis is that a collaborative, non-hierarchical team model incorporating rehabilitative specialists, who often operate independently of one another, can be successful in this setting, where patients appear to have a strong and previously under-attended need for rehabilitative intervention.

Effects of interprofessional education for medical and nursing students: enablers, barriers and expectations for optimizing future interprofessional collaboration - a qualitative study.

PubMed

Homeyer, Sabine; Hoffmann, Wolfgang; Hingst, Peter; Oppermann, Roman F; Dreier-Wolfgramm, Adina

2018-01-01

To ensure high quality patient care an effective interprofessional collaboration between healthcare professionals is required. Interprofessional education (IPE) has a positive impact on team work in daily health care practice. Nevertheless, there are various challenges for sustainable implementation of IPE. To identify enablers and barriers of IPE for medical and nursing students as well as to specify impacts of IPE for both professions, the 'Cooperative academical regional evidence-based Nursing Study in Mecklenburg-Western Pomerania' (Care-N Study M-V) was conducted. The aim is to explore, how IPE has to be designed and implemented in medical and nursing training programs to optimize students' impact for IPC. A qualitative study was conducted using the Delphi method and included 25 experts. Experts were selected by following inclusion criteria: (a) ability to answer every research question, one question particularly competent, (b) interdisciplinarity, (c) sustainability and (d) status. They were purposely sampled. Recruitment was based on existing collaborations and a web based search. The experts find more enablers than barriers for IPE between medical and nursing students. Four primary arguments for IPE were mentioned: (1) development and promotion of interprofessional thinking and acting, (2) acquirement of shared knowledge, (3) promotion of beneficial information and knowledge exchange, and (4) promotion of mutual understanding. Major barriers of IPE are the coordination and harmonization of the curricula of the two professions. With respect to the effects of IPE for IPC, experts mentioned possible improvements on (a) patient level and (b) professional level. Experts expect an improved patient-centered care based on better mutual understanding and coordinated cooperation in interprofessional health care teams. To sustainably implement IPE for medical and nursing students, IPE needs endorsement by both, medical and nursing faculties. In conclusion, IPE promotes interprofessional cooperation between the medical and the nursing profession. Skills in interprofessional communication and roles understanding will be primary preconditions to improve collaborative patient-centered care. The impact of IPE for patients and caregivers as well as for both professions now needs to be more specifically analysed in prospective intervention studies.

Implementation and evaluation of a community-based interprofessional learning activity.

PubMed

Luebbers, Ellen L; Dolansky, Mary A; Vehovec, Anton; Petty, Gayle

2017-01-01

Implementation of large-scale, meaningful interprofessional learning activities for pre-licensure students has significant barriers and requires novel approaches to ensure success. To accomplish this goal, faculty at Case Western Reserve University, Ohio, USA, used the Ottawa Model of Research Use (OMRU) framework to create, improve, and sustain a community-based interprofessional learning activity for large numbers of medical students (N = 177) and nursing students (N = 154). The model guided the process and included identification of context-specific barriers and facilitators, continual monitoring and improvement using data, and evaluation of student learning outcomes as well as programme outcomes. First year Case Western Reserve University medical students and undergraduate nursing students participated in team-structured prevention screening clinics in the Cleveland Metropolitan Public School District. Identification of barriers and facilitators assisted with overcoming logistic and scheduling issues, large class size, differing ages and skill levels of students and creating sustainability. Continual monitoring led to three distinct phases of improvement and resulted in the creation of an authentic team structure, role clarification, and relevance for students. Evaluation of student learning included both qualitative and quantitative methods, resulting in statistically significant findings and qualitative themes of learner outcomes. The OMRU implementation model provided a useful framework for successful implementation resulting in a sustainable interprofessional learning activity.

The first 3 minutes: Optimising a short realistic paediatric team resuscitation training session.

PubMed

McKittrick, Joanne T; Kinney, Sharon; Lima, Sally; Allen, Meredith

2018-01-01

Inadequate resuscitation leads to death or brain injury. Recent recommendations for resuscitation team training to complement knowledge and skills training highlighted the need for development of an effective team resuscitation training session. This study aimed to evaluate and revise an interprofessional team training session which addressed roles and performance during provision of paediatric resuscitation, through incorporation of real-time, real team simulated training episodes. This study was conducted applying the principles of action research. Two cycles of data collection, evaluation and refinement of a 30-40 minute resuscitation training session for doctors and nurses occurred. Doctors and nurses made up 4 groups of training session participants. Their responses to the training were evaluated through thematic analysis of rich qualitative data gathered in focus groups held immediately after each training session. Major themes included the importance of realism, teamwork, and reflective learning. Findings informed important training session changes. These included; committed in-situ training; team diversity; realistic resources; role flexibility, definition and leadership; increased debriefing time and the addition of a team goal. In conclusion, incorporation of interprofessional resuscitation training which addresses team roles and responsibilities into standard medical and nursing training will enhance preparedness for participation in paediatric resuscitation. Copyright © 2017 Elsevier Ltd. All rights reserved.

The academic librarian as co-investigator on an interprofessional primary research team: a case study.

PubMed

Janke, Robert; Rush, Kathy L

2014-06-01

The objective of this study was to explore the role librarians play on research teams. The experiences of a librarian and a faculty member are situated within the wider literature addressing collaborations between health science librarians and research faculty. A case study approach is used to outline the involvement of a librarian on a team created to investigate the best practices for integrating nurses into the workplace during their first year of practice. Librarians contribute to research teams including expertise in the entire process of knowledge development and dissemination including the ability to navigate issues related to copyright and open access policies of funding agencies. The librarian reviews the various tasks performed as part of the research team ranging from the grant application, to working on the initial literature review as well as the subsequent manuscripts that emerged from the primary research. The motivations for joining the research team, including authorship and relationship building, are also discussed. Recommendations are also made in terms of how librarians could increase their participation on research teams. The study shows that librarians can play a key role on interprofessional primary research teams. © 2014 The authors. Health Information and Libraries Journal © 2014 Health Libraries Group.

Interprofessional Team Training at the Prelicensure Level: A Review of the Literature.

PubMed

Nelson, Sioban; White, Catriona F; Hodges, Brian D; Tassone, Maria

2017-05-01

The authors undertook a descriptive analysis review to gain a better understanding of the various approaches to and outcomes of team training initiatives in prelicensure curricula since 2000. In July and August 2014, the authors searched the MEDLINE, PsycINFO, Embase, Business Source Premier, and CINAHL databases to identify evaluative studies of team training programs' effects on the team knowledge, communication, and skills of prelicensure students published from 2000 to August 2014. The authors identified 2,568 articles, with 17 studies meeting the selection criteria for full text review. The most common study designs were single-group, pre/posttest studies (n = 7), followed by randomized controlled or comparison trials (n = 6). The Situation, Background, Assessment, Recommendation communication tool (n = 5); crisis resource management principles (n = 6); and high-fidelity simulation (n = 4) were the most common curriculum bases used. Over half of the studies (n = 9) performed training with students from more than one health professions program. All but three used team performance assessments, with most (n = 8) using observed behavior checklists created for that specific study. The majority of studies (n = 16) found improvements in team knowledge, communication, and skills. Team training appears effective in improving team knowledge, communication, and skills in prelicensure learners. Continued exploration of the best method of team training is necessary to determine the most effective way to move forward in prelicensure interprofessional team education.

Labour saver or building a cohesive interprofessional team? The role of the nurse practitioner within hospitals.

PubMed

Hurlock-Chorostecki, Christina; Forchuk, Cheryl; Orchard, Carole; van Soeren, Mary; Reeves, Scott

2014-05-01

Nurse practitioners (NP) are employed within hospital interprofessional (IP) teams in several countries worldwide. There have been some efforts to describe the nature of the NP role within IP teams largely focussing on how the role may augment care processes. Here, using a constructivist grounded theory approach, the perceptions of NPs about their role were compared and integrated into a previously published team perspective as the second phase of a larger study. Seventeen hospital-based (HB) NPs across Ontario, Canada, participated in group and individual interviews. The NP perspective substantiated and expanded the previously reported team perspective, resulting in an IP perspective. The three practice foci illustrating role value meaning of this perspective became: evolve NP role and advance the specialty, focus on team working, and hold patient care together. The IP perspective, juxtaposed with an existing contingency approach, revealed that NPs were promoting IP work, predominantly at the collaboration and teamwork levels, and aiding IP team transitions to appropriate forms of IP work. The practice, "focus on team working"' was strongly related to promoting IP work. The findings were consistent with HB NPs enacting a role in building IP team cohesiveness rather than merely acting as a labour saver. This is the first study to align NP and team understanding of HB NP role value using an IP framework.

The development of professional identity and the formation of teams in the Veterans Affairs Connecticut Healthcare System's Center of Excellence in Primary Care Education Program (CoEPCE).

PubMed

Meyer, Emily M; Zapatka, Susan; Brienza, Rebecca S

2015-06-01

The United States Department of Veterans Affairs Connecticut Healthcare System (VACHS) is one of five Centers of Excellence in Primary Care Education (CoEPCE) pilot sites. The overall goal of the CoEPCE program, which is funded by the Office of Academic Affiliations, is to develop and implement innovative approaches for training future health care providers in postgraduate education programs to function effectively in teams to provide exceptional patient care. This longitudinal study employs theoretically grounded qualitative methods to understand the effect of a combined nursing and medical training model on professional identity and team development at the VACHS CoEPCE site. The authors used qualitative approaches to understand trainees' experiences, expectations, and impressions of the program. From September 2011 to August 2012, they conducted 28 interviews of 18 trainees (internal medicine [IM] residents and nurse practitioners [NPs]) and subjected data to three stages of open, iterative coding. Major themes illuminate both the evolution of individual professional identity within both types of trainees and the dynamic process of group identity development. Results suggest that initially IM residents struggled to understand NPs' roles and responsibilities, whereas NP trainees doubted their ability to work alongside physicians. At the end of one academic year, these uncertainties disappeared, and what was originally artificial had transformed into an organic interprofessional team of health providers who shared a strong sense of understanding and trust. This study provides early evidence of successful interprofessional collaboration among NPs and IM residents in a primary care training program.

Exposure and attitudes toward interprofessional teams: a three-year prospective study of longitudinal integrated clerkship versus rotation-based clerkship students.

PubMed

Myhre, Douglas L; Woloschuk, Wayne; Pedersen, Jeanette Somlak

2014-05-01

This study explored exposure to, and attitudes toward, interprofessional (IP) teams between third-year longitudinal integrated clerkship (LIC) and traditional rotation-based clerkship (RBC) students at the University of Calgary medical school. Students completed a survey pre-post 32-week LIC or 6-week rural, regional or urban RBC family medicine rotations. Pre and post rotation surveys were completed by 213 (48%) students (LIC = 33/34; rural = 76/152; regional = 24/46; urban = 80/208). More LIC students (76%) reported participating on six or more IP teams than RBC students (rural = 38%; regional = 25%; urban = 21%). At pre rotation, the mean attitude to IP teams score of LIC and rural RBC students was high and did not differ. At post rotation, the mean attitude score of LIC students was significantly greater than the mean reported by rural RBC students. Only LIC students reported a significant pre-post rotation increase in attitude. Exposure to IP teams, possibly facilitated by a longer duration of rotation, appears to be an important factor in affecting attitude to IP teams.

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 Education on Adverse Childhood Experiences for Associate Degree Nursing Students.

PubMed

Olsen, Jeanette M; Warring, Sarah L

2018-02-01

The health impact of adverse childhood experiences (ACEs) is significant. Nurses need knowledge and must work in multidisciplinary teams to address this problem. This study examined the effects of an interprofessional education (IPE) activity with nonhealth care students on associate degree nursing (ADN) students' ACEs knowledge and perspectives on IPE. The mixed-methods approach used a quasi-experimental pretest-posttest design with an intervention and control group and thematic analysis of focus group data. Readiness for Interprofessional Learning scale mean scores indicated positive baseline IPE perspectives. Scores changed minimally for most measures in both the intervention and control groups on posttest. However, four major relevant themes related to ACEs knowledge and two related to interprofessional learning were identified. IPE with nonhealth care students is an effective way to teach ADN students about ACEs and infuse interprofessional learning in a nonuniversity setting. However, outcomes are best captured with qualitative data. [J Nurs Educ. 2018;57(2):101-105.]. Copyright 2018, SLACK Incorporated.

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.

Effect of interprofessional clinical education programme length on students' attitudes towards teamwork.

PubMed

Renschler, Lauren; Rhodes, Darson; Cox, Carol

2016-05-01

This article reports on a study involving a range of health professions students who participated in similar one-semester (short) or two-semester (long) interprofessional clinical education programmes that focused on clinical assessment of senior citizens living independently in the community. Students' attitudes towards teamwork skills and perceptions of their own teamwork skills both before and after the programmes were assessed using two validated scales. Osteopathic medical student participants reported no significant changes in attitudes towards interprofessional healthcare teamwork skills or their perceptions of their own interprofessional teamwork skills after either the one- or two-semester programmes. For athletic training, speech-language pathology, exercise sciences, public health, and nursing students, though, attitudes towards teamwork skills significantly improved (p < .05) after the one-semester programme; and perceptions of their own team skills significantly improved (p < .05) after both the one- and two-semester programmes. Overall, this study provides some support for interprofessional teamwork attitude change, but with a significant difference between medical as compared to nursing, allied health, and public health students.

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.

Incorporating a pharmacist into an interprofessional team providing transgender care under a medical home model.

PubMed

Newsome, Cheyenne; Colip, Leslie; Sharon, Nathaniel; Conklin, Jessica

2017-02-01

A pharmacist's role in providing care to transgender and gender-nonconforming (TGNC) patients within a medical home model of care is described. A comprehensive transgender services clinic was established in February 2015 in New Mexico. Clinic services are provided under an "informed consent" model of care, as opposed to the traditional "gatekeeper" approach. The clinic's interprofessional team consists of a clinical pharmacist, a psychiatrist, a nurse practitioner, an endocrinologist, a diabetes educator, a massage therapist, a nurse, a nutritionist, and medical assistants. The clinical pharmacist has served in the following roles: (1) assessing health literacy and tailoring the consent process to the patient's literacy level, (2) initiating in-depth discussion of the medical risks and benefits of cross-sex hormone therapy (HT), as well as HT alternatives, (3) discussing typical timelines for physical outcomes of HT, (4) discussing a patient's expectations and goals for csHT, (5) discussing the different HT formulations and helping to determine which formulation is best suited to meeting patient's goals, (6) helping the team obtain prior authorizations for csHT, and (7) managing risk reduction strategies such as smoking cessation and weight loss. Involvement of a pharmacist in the clinic has improved care access and quality for TGNC patients in the southwestern United States. A pharmacist in an interprofessional team staffing a clinic for TGNC people has assumed multiple responsibilities and helped improve patient care. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Impact of an academic-community partnership in medical education on community health: evaluation of a novel student-based home visitation program.

PubMed

Rock, John A; Acuña, Juan M; Lozano, Juan Manuel; Martinez, Iveris L; Greer, Pedro J; Brown, David R; Brewster, Luther; Simpson, Joe L

2014-04-01

Current US healthcare delivery systems do not adequately address healthcare demands. Physicians are integral but rarely emphasize prevention as a primary tool to change health outcomes. Home visitation is an effective method for changing health outcomes in some populations. The Florida International University Herbert Wertheim College of Medicine Green Family Foundation NeighborhoodHELP service-learning program assigns medical students to be members of interprofessional teams that conduct household visits to determine their healthcare needs. We performed a prospective evaluation of 330 households randomly assigned to one of two groups: visitation from a student team (intervention group) or limited intervention (control group). The program design allowed randomly selected control households to replace intervention-group households that left the program of their own volition. All of the households were surveyed at baseline and after 1 year of participation in the study. After 1 year in the program and after adjustment for confounders, intervention group households proved more likely (P ≤ 0.05) than control households to have undergone physical examinations, blood pressure monitoring, and cervical cytology screenings. Cholesterol screenings and mammograms were borderline significant (P = 0.05 and P = 0.06, respectively). This study supports the value of home visitation by interprofessional student teams as an effective way to increase the use of preventive health measures. The study underscores the important role interprofessional student teams may play in improving the health of US communities, while students concurrently learn about primary prevention and primary care.

"They Are Talking About Me, but Not with Me": A Focus Group Study to Explore the Patient Perspective on Interprofessional Team Meetings in Primary Care.

PubMed

van Dongen, Jerôme Jean Jacques; de Wit, Maarten; Smeets, Hester Wilhelmina Henrica; Stoffers, Esther; van Bokhoven, Marloes Amantia; Daniëls, Ramon

2017-08-01

The number of people with multiple chronic conditions receiving primary care services is growing. To deal with their increasingly complex health care demands, professionals from different disciplines need to collaborate. Interprofessional team (IPT) meetings are becoming more popular. Several studies describe important factors related to conducting IPT meetings, mostly from a professional perspective. However, in the light of patient-centeredness, it is valuable to also explore the patients' perspective. The aim was to explore the patients' perspectives regarding IPT meetings in primary care. A qualitative study with a focus group design was conducted in the Netherlands. Two focus group meetings took place, for which the same patients were invited. The participants, chronically ill patients with experience on interprofessional collaboration, were recruited through the regional patient association. Participants discussed viewpoints, expectations, and concerns regarding IPT meetings in two rounds, using a focus group protocol and selected video-taped vignettes of team meetings. The first meeting focused on conceptualization and identification of themes related to IPT meetings that are important to patients. The second meeting aimed to gain more in-depth knowledge and understanding of the priorities. Discussions were audio-taped and transcribed verbatim, and analyzed by means of content analysis. The focus group meetings included seven patients. Findings were divided into six key categories, capturing the factors that patients found important regarding IPT meetings: (1) putting the patient at the center, (2) opportunities for patients to participate, (3) appropriate team composition, (4) structured approach, (5) respectful communication, and (6) informing the patient about meeting outcomes. Patients identified different elements regarding IPT meetings that are important from their perspective. They emphasized the right of patients or their representatives to take part in IPT meetings. Results of this study can be used to develop tools and programs to improve interprofessional collaboration.

A Community Needs Assessment for the Development of an Interprofessional Palliative Care Training Curriculum.

PubMed

Coats, Heather; Paganelli, Tia; Starks, Helene; Lindhorst, Taryn; Starks Acosta, Anne; Mauksch, Larry; Doorenbos, Ardith

2017-03-01

There is a known shortage of trained palliative care professionals, and an even greater shortage of professionals who have been trained through interprofessional curricula. As part of an institutional Palliative Care Training Center grant, a core team of interprofessional palliative care academic faculty and staff completed a state-wide palliative care educational assessment to determine the needs for an interprofessional palliative care training program. The purpose of this article is to describe the process and results of our community needs assessment of interprofessional palliative care educational needs in Washington state. We approached the needs assessment through a cross-sectional descriptive design by using mixed-method inquiry. Each phase incorporated a variety of settings and subjects. The assessment incorporated multiple phases with diverse methodological approaches: a preparatory phase-identifying key informants; Phase I-key informant interviews; Phase II-survey; and Phase III-steering committee endorsement. The multiple phases of the needs assessment helped create a conceptual framework for the Palliative Care Training Center and developed an interprofessional palliative care curriculum. The input from key informants at multiple phases also allowed us to define priority needs and to refine an interprofessional palliative care curriculum. This curriculum will provide an interprofessional palliative care educational program that crosses disciplinary boundaries to integrate knowledge that is beneficial for all palliative care clinicians. The input from a range of palliative care clinicians and professionals at every phase of the needs assessment was critical for creating an interprofessional palliative care curriculum.

Advancing medical education: connecting interprofessional collaboration and education opportunities with integrative medicine initiatives to build shared learning.

PubMed

Templeman, Kate; Robinson, Anske; McKenna, Lisa

2016-12-01

BackgroundImproved teamwork between conventional and complementary medicine (CM) practitioners is indicated to achieve effective healthcare. However, little is known about interprofessional collaboration and education in the context of integrative medicine (IM). MethodsThis paper reports the findings from a constructivist-grounded theory method study that explored and highlighted Australian medical students' experiences and opportunities for linking interprofessional collaboration and learning in the context of IM. Following ethical approval, in-depth semi-structured interviews were conducted with 30 medical students from 10 medical education faculties across Australian universities. Results Medical students recognised the importance of interprofessional teamwork between general medical practitioners and CM professionals in patient care and described perspectives of shared responsibilities, profession-specific responsibilities, and collaborative approaches within IM. While students identified that limited interprofessional collaboration currently occurred in the medical curriculum, interprofessional education was considered a means of increasing communication and collaboration between healthcare professionals, helping coordinate effective patient care, and understanding each healthcare team members' professional role and value. Conclusions The findings suggest that medical curricula should include opportunities for medical students to develop required skills, behaviours, and attitudes for interprofessional collaboration and interprofessional education within the context of IM. While this is a qualitative study that reflects theoretical saturation from a selected cohort of medical students, the results also point to the importance of including CM professionals within interprofessional collaboration, thus contributing to more person-centred care.

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.

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.

How School Leadership Development Evolves: Crossing Timescales and Settings

ERIC Educational Resources Information Center

Jensen, Ruth; Vennebo, Kirsten Foshaug

2016-01-01

Purpose: This paper aims to address workplace learning in terms of investigating school leadership development in an inter-professional team (the team) in which principals, administrators and researchers work together on a local school improvement project. The purpose is to provide an enriched understanding of how school leadership development…

An Interprofessional Curriculum on Antimicrobial Stewardship Improves Knowledge and Attitudes Toward Appropriate Antimicrobial Use and Collaboration

PubMed Central

Schwartz, Brian S.; Kim, Lisa; Nanamori, Mari; Shekarchian, Sharmin; Chin-Hong, Peter V.

2017-01-01

Abstract Background. Inappropriate antimicrobial use can threaten patient safety and is the focus of collaborative physician and pharmacist antimicrobial stewardship teams. However, antimicrobial stewardship is not comprehensively taught in medical or pharmacy school curricula. Addressing this deficiency can teach an important concept as well as model interprofessional healthcare. Methods. We created an antimicrobial stewardship curriculum consisting of an online learning module and workshop session that combined medical and pharmacy students, with faculty from both professions. Learners worked through interactive, branched-logic clinical cases relating to appropriate antimicrobial use. We surveyed participants before and after the curriculum using validated questions to assess knowledge and attitudes regarding antimicrobial stewardship and interprofessional collaboration. Results were analyzed using paired χ2 and t tests and mixed-effects logistic regression. Results. Analysis was performed with the 745 students (425 medical students, 320 pharmacy students) who completed both pre- and postcurriculum surveys over 3 years. After completing the curriculum, significantly more students perceived that they were able to describe the role of each profession in appropriate antimicrobial use (34% vs 82%, P < .001), communicate in a manner that engaged the interprofessional team (75% vs 94%, P < .001), and describe collaborative approaches to appropriate antimicrobial use (49% vs 92%, P < .001). Student favorability ratings were high for the online learning module (85%) and small group workshop (93%). Conclusions. A curriculum on antimicrobial stewardship consisting of independent learning and an interprofessional workshop significantly increased knowledge and attitudes towards collaborative antimicrobial stewardship among preclinical medical and pharmacy students. PMID:28480231

An Interprofessional Curriculum on Antimicrobial Stewardship Improves Knowledge and Attitudes Toward Appropriate Antimicrobial Use and Collaboration.

PubMed

MacDougall, Conan; Schwartz, Brian S; Kim, Lisa; Nanamori, Mari; Shekarchian, Sharmin; Chin-Hong, Peter V

2017-01-01

Inappropriate antimicrobial use can threaten patient safety and is the focus of collaborative physician and pharmacist antimicrobial stewardship teams. However, antimicrobial stewardship is not comprehensively taught in medical or pharmacy school curricula. Addressing this deficiency can teach an important concept as well as model interprofessional healthcare. We created an antimicrobial stewardship curriculum consisting of an online learning module and workshop session that combined medical and pharmacy students, with faculty from both professions. Learners worked through interactive, branched-logic clinical cases relating to appropriate antimicrobial use. We surveyed participants before and after the curriculum using validated questions to assess knowledge and attitudes regarding antimicrobial stewardship and interprofessional collaboration. Results were analyzed using paired χ 2 and t tests and mixed-effects logistic regression. Analysis was performed with the 745 students (425 medical students, 320 pharmacy students) who completed both pre- and postcurriculum surveys over 3 years. After completing the curriculum, significantly more students perceived that they were able to describe the role of each profession in appropriate antimicrobial use (34% vs 82%, P < .001), communicate in a manner that engaged the interprofessional team (75% vs 94%, P < .001), and describe collaborative approaches to appropriate antimicrobial use (49% vs 92%, P < .001). Student favorability ratings were high for the online learning module (85%) and small group workshop (93%). A curriculum on antimicrobial stewardship consisting of independent learning and an interprofessional workshop significantly increased knowledge and attitudes towards collaborative antimicrobial stewardship among preclinical medical and pharmacy students. © The Author 2017. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

Long-term effect of a short interprofessional education interaction between medical and physical therapy students.

PubMed

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 an opportunity to expose students to interprofessional education (IPE) early in their training. The purpose of this study is to describe an IPE experience and report if the experience has lasting influence on the participating students. The Readiness for Interprofessional Learning Scale (RIPLS) questionnaire was administered to first year medical (MD) and physical therapy (PT) students at Mayo Medical School and Mayo School of Health Sciences. Results demonstrated an openness on the part of the students to IPE. Interprofessional education experiences were incorporated into gross anatomy courses in both medical and PT curricula. The IPE experiences included a social event, peer-teaching, and collaborative clinical problem-solving sessions. These sessions enhanced gross anatomy education by reinforcing previous material and providing the opportunity to work on clinical cases from the perspective of two healthcare disciplines. After course completion, students again completed the RIPLS. Finally, one year after course completion, students were asked to provide feedback on their experience. The post-curricular RIPLS, similar to the pre-curricular RIPLS, illustrated openness to IPE from both MD and PT students. There were however, significant differences in MD and PT perceptions of roles and responsibilities. One-year follow-up indicated long-term retention of lessons learned during IPE. © 2015 American Association of Anatomists.

Delivering team training to medical home staff to impact perceptions of collaboration.

PubMed

Treadwell, Janet; Binder, Brenda; Symes, Lene; Krepper, Rebecca

2015-01-01

The purpose of this study was to explore whether an evidence-based educational and experiential intervention to develop team skills in medical homes would positively affect team members' perceptions of interprofessional collaboration. The study population consisted of primary care medical home practices associated with the health plan sponsor of this research. All practices were located within the greater Houston region of Texas and had more than 500 patients. A cluster design experimental study was conducted between August 2013 and June 2014. Fifty medical home practices, 25 intervention and 25 attention control, were recruited as study sites. Results indicate that individual team members in the medical homes receiving the intervention were significantly more likely than the individual team members in the attention control groups to report higher levels of positive perception of team collaboration after the 12-week intervention. This research indicates that educating teams about interprofessional collaboration tools and supporting technique use may be an effective strategy to assist medical homes in developing collaborative environments. Case management experience in collaboration supports the role facilitating team training. Transforming culture from hierarchical to team-based care supports the case management approach of collaborative practice. In addition, role satisfaction attained through the respect and communication of team-based care delivery may influence retention within the case management profession. As case managers in primary care settings assume roles of embedded care coordinators, program leaders, and transition facilitators, an understanding of collaboration techniques is needed to support the entire care team to achieve desired outcomes.

An Interprofessional Education and Collaborative Practice Model for Dentistry and Pharmacy.

PubMed

Branch-Mays, Grishondra L; Pittenger, Amy L; Williamson, Kristyn; Milone, Anna; Hein, Emily; Thierer, Todd

2017-12-01

The aims of this study were to evaluate the feasibility of an interprofessional education and collaborative practice model (IECPM) developed by the School of Dentistry (SOD) and College of Pharmacy (COP) for the University of Minnesota dental clinics and to report results of the needs assessment using specific primary care metrics and medication histories gathered through use of the model in 2015-16. Planning focused on establishing a workflow to implement the IECPM by the SOD and COP. The interprofessional team that provided patient care for the study consisted of 50 dental students, ten dental therapy students, one pharmacy student, one pharmacy resident, one faculty pharmacist, one dental assistant, one faculty dental hygienist, and two dentists. The team selected 190 patients in the SOD clinic for the study based on the inclusion criteria: patients with two or more chronic medical conditions who were taking medications. The 190 patients received a comprehensive dental exam, review of social and medical history, and medication therapy management assessment by the interprofessional team. Specific core primary care metrics (blood pressure, pulse, tobacco use, and diabetes status) and identification of drug therapy problems (DTPs) were monitored and/or screened for during the dental visit. The results showed that the IECPM helped identify that this cohort of patients presented with chronic conditions: 64% had hypertension, 34% had diabetes, and 10.5% reported smoking cigarettes. Several DTPs were identified, of which "needs additional drug therapy" was the most common. This cohort was taking multiple medications (2-34 per patient) to address a variety of medical conditions. The study concluded that the IECPM with the SOD and COP helped address a primary care need that often goes unmet in dental clinics.

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.

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.

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.

Students' approaches to learning in clinical interprofessional context.

PubMed

Hylin, Uffe; Lonka, Kirsti; Ponzer, Sari

2011-01-01

Health care professionals are supposed to work in teams. Students in health care need to learn how to collaborate during their undergraduate education. Interprofessional learning environments, where collaboration is necessary, may be differently accepted by students depending on their approach to learning. We investigated health care students' evaluations of interprofessional clinical training in relation to their study orientations. The participants were 369 students (40 occupational therapy-, 85 medical-, 52 physiotherapy-, and 192 nursing students) attending an IPE course at a Swedish University Hospital. Data were collected by questionnaires measuring orientations to studying and attitudes towards the clinical training and the IPE concept before and after the training. The response rate was 77 %. Study groups were formed by a cluster analysis on the basis of the students' learning orientations. Three clusters were found: Low collaboration-, Collaborative Constructivist-, and Cookbook groups. These clusters were related to different professions and how students perceived their interprofessional learning environment. Study orientations appear to play a role in the way students evaluate interprofessional training. This should be taken into account in instruction. Students with a 'Cookbook' approach to learning showed an increased understanding of interprofessional collaboration after the course.

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.

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.

Studio-based learning in interprofessional education.

PubMed

Shraiky, James Rodolfo; Lamb, Gerri

2013-11-01

The recent growth of interprofessional education (IPE) in healthcare has been accompanied by exploration of teaching strategies to improve its effectiveness. Experts in IPE advise faculty to explore teaching models from other disciplines outside of healthcare. Studio-based learning (SBL) in design education embodies many of the features that are integral to effective IPE. Students work in teams to design new processes and products to solve complex and real-life problems. The purpose of this paper is to describe features of SBL that enhance IPE and examine student experiences of interprofessional learning from three healthcare design studios. Findings from an exploratory case study of these design studios involving students from a range of professions suggest that the students transition through learning stages in SBL that may enhance IPE. The paper goes on to discuss the unique features of SBL and how they offer new and complementary strategies for building interprofessional curricula.

"A golden opportunity": Exploring interprofessional learning and practice in rural clinical settings.

PubMed

Spencer, Judy; Woodroffe, Jessica; Cross, Merylin; Allen, Penny

2015-01-01

Little is known about interprofessional practice (IPP) and interprofessional learning (IPL) in rural health services, despite national funding and continuing emphasis on increasing students' clinical placements in rural areas. This short paper outlines a study in Tasmania, Australia, which investigated how and under what contexts and conditions IPP and IPL occur in rural clinical settings, and the enabling factors and strategies that promote this learning and practice. This study employed a mixed method design comprising focus group discussions and a survey involving health professionals from two rural health services. The findings demonstrate that formal and informal arrangements, the collaborative nature of small, close-knit healthcare teams and patient-centred models of care employed in rural practice settings, provide ideal contexts for IPP and IPL. The study has implications for promoting organisational readiness for IPP and IPL and harnessing the potential of rural services to promote and develop students' interprofessional capability.

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.

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: 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.

Using employee experts to offer an interprofessional diabetes risk reduction program to fellow employees.

PubMed

Lenz, Thomas L; Gillespie, Nicole D; Skrabal, Maryann Z; Faulkner, Michele A; Skradski, Jessica J; Ferguson, Liz A; Pagenkemper, Joni J; Moore, Geri A; Jorgensen, Diane

2013-03-01

A recent increase in the incidence of diabetes and pre-diabetes is causing many employers to spend more of their healthcare benefit budgets to manage the conditions. A self-insured university in the USA has implemented an interprofessional diabetes mellitus risk reduction program using its own employee faculty and staff experts to help fellow employees manage their diabetes and pre-diabetes. The interprofessional team consists of five pharmacists, a dietitian, an exercise physiologist, a health educator and a licensed mental health practitioner. In addition, the participant's physician serves as a consultant to the program, as does a human resources healthcare benefits specialist and a wellness coordinator. The volunteer program takes place at the worksite during regular business hours and is free of charge to the employees. The faculty and staff delivering the program justify the cost of their time through an interprofessional educational model that the program will soon provide to university students.

The role of inter-professional relationships and support for nurse prescribing in acute and chronic pain.

PubMed

Stenner, Karen; Courtenay, Molly

2008-08-01

This paper is a report of a study to explore nurse prescribers' views on the role of inter-professional relationships and other means of support for nurse prescribing for patients in acute and chronic pain. Research indicates that good team relationships are important for supporting nurse prescribing but that poor understanding of the role by other healthcare professionals can act as a barrier. While collaborative working is central to the role of pain nurses, there is a lack of research on the impact of nurse prescribing on inter-professional working or the support needs of these nurses. A qualitative approach was adopted using thematic analysis of semi-structured interview data collected during 2006 and 2007. Participants were 26 nurses who prescribed medicines for patients with acute and/or chronic pain. Nurses' believed that prescribing encouraged collaborative working and sharing of knowledge across professional boundaries and that this helped to broaden understanding of the wider remit of pain management. Collaboration with doctors served a number of functions, including support and continuous learning. Barriers to effective nurse prescribing were a lack of understanding of its role amongst healthcare professionals and inadequate support. Formal support structures, such as regular clinical supervision, were seen as crucial to meeting nurses' ongoing learning. Factors that promote understanding of nurse prescribing and support inter-professional relationships are likely to have a positive impact on the effectiveness of nurse prescribing. A more consistent approach is required within organisations to support nurse prescribing.

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.

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.

Dissecting through barriers: A mixed-methods study on the effect of interprofessional education in a dissection course with healthcare professional students.

PubMed

Fernandes, Alisha Rebecca; Palombella, Andrew; Salfi, Jenn; Wainman, Bruce

2015-01-01

Healthcare delivery is reliant on a team-based approach, and interprofessional education (IPE) provides a means by which such collaboration skills can be fostered prior to entering the workplace. IPE within healthcare programs has been associated with improved collaborative behavior, patient care and satisfaction, reduced clinical error, and diminished negative professional stereotypes. An intensive interprofessional gross anatomy dissection course was created in 2009 to facilitate IPE at McMaster University. Data were collected from five cohorts over five years to determine the influence of this IPE format on the attitudes and perceptions of students towards other health professions. Each year, 28 students from the medicine, midwifery, nursing, physician's assistant, physiotherapy, and occupational therapy programs were randomly assigned into interprofessional teams for 10 weeks. Sessions involved an anatomy and scope-of-practice presentation, a small-group case-based session, and a dissection. A before/after design measured changes in attitudes and perceptions, while focus group data elaborated on the student experience with the course. Pre- and postmatched data revealed significant improvements in positive professional identity, competency and autonomy, role clarity and attitudes toward other health professions. Qualitative analysis of intraprofessional focus group interviews revealed meaningful improvements in a number of areas including learning anatomy, role clarity, and attitudes towards other health professions. © 2015 American Association of Anatomists.

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.

Where is the client/patient voice in interprofessional healthcare team assessments? Findings from a one-day forum.

PubMed

Soklaridis, Sophie; Romano, Donna; Fung, Wai Lun Alan; Martimianakis, Maria Athina Tina; Sargeant, Joan; Chambers, Jennifer; Wiljer, David; Silver, Ivan

2017-01-01

There is a growing interest in interprofessional care (IPC) as a way to provide better healthcare. However, it is difficult to evaluate this mode of healthcare delivery because identifying the appropriate measurement tool is a challenge, given the wide diversity in team composition and settings. Adding to this complexity is a key gap in the IPC evaluation research: the client/patient perspective. This perspective has generally not been included in the development of IPC healthcare team evaluations. The authors received a Canadian Institute for Health Research Planning Grant to host a one-day forum with 24 participants from across Canada representing health professions such as social work, medicine, occupational therapy, and physical therapy, in addition to researchers, client/patient advocates, and hospital administrators. The overarching goal of the forum was to create a demonstration project that supports the development of an IPC assessment tool for healthcare teams that includes clients/patients. Using a concept mapping methodology, participants discussed client/patient inclusion in IPC assessments, and through a consensus process, chose a demonstration project for further development.

The impact of team based interprofessional comprehensive assessments on the diagnosis and management of diabetic foot ulcers: A retrospective cohort study

PubMed Central

Persaud, Reneeka; Lim, Morgan; Goodman, Laurie; Sibbald, R. Gary

2017-01-01

Background Diabetic foot ulcers (DFU) are increasingly prevalent, and associated with significant morbidity, mortality, and cost. An interprofessional approach to DFU management is critical given the etiological complexity involved. This study aimed to assess the impact of an interprofessional team approach on DFU diagnosis and management for a cohort of patients receiving treatment in an Ontario Canada home care setting. Methods A retrospective cohort study of patients attending a large regional Community Care Access Centre (CCAC) between February 11, 2013-September 30, 2014 was conducted. Following CCAC referral, patients were assessed by an interprofessional team at the Toronto Regional Wound Healing Centre (TRWHC). Those aged > 18 years with a DFU of > 6 weeks duration were included. The primary outcome was the precision of the initial diagnosis relating to DFU etiology (i.e. neuropathic, ischemic or mixed etiology). Secondary outcomes included wound healing, and infection parameters. Analysis was completed with STATA 13.1 (College Stn., TX) of pre-determined outcomes with 2 sided α of 0.05. Results A total of 308 patients were screened, and 49 patients (67.3% male) of mean age 64.2 years (SD 13.7) with a diagnosis of DFU > 6 weeks duration were included for analysis. Of these, 95% were referred with unspecified DFU, and were reclassified to a precise diagnosis relating to etiology, including neuropathy, ischemia or neuroischemic etiology following TRWHC assessment (p < 0.001). For secondary outcomes post-assessment, healability assessment was conducted for a greater proportion of patients (100% versus 44%, p < 0.001). Infection was identified in a greater number of patients (p = 0.04), and of the 35 patients, 94.5% had deep and surrounding infection, and 88.0% were initiated on systemic antibiotics. Vascular insufficiency was diagnosed in an additional 14.3% of the cohort (p = 0.03). Offloading/footwear assessment was conducted in all patients compared with 30.6% prior to referral (p < 0.001) Dressing change frequency decreased significantly following TRWHC assessment (pre: 4.31/week; post: 3.54/week; p = 0.03). Pain scores decreased (2.18 to 1.67) on the numerical rating scale but this was not statistically significant at the final TRWHC assessment. Notably, 36.7% (18/49) reported improved quality of life by the second TRWHC encounter. Conclusions Interprofessional care teams are associated with improved diagnostic acumen and wound healing outcomes over conventional community care services. Initiatives including best practice interprofessional diabetic foot care pathways are recommended with timely vascular management of ischemia, treatment of deep and surrounding infection as well as the availability of foot care and footwear. PMID:28949996

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.

Comprehension through cooperation: Medical students and physiotherapy apprentices learn in teams - Introducing interprofessional learning at the University Medical Centre Mannheim, Germany.

PubMed

Mette, Mira; Dölken, Mechthild; Hinrichs, Jutta; Narciß, Elisabeth; Schüttpelz-Brauns, Katrin; Weihrauch, Ute; Fritz, Harald M

2016-01-01

In order to better prepare future health care professionals for interprofessional cooperation, interprofessional learning sessions for medical students and physiotherapy apprentices were developed at the University Medical Centre Mannheim, Germany. The experience gained from designing, implementing and evaluating these learning sessions is presented and discussed. A total of 265 medical students and 43 physiotherapy apprentices attended five interprofessional learning sessions. Of these, 87-100% responded to closed and open-ended questions on a self-developed questionnaire (24 items). The responses regarding self-reported learning gains, benefit, motivation and satisfaction with the sessions were analyzed separately by professions. The learning sessions were well received by both groups. More than 75% of all participants were of the opinion that they could not have learned the new material in a better way. Significant differences between the medical students and the physiotherapy apprentices were mainly found with regard to perceived learning gains, which physiotherapy apprentices reported as being lower. Positive aspects of interprofessionalism were most often emphasized in the responses to the open-ended questions. Most frequently criticized were organizational aspects and a lack of perceived learning gains. The introduction of interprofessional learning entails great effort in terms of organizational and administrative challenges. However, the project is considered worthwhile because the interprofessional aspects of the learning sessions were indeed valued by the participants. Permanently including and expanding interprofessional learning in the curricula of both professions longitudinally is therefore something to strive for.

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 teamwork and team interventions in chronic care: A systematic review.

PubMed

Körner, Mirjam; Bütof, Sarah; Müller, Christian; Zimmermann, Linda; Becker, Sonja; Bengel, Jürgen

2016-01-01

To identify key features of teamwork and interventions for enhancing interprofessional teamwork (IPT) in chronic care and to develop a framework for further research, we conducted a systematic literature review of IPT in chronic care for the years 2002-2014. Database searches yielded 3217 abstracts, 21 of which fulfilled inclusion criteria. We identified two more studies on the topic by scanning the reference lists of included articles, which resulted in a final total of 23 included studies. The key features identified in the articles (e.g., team member characteristics, common task, communication, cooperation, coordination, responsibility, participation, staff satisfaction, patient satisfaction, and efficiency) were structured in line with the input-process-output model, and evaluated interventions, such as tools, workshops, and changes in team structure, were added to the model. The most frequently evaluated team interventions were complex intervention programs. All but one of the 14 evaluation studies resulted in enhancement of teamwork and/or staff-related, patient-related, and organization-related outcome criteria. To date, there is no consensus about the main features of IPT and the most effective team interventions in chronic care. However, the findings may be used to standardize the implementation and evaluation of IPT and team interventions in practice and for further research.

Refining a self-assessment of informatics competency scale using Mokken scaling analysis.

PubMed

Yoon, Sunmoo; Shaffer, Jonathan A; Bakken, Suzanne

2015-01-01

Healthcare environments are increasingly implementing health information technology (HIT) and those from various professions must be competent to use HIT in meaningful ways. In addition, HIT has been shown to enable interprofessional approaches to health care. The purpose of this article is to describe the refinement of the Self-Assessment of Nursing Informatics Competencies Scale (SANICS) using analytic techniques based upon item response theory (IRT) and discuss its relevance to interprofessional education and practice. In a sample of 604 nursing students, the 93-item version of SANICS was examined using non-parametric IRT. The iterative modeling procedure included 31 steps comprising: (1) assessing scalability, (2) assessing monotonicity, (3) assessing invariant item ordering, and (4) expert input. SANICS was reduced to an 18-item hierarchical scale with excellent reliability. Fundamental skills for team functioning and shared decision making among team members (e.g. "using monitoring systems appropriately," "describing general systems to support clinical care") had the highest level of difficulty, and "demonstrating basic technology skills" had the lowest difficulty level. Most items reflect informatics competencies relevant to all health professionals. Further, the approaches can be applied to construct a new hierarchical scale or refine an existing scale related to informatics attitudes or competencies for various health professions.

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.

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 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.

Interprofessional teaching and learning in the health care professions: A qualitative evaluation of the Robert Bosch Foundation's grant program "Operation Team"

PubMed Central

Nock, Lukas

2016-01-01

Aim: Interprofessional teaching and learning is gaining significance in the health professions. At the same time, the development and implementation of such educational courses is demanding. Focusing on factors critical to success, the aim of this paper is to evaluate the experience gathered by eight grant projects in which interprofessional courses were designed. Emphasis is placed on the level of cooperation between the participating educational institutions, course content, the operative implementation of the course units and their permanent integration into curricula. Method: Data was collected in semi-structured, guideline-based interviews with project leaders and team members (n=43). University and vocational students who had attended the evaluated courses were also included in the survey (n=7) as a means to triangulate data. Analysis was carried out based on qualitative content analysis. Results: A participatory, dialogue-centered model of cooperation appears to be most suited for developing and implementing courses. Belonging to the factors critical to success are the time when courses are offered, the conditions for attendance, the different teaching and learning cultures of the professions involved, preparation and deployment of instructors, and the role played by project coordination. Permanently integrating interprofessional units into medical curricula revealed itself to be difficult. Conclusion: While the development and realization of interprofessional courses can be achieved easily enough in projects, curricular integration of the new course units is challenging. In respect to the latter, not only a large amount of staffing resources and time are required, but also the creation of the necessary system-level structures, not just within the educational institutions (organizational development) but also in the frameworks governing the professions. PMID:27280127

Interprofessional teaching and learning in the health care professions: A qualitative evaluation of the Robert Bosch Foundation's grant program "Operation Team".

PubMed

Nock, Lukas

2016-01-01

Interprofessional teaching and learning is gaining significance in the health professions. At the same time, the development and implementation of such educational courses is demanding. Focusing on factors critical to success, the aim of this paper is to evaluate the experience gathered by eight grant projects in which interprofessional courses were designed. Emphasis is placed on the level of cooperation between the participating educational institutions, course content, the operative implementation of the course units and their permanent integration into curricula. Data was collected in semi-structured, guideline-based interviews with project leaders and team members (n=43). University and vocational students who had attended the evaluated courses were also included in the survey (n=7) as a means to triangulate data. Analysis was carried out based on qualitative content analysis. A participatory, dialogue-centered model of cooperation appears to be most suited for developing and implementing courses. Belonging to the factors critical to success are the time when courses are offered, the conditions for attendance, the different teaching and learning cultures of the professions involved, preparation and deployment of instructors, and the role played by project coordination. Permanently integrating interprofessional units into medical curricula revealed itself to be difficult. While the development and realization of interprofessional courses can be achieved easily enough in projects, curricular integration of the new course units is challenging. In respect to the latter, not only a large amount of staffing resources and time are required, but also the creation of the necessary system-level structures, not just within the educational institutions (organizational development) but also in the frameworks governing the professions.

Engagement studios: students and communities working to address the determinants of health.

PubMed

Bainbridge, Lesley; Grossman, Susan; Dharamsi, Shafik; Porter, Jill; Wood, Victoria

2014-01-01

This article presents an innovative model for interprofessional community-oriented learning. The Engagement Studios model involves a partnership between community organizations and students as equal partners in conversations and activities aimed at addressing issues of common concern as they relate to the social determinants of health. Interprofessional teams of students from health and non-health disciplines work with community partners to identify priority community issues and explore potential solutions. The student teams work with a particular community organization, combining their unique disciplinary perspectives to develop a project proposal, which addresses the community issues that have been jointly identified. Approved proposals receive a small budget to implement the project. In this paper we present the Engagement Studios model and share lessons learned from a pilot of this educational initiative.

Team dynamics within quality improvement teams: a scoping review.

PubMed

Rowland, Paula; Lising, Dean; Sinclair, Lynne; Baker, G Ross

2018-03-31

This scoping review examines what is known about the processes of quality improvement (QI) teams, particularly related to how teams impact outcomes. The aim is to provide research-informed guidance for QI leaders and to inform future research questions. Databases searched included: MedLINE, EMBASE, CINAHL, Web of Science and SCOPUS. Eligible publications were written in English, published between 1999 and 2016. Articles were included in the review if they examined processes of the QI team, were related to healthcare QI and were primary research studies. Studies were excluded if they had insufficient detail regarding QI team processes. Descriptive detail extracted included: authors, geographical region and health sector. The Integrated (Health Care) Team Effectiveness Model was used to synthesize findings of studies along domains of team effectiveness: task design, team process, psychosocial traits and organizational context. Over two stages of searching, 4813 citations were reviewed. Of those, 48 full-text articles are included in the synthesis. This review demonstrates that QI teams are not immune from dysfunction. Further, a dysfunctional QI team is not likely to influence practice. However, a functional QI team alone is unlikely to create change. A positive QI team dynamic may be a necessary but insufficient condition for implementing QI strategies. Areas for further research include: interactions between QI teams and clinical microsystems, understanding the role of interprofessional representation on QI teams and exploring interactions between QI team task, composition and process.

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.

Interprofessional education through service-learning: lessons from a student-led free clinic.

PubMed

Farlow, Janice L; Goodwin, Charles; Sevilla, Javier

2015-05-01

The academic community must replicate and strengthen existing models for interprofessional education (IPE) to meet widespread calls for team-based patient-centered care. One effective but under-explored possibility for IPE is through student-led clinics, which now exist in the majority of medical schools. This short report presents the Indiana University Student Outreach Clinic (IU-SOC), which involves seven different professional programs across three institutions, as a model for how IPE can be delivered formally through service learning. Lessons learned, such as nurturing an intentional interprofessional program, structured orientation and reflection, and resource and knowledge sharing between the clinic and academic institutions, can be applied to all student-led clinics, but also can inform other IPE initiatives in health professional curricula.

[Co-management in geriatric traumatology].

PubMed

Kammerlander, C; Blauth, M; Gosch, M; Böcker, W

2015-09-01

Fragility fractures are becoming more common and are leading to significantly increased morbidity and mortality rates. In order to improve the outcome of these patients, they are increasingly being treated from the beginning interdisciplinarily and interprofessionally as part of co-management models. The main contents of these systems are rapid surgical stabilization for rapid remobilization, treatment with standardized paths and regular communication within the team and a well-functioning discharge management. Furthermore, the organization is a key ingredient in secondary prevention of geriatric traumatology. If this system can be implemented as a whole, this will lead to an improvement of the functional outcomes for the patient as well as to cost savings.

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.

First Contact: interprofessional education based on medical students' experiences from their nursing internship

PubMed Central

Eich-Krohm, Astrid; Kaufmann, Alexandra; Winkler-Stuck, Kirstin; Werwick, Katrin; Spura, Anke; Robra, Bernt-Peter

2016-01-01

Goal: The aim of the course “interprofessional communication and nursing” is to reflect medical students’ experiences from the nursing internship. The content of the course focuses on barriers and support of interprofessional communication as a foundation for teamwork between nursing professionals and physicians. The nursing internship is for most medical students the first contact with nursing professionals and can lead to perceptions about the other group that might hinder interprofessional teamwork and consequently harm patients. To meet the demographic challenges ahead it is important to emphasize interprofessional education in the study of medicine and better prepare future physicians for interprofessional collaboration. Method: The design of the course includes an assessment of a change in the students’ perceptions about nursing and interprofessional communication. The first class meeting presents the starting point of the assessment and visualizes students’ perceptions of nursing and medicine. The content of the following class meetings serve to enhance the students’ knowledge about nursing as a profession with its own theories, science and scholarship. In addition, all students have to write a research paper that entails to interview one nursing professional and one physician about their ideas of interprofessional communication and to compare the interviews with their own experiences from the nursing internship. To access what students learned during the course a reflective discussion takes place at the last meeting combined with an analysis of the students’ research papers. Results: The assessment of the students’ perceptions about the nursing profession and the importance of successful interprofessional communication showed a new and deeper understanding of the topic. They were able to identify barriers and support measures of interprofessional communication and their own responsibilities as part of a team. Conclusion: Interprofessional education is an important part of medical education and should be a topic from the beginning. The assessment of the course shows that it is possible and important to integrate the topic early in the curriculum. PMID:27280131

First Contact: interprofessional education based on medical students' experiences from their nursing internship.

PubMed

Eich-Krohm, Astrid; Kaufmann, Alexandra; Winkler-Stuck, Kirstin; Werwick, Katrin; Spura, Anke; Robra, Bernt-Peter

2016-01-01

The aim of the course "interprofessional communication and nursing" is to reflect medical students' experiences from the nursing internship. The content of the course focuses on barriers and support of interprofessional communication as a foundation for teamwork between nursing professionals and physicians. The nursing internship is for most medical students the first contact with nursing professionals and can lead to perceptions about the other group that might hinder interprofessional teamwork and consequently harm patients. To meet the demographic challenges ahead it is important to emphasize interprofessional education in the study of medicine and better prepare future physicians for interprofessional collaboration. The design of the course includes an assessment of a change in the students' perceptions about nursing and interprofessional communication. The first class meeting presents the starting point of the assessment and visualizes students' perceptions of nursing and medicine. The content of the following class meetings serve to enhance the students' knowledge about nursing as a profession with its own theories, science and scholarship. In addition, all students have to write a research paper that entails to interview one nursing professional and one physician about their ideas of interprofessional communication and to compare the interviews with their own experiences from the nursing internship. To access what students learned during the course a reflective discussion takes place at the last meeting combined with an analysis of the students' research papers. The assessment of the students' perceptions about the nursing profession and the importance of successful interprofessional communication showed a new and deeper understanding of the topic. They were able to identify barriers and support measures of interprofessional communication and their own responsibilities as part of a team. Interprofessional education is an important part of medical education and should be a topic from the beginning. The assessment of the course shows that it is possible and important to integrate the topic early in the curriculum.

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

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.

Innovative interprofessional geriatric education for medical and nursing students: focus on transitions in care.

PubMed

Balogun, S A; Rose, K; Thomas, S; Owen, J; Brashers, V

2015-06-01

Interprofessional education (IPE) is crucial in fostering effective collaboration and optimal team-based patient care, all of which improve patient care and outcomes. Appropriate interprofessional communication is especially important in geriatrics where patients are vulnerable to adverse effects across the care continuum. Transitions in geriatric care are complex, involving several disciplines and requiring careful coordination. As part of the University of Virginia's initiative on IPE, we developed and implemented an interprofessional geriatric education workshop for nursing and medical students with a focus on transitions in care. A total of 254 students (144 medical students, 107 nursing students and 3 unknown) participated in a 90-min interactive, case-based workshop. Nursing and medical faculty facilitated the monthly workshops with small groups of medical and nursing students over 1 year. Self-perceived competencies in IPE skills and attitudes toward interprofessional teamwork were measured through post-workshop surveys. Data were analyzed using descriptive and nonparametric statistics, excluding the three unknown students. Over 90% of students were better able to describe the necessary interprofessional communication needed to develop a patient-centered care plan in transitioning patients between clinical sites. Four out of five students reported an enhanced appreciation of interprofessional teamwork. They were also able to identify legal, financial and social implications in transitions of care (75%). Nursing students consistently rated the workshop more highly than medical students across most domains (P < 0.05). Students improved and demonstrated their knowledge of interprofessional communication and teamwork skills required in transitions of geriatric care. Introducing these concepts in medical and nursing training may help in fostering effective interprofessional communication and collaboration. © The Author 2014. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Holistic Leadership-Nursing's Unique Contribution to Healthcare.

PubMed

Clarke, Pamela N; Bleich, Michael R

2018-04-01

This dialogue is focused on holistic leadership from the perspective of a well-known leader in nursing. He frames the changing healthcare environment and nursing's unique contribution on the interprofessional team.

"Teamwork in hospitals": a quasi-experimental study protocol applying a human factors approach.

PubMed

Ballangrud, Randi; Husebø, Sissel Eikeland; Aase, Karina; Aaberg, Oddveig Reiersdal; Vifladt, Anne; Berg, Geir Vegard; Hall-Lord, Marie Louise

2017-01-01

Effective teamwork and sufficient communication are critical components essential to patient safety in today's specialized and complex healthcare services. Team training is important for an improved efficiency in inter-professional teamwork within hospitals, however the scientific rigor of studies must be strengthen and more research is required to compare studies across samples, settings and countries. The aims of the study are to translate and validate teamwork questionnaires and investigate healthcare personnel's perception of teamwork in hospitals (Part 1). Further to explore the impact of an inter-professional teamwork intervention in a surgical ward on structure, process and outcome (Part 2). To address the aims, a descriptive, and explorative design (Part 1), and a quasi-experimental interventional design will be applied (Part 2). The study will be carried out in five different hospitals (A-E) in three hospital trusts in Norway. Frontline healthcare personnel in Hospitals A and B, from both acute and non-acute departments, will be invited to respond to three Norwegian translated teamwork questionnaires (Part 1). An inter-professional teamwork intervention in line with the TeamSTEPPS recommend Model of Change will be implemented in a surgical ward at Hospital C. All physicians, registered nurses and assistant nurses in the intervention ward and two control wards (Hospitals D and E) will be invited to to survey their perception of teamwork, team decision making, safety culture and attitude towards teamwork before intervention and after six and 12 months. Adult patients admitted to the intervention surgical unit will be invited to survey their perception of quality of care during their hospital stay before intervention and after six and 12 month. Moreover, anonymous patient registry data from local registers and data from patients' medical records will be collected (Part 2). This study will help to understand the impact of an inter-professional teamwork intervention in a surgical ward and contribute to promote healthcare personnel's team competences with an opportunity to achieve changes in work processes and patient safety. Trial registration number (TRN) is ISRCTN13997367. The study was registered retrospectively with registration date 30.05.2017.

Incentives and disincentives for treating of depression and anxiety in Ontario Family Health Teams: protocol for a grounded theory study.

PubMed

Ashcroft, Rachelle; Menear, Matthew; Silveira, Jose; Dahrouge, Simone; McKenzie, Kwame

2016-11-14

There is strong consensus that prevention and management of common mental disorders (CMDs) should occur in primary care and evidence suggests that treatment of CMDs in these settings can be effective. New interprofessional team-based models of primary care have emerged that are intended to address problems of quality and access to mental health services, yet many people continue to struggle to access care for CMDs in these settings. Insufficient attention directed towards the incentives and disincentives that influence care for CMDs in primary care, and especially in interprofessional team-based settings, may have resulted in missed opportunities to improve care quality and control healthcare costs. Our research is driven by the hypothesis that a stronger understanding of the full range of incentives and disincentives at play and their relationships with performance and other contextual factors will help stakeholders identify the critical levers of change needed to enhance prevention and management of CMDs in interprofessional primary care contexts. Participant recruitment began in May 2016. An explanatory qualitative design, based on a constructivist grounded theory methodology, will be used. Our study will be conducted in the Canadian province of Ontario, a province that features a widely implemented interprofessional team-based model of primary care. Semistructured interviews will be conducted with a diverse range of healthcare professionals and stakeholders that can help us understand how various incentives and disincentives influence the provision of evidence-based collaborative care for CMDs. A final sample size of 100 is anticipated. The protocol was peer reviewed by experts who were nominated by the funding organisation. The model we generate will shed light on the incentives and disincentives that are and should be in place to support high-quality CMD care and help stimulate more targeted, coordinated stakeholder responses to improving primary mental healthcare quality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Interprofessional education increases knowledge, promotes team building, and changes practice in the care of Parkinson's disease.

PubMed

Cohen, Elaine V; Hagestuen, Ruth; González-Ramos, Gladys; Cohen, Hillel W; Bassich, Celia; Book, Elaine; Bradley, Kathy P; Carter, Julie H; Di Minno, Mariann; Gardner, Joan; Giroux, Monique; González, Manny J; Holten, Sandra; Joseph, Ricky; Kornegay, Denise D; Simpson, Patricia A; Tomaino, Concetta M; Vandendolder, Richard P; Walde-Douglas, Maria; Wichmann, Rosemary; Morgan, John C

2016-01-01

Examine outcomes for the National Parkinson Foundation (NPF) Allied Team Training for Parkinson (ATTP), an interprofessional education (IPE) program in Parkinson's disease (PD) and team-based care for medicine, nursing, occupational, physical and music therapies, physician assistant, social work and speech-language pathology disciplines. Healthcare professionals need education in evidence-based PD practices and working effectively in teams. Few evidence-based models of IPE in PD exist. Knowledge about PD, team-based care, the role of other disciplines and attitudes towards healthcare teams were measured before and after a protocol-driven training program. Knowledge, attitudes and practice changes were again measured at 6-month post-training. Trainee results were compared to results of controls. Twenty-six NPF-ATTP trainings were held across the U.S. (2003-2013). Compared to control participants (n = 100), trainees (n = 1468) showed statistically significant posttest improvement in all major outcomes, including self-perceived (p < 0.001) and objective knowledge (p < 0.001), Understanding Role of Other Disciplines (p < 0.001), Attitudes Toward Health Care Teams Scale (p < 0.001), and the Attitudes Toward Value of Teams (p < 0.001) subscale. Despite some decline, significant improvements were largely sustained at six-month post-training. Qualitative analyses confirmed post-training practice changes. The NPF-ATTP model IPE program showed sustained positive gains in knowledge of PD, team strategies and role of other disciplines, team attitudes, and important practice improvements. Further research should examine longer-term outcomes, objectively measure practice changes and mediators, and determine impact on patient outcomes. Copyright © 2015 Elsevier Ltd. 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.

Comprehension through cooperation: Medical students and physiotherapy apprentices learn in teams – Introducing interprofessional learning at the University Medical Centre Mannheim, Germany

PubMed Central

Mette, Mira; Dölken, Mechthild; Hinrichs, Jutta; Narciß, Elisabeth; Schüttpelz-Brauns, Katrin; Weihrauch, Ute; Fritz, Harald M.

2016-01-01

Aim: In order to better prepare future health care professionals for interprofessional cooperation, interprofessional learning sessions for medical students and physiotherapy apprentices were developed at the University Medical Centre Mannheim, Germany. The experience gained from designing, implementing and evaluating these learning sessions is presented and discussed. Method: A total of 265 medical students and 43 physiotherapy apprentices attended five interprofessional learning sessions. Of these, 87-100% responded to closed and open-ended questions on a self-developed questionnaire (24 items). The responses regarding self-reported learning gains, benefit, motivation and satisfaction with the sessions were analyzed separately by professions. Results: The learning sessions were well received by both groups. More than 75% of all participants were of the opinion that they could not have learned the new material in a better way. Significant differences between the medical students and the physiotherapy apprentices were mainly found with regard to perceived learning gains, which physiotherapy apprentices reported as being lower. Positive aspects of interprofessionalism were most often emphasized in the responses to the open-ended questions. Most frequently criticized were organizational aspects and a lack of perceived learning gains. Conclusion: The introduction of interprofessional learning entails great effort in terms of organizational and administrative challenges. However, the project is considered worthwhile because the interprofessional aspects of the learning sessions were indeed valued by the participants. Permanently including and expanding interprofessional learning in the curricula of both professions longitudinally is therefore something to strive for. PMID:27280142

Understanding healthcare professionals' self-efficacy to resolve interprofessional conflict.

PubMed

Sexton, Martha; Orchard, Carole

2016-05-01

Conflict within interprofessional healthcare teams, when not effectively resolved, has been linked to detrimental consequences; however, effective conflict resolution has been shown to enhance team performance, increase patient safety, and improve patient outcomes. Alarmingly, knowledge of healthcare professionals' ability to resolve conflict has been limited, largely due to the challenges that arise when researchers attempt to observe a conflict occurring in real time. Research literature has identified three central components that seem to influence healthcare professional's perceived ability to resolve conflict: communication competence, problem-solving ability, and conflict resolution education and training. The purpose of this study was to investigate the impact of communication competence, problem-solving ability, and conflict resolution education and training on healthcare professionals' perceived ability to resolve conflicts. This study employed a cross-sectional survey design. Multiple regression analyses demonstrated that two of the three central components-conflict resolution education and training and communication competence-were found to be statistically significant predictors of healthcare professionals' perceived ability to resolve conflict. Implications include a call to action for clinicians and academicians to recognize the importance of communication competence and conflict resolution education and training as a vital area in interprofessional pre- and post-licensure education and collaborative practice.

Staff perception of interprofessional working relationships after a work redesign intervention in a Danish orthopaedic hand unit outpatient clinic.

PubMed

de Beijer, Anke Elisabeth; Hansen, Torben Bæk; Stilling, Maiken; Jakobsen, Flemming

2016-01-01

There is evidence that clinical pathways improve quality of care; however, knowledge is limited concerning the influence on and the benefits experienced by the interprofessional teams working with these pathways. Our working methods in a hand unit in an orthopaedic outpatient clinic in Denmark were redesigned to include, among other changes, the introduction of clinical pathways. Changes included standardising treatment and communication methods, delegating tasks from medical specialists to nurses, and providing nurses with their own consultation room. Using focus group interviews before and after the implementation of the new working methods, we investigated staff-perceived experiences of the effects on working relationships and the utilisation of professional skills and attitudes, resulting from the mentioned change in working methods. The results were changes in daily communication methods among healthcare staff and improvements in the actual communication and collaborative problem solving skills concerning standard patients with simple hand pathology; however, there are still challenges for patients with more complex hand pathology. Though this new interprofessional arrangement improves the use of nurse and medical specialist professional competencies, it also requires a high degree of trust among the team members.

Patients as educators: interprofessional learning for patient-centred care.

PubMed

Towle, Angela; Godolphin, William

2013-01-01

Patients with chronic conditions have unique expertise that enhances interprofessional education. Although their active involvement in education is increasing, patients have minimal roles in key educational tasks. A model that brings patients and students together for patient-centred learning, with faculty playing a supportive role, has been described in theory but not yet implemented. To identify issues involved in creating an educational intervention designed and delivered by patients and document outcomes. An advisory group of community members, students and faculty guided development of the intervention (interprofessional workshops). Community educators (CEs) were recruited through community organizations with a healthcare mandate. Workshops were planned by teams of key stakeholders, delivered by CEs, and evaluated by post-workshop student questionnaires. Workshops were delivered by CEs with epilepsy, arthritis, HIV/AIDS and two groups with mental health problems. Roles and responsibilities of planning team members that facilitated control by CEs were identified. Ten workshops attended by 142 students from 15 different disciplines were all highly rated. Workshop objectives defined by CEs and student learning both closely matched dimensions of patient-centredness. Our work demonstrates feasibility and impact of an educational intervention led by patient educators facilitated but not controlled by faculty.

Developing inter-professional learning: tactics, teamwork and talk.

PubMed

Begley, Cecily M

2009-04-01

Teamwork and collaboration between all health professionals results in high quality clinical care, and increased job satisfaction for staff. Encouraging inter-professional learning (IPL) may be advantageous in developing more effective teams. There is little rigorous research in this area, but many small uncontrolled studies do demonstrate positive results. IPL involves structured learning opportunities that enhance problem-solving abilities and conflict resolution. It should be clearly differentiated from shared teaching (or multidisciplinary/multiprofessional learning), where common content is taught to many professions without any intention to develop interaction. To counteract the sometimes negative attitudes in both students and staff, educators need to commence IPL early in the programme, base it in both theoretical and clinical placements and ensure that it is valued and assessed. Difficulties with timetabling and accommodation need to be solved prior to commencement. A facilitator should be employed, and a team of committed lecturers developed, with an emphasis on teamwork and the discouragement of individualism. Opportunities for student interaction and ways of improving group dynamics within non-threatening learning environments should to be sought, and instances of conflict embraced and resolved. Future IPL programmes should be rigorously evaluated and may demonstrate enhanced inter-professional relationships and improved quality of patient/client care.

Evaluating team-based inter-professional advanced life support training in intensive care-a prospective observational study.

PubMed

Brewster, D J; Barrett, J A; Gherardin, E; O'Neill, J A; Sage, D; Hanlon, G

2017-01-01

Recent focus on national standards within Australian hospitals has prompted a focus on the training of our staff in advanced life support (ALS). Research in critical care nursing has questioned the traditional annual certification of ALS competence as the best method of delivering this training. Simulation and team-based training may provide better ALS education to intensive care unit (ICU) staff. Our new inter-professional team-based advanced life support program involved ICU staff in a large private metropolitan ICU. A prospective observational study using three standardised questionnaires and two multiple choice questionnaire assessments was conducted. Ninety-nine staff demonstrated a 17.8% (95% confidence interval 4.2-31, P =0.01) increase in overall ICU nursing attendance at training sessions. Questionnaire response rates were 93 (94%), 99 (100%) and 60 (61%) respectively; 51 (52%) staff returned all three. Criteria were assessed by scores from 0 to 10. Nurses reported improved satisfaction with the education program (9.4 to 7.1, P <0.001), as well as improvement in role understanding (8.7 and 9.1 versus 7.9 and 8.2, P <0.001) and confidence (8.4 and 8.8 versus 7.4 and 7.8, P <0.001) during ALS provision (outside ICU and inside ICU) following the course when compared to before the program. Doctors' only statistically significant improvement was in their confidence in ALS provision outside ICU (8.7 versus 8.1, P =0.04). The new program cost approximately an extra $16,500 in nursing salaries. We concluded that team-based, inter-professional ALS training produced statistically significant improvements in nursing attendance, satisfaction with ALS education, confidence and role understanding compared to traditional ALS training.

Simulating a patient's fall as a means to improve routine communication: Joint training for nursing and fifth-year medical students.

PubMed

Flentje, Markus; Müßel, Thomas; Henzel, Bettina; Jantzen, Jan-Peter

2016-01-01

Physicians and nursing staff interact as a team on a daily basis in hospital settings. However, both educational paths offer few opportunities to establish contact with the other professional group. Neither professional group can practice its later role with the other group in a "safe" learning environment. Routine interprofessional collaboration is described as being in need of great improvement and carries with it the potential for conflict. To improve interprofessional communication and task management, a simulation-based emergency training session for nursing students and fifth-year medical students was developed at the KRH Klinikum Nordstadt in Hanover, Germany. As a pilot project, the course was held twice in the form of a one-day session with ten nursing and four medical students. Using the example of a patient's fall, course participants were able to observe and actively treat multiple simulated patients. Following each simulation the trainer conducted a comprehensive debriefing. The course was then evaluated using a questionnaire. The evaluation of the team training showed a high level of acceptance among the two participating professional groups. On a scale of 1 (hardly applicable) to 5 (strongly applicable), the course was given a 4 by both professional groups for its relevance to daily work. In the open-ended written responses praise was specifically given for the opportunity to learn how to switch perspectives as a result of the simulation exercises. A common emergency on the hospital ward offers a good opportunity to establish and practice interprofessional team skills. With the knowledge gained about communication and the ability to change viewpoints, participants are able to improve their team skills. Participants demonstrated a high degree of acceptance for the training program.

Preparing rehabilitation healthcare providers in the 21st century: implementation of interprofessional education through an academic-clinical site partnership.

PubMed

Sheldon, Michael; Cavanaugh, James T; Croninger, William; Osgood, Wendy; Robnett, Regi; Seigle, Janice; Simonsen, Linda

2012-01-01

Health profession education programs often struggle with barriers to implementing interprofesssional educational (IPE) initiatives, limiting early and consistent exposure of students to core IPE competencies. Few published reports are available to guide the implementation of IPE programs into practice. This article describes a successful and evolving partnership between an independent university and a tertiary care hospital. The IPE goals of this partnership were to expose students to roles of other disciplines in the complex hospital environment and integrate acute care exposure throughout the Doctor of Physical Therapy and Master of Science in Occupational Therapy curricula. Faculty and students, patients and families, and occupational and physical therapy clinicians participated in a series of learning activities in an acute care setting involving interprofessional teams of students. Activities included observations of OT and PT clinicians providing standard patient care, practice conducting team patient interviews, and interactive treatment planning sessions conducted live via videoconferencing technology between a patient's hospital room and an academic classroom on the university campus. The activities generally were designed to improve student preparedness for working as part of an interprofessional team in an acute care setting. Student and clinician feedback support the early development of student IPE competencies, including the appreciation and understanding of professional roles in the team approach to patient care and the development of effective communication skills. The partnership between the academic institution and tertiary care hospital is an effective vehicle to deliver and sustain IPE educational initiatives in the acute care setting. Current and planned IPE curriculum integration are discussed along with a preliminary analysis of IPE outcomes.

On a wing and a prayer: an assessment of modularized crew resource management training for health care professionals.

PubMed

Clay-Williams, Robyn; Greenfield, David; Stone, Judy; Braithwaite, Jeffrey

2014-01-01

Evidence suggests that Crew Resource Management (CRM), a form of team training, is beneficial. In CRM training, participants learn individual portable team skills such as communication and decision making through group discussion and activities. However, the usual 1-day course format is not always compatible with health care organizational routines. A modular training format, while theoretically sound, is untested for interprofessional team training. The aim of this study was to explore the potential for modularized CRM training to be delivered to a group of interprofessional learners. Modularized CRM training, consisting of two 2-hour workshops, was delivered to health care workers in an Australian tertiary hospital. Kirkpatrick's evaluation model provided a framework for the study. Baseline attitude surveys were conducted prior to each workshop. Participants completed a written questionnaire at the end of each workshop that examined their motivations, reactions to the training, and learner demographics. An additional survey, administered 6 weeks post training, captured self-assessed behavior data. Twenty-three individuals from a range of professions and clinical streams participated. One in 5 participants (22%) reported that they translated teamwork skills to the workplace. While positive about the workshop format and content, many respondents identified personal, team, and organizational barriers to the application of the workshop techniques. CRM training when delivered in a modular format has positive outcomes. Following the training, some respondents overcame workplace barriers to attempt to change negative workplace behavior. This progress provides cautious optimism for the potential for modular CRM training to benefit groups of interprofessional health staff. © 2014 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education.

Acute care clinical pharmacy practice: unit- versus service-based models.

PubMed

Haas, Curtis E; Eckel, Stephen; Arif, Sally; Beringer, Paul M; Blake, Elizabeth W; Lardieri, Allison B; Lobo, Bob L; Mercer, Jessica M; Moye, Pamela; Orlando, Patricia L; Wargo, Kurt

2012-02-01

This commentary from the 2010 Task Force on Acute Care Practice Model of the American College of Clinical Pharmacy was developed to compare and contrast the "unit-based" and "service-based" orientation of the clinical pharmacist within an acute care pharmacy practice model and to offer an informed opinion concerning which should be preferred. The clinical pharmacy practice model must facilitate patient-centered care and therefore must position the pharmacist to be an active member of the interprofessional team focused on providing high-quality pharmaceutical care to the patient. Although both models may have advantages and disadvantages, the most important distinction pertains to the patient care role of the clinical pharmacist. The unit-based pharmacist is often in a position of reacting to an established order or decision and frequently is focused on task-oriented clinical services. By definition, the service-based clinical pharmacist functions as a member of the interprofessional team. As a team member, the pharmacist proactively contributes to the decision-making process and the development of patient-centered care plans. The service-based orientation of the pharmacist is consistent with both the practice vision embraced by ACCP and its definition of clinical pharmacy. The task force strongly recommends that institutions pursue a service-based pharmacy practice model to optimally deploy their clinical pharmacists. Those who elect to adopt this recommendation will face challenges in overcoming several resource, technologic, regulatory, and accreditation barriers. However, such challenges must be confronted if clinical pharmacists are to contribute fully to achieving optimal patient outcomes. © 2012 Pharmacotherapy Publications, Inc.

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.

A Quality Improvement Activity to Promote Interprofessional Collaboration Among Health Professions Students

PubMed Central

Stevenson, Katherine; Busch, Angela; Scott, Darlene J.; Henry, Carol; Wall, Patricia A.

2009-01-01

Objectives To develop and evaluate a classroom-based curriculum designed to promote interprofessional competencies by having undergraduate students from various health professions work together on system-based problems using quality improvement (QI) methods and tools to improve patient-centered care. Design Students from 4 health care programs (nursing, nutrition, pharmacy, and physical therapy) participated in an interprofessional QI activity. In groups of 6 or 7, students completed pre-intervention and post-intervention reflection tools on attitudes relating to interprofessio nal teams, and a tool designed to evaluate group process. Assessment One hundred thirty-four students (76.6%) completed both self-reflection instruments, and 132 (74.2%) completed the post-course group evaluation instrument. Although already high prior to the activity, students' mean post-intervention reflection scores increased for 12 of 16 items. Post-intervention group evaluation scores reflected a high level of satisfaction with the experience. Conclusion Use of a quality-based case study and QI methodology were an effective approach to enhancing interprofessional experiences among students. PMID:19657497

Developing Staffing Models to Support Population Health Management And Quality Oucomes in Ambulatory Care Settings.

PubMed

Haas, Sheila A; Vlasses, Frances; Havey, Julia

2016-01-01

There are multiple demands and challenges inherent in establishing staffing models in ambulatory heath care settings today. If health care administrators establish a supportive physical and interpersonal health care environment, and develop high-performing interprofessional teams and staffing models and electronic documentation systems that track performance, patients will have more opportunities to receive safe, high-quality evidence-based care that encourages patient participation in decision making, as well as provision of their care. The health care organization must be aligned and responsive to the community within which it resides, fully invested in population health management, and continuously scanning the environment for competitive, regulatory, and external environmental risks. All of these challenges require highly competent providers willing to change attitudes and culture such as movement toward collaborative practice among the interprofessional team including the patient.

Interprofessional Education: Opportunities and Challenges for Psychology.

PubMed

Ward, Wendy; Zagoloff, Alexandra; Rieck, Cortney; Robiner, William

2018-02-16

This manuscript is an outgrowth of an invited panel presentation at the national Association for Psychologists in Academic Health Centers Conference in 2017 on Interprofessional Education (IPE). IPE is a structured and transformative educational strategy designed to provide active learning experiences where trainees from diverse healthcare professions gain shared content knowledge plus collaboration skills as they learn about, from, and with each other. Collaboration skills include understanding professional role distinctions and overlap, effective team-based communication, shared values/ethics and respect for each other's expertise, and teamwork dynamics. It is increasingly important to expand training beyond the intraprofessional activities in which psychology trainees engage to prepare them to participate in interprofessional collaborative care. As healthcare systems move to team-based collaborative practice and value-based reimbursement models, the profession of psychology needs leaders at every academic health center to facilitate the design and/or implementation of IPE activities. The panel of psychologists presented roles that psychologists play in IPE institutional program design and implementation, graduate training programs, and the perspectives of an early career psychologist and psychology trainee. Opportunities and challenges are highlighted, culminating in a call to action. Psychologists must embrace their identity as health professionals and engage their learners in IPE so that the emerging cognitive schemata of healthcare that is developed includes the profession of psychology. Otherwise, healthcare teams and health professionals will not understand the value, roles, or potential contributions of psychologists in enhancing patient care outcomes, ultimately jeopardizing psychologists' referrals, involvement in healthcare delivery, and career opportunities.

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

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.

Developing cultural competence through self-reflection in interprofessional education: Findings from an Australian university.

PubMed

Olson, Rebecca; Bidewell, John; Dune, Tinashe; Lessey, Nkosi

2016-05-01

Interprofessional education and cultural competence are both necessary for health professionals working in interprofessional teams serving diverse populations. Using a pre-post-survey case series design, this study evaluates a novel learning activity designed to encourage self-reflection and cultural competence in an Australian interprofessional education context. Undergraduate health professional students in a large subject viewed three 7-15 minute videos featuring interviews with persons of a minority cultural, linguistic, or sexual group who were living with a disability or managing a health condition. Immediately afterwards, students in interprofessional groups completed a structured activity designed to promote interprofessional and cultural reflection. A localised version of a validated scale measured cultural competence before and after the learning activity. Results suggest the value of video-based learning activities based on real-life examples for improving cultural competence. Despite initially rating themselves highly, 64% of students (n = 273) improved their overall cultural competence, though only by M = 0.13, SD = 0.08, of a 5-point rating-scale interval. A nuanced approach to interpreting results is warranted; even slight increases may indicate improved cultural competence. Suggestions for improving the effectiveness of video-based cultural competence learning activities, based on qualitative findings, are provided. Overall the findings attest to the merit of group discussion in cultural competence learning activities in interprofessional education settings. However, the inclusion of group discussions within such learning activities should hinge on group dynamics.

The Interdisciplinary Curriculum for Oncology Palliative Care Education (iCOPE): meeting the challenge of interprofessional education.

PubMed

Head, Barbara A; Schapmire, Tara; Hermann, Carla; Earnshaw, Lori; Faul, Anna; Jones, Carol; Kayser, Karen; Martin, Amy; Shaw, Monica Ann; Woggon, Frank; Pfeifer, Mark

2014-10-01

Background: Interprofessional education is necessary to prepare students of the health professions for successful practice in today's health care environment. Because of its expertise in interdisciplinary practice and team-based care, palliative care should be leading the way in creating educational opportunities for students to learn the skills for team practice and provision of quality patient-centered care. Multiple barriers exist that can discourage those desiring to create and implement truly interdisciplinary curriculum. An interdisciplinary faculty team planned and piloted a mandatory interdisciplinary palliative oncology curriculum and responded to formative feedback. The project took place at a large public metropolitan university. Medical, nursing, and social work students and chaplains completing a clinical pastoral education internship participated in the curriculum. Formative feedback was received via the consultation of an interdisciplinary group of palliative education experts, focus groups from students, and student evaluations of each learning modality. Multiple barriers were experienced and successfully addressed by the faculty team. Curricular components were redesigned based on formative feedback. Openness to this feedback coupled with flexibility and compromise enabled the faculty team to create an efficient, sustainable, and feasible interdisciplinary palliative oncology curriculum. Interdisciplinary palliative education can be successful if faculty teams are willing to confront challenges, accept feedback on multiple levels, and compromise while maintaining focus on desired learner outcomes.

Person-Centered Care: A Definition and Essential Elements.

PubMed

2016-01-01

Improving healthcare safety, quality, and coordination, as well as quality of life, are important aims of caring for older adults with multiple chronic conditions and/or functional limitations. Person-centered care is an approach to meeting these aims, but there are no standardized, agreed-upon parameters for delivering such care. The SCAN Foundation charged a team from the American Geriatrics Society (AGS) in collaboration with a research and clinical team from the Keck School of Medicine of the University of Southern California to provide the evidence base to support a definition of person-centered care and its essential elements. An interprofessional panel of experts in person-centered care principles and practices that the AGS convened developed this statement. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

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.

Addressing outpatient continuity for ambulatory training: A novel tool for longitudinal primary care sign out.

PubMed

Long, Theodore; Uradu, Andrea; Castillo, Ronald; Brienza, Rebecca

2016-01-01

We created a tool to improve communication among health professional trainees in the ambulatory setting. The tool was devised to both inform practice partner teams about high-risk patients and assign patient follow-up issues to team members. Team members were internal medicine residents and nurse practitioner fellows in the VA Connecticut Healthcare System Center of Excellence in Primary Care Education (CoEPCE), an interprofessional training model in primary care. We used a combination of Likert scale response questions and open ended questions to evaluate trainee attitudes before and after the implementation of the tool, as well as solicited feedback to improve the tool. After using the primary care sign out tool, trainees expressed greater confidence that they could identify high-risk patients that had been cared for by other trainees and that important patient care issues would be followed up by others when they were not in clinic. In terms of areas for improvement, respondents wanted to have the sign out tool posted online. Our sign out tool offers a strategy that others can use to improve communication and knowledge of shared patients within teams comprised of interprofessional trainees.

Preparing healthcare students who participate in interprofessional education for interprofessional collaboration: A constructivist grounded theory study protocol.

PubMed

Bianchi, Monica; Bagnasco, Annamaria; Aleo, Giuseppe; Catania, Gianluca; Zanini, Milko Patrick; Timmins, Fiona; Carnevale, Franco; Sasso, Loredana

2018-05-01

This article presents a qualitative research protocol to explore and understand the interprofessional collaboration (IPC) preparation process implemented by clinical tutors and students of different professions involved in interprofessional education (IPE). Many studies have shown that IPE initiatives improve students' understanding of the roles and responsibilities of other professionals. This improves students' attitudes towards other professions, facilitating mutual respect, and IPC. However, there is limited information about how students are prepared to work collaboratively within interprofessional teams. This is a constructivist grounded theory (GT) study, which will involve data collection through in-depth semi-structured interviews (to 9-15 students and 6-9 clinical tutors), participant observations, and the analysis of documentation. After analysing, coding, integrating, and comparing the data if necessary, a second round of interviews could be conducted to explore any particularly interesting aspects or clarify any issues. This will then be followed by focused and theoretical coding. Qualitative data analysis will be conducted with the support of NVivo 10 software (Victoria, Australia). A better conceptual understanding will help to understand if IPE experiences have contributed to the acquisition of competencies considered important for IPC, and if they have facilitated the development of teamwork attitudes.

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.

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.