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Cahn PS, Watkins Liu C, Hobbs M. Using narrative to integrate anti-oppression into interprofessional collaborative practice competencies. J Interprof Care 2024; 38:583-586. [PMID: 38219266 DOI: 10.1080/13561820.2024.2303498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/04/2024] [Indexed: 01/16/2024]
Abstract
Many institutions of higher education have designed curricula for health professions learners based on the Interprofessional Education Collaborative (IPEC) core competencies for interprofessional collaborative practice. As part of a periodic cycle of revision, in 2023, IPEC released revised competencies that, for the first time, explicitly embedded concepts of anti-oppressive practice. Curriculum designers seeking to revise their interprofessional learning activities to map onto the new competencies can benefit from the experience of a health professions graduate school in Boston, MA. Since 2021, faculty members and experts in justice, equity, diversity, and inclusion have revamped a required interprofessional education curriculum to include anti-oppression competencies. They targeted narrative elements of the courses like a common reading, case studies, and simulation scenarios for revision. By using narrative to introduce anti-oppression competencies like recognizing bias, analyzing systems of power, and intervening to mitigate microaggressions, course designers encouraged learners to cultivate reflection about their relationship to the care team, the patient, and the community.
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Affiliation(s)
- Peter S Cahn
- Office of the Provost, MGH Institute of Health Professions, Boston, MA, USA
| | - Callie Watkins Liu
- Office of Justice, Equity, Diversity, and Inclusion, MGH Institute of Health Professions, Boston, MA, USA
| | - Midge Hobbs
- Office of the Provost, MGH Institute of Health Professions, Boston, MA, USA
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Chou YF, Hsieh SI, Tseng YP, Yeh SL, Chiang MC, Hsiao CC, Lin CT, Hu ST, Chen SH, Liao MN. Development and Validation of the Interprofessional Collaboration Practice Competency Scale (IPCPCS) for Clinical Nurses. Healthcare (Basel) 2024; 12:806. [PMID: 38610228 PMCID: PMC11012165 DOI: 10.3390/healthcare12070806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 03/12/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024] Open
Abstract
Interprofessional collaborative practice is a core competency and is the key to strengthening health practice systems in order to deliver safe and high-quality nursing practice. However, there is no Interprofessional Collaboration Practice Competency Scale (IPCPCS) for clinical nurses in Taiwan. Therefore, the purposes of this study were to develop an IPCPCS and to verify its reliability and validity. This was a psychometric study with a cross-sectional survey using convenience sampling to recruit nurses from the seven hospitals of a medical foundation. A self-designed structured IPCPCS was rolled out via a Google survey. The data were analyzed using descriptive statistics, principal-axis factoring (PAF) with Promax rotation, Pearson correlation, reliability analysis, and one-way ANOVA. PAF analysis found that three factors could explain 77.76% of cumulative variance. These were collaborative leadership and interprofessional conflict resolution, interprofessional communication and team functioning, and role clarification and client-centered care. The internal consistency of the three factors (Cronbach's α) was between 0.970 to 0.978, and the Pearson correlation coefficients were between 0.814 to 0.883. Significant differences were presented in the IPCPCS score by age, education level, total years of work experience, position on the nursing clinical ladder, and participation in interprofessional education. In conclusion, the three factors used in the IPCPCS have good reliability and construct validity. This scale can be used as an evaluation tool of in-service interprofessional education courses for clinical nurses.
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Affiliation(s)
- Yen-Fang Chou
- Department of Nursing, Chiayi Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan; (Y.-F.C.); (C.-C.H.)
- School of Nursing, College of Nursing, Taipei Medical University, Taipei City 11031, Taiwan
- Department of Gerontology and Health Care Management, Chang Gung University of Science and Technology, Taoyuan City 33303, Taiwan
| | - Suh-Ing Hsieh
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan City 33303, Taiwan
| | - Yi-Ping Tseng
- Department of Nursing, Taoyuan Chang Gung Memorial Hospital, Taoyuan City 33378, Taiwan;
- School of Nursing, College of Medicine, National Taiwan University, Taipei City 10617, Taiwan
| | - Shu-Ling Yeh
- Department of Nursing, Keelung Chang Gung Memorial Hospital, Keelung City 20401, Taiwan; (S.-L.Y.); (S.-T.H.)
| | - Ming-Chu Chiang
- Department of Nursing, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung City 83301, Taiwan;
| | - Chia-Chi Hsiao
- Department of Nursing, Chiayi Chang Gung Memorial Hospital, Chiayi County 61363, Taiwan; (Y.-F.C.); (C.-C.H.)
| | - Chiu-Tzu Lin
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan City 33305, Taiwan;
| | - Shui-Tao Hu
- Department of Nursing, Keelung Chang Gung Memorial Hospital, Keelung City 20401, Taiwan; (S.-L.Y.); (S.-T.H.)
| | - Sue-Hsien Chen
- Administration Center, Chang Gung Medical Foundation, Taoyuan City 33305, Taiwan; (S.-H.C.); (M.-N.L.)
- Department of Nursing, Chang Gung University, Taoyuan City 33375, Taiwan
| | - Mei-Nan Liao
- Administration Center, Chang Gung Medical Foundation, Taoyuan City 33305, Taiwan; (S.-H.C.); (M.-N.L.)
- Department of Nursing, Chang Gung University, Taoyuan City 33375, Taiwan
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Kerins J, Smith SE, Tallentire VR. "Ego massaging that helps": a framework analysis study of internal medicine trainees' interprofessional collaboration approaches. MEDICAL EDUCATION ONLINE 2023; 28:2243694. [PMID: 37535844 PMCID: PMC10402837 DOI: 10.1080/10872981.2023.2243694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/19/2023] [Accepted: 07/28/2023] [Indexed: 08/05/2023]
Abstract
INTRODUCTION Patient care depends on collaborative practice. Debate remains as to the best approach to providing education for collaboration, with educational interventions often far removed from the realities of the clinical workplace. Understanding the approaches used for collaboration in clinical practice could inform practical strategies for training. For internal medicine trainees, this involves collaboration with other professions but also with other specialties. This study aimed to explore the approaches that internal medicine trainees use for interprofessional collaboration and the ways that these approaches vary when internal medicine trainees interact with different healthcare provider groups. METHODS Following ethical approval and participant consent, interprofessional communication workshops between August 2020 and March 2021 were audio recorded and transcribed verbatim. Workshops involved groups of internal medicine trainees discussing collaboration challenges and the approaches they use in clinical practice. This framework analysis study used the interprofessional collaboration framework described by Bainbridge and Regehr (building social capital, perspective taking and negotiating priorities and resources), and cross-referenced the categorised data with the healthcare groups that trainees collaborate with, to look for patterns in the data. RESULTS Seventeen workshops, involving 100 trainees, were included. Trainees described relationship building, perspective taking and negotiating priorities and resources. Relationship building was a modification to the original framework domain of building social capital. Themes of power and civility transcended domains with evidence of using hierarchy as leverage when negotiating and employing civility as a tactical approach throughout. DISCUSSION This bi-dimensional analysis highlights patterns of perspective taking when collaborating with other specialties and professions, and the approaches to negotiation of courting favour and coercion when interacting with other specialties. This study provides evidence of the strategies currently utilised by internal medicine trainees, with different healthcare groups, and presents a modified framework which could inform the development of training for collaboration.
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Affiliation(s)
- Joanne Kerins
- Scottish Centre for Simulation and Clinical Human Factors, NHS Forth Valley, Larbert, UK
- Acute medicine, NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK
| | - Samantha Eve Smith
- Scottish Centre for Simulation and Clinical Human Factors, NHS Forth Valley, Larbert, UK
- Medical Education Directorate, NHS Lothian, Edinburgh, UK
| | - Victoria Ruth Tallentire
- Scottish Centre for Simulation and Clinical Human Factors, NHS Forth Valley, Larbert, UK
- Medical Education Directorate, NHS Lothian, Edinburgh, UK
- Medical Directorate, NHS Education for Scotland, Edinburgh, Scotland, UK
- College of Medicine and Vetinary Medicine, University of Edinburgh, Edinburgh, Scotland, UK
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Chou WK, Cheng MT, Lin CH, Shih FY. The Effectiveness of Functional Exercises for Teaching Method Disaster Medicine to Medical Students. Cureus 2021; 13:e15151. [PMID: 34178486 PMCID: PMC8216576 DOI: 10.7759/cureus.15151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction Functional exercises are effective for testing disaster management training. Previously, we found that functional exercises promote student engagement and improve the perception of learning after exercise. Objective The study objective is to investigate whether functional exercise is effective for teaching disaster medicine. Methods Students who partook in a two-day course of disaster medicine were recruited. The course consisted of lectures and workshops followed by a half-day functional exercise and was designed based on four core competency domains which included major disaster medicine concepts. After the lectures and workshops, participants completed a test to assess their knowledge of the core competency domains and a questionnaire to evaluate their willingness to pursue further training and participate in a disaster medical assistance team (DMAT) and their interest in disaster exercises. The functional exercise involved the scenario of an earthquake and mass-casualty incident and participants acted as DMAT members in the exercise. A post-exercise debrief was conducted by the evaluators to discuss performance and evaluate the results of the exercise. Participants then completed the same tests and questionnaires as before the exercise. Results Ninety-seven students were recruited, 72 of which were medical students. Pre- and post-exercise tests and questionnaires were completed by 48. We found disaster scene safety knowledge to be significantly improved after the functional exercise. Students’ willingness for further training and participation in a DMAT as well as their interest in disaster training was high before and after the exercise. Conclusion Disaster scene safety is a vital element of disaster medicine training but it is difficult to teach. Functional exercises represent a good tool for this purpose and can maintain enthusiasm for learning and participating in disaster medicine-related activities.
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Affiliation(s)
- Wei-Kuo Chou
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, TWN
| | - Ming-Tai Cheng
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, TWN
| | - Chien-Hao Lin
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, TWN
| | - Fuh-Yuan Shih
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, TWN
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Brottman MR, Char DM, Hattori RA, Heeb R, Taff SD. Toward Cultural Competency in Health Care: A Scoping Review of the Diversity and Inclusion Education Literature. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:803-813. [PMID: 31567169 DOI: 10.1097/acm.0000000000002995] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
PURPOSE To explore best practices for increasing cultural competency and reducing health disparities, the authors conducted a scoping review of the existing literature. METHOD The review was guided by 2 questions: (1) Are health care professionals and medical students learning about implicit bias, health disparities, advocacy, and the needs of diverse patient populations? (2) What educational strategies are being used to increase student and educator cultural competency? In August 2016 and July 2018, the authors searched 10 databases (including Ovid MEDLINE, Embase, and Scopus) and MedEdPORTAL, respectively, using keywords related to multiple health professions and cultural competency or diversity and inclusion education and training. Publications from 2005 to August 2016 were included. Results were screened using a 2-phase process (title and abstract review followed by full-text review) to determine if articles met the inclusion or exclusion criteria. RESULTS The search identified 89 articles that specifically related to cultural competency or diversity and inclusion education and training within health care. Interventions ranged from single-day workshops to a 10-year curriculum. Eleven educational strategies used to teach cultural competency and about health disparities were identified. Many studies recommended using multiple educational strategies to develop knowledge, awareness, attitudes, and skills. Less than half of the studies reported favorable outcomes. Multiple studies highlighted the difficulty of implementing curricula without trained and knowledgeable faculty. CONCLUSIONS For the field to progress in supporting a culturally diverse patient population, comprehensive training of trainers, longitudinal evaluations of interventions, and the identification and establishment of best practices will be imperative.
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Affiliation(s)
- Melissa R Brottman
- M.R. Brottman is currently occupational therapist, Schwab Rehabilitation Hospital, Chicago, Illinois. At the time of writing, she was a third-year clinical doctorate student, Program in Occupational Therapy, Washington University School of Medicine in St. Louis, St. Louis, Missouri. D.M. Char is professor of emergency medicine and director of faculty development for emergency medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri. R.A. Hattori is senior project manager, Program in Occupational Therapy, Washington University School of Medicine in St. Louis, St. Louis, Missouri. R. Heeb was a third-year clinical doctorate student, Program in Occupational Therapy, Washington University School of Medicine in St. Louis, St. Louis, Missouri, at the time of writing. She is currently a rehabilitation and participation science doctoral student, Program in Occupational Therapy, Washington University School of Medicine in St. Louis, St. Louis, Missouri. S.D. Taff is associate professor of occupational therapy and medicine and director, Division of Professional Education, Program in Occupational Therapy, Washington University School of Medicine in St. Louis, St. Louis, Missouri
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Javadi M, Ashrafi N, Salari P. Assessment of Pharmacists Experiences and Attitudes Toward Professionalism and its Challenges in Pharmacy Practice. IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2018; 17:168-177. [PMID: 29796042 PMCID: PMC5958337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Nowadays pharmacists should be involved in patients care and providing pharmaceutical care more than before, but still there is a gap between standard of care and pharmacy practice in pharmacies. In this study we aimed at evaluating the pharmacists experiences and attitudes about ethical professional practice in pharmacies. The study was conducted in the Tehran University of Medical Sciences, Tehran, Iran. This study performed as a mixed method study including 12 semi-structured interviews and two focus group discussions (FGDs). All interviews and FGDs were recorded verbatim. The study evaluates the pharmacy practice based on the Code of Ethics for National Pharmaceutical System requirements. Our study presents the pharmacists ethical challenges in 14 areas of practice such as lack of proper pharmacists-patients and inter and intra-professional relationship; poor management of medication error; lack of pharmacists awareness about their responsibilities, professional rules and regulations; non-OTC drug dispensing without prescription; no collaboration with custodian organizations; dissatisfaction from profession; financial problems; mismanagement in confronting with ads and offers of pharmaceutical companies, and conflict of interest; and uneven drug distribution during shortage. For providing standard pharmaceutical care modification of infra structures, educational system and regulations in pharmaceutical system is highly recommended.
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Affiliation(s)
- Mohammadreza Javadi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences.
| | - Nikinaz Ashrafi
- Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.
| | - Pooneh Salari
- Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences.
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Patel Gunaldo T, Brisolara KF, Davis AH, Moore R. Aligning interprofessional education collaborative sub-competencies to a progression of learning. J Interprof Care 2017; 31:394-396. [PMID: 28272902 DOI: 10.1080/13561820.2017.1285273] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
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.
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Affiliation(s)
- Tina Patel Gunaldo
- a Center for Interprofessional Education and Collaborative Practice , Louisiana State University Health New Orleans , New Orleans , Louisiana , USA
| | - Kari Fitzmorris Brisolara
- b Department of Environmental and Occupational Health Sciences, School of Public Health , Louisiana State University Health New Orleans , New Orleans , Louisiana , USA
| | - Alison H Davis
- c School of Nursing , Louisiana State University Health New Orleans , New Orleans , Louisiana , USA
| | - Robert Moore
- a Center for Interprofessional Education and Collaborative Practice , Louisiana State University Health New Orleans , New Orleans , Louisiana , USA
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Lie DA, Richter-Lagha R, Forest CP, Walsh A, Lohenry K. When less is more: validating a brief scale to rate interprofessional team competencies. MEDICAL EDUCATION ONLINE 2017; 22:1314751. [PMID: 28475438 PMCID: PMC5508637 DOI: 10.1080/10872981.2017.1314751] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 03/29/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND 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. OBJECTIVE 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. DESIGN 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). RESULTS 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). CONCLUSION 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. ABBREVIATIONS IPE: Interprofessional education; SP: Standardized patient; TOSCE: Team objective structured clinical encounter.
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Affiliation(s)
- Désirée A. Lie
- Department of Family Medicine, Keck School of Medicine of the University of Southern California, CA, USA
| | - Regina Richter-Lagha
- Department of Family Medicine, Keck School of Medicine of the University of Southern California, CA, USA
| | - Christopher P. Forest
- Department of Family Medicine, Keck School of Medicine of the University of Southern California, CA, USA
| | - Anne Walsh
- Department of Family Medicine, Keck School of Medicine of the University of Southern California, CA, USA
| | - Kevin Lohenry
- Department of Family Medicine, Keck School of Medicine of the University of Southern California, CA, USA
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