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Schwartz JI, Gonzalez-Colaso R, Gan G, Deng Y, Kaplan MH, Vakos PA, Kenyon K, Ashman A, Sofair AN, Huot SJ, Chaudhry SI. Structured interdisciplinary bedside rounds improve interprofessional communication and workplace efficiency among residents and nurses on an inpatient internal medicine unit. J Interprof Care 2024; 38:427-434. [PMID: 33433262 DOI: 10.1080/13561820.2020.1863932] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 11/06/2020] [Accepted: 12/08/2020] [Indexed: 10/22/2022]
Abstract
Structured Interdisciplinary Bedside Rounds (SIBR) is a standardized, team-based intervention for hospitals to deliver high quality interprofessional care. Despite its potential for improving IPC and the workplace environment, relatively little is known about SIBR's effect on these outcomes. Our study aimed to assess the fidelity of SIBR implementation on an inpatient medicine teaching unit and its effects on perceived IPC and workplace efficiency. We conducted a quasi-experimental study with 88 residents and 44 nurses at a large academic medical center and observed 1308 SIBR encounters over 24 weeks. Of these 1308 encounters, the bedside nurse was present for 96.7%, physician for 97.6%, and care manager for 94.7, and 64.7% occurred at the bedside. Following SIBR implementation, perceived IPC improved significantly among residents (93.3% versus 67.9%, p < .024) and nurses (73.7% versus 36.0%, p < .008) compared to before implementation. Moreover, residents perceived greater workplace efficiency operationalized as being paged less frequently with questions by nurses (20.0% versus 49.1%, p = .01). No statistically significant improvements were reported regarding burnout, meaning at work, and workplace satisfaction. Our implementation of SIBR significantly improved perceived IPC and workplace efficiency, which are two important domains of healthcare quality. Future work should examine the impact of SIBR on patient-centered outcomes such as patient experience.
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Affiliation(s)
- Jeremy I Schwartz
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | | | - Geliang Gan
- Yale Center for Analytic Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Yanhong Deng
- Yale Center for Analytic Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Michael H Kaplan
- Department of Medicine, Icahn School of Medicine, New York, NY, USA
| | | | | | | | - Andre N Sofair
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Stephen J Huot
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Sarwat I Chaudhry
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
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Ohta R, Nitta T, Shimizu A, Sano C. Role of family medicine physicians in providing nutrition support to older patients admitted to orthopedics departments: a grounded theory approach. BMC Prim Care 2024; 25:121. [PMID: 38641569 PMCID: PMC11027398 DOI: 10.1186/s12875-024-02379-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 04/09/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Care of older adults requires comprehensive management and control of systemic diseases, which can be effectively managed by family physicians. Complicated medical conditions in older patients admitted to orthopedic departments (orthopedic patients) necessitate interprofessional collaboration. Nutrition is one of the essential components of management involved in improving the systemic condition of older patients. Nutrition support teams play an important role in nutrition management and can be supported by family physicians. However, the role of family physicians in nutrition support teams is not well documented. This study aimed to investigate the role of family physicians in supporting nutrition management in orthopedic patients. METHODS This qualitative study was conducted between January and June 2023 using constructivist grounded theory methodology. Eight family medicine physicians, three orthopedic surgeons, two nurses, two pharmacists, four rehabilitation therapists, four nutritionists, and one laboratory technician working in Japanese rural hospitals participated in the research. Data collection was performed through ethnography and semi-structured interviews. The analysis was performed iteratively during the study. RESULTS Using a grounded theory approach, four theories were developed regarding family physicians' role in providing nutrition support to orthopedic patients: hierarchical and relational limitation, delay of onset and detection of the need for geriatric care in orthopedic patients, providing effective family medicine in hospitals, and comprehensive management through the nutrition support team. CONCLUSIONS The inclusion of family physicians in nutrition support teams can help with early detection of the rapid deterioration of orthopedic patients' conditions, and comprehensive management can be provided by nutrition support teams. In rural primary care settings, family physicians play a vital role in providing geriatric care in community hospitals in collaboration with specialists. Family medicine in hospitals should be investigated in other settings for better geriatric care and to drive mutual learning among healthcare professionals.
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Affiliation(s)
- Ryuichi Ohta
- Community Care, Unnan City Hospital, 96-1 Iida, Daito-cho, Unnan, Shimane, 699-1221, Japan.
| | - Tachiko Nitta
- Community Care, Unnan City Hospital, 96-1 Iida, Daito-cho, Unnan, Shimane, 699-1221, Japan
| | - Akiko Shimizu
- Community Care, Unnan City Hospital, 96-1 Iida, Daito-cho, Unnan, Shimane, 699-1221, Japan
| | - Chiaki Sano
- Department of Community Medicine Management, Faculty of Medicine, Shimane University, 89-1 Enya cho, Izumo, Shimane, 693-8501, Japan
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Zilberstein K, Brown A, Hatcher AJ, Burton J, Gau J. Providers' experiences collaborating with child welfare workers: The good, the bad, and the impacts. Child Abuse Negl 2024; 152:106772. [PMID: 38574602 DOI: 10.1016/j.chiabu.2024.106772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/12/2024] [Accepted: 03/20/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Successful interprofessional collaborations have been identified as a potential solution to mitigate problems associated with negative outcomes for clients involved with the child welfare system. The barriers to collaborative relationships need to be better understood and effectively addressed. OBJECTIVE To understand the characteristics, barriers, and facilitators of collaborations between different types of providers and child welfare workers, as well as their impacts. PARTICIPANTS AND SETTING Mental health professionals, foster and kinship parents, legal professionals, and other providers responded to an online survey distributed in a Northeastern State of the United States of America. METHOD Participants (n = 208) completed the Quality of Collaboration with Child Welfare survey. Qualitative responses were analyzed by three coders using three levels of axial coding with constant comparison. RESULTS Participants identified different aspects of communication, relationships, and follow-through as key elements of successful collaborations, as well as the items most likely to interfere with their formation. Providers differed somewhat in how concerned they were with various aspects of collaborations in accordance with their professional roles. Barriers to successful collaborations included both individual and systemic factors which often resulted in negative outcomes. Overall, more negative experiences were offered than positive ones. CONCLUSIONS Strategies are needed to improve communication, promote positive relationships, and address systemic barriers to enhance collaboration and, in turn, improve outcomes for child welfare-involved clients.
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Affiliation(s)
| | - Adam Brown
- Silberman School of Social Work at Hunter College, NY, New York, USA.
| | | | - J Burton
- Clinical and Support Options, Northampton, MA, USA
| | - Jeff Gau
- Oregon Research Institute, Eugene, OR, USA.
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4
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van Klaveren LM, Geukers V, de Vos R. Care complexity, perceptions of complexity and preferences for interprofessional collaboration: an analysis of relationships and social networks in paediatrics. BMC Med Educ 2024; 24:334. [PMID: 38528513 DOI: 10.1186/s12909-024-05304-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/13/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND In the context of increasingly intricate healthcare systems, professionals are compelled to collaborate within dynamically changing interprofessional teams. Moreover, they must adapt these collaborative processes to effectively and efficiently manage the evolving complexity of care needs. It remains unclear how professionals determine care complexity and relate this complexity to their preferences for interprofessional collaboration (IPC). This study investigated the relationships between care complexity, professionals' perceived complexity and IPC preferences, and examined the variation in individual and team characteristics of IPC-practices across different levels of complexity in paediatric care. METHODS In an online questionnaire, 123 healthcare professionals working at an academic tertiary children's hospital scored their perceptions of complexity and preferences for IPC. They also selected family and various professions as members of the interprofessional (IP-) team based on thirteen patient cases. We employed conjoint analysis to systematically model the complexity of case descriptions across the five domains of the International Classification of Functioning, Disability and Health (ICF). Additionally, we applied social network analysis to identify important professions, crucial connectors and influential professions in the IP-team, and to describe the cohesiveness of IP-teams. RESULTS Modelled case complexity, professionals' perceived complexity and IPC preferences were positively associated. We found large inter-individual variations in the degree of these associations. Social network analysis revealed that the importance and influence of professions was more equally distributed when case complexity increased. Depending on the context and complexity of the case, different professions (e.g. medical doctors, social professionals, extramural professionals) were considered to be more crucial connectors within the IP-team. Furthermore, team cohesion was positively associated with modelled and perceived care complexity. CONCLUSIONS In conclusion, our study contributes to the existing knowledge by integrating task-specific insights and broadening the use of conjoint and social network analysis in the context of IPC. The findings substantiate the contingency theory that relates characteristics of IPC to care complexity, offering quantified insights into how IP-teams adapt to situational needs. This understanding of relationships and variations within IPC holds crucial implications for designing targeted interventions in both clinical and health profession education contexts. Consequently, it contributes to advancements in healthcare systems.
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Affiliation(s)
- Lisa-Maria van Klaveren
- Institute for Education and Training, Amsterdam Universities Medical Centres location University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands.
| | - Vincent Geukers
- Emma Children's Hospital, Amsterdam Universities Medical Centres location University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands
| | - Rien de Vos
- Institute for Education and Training, Amsterdam Universities Medical Centres location University of Amsterdam, Meibergdreef 15, 1105 AZ, Amsterdam, The Netherlands
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Matthews EB. The Impact of Delivery Reform on Health Information Exchange with Behavioral Health Providers: Results from a National Representative Survey of Ambulatory Physicians. Adm Policy Ment Health 2024:10.1007/s10488-024-01367-1. [PMID: 38512556 DOI: 10.1007/s10488-024-01367-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 03/23/2024]
Abstract
Health information exchange (HIE) is an effective way to coordinate care, but HIE between health and behavioral health providers is limited. Recent delivery reform models, including the Accountable Care Organization (ACO) and Patient Centered Medical Home (PCMH) prioritize interprofessional collaboration, but little is known about their impact on behavioral health HIE. This study explores whether delivery reform participation affects behavioral health HIE among ambulatory health providers using pooled 2015-2019 data from the National Electronic Health Record Survey, a nationally representative survey of ambulatory physicians' technology use (n = 8,703). The independent variable in this analysis was provider participation in ACO, PCMH, Hybrid ACO-PCMH, or standard care. The dependent variable was HIE with behavioral health providers. Chi square analysis estimated unweighted rates of behavioral health HIE across reform models. Logistic regression estimated the impact of delivery reform participation on rates of behavioral health HIE. Unweighted estimates indicated that Hybrid ACO-PCMH providers had the highest rates of HIE (n = 330, 33%). In the fully adjust model, rates of HIE were higher among ACO (AOR = 2.66, p < .01), PCMH (AOR = 4.73, p < .001) and Hybrid ACO-PCMH participants (AOR = 5.55, p < .001) compared to standard care, but they did not significantly vary between delivery models. Physicians infrequently engage in HIE with behavioral health providers. Compared to standard care, higher rates of HIE were found across all models of delivery reform. More work is needed to identify common elements of delivery reform models that are most effective in supporting this behavior.
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Affiliation(s)
- Elizabeth B Matthews
- Graduate School of Social Service, Fordham University, 113 W. 60th st. 7th Fl, New York, NY, 10023, USA.
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Mehringer D, Jahn P, Linoh KP, Wienke A, Michl P, Walldorf J. [Practice and challenges of delegating medical tasks in the interprofessional everyday work of inpatient healthcare in Germany - An exploratory survey]. Z Evid Fortbild Qual Gesundhwes 2024:S1865-9217(24)00012-6. [PMID: 38519356 DOI: 10.1016/j.zefq.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/20/2024] [Accepted: 01/27/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND The delegation of medical tasks (DMT) plays a significant role in the everyday practice of inpatient care but also presents a potential challenge in interprofessional collaboration. Assessing the conditions of DMT in everyday work is crucial to identify areas for optimization. METHODS In a nationwide exploratory study, physicians, nursing and allied health professionals working for inpatient care facilities were surveyed regarding various aspects of DMT using a standardized online questionnaire. RESULTS The majority of the 757 participants (64.9% physicians), perceived DMT to be both economically and time-efficient (88.5% agreement) and in the best interest of patients (74%). For 78.7% of the respondents, DMT represents a potential conflict in their daily work, depending on the quality of interprofessional communication. Inadequate staffing was identified as a barrier to a broader implementation of DMT by 83.8% of participants. 63.2% of the participants considered their knowledge of legal aspects related to DMT to be at least good (participants with less than 5 years of professional experience: 52.6%). Physicians primarily acquire relevant knowledge through professional practice (71.3% vs. non-physicians 39.5%). CONCLUSION Across the different professional groups DMT was considered beneficial and serving the interests of patients. Targeted promotion of safe and cost-effective DMT should be incorporated into medical education. Achieving greater benefits from DMT requires explicit legal frameworks, effective communication within the team and, in particular, adequate staffing among the professional groups responsible for delegated tasks.
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Affiliation(s)
- Dajana Mehringer
- Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - Patrick Jahn
- AG Versorgungsforschung, Pflege im Krankenhaus, Department für Innere Medizin, Universitätsmedizin Halle (Saale), Halle, Deutschland
| | - Kim Philip Linoh
- Lehrstuhl für Strafrecht, Strafprozessrecht und Medizinrecht, Juristischer Bereich, Juristische und Wirtschaftswissenschaftliche Fakultät der Martin-Luther-Universität Halle-Wittenberg, Halle (Saale), Deutschland
| | - Andreas Wienke
- Institut für Medizinische Epidemiologie, Biometrie und Informatik, Profilzentrum für Gesundheitswissenschaften, Medizinische Fakultät Halle, Halle, Deutschland
| | - Patrick Michl
- Klinik für Innere Medizin IV, Heidelberg University Hospital, Heidelberg, Deutschland
| | - Jens Walldorf
- Klinik für Innere Medizin I, Universitätsklinikum Halle (Saale), Halle, Deutschland.
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Doornebosch AJ, Achterberg WP, Smaling HJA. Factors influencing interprofessional collaboration in general and during multidisciplinary team meetings in long-term care and geriatric rehabilitation: a qualitative study. BMC Med Educ 2024; 24:285. [PMID: 38486216 PMCID: PMC10941503 DOI: 10.1186/s12909-024-05291-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 03/11/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Interprofessional collaboration is essential to maintain high-quality care in long-term care and geriatric rehabilitation. However, little is known regarding perceived factors influencing interprofessional collaboration by people involved in care. This concerns both long-term care and geriatric rehabilitation. Moreover, knowledge of using patient outcome measures to enhance interprofessional collaboration during multidisciplinary team meetings is insufficient. This study examined the perceived facilitators of and barriers to interprofessional collaboration in general and during multidisciplinary team meetings, specifically according to healthcare professionals, patients, and informal caregivers. Differences between long-term care and geriatric rehabilitation were also investigated. Finally, it was examined which patient outcome measures were used in multidisciplinary team meetings. METHODS A constructivist qualitative study using 10 focus groups and 18 semi-structured interviews with 14 patients, 13 informal caregivers,10 managers, and 22 healthcare professionals from eight Dutch long-term care and geriatric rehabilitation facilities. A combined inductive and deductive approach to a thematic analysis was performed. RESULTS The perceived influencing factors of interprofessional collaboration were classified into two general themes: (1) 'Involvement of patient, informal caregiver, and healthcare professional', categorised into: 'participation of patients and informal caregivers', 'behaviour and attitude of team members', 'expectations of team members towards each other', and 'exchange of information, knowledge, and reciprocity in communication'; and (2) 'A systematic approach to providing care for older people', consisting of: 'coordination of team procedures', and 'coordination of organisational procedures'. Also, one theme for multidisciplinary team meetings was identified: 'Organised participation of patient, informal caregiver, and healthcare professional in multidisciplinary team meeting, categorised into: 'team procedures', 'working systematically', and 'participation in multidisciplinary team meetings. Standardised patient outcome measures were scarcely used in multidisciplinary team meetings. CONCLUSION People involved in long-term care and geriatric rehabilitation indicated that, apart from working systematically, being involved in care and multidisciplinary team meetings are essential factors for interprofessional collaboration. These factors must be taken into consideration to provide valuable, high-quality care to older people residing in long-term care and geriatric. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Arno J Doornebosch
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
- University Network for the Care sector Zuid-Holland, Leiden University Medical Center, Leiden, the Netherlands.
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- University Network for the Care sector Zuid-Holland, Leiden University Medical Center, Leiden, the Netherlands
| | - Hanneke J A Smaling
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- University Network for the Care sector Zuid-Holland, Leiden University Medical Center, Leiden, the Netherlands
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Teuwen CJ, Kusurkar RA, Schreurs H, Daelmans HEM, Peerdeman SM. Interprofessional collaboration skills and motivation one year after an interprofessional educational intervention for undergraduate medical and nursing students. BMC Med Educ 2024; 24:269. [PMID: 38468246 DOI: 10.1186/s12909-024-05262-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/04/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND The increasingly complex patient care in the twenty-first century is delivered by interprofessional health care teams. Interprofessional collaboration can be taught during interprofessional education. However, whether a long-term change in collaborative competencies can be achieved by interprofessional education has not been studied sufficiently. Our research questions were: How does motivation for interprofessional collaboration and interprofessional collaborative skills change up to one year after an interprofessional educational intervention? How are they related to each other? METHODS During a one-year period, undergraduate medical and nursing students attended four interprofessional (intervention) or uniprofessional (control group) education sessions. Self-determination Theory was used as the theoretical framework. Autonomous and controlled motivation scores for interprofessional collaboration were calculated using the Academic Self-Regulation Questionnaire, before (T1), directly after (T2) and one year post-intervention (T3). At T3, the students also filled out the Interprofessional Collaborative Competencies Attainment Survey (ICCAS), which measured the perceived attainment of collaborative competencies by a retrospective pre-test/post-test design. We used linear mixed effects models to analyse the motivation scores and linear regression for the relation between motivation and competence. RESULTS In the interprofessional group, autonomous motivation scores of the participants were significantly lower at T2 vs. T1. Controlled motivation scores were significantly higher at T3 vs. T1. Controlled motivation scores for T2 were significantly higher in the uniprofessional group than in the interprofessional group. Perceived competence was related to higher autonomous motivation scores. At T3 the interprofessional collaborative competencies seemed to have grown more among students in the interprofessional group. CONCLUSIONS The perceived growth in interprofessional collaboration competence lasted at least up to one year after the intervention, and was measurable with the ICCAS. The growth was significantly more in the IPE students than in the UPE students. The few differences found in motivation scores for interprofessional collaboration were probably caused by an imbalance of nursing versus medical students over the different time points. This finding indicates that classroom based IPE can contribute to interprofessional collaboration skills of nursing and medical students at least up to one year after an intervention.
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Affiliation(s)
- Carolyn Joyce Teuwen
- Noordwest Academie, Noordwest Ziekenhuisgroep Alkmaar, P.O. box 501, 1800 AM, Alkmaar, the Netherlands.
- Research in Education, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1118, Amsterdam, the Netherlands.
| | - Rashmi A Kusurkar
- Research in Education, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1118, Amsterdam, the Netherlands
- LEARN! Research Institute for Learning and Education, Faculty of Psychology and Education, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands
| | - Hermien Schreurs
- Department of Surgery, Noordwest Ziekenhuisgroep Alkmaar, Alkmaar, the Netherlands
| | - Hester E M Daelmans
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Faculty of Medicine Vrije, Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Saskia M Peerdeman
- Teaching & Learning Centre (TLC) FdG - UvA, Amsterdam UMC Location AMC, Amsterdam, the Netherlands
- Department of Neurosurgery, University of Amsterdam, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Robert A, Johnmark N, Radiana KM, Haulat K, Ivan S, Rajab K, Ebong K. Evaluating the role of intern pharmacists in pharmaceutical care in hospitals in Uganda. J Pharm Policy Pract 2024; 17:2320282. [PMID: 38476502 PMCID: PMC10930095 DOI: 10.1080/20523211.2024.2320282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024] Open
Abstract
Background In Uganda, there is limited adoption of pharmaceutical care in hospitals due to pharmacist shortages and limited collaboration among healthcare professionals. Intern pharmacists are deployed annually to assist in patient care to address pharmacist shortages. Objectives Evaluate intern pharmacist's extent of involvement in pharmaceutical care activities, assess facilitators and barriers, and explore healthcare professionals' perceptions, attitudes, and opinions on implementation of pharmaceutical care. Methods A mixed-method concurrent study was carried out for four months. We conducted an online survey among 107 intern pharmacists from 26 hospitals, including National Referral, Regional Referral, Private Not-For-Profit, and General hospitals; predictors of extent of involvement were identified using linear regression models, using STATA 14. 24 key informants (nurses, prescribers, pharmacists) from five hospitals were interviewed; themes were developed using a deductive thematic analysis approach. Results Intern pharmacists had a median (Interquartile range[IQR]) age of 25 years (25-27) and 74.7% were male. About half (54.1%) of key informants were female and had a median (IQR) of 10 years (4.0-15.5) of professional experience. Interns focused on patient counseling, lacked documentation, and showed positive attitudes, and knowledge. Key informants supported implementation, but prescribers expressed dissatisfaction with interns' performance. Conclusion Enhancing pharmacy internship and training through developing policies and guidelines on pharmaceutical care practice, improving working conditions, and mentorship can address gaps impeding pharmaceutical care implementation by intern pharmacists.
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Affiliation(s)
- Agaba Robert
- Pharmaceutical Society of Uganda, Pharmacum Care Uganda Project, Kampala, Uganda
| | - Ndinawe Johnmark
- Pharmaceutical Society of Uganda, Pharmacum Care Uganda Project, Kampala, Uganda
| | | | - Kiiza Haulat
- Pharmaceutical Society of Uganda, Pharmacum Care Uganda Project, Kampala, Uganda
| | - Segawa Ivan
- Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Kalidi Rajab
- Department of Pharmacy, Makerere University, Kampala, Uganda
| | - Keren Ebong
- Department of Pharmacy, Mulago National Referral Hospital, Kampala, Uganda
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Sekanina U, Tetzlaff B, Mazur A, Huckle T, Kühn A, Dano R, Höckelmann C, Scherer M, Balzer K, Köpke S, Hummers E, Müller C. Interprofessional collaboration in the home care setting: perspectives of people receiving home care, relatives, nurses, general practitioners, and therapists-results of a qualitative analysis. BMC Prim Care 2024; 25:79. [PMID: 38438843 PMCID: PMC10910757 DOI: 10.1186/s12875-024-02313-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/16/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND About one million people in need of home care in Germany are assisted by 15,400 home care services. Home healthcare is mostly a complex endeavour because interprofessional collaboration is often challenging. This might negatively impact patient safety. The project interprof HOME aims to develop an interprofessional person-centred care concept for people receiving home care in a multistep approach. In one of the work packages we explored how people receiving home care, relatives, nurses, general practitioners, and therapists (physiotherapists, occupational therapists, and speech therapists) perceive collaboration in this setting. METHODS Semi-structured interviews were conducted with 20 people receiving home care and with 21 relatives. Additionally, we worked with nine monoprofessional focus groups involving nurses of home care services (n = 17), general practitioners (n = 14), and therapists (n = 21). The data were analysed by content analysis. RESULTS Three main categories evolved: "perception of interprofessional collaboration", "means of communication", and "barriers and facilitators". People receiving home care and relatives often perceive little to no interprofessional collaboration and take over a significant part of the organisational coordination and information exchange. Interprofessional collaboration in steady care situations does exist at times and mostly occurs in coordination tasks. Contact and information exchange are rare, however, interprofessional personal encounters are sporadic, and fixed agreements and permanent contact persons are not standard. These trends increase with the complexity of the healthcare situation. Joint collaborations are often perceived as highly beneficial. Means of communications such as telephone, fax, or e-mail are used differently and are often considered tedious and time-consuming. No interprofessional formal written or electronic documentation system exists. Personal acquaintance and mutual trust are perceived as being beneficial, while a lack of mutual availability, limited time, and inadequate compensation hinder interprofessional collaboration. CONCLUSIONS Interprofessional collaboration in home care occurs irregularly, and coordination often remains with people receiving home care or relatives. While this individual care set-up may work sufficiently well in low complex care situations, it becomes vulnerable to disruptions with increasing complexity. Close interactions, joint collaboration, and fixed means of communication might improve healthcare at home. The findings were integrated into the development of the person-centred interprofessional care concept interprof HOME. TRIAL REGISTRATION This study is registered on the International Clinical Trails registry platform ClinicalTrials.gov as NCT05149937 on 03/11/2021.
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Affiliation(s)
- Uta Sekanina
- Department of General Practice, University Medical Center Goettingen, Humboldtallee 38, 37073, Göttingen, Germany.
| | - Britta Tetzlaff
- Department of General Practice and Primary Care, University Medical Center Hamburg- Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Ana Mazur
- Department of General Practice, University Medical Center Goettingen, Humboldtallee 38, 37073, Göttingen, Germany
| | - Tilman Huckle
- Nursing Research Unit, Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Anja Kühn
- Nursing Research Unit, Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Richard Dano
- Institute of Nursing Science, Medical Faculty, University of Cologne, University Hospital Cologne, Gleueler Str. 176-178, 50935, Köln, Germany
| | - Carolin Höckelmann
- Institute of Nursing Science, Medical Faculty, University of Cologne, University Hospital Cologne, Gleueler Str. 176-178, 50935, Köln, Germany
| | - Martin Scherer
- Department of General Practice and Primary Care, University Medical Center Hamburg- Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Katrin Balzer
- Nursing Research Unit, Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Sascha Köpke
- Institute of Nursing Science, Medical Faculty, University of Cologne, University Hospital Cologne, Gleueler Str. 176-178, 50935, Köln, Germany
| | - Eva Hummers
- Department of General Practice, University Medical Center Goettingen, Humboldtallee 38, 37073, Göttingen, Germany
| | - Christiane Müller
- Department of General Practice, University Medical Center Goettingen, Humboldtallee 38, 37073, Göttingen, Germany
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Zhang T, Mohsen M, Abbaticchio A, Battistella M. Patients' experiences of medication management while navigating ongoing care between outpatient services: A qualitative case study of patients on hemodialysis. Explor Res Clin Soc Pharm 2024; 13:100418. [PMID: 38374965 PMCID: PMC10875289 DOI: 10.1016/j.rcsop.2024.100418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 02/05/2024] [Accepted: 02/07/2024] [Indexed: 02/21/2024] Open
Abstract
Background Patients on hemodialysis have complex medical diagnoses and medication regimens, requiring access to numerous health services and consultation with various healthcare providers. While interprofessional collaboration can optimize care among hemodialysis patients, these patients commonly experience medication-related problems and frequent hospitalizations resulting from miscommunications and mismanagement of medications. Objectives This study aims to capture the lived experiences of patients on hemodialysis to reveal their medication management needs as they navigate ongoing care between various outpatient services. Methods A qualitative methodology was used to explore the perspectives of hemodialysis patients. One-on-one, in-person, semi-structured interviews were conducted at an outpatient hemodialysis clinic located inside an urban teaching hospital. English-speaking adults 18 years and older who have been followed at the clinic for at least three months were selected through random, convenience sampling. Interviews were recorded and transcribed verbatim. Patients were recruited and data were collected iteratively and continued until data saturation was reached. Data was analyzed through the lens of the Picker Principles of Patient Centered Care using a general inductive approach. Results A total of nine interviews were conducted. Two major themes, medication management and care navigation, were identified. Though patients had a wealth of knowledge about their medications, and they were motivated to self-manage their medications to enhance their well-being, they experienced barriers with medication management. Patients further expressed challenges with navigating care and spoke of the importance of having good rapport with healthcare providers who are attentive to their needs. Conclusions The results revealed a need for improved support for self-care and interprofessional collaboration to possibly reduce the burden of medications and care fragmentation experienced by patients and improve continuity of care for patients.
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Affiliation(s)
- Tracy Zhang
- Leslie Dan Faculty of Pharmacy, University of Toronto, Ontario, Canada
- Department of Nephrology, Toronto General Hospital – University Health Network, Ontario, Canada
| | - Mai Mohsen
- Leslie Dan Faculty of Pharmacy, University of Toronto, Ontario, Canada
- Department of Nephrology, Toronto General Hospital – University Health Network, Ontario, Canada
| | - Angelina Abbaticchio
- Department of Nephrology, Toronto General Hospital – University Health Network, Ontario, Canada
| | - Marisa Battistella
- Leslie Dan Faculty of Pharmacy, University of Toronto, Ontario, Canada
- Department of Nephrology, Toronto General Hospital – University Health Network, Ontario, Canada
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Kosteniuk J, Morgan D, Elliot V, Bayly M, Froehlich Chow A, Boden C, O'Connell ME. Factors identified as barriers or facilitators to EMR/EHR based interprofessional primary care: a scoping review. J Interprof Care 2024; 38:319-330. [PMID: 37161449 DOI: 10.1080/13561820.2023.2204890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 04/06/2023] [Indexed: 05/11/2023]
Abstract
As interprofessional collaboration (IPC) in primary care receives increasing attention, the role of electronic medical and health record (EMR/EHR) systems in supporting IPC is important to consider. A scoping review was conducted to synthesize the current literature on the barriers and facilitators of EMR/EHRs to interprofessional primary care. Four online databases (OVID Medline, EBSCO CINAHL, OVID EMBASE, and OVID PsycINFO) were searched without date restrictions. Twelve studies were included in the review. Of six facilitator and barrier themes identified, the key facilitator was teamwork support and a significant barrier was data management. Other important barriers included usability related mainly to interoperability, and practice support primarily in terms of patient care. Additional themes were organization attributes and user features. Although EMR/EHR systems facilitated teamwork support, there is potential for team features to be strengthened further. Persistent barriers may be partly addressed by advances in software design, particularly if interprofessional perspectives are included. Organizations and teams might also consider strategies for working with existing EMR/EHR systems, for instance by developing guidelines for interprofessional use. Further research concerning the use of electronic records in interprofessional contexts is needed to support IPC in primary care.
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Affiliation(s)
- Julie Kosteniuk
- Canadian Centre for Health & Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Debra Morgan
- Canadian Centre for Health & Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Valerie Elliot
- Canadian Centre for Health & Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Melanie Bayly
- Canadian Centre for Health & Safety in Agriculture, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | | | - Catherine Boden
- Leslie and Irene Dubé Health Sciences Library, University of Saskatchewan, Saskatoon, Canada
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, Canada
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Crunenberg R, Charles C, Lallemand A, Buret L, Philippe G, Ethgen O. Interpretative phenomenological analysis of the collaboration among healthcare professionals in the nursing home setting. Explor Res Clin Soc Pharm 2024; 13:100424. [PMID: 38516547 PMCID: PMC10955404 DOI: 10.1016/j.rcsop.2024.100424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 02/12/2024] [Accepted: 02/16/2024] [Indexed: 03/23/2024] Open
Abstract
Background The theory of planned behavior (TPB) postulates that behavioral performance is guided by the intention to perform that behavior, influenced by attitudes, subjective norms, and perceived behavioral control. This framework can be applied to studying interprofessional collaboration among healthcare professionals to enhance patient safety and public health within nursing homes. Objectives This study aimed to explore the roles of physicians, pharmacists, and nurses in the interprofessional collaboration process while identifying facilitators and barriers to effective collaboration among healthcare professionals. Methods A qualitative interpretative phenomenological analysis (IPA) was carried out. Individual semi-structured interviews were conducted with 19 healthcare professionals. Qualitative data were then integrated and analyzed through the lens of the TPB. Findings The IPA revealed the ten following themes, considered as both facilitators and barriers to interprofessional collaboration among healthcare professionals in the nursing home setting: communication, roles and responsibilities, willingness and recognition of collaboration's importance, mutual knowledge, trust, confidence, support from decision-makers, protocols, and technology were considered as facilitators while distance was considered as a barrier. Conclusion Enhancing pharmacist-physician collaboration and refining pharmacist-nurse collaboration were essential goals. Intention for collaboration was influenced by attitudes (such as communication and mutual understanding), subjective norms (including support from decision-makers), and perceived behavioral control (such as confidence and adherence to protocols and technology). Addressing these factors could improve collaboration, enhancing residents' quality of life and professionals' sense of achievement.
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Affiliation(s)
- Robin Crunenberg
- Faculty of Medicine, Department of Pharmacy, Center for Interdisciplinary Research on Medicines (CIRM), University of Liège, Liège, Belgium
- Faculty of Medicine, Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Liège, Belgium
| | - Camille Charles
- Faculty of Medicine, Department of Pharmacy, Center for Interdisciplinary Research on Medicines (CIRM), University of Liège, Liège, Belgium
| | - Alice Lallemand
- Faculty of Medicine, Department of Pharmacy, Center for Interdisciplinary Research on Medicines (CIRM), University of Liège, Liège, Belgium
| | - Laetitia Buret
- Faculty of Medicine, Department of General Medicine, University of Liège, Liège, Belgium
| | - Geneviève Philippe
- Faculty of Medicine, Department of Pharmacy, Center for Interdisciplinary Research on Medicines (CIRM), University of Liège, Liège, Belgium
| | - Olivier Ethgen
- Faculty of Medicine, Department of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Liège, Belgium
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Shimizu T, Shimizu Y. Interprofessional collaboration in the cardiovascular management of Marfan syndrome: A qualitative study based on interviews with professionals. J Vasc Nurs 2024; 42:18-25. [PMID: 38555174 DOI: 10.1016/j.jvn.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/23/2023] [Accepted: 11/18/2023] [Indexed: 04/02/2024]
Abstract
BACKGROUND AND AIM Patients with Marfan syndrome, who present with a variety of symptoms and complex psychosocial problems, require interprofessional collaboration in their care. However, it is unclear how health care providers contribute to interprofessional collaboration for these patients. The purpose of this study was to determine the characteristics of interprofessional collaboration for patients with Marfan syndrome in the cardiovascular field. METHODS Semi-structured interviews were conducted with health care specialists (5 physicians, 2 nurses, and 3 certified genetic counselors) were analyzed qualitatively. RESULTS Based on the medical collaboration for the management of cardiovascular complications in patients and their relatives, interprofessional collaboration was identified, such as collaboration and cooperation between physicians and certified genetic counselors, and nursing practice to facilitate interprofessional collaboration. In addition, issues such as difficulties in dealing with and coordinating medical care for noncardiovascular complications, lack of specialist physicians, and lack of opportunities to collaborate with nurses were identified. CONCLUSIONS Effective interprofessional collaboration requires the acquisition of Marfan syndrome and genetic knowledge by healthcare providers and the development of a healthcare delivery system based on departments that can provide leadership. In addition, the assignment of nurses to work across organizational boundaries and effective collaboration between genetic counselors and nurses should be considered.
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Affiliation(s)
- Tomoko Shimizu
- Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
| | - Yasuko Shimizu
- Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
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Kolltveit BCH, Oftedal BF, Thorne S, Lomborg K, Graue M. Experiences of an interprofessional follow-up program in primary care practice. BMC Health Serv Res 2024; 24:238. [PMID: 38395910 PMCID: PMC10885432 DOI: 10.1186/s12913-024-10706-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 02/11/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND An integrative cooperation of different healthcare professional is a key component for high quality health services. With an aging population and many with long-term conditions, more health tasks and follow-up care are being transferred to primary care and locally where people live. Interprofessional collaboration among providers of different professional designations will be of increasing importance to optimizing primary care capacity in years to come. There is a call for further exploration of models of interprofessional collaboration that might be applicable in Norwegian primary care. The aim of this study was to explore experiences of interprofessional collaboration between primary care physicians and nurses working in primary care by applying an intervention for people with type 2 diabetes. Specifically, this study was designed to strengthen and gain deeper insight into interprofessional collaboration between primary care physicians and nurses in primary care settings. METHODS We applied Interpretive Description as a research strategy. The participants within this study were primary care physicians and nurses from four different primary care practices in the western and eastern parts of Norway. We used semi-structured telephone interviews for collecting the data between January and September 2021. RESULTS The analysis revealed two key features of the primary care physicians and the nurses experience with interprofessional collaboration in primary care practices. The first involved managing the influence of discrepancies in their expectations of IPC and the second involved becoming aware of the competence they developed that allowed for better complementarity consultation. CONCLUSIONS This study indicates that interprofessional collaboration in primary care practice requires that primary care physicians and nurses clarify their expectations and, in turn, determine how flexible they can become in changing their usual primary care practices. Moreover, findings reveal that nurses and primary care physicians had discrepancies in expectations of how interprofessional collaboration should be carried out in primary care practice. However, both the nurses and primary care physicians appreciated the blending of complementary competencies and skills that facilitated a more collaborative care practice. They experienced that this interprofessional collaboration represented an essential quality improvement in the primary care services. TRIAL REGISTRATION The trial is registered 03/09/2019 in ClinicalTrials.gov (ID: NCT04076384).
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Affiliation(s)
- Beate-Christin Hope Kolltveit
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
- Vossevangen medical centre, Voss, Norway.
| | | | - Sally Thorne
- School of Nursing, University of British Columbia, Vancouver, CA, Canada
| | - Kirsten Lomborg
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Copenhagen, Denmark
| | - Marit Graue
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
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Ebinghaus M, Agricola CJ, Schmittinger J, Makarova N, Zyriax BC. Assessment of women's needs, wishes and preferences regarding interprofessional guidance on nutrition in pregnancy - a qualitative study. BMC Pregnancy Childbirth 2024; 24:154. [PMID: 38383376 PMCID: PMC10880225 DOI: 10.1186/s12884-024-06351-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 02/14/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND A healthy nutrition in pregnancy supports maternal health and fetal development, decreasing the risk for adverse pregnancy outcomes. Guidance by prenatal care professionals can increase women's awareness regarding the importance of nutrition in pregnancy and thereby contribute to a reduced risk for adverse pregnancy outcomes. The aim of this study was to assess the needs, wishes and preferences of pregnant women regarding the interprofessional guidance on nutrition in pregnancy. METHODS Using a qualitative approach and a purposive maximum variation sampling strategy, 25 pregnant women were recruited to participate in six semi-structured, guideline-oriented online focus groups. In addition, two semi-structured, guideline-oriented interviews, with a midwife and an obstetrician, were conducted. The focus groups and interviews were audio-recorded and transcribed. Transcripts were analysed using a systematic deductive-inductive approach to qualitative content analysis according to Kuckartz. RESULTS Focus group participants covered diverse perspectives in terms of their age, different models of prenatal care as well as dietary forms from omnivorous to vegan. The majority of women perceived the guidance on nutrition during pregnancy as insufficient. Involved healthcare professionals, namely midwives and obstetricians, should provide more consistent information, especially to avoid uncertainties exacerbated by the internet and social media. There is a need for individual nutrition information regarding dietary supplements and the specifics of different dietary forms during pregnancy, such as a vegan diet. The majority of participants supported the integration of a free-of-charge professional nutrition counselling in prenatal care. Interviews with experts identified time pressure and the complexity of nutrition as a topic as the main obstacles in consultation settings. Both midwife and obstetrician emphasised the need for improved professional education on nutrition in pregnancy in their respective studies. CONCLUSION Professional guidance for pregnant women on nutrition and uncertainties going along with certain forms of diet during pregnancy could alleviate the burden and overwhelming amount of web-based information. Additionally, information adapted to the needs, wishes and preferences of pregnant women would improve prenatal care through a more personalised approach. The quality of nutrition guidance in pregnancy should be improved by the implementation of this topic in the education of involved healthcare professionals.
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Affiliation(s)
- Merle Ebinghaus
- Midwifery Science-Health Care Research and Prevention, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany.
| | - Caroline Johanna Agricola
- Midwifery Science-Health Care Research and Prevention, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - Janne Schmittinger
- Midwifery Science-Health Care Research and Prevention, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - Nataliya Makarova
- Midwifery Science-Health Care Research and Prevention, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
| | - Birgit-Christiane Zyriax
- Midwifery Science-Health Care Research and Prevention, Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Martinistraße 52, 20246, Hamburg, Germany
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Nagel DA, Penner JL, Halas G, Philip MT, Cooke CA. Exploring experiential learning within interprofessional practice education initiatives for pre-licensure healthcare students: a scoping review. BMC Med Educ 2024; 24:139. [PMID: 38350938 PMCID: PMC10863283 DOI: 10.1186/s12909-024-05114-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/30/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Interprofessional collaborative team-based approaches to care in health service delivery has been identified as important to health care reform around the world. Many academic institutions have integrated interprofessional education (IPE) into curricula for pre-licensure students in healthcare disciplines, but few provide formal initiatives for interprofessional practice (IPP). It is recognized that experiential learning (EL) can play a significant role supporting IPP education initiatives; however, little is known of how EL is used within education for IPP in healthcare settings. METHODS We conducted a scoping review to map peer-reviewed literature describing IPP education initiatives involving EL for pre-licensure students in healthcare disciplines. A literature search was executed in MEDLINE, CINAHL, EMBASE, ERIC, PsycINFO, Scopus, and Social Services Abstracts. After deduplication, two independent reviewers screened titles and abstracts of 5664 records and then 252 full-text articles that yielded 100 articles for data extraction. Data was extracted using an Excel template, and results synthesized for presentation in narrative and tabular formats. RESULTS The 100 included articles represented 12 countries and IPP education initiatives were described in three main typologies of literature - primary research, program descriptions, and program evaluations. Forty-three articles used a theory, framework, or model for design of their initiatives with only eight specific to EL. A variety of teaching and learning strategies were employed, such as small interprofessional groups of students, team huddles, direct provision of care, and reflective activities, but few initiatives utilized a full EL cycle. A range of perspectives and outcomes were evaluated such as student learning outcomes, including competencies associated with IPP, impacts and perceptions of the IPP initiatives, and others such as client satisfaction. CONCLUSION Few educational frameworks specific to EL have been used to inform EL teaching and learning strategies to consolidate IPE learning and prepare students for IPP in healthcare settings. Further development and evaluation of existing EL frameworks and models would be beneficial in supporting robust IPP educational initiatives for students in healthcare disciplines. Intentional, thoughtful, and comprehensive use of EL informed by theory can contribute important advances in IPP educational approaches and the preparation of a future health care workforce.
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Affiliation(s)
- Daniel A Nagel
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
| | - Jamie L Penner
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Gayle Halas
- Rady Chair in Interprofessional Collaborative Practice, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Mark T Philip
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Carol A Cooke
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, Canada
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Lias N, Lindholm T, Holmström AR, Uusitalo M, Kvarnström K, Toivo T, Nurmi H, Airaksinen M. Harmonizing the definition of medication reviews for their collaborative implementation and documentation in electronic patient records: A Delphi consensus study. Res Social Adm Pharm 2024:S1551-7411(24)00047-0. [PMID: 38423929 DOI: 10.1016/j.sapharm.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/04/2023] [Accepted: 01/31/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Medication review practices have evolved internationally in a direction in which not only physicians but also other healthcare professionals conduct medication reviews according to agreed practices. Collaborative practices have increasingly highlighted the need for electronic joint platforms where information on medication regimens and their implementation can be documented, kept updated, and shared. OBJECTIVE The aim of this study was to harmonize the definition of medication reviews and create a unified conceptual basis for their collaborative implementation and documentation in electronic patient records (definition appellation: collaborative medication review). METHODS The study was conducted using the Delphi consensus survey with three interprofessional expert panel rounds in September-December 2020. The consensus rate was set at 80%. Experts assessed the proposed definition of collaborative medication review based on an international and national inventory of medication review definitions. The expert panel (n = 41) involved 12 physicians, 13 pharmacists, 10 nurses, and six information management professionals. The range of response rates for the rounds was 63-88%. RESULTS The experts commented on which of the pre-selected items (n = 75) characterizing medication reviews should be included in the definition of collaborative medication review. The items were divided into the following five themes and 51 of them reached consensus: 1) Actions included in the collaborative medication review (n = 24/24), 2) Settings where the review should be conducted (n = 5/5), 3) Situations where the review should be considered as needed and carried out (n = 10/11), 4) Prioritization of top five benefits to be achieved by the review and 5) Prioritization of top five patient groups to whom the review should be targeted. CONCLUSIONS A strong interprofessional consensus was reached on the definition of collaborative medication review. The most challenging was to identify individual patient groups benefiting from the review.
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Affiliation(s)
- Noora Lias
- Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. Box 56, 00014, Finland.
| | - Tanja Lindholm
- Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. Box 56, 00014, Finland.
| | - Anna-Riia Holmström
- Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. Box 56, 00014, Finland.
| | - Marjo Uusitalo
- Innovation and Development Unit, Istekki Ltd., P.O. Box 4000, FI-70601, Kuopio, Finland; Faculty of Medicine and Health Technology, Tampere University, FI-33014, Finland.
| | - Kirsi Kvarnström
- Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. Box 56, 00014, Finland; HUS Pharmacy, Helsinki University Hospital and University of Helsinki, 00029, Helsinki, Finland; HUS Internal Medicine and Rehabilitation, Helsinki University Hospital and University of Helsinki, 00029, Helsinki, Finland.
| | - Terhi Toivo
- Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. Box 56, 00014, Finland; Hospital Pharmacy, Wellbeing Services County of Pirkanmaa, Tampere University Hospital, P.O. Box 272, FI-33101, Tampere, Finland.
| | - Harri Nurmi
- Finnish Medicines Agency Fimea, P.O. Box 55, FI-00034, Fimea, Finland.
| | - Marja Airaksinen
- Clinical Pharmacy Group, Division of Pharmacology and Pharmacotherapy, Faculty of Pharmacy, University of Helsinki, Viikinkaari 5 E, P.O. Box 56, 00014, Finland.
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Macé F, Boulin M, Cransac A, Pistre P, Peyron C. [Patients treated with anticancer drugs: Practices and expectations of community pharmacists]. Bull Cancer 2024; 111:176-189. [PMID: 38087731 DOI: 10.1016/j.bulcan.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 09/28/2023] [Accepted: 11/13/2023] [Indexed: 02/12/2024]
Abstract
INTRODUCTION The evolution of pharmacotherapeutic management of cancer patients makes essential the role of the community pharmacist through its management conducted in community pharmacy as well as its relationships with the hospital and primary care professionals. The objective of this work is to study this pharmacotherapeutic management, for all routes of administration considered. METHODS This observational study is based on a questionnaire and semi-structured interviews conducted with community pharmacists in contact with the Unité médicale ambulatoire de cancérologie (UMAC) of the University Hospital of Dijon. RESULTS The main objective of community pharmacists is to ensure that patients understand and comply with their treatment. Twenty-one percent of them have already implemented oral anticancer drug interviews. Sixty-five percent have partial information about the injectable treatments administered to their patients while only 3 % have complete knowledge. Sixty-nine percent of community pharmacists are satisfied with the documents sent by the UMAC (summary of drug treatments, pharmaceutical report, individualized pharmaceutical plan). However, the lack of information from hospital structures generally represents one of the main difficulties in the management of cancer patients by community pharmacists and coordination with other professionals. DISCUSSION The information and training of community pharmacists represent possible improvements for a better care and coordination between healthcare professionals. Some emerging practices, such as the implementation of oral anticancer drug interviews in community pharmacies and the participation of community pharmacists in primary care coordination organizations, also represent opportunities to strengthen their role in the management of cancer patients.
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Affiliation(s)
- Florent Macé
- Université Bourgogne-Franche-Comté, laboratoire d'économie de Dijon (LEDi), EA 7467, 2, boulevard Gabriel, 21000 Dijon, France.
| | - Mathieu Boulin
- Université Bourgogne-Franche-Comté, CHU, département de pharmacie, EPICAD LNC UMR 1231, 12, boulevard Maréchal de Lattre de Tassigny, 21000 Dijon, France
| | - Amélie Cransac
- Université Bourgogne-Franche-Comté, CHU, département de pharmacie, LNC UMR 1231, 12, boulevard Maréchal de Lattre de Tassigny, 21000 Dijon, France
| | - Pauline Pistre
- Université Bourgogne-Franche-Comté, CHU, département de pharmacie, LNC UMR 1231, 12, boulevard Maréchal de Lattre de Tassigny, 21000 Dijon, France
| | - Christine Peyron
- Université Bourgogne-Franche-Comté, laboratoire d'économie de Dijon (LEDi), EA 7467, 2, boulevard Gabriel, 21000 Dijon, France
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Kim HW, Roh YS. Perceived trauma nursing core competency, interprofessional collaborative competency, and associated barriers among regional trauma center nurses. Int Emerg Nurs 2024; 72:101388. [PMID: 38134844 DOI: 10.1016/j.ienj.2023.101388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 10/30/2023] [Accepted: 11/16/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION As key members of interprofessional teams working in complex settings, nurses in trauma centers require trauma nursing core competency. PURPOSE This study sought to determine the levels and relationships of the perceived importance and performance of trauma nursing core competency, as well as the interprofessional collaborative competency and associated barriers among Korean regional trauma center nurses. METHODS This cross-sectional, descriptive, and correlational survey involved a convenience sample of 190 Korean trauma center nurses. Data were collected using a web-based self-reporting questionnaire about the perceived importance and performance of trauma nursing core competency, as well as the interprofessional collaborative competency and associated barriers. Data were analyzed using descriptive statistics, Pearson's correlation, and multiple regression (Enter method) analyses. RESULTS The perceived performance and importance of interprofessional collaborative competency, the perceived importance of trauma nursing core competency, and the perceived barriers to resources, training, competency, and interest significantly affected trauma nursing core competency performance, accounting for 64.5 % of the variance. CONCLUSIONS Training programs are needed to improve the core and interprofessional collaborative competencies of trauma nurses. Individual, team, and organizational approaches are essential to addressing the perceived barriers. The effects of training programs on the core competency of trauma nurses should be validated.
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Affiliation(s)
- Hyo-Won Kim
- Graduate School of Nursing & Health Sciences, Chung-Ang University, Seoul, Republic of Korea
| | - Young Sook Roh
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro Dongjak-gu, Seoul 06974, Republic of Korea.
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Mudadi L, Mutandiro L, Bwanga O, Nyawani P, Matika W, Chinene B. Attitudes and barriers to interprofessional collaboration among radiographers: A multi-country perspective. J Med Imaging Radiat Sci 2024:S1939-8654(23)01943-4. [PMID: 38212180 DOI: 10.1016/j.jmir.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/13/2024]
Abstract
INTRODUCTION To promote effective interprofessional collaboration (IPC), it is crucial to understand the attitudes of healthcare workers towards IPC and identify any barriers they may face. This is particularly important in the radiography profession where IPC is vital for providing holistic care and ensuring radiation protection and safety. However, there is limited research available on the attitudes and barriers to IPC specifically among radiographers. Therefore, this study aimed to assess the attitudes and barriers to IPC among radiographers from multiple countries. METHODS A quantitative descriptive cross-sectional online survey was conducted using the adapted attitudes toward healthcare teams scale (ATHCT) and barriers scale towards IPC. Data analysis was performed using descriptive statistics, Wilcoxon rank-sum, Kruskal-Wallis tests, and exploratory factor analysis. RESULTS A total of 233 radiographers across the globe participated in this survey. The study found that the overall mean score on the ATHCT scale was 54.68 (SD = 5.75). Although not statistically significant, radiographers with over 15 years of experience tended to strongly agree with all the statements, indicating a more positive attitude towards IPC. The study also identified three subscales related to IPC: quality of care, team efficiency, and time constraint. The top three barriers to IPC reported by radiographers include i. a lack of clearly defined, shared, and measurable purpose, ii. poor communication, and iii. a lack of commitment from team members. CONCLUSIONS The findings highlight the need for interventions and programs that promote effective communication and establish a shared vision among healthcare team members.
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Affiliation(s)
- L Mudadi
- Royal Papworth Hospital, NHS Foundation Trust, Cambridge, United Kingdom
| | - L Mutandiro
- Harare Institute of Technology, Department of Radiography, Belvedere, Harare, Zimbabwe
| | - O Bwanga
- Midland University Hospital Tullamore, Radiology Department, Co. Offaly, Ireland
| | - P Nyawani
- Harare Institute of Technology, Department of Radiography, Belvedere, Harare, Zimbabwe
| | - W Matika
- Harare Institute of Technology, Department of Radiography, Belvedere, Harare, Zimbabwe
| | - B Chinene
- Harare Institute of Technology, Department of Radiography, Belvedere, Harare, Zimbabwe.
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Huyen NTT, Tsakitzidis G, Tam NM, Valcke M, Chuong HV, Wens J. Perceptions and experiences of primary healthcare providers toward interprofessional collaboration in chronic disease management in Hue, Vietnam. J Interprof Care 2024; 38:52-61. [PMID: 37366565 DOI: 10.1080/13561820.2023.2227650] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 04/19/2023] [Accepted: 06/08/2023] [Indexed: 06/28/2023]
Abstract
In Vietnam, each primary care community health center (CHC) consists of a multi-professional team with six disciplines, including a physician, assistant physician, nurse, pharmacist, midwife, and Vietnamese traditional physician, who are able to meet the majority of patient's needs at the primary care level. How they collaborate, especially in chronic disease management (CDM), is still limited described in the literature. This study aims to gain insight into the perceptions and the experiences of primary health care providers (PHCPs) toward interprofessional collaboration (IPC) in CDM in CHCs in (Hue) Vietnam. A qualitative study of descriptive phenomenology was performed using two focus groups and 15 semi-structured interviews with PHCPs from six professions relevant to CDM in CHCs. The data were analyzed using NVivo 12.0 with a thematic analysis method by a multiprofessional research team. From the analysis, the data were classified into three main themes: "lack of collaborative practice," "knowledge," and "facilitators and barriers to IPC." This study provided evidence of the awareness that actual collaboration in daily care is fragmentarily organized and that PHCPs try to finish their tasks within their profession. PHCPs work multiprofessionally and lack shared decision-making in patient-centered care. There is a need to develop an interprofessional education program and training to address these deficiencies in the Vietnamese context to improve interprofessional collaboration in health care.
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Affiliation(s)
- Nguyen Thi Thanh Huyen
- Department of Family Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium
| | - Giannoula Tsakitzidis
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium
| | - Nguyen Minh Tam
- Department of Family Medicine, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam
| | - Martin Valcke
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, Ghent, Belgium
| | - Huynh Van Chuong
- The Education Quality Management Agency, Ministry of Education and Training, Vietnam
| | - Johan Wens
- Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerpen, Belgium
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Peterson E, Keehn MT, Hasnain M, Gruss V, Axelsson M, Carlson E, Jakobsson J, Kottorp A. Exploring differences in and factors influencing self-efficacy for competence in interprofessional collaborative practice among health professions students. J Interprof Care 2024; 38:104-112. [PMID: 37551921 DOI: 10.1080/13561820.2023.2241504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 05/12/2023] [Indexed: 08/09/2023]
Abstract
The value of health care delivered via effective interprofessional teams has created an imperative for interprofessional education (IPE) and interprofessional collaborative practice (ICP). To inform IPE strategies, we investigated differences in perceived self-efficacy (SE) for competence in ICP among health professions students. The study data were collected between 2015 and 2019 from students from 13 different health professions programmes (N = 3,497) before an annual institutional interprofessional programme. Students completed the IPECC-SET-27, a validated instrument evaluating perceived SE for competence in ICP, and rated their 1) amount of previous contact with, and 2) perceived understanding of, the role of different health professions. Students in different health professions education programmes were compared using parametric statistics. Regression analyses explored factors influencing SE for competence in ICP. Findings revealed significant differences in perceived SE for competence in ICP between programmes (p < .05). Specifically, health information management/health informatics, dentistry, medicine, and nursing students expressed relatively higher SE, whereas physical therapy and occupational therapy students expressed relatively lower SE. Perceived understanding of the role of health professions (p < .01) and gender (p < .01) contributed significantly to predicting perceived SE for competence in ICP, while the amount of previous contact with other health professions did not (p = .42). The findings highlight the value of designing IPE with consideration of specific learner needs.
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Affiliation(s)
- Elizabeth Peterson
- Department of Occupational Therapy, University of Illinois Chicago, Chicago, Illinois, USA
| | - Mary Therese Keehn
- Office of the Vice Chancellor for Health Affairs, University of Illinois Chicago, Chicago, Illinois, USA
| | - Memoona Hasnain
- Department of Family and Community Medicine, College of Medicine, University of Illinois Chicago, Chicago, Illinois, USA
| | - Valerie Gruss
- College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA
| | - Malin Axelsson
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
| | - Elisabeth Carlson
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
| | - Jenny Jakobsson
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
| | - Anders Kottorp
- Faculty of Health and Society, Malmö University, Malmö, Sweden
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Harcke K, Graue M, Skinner TC, Olsson CB, Saleh-Stattin N. Making prediabetes visible in primary health care: a qualitative study of health care professionals' perspectives. BMC Prim Care 2023; 24:266. [PMID: 38087202 PMCID: PMC10717089 DOI: 10.1186/s12875-023-02230-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND People with prediabetes are at high risk of developing type 2 diabetes and its complications, such as cardiovascular diseases and premature mortality. Primary prevention and health maintenance are therefore imperative. Evidence has shown that prediabetes can be prevented or delayed with behavioural change, mainly in eating habits and physical activity. Interventions that use a person-centered approach can lead to improvements in self-management, quality of life, and health outcomes. Nevertheless, there is a need for further research that engages healthcare professionals and people with prediabetes in constructing and implementing preventive programs. The purpose of this study is to explore and describe how healthcare professionals perceive prediabetes, the current challenges in its detection and treatment, and what is needed to improve quality of care. METHODS This qualitative study was conducted in Region Stockholm. A total of 26 primary health care professionals participated in individual interviews: 15 diabetes nurses and/or district nurses, five general practitioners, five dietitians, and one physiotherapist. Interview transcripts were analyzed with qualitative content analysis. RESULTS The analysis revealed two main themes that emphasize the need to make prediabetes more visible in primary health care. Despite the healthcare professionals' engagement and their motivation to improve prediabetes care, ad hoc practices and the absence of clear screening guidelines and referral pathways made it harder to focus on primary prevention. Supporting professionals in implementing structured care for people with prediabetes might encourage more efficient interprofessional collaboration and contribute to better strategies for promoting behavioural change. CONCLUSIONS Establishing prediabetes care guidelines, supporting health care professionals´ knowledge and skills in prediabetes care, and implementing interprofessional referral pathways are some steps to enhance prediabetes detection and care precedence in primary health care. These steps could lead to more preventive care and ensure patient safety and health care equity.
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Affiliation(s)
- Katri Harcke
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Huddinge, Region Stockholm, Sweden.
- Academic Primary Health Care Centre, Solnavägen 1E Torsplan, plan 7, Stockholm, 11365, Region Stockholm, Sweden.
| | - Marit Graue
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Timothy Charles Skinner
- Institute of Psychology, University of Copenhagen, Copenhagen, Denmark
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
- Australian Centre for Behavioural Research in Diabetes, Melbourne, Australia
| | - Christina B Olsson
- Academic Primary Health Care Centre, Solnavägen 1E Torsplan, plan 7, Stockholm, 11365, Region Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Region Stockholm, Sweden
| | - Nouha Saleh-Stattin
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Huddinge, Region Stockholm, Sweden
- Academic Primary Health Care Centre, Solnavägen 1E Torsplan, plan 7, Stockholm, 11365, Region Stockholm, Sweden
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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. Med Educ 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Favez L, Zúñiga F, Meyer-Massetti C. Exploring medication safety structures and processes in nursing homes: a cross-sectional study. Int J Clin Pharm 2023; 45:1464-1471. [PMID: 37561370 PMCID: PMC10682270 DOI: 10.1007/s11096-023-01625-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 07/11/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Medication safety is important to limit adverse events for nursing home residents. Several factors, such as interprofessional collaboration with pharmacists and medication reviews, have been shown in the literature to influence medication safety processes. AIM This study had three main objectives: (1) To assess how facility- and unit-level organization and infrastructure are related to medication use processes; (2) To determine the extent of medication safety-relevant processes; and (3) To explore pharmacies' and pharmacists' involvement in nursing homes' medication-related processes. METHOD Cross-sectional multicenter survey data (2018-2019) from a convenience sample of 118 Swiss nursing homes were used. Data were collected on facility and unit characteristics, pharmacy services, as well as medication safety-related structures and processes. Descriptive statistics were used. RESULTS Most of the participating nursing homes (93.2%) had electronic resident health record systems that supported medication safety in various ways (e.g., medication lists, interaction checks). Electronic data exchanges with outside partners such as pharmacies or physicians were available for fewer than half (10.2-46.3%, depending on the partner). Pharmacists collaborating with nursing homes were mainly involved in logistical support. Medication reviews were reportedly conducted regularly in two-thirds of facilities. CONCLUSION A high proportion of Swiss nursing homes have implemented diverse processes and structures that support medication use and safety for residents; however, their collaboration with pharmacists remains relatively limited.
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Affiliation(s)
- Lauriane Favez
- Pflegewissenschaft - Nursing Science, Department Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland
- School of Engineering and Management Vaud, HES-SO University of Applied Sciences and Arts, Western Switzerland, Yverdon-les-Bains, Switzerland
| | - Franziska Zúñiga
- Pflegewissenschaft - Nursing Science, Department Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Carla Meyer-Massetti
- Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.
- Institute for Primary Healthcare BIHAM, University of Bern, Bern, Switzerland.
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Clinic for General Internal Medicine, Inselspital - University Hospital of Bern, Bern, Switzerland.
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Macé F, De Vriese C, Nelissen-Vrancken M, Ruggli M, Brülhart M, Peyron C. General practitioners-community pharmacists pharmacotherapy discussion groups: Analysis of their implementation through a series of case studies. Explor Res Clin Soc Pharm 2023; 12:100331. [PMID: 37772034 PMCID: PMC10523268 DOI: 10.1016/j.rcsop.2023.100331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 09/30/2023] Open
Abstract
Background The evolution of primary care practice has led to the implementation of pharmacotherapy discussion groups between general practitioners and community pharmacists (PPPDGs) in some countries. The aim of these groups is to improve drug prescribing practices and strengthen interprofessional relationships. Objective To gain more insight into factors involved in successful implementation of PPPDGs. Methods PPPDG implementation in three countries (Belgium, the Netherlands, Switzerland), was analyzed in a series of case studies. A grid describing different evaluation criteria was completed by stakeholders in their respective country. The data collection was followed by a literature review. Results Various models were used to implement PPPDGs within each country and different dynamics were encountered. PPPDGs lead to positive effects on the quality and cost-effectiveness of drug prescribing and on the collaboration between general practitioners (GPs) and community pharmacists (CPs). Factors involved in implementation were also identified, such as expectations of GPs and CPs, configuration of the implemented model, and the role of CPs in the healthcare organization. Conclusions This study provides insight into the factors involved in successful implementation of PPPDGs in Belgium, the Netherlands and Switzerland. The findings can be used by healthcare professionals to improve the safety, cost-effectiveness of drug prescriptions and systems in primary care. This study offers a starting point for further research in the field.
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Affiliation(s)
- Florent Macé
- Economics Laboratory of Dijon, University of Burgundy, Dijon, France
| | - Carine De Vriese
- Department of Pharmacotherapy and Pharmaceutics, Faculty of Pharmacy, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Martine Ruggli
- President of pharmaSuisse, Swiss Society of Pharmacists, Berne-Liebefeld, Switzerland
| | - Mélanie Brülhart
- Project manager Quality Circles, Swiss Society of Pharmacists, pharmaSuisse, Berne-Liebefeld, Switzerland
| | - Christine Peyron
- Economics Laboratory of Dijon, University of Burgundy, Dijon, France
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Ng G, Desai C, Gagliardi L, Donaghy S, Prospero LD. Implementing digital devices to maintain family connections during the COVID-19 pandemic: Experience of a large academic urban hospital. J Med Imaging Radiat Sci 2023:S1939-8654(23)01888-X. [PMID: 38040496 DOI: 10.1016/j.jmir.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/04/2023] [Accepted: 11/08/2023] [Indexed: 12/03/2023]
Abstract
INTRODUCTION The COVID-19 pandemic lockdown imposed drastic measures at hospitals internationally to rapidly pivot their approaches to patient care. Early on when the pandemic was declared, hospitals responded to local public health restrictions by limiting all non-essential visits for their patients. Digital devices allowed Canadians to remain connected with their friends and families during the imposed isolation restrictions. The aim of this clinical perspective is to share the experience with the immediate implementation of digital connections for patients by exploring the impact as well as to describe key learnings from the initiative. METHODS 150 iPads were distributed to clinical teams for use by patients, for either clinical care or for social connection. An iterative evaluation process, guided by quality improvement methodology, was followed which ensured that any changes to the iPad implementation process were responsive in real time. The evaluation measures included a clinician survey and collection of narratives from patients and clinicians. RESULTS All clinician respondents (n=7) indicated that the iPads were a valuable tool to support patients and families. Narratives from patients indicated that virtual connections brought joy to them especially given that they were isolated from their support systems during the initial days of COVID-19. Key learnings for the Implementation Team were: the importance in maintaining cognitive stimulation as an enabler to recovery for patients; staff members provide support beyond direct clinical care; technology needs to be harnessed to facilitate clinical care; technology should be leveraged to support clinical care; and interprofesssional collaboration of the entire Implementation Team is a key enabler of success. CONCLUSION Since implementation, iPads have been integrated as a supporting digital tool for both social connections as well as clinical care as a result of the benefits seen during this initiative. The iPads have also been recognized as a tool to complement patient connection and care and currently being expanded as part of services to patients, families and their clinicians.
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Affiliation(s)
- Genny Ng
- Quality and Patient Safety, Sunnybrook Health Sciences Centre, Toronto ON.
| | - Chaitali Desai
- Practice-Based Research and Innovation, Sunnybrook Health Sciences Centre, Toronto ON
| | - Lina Gagliardi
- Social Work and Spiritual & Religious Care, Sunnybrook Health Sciences Centre, Toronto ON
| | - Siobhan Donaghy
- St. John's Rehab, Sunnybrook Health Sciences Centre, Toronto ON; Department of Radiation Oncology, Temerty Faculty of Medicine, University of Toronto, Toronto ON
| | - Lisa Di Prospero
- Practice-Based Research and Innovation, Sunnybrook Health Sciences Centre, Toronto ON; Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto
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Bouton C, Journeaux M, Jourdain M, Angibaud M, Huon JF, Rat C. Interprofessional collaboration in primary care: what effect on patient health? A systematic literature review. BMC Prim Care 2023; 24:253. [PMID: 38031014 PMCID: PMC10685527 DOI: 10.1186/s12875-023-02189-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 10/20/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND In a period of change in the organization of primary care, Interprofessional Collaboration (IPC) is presented as one of the solutions to health issues. Although the number of inter-professional interventions grounded in primary care increases in all developed countries, evidence on the effects of these collaborations on patient-centred outcomes is patchy. The objective of our study was to assess the effects of IPC grounded in the primary care setting on patient-centred outcomes. METHODS We conducted a systematic literature review using the PubMed, Embase, PsycINFO and CINAHL databases from 01/01/1995 to 01/03/2021, according to the PRISMA guidelines. Studies reporting the effects of IPC in primary care on patient health outcomes were included. The quality of the studies was assessed using the revised Downs and Black checklist. RESULTS Sixty-five articles concerning 61 interventions were analysed. A total of 43 studies were prospective and randomized. Studies were classified into 3 main categories as follows: 1) studies with patients at cardiovascular risk (28 studies)-including diabetes (18 studies) and arterial hypertension (5 studies); 2) studies including elderly and/or polypathological patients (18 studies); and 3) patients with symptoms of mental or physical disorders (15 studies). The number of included patients varied greatly (from 50 to 312,377). The proportion of studies that reported a positive effect of IPC on patient-centred outcomes was as follows: 23 out of the 28 studies including patients at cardiovascular risk, 8 out of the 18 studies of elderly or polypathological patients, and 11 out of the 12 studies of patients with mental or physical disorders. CONCLUSIONS Evidence suggests that IPC is effective in the management of patients at cardiovascular risk. In elderly or polypathological patients and in patients with mental or physical disorders, the number of studies remains very limited, and the results are heterogeneous. Researchers should be encouraged to perform studies based on comparative designs: it would increase evidence on the positive effect and benefits of IPC on patient variables.
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Affiliation(s)
- Céline Bouton
- Department of General Practice, Faculty of Medicine, University of Nantes, 1, Rue Gaston Veil, 44035, Nantes, France.
- Primary Care Federative Department, Faculty of Medicine, University of Nantes, Nantes, France.
| | - Manon Journeaux
- Department of General Practice, Faculty of Medicine, University of Nantes, 1, Rue Gaston Veil, 44035, Nantes, France
| | - Maud Jourdain
- Department of General Practice, Faculty of Medicine, University of Nantes, 1, Rue Gaston Veil, 44035, Nantes, France
- Primary Care Federative Department, Faculty of Medicine, University of Nantes, Nantes, France
| | - Morgane Angibaud
- Primary Care Federative Department, Faculty of Medicine, University of Nantes, Nantes, France
| | - Jean-François Huon
- Primary Care Federative Department, Faculty of Medicine, University of Nantes, Nantes, France
- Faculty of Pharmacy, University of Nantes, Nantes, France
| | - Cédric Rat
- Department of General Practice, Faculty of Medicine, University of Nantes, 1, Rue Gaston Veil, 44035, Nantes, France
- Primary Care Federative Department, Faculty of Medicine, University of Nantes, Nantes, France
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Bosdijk A, Nieboer AP, Cramm JM. The development of an integrated neighborhood approach for health promotion and prevention: a qualitative exploration of stakeholders' views. Health Res Policy Syst 2023; 21:125. [PMID: 38017576 PMCID: PMC10683097 DOI: 10.1186/s12961-023-01077-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 11/20/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Although the promise of integrated neighborhood approaches, including the essential roles of communities and collaboration between the medical and social domains, has been widely acknowledged, the realization of such approaches in practice often remains difficult. To gain insight into the development of integrated neighborhood approaches, this case study describes the experiences of stakeholders involved in such an approach for health promotion and prevention in Rotterdam. METHODS Interviews with 18 stakeholders (including health and social care professionals, health insurance employees, and policymakers) were conducted, and stakeholders' statements were analyzed thematically. RESULTS The results reveal a lack of alignment among the professional, organizational, and system levels. Elements needed for collaboration between health and social care professionals are not supported at the organizational and system levels. The lack of integration at the policy and organizational levels encourages competition and self-interest instead of stimulating collaboration. CONCLUSIONS Intersectoral collaboration and coordination must take place not only between professionals, but also at the organizational and policy levels. As long as integration at the organizational and system levels is lacking, professionals' ability to collaborate and provide coordinated support to neighborhood residents will be compromised.
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Affiliation(s)
- Anniek Bosdijk
- Department of Socio-Medical Sciences, Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.
| | - Anna Petra Nieboer
- Department of Socio-Medical Sciences, Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
| | - Jane Murray Cramm
- Department of Socio-Medical Sciences, Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands
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31
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Drgac D, Himmelsbach R. Acts of negotiation: toward a grounded theory of nursing practice in chronic wound care in Austria. BMC Health Serv Res 2023; 23:1253. [PMID: 37964276 PMCID: PMC10647116 DOI: 10.1186/s12913-023-10276-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 11/03/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Demographic change and the rise of diabetes mellitus are leading to a projected increase in the prevalence of chronic wounds. People suffering from chronic wounds experience significant losses in their health-related quality of life. Health systems struggle to meet the needs of these persons, even in high-income countries. This paper explores wound nurses' perspectives on their professional practice in Austria. They play a key role as they do much of the treatment work, contribute to advancing the field, and enable interprofessional coordination. Their perspectives enable insights into how a health system provides care for elderly and chronically ill people. METHODS We used the Constructivist Grounded Theory framework to analyse transcripts of 14 semi-structured qualitative interviews with nurses who work in different treatment settings. RESULTS We identified three themes. Firstly, the interviewees characterise working with patients as a balancing act between offering enough support to build a trustful relationship while protecting themselves against the overwhelming situation of caring for a chronically ill person. Secondly, the interviewees compensate for nonexistent care pathways by building informal networks with doctors, which requires delicate relationship work. Thirdly, the study participants must prove their competence in every new professional encounter. Their need for professional autonomy clashes with the traditional doctor-nurse hierarchy. Based on these insights, we propose a grounded theory that conceives of nursing practice in terms of 'acts of negotiations'. CONCLUSION Our results demonstrate that wound nurses in Austria operate in an institutional environment whose outdated imagination of the nursing role is at odds with the care demands that arise from a growing number of elderly and chronically ill people. We detailed the 'acts of negotiation' nurses deploy to compensate for this situation. We identify areas for policy intervention to strengthen the autonomy of wound nurses, including access to statutory health insurance billing.
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Affiliation(s)
- Deborah Drgac
- Department of Political Science, University of Vienna, Universitätsstraße 7/2, Vienna, 1010, Austria.
- Research Group Senescence and Healing of Wounds, Ludwig Boltzmann Gesellschaft, Donaueschingenstraße 13, Vienna, 1200, Austria.
| | - Raffael Himmelsbach
- Research Group Senescence and Healing of Wounds, Ludwig Boltzmann Gesellschaft, Donaueschingenstraße 13, Vienna, 1200, Austria
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Przymuszała P, Fabianowska S, Zielińska-Tomczak Ł, Cerbin-Koczorowska M, Marciniak R. Factors influencing behavioral intentions of graduating pharmacy students regarding interprofessional collaboration - a theory-driven qualitative study. BMC Health Serv Res 2023; 23:1207. [PMID: 37926826 PMCID: PMC10626734 DOI: 10.1186/s12913-023-10224-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/27/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Interprofessional collaboration enhances the use of competencies of different medical team members. Additionally, pharmacists' involvement in patient care has been shown to improve their outcomes and seems particularly valuable in chronic diseases. Therefore, due to the aging of society and the increasing prevalence of chronic diseases, efforts are needed to involve pharmacists more broadly in patient care. However, there is a limited understanding of what factors could influence their willingness to participate in an interprofessional care team, especially among pharmacy students only entering the profession. This study aimed to fill these knowledge gaps by exploring graduating pharmacy students' intentions in this regard guided by the theory of planned behavior. METHODS We conducted seventeen semi-structured interviews with graduating pharmacy students of Poznan University of Medical Sciences, which were then thematically analyzed by two researchers. RESULTS Positive attitudes of respondents, who mentioned the possibility of acquiring new knowledge, skills, and competencies, increased prestige and appreciation of the pharmacist's profession, a better quality of patient care, and the support and relief offered to other team members as a result of collaboration, seem to strengthen their intentions. However, they also expressed their worries about potential errors and knowledge gaps, which constituted an example of some existing negative feelings. The identified sources of generally mixed social pressure toward the behavior included other pharmacists and pharmacy students, physicians, patients, their relatives and friends, and the decision and policymakers. Finally, their intentions may also be weakened by the mentioned perceived behavioral control aspects, like their level of pharmaceutical and clinical knowledge, skills, and experience, their knowledge of representatives of other professions and collaboration, the atmosphere at their future place of work, co-workers' potential reluctance to collaborate with them, finding time for collaboration, the existence of incentives and gratification system, and existing legal regulations. CONCLUSIONS The attitudes of graduating pharmacy students toward interprofessional collaboration seem mostly positive, but their intentions might be weakened by the mixed sense of social pressure and factors decreasing their perceived behavioral control.
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Affiliation(s)
- Piotr Przymuszała
- Department of Medical Education, Poznan University of Medical Sciences, 7 Rokietnicka St, Poznan, 60-806, Poland.
| | - Sandra Fabianowska
- Students' Scientific Club of Medical Education, Department of Medical Education, Poznan University of Medical Sciences, Poznan, Poland
| | - Łucja Zielińska-Tomczak
- Department of Medical Education, Poznan University of Medical Sciences, 7 Rokietnicka St, Poznan, 60-806, Poland
| | - Magdalena Cerbin-Koczorowska
- Department of Medical Education, Poznan University of Medical Sciences, 7 Rokietnicka St, Poznan, 60-806, Poland
- Edinburgh Medical School: Medical Education, Chancellor's Building, University of Edinburgh, Edinburgh, Scotland, UK
| | - Ryszard Marciniak
- Department of Medical Education, Poznan University of Medical Sciences, 7 Rokietnicka St, Poznan, 60-806, Poland
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Boltey E, Iwashyna T, Cohn A, Costa D. Identifying the unique behaviors embedded in the process of interprofessional collaboration in the ICU. J Interprof Care 2023; 37:857-865. [PMID: 37086195 DOI: 10.1080/13561820.2023.2202218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 02/16/2023] [Accepted: 04/06/2023] [Indexed: 04/23/2023]
Abstract
Interprofessional collaboration (IPC) is an important aspect of high-quality care in intensive care units (ICUs). The practice of IPC, however, is complex and the components that constitute IPC are not well defined. We sought to identify distinct behaviors embedded in clinician workflow that indicate engagement in the IPC process. We conducted a clinical ethnography in two ICUs in southeastern Michigan. From March 2017 to March 2019, we collected 31 hours of observations and completed 12 separate clinician shadowings and 12 interviews with ICU nurses, physicians, and respiratory therapists. We applied an iterative analytical approach to identify two types of IPC behaviors which we a priori labeled as "enablers" (i.e. the ways clinicians transition into or facilitate collaboration) and "collaborative activities" (i.e. behaviors clinicians use to directly collaborate with other professionals). 18 IPC behaviors were identified - ten "enablers" and eight "collaborative activities." Specifically, the enablers include: active listening, approach, coordinating work, intraprofessional consultation, invitation, nonverbal accessibility, reflexive questioning, sending pages/call, validation, and verbal accessibility. The collaborative activities are: correction, fill in the gap, information exchange, negotiation, providing help, socializing, teaching/training, and troubleshooting. By identifying IPC behaviors embedded in clinician workflow, our results may support more focused assessments of IPC in practice and guide clinicians toward behaviors they can use to engage in the IPC process.
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Affiliation(s)
- Emily Boltey
- VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, United States
| | - Theodore Iwashyna
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, MD, United States
| | - Amy Cohn
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, United States
- Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, Michigan
| | - Deena Costa
- School of Nursing, Yale University, New Haven, CT
- Department of Internal Medicine, Section of Pulmonary, Critical Care & Sleep Medicine, Yale School of Medicine, New Haven, CT
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Ho JT, See MTA, Tan AJQ, Levett-Jones T, Lau TC, Zhou W, Liaw SY. Healthcare professionals' experiences of interprofessional collaboration in patient education: A systematic review. Patient Educ Couns 2023; 116:107965. [PMID: 37677919 DOI: 10.1016/j.pec.2023.107965] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 07/14/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVES This study explores interprofessional collaboration amongst healthcare professionals in patient education. METHODS A systematic review was conducted. A search in seven databases was conducted from 2011 to 2022 and screened against the inclusion criteria. Quality appraisal was done independently by two reviewers. Studies were extracted and synthesised using the data-based convergent synthesis design. RESULTS Twenty-one studies were included. Five themes on factors affecting interprofessional collaboration in patient education emerged: 1) role clarification, 2) communication infrastructure, 3) shared space for collaboration, 4) interprofessional trust, and 5) organisational support. CONCLUSION Findings highlighted the importance of developing trustful relationships within the multidisciplinary team in delivering patient education. Channels for additional infrastructural support, guidelines and training in patient education delivery is required. Future research could explore patients' perspectives on how their learning needs in patient education may be optimised through a multidisciplinary approach. PRACTICE IMPLICATIONS Healthcare leaders could promote shared goals within the team by facilitating a common space and time for interprofessional team rounding, and by developing shared patient education resources and documentation processes. Interprofessional education focusing on the delivery of team-based patient education could be implemented to foster understanding of the interdependent role of multidisciplinary healthcare professionals.
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Affiliation(s)
| | - Min Ting Alicia See
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Apphia Jia Qi Tan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Tracy Levett-Jones
- School of Nursing & Midwifery, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Tang Ching Lau
- Yong Loo Lin School Medicine, National University of Singapore, Singapore
| | - Wentao Zhou
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Chu M, Xu L, Liu Y, Ye H, Zhang Y, Xue Y, Li Y, Gao X, Hao J, Wang L, Guo Q, Wang Y. Interprofessional education in problem-based learning: A frontier form of PBL in medical education. J Educ Health Promot 2023; 12:376. [PMID: 38144018 PMCID: PMC10743944 DOI: 10.4103/jehp.jehp_62_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/07/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND Interprofessional education (IPE) aims to educate healthcare students to improve collaboration and the quality of care. The delivery of IPE through a problem-based learning (PBL) setting appears to hold good validity. However, there are few studies that show the value of combining these two teaching modes. MATERIALS AND METHODS The research was a longitudinal intervention study. A total of 360 students were randomly divided into three interprofessional PBL (IPBL) groups that mixed nursing, pharmacy, and clinical medical students and three uniprofessional PBL (UPBL) groups that consisted of a single profession. An improved Attitude and Learning Ability Questionnaire (ALAQ) was used to measure the improvement in attitudes toward interprofessional cooperation and learning outcomes. The tutorial session and final examination grades were compared between IPBL and UPBL by Chi-square tests and Cochran-Mantel-Haenszel tests. Cronbach's α analysis was calculated to assess the validity and reliability. Cronbach's alpha coefficient of the questionnaire was 0.887, demonstrating high levels of reliability (95% confidence interval [CI]: 0.842 0.916). RESULTS According to Chi-square tests and Cochran-Mantel-Haenszel tests, we observed the student's positive attitudes toward interprofessional collaboration and the student's role awareness in the IPBL students was increased compared with UPBL students. In addition, a great majority of IPBL students felt that they had improved their self-learning ability and maintained a high enthusiasm for learning during the course. CONCLUSION Our study found that the IPBL teaching model was more effective than the UPBL teaching model in healthcare student's positive attitudes toward interprofessional collaboration and learning outcomes.
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Affiliation(s)
- Ming Chu
- Department of Immunology, School of Basic Medical Sciences, Peking University, NHC Key Laboratory of Medical Immunology (Peking University), Beijing, China
| | - Lan Xu
- Department of Immunology, School of Basic Medical Sciences, Peking University, NHC Key Laboratory of Medical Immunology (Peking University), Beijing, China
| | - Yuan Liu
- Department of Immunology, School of Basic Medical Sciences, Peking University, NHC Key Laboratory of Medical Immunology (Peking University), Beijing, China
| | - Huihui Ye
- Department of Immunology, Hunan Polytechnic of Environment and Biology, Hengyang, China
| | - Yan Zhang
- Teaching Office, School of Basic Medical Sciences, Department of Immunology, Peking University Health Science Center, Beijing, China
| | - Yintong Xue
- Department of Immunology, School of Basic Medical Sciences, Peking University, NHC Key Laboratory of Medical Immunology (Peking University), Beijing, China
| | - Yan Li
- Department of Immunology, School of Basic Medical Sciences, Peking University, NHC Key Laboratory of Medical Immunology (Peking University), Beijing, China
| | - Xiang Gao
- Department of Immunology, School of Basic Medical Sciences, Peking University, NHC Key Laboratory of Medical Immunology (Peking University), Beijing, China
| | - Jie Hao
- Department of Immunology, School of Basic Medical Sciences, Peking University, NHC Key Laboratory of Medical Immunology (Peking University), Beijing, China
| | - Lijun Wang
- Department of Immunology, School of Basic Medical Sciences, Peking University, NHC Key Laboratory of Medical Immunology (Peking University), Beijing, China
| | - Qi Guo
- Student Office, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Yuedan Wang
- Department of Immunology, School of Basic Medical Sciences, Peking University, NHC Key Laboratory of Medical Immunology (Peking University), Beijing, China
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Carter C, Mohammed S, Upshur R, Kontos P. "I don't see the whole picture of their health": a critical ethnography of constraints to interprofessional collaboration in end-of-life conversations in primary care. BMC Prim Care 2023; 24:225. [PMID: 37898764 PMCID: PMC10612350 DOI: 10.1186/s12875-023-02171-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 10/04/2023] [Indexed: 10/30/2023]
Abstract
CONTEXT Interprofessional collaboration is recommended in caring for frail older adults in primary care, yet little is known about how interprofessional teams approach end-of-life (EOL) conversations with these patients. OBJECTIVE To understand the factors shaping nurses' and allied health clinicians' involvement, or lack of involvement in EOL conversations in the primary care of frail older adults. METHODS/SETTING A critical ethnography of a large interprofessional urban Family Health Team in Ontario, Canada. Data production included observations of clinicians in their day-to-day activities excluding direct patient care; one-to-one semi-structured interviews with clinicians; and document review. Analysis involved coding data using an interprofessional collaboration framework as well as an analysis of the normative logics influencing practice. PARTICIPANTS Interprofessional clinicians (n = 20) who cared for mildly to severely frail patients (Clinical Frailty Scale) at the Family Health Team. RESULTS Findings suggest primary care nurses and allied health clinicians have the knowledge, skills, and inclination to engage frail older adults in EOL conversations. However, the culture of the clinic prioritizes biomedical care, and normalizes nurses and allied health clinicians providing episodic task-based care, which limits the possibility for these clinicians' engagement in EOL conversations. The barriers to nurses' and allied health clinicians' involvement in EOL conversations are rooted in neoliberal-biomedical ideologies that shapes the way primary care is governed and practiced. CONCLUSIONS Our findings help to explain why taking an individual-level approach to addressing the challenge of delayed or avoided EOL conversations, is unlikely to result in practice change. Instead, primary care teams can work to critique and redevelop quality indicators and funding models in ways that promote meaningful interprofessional practice that recognize the expertise of nursing and allied health clinicians in providing high quality primary care to frail older patients, including EOL conversations.
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Affiliation(s)
- Celina Carter
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
| | - Shan Mohammed
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - Ross Upshur
- Department of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Pia Kontos
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
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Alabdouli SR, Alriyami HM, Ahmad SZ, Mertzanis C. Interprofessional nursing education and the role of swift trust and task conflict in team creativity: the mediating role of team interactive behaviors. J Health Organ Manag 2023; ahead-of-print. [PMID: 37850986 DOI: 10.1108/jhom-01-2023-0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
PURPOSE This paper aims to explore the impact of interprofessional healthcare collaboration among nurses on patient healthcare services in the United Arab Emirates (UAE). DESIGN/METHODOLOGY/APPROACH Data were gathered through a randomly distributed questionnaire (N = 248), constructed using established scales or the variables under study. The sample consisted of nurses and patients from various hospitals and clinics across the UAE. The collected data were analyzed using SPSS (Version 28) and Amos (Version 29) software, employing factor analysis, reliability testing and mediation analysis. FINDINGS The study reveals a positive relationship between swift trust (ST) and its dimensions with both team interactive behavior (TIB) and nurse team creativity (TC). TIB was found to significantly mediate the effect of ST on TC. Additionally, based on closed-ended questions, a positive correlation was observed between team task conflict (TTC) and TC. However, no significant impact of TTC on nurse TC was identified through open-ended questions. ORIGINALITY/VALUE This research presents a unique analysis of the influence of interprofessional collaboration on patient healthcare services in the UAE, offering valuable insights for policy improvement by enhancing nursing conditions. Furthermore, the study contributes to the existing literature by examining the relationship between ST, TIB, TTC and TC.
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Affiliation(s)
- Shaikhah Rashed Alabdouli
- Department of Management, College of Business, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Hajer Mousa Alriyami
- Department of Management, College of Business, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Syed Zamberi Ahmad
- Department of Management, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Charilaos Mertzanis
- Department of Finance, College of Business, Abu Dhabi University, Abu Dhabi, United Arab Emirates
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Lukhele S, Mulaudzi FM, Sepeng N, Netshisaulu K, Ngunyulu RN, Musie M, Anokwuru R. The training of midwives to perform obstetric ultrasound scan in Africa for task shifting and extension of scope of practice: a scoping review. BMC Med Educ 2023; 23:764. [PMID: 37828497 PMCID: PMC10571413 DOI: 10.1186/s12909-023-04647-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 09/04/2023] [Indexed: 10/14/2023]
Abstract
INTRODUCTION Ultrasound scan is one of the essential assessments that is crucial in the early identification of health risks during antenatal care. Its accessibility to women in low-and middle-income countries remains a serious challenge because ultrasound scans are not within the scope of practice for midwives. However, task shifting and extension of scope of practice aim to train midwives to assess pregnant women through an ultrasound scan. This paper aims to report the findings of a scoping review on the training of midwives to perform obstetric ultrasound scans in Africa. METHODS The 6-step iterative framework for scoping reviews by Arksey and O'Malley was used to determine the extent of qualitative and quantitative evidence available on the training of midwives on obstetric ultrasound scans, which includes specifying the research question, identifying relevant studies, selecting studies, extracting and charting data, collating, summarising, and synthesising and reporting findings. RESULTS A total of 12 articles from eight African countries were included in this scoping review. Three main themes and 13 sub-themes emerged and they are: obstetric ultrasound scan training, challenges experienced by midwives from task shifting and extension of scope of practice regarding obstetric ultrasound scan, and the value of task shifting and extension of scope of practice regarding obstetric ultrasound scan to midwives. DISCUSSION Despite the available evidence that the training of midwives on obstetric ultrasound scans is essential to ensure the accessibility of quality antenatal health services, the training of midwives on obstetric ultrasound scans in some African countries remains a serious challenge. It is evident from this scoping review results that there is a need for African countries to incorporate obstetric ultrasound scans as part of the scope of practice of midwives. Task shifting necessitates prioritising the training of midwives on the use of obstetric ultrasound scans as one of the steps towards the achievement of the United Nations Sustainable Development Goal number 3 targets by 2030.
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Affiliation(s)
- Sanele Lukhele
- Department of Nursing, University of Johannesburg, Johannesburg, Republic of South Africa.
| | | | - Nombulelo Sepeng
- Department of Nursing, University of Pretoria, Pretoria, Republic of South Africa
| | - Khathutshelo Netshisaulu
- Department of Advanced Nursing Science, University of Venda, Thohoyandou, Republic of South Africa
| | | | - Maurine Musie
- Department of Nursing, University of Pretoria, Pretoria, Republic of South Africa
| | - Rafiat Anokwuru
- Department of Nursing, University of Pretoria, Pretoria, Republic of South Africa
- Department of Maternal and Child Health, Ilishan School of Nursing, Babcock University, Remo, Ogun State, Nigeria
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Han SP, Jumat MR, Cleland JA. Interprofessional collaboration (or lack thereof) between faculty and learning technologists in the creation of digital learning. BMC Med Educ 2023; 23:727. [PMID: 37794342 PMCID: PMC10548781 DOI: 10.1186/s12909-023-04728-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/27/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND As digital learning becomes more prevalent and important in health professions education, learning technologists play increasingly central roles in designing and delivering learning materials. However, little is understood about the process by which learning technologists have integrated into the existing teaching and learning ecosystem, and it seems that they remain marginal and undervalued. Our aim in this paper was therefore to examine the process of interprofessional co-development of course materials as experienced by educators and learning technologists. METHODS Our approach was qualitative, using individual semi-structured interviews (conducted between July 2021 to May 2022) to explore the working relationship between faculty and learning technologists. Transcripts were analysed abductively. RESULTS We found that the attitudes of both faculty and learning technologists towards collaborating to drive digital adoption in health professions education fell into two main themes: "embrace" and "replace" - and "conflict", which we present as a third theme. Our results revealed that faculty did not take an active and agentic role in developing their digital practices in respect of education delivery. Learning technologists positioned themselves as a resource to support faculty's knowledge and skill gap in digital competence. There was an obvious power differential between the two groups: learning technologists lacked agency and seemed in the position of servants to faculty masters. This created barriers to effective collaboration. CONCLUSIONS By examining the process of co-development of course materials by faculty and learning technologists, we open up a space to examine the social, relational and organisational complexities associated with interprofessional collaboration in digital health professions education. Our study also has important implications for guiding educational policy to better position learning technologists to effectively collaborate with faculty and realise the potential of digital health professions education.
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Affiliation(s)
- Siew Ping Han
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
| | | | - Jennifer Anne Cleland
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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Chong JBK, Yap CYH, Tan SLL, Thong XR, Fang Y, Smith HE. General practitioners' perceptions of the roles of community pharmacists and their willingness to collaborate with pharmacists in primary care. J Pharm Policy Pract 2023; 16:114. [PMID: 37789392 PMCID: PMC10546622 DOI: 10.1186/s40545-023-00613-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 09/16/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Community pharmacists (CPs) have the capacity to contribute to patient care given their expertise in medication and accessibility to residents in the community. However, multidisciplinary patient care programmes where CPs collaborate with general practitioners (GPs) in patient care is rare in Singapore despite increasing healthcare demand. OBJECTIVES This study explores GPs' perceptions of CPs' current roles and GPs' ideas for and attitudes towards interprofessional collaboration. METHODS Semi-structured qualitative interviews were conducted with 20 private GPs from August to December 2020 via an online video-chat platform. GPs were recruited from the Primacy Care Research Network (pcRn), primary care networks, and using snowballing strategies. All interviews were recorded, transcribed and coded thematically. RESULTS Current working relationships between GPs and CPs appeared amicable but limited. GPs appreciate the existing roles of CPs: dispensing drugs not stocked in their practices and clarifying prescription details. Still, GPs appeared to rarely consider collaborative working. GPs acknowledged that CPs could enhance patient care with initiatives including medication reconciliation and advising on using medical devices. It was suggested that CPs could coordinate the purchase of drugs for primary care networks to improve GPs' inventory management, but less enthusiasm was expressed for clinical collaborations with CPs. Major concerns about GP-CP clinical collaborations included direct competition with GPs' own business interests, perceived low acceptability of pharmacy-led services by patients (citing extra time and cost), threat to continuity of care and the absence of a shared patient electronic health record system. Current funding mechanisms do not enable reimbursement of clinical services provided by CPs. Adoption of telemedicine technologies and governmental financial support were identified as possible enablers of GP-CP collaboration. CONCLUSIONS GPs saw potential in CPs' increased involvement in patient care, but perceived multiple barriers. Strategies focusing on overcoming these barriers could enable GP-CP collaboration to enhance patient care.
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Affiliation(s)
- Joy Boon Ka Chong
- Watson's Personal Care Stores Pte Ltd, 300 Beach Road, The Concourse, #39-01/04, Singapore, 199555, Singapore.
| | - Clivia Yao Hua Yap
- Watson's Personal Care Stores Pte Ltd, 300 Beach Road, The Concourse, #39-01/04, Singapore, 199555, Singapore.
| | - Shawn Lien Ler Tan
- Ministry of Health Holdings Pte Ltd, 1 Maritime Square, #11-25, Singapore, 099253, Singapore
| | - Xuan Rong Thong
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308232, Singapore
| | - Yang Fang
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308232, Singapore
| | - Helen E Smith
- Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Mandalay Road, Singapore, 308232, Singapore
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Etenaille M, Lecocq D, Herpelinck P, Parent F, Foucart J. Evaluation of inter-professional seminar involving patient-partners and caregivers. Patient Educ Couns 2023; 115:107902. [PMID: 37499448 DOI: 10.1016/j.pec.2023.107902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 07/11/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVE To assess the contribution of interprofessional education (IPE) for pre-graduate students from eight study branches. These seminars had patient-partners and caregivers as co-facilitators for reflexive conversations, with educational goals of learning interprofessional communication and involving patients in decision-making. METHODS A pre/post seminar comparison with 2 questionnaires about the students' professional identity, multidisciplinary collaboration and patients' involvement, and the richness of stakeholders' definitions. RESULTS 1142 students participated in the course (n = 740 after removing missing data). The results indicate that this type of education helps students feel more confident in their ability to communicate and collaborate (z = -10,204; p < 0,001), involves patients in their care plan (z = -7,996; p < 0,001) and fosters the competence and autonomy of the post-graduate students in their own professional field (z = -10,627; p < 0,001). It also enriches the definition of patients' roles (n = 399; z = -17,276; p < 0,001). CONCLUSION Including patients-partners and caregivers in IPE enriches the professional identity and increases the self-efficacy of futures caregivers. PRACTICE IMPLICATIONS This program exposed students to collaborative care practices, can reduce their resistance to this type of practice after graduation by making them more confident in using a structured team approach and recognising its benefits for both patients and caregivers.
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Affiliation(s)
- Maxime Etenaille
- Research Unit in Sciences of Osteopathy, Faculty of Motor Sciences, Université libre de Bruxelles, Brussels, Belgium; Research Unit in Motor Psychophysiology, Faculty of Motor Sciences, Université libre de Bruxelles, Brussels, Belgium
| | - Dan Lecocq
- Center for Research in Health Economics, Management of Health Care Institutions and Nursing, School of Public Health, Université libre de Bruxelles, Brussels, Belgium; Nursing Section, Health Department, Haute École Libre de Bruxelles Ilya Prigogine, Brussels, Belgium; Education Department, School of Public Health, Université libre de Bruxelles, Bruxelles, Belgium
| | - Pascaline Herpelinck
- Nursing Section, Health Department, Haute École Libre de Bruxelles Ilya Prigogine, Brussels, Belgium; Education Department, School of Public Health, Université libre de Bruxelles, Bruxelles, Belgium
| | - Françoise Parent
- Healthcare Division, Université libre de Bruxelles, Brussels, Belgium
| | - Jennifer Foucart
- Research Unit in Motor Psychophysiology, Faculty of Motor Sciences, Université libre de Bruxelles, Brussels, Belgium.
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Madisa M, Filmalter CJ, Heyns T. Healthcare professionals and pregnant and post-natal women's perceptions of interprofessional collaboration in a maternity care facility: A qualitative study from Botswana. Midwifery 2023; 125:103768. [PMID: 37467547 DOI: 10.1016/j.midw.2023.103768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 05/11/2023] [Accepted: 06/25/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE To explore the perceptions of healthcare professionals and pregnant and post-natal women regarding interprofessional collaboration in a maternity care setting in Botswana, a low-to-middle-income country in Sub-Sahara Africa. DESIGN A descriptive qualitative design using in-depth interviews with forty participants, including healthcare professionals and women in maternity wards. Data were transcribed and thematically analysed. SETTING Antenatal, delivery and post-natal maternity wards in a referral hospital that provides basic and specialist care in Botswana. PARTICIPANTS We interviewed 13 pregnant and post-natal women and 27 healthcare professionals in the maternity care wards. FINDINGS Participants perceived several interrelated factors that influenced the delivery of interprofessional collaborative care. Interpersonal factors such as poor communication, disrespectful behaviours and inadequate teamwork practices prevented interprofessional collaboration. Other barriers to collaboration included lack of understanding of each other's roles and responsibilities, ineffective coordination of resources, hierarchical power struggles and poor collaborative leadership. KEY CONCLUSIONS Effective interprofessional collaboration remains elusive in this maternity care setting. Healthcare systems in low-to-middle-income countries may benefit from interventions for healthcare professionals to learn and practice interprofessional collaborative care.
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Affiliation(s)
- Montlenyane Madisa
- Department of Nursing Science, University of Pretoria, Pretoria, South Africa.
| | - Celia J Filmalter
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Tanya Heyns
- Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Kemp S, Brewer M. Early stages of learning in interprofessional education: stepping towards collective competence for healthcare teams. BMC Med Educ 2023; 23:694. [PMID: 37740200 PMCID: PMC10517498 DOI: 10.1186/s12909-023-04665-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 09/10/2023] [Indexed: 09/24/2023]
Abstract
BACKGROUND Interprofessional education (IPE) is a core element of many health professional education curricula. To date the focus of much research has been on student perceptions of, and attitudes towards, the learning experience. Little is known about the impact of early IPE experience on how students understand and learn about effective interprofessional teamwork. METHODS This qualitative study involved first year university students enrolled in health professions degrees and investigated their descriptions of interprofessional teamwork through graphic elicitation and interviews. Participants were enrolled in a large-scale interprofessional unit (subject) in the university. RESULTS The data were analysed through the lens of a tool that classifies dimensions of interprofessional activity. The findings indicated the majority of students had what was classified as a Stage 1 (or 'nascent') understanding of integration between work practices and a Stage 2 (or 'emerging') understanding of the dimensions of interprofessional teamwork which were commitment, identity, goals, roles and responsibilities, and interdependence. CONCLUSIONS Based on the findings, the stages for a learning trajectory for interprofessional education are proposed and each stage is mapped to dimensions of interprofessional activity. A number of pedagogical strategies are suggested in order to move students through this two-stage model of learning and ensure their readiness for interprofessional teamwork as health professionals.
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Affiliation(s)
- Sandra Kemp
- Graduate School of Medicine, University of Wollongong, Wollongong, Australia.
| | - Margo Brewer
- Curtin School of Allied Health, Curtin University, Perth, Australia
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Lachmann H, Löfvenmark C. Academic emotions and attitudes regarding interprofessional collaboration in health care activities: a prospective study among newly arrived physicians participating in a fourteen-week course. BMC Med Educ 2023; 23:643. [PMID: 37679684 PMCID: PMC10486000 DOI: 10.1186/s12909-023-04620-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/28/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND One way of facilitating entrance into the Swedish health care system, for newly arrived physicians from outside the European Union/European Economic Area, could be to set up and offer a course aimed to enhance understanding of it. This course was offered to increase insight about clinical practices, interprofessional teamwork and topics such as, Swedish health care laws, culture, and ethics. Acceptance of, and a flexible attitude towards, interprofessional teamwork are important for maintaining both the physician's professional identity and a high quality of patient care. The aim of this study was to investigate newly arrived physicians', academic emotions, experience of stress and flow during a fourteen-week course, as well as attitudes to interprofessional collaboration, both before and after. METHOD A prospective study was conducted, with participants asked to respond on one questionnaire every course day, by using the Contextual Activity Sampling System methodology. The participants were asked to complete a questionnaire comprising ten questions about ongoing activity and in what way they experience, e.g., collaboration, interprofessional teamwork, academic emotions, flow, and stress. Furthermore, the participants were asked to score their attitude towards interprofessional teamwork by using the interdisciplinary education perception scale both before and after the course. RESULTS The total sample comprised 27 qualified physicians, from outside the European Union/European Economic Area. In the interdisciplinary education perception scale category, "perception of actual cooperation¨, the participants had significantly higher scores after the course. Flow and academic emotions were felt mostly during own periods of study, seminars, and lectures. The academic emotions were apathy, anxiety, and boredom. The most frequently experienced academic emotion was apathy. Course participants rated stress highest in connection with the examination. CONCLUSION The results show that the course had a positive impact on the participants perception of actual cooperation. It appears that participating in this kind of course was a positive experience for the participants, since they mostly experienced high levels of flow. Collaborating with others was experienced as positive, with participants reporting a high degree of flow in activities during collaboration.
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Affiliation(s)
- Hanna Lachmann
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Caroline Löfvenmark
- Department of health promoting science, Sophiahemmet University, P. O. Box 5605, 114 86, Stockholm, Sweden
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Drenth H, Krijnen W, van der Weerd L, Reinders JJ, Hobbelen H. Nursing home geriatric rehabilitation care and interprofessional collaboration; a practice-based study. BMC Geriatr 2023; 23:539. [PMID: 37670260 PMCID: PMC10478267 DOI: 10.1186/s12877-023-04212-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 08/01/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Frailty and multimorbidity are common among patients in geriatric rehabilitation care (GRC). Proper care of these patients involves multiple professionals which requires optimal interprofessional collaboration to provide the best possible support. Interprofessional collaboration (IPC) goes beyond multi-professional collaboration. It requires professionals to think beyond the expertise of their own discipline and work on joint outcomes in which the patient is actively involved. This study describes the development of the GRC teams of an elderly care organization towards the IPC. METHODS Mixed method pre-post study of 15 months. The interprofessional training program comprised team trainings, webinars, and online team sessions. Data was aggregated by administering the Extended Professional Identity Scale (EPIS) and QuickScan Interprofessional Collaboration (QS) measurements to GRC staff and by observations of the multi-professional team consultation (MPC) meetings of six GRC teams of an organization for elderly care in Drachten and Dokkum in the Netherlands. ADL independence (Barthel Index) and number of inpatient days were analyzed before and after the project. RESULTS Pretest healthcare professional response was 106, patients for analyses was 181; posttest response was 84, patients was 170. The EPIS shows improvement on "interprofessional belonging" (P = .001, 95%CI: 0.57-2.21), "interprofessional commitment" (P = .027, 95%CI: 0.12-1.90), and overall "interprofessional identity" (P = .013, 95%CI: 0.62 - 5.20). On the QS, all domains improved; "shared values" (P = .009, 95%CI: 0.07 - 0.47), "context" (P = .005, 95%CI: 0.08 - 0.44), "structure & organization" (P = .001, 95%CI: 0.14 - 0.56), "group dynamics & interaction" (P < .001, 95%CI: 0.18 - 0.58), and "entrepreneurship & management" (P = .039, 95%CI: 0.01 - 0.48). A qualitative analysis of the reflection responses and MPC observations indicate a shift from multi-professional to more IPC. Differences in ADL over time were not statistically significant. The mean number of inpatient days was reduced by 11.8 (P < .001, 95%CI: -17.34 - - 6.31) days. CONCLUSIONS Within the GRC teams, there was a shift observed to more IPC and better representation of the patient's wishes and needs. ADL independence did not change, yet we found a statistically significant decrease in the number of inpatient days. The basis for IPC was well established, however, it remains necessary that the teams continue to develop and invest in the collaboration with each other and the patient to further improve it.
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Affiliation(s)
- Hans Drenth
- Research group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.
- ZuidOostZorg, Friesland, The Netherlands.
- FAITH research, Leeuwarden, Groningen, The Netherlands.
| | - Wim Krijnen
- Research group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- FAITH research, Leeuwarden, Groningen, The Netherlands
| | - Lourens van der Weerd
- Research group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- FAITH research, Leeuwarden, Groningen, The Netherlands
| | - Jan Jaap Reinders
- Research group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- FAITH research, Leeuwarden, Groningen, The Netherlands
- LEARN, Research Institute SHARE, Groningen, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Research Group on Interprofessional Identity and Collaboration, Kaunas University of Applied Sciences, Kaunas, Lithuania
| | - Hans Hobbelen
- Research group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- FAITH research, Leeuwarden, Groningen, The Netherlands
- Department of General Practice and Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Brühmann BA, von der Warth R, Kaier K, Sehlbrede M, Ott M, Farin-Glattacker E. [Impact of CoCare, a Complex Model Intervention, on medical care in long-term care nursing homes in Germany: An overview of the outcome and process evaluation]. Z Evid Fortbild Qual Gesundhwes 2023; 181:42-54. [PMID: 37357109 DOI: 10.1016/j.zefq.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION More and more people are being cared for in nursing homes these days. Multimorbidity results in frequent but sometimes unnecessary patient transports and hospitalisations. The CoCare intervention was developed as a nursing home-based intervention to improve coordination of medical care and GP and specialist care in long-term care homes. The project aimed to reduce avoidable hospital admissions and ambulance transportation, minimise costs through the resulting better collaboration and improving the quality of life of nursing home residents. This article presents the results of the process and outcome evaluation of the intervention in an integrated way and assesses them against the background of the project objectives. METHODS Intervention and data collection started in January 2018 and ended in September 2020. A mixed-methods design was chosen for the evaluation. The (cost) effectiveness of the intervention was tested by a controlled observational study, comparing intervention (IG) and control group (CG). As part of the evaluation of the results, claims data from health insurance funds and a questionnaire-based survey among nursing staff, physicians and nursing home residents were analysed. As part of the process evaluation, subjectively perceived changes in care and implementation difficulties were recorded with the help of focus groups and telephone interviews conducted quarterly. RESULTS From the point of view of the health economic evaluation, with a decrease in total costs of € 468.56 (p<.001) per nursing home resident and quarter, an advantageous cost-benefit ratio can be assumed. Thus, the significant increase in outpatient care for nursing home residents goes along with a reduction of ambulance transportation by 0.19 (p=.049) and hospitalization rates by 0.08 (p=.001). In the nursing staff sample, a significant positive difference between IG (T1) and CG was observed with regard to communication and cooperation. In addition, pre-post comparison showed a significant improvement in the nursing staff's assessment of interprofessional cooperation in IG at T1 compared to T0. Both nursing staff and physicians perceived positive changes in care and positively assessed the benefit of the intervention. While practitioners experienced an intensification and improvement of communication and cooperation through the implementation of the CoCare measures, these changes were not perceived by residents. DISCUSSION The CoCare intervention lowered the barriers for nursing homes to contact general practitioners, specifically in unclear situations and can thus be seen as an effective tool to reduce potentially avoidable hospital admissions and costs. It is conceivable that results can be transferred to other regions in Germany and to similar care scenarios. It should be examined to what extent approaches of this new form of care can be transferred to standard care and whether adjustments to facilitate the implementation of coordinated care approaches across occupational groups in inpatient care facilities can be proposed within the framework of legislative procedures.
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Affiliation(s)
- Boris A Brühmann
- Institut für Medizinische Biometrie und Statistik, Sektion Versorgungsforschung und Rehabilitationsforschung (SEVERA), Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland.
| | - Rieka von der Warth
- Institut für Medizinische Biometrie und Statistik, Sektion Versorgungsforschung und Rehabilitationsforschung (SEVERA), Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Klaus Kaier
- Institut für Medizinische Biometrie und Statistik, Abteilung Methoden der klinischen Epidemiologie, Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Matthias Sehlbrede
- Institut für Medizinische Biometrie und Statistik, Sektion Versorgungsforschung und Rehabilitationsforschung (SEVERA), Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Margrit Ott
- Zentrum für Geriatrie und Gerontologie Freiburg (ZGGF), Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
| | - Erik Farin-Glattacker
- Institut für Medizinische Biometrie und Statistik, Sektion Versorgungsforschung und Rehabilitationsforschung (SEVERA), Universitätsklinikum Freiburg, Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland
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Hayashi H, Gravier M, Gustavson K, Bernstein-Ellis E. Perspectives of U.S. speech-language pathologists on supporting the psychosocial health of individuals with aphasia. J Commun Disord 2023; 105:106365. [PMID: 37481944 DOI: 10.1016/j.jcomdis.2023.106365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 07/05/2023] [Accepted: 07/10/2023] [Indexed: 07/25/2023]
Abstract
INTRODUCTION Individuals living with aphasia (IWA) are more likely than stroke survivors without aphasia to experience depression, anxiety, stress, and social isolation due to communication difficulties, social and life barriers, and neurobiological changes (Hilari, 2011). Researchers in the U.K., Australia, and elsewhere have surveyed speech-language pathologists (SLPs) to ascertain their training and confidence in addressing the psychosocial well-being of IWA (Northcott et al., 2017; Sekhon et al., 2015). To date, no similar survey has been performed in the U.S. The aim of this study was to survey the perspectives of U.S. SLPs on addressing the psychosocial well-being of IWA. METHODS The survey questions were drawn from Northcott et al. (2017), with adjustments for a U.S. audience and additional questions. We conducted a Qualtrics survey which remained open from November 2021 through May 2022 and collected 101 responses. Responses to the closed questions were analyzed using descriptive statistics and open-ended responses were analyzed with qualitative content analysis. RESULTS Some of the most significant findings of this survey include the low levels of confidence in addressing psychological health, lack of training among SLPs, and rarity of successful collaboration with mental health professionals. In comparison to surveys conducted in other countries, many overarching themes were similar, but there was some variation in specific responses and patterns. Categories emerging from the open-ended responses included the need for more trained mental health professionals, improved collaboration, and emphasis on the importance of the topic. CONCLUSIONS This research highlights the necessity of increased training, as well as improved interprofessional collaboration between SLPs and mental health professionals. Limitations of the study include the potential bias of respondents, as well as the number and scope of the questions and responses. Future studies can employ interviews, trial models for collaboration, and partner with IWA to explore their experiences with psychosocial health support and services.
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Affiliation(s)
- Haley Hayashi
- California State University, East Bay 25800 Carlos Bee Blvd, Hayward, CA 94542, United States.
| | - Michelle Gravier
- California State University, East Bay 25800 Carlos Bee Blvd, Hayward, CA 94542, United States
| | - Kristen Gustavson
- California State University, East Bay 25800 Carlos Bee Blvd, Hayward, CA 94542, United States
| | - Ellen Bernstein-Ellis
- California State University, East Bay 25800 Carlos Bee Blvd, Hayward, CA 94542, United States
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Coelho N, Neves A, Gregório J. Physicians and nurses professional relationship with criminal investigation in dealing with survivors of sexual abuse: a scoping review. Health Justice 2023; 11:33. [PMID: 37615818 PMCID: PMC10464451 DOI: 10.1186/s40352-023-00235-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/07/2023] [Indexed: 08/25/2023]
Abstract
Survivors of sexual abuse and their families seek help from criminal law enforcement agencies and health professionals to obtain justice and health care. Many communities have implemented multi-professional collaborative models so that the victim's well-being is assured and the truth is established. However, there is a general lack of evidence on how to best articulate these teams with the healthcare professionals caring for the survivors.Therefore, this Scoping Review was conducted in order to analyze and to map the barriers and facilitators of the relationship between health professionals and the criminal investigation team in the care of survivors of sexual abuse. The methodology proposed by the Joanna Briggs Institute for Scoping Reviews was used, and the Bronstein five dimension model of interprofessional collaboration served as the basis for the analysis of barriers and facilitators. Quantitative, qualitative and mixed studies, primary and secondary sources, text and opinion documents were included. Content analysis was performed on the main findings of the collected studies. Twelve articles were identified and analyzed. Collaboration, communication, hierarchy, skills, confidentiality, and leadership emerged as key themes. Multidisciplinary Sexual Assault Nurse Examiner (SANE) and Sexual Assault Response Teams (SARTs) were implemented to coordinate care, but conflicting goals and values among professionals posed challenges. Communication failures and inadequate information sharing hindered collaboration. Neutral leaders who coordinate teams, minimize groupthink, and improve decision-making were found to be valuable. Engaging across disciplinary boundaries and addressing power dynamics were challenging but could be addressed through facilitation and conflict resolution. This review highlights the importance of effective collaboration and interaction within teams and with other professionals in the care of sexual abuse survivors.
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Affiliation(s)
- Nuno Coelho
- Instituto de Polícia Judiciária e Ciências Criminais (Institute for Judiciary Police and Criminal Science), Loures, Portugal.
- Center for Research in Biosciences and Health Technologies, CBIOS. Lusófona University, Lisbon, Portugal.
- Health Sciences PhD Program, U Alcalá, Madrid, Spain.
| | - Anabela Neves
- Instituto Nacional de Medicina Legal e Ciências Forenses (National Institute of Forensic Medicine and Forensic Science), Coimbra, Portugal
- Medical and Forensic Office of North Lisbon Area, Lisbon, Portugal
| | - João Gregório
- Center for Research in Biosciences and Health Technologies, CBIOS. Lusófona University, Lisbon, Portugal
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Oliveira A, Brewer-Deluce D, Akhtar-Danesh N, Wojkowski S. Readiness for interprofessional learning among health science students: a cross-sectional Q-methodology and likert-based study. BMC Med Educ 2023; 23:583. [PMID: 37596571 PMCID: PMC10439564 DOI: 10.1186/s12909-023-04566-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/03/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND Interprofessional education (IPE) prepares healthcare students for collaboration in clinical practice, but the effectiveness of this teaching method depends on students' readiness for and perceptions of IPE. Evaluating students' readiness for and perceptions of IPE is challenging, due to the lack of comprehensive measures. This study characterized the level of IPE readiness and perspectives across first-year undergraduate and graduate health science students using the readiness for interprofessional learning Likert Scale (RIPLS) and Q-methodologies. METHODS This is a cross-sectional, online study. Students were randomized to answer the Likert-scale version of RIPLS (80%) or a matched Q-methodology survey (20%). An ANCOVA compared RIPLS scores between students from different program levels (graduate/undergraduate) and specialization (health professional and general programs). The Q-data was analysed using a by-person factor analysis. RESULTS Three hundred and four (33% response rate) and 71 (30% response rate) students completed the Likert scale and the Q-methodology surveys, respectively. Students from graduate programs demonstrated high readiness for IPE (higher total RIPLS scores p < 0.001) in comparison to undergraduates. Three factors, associated with program specialization (p = 0.04), emerged from the Q-methodology analysis characterizing students learning priorities. Students in undergraduate general programs were focused on IPE relevance and benefits to "the clinical team", students in graduate programs focused on "the patient", and those in undergraduate health professional programs focused on themselves ("me"). CONCLUSIONS This novel mixed-methods approach combining traditional Likert-scales with Q-methodology elucidated not only associations between program and specialization with readiness (Likert) but also which components of IPE were valued the most (Q-methodology) and by whom.
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Affiliation(s)
- Ana Oliveira
- Program for Interprofessional Practice, Education and Research (PIPER), McMaster University, 1400 Main Street West, Hamilton, ON, L8S 1C7, 647-765- 1525, Canada.
- Respiratory Medicine, West Park Healthcare Centre, Toronto, Canada.
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal.
- Department of Medical Sciences, iBiMED - Institute of Biomedicine, University of Aveiro, Aveiro, Portugal.
| | - Danielle Brewer-Deluce
- Program for Interprofessional Practice, Education and Research (PIPER), McMaster University, 1400 Main Street West, Hamilton, ON, L8S 1C7, 647-765- 1525, Canada
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | | | - Sarah Wojkowski
- Program for Interprofessional Practice, Education and Research (PIPER), McMaster University, 1400 Main Street West, Hamilton, ON, L8S 1C7, 647-765- 1525, Canada
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El Nsouli D, Nelson D, Nsouli L, Curtis F, Ahmed SI, McGonagle I, Kane R, Ahmadi K. The Application of Kirkpatrick's Evaluation Model in the Assessment of Interprofessional Simulation Activities Involving Pharmacy Students: A Systematic Review. Am J Pharm Educ 2023; 87:100003. [PMID: 37597909 DOI: 10.1016/j.ajpe.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/21/2023]
Abstract
OBJECTIVES To our knowledge, this systematic review is the first to assess pharmacy-involved interprofessional education (IPE) simulation activities in establishing current methodological effectiveness using Kirkpatrick's Evaluation Model. This is a training evaluative model that assesses educational training activities according to 4 levels: reaction, learning, behavior, and results. FINDINGS From the 3108 studies retrieved, 14 studies met the inclusion criteria. Thirteen studies achieved levels 1 and 2 of Kirkpatrick's Evaluation Model, and 1 achieved level 3. One study only achieved level 1. Single-group, pre- and posttest studies were the most common study designs (n = 9), and 1 study followed a longitudinal approach. IPE duration ranged from 45 min to 5 days, and most of the studies were conducted in the United States (n = 10). Most studies alluded to an underpinning theory behind IPE simulation design and chose surveys as their mode of data collection. SUMMARY The most common limitation reported was the uneven representation of professions and a lack of data on the studies' effect in practice. To demonstrate the achievement of outcomes in relation to levels 3 and 4, there is a need for longitudinal studies of IPE simulation activities. Although evaluative studies showed a positive response to IPE simulation at a basic level, there is a lack of effective integration of theory behind IPE design. Future studies need to consider this when setting the infrastructure of IPE design, as well as making efforts to mobilize stakeholders in the workplace to help facilitate transfer of learning.
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Affiliation(s)
- Dayana El Nsouli
- Pharmacy Department, Royal Derby Hospital, University Hospitals of Derby and Burton, Derby, UK.
| | - David Nelson
- Lincoln International Institute for Rural Health (LIIRH) at the University of Lincoln, Lincoln, UK
| | | | - Ffion Curtis
- Centre for Ethnic Health Research, NIHR Applied Research Collaboration (ARC), East Midlands, Diabetes Research Centre, University of Leicester, Leicester, UK.
| | | | - Ian McGonagle
- School of Health and Social Care, University of Lincoln, Lincoln, UK.
| | - Ros Kane
- School of Health and Social Care, University of Lincoln, Lincoln, UK.
| | - Keivan Ahmadi
- NIHR ARC Northwest London and the Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, UK.
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