Journal of Interprofessional Education and Practice最新文献

Learners from six health professions programs (athletic training, nursing, optometry, osteopathic medicine, pharmacy, and physical therapy) participated in a telehealth primary care simulation. The learners’ purpose of the simulated visit was to evaluate and manage a patient experiencing complications of type 2 diabetes, including vision changes, frequent falls, and a foot wound.

Objectives

The objectives of the activity were to: 1) assess changes in perceived interprofessional abilities in the areas of communication, collaboration, roles and responsibilities, patient/family-centered care, conflict management and resolution, and team functioning, and 2) assess learner perceptions regarding the value of the interprofessional primary care simulation.

Activity

Learners were divided into teams with 1–2 learners from each program (8–9 total learners per team) and each team interacted face-to-face in small individual classrooms. Trained faculty served as simulation facilitators in each classroom. Each team conducted a two-phase videoconference encounter with a trained standardized patient and family member. Between the two phases, each team conducted an interprofessional care planning session. Learner evaluation of the exercise used two validated tools, the revised Interprofessional Collaborative Competency Attainment Survey (ICCAS-R), and the modified Simulation Effectiveness Tool (SET-M) to inform the faculty.

Findings

Paired t-test values on all 20 items of the ICCAS-R indicated statistically significant results (p < .001), and SET-M results indicated that over 88 % of learners strongly agreed or somewhat agreed with questions pertaining to their satisfaction with the activity. Findings from this activity can be used by other educational institutions to develop a primary care simulation based on the health professions available, thus enhancing interprofessional learning opportunities and overcoming a common barrier of limited clinical sites for interprofessional practice.

Tooth decay is the most common chronic disease in children, and children often see their primary care practitioners more frequently than dentists (Adjaye-Gbewonyo and Black 2019-2020; National Center for Health Statistics 2019-2020). This Infant Oral Health Education Program included two online training sessions for trainees in social work, nursing, medicine, and dentistry. Trainees were assessed on anticipated changes to their practice related to children's oral health. During the first training session, trainees received a lecture on infant oral health, and then discussed a case study in interprofessional groups to reinforce the content. Trainees in medicine and nursing completed training to receive Medicaid reimbursement for performing preventive oral health services. The second training session was profession specific with tailored instructions in the form of videos, as well as a demonstration on fluoride varnish application. Of the 78 trainees (22 social work, 4 pediatric nurse practitioner, 38 pediatric medicine residents, and 14 pediatric dentistry residents), 91 % (n = 70) reported that they were introduced to at least one new health information resource or tool. Four-fifths of the eligible trainees (n = 16/20, 80 %) who completed the evaluation had fulfilled the State's requirements to receive Medicaid reimbursement for performing preventive oral health services. Three-fourths of trainees (n = 22/29, 75 %) reported that they are likely to promote children's oral health in future clinical practice. Trainees from all four professions provided positive feedback about the content.

Background

Severe Persistent Mental Illness (SPMI) is associated with increased morbidity compared with the general population. Our clinic serves a high percentage of SPMI patients.

Purpose

A Substance Abuse and Mental Health Services Administration (SAMHSA) grant enabled our clinic to integrate medical and mental health services with the aim of decreasing morbidity in SPMI patients.

Methods

This multiyear integration project included protocols for metabolic screening, increased staff to coordinate medical and mental health care, formation of an integrated treatment team, and increased patient engagement. Outcomes included biometrics and clinician feedback.

Discussion

Despite significant challenges from the COVID-19 pandemic and civil unrest in our community, we saw improvements in patient biometric measurements by year 3 of the project.

Conclusion

The results of this care model transformation project suggest that integration of primary and mental health care is a promising approach to decrease the burden of physical comorbidities in patients with SPMI.

Purpose

This paper describes lessons learned from the implementation and evaluation of a cross-training event that was held in response to continuing education needs expressed by stakeholders of health, social, justice and public safety sectors regarding individuals who experience multiple exclusion homelessness.

Method

The intersectoral training was documented through the administration of online questionnaires on cross-sector practices, clinical vignettes, an appreciation questionnaire in addition to the use of a Lessons Learned framework through the planning, implementation and evaluation phases.

Discussion

The results indicate no significant differences before and after the training on the participants' knowledge of one's and others' roles and responsibilities, available resources and helpful practices, but a significant improvement in the perceived benefits of cross-sector practice in terms of knowledge and understanding of other contexts of practice and other actors' interventions.

Conclusions

The Lessons Learned framework was useful to identify factors supporting the implementation of cross-sector training. Structural and systemic factors, such as silos between research and practice, and tensions between social justice and public safety roles, emerged as barriers to cross-sector learning.

Background

In high-stakes contexts, sporting organisations commonly employ interprofessional healthcare teams. Yet, it is currently unclear how team-oriented teaching and learning might be structured to help deliver superior outcomes in athlete health and performance.

Purpose

To explore whether interprofessional education (IPE) currently exists within a high-stakes interprofessional practice (IPP) environment and how a learning community of athlete-focused health care practitioners inform and develop their own practice.

Method

An explorative qualitative, single case study was conducted, the unit of analysis being a Danish premiere league football club's health care team.

Results, discussion and conclusions

A thematic analysis of semi-structured interview data revealed that IPE exists mainly as an informal/hidden curriculum. Key educational competencies were developed through a community of practice with IPP; mainly through peer learning and mentorship activities. These findings highlight an underdeveloped and potentially important area of focus for interprofessional education and practice in the context of elite athletic health and performance practice.

Introduction

Delays to care and treatment in emergency departments (EDs) can lead to medical errors that harm patients. To optimize ED outcomes, indicators exist that define time frames within which patients should be assessed, receive care, and be discharged and they include time to triage, time to physician assessment (PIA), and time to discharge. The purpose of this study was to examine the relationship between temporal TMS and medical errors as delays to care in EDs. Methods: A nonexperimental, quantitative, cross-sectional, and correlational research design was used to study the relationship between differences in IP team membership due to shift work schedules (i.e., TMS) and medical errors as patient outcomes within EDs. Fifteen EDs and urgent care centres (referred collectively as EDs) located in the province of Manitoba, Canada were selected for this study. Results: medical errors occurred at each ED but to different extents; ED teams had low temporal stability; TMS and medical errors were not statistically significant, but worked experience captured by the individual team competence index (ITCI) decreased time to physician and length of stay was. TMS had a negative moderating effect on ITCI and neither TMS nor ITCI were statistically significant when patient volumes and levels of acuity were controlled. In contrast, when team size was controlled, TMS had a large effect size on time to physician. Conclusion: low TMS was not a significant factor in medical errors measured as delays to care but probably related to other organizational factors and team dynamics.