Journal of Interprofessional Care最新文献

We aimed to assess perceptions about interprofessional collaboration (IPC) of healthcare professionals working in an acute medical unit (AMU) in an internal medicine department in the United Arab Emirates. The AMU provides care during the initial 24 to 72 hours of admission and emphasizes interprofessional collaboration. Using the Assessment of Interprofessional Team Collaboration Scale II, the study measured partnership, cooperation, and coordination among team members. Between November 5, 2022, and January 5, 2023, 81 participants completed the survey, including physicians (n = 45; 55.5%), nurses (n = 18; 22.2%), and clinical and non-clinical allied health professionals (n = 18; 22.2%). On a Likert-type scale of one to five, most respondents perceived partnership, cooperation, and team coordination as good collaboration on the AMU, with mean scores of 4.29, 4.16, and 4.15, respectively. There was no significant difference between physicians' (4.18) and nurses' (4.45) perspectives of IPC on the AMU (p = .10), but physicians were less likely to notice collaborative practice changes compared to other professionals. Introducing IPC early in medical education might enhance future collaborative practice. This study sheds light on IPC in non-Western contexts and provides insights into how collaboration is perceived and practiced in diverse healthcare settings.

Expanding workforce training opportunities for opioid use disorder (OUD) treatment is a priority. We report on the impact of a 6-month-long team training program using the Extension for Community Healthcare Outcomes (ECHO) model to scale an interprofessional education (IPE) intervention to primary care teams who offered medications for OUD treatment as part of their care plan. Thirteen healthcare teams participated in the program's first cohort. We studied 52 participants' pre-post responses to seven scales that examined individual efficacy, team efficacy, high performance teamwork behaviors, adaptive teamwork behaviors, ability to treat patients in two case examples, and stigma and harm reduction. Significant improvements occurred on six scales. Large effect sizes were observed for individual efficacy (d = 0.78), team efficacy (d = 1.25), and team's ability to treat patients (d = 0.77, d = 0.83). Moderate effect sizes were observed for high performance teamwork behaviors (d = 0.69) and adaptive teamwork behaviors (d = 0.57). Only stigma and harm reduction did not show a change. The training program delivered an IPE-ECHO intervention that was effective at increasing the teams' perceptions of their efficacy, functioning, and ability to treat patients. Future researchers should use objective measures to verify the team's perceptions of their increased ability to work together.

Healthcare clinical microsystems are small, goal-oriented groups of healthcare professionals that work together on a regular basis to provide care to discrete patient populations. They often include team-based frameworks such as bedside interprofessional rounds, geographic colocation of healthcare team members, interprofessional staff leadership, and unit-level data sharing. In inpatient settings, microsystems improve interprofessional communication and collaboration. In this qualitative study, we examined physician experiences of clinical microsystems and the mechanisms underpinning interprofessional communication in this environment. We interviewed 51 resident and hospitalist physicians. Thematic analysis of physician experiences revealed three key themes: (a) Clinical microsystem effect on workflow, (b) Open forum and work relationships, and (c) Face-to-face vs technology-based communication. Physicians described strong interprofessional relationships based on frequent face-to-face communication. Familiarity with healthcare team members, often resulting from being co-located to the same units, created a comfortable work environment, advanced patient care, and accelerated workflow. Physicians preferred in-person communication with interprofessional colleagues over technology-based communicationand described how in-person interactions enriched subsequent technology-led interactions. As the use of technology-based communication grows in inpatient settings, decreasing face-to-face interactions and facilitating dispersed care, understanding and implementing optimal conditions for effective interprofessional communication is essential.

The modified Attitudes Toward Health Care Teams Scale (mATHCTS) is a self-administered questionnaire with 14 items to assess participants' perceptions of the impact of interprofessional collaboration. Its validity and reliability have been widely evaluated. The effect of interprofessional education (IPE) has been evaluated using changes in mATHCTS factor scores. However, several aspects of the scale require clarification: the difficulty of correctly answering each item; how well each item discriminates between respondents' abilities; and whether the mATHCTS is better at identifying those with higher/lower abilities. We investigated the mATHCTS's item characteristics such as difficulty, discrimination, and measurement accuracy using item-response theory (IRT) analysis. Health and welfare university students were administered a questionnaire prior to starting IPE in 2021. The results for 180 participants were analyzed based on IRT. The test-response (TRF) and test-information (TIF) functions, discrimination, and difficulty were estimated. All items' discrimination and difficulty were adequate. The TRF, which shows the relationship between scores and ability, increased monotonically. The TIF, which shows the relationship between ability and measurement accuracy, decreased as the total score increased. The mATHCTS effectively assessed participants' attitudes toward health care teams as a one-dimensional ability. The mATHCTS performed well in identifying participants with relatively low scores.

In the first of three articles, we scanned global and national sources to help understand the concept and scope of integrated care. New policy directives seek closer working relationships between health and social care systems and practitioners to tackle modern challenges relating to the ageing population, poverty, disadvantage, and mental health. We identified that the practitioner workforce has not been fully considered or prepared for large shifts in working practices, often bringing new practitioners' roles to address local needs in newly managed interprofessional working systems for integrated care. In this second article, we consider the major themes identified by our review of integrated care policy to explore their implications for interprofessional learning, drawing on developmental pathways for interprofessional education from organic to strategic and systemic responses, to ask in what ways we will need to prepare our learners for these new ways of delivering integrated care.

Up to 175 conditions influencing interprofessional practices have been identified. Still, little is known about to what extent these conditions interact, influence communication, and vary across professional groups and settings. We explored these knowledge gaps by examining communication among staff in home care and home nursing units in two Danish municipalities, Herning and Holstebro. Conditions were categorized into two types (programme and context) and two levels (professional and organizational). Structural Equation Modeling was used with a sample of 395 staff and 21 managers to analyze the condition categories' interactions, influences on communication, and variations by unit type and municipality. Context conditions strongly influenced programme conditions on the professional and organizational levels. Organizational-level context conditions had no significant influence, organizational-level programme conditions had a weak influence, and professional-level programme and context conditions had moderate influences on communication. Lastly, professional-level programme conditions had the biggest influence on communication for staff in home care units and in Holstebro. In contrast, professional-level context conditions had the biggest influence on communication for staff in home nursing units and in Herning. These findings offer unique insights into conditions' interactions, influences, and variances, contributing to our understanding of what makes communication work and for whom.

Researchers have highlighted gaps in the work readiness (WR) of allied health (AH) graduates and the capabilities required to successfully work in an interprofessional collaborative practice healthcare environment. In the studies conducted, the focus has generally been on one AH discipline or on one participant group across disciplines, such as new graduates. We explored WR capability of new AH graduates across three participant groups (managers, supervisors, and graduates) and across several AH disciplines in the health sector. Focus groups using Critical Incident Technique (CIT) were conducted with 47 participants (14 new graduates, 13 supervisors, and 20 managers) from four public health organisations across Eastern Australia. CIT identified examples where new AH graduates had/did not have necessary WR capabilities to manage situations in the collaborative practice environment. Using thematic analysis, we found four main themes related to WR expectations of AH graduates (work skills and knowledge, working with others, personal attributes, and organisational knowledge), with several sub-themes. Some aspects of identified themes/sub-themes were unique to the AH interprofessional work context. Understanding of AH graduates' WR from multiple perspectives could support development of programs to enable graduate success in interprofessional working environments.

Research on interprofessional identity using the Extended Professional Identity Theory (EPIT) has shown promising results in measuring this identity, predicting interprofessional collaboration, and improving team outcomes. However, EPIT-based interprofessional identity has not been studied in Türkiye due to the absence of a Turkish version of the Extended Professional Identity Scale (EPIS). We aimed to develop and validate a Turkish EPIS, the EPIS-TR, and explore interprofessional identities across eight different professions. A cross-cultural adaptation of EPIS was made by linguistic validation, followed by analysis of psychometric properties using a sample of students from four Turkish universities and eight professions/programs (n = 405). Confirmatory factor analysis and reliability analyses were performed. Differences between professions were explored with ANOVA and a post hoc test. Three out of seven goodness-of-fit indices showed acceptable fit (x²/df = .004; RMSEA = .07; GFI = .94), and others showed excellent fit (SRMR = .04; AGFI = .91; CFI = .97; NNFI = .96). The internal consistency of the EPIS-TR is .93. The EPIS-TR scale has strong psychometric properties. The construct validity of the EPIS-TR was similar to that of the original version. The interprofessional identity scores of the different professions were mostly similar. Based on these findings, the EPIS-TR is well suited for measuring interprofessional identity.

Addressing health disparities through community engagement and interprofessional partnerships is increasingly critical. However, learner-led approaches that integrate medical students, resident physicians, and social work students are not well-studied. We designed a learner-led, interprofessional, public health campaign for a majority Hispanic community, with the goals of building interprofessional leadership skills, engaging learners to address COVID-19 inequities, and disseminating lessons learned. Faculty and students from the University of Texas Rio Grande Valley Schools of Medicine and Social Work partnered with community leaders to pilot an interprofessional project supported by the American Association of Medical Colleges' Nurturing Experiences for Tomorrow's Community Leaders (AAMC NEXT) Award. We describe the process of selection of a 12-member learner team of medical students, resident physicians, and social work students, and how we enacted the project from December 2020 to June 2021. Lessons learned in implementing our learner-led, community-engaged, interprofessional approach included: building interprofessional leadership skills, setting member roles and responsibilities, instilling requisite knowledge and skills, engaging with the community, and disseminating research findings. These lessons can guide other institutions seeking community-engaged interprofessional projects with learners.