Journal of Interprofessional Care最新文献

Healthcare practitioners must be trained to collaborate in a dynamic environment where patients are complex and teams can change from day-to-day, but choosing the right measures to assess the effectiveness of interprofessional teamwork among learners is challenging. This study used measures representing four different perspectives to assess student teams in a practice setting where team composition varied each day. We tested the strength of the relationships between these measures, and we examined the impact of additional variables on each measure. Participants were students from different health professions at a single university and patients in a community-based wellness program. We sampled 100 wellness visits where an interprofessional student team met with a patient, and we assessed team effectiveness using student perceptions of their team, patient ratings, observer ratings, and faculty assessments of team healthcare plans for the patient. We calculated bivariate correlations between the four measures and used regression analyses to assess the impact of predictors including student, patient, and clinic/site characteristics, on each measure of team effectiveness. There were small but significant negative correlations between the assessments of faculty and observers (r = - 0.23), as well as between faculty and patients (r = - 0.14). Conversely, a small but significant positive correlation was found between the assessments of patients and observers (r = 0.15). Among the regression models, faculty and patient ratings of team effectiveness were more strongly related to the predictors measured (R-squared = 53.6% and 41.7%, respectively). Patient age and number of clinic visits, team size, and clinic site were significant factors for predicting team effectiveness across the two measures. Our findings provide evidence that different perspectives of team effectiveness measure different constructs. While all approaches have value, in IPE practice settings, team effectiveness should be evaluated with multiple measures to understand performance and identify opportunities for improvement. Teamwork in dynamic healthcare environments is complex, and simple measurement approaches may mischaracterize learning and clinical outcomes.

The growing complexity of care and healthcare workforce shortages in the Netherlands necessitates exploring interprofessional collaboration (IPC). However, the predominant single-professional education may result in a professional identity (PI) among healthcare students, which may not support successful IPC. Internships in student-run interprofessional learning wards (SR-IPLW) could foster interprofessional identity (IPI) development. There is a need for a better understanding of the intricacies involved in learning to work collaboratively, particularly when undergraduates are still shaping their professional identities. Our aim, therefore, was to identify facilitators and barriers for interprofessional education (IPE), IPC, and identity development among 21 healthcare students during a 20-week clinical placement on a SR-IPLW in rehabilitation medicine. An action-based prospective study using grounded theory analysis of nine focus groups across three semesters identified 17 theoretical codes. These codes are elaborated in a conceptual model highlighting facilitators and barriers for IPC and identity development, emphasizing the importance of fostering feelings of relatedness, competence, and autonomy. There are indications that professional and interprofessional identities changed during the internship. Implications for preceptors are delineated, showing the importance of personal relationships and elements of a positive learning climate.

We aimed to perform cross-cultural adaptation of the Interprofessional Collaboration Scale (IPC-BR) and to evaluate evidence of its validity for the Brazilian hospital context. The research consisted of six steps: translation of the instrument into the new language, synthesis of the translated versions, back-translation, synthesis of the versions in the original language, evaluation of the syntheses by an expert committee, and pilot testing or pretesting and validation of the internal structure of the items of the instrument. The pilot testing involved 4 translators, 14 judges, and 30 healthcare professionals; the validation of the internal structure involved 686 professionals including nurses, physicians and physiotherapists. Translation and cross-cultural adaptation revealed no significant changes or discrepancies in meaning from the original model. Exploratory, confirmatory, and parallel factor analyses confirmed that the Brazilian scale is unidimensional. We found unidimensional characteristics and satisfactory factor loadings, with good levels of reliability, which makes the instrument provide consistent and reliable internal evidence for measuring the construct. Thus, the possibility of using it to assess interprofessional collaboration among different target groups in the Brazilian scenario was confirmed.

The Interprofessional Attitudes Scale (IPAS) is a promising tool for assessing interprofessional education (IPE) attitudes, especially in community-oriented initiatives. To meet the need for validated IPE tools in Vietnam, we translated the IPAS into Vietnamese (Viet-IPAS) and evaluated its psychometric properties. The preparatory phases included forward and backward translation, expert consultations, and student feedback, resulting in strong content validity, face validity, linguistic comprehensibility, and test-retest reliability. During the 2020-2021 academic year, health students from the University of Medicine and Pharmacy at Ho Chi Minh City were invited for the main phase. A total of 282 students from medical, nursing, pharmacy, and rehabilitation science programs completed an online survey using the Viet-IPAS. Cronbach's alphas for the Teamwork, roles and responsibilities (TRR), Patient-centeredness, Interprofessional biases (IB), Diversity and ethics, and Community-centeredness subscales were .84, .79, .56, .86, and .81, respectively. Confirmatory factor analysis indicated an acceptable fit (normed χ2: 2.618, RMSEA: .076, CFI: .874, AGFI: .77). Factor loadings were above .70, except for IB3 and TRR8 items. Modified models by removing IB subscale and TRR8 item showed slightly improved fit. We recommend using the Viet-IPAS with modifications in Vietnamese health student populations and encourage further review and refinement of the instrument.

Despite a growing awareness of the importance of interprofessional teamwork in relation to patient safety, many hospital units lack effective teamwork. The aim of this study was to explore if an interprofessional teamwork intervention in a surgical ward changed the healthcare personnel's perceptions of patient safety culture, perceptions of teamwork, and attitudes toward teamwork over 12 months. Healthcare personnel from surgical wards at two hospitals participated in a controlled quasi-experimental study. The intervention consisted of six hours of TeamSTEPPS team training and 12 months for the implementation of teamwork tools and strategies. The data collection was conducted among the healthcare personnel in the intervention group and the control group at baseline and at the end of the 12 month study period. The results within the intervention group showed that there were significantly improved scores in three of 12 patient safety culture dimensions and in three of five perceptions of teamwork dimensions after 12 months. When comparing between groups, significant differences were found in three patient safety culture measures in favor of the intervention group. The results of the study suggest that the teamwork intervention had a positive impact on patient safety culture and teamwork in the surgical ward.

People with severe mental illnesses have complex needs that require coordinated care. However, students in different health professions are usually educated in silos without an emphasis on collaborative skills. Students would benefit from exposure to other disciplines that would increase appreciation of collaboration. This pilot study sought to understand how a mental health simulation (SIM) would influence a student's perception of collaboration. The mental health SIM involved nursing, social work, occupational therapy and public health students who worked with standardized patients. Students were given the Interprofessional Socialization and Valuing Scale-21 (ISVS-21) that measures attitudes, values, and feelings about interprofessional collaboration. A baseline of 113 students in the four health professions were administered the pretest and a subset of nine who participated in the SIM completed the posttest. This study suggests that SIM may be a promising way of improving attitudes toward collaborative care, though it is important for the SIM to reflect real life treatment conditions.

Effective physician-nurse communication is critical to patient safety, yet internal medicine trainees are rarely given feedback on this skill. In order to address this gap, we developed a 4-week simulated paging curriculum for senior medical students. Standardized Registered Nurses administered five acute inpatient paging cases to students via telephone and scored communication on a 10-point global scale (1 = highly ineffective to 10 = highly effective) and seven communication domains using a 5-point Likert-type scale. The domains included precision/clarity, instructive, directing, assertive, ability to solicit information, engaged, and structured communication. Students received verbal and written feedback from the nurses on communication skills and clinical decision-making. Our primary goal was to determine if student-nurse communication improved throughout the curriculum. Data were analyzed using multivariate ANOVAs with repeated measures. Twenty-seven students participated. Global communication scores increased significantly from case 1 to case 5 (7.1 to 8.7, p < .01). The following communication domains increased significantly: precision (3.8 to 4.4, p < .01), instructive (3.6 to 4.7, p < .01), directing (4.0 to 4.6, p = .02), assertiveness (4.0 to 4.7, p = .04), engaged (4.1 to 4.7, p < .01). In conclusion, this curriculum can be an innovative approach to improve physician-nurse communication using standardized registered nurses to deliver structured feedback to medical trainees.

In Lausanne, Switzerland, Interprofessional Education (IPE) is embedded in the curriculum of every undergraduate healthcare student. Since 2011, five educational and healthcare institutions have implemented a short interprofessional education course to bring together 2307 undergraduates from six different disciplines (medicine, midwifery, nursing, occupational therapy, physiotherapy, medical radiology technician) between 2017 and 2020. This pre-post study aimed to explore how this course influenced students' attitudes toward IPE using a French translation of the validated questionnaire called the "University West of England Interprofessional Questionnaire." Students were asked to complete an online survey prior to and at the end of the IPE course to measure students' attitudes toward interprofessional (IP) relationships and collaborative learning. A total of 942 students answered the survey between 2017 and 2020, before and after the course. Each year, students' attitudes toward IP relationships improved after the course whereas a positive change in students' attitudes toward IP learning was observed only in 2020. A short exposure to an IPE course could improve students' attitudes toward IPE and, more specifically, toward IP relationships. Our findings could inform IP leaders to design repetitive, various, and longitudinal IPE experiences to balance the development of uniprofessional and interprofessional identity.

Increased demand for interprofessional collaboration within the educational field also increases the need for the development and evaluation of interventions to improve collaboration. In Norway, the LOG model was developed and implemented in compulsory schools to facilitate interprofessional collaboration by increasing arenas for more efficient use of existing interprofessional resources. We evaluate the effects of the model on teachers' perceptions of interprofessional collaboration in a cluster-randomized trial, with 19 schools randomized to the experimental group and 16 schools to the control group. We use data from 5^th-7^th grade teachers in the 35 participating schools (N = 157) prior to randomization and one-year into the implementation. Response rates were 70% and 74%, respectively. The PINCOM-Q scale was used to analyze effects of the model on various dimensions of interprofessional collaboration. At the one-year follow-up, the LOG model demonstrates no significant effects on teachers' perceptions of interprofessional collaboration. However, there is an indication of effect on the organizational aim dimension (ES = -0.39, CI = -0.82-0.03), but the evidence is not conclusive.

Intrahospital transport of critically ill patients for diagnostic or therapeutic procedures can be compromised by patient instability, equipment problems or inexperienced teamworking. This quasi-experimental study aimed to assess the effectiveness of an in-situ interprofessional simulation-based training (IIST) model for junior member transport teams. Newly registered postgraduate physicians, nurses and respiratory therapists underwent the IIST. The technical skills (TS) of each participant and non-technical skills (NTS) of each interprofessional team were assessed using well-validated checklists. Thirty-six participants enrolled and were randomly assigned to six experimental and six control teams. Most participants achieved a significantly higher level of both TS and NTS. Both the control and experimental teams overvalued their NTS in the pretest, while the posttest self-assessment scores among the experimental groups more closely matched the expert assessments. Despite challenges in scheduling and the setting, the IIST was successfully conducted in a crowded hospital, which enabled trainees to optimize their learning in a real-life environment. In conclusion, the IIST model can facilitate the development of both TS and NTS for transport team members. Transport teams made up of newly registered staff from different disciplines may lack insight into their NTS in critical patient transfer management, but simulation training may cause improvements.