Journal of Interprofessional Care最新文献

This dental student-led study aimed to explore the extent to which an interprofessional intervention can be incorporated within the management of Parkinson's Disease (PD) to address the oral health needs of those living with the condition. Existing integrated or interprofessional (IP) care models lack the inclusion of oral health to improve clinical outcomes. We conducted key informant interviews with five neurologists and four dentists to ascertain their willingness, and the process needed, to facilitate collaborative referral management for patients with PD. We conducted a focus group composed of eight patients living with PD to understand their oral health needs and perspective on an integrated oral health management care team. Both neurologists and dentists were receptive IP the idea of integrating oral health into the overall management of patients, with the expectation of improved communication and collaboration. Patients commonly expressed a need for their oral health to be addressed by both neurologists and dentists. These results reveal an opportunity for an IP care model that includes oral health management in the care for patients with PD. It also provides clues on how to incorporate care for PD into a dental education curriculum.

In the first of three articles we shared our understanding of integrated care and traced the evolution of interprofessional learning from organic to strategic and systemic, prepared to play its part in the implementation of integrated care. In this third article, joined by Lee-Ann Fenge, we focus on the role of the social worker in integrating care and clarifying their roles in collaboration with other professions. We distinguish between social work as a profession and social care as a field of practice, which includes many professions as well as other occupations. We share the literature on where social work plays a role in integrated care and ask questions about the lack of interprofessional education involving social workers and without whom integrated care cannot succeed.

University core curricula and accreditation standards for healthcare profession programs can be challenging to align. Additionally, interprofessional education (IPE) requirements for healthcare professions curricula have been designed to prepare learners for future practice. This paper describes alignment of an introductory IPE course with embedded Interprofessional Education Collaborative core competencies to specific university Core Curriculum attributes. A cross-sectional, mixed methods design was used to examine 117 learners' reflections on the IPE course content and learning outcomes. Learners from seven pre-licensure health professions programs provided responses on aspects of their IPE learning experience through reflections, surveys, written examinations, and optional focus groups. Open-ended responses were interpreted thematically from a constructivist lens. Results revealed positive perceptions of the course with feedback for areas of consideration for future course activities. Learners reported more engagement with the Core Curriculum attribute of Identities in Context than that of Global Interdependence. Additionally, responses indicated a perception of task work versus teamwork within the interprofessional team activities. Outcomes provided data that enabled continuous quality improvement of the course. Educators seeking to align IPE courses with institutional core curricula and accreditation standards may use this work to inform structure, assessment, and delineation of teamwork as compared to task work.

Social workers frequent interprofessional healthcare teams, but few studies examine the day-to-day experiences of these providers on interprofessional teams. Our study utilized semi-structured interviews with 54 medical social workers practicing on interprofessional healthcare teams. A thematic analysis was used to analyze the day-to-day functions of these social workers. The analysis resulted in three primary themes: 1) Social Workers' Self-Perceptions of their Roles within Interprofessional Teams, 2) Social Workers Shifting Roles on Interprofessional Teams, and 3) Interprofessional Team Dynamics that Impact the Role of a Social Worker. Social workers perceived their primary roles as contributing a unique systems approach to interprofessional healthcare teams while emphasizing patient self-determination. These self-perceptions influenced their shifting roles on interprofessional healthcare teams (e.g. clinician, case manager, bridge builder). In addition to individual self-perceptions, the healthcare system infrastructure influenced social work roles. For example, social workers in outpatient settings more frequently assumed the role of a mental health practitioner compared to those in inpatient settings. Last, there was variation in interprofessional communication and workflow assignment based on the healthcare infrastructure. Future research should examine the education and training efforts of social workers and other allied health professions for interprofessional healthcare teams.

Clinicians are increasingly required to work and learn interprofessionally, yet few studies explore the nature of being interprofessional. The purpose of this study was to explore the lived experience of clinicians who identify as interprofessional or have an interprofessional identity. Interpretive phenomenological analysis (IPA) was applied as a qualitative research approach and analytical method. Fifteen key informants from a range of professions, settings, and roles were recruited via purposive sampling. Data was collected via semi-structured interviews, observation of participants' day-to-day practice, and review of organizational documents, and analyzed using IPA. Six interdependent Group Experiential Themes were developed: (i) The power of person-centered holistic care, (ii) Learning and growth through curiosity, reflection, and willingness to be vulnerable, (iii) Welcomes, values, and empowers all others, (iv) Trust and mutual respect through belonging and connection, (v) The contribution of background and previous experiences, and (vi) The influence of workplace context. Each Group Experiential Theme had between two and nine sub-themes. Results support the value of understanding and making explicit the concepts that comprise clinician interprofessional identity. The findings can be used to support clinicians, educators, leaders, and policy makers to develop and sustain interprofessional identity, and subsequently cultivate a culture of interprofessional collaborative practice. Future research is needed to further explore the themes, investigate their inter-relationships, and present the concepts that comprise clinician interprofessional identity in a way that is accessible to healthcare professionals and facilitates their integration into practice.

In this first of three papers, we seek to understand how the new "integrated care" global policy directive, pursuing greater alignment for health and social care systems, will be translated into preparation for practice concerning interprofessional education (IPE) from pre-to-post registration level and for continuing professional development. We ask questions about the implications for leaders and practitioners in the field of IPE and collaborative practice (CP). In seeking to understand this new global policy directive, we explore the plethora of definitions, concepts and perspectives, continuously evolving and at times counterproductive as they try to synthesize complexity, to describe how health and social care systems and practitioners work together. We trace research on how integrated care is understood drawing upon transnational current understandings of integrated working in North America, Europe and the UK. We ask questions of the ambitions of integrated care aligned to forging closer working relationships between health and social care practitioners to tackle modern complex healthcare challenges. In reading the literature we have sought to identify the themes which emerge to direct the field of IPE and CP so that the workforce is prepared to deliver care, as policy makers intended, within locally designed new innovative care systems. We conclude that it remains unclear as to whether these new policy aspirations will achieve the connectivity required, for a supported workforce, committed to working together to deliver care envisaged to help people experiencing complex long-term conditions, disadvantage and health inequalities. In our second paper, we review the developmental pathway for IPE, taking a closer look at preparation for integrated care pathways and collaborative practice, seeking evidence to guide us. Finally, in our third paper, we turn our attention to the implications for the workforce composition, dynamics, and relationships, exploring heightened progressive ever-changing roles and responsibilities, focusing on social work.

Interprofessional education (IPE) is vital for preparing a competent health workforce. Despite the proven benefits of interprofessional collaborative practice (IPCP), barriers to its implementation persist. Given the importance of health professionals' perspectives for IPCP success, we investigated the perceptions of IPCP among final-year health science students at Khon Kaen University, Thailand, while they transition into practice. A cross-sectional online survey conducted from February to April 2023 included 989 students across six health science disciplines, with a response rate of 57.8%. Using the SPICE-R2 questionnaire on a five-point Likert-type scale, we assessed perceptions related to interprofessional teamwork, roles and responsibilities, and patient outcomes. Results showed significant diversity in IPCP perceptions and experiences with IPE. Nursing students consistently demonstrated the highest IPCP perceptions, while medical and public health students scored the lowest. Positive perceptions about IPCP were notably associated with nursing students and those satisfied with the learning process. Dentistry students and those with IPE experience also exhibited more favorable views on teamwork. This study suggests the need to address disparities in IPCP perceptions among student groups, which is essential for enhancing interprofessional collaboration in future health professionals.

Research into metacognitive processes within interprofessional clinical simulation has been largely overlooked in the literature. This study explores how interprofessional simulation may influence cognitive and metacognitive processes across several professional programmes; medicine, nursing, pharmacy, and occupational therapy. This study focused on changes in performance pre- and post-simulation, with undergraduate students from each profession answering a set of questions related to the simulation case, requiring specialized knowledge from each profession. Question scores, item confidence judgment ratings, and calibration values were collected and analyzed. The data revealed a pattern of convergence in post-simulation assessments, where professions initially with lower performance in the pre-simulation phase improved, and those initially performing well demonstrating a decline in performance. Calibration values indicated that medical students developed metacognitive errors from their interactions in the simulation, which were not present pre-simulation, and that occupational therapy students suffered a loss of confidence and calibration in questions within their own field resulting from their experience (being more accurate pre-simulation). The authors anticipate that the phenomenon of convergence may have longer-term consequences, potentially fostering distrust among professions for those with declining performance. The authors propose that expanding awareness of convergence phenomena and conducting repeated simulations (thus facilitating further team development) could mitigate this issue.

Effective interprofessional collaboration practice (IPCP) promotes healthcare outcomes but is often hindered by poor communication. Traditional teaching methods with limited interdisciplinary interactions may not effectively foster IPCP behaviors. This study evaluated the effectiveness of nurse-led World Cafe (NWC) approach in promoting IPCP behaviors and learning engagement. Seventy-six healthcare professionals (38 in each group) participated in this quasi-experimental study. Data were collected before, one-week, and four-week post-intervention, using Lee's (2016) Interprofessional Collaborative Practice Behavior Inventory (IPCPBI) and Ciou's (2020) Learning Engagement Scale. Five medical technologists in the control group were excluded from data analysis to ensure group equivalence. Before the intervention, there were no significant differences in IPCPBI between groups. One week post-intervention, the experimental group scored higher in IPCPBI, yet lacked statistical significance (p > .05). Four weeks post-intervention, the experimental group significantly improved in IPCPBI (p < .05). While no statistically significance was found in learning engagement between groups, the experimental group scored significantly higher in the active engagement sub-domain (p < .05). The NWC approach boosted IPCP behaviors and learning engagement, fostering a collaborative learning environment that improves outcomes through interdisciplinary interactions. Healthcare settings could benefit from adopting the NWC approach to enhance clinicians' IPCP competency.

Interprofessional meetings are crucial for achieving patient-centeredness in healthcare. Exactly how patient-centeredness is reached during these meetings remains underexamined. Adopting an Ethnomethodology and Conversation Analysis (hereafter EMCA) perspective, this contribution looks at video-recordings of interprofessional meetings in two distinct healthcare settings: rehabilitation and internal medicine. It aims to provide new insight into how investigations of patient-centeredness as a reflexive achievement allow us to better understand the organizational and relational efforts required to achieve it in practice. This contribution outlines how different healthcare contexts result in variety in the meeting frequency, duration, aims, participants, and agendas, which in turn means that the opportunities for patient-centeredness are not the same. But it also illustrates how patient-centeredness depends on the ways the various opportunities are seized and play out in the interprofessional interactions. It is therefore argued here that research on how patient-centeredness is reached in interprofessional meetings and the development of recommendations for enhancing it both require consideration of context-specific conditions and how participants adapt to and simultaneously modify them to achieve patient-centeredness in practice.