Journal of Interprofessional Care最新文献

Speech-language pathologists (SLPs) work in diverse settings-including schools, hospitals, skilled nursing facilities, and home health-that require interprofessional practice (IPP). Interprofessional education (IPE) prepares professionals from multiple disciplines to learn with, from, and about each other to enable effective collaboration and improve outcomes. This content analysis examines how state licensure and national certification requirements for SLPs emphasize IPE and IPP. To analyze the extent to which licensing and certification bodies for SLPs in the United States incorporate IPE and IPP requirements into their professional standards. A descriptive content analysis was conducted on 50 U.S. state licensure requirements and the American Speech-Language-Hearing Association (ASHA) national certification standards. Each document was reviewed for the presence of 12 keywords related to IPE and IPP. Frequency counts and qualitative contextual analysis were performed to identify both the occurrence and the context in which the terms were mentioned. This study used a sequential explanatory mixed methods design. None of the state licensure documents explicitly referenced IPE or IPP. The most frequently mentioned related professions were physicians (76%), teachers (40%), and nursing (38%), but these references rarely reflected structured interprofessional roles. ASHA certification standards referenced IPE and IPP more often than state documents but did not consistently identify key collaborative partners such as nursing or dietetics. Findings suggest a limited emphasis on IPE and IPP in U.S. SLP licensure and certification requirements. Strengthening these standards to explicitly address interprofessional competencies could better prepare future SLPs to collaborate effectively across settings and with diverse partners, thereby improving outcomes for clients, and students.

Interprofessional education (IPE) underpins interprofessional collaborative practice (IPCP), which promotes safe and high-quality health care. Whilst IPE is known to improve healthcare student's individual collaborative competencies, less is understood about its impact on qualified health care professionals (HCPs) practice and organizational change. This review critically examines evidence of practice change, identified using Level 3 and Level 4a of Kirkpatrick's Modified Model of Learning, and barriers following IPE interventions. In February 2025 an integrated mixed methods systematic review was conducted following PRISMA guidelines. Six databases (PubMed, ProQuest, EBSCO/MEDLINE, EBSCO/ERIC, EBSCO/CINAHL, and EBSCO/PsycInfo) were searched using predefined criteria. Study quality was assessed using the Mixed Methods Appraisal Tool (MMAT), and data synthesized using the Johanna Briggs Institute (JBI) convergent integrated approach. Seventy-one studies were included. Four categories of practice change were identified: (1) improvements to clinical care provision, (2) improvements in team communication, (3) changes in teams and teamwork, and (4) increased professional development including research. The studies quality varied, with 56% meeting at least four out of five MMAT criteria. Studies revealed practice change is mostly self-reported (87%), at single time points (35%), and at an individual level (96%) by HCPs. Nine studies reported barriers in achieving practice changes following IPE. This paper provides evidence to support IPE for qualified HCPs to improve IPCP and the delivery of high quality and safe healthcare. The identified practice changes align with the Interprofessional Education Collaborative (IPEC) and the Canadian Interprofessional Health Collaborative (CIHC) IPCP frameworks. Further research is required focusing on whether changes are sustained long term and if more flexible evaluation methods such as a realist synthesis would be beneficial. This would allow a deeper understanding of practice changes, in particular how team behaviors change, and to explore the influence of healthcare decision makers on IPE and IPCP.

In health and social care, disagreements over referrals involve professionals contesting between them the power to define the situation. An aspect of practice that commonly gives rise to such disagreements is self-neglect because of its high ambiguity for services. Self-neglect therefore provides a useful case to explore how professionals anticipate and respond to interagency barriers to referral when criteria and thresholds are only loosely defined, and collaboration is often ad hoc. To investigate the dynamics of interagency referral for self-neglect, we interviewed 69 practitioners: health and social care professionals; and fire and rescue, environmental health, and housing officers, all of whom regularly respond to both crisis and chronic situations of self-neglect. Dynamics that influence referrers and hinder coordination between interprofessional networks included uncertainties about the right route, perceived barriers to referral acceptance, and feeling unable to refer. These present barriers to the anticipatory labor needed to make interagency referrals land successfully with the receiving agency and may lead to a self-fulfilling cycle that discourages practitioners from thoughtful referral practice. Although referral failures are often treated in research on referral in safeguarding as a technical knowledge-deficit problem, the data show the significance of wider interagency relations, perceptions, and expectations in accounting for the barriers.

Measuring functional status allows clinicians to deliver evidence-based interventions to prevent or delay associated adverse outcomes. Functional status is seldom routinely measured in primary care settings where most older adults receive care. Interprofessional team-based care is increasingly regarded as an important feature of high quality and efficient health care systems. Yet despite growing evidence of the benefits of team-based care, in primary care there are not yet standards for how to operationalize interprofessional practice. In this study we explored interprofessional perspectives on assessing functional status among older adults in team-based VA primary care clinics. We conducted qualitative interviews with 57 primary care team members (nursing staff, primary care providers, and social workers) from six geographically diverse VA medical centers. We drew from implementation science frameworks and sociotechnical theories to ground our thematic analysis in dynamic, real-world contexts. Interviews revealed the view that all primary care team members play a role in measuring and addressing functional status. Participants also described a perceived hierarchy of accuracy of assessment based on role and outlined strategies for validating the accuracy of functional status assessments. These results can inform guidelines for functional status measurement in primary care that improve interprofessional assessment and team-based communication.

Interprofessional Education and Collaborative Practice (IPECP) involves healthcare workers and/or students from at least two professions working alongside patients, to improve the quality of healthcare provided. IPECP implementation in rural areas, however, lags due to limited resources and workforce shortages. This systematic review was undertaken to identify the enablers and barriers to the implementation of IPECP initiatives in rural healthcare settings. The JBI mixed methods review methodology and PRISMA guidelines were followed. Studies included peer-reviewed articles of IPECP initiatives implemented in rural healthcare settings identified in PubMed, Scopus, Embase, and Web of Science, alongside gray literature searches. Following screening, data were extracted and critically appraised using the Mixed Methods Appraisal Tool. Forty-eight papers were included in the final review. Enablers of IPECP in rural settings were student factors, supervisor and clinician factors, and strength of the community. Barriers included funding, resources and time constraints, lack of trained IPECP facilitators, and low prioritization of IPECP initiatives. The identified enablers and barriers of IPECP implementation in rural settings can inform further policy and practice developments. Future researchers could investigate strategies to aid IPECP implementation and use of longitudinal designs to assess their long-term impact.

This systematic review examines the content, structure, and process characteristics of interprofessional case discussions (InCaD) involving nurses in adult acute hospital care. Given the complexity of patient care and the need for enhanced interprofessional collaboration. Drawing on the structuration model of interprofessional collaboration framework, a comprehensive search was conducted in PubMed, CINAHL, Cochrane Library and PsycINFO (last search: December 2024). Studies with any type of multiprofessional case discussion were included if they described nurse´s tasks and roles. It was conducted a Level of Evidence statement. In total 42 out of 4541 studies were included. Eight types of InCaD were identified, including interprofessional bedside rounds (I(B)Rs), interdisciplinary rounds (IDRs), structured interdisciplinary bedside rounds (SIBR), and multidisciplinary team meetings (MDTM). Central contents of InCaD encompass collaborative decision-making, coordination of care, ethical reflection, and the integration of patient and family perspectives. Nurses play a pivotal role in InCaD, fulfilling tasks related to information exchange, ethical reflection, and coordination of care. However, nurses rarely assume leadership roles within InCaD. Our results reveal considerable heterogeneity in InCaD formats, theoretical foundations, and methodological approaches, no meta-analysis was feasible. While InCaD are seen as a valuable tool to improve care outcomes, further research to establish standardized frameworks and best practices is needed. These findings underscore the need for clear guidelines, nurse-led initiatives, and structured implementation strategies to optimize InCaD in clinical practice. The broad definition used may limit coherence and generalizability, and robust evidence on effectiveness remains scarce. This review provides insights for healthcare leaders, nurse educators by highlighting how the heterogeneity of InCaD formats can be harnessed as a flexible toolkit to develop context-sensitive implementation strategies, strengthen interprofessional collaboration, and ensure patient-centered, team-based care across diverse clinical settings.

There are increasing demands for including interprofessional education (IPE) within medical curricula. Primary care is a relatively new medium for IPE. Traditionally in medical programs, most primary care placements are in general medical practice. However, primary care may provide a sustainable solution for practice-based interprofessional learning; ultimately, improving interprofessional collaborative practice. An innovative program at Sydney Medical Program (Australia) incorporates medical student placements with various primary care interprofessional supervisors. Uniprofessional supervisor experiences are well documented. In this qualitative study, we aimed to gain an in-depth understanding of interprofessional supervisor experiences and motivating factors affecting their recruitment and ongoing engagement. Semi-structured interviews were conducted with 21 supervisors from various health professions. Themes were developed through reflexive thematic analysis and further explored using self-determination theory (SDT) as a theoretical lens. Key themes impacting motivation were identified: (a) Affordances and challenges in providing placements (b) Developing competencies and enhancing skills (c) Bridging gaps in primary care. Using SDT as a framework enabled a better understanding of supervisor perceptions and motivation for participating in student placements. Encouraging supervisor autonomy, engaging supervisors in faculty development, and strengthening their relatedness to universities are key to forming sustainable partnerships and enriching student learning in uni- and interprofessional settings.

Vietnam's health care system is increasingly recognizing the importance of interprofessional education (IPE). Understanding stereotypes among healthcare professionals is critical to fostering successful collaboration, yet little is known about the impact of IPE on stereotypes. This study evaluated health professions students' stereotypes of medicine, nursing, pharmacy, and rehabilitation therapy before and after participating in an IPE program. Students completed an online survey at two points: before and after the IPE course at the University of Medicine and Pharmacy at Ho Chi Minh City in 2021. Data collected included demographics, the Student Stereotypes Rating Questionnaire (SSRQ), and the 19-item Readiness for Interprofessional Learning Scale. A total of 163 students completed both online surveys (80.7% completion rate). Total SSRQ scores for all professions increased significantly after the IPE course (p < .05; effect size Cohen's dz = 0.3-0.4). Factors associated with stereotype change were also explored. Although healthcare students improved their perceptions of each profession, certain stereotypes persisted - for example, medicine was viewed more highly than other professions, and nursing and rehabilitation were viewed as less capable of leadership and independent work. Further research is needed to develop targeted interventions to address these stereotypes and improve interprofessional collaboration.