Journal of Interprofessional Care最新文献

Healthcare services are accountable to their clients, communities, governments and funding sources to clearly demonstrate the effectiveness of interventions. A First Australian children's therapy service delivering culturally responsive, interprofessional collaborative practice aimed to evaluate their service. However, this process was constrained by available outcome measures which lacked the flexibility necessary for meaningful use within the dynamic and relational nature of their service delivery. This paper outlines an action research process in three cycles which was used to develop the Australian Therapies Outcome Measure for Indigenous Clients (ATOMIC) with the aim of evaluating therapy outcomes for urban First Australian children engaged in culturally responsive interprofessional therapy. Interrater reliability values of 0.995 and 0.982 were established for ATOMIC pre- and post-therapy measures, respectively, during a pilot phase involving 16 participants. Participants in the main study were 80 First Australian children aged two to 16 years who attended between two and nine interprofessional therapy sessions with occupational therapists and speech pathologists. Pre- and post-therapy ATOMIC scores confirmed progress on pre-determined functional goals across a range of skill domains. Outcomes of this study demonstrated that real gains are being made in urban First Australian children's lives following interprofessional collaborative service provision.

Early childhood caries (tooth decays) is a severe oral health condition that develops under the age of six. In many countries, oral health (including cavity treatment) is provided solely by dentists, who work independently. This organizational structure results in missed opportunities to prevent illnesses that occur throughout the child's health pathway, from birth and even before. The article aims to describe existing strategies for interprofessionality in pediatric oral health, as well as the obstacles and facilitators to their implementation. A scoping review was conducted on PubMed, Web of Science, Embase and Google Scholar between 2013 and 2025 to identify existing interprofessional collaboration strategies. Articles had to present a model of interprofessionality (oral health professional and other professionals), without being associated with a specific disease. Books, conferences or case reports were not included. The 10 articles included propose 3 major strategies such as the integration of dental hygienists into primary care. Others models focus on collaborative practice, with oral health training for healthcare professionals, recommendations or shared assessment tools. These collaborations sometimes go as far as the delegation of skills, if legislative support allow. Finally, new technologies can be used, such as telehealth and dental applications for assessing the risk of caries. The results were discussed in the light of D'Amour's interprofessional model of care, to identify the obstacles and facilitators of the different strategies with an operational aim (creation of a model applicable in France). Results highlight the need to set up a pediatric oral health network, that is sufficiently structured and focused on patients' interests to reduce social and territorial inequalities in oral health.

Collaboration among healthcare providers is regarded as a promising method to improve care quality and patient outcomes with limited human and financial resources. In Norway, "hospital-at-home" refers to care given by teams from the hospital pediatric wards who provide treatment and care in the family's home. When children need home visits multiple times daily, the hospital-at-home often reaches out to municipality healthcare providers, asking them to share this task. We aimed to explore the collaboration between stakeholders to gain knowledge on matters concerning the transfer of pediatric competence between hospital and home-based care, and to gain insight into how to set up the service for children in the future. We conducted three focus group interviews. The results showed that managing hospital-at-home collaboratively came with various challenges concerning unclear responsibilities between hospitals and homecare services and several obstacles to setting up cooperation across service levels. Thus, positive collaboration experiences between hospital and homecare settings were shared. Formalizing this collaboration was considered important for future collaboration. Building competence and learning from and with each other ensures better conditions for success if the collaboration is organized and facilitated through agreements between the hospital and the municipalities.

Meeting the needs of patients with substance use disorders (SUDs), complex comorbidity, and social determinants of poor health is challenging in traditional primary care environments. Interprofessional primary care (IPC) can better address these needs and may reduce acute care utilization and healthcare costs. We used a retrospective cohort study design (n = 994 patients) to compare healthcare utilization and costs 2 years before and after patients enrolled in an IPC model in the US Veterans Health Administration. Patients were grouped based on histories of high emergency department (ED) use, SUDs, homelessness, and combinations of these vulnerabilities. Generalized estimating equations (GEE) tested for differences in utilization and costs across groups. Following IPC enrollment, primary care visits and costs increased overall (adjusted increase = 2.90-7.24 visits/person-year; $1,032-$2,817/person-year). Among patients with prior high ED use, acute care costs declined; among patients without prior high ED use, acute care costs were mixed and ED use increased. Total costs decreased, were neutral, and increased for patients with 3, 1-2, and no vulnerabilities, respectively. Primary care engagement, reduced acute care, and limited cost increases suggest high value in this IPC model and highlight the need to further study IPC in addressing addiction and social determinants of poor health.

Role clarification is essential for health care professionals to understand each role in a health professions team. However, educators struggle to design and execute effective learning activities focusing on role clarification within interprofessional education programmes, often due to a limited understanding of each other's professions or limited experience within interprofessional teams. To assist in addressing this issue, a qualitative exploratory design was applied using a desktop-based virtual reality (VR) simulation to facilitate a discussion on role clarification and explore the influence of virtual reality in the development of shared mental models about role clarification. Ten educators were recruited to participate in a workshop, after which they engaged in a discussion session on the facilitation of role clarification in Interprofessional education (IPE) programmes. Educators were first expected to individually create their desktop-based virtual reality scenario, which reflected their professional roles. Once completed, other educators interacted with their scenario by asking questions and reflecting on their practice as educators and practitioners. Narrative data collected during the discussions on the scenarios of each of the educators were analyzed thematically, resulting in four themes, namely "skills and tasks," "responsibilities in patient care," "tools of the trade" and "communication." The educators discussed various aspects of their professional roles but ignored the fact that they have dual roles as practitioners and educators. The length of the workshop limited the development of fully shared mental models. Future research should explore the longitudinal use of desktop-based VR in role clarification toward shared mental models.

Traditional hierarchies and structures in healthcare, as well as traditional professional socialization practices, continue to create barriers to effective interprofessional collaboration. Nevertheless, some studies indicate that early socialization with other health professionals can build bridges and improve understanding of each other's roles and contributions to patient care. This pilot study aimed to gain insights into the nursing and medical students' experiences of interprofessional medical history taking during a collective learning activity. A descriptive case study was conducted using modified interviews based on the speed-dating (SD) technique to explore participants' reasons for the choice of profession (SD1) and experiences of interprofessional history taking (SD2). Data were digitally captured using audio-recordings. An inductive-deductive approach to qualitative content analysis of transcribed responses was undertaken. Eighteen students (medicine n = 6; nursing n = 12) participated. Two main categories with sub-themes emerged from the inductive SD1 analysis: (a) reasons for choosing a career and (b) knowledge about professions. The SD2 deductive analysis identified three major categories with sub-themes: (a) breaking down barriers, (b) interprofessional role learning - interprofessional collaboration and (c) dual-identity development. Our findings showed that early interprofessional socialization of students supported their learning about the complementary roles of doctors and nurses and enabled them to gain early experiences of interprofessional teamwork.

An interprofessional team is required to address comprehensive healthcare needs of people living with mental health conditions in the US. Within interprofessional teams, collaborative decision-making improves patient care quality. This process relies on development of constructive learning behaviors - including sharing of knowledge, exploring divergent opinions, building on team members' ideas, and coming to consensus - that must be taught, practiced, and assessed. Without explicit description of these behaviors, it is difficult to communicate expectations to learners and provide them with formative feedback to support progression. A novel observational assessment tool, Tool for Observing Construction of Knowledge in Interprofessional teams (TOCK-IP), was designed to guide clinical educators' observations and formative assessment of discrete, constructive learning behaviors and to support greater consistency and quality of feedback to learners. Faculty raters applied the TOCK-IP to learner teams in the year-long didactic portion of the interprofessional Doctor of Nursing Psychiatric Mental Health Practitioner/Doctor of Pharmacy program to assess its feasibility and utility in real-use situations. This short report provides the results of this assessment, using feedback from learners and faculty raters. Application of the TOCK-IP was feasible and useful in an interprofessional educational setting.

Identity development within the interprofessional field is an emerging area of research. This scoping review aims to establish how professional and interprofessional identities are defined, conceptualized, theorized and measured within the interprofessional literature. Six databases were systematically searched for papers focusing on professional and/or interprofessional identities in interprofessional healthcare and education using a scoping review methodology. A total of 84 papers were included. Most papers discussed professional identity only; the minority discussed both identities. There were three key findings. First, no universal definition of interprofessional identity exists. Second, there is no shared understanding of interprofessional identity and its relationship with professional identity. Third, poor alignment between definitions, conceptualizations, theories and measures of interprofessional identity exists. The absence of a psychometrically robust instrument that specifically measures interprofessional identity and the short-term focus of current interprofessional identity research further limits understanding. Research that critically examines professional and interprofessional identity development should be underpinned by clear definitions, concepts, theories and measures of both identities. High-quality research will allow greater understanding of interprofessional identity development and its impact on interprofessional practice.

The increase in long-term conditions and healthcare costs in Europe requires a strategic approach, prioritizing the establishment of Community-Based Interprofessional Teams (CBIT). Health and social care professionals (HSCP) in community primary care and CBIT require specific transversal skills and competencies (S&C). This rapid review synthesized the essential transversal S&C across European countries and identified corresponding curricula learning objectives. The Mixed Methods Appraisal Tool (MMAT) was adopted to assess quality evidence. Identified S&C were clustered following the European Skills, Competences, Qualifications, and Occupations (ESCO) Framework, which clusters transversal S&C into six groups: Social and Communication, Self-Management, Thinking, Life, Core, and Physical & Manual S&C. Eight qualitative studies met our coherence eligibility criteria. Among ESCO clusters, Social and Communication S&C was emphasized as crucial, encompassing effective communication, team support, collaboration, leadership, and adherence to ethical codes. Self-management S&C highlighted efficient work and a learning-oriented mind-set, while Thinking S&C emphasized information processing, holistic thinking, and planning. Life S&C focused emphasized health-related applications, and Core S&C highlighted digital proficiency. No skills from the Physical and Manual S&C cluster were reported. To classify these S&C in learning objectives, Bloom's Taxonomy was adopted. Most learning objectives fell under "Procedural Knowledge," emphasizing understanding "How to do something." Future studies should explore the benefits of transversal S&C to enhance work in community primary care and CBIT practices.