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Is Project ECHO the transformational silver lining for interprofessional and interorganizational collaboration? ECHO 项目是专业间和组织间合作的转型银线吗?
IF 2.7 3区 医学 Q1 Medicine Pub Date : 2024-04-24 DOI: 10.1080/13561820.2024.2343832
Phillip G Clark
The globally disruptive impact of the COVID-19 pandemic on both healthcare systems and health profession education has created an opportunity for a reassessment of methods for delivering interprofessional practice education (IPE). A good candidate for consideration is Project ECHO (Extension for Community Healthcare Outcomes). Its unique combination of structural design in connecting specialist and community-based clinical sites, foundational education theories, and didactic and case-based learning methods present an innovative and promising new method of promoting both interprofessional and interorganizational collaboration. This paper first provides a description of Project ECHO, its major features, recent expansion during the pandemic, and IPE-related research history. Second, the educational concepts and theories underlying its use and their implications for interprofessional and interorganizational collaboration are reviewed. These include community of practice and single and double-loop learning. Third, the expression of these concepts in how key elements of ECHO are utilized - including the didactic presentation; the case study presentation, discussion, and tele-mentoring; and the power of community and tele-networking - will be explored. Finally, implications and applications for the expansion of ECHO into promoting competency-based education and innovative interprofessional and interorganizational collaboration will be presented.
COVID-19 大流行病在全球范围内对医疗保健系统和卫生专业教育都产生了破坏性影响,这为重新评估提供跨专业实践教育(IPE)的方法创造了机会。社区医疗保健成果扩展项目(ECHO)就是一个很好的候选项目。它将连接专科和社区临床站点的结构设计、基础教育理论、说教式和基于案例的学习方法独特地结合在一起,为促进跨专业和跨组织合作提供了一种创新且前景广阔的新方法。本文首先介绍了 ECHO 项目、其主要特点、最近在大流行期间的扩展情况以及 IPE 相关研究历史。其次,回顾了其使用所依据的教育概念和理论及其对跨专业和跨组织合作的影响。这些概念和理论包括实践社区、单环和双环学习。第三,将探讨这些概念在如何利用 ECHO 关键要素中的表现形式,包括授课演示、案例研究演示、讨论和远程指导,以及社区和远程网络的力量。最后,还将介绍将 ECHO 扩展到促进以能力为基础的教育以及创新的跨专业和跨组织合作的意义和应用。
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引用次数: 0
Collaboration in action: successful implementation of a learner-driven virtual interprofessional education curriculum in the clinical learning environment. 行动中的合作:在临床学习环境中成功实施以学习者为导向的虚拟跨专业教育课程。
IF 2.7 3区 医学 Q1 Medicine Pub Date : 2024-04-24 DOI: 10.1080/13561820.2024.2343826
Sara North, Roni Lafky, Bonnie Horgos, Cheri L. Friedrich
Though technological capabilities to provide high-quality, flexible interprofessional education (IPE) have continued to grow, this remains a largely undeveloped area in the clinical learning environment (CLE). To address this gap, the University of Minnesota launched the Collaboration in Action: Learner-Driven Curriculum (CIA-LDC) as an IPE model designed for sustainability in a post-pandemic world. Over the course of two academic years, the CIA-LDC framework evolved and expanded through an iterative, data-informed approach incorporating student feedback, academic programme co-creation, evolving literature, and lessons learned. Modifications to individual activities and the overall model are presented, as well as key lessons learned. The majority of CIA-LDC evaluation responses across 2 years agreed that the amount of time spent was reasonable, participation placed little to no burden on their preceptor or site, the experience supported target interprofessional competency development, and that IPE should be provided in the CLE. The CIA-LDC holds promise as a successful, quality model for IPE in the CLE, available to learners from any profession in any geographic location in any practice setting. Outcomes demonstrate a pedagogical design with buy-in and feasibility in a post-pandemic world, with tremendous potential for advanced educational research to prepare the next generation as a collaborative practice-ready workforce.
尽管提供高质量、灵活的跨专业教育(IPE)的技术能力在不断提高,但在临床学习环境(CLE)中,这仍然是一个基本上尚未开发的领域。为了弥补这一差距,明尼苏达大学推出了 "行动中的协作":Learner-Driven Curriculum (CIA-LDC) 作为一种 IPE 模式,旨在实现流行病后世界的可持续发展。在两个学年的时间里,CIA-LDC 框架通过一种迭代的、以数据为依据的方法,结合学生的反馈、学术计划的共同创造、不断发展的文献和吸取的经验教训,得到了发展和扩展。本文介绍了对个别活动和整体模式的修改,以及主要的经验教训。两年来,大多数 CIA-LDC 评估回复都认为,花费的时间是合理的,参与活动几乎没有给他们的实习医生或实习基地带来任何负担,这种体验支持了目标跨专业能力的发展,而且应在 CLE 中提供 IPE。CIA-LDC 有望成为 CLE 中成功、优质的 IPE 模式,供来自任何地理位置、任何实践环境的任何专业的学员使用。其结果表明,在流行病后的世界里,这种教学设计具有可接受性和可行性,在高级教育研究方面具有巨大的潜力,可培养下一代成为具备协作实践能力的劳动力。
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引用次数: 0
Reclaiming the rounds: an interprofessional imperative 恢复巡视:跨专业的当务之急
IF 2.7 3区 医学 Q1 Medicine Pub Date : 2024-04-11 DOI: 10.1080/13561820.2024.2339624
Andreas Xyrichis
Published in Journal of Interprofessional Care (Vol. 38, No. 3, 2024)
发表于《跨专业护理杂志》(第 38 卷第 3 期,2024 年)
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引用次数: 0
The impact of using an authentic patient video on health professional students’ attitudes toward interprofessional and person-centered care 使用真实病人视频对卫生专业学生跨专业和以人为本的护理态度的影响
IF 2.7 3区 医学 Q1 Medicine Pub Date : 2024-04-10 DOI: 10.1080/13561820.2024.2334959
Kahlia Nissen, Lucy Chipchase, Tiffany Conroy, Olivia Farrer
Authentic patient activities in an interprofessional education (IPE) setting can develop collaborative, practice ready health professionals who have the skills to work within and across teams with ...
在跨专业教育(IPE)环境中开展真实的患者活动,可以培养具有协作精神、为实践做好准备的卫生专业人员,使他们掌握在团队内部和跨团队工作的技能。
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引用次数: 0
Effect of nurse-physician collaboration on the incidence of complications, negative emotions and quality of life in cervical cancer patients: a randomized controlled study. 护士与医生合作对宫颈癌患者并发症发生率、负面情绪和生活质量的影响:随机对照研究。
IF 2.7 3区 医学 Q1 Medicine Pub Date : 2024-03-25 DOI: 10.1080/13561820.2024.2327621
Ping Guan, Xingping Han, Dan Li, Bizhen Liao

The aim of this study was to evaluate the effect of nurse-physician collaboration on the incidence of complications, anxiety and depression, quality of life, and satisfaction with nursing care among cervical cancer patients undergoing three-dimensional intracavitary brachytherapy. In this randomized, single-blinded, placebo-controlled trial, 92 eligible cervical cancer patients were equally divided into two groups upon admission. The control group was given routine nursing, and the intervention group received a nurse-physician collaboration in addition to routine care. Anxiety, depression, and health-related quality of life in both groups were assessed and compared at baseline and discharge. The intervention group had significantly fewer complications and showed marked improvements in mental health and quality of life compared to the control group. Satisfaction with nursing care was substantially greater in the intervention group. These results support the clinical adoption of a nurse-physician collaborative care model in the management of cervical cancer with three-dimensional intracavitary brachytherapy.

本研究旨在评估护士与医生合作对接受三维腔内近距离治疗的宫颈癌患者的并发症发生率、焦虑和抑郁、生活质量以及护理满意度的影响。在这项随机、单盲、安慰剂对照试验中,92 名符合条件的宫颈癌患者在入院时被平均分为两组。对照组接受常规护理,干预组除常规护理外,还接受护士与医生的合作。在基线和出院时对两组患者的焦虑、抑郁和与健康相关的生活质量进行评估和比较。与对照组相比,干预组的并发症明显减少,心理健康和生活质量明显改善。干预组对护理服务的满意度大幅提高。这些结果支持在临床上采用护士-医生合作护理模式来管理宫颈癌的三维腔内近距离治疗。
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引用次数: 0
Social work involvement on student interprofessional teams: a qualitative investigation. 学生跨专业团队的社会工作参与:一项定性调查。
IF 2.7 3区 医学 Q1 Medicine Pub Date : 2024-03-01 Epub Date: 2023-11-09 DOI: 10.1080/13561820.2023.2271505
Heather M Sloane Cleary, Cara Swain

Social workers on interprofessional teams help highlight the mental health aspects of wellness and alert teams to potential social barriers to care. Social work students have been valued in new interprofessional education (IPE) initiatives across the United States; however, researchers have shown that social work practitioners often feel outside of and not valued by interprofessional teams. Social work student reflections were analyzed as research data to explore experiences on student IPE teams. This was an inductive, qualitative study informed by literary analysis methods, reading for power dynamics and implicit bias. This analysis uncovered social work students holding on to stereotypes of other professions as well as detrimental stereotypes of their own profession. Displays of respect for social work and early opportunities for successful advocacy allowed social work students to feel confident in their role and encouraged participation. This study considers how social work participation can be encouraged on interprofessional student teams.

跨专业团队的社会工作者帮助强调健康的心理健康方面,并提醒团队注意护理的潜在社会障碍。社会工作学生在美国新的跨专业教育(IPE)倡议中受到重视;然而,研究人员已经表明,社会工作从业者往往觉得自己被跨专业团队所排斥,不受重视。将社会工作学生的反思作为研究数据进行分析,以探索学生IPE团队的经验。这是一项归纳的、定性的研究,采用了文学分析方法,阅读权力动态和隐性偏见。这项分析揭示了社会工作学生对其他职业的刻板印象以及对自己职业的有害刻板印象。对社会工作的尊重和早期成功倡导的机会使社会工作学生对自己的角色充满信心,并鼓励他们参与。这项研究考虑了如何鼓励跨专业学生团队参与社会工作。
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引用次数: 0
German translation and validation of the Interprofessional Facilitation Scale. 专业间促进量表的德文翻译和验证。
IF 2.7 3区 医学 Q1 Medicine Pub Date : 2024-03-01 Epub Date: 2023-12-23 DOI: 10.1080/13561820.2023.2287024
Matthew J Kerry, Adeline Paignon, Joanne Wiesner Conti, Michael Sy, Marion Huber

We identified evidence from item response theory (IRT) to examine a German translation of the Interprofessional Facilitation Scale (IPFS). The IPFS was administered to n = 130 mixed-health profession participants in a post-interprofessional education practicum questionnaire. We used IRT analyses to examine the following three aspects of the IPFS: (a) general factor strength, (b) subscale usability, and (c) item bias. First, findings indicate a strong, general factor underlying the IPFS that supports unidimensional interpretations. Second, findings supported IPFS overall reliability, but failed to support subscale reliabilities. Third, item bias assessment using a comparator-French sample (n = 89) indicated insubstantial differences across German and French samples. Taken together, we find sufficient evidence to support the IPFS-German translation's application in IPE contexts and unidimensional interpretations. Subscores are not advisable for interpretation, and future researchers should aim to further inspect potential item bias.

我们从项目反应理论(IRT)中找出证据,对专业间促进量表(IPFS)的德文译本进行了研究。在跨专业教育实习后的问卷调查中,IPFS 的施测对象为 n = 130 名混合医疗专业的参与者。我们使用 IRT 分析法考察了 IPFS 的以下三个方面:(a)总体因子强度;(b)子量表可用性;(c)项目偏差。首先,研究结果表明 IPFS 有一个强大的总体因子,支持单维解释。其次,研究结果支持 IPFS 的总体信度,但不支持子量表的信度。第三,使用参照法国样本(n = 89)进行的项目偏差评估表明,德国和法国样本之间的差异不大。综上所述,我们发现有足够的证据支持 IPFS-德语翻译在 IPE 情境中的应用和单维度解释。对于解释而言,分值并不可取,未来的研究人员应致力于进一步检查潜在的项目偏差。
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引用次数: 0
Knowledge, skills, and training of community health workers to contribute to interprofessional education: a scoping review. 社区卫生工作者在促进跨专业教育方面的知识、技能和培训:范围界定综述。
IF 2.7 3区 医学 Q1 Medicine Pub Date : 2024-03-01 Epub Date: 2023-02-23 DOI: 10.1080/13561820.2023.2176472
Annemarie Joubert, Marianne Reid

A scoping review of 32 publications was conducted with the aim of mapping literature to determine what is known about the knowledge, skills, and training of community health workers that could contribute to interprofessional education. Interprofessional education, as a pedagogical approach, prepares health professions students to serve patients in collaboration with other health professionals to improve patient outcomes. All over the world, the role of community health workers is vital for its support of community service and community health outcomes. However, no evidence could be found on the knowledge, skills, and training of community health workers that contribute to interprofessional education. The knowledge that community health workers need to contribute to interprofessional education, as reported by the literature, relates to case management, communication, health education, recordkeeping and referrals. Skills, such as critical thinking, interprofessional collaboration, and various clinical procedures, were noted. Training approaches reported included the use of technology such as mobile phones and web-based learning. The scoping review improved our understanding of the knowledge, skills, and training of community health workers that could contribute to interprofessional education. Applying a fit-for-purpose approach, and building on existing knowledge, skills, and training, could fast-track the contribution of community health workers to interprofessional education.

我们对 32 篇出版物进行了范围审查,目的是对文献进行梳理,以确定人们对社区卫生工作者的知识、技能和培训有哪些了解,从而为跨专业教育做出贡献。跨专业教育作为一种教学方法,培养卫生专业学生与其他卫生专业人员合作为患者提供服务,以改善患者的治疗效果。在全球范围内,社区卫生工作者在支持社区服务和社区卫生成果方面发挥着至关重要的作用。然而,目前还没有证据表明社区卫生工作者的知识、技能和培训有助于跨专业教育。根据文献报道,社区卫生工作者需要为跨专业教育做出贡献的知识涉及病例管理、沟通、健康教育、记录和转诊。还提到了一些技能,如批判性思维、跨专业合作和各种临床程序。所报告的培训方法包括使用移动电话和网络学习等技术。范围界定审查提高了我们对社区卫生工作者的知识、技能和培训的认识,有助于开展跨专业教育。采用适合目的的方法,以现有的知识、技能和培训为基础,可以快速推动社区卫生工作者为跨专业教育做出贡献。
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引用次数: 0
Collaborative practice competencies needed for telehealth delivery by health and social care professionals: a scoping review. 医疗和社会护理专业人员提供远程医疗服务所需的协作实践能力:范围界定审查。
IF 2.7 3区 医学 Q1 Medicine Pub Date : 2024-03-01 Epub Date: 2023-05-24 DOI: 10.1080/13561820.2023.2213712
Marie-Eve Poitras, Yves Couturier, Priscilla Beaupré, Ariana Girard, Francois Aubry, Vanessa T Vaillancourt, Jean-Daniel Carrier, Laurie Fortin, Julie Racine, Jean Morneau, Amélie Boudreault, Caroline Cormier, Anaëlle Morin, Monica McGraw

In the context of the COVID-19 pandemic, many healthcare and social services professionals have had to provide services through virtual care. In the workplace, such professionals often need to be sufficiently resourced to collaborate and address collaborative care barriers in telehealth. We performed a scoping review to identify the competencies required to support interprofessional collaboration among clinicians in telehealth. We followed Arksey and O'Malley's and the Joanna Briggs Institute's methodological guidelines, including quantitative and qualitative peer-reviewed articles published between 2010 and 2021. We expanded our data sources by searching for any organization or experts in the field via Google. The analysis of the resulting thirty-one studies and sixteen documents highlighted that health and social services professionals are generally unaware of the competencies they need to develop or maintain interprofessional collaboration in telehealth. In an era of digital innovations, we believe this gap may jeopardize the quality of the services offered to patients and needs to be addressed. Of the six competency domains in the National Interprofessional Competency Framework, it was observed that interprofessional conflict resolution was the competency that emerged least as an essential competency to be developed, while interprofessional communication and patient/client/family/community-centered care were identified as the two most reported essential competencies.

在 COVID-19 大流行的背景下,许多医疗保健和社会服务专业人员不得不通过虚拟护理提供服务。在工作场所,这些专业人员往往需要足够的资源来开展协作,并解决远程医疗中的协作护理障碍。我们进行了一次范围审查,以确定支持远程医疗中临床医生之间跨专业协作所需的能力。我们遵循 Arksey 和 O'Malley 以及 Joanna Briggs 研究所的方法指南,包括 2010 年至 2021 年间发表的定量和定性同行评审文章。我们通过谷歌搜索该领域的任何组织或专家,扩大了数据来源。通过对 31 项研究和 16 份文件的分析,我们发现医疗和社会服务专业人员普遍不了解在远程医疗中发展或维持跨专业合作所需的能力。在数字创新的时代,我们认为这一差距可能会危及为患者提供的服务质量,因此需要加以解决。在 "国家跨专业能力框架 "的六个能力领域中,我们发现,跨专业冲突解决能力是最不需要培养的基本能力,而跨专业沟通和以患者/客户/家庭/社区为中心的护理被认为是报告最多的两个基本能力。
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引用次数: 0
Use of qualitative methods to optimize collaborative practices by highlighting differences in perceptions between professionals: an example of patient education. 使用定性方法,通过强调专业人员之间的认知差异来优化合作实践:以患者教育为例。
IF 2.7 3区 医学 Q1 Medicine Pub Date : 2024-03-01 Epub Date: 2024-02-20 DOI: 10.1080/13561820.2023.2289509
Laetitia Ricci, Laetitia Minary, Joëlle Kivits, Carole Ayav, Anne-Christine Rat

Interprofessional working must be approached within health promotion interventions using systematic methods to identify areas of suboptimal collaboration. We designed a qualitative study with a purposive sample of seven French therapeutic patient education programs. Semi-structured individual interviews were conducted with 14 healthcare providers and seven clinician leaders (coordinators) involved in patient education. We used the same interview guide and thematic grid regardless of the professional's profile to compare their perceptions on elements affecting outcome, participation and sustainability of programs. Healthcare providers and coordinators addressed non-convergent issues at both ends of a continuum from a micro-level nested in the program delivery to a macro-level corresponding to the structured implementation and sustainability of the program. Meso-level issues featured convergent perspectives. Our methodology could be used at the level of health services in a health system to provide a complete recovery of stakeholders' perspectives (without "blind spots" from one stakeholder or another). In our study, we focused on patient education in the French health system and pointed out possible considerations to optimize the functioning of programs. Such considerations include specific training plan development, encouraging reflection on the content and use of initial assessment, leading sessions in pairs to save on work time, and communication on the ins and outs of organizational imperatives that require healthcare providers' contributions.

在健康促进干预措施中,必须采用系统的方法来开展跨专业工作,以确定合作不理想的领域。我们设计了一项定性研究,对七个法国治疗性患者教育项目进行了有目的的抽样调查。我们对参与患者教育的 14 名医疗服务提供者和 7 名临床医生领导者(协调员)进行了半结构化个人访谈。无论专业人员的情况如何,我们都使用了相同的访谈指南和主题网格,以比较他们对影响项目成果、参与度和可持续性的因素的看法。医疗服务提供者和协调者在连续统一体的两端讨论了非趋同性问题,从嵌套在计划实施中的微观层面到与计划的结构化实施和可持续性相对应的宏观层面。中观层面的问题具有趋同的观点。我们的方法可用于卫生系统中的卫生服务层面,以全面恢复利益相关者的观点(不存在某个利益相关者的 "盲点")。在我们的研究中,我们重点关注了法国医疗系统中的患者教育,并指出了优化项目运作的可能考虑因素。这些考虑因素包括制定具体的培训计划,鼓励对初步评估的内容和使用进行反思,以两人一组的方式引导课程以节省工作时间,以及就需要医疗服务提供者做出贡献的组织要务的来龙去脉进行沟通。
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引用次数: 0
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Journal of Interprofessional Care
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