Journal of Interprofessional Care最新文献

The Danish healthcare system faces serious challenges in recruiting nurses. One solution to this challenge has been to employ physiotherapists and occupational therapists in vacant nursing positions, enabling task-shifting from nurses to these professionals as needed and appropriate. However, the dynamics of nurse-therapist task-shifting are not well understood in practical settings. Using a constructivist grounded theory approach, we developed a context-specific theory of task-shifting from nurses to therapists. Three physiotherapists, two occupational therapists (rehabilitation therapists), and 25 nurses from three different inpatient wards at a Danish university hospital participated in the study. Through comparative data collection and analysis, we identified a shared main concern in nurses' and rehabilitation therapists' task-shifting: The fear of losing professional identity. To address this, they used various strategies in task-shifting: (a) Equal, (b) Asymmetrical, (c) Non-coordinated, and (d) Negotiated. The findings contribute to understanding task-shifting between nurses and therapists in practice.

Clinical healthcare services need for positive interprofessional collaboration among workers, as a collaborative practice support better health outcomes for patients, workers and population. To develop future interprofessional practitioners, health sciences curricula need to address this from the earliest stages of student education, including by providing for the measurement of student attitudes toward interprofessional learning and practice. The study aims to translate and adapt the "University of the West of England Interprofessional Questionnaire" (UWE-IPQ) into Italian, and assess its face, content, and construct validity, test-retest reliability, and internal consistency. A sample of 465 Italian students enrolled in health-care undergraduate programs participated alongside a panel of 12 experts in health professions education. Results indicated that the Italian version (UWE-IPQ-Ita) of the tool demonstrated adequate face and content validity and aligned well with the original questionnaire. Confirmatory factor analysis results supported the 4-factor structure of the scale and its construct validity. Additionally, the questionnaire exhibited acceptable to excellent internal consistency across all scales. Test-retest reliability was also found to be good or excellent. Overall, the UWE-IPQ-Ita showed adequate validity and reliability, suggesting its suitability for assessing students' perceptions and attitudes in interprofessional education and research.

The purpose of this study was to develop and evaluate an interprofessional identity measurement instrument based on Extended Professional Identity Theory (EPIT). The latter states that interprofessional identity is a social identity superordinate to a professional identity consisting of three interrelated interprofessional identity characteristics: belonging, commitment and beliefs. Scale development was based on five stages: 1) construct clarification, 2) item pool generation, 3) review of initial item pool, 4) shortening scale length (EFA to determine top four highest factor loadings per subscale; 97 dental and dental hygiene students), and 5) cross-validation and construct validity confirmation (CFA; 152 students and 48 teachers from six curricula). Explained variance of the EPIS was 65%. Internal consistency of the subscales was 0.79, 0.81 and 0.80 respectively and 0.89 of the overall scale. CFA confirmed three-dimensionality as theorized by EPIT. Several goodness-of-fit indexes showed positive results: CFI = 0.968 > 0.90, RMSEA = 0.039 < 0.05, and SRMR = 0.056 ≤ 0.08. The factor loadings of the CFA ranged from 0.58 to 0.80 and factors were interrelated. The Extended Professional Identity Scale (EPIS) is a 12-item measurement instrument with high explained variance, high internal consistency and high construct validity with strong evidence for three-dimensionality.

Healthcare clinicians must be familiar with the process of organ donation and be prepared to communicate effectively and compassionately with the families of organ donors. They also must develop resiliency practices to face the complex ethical issues that often arise in cases involving brain death and organ donation. In this paper, we describe an ethics-oriented interprofessional education (IPE) initiative that aims to improve knowledge of the organ donation process, awareness of ethical issues that commonly arise in that process, and IPE-based strategies to decrease moral distress. Using three instruments, we evaluated the ethics-oriented IPE with 127 medical students and student nurses. The largest gains were seen in student understanding and appreciation for professional roles and responsibilities, as well as interprofessional teamwork. Additionally, student moral distress decreased after the facilitated debrief. The ethics-oriented IPE is innovative in its focus on interprofessional teamwork and clinical ethics, as well as in its inclusion of moral distress awareness and moral resiliency training.

We report a concept analysis of the term interprofessional socialization, conducted using the Walker and Avant approach. Our literature search resulted in 27 publications with meaningful insights regarding interprofessional socialization, published between 1994-2022. We identified five defining attributes of interprofessional socialization: (a) learning about other professionals and the roles they play on interprofessional teams, (b) recognizing the value of collaborating with other professionals, (c) identifying a common goal shared across professions, (d) breaking down barriers between professional silos, and (e) developing dual identity: a professional identity and an interprofessional identity. We identified antecedents, consequences, empirical referents, and cases to better illustrate the concept. Insights from this concept analysis provided the foundation for a conceptual definition. Interprofessional socialization is an iterative process in which members from different professions come together to learn about and value each other's perspectives and contributions, while dispelling misconceptions and prejudices, continuously working toward formation of a dual identity: one for professional identity and one for interprofessional identity. Future research is needed to explore how interprofessional socialization changes over the course of a career and how efforts to increase interprofessional socialization across healthcare settings might impact interprofessional initiatives throughout healthcare systems.

According to the World Health Organization interprofessional education (IPE) is a necessary step in preparing a collaborative practice-ready health work force. However, the processes of developing professional identity within interprofessional education programs have not been fully explored and require a deeper understanding. Participation in interprofessional education groups may influence the development of professional identity including increased awareness of one's own profession-specific competence as well as socialization into a professional role. Interprofessional education is a dynamic social process related to students' memberships in IPE-groups. We conducted focus groups with representatives from students in seven different professional education programs involved in interprofessional education during all three years of their educational programs. We used the principles of systematic text condensation as an analytical frame. This article is a contribution toward grasping how IPE can contribute to both professional and interprofessional identity. Group collaboration in interprofessional education enabled students to identify with their profession as well as creating a safe place to gain insight into other professions' competencies. Moreover, students could obtain knowledge about being a professional participant and could enrich their professional identity, as they were involved with students from other professions. IPE-groups strengthened professional identity rather than threatened it.

The Deans' Interprofessional Honors Colloquium (DIHC) is an honors-level interprofessional elective course that provides a seminar-based forum for students from eleven academic programs to explore the characteristics and implications of collaborative interprofessional practice around a contemporary health topic. This project-based course combines didactic presentations, interactive group learning, and an interprofessional shadowing experience with a corresponding written reflection paper. Ten semesters of Interprofessional Shadowing Reflections (n = 401) were studied via thematic and content analyses to examine the extent to which a brief interprofessional shadowing experience influenced interprofessional identity development. Interprofessional socialization framework was employed as a lens to refine themes and to track students' trajectory in developing a dual professional identity. This exploratory case study indicated that nearly all participants' reflections included content indicative of the second stage (interprofessional role learning) of the interprofessional socialization framework, and many progressed toward the third stage (dual identity development). Major themes included emergent role learning, increased differentiation among roles and care models, and increased appreciation for other professionals. The experience provided an opportunity for correction of misconceptions and improved understanding of the role and practice of other professions. Nearly all of the participating students (1) reflected on the benefits of interprofessional collaboration and (2) indicated a desire to work interprofessionally in the future, an early indication of dual identity formation. Findings indicated that the interprofessional shadowing experience and written reflection were highly valuable elements of the DIHC and provided a critical opportunity for interprofessional identity development.

Interpersonal communication is recognized as fundamental to interprofessional collaboration in healthcare; however, its processes remain understudied. We examined the interactive processes of constructing and negotiating interprofessional collaboration and professional identities as intercultural communication. We aimed to understand how intercultural narratives employed in an interprofessional healthcare team's meetings inform the construction of interprofessional collaboration. We used the framework of "small culture formation on the go" to investigate how people jointly construct rules, meanings, and relationships to position themselves and others. The theory we employed is based on the concepts of block and thread narratives: Blocks emphasize cultural boundaries between professions; threads create common ground. Positioning and thematic analysis was used on a dataset of audio recordings and transcripts of five meetings among nurses, physiotherapists, and ward clerks working in a Finnish hospital. The findings show that besides highlighting differences, blocks were used to organize collaboration and negotiate structural issues in interprofessional healthcare teamwork. Threads constructed shared understanding of joint processes, team membership, and patient-centeredness, reinforcing the mutual objectives of collaborative care. These findings challenge the original framework that views block narratives as something to avoid. We argue that in interprofessional settings, both blocks and threads can be beneficial, if not essential.

Research on interprofessional collaboration often includes the assumption that leadership is enacted individually. However, collaboration involves a form of leadership, sometimes known as plural leadership, that occurs from the combined influence of individuals. We examined plural leadership in practice for the purpose of informing strategies to support leadership specifically, and interprofessional collaboration more generally. We conducted a secondary analysis of 13 semi-structured interviews collected as part of a larger study on interprofessional collaboration in long-term care. First, we categorized data using concepts theorized from research on plural leadership. Next, we identified themes within each of the categories that represented how plural leadership is enacted according to the concepts. We then combined these themes to arrive at three actionable ways that plural leadership is enacted in long-term care: familiarity to create leaders; sharing and empathy to foster leadership; and structuring leadership. We use these to offer some practical approaches based on evidence and theory to support plural leadership in practice. Strategies include supporting staff continuity, providing space to share knowledge, and equipping team members with tools for navigating organizational structures. Our work contributes theoretical ideas about how to study and support leadership in collaboration.