Journal of Interprofessional Care最新文献

The purpose of this study was to assess the effect of an interprofessional socialization (IPS) based interprofessional education (IPE) program intervention on health professions students' IPS process and dual identity development. Despite the growing acknowledgment of IPS in recent literature, there is a paucity of research investigating socialization processes learners move through in order to develop dual identity - professional and interprofessional. A concurrent embedded mixed-method design was used. One hundred and eight pre-licensure students from seven different health professions completed the IPS program intervention. Latent Growth Curve (LGC) modeling and thematic content analysis were used to analyze the quantitative and qualitative data, respectively. A significant and consistent growth rate in dual identity was found among the participants. The thematic analysis resulted in four emerging themes (uniprofessional education as a barrier, IPS program as an eye-opener, learning to collaborate, and collective unified team). The integrated findings provide support for the use of the interprofessional socialization framework.

Healthcare providers need to simultaneously identify with their own profession and the broader interprofessional group to improve interprofessional team functioning and collaboration. The purpose of this study was to explore firstyear healthcare students' interprofessional identity development following a brief introductory interprofessional activity. The Extended Professional Identity Theory (EPIT) served as the framework for this qualitative study. The sample included 1,047 students from 19 different health professions at one institution in the first semester of their professional program. Deductive content analysis was used to analyze students' reflections from two reflective questions in a mandatory course evaluation survey. The 24-item version of the Extended Professional Identity Scale was used as a structured categorization matrix for deductive coding of student reflections to the three EPIT constructs: interprofessional belonging, commitment, and beliefs. Participant responses, spanning all three EPIT constructs, support the ability of early health professions learners to demonstrate the development of an emerging interprofessional identity. Future research is needed to assess IPI at various points across the curriculum and to explore between profession differences and the implications for foundational IPE design and learning along the continuum into practice.

The growing complexity of care and healthcare workforce shortages in the Netherlands necessitates exploring interprofessional collaboration (IPC). However, the predominant single-professional education may result in a professional identity (PI) among healthcare students, which may not support successful IPC. Internships in student-run interprofessional learning wards (SR-IPLW) could foster interprofessional identity (IPI) development. There is a need for a better understanding of the intricacies involved in learning to work collaboratively, particularly when undergraduates are still shaping their professional identities. Our aim, therefore, was to identify facilitators and barriers for interprofessional education (IPE), IPC, and identity development among 21 healthcare students during a 20-week clinical placement on a SR-IPLW in rehabilitation medicine. An action-based prospective study using grounded theory analysis of nine focus groups across three semesters identified 17 theoretical codes. These codes are elaborated in a conceptual model highlighting facilitators and barriers for IPC and identity development, emphasizing the importance of fostering feelings of relatedness, competence, and autonomy. There are indications that professional and interprofessional identities changed during the internship. Implications for preceptors are delineated, showing the importance of personal relationships and elements of a positive learning climate.

This study examined the impact of student-led interprofessional activity on knowledge about obesity, communication within a team, and the ability to formulate a shared management plan. A mixed-method approach was used to collect data from students across four health science colleges, including medicine, pharmacy, nursing, and applied medical health. The quantitative data was collected in two stages; the first stage involved a pre-knowledge test and a Performance Assessment for Communication and Teamwork (PACT) Tool test, which were conducted before allowing the students to interview a patient with obesity and write their management plan as uni-professional teams. After attending an obesity awareness day, students were split into two IP teams to develop interprofessional care plans collaboratively. The second stage included post-knowledge tests and post-activity PACT tests. A reflection session was also held to gather students' perspectives of the IP educational experience. Qualitative data were summarized to identify emerging themes, which were illustrated with relevant quotes from the reflections. Results from the post-performance PACT test showed significant improvement in familiarity with team-based learning, performance, and the learning environment. Key themes that emerged from students' reflections highlighted the importance of teamwork, shared decision-making, effective communication, accepting and respecting other professionals, and the ability to develop comprehensive care plans. Participants appreciated the roles and responsibilities of each profession and stated that the IP collaboration helped fill gaps in the patient management care plan. In conclusion, interprofessional education can positively influence students' learning processes and teamwork skills, promoting mutual learning and enabling the development of holistic obesity management plans.

Interprofessional education (IPE) and interprofessional collaborative practice (IPCP) are essential for high-quality safe, effective, and efficient healthcare. This program of work aimed to build a culture of IPE and IPCP across a large metropolitan health service. This study was a repeated cross-sectional study which evaluated an approach to integrating IPE and IPCP as an embedded model of care across a health service. The Interprofessional Collaborative Organisation Map and Preparedness Assessment (IP-COMPASS) was used to (i) understand the current state of IPE and IPCP across the organization, (ii) guide a cohesive and comprehensive program of work to implement systems, structures, governance, practices, and education that support and develop IPE and IPCP, and (iii) evaluate the change in IPE and IPCP following the program of work. Eleven out of 22 interprofessional attributes (50%) were weak or absent at baseline. Following 18-months implementation of targeted interprofessional initiatives, strategies, and education, five attributes (22%) were weak or absent. Thirteen attributes improved (59%), six remained the same (27%), and three declined (14%). Many interprofessional attributes improved with a program of initiatives targeted to enhance the systems, structures, governance, practices, and education that support and develop IPE and IPCP. A small number of attributes declined, which may reflect increased awareness of IPE and IPCP as a previously unrecognized gap, leading to the realization that this critical way of working is absent. Despite improvements, many interprofessional attributes remained inadequate, highlighting the challenges and extended timeframes required for systems level change.

Today more older people are living longer with complex health conditions and social care needs. Multimorbidity is often managed by community practitioners who oversee the use of multiple medications, which can lead to polypharmacy safety concerns. While clinical pharmacists' roles are established in acute settings, they are in the main new in family practice or primary care. To help medical and pharmacy students understand more about clinical pharmacists in primary care, we used an interactive experiential learning model for students over two days. Students in small groups were prepared to visit a patient in their own home to holistically review the patients' medicines and care. This mixed methods study reports on the learning between 2017 and 2020, including 448 pre-post questionnaires with free text comments and one exploratory qualitative case study with two student focus groups, a practice GP and patient. All students valued the clinical relevance of this practice-based course. Medical students highly valued this way of learning and significantly increased their learning on complex medication reviews (p = .000), recognizing the future significance of working closely with pharmacists when qualified because of their contribution to prescribing. Pharmacy students highly rated this learning because they worked as equals alongside the medical students, felt valued, and they perceived the importance of learning with patients (p = .000). The student work highlighted unsafe practice and in some cases actually changed patient management. The interviewed patient and GP welcomed the course. Integrating medical and pharmacy students interprofessional learning in primary care was valued by students and the clinical team.

Interprofessional teamwork is touted as essential to positive patient, staff, and organizational outcomes. However, differing understandings of teamwork and divergent professional cultures amongst healthcare providers influence the success of teamwork. In labour and delivery, nurse-physician teamwork is vital to safe, family-centered maternity care. In this focused ethnography, the perceptions of obstetrical nurses were sought to understand nurse-physician teamwork and the features that facilitate or impede it. These nurses acknowledged working in a normative hierarchy, with physicians ultimately responsible for patient care decision-making. They described myriad ways in which they navigated traditional power dynamics and smoothed working relationships with physicians, such as circumventing disrespectful behaviors, venting with each other, highlighting their own autonomy, using tactical communication, and managing unit resources. According to these nurses, key facilitators of functional nurse-physicians relationships were time, trust, respect, credibility, and social connection. Further, the nature of their working relationships with physicians influenced their perceptions regarding intent to stay, workplace morale, and patient outcomes.

One in two women in Australia use complementary medicine (CM) during pregnancy including consulting with CM practitioners for pregnancy-related health concerns. Yet, very little is known about the everyday care and practice of this group of health professionals as it relates to the provision of care to childbearing women. As such, this study aims to examine the perceptions and experiences of CM practitioners who provide care to childbearing women. Semi-structured interviews were conducted with 23 practitioners from six CM professions (acupuncturists, doulas, chiropractors, massage therapists, naturopaths, and osteopaths) who identified as providing care to pregnant and birthing women in their clinical practice. The participants described professional issues affecting their provision of care to childbearing women including scope of practice, regulation and standards, and practice-specific issues, all of which they linked back to their profession and the reputation of their profession among other health professionals and the community. The study results draw attention to the importance of considering the perspectives of CM maternity care providers and place on interprofessional collaboration, as well as the barriers they face to achieving this collaboration. The insights afforded by this study have the capacity to inform new policy and practice initiatives to support improved interprofessional maternity care.

Interprofessional teamwork is essential to high-quality healthcare, however disrespect and incivility amongst team members is a challenge to creating and sustaining effective teams. We describe and assess the impact of a multifaceted improvement project with the primary intervention being a Compassionate Communication (CC) training on a Labor and Birth unit. Our hypothesis was this improvement project would increase staff members' capacity for perspective-taking and self-reflection, which would in turn correlate with positive interpersonal interactions, respect and teamwork. Secondly, we hypothesized that enhanced respect and teamwork would correlate with enhanced affective commitment to the organization. Staff was surveyed midway through the project and 6 months after the CC training. A total of 74 (57%) staff completed the initial pre-training surveys and 50 (38%) staff completed post-training surveys. At 6 months post-CC training we saw changes in self-reflection and an awakening of self-awareness. There were no significant changes in perspective-taking. However, we did see changes in staffs' perceptions of respect and teamwork. Team members' affective commitment to the organization increased. In this Labor and Birth setting, a multifaceted improvement project with the primary intervention being CC training was beneficial in improving a culture of respect and interprofessional teamwork.