New Research 10/24-10/30
From: Humanities
Homi K. Bhabha is a post-colonial and cultural theorist who describes the emergence of new cultural forms from multiculturalism. When health profession students enculturated into their profession discuss patient care in an interprofessional group, their unilateral view is challenged. The students are in that ambiguous area, or Third Space, where statements of their profession’s view of the patient enmesh and an interprofessional identity begins to form. The lessons learned from others ways of assessing and treating a patient, seen through the lens of hybridity allow for the development of a richer, interprofessional identity. This manuscript will seek out the ways Bhabha’s views of inbetweenness enhance understanding of the student’s development of an interprofessional viewpoint or identity, and deepen the author’s developing framework of an Interprofessional Community of Practice.
From: Medical Reference Services Quarterly
When the University of Mississippi Medical Center embraced a didactic shift to patient-centered, interprofessional education of its medical, dental, nursing, pharmacy, and allied health students, the Rowland Medical Library repurposed space to support the cause and created a collaborative learning space designated for campus-wide utility.
3. Promoting interprofessional understandings through online learning: a qualitative examination
From: Nurs Health Sci
Interprofessional education is increasingly a core component of health professional curricula. It has been suggested that interprofessional education can directly enhance patient care outcomes. However, literature has reported many difficulties in its successful implementation. This study investigated students' perceptions of participating in an online, Web-based module to facilitate interprofessional education. Three focus groups, each with 13-15 students, from emergency health (paramedic), nursing, occupational therapy, physiotherapy, and nutrition and dietetics were conducted with students who participated in an online interprofessional education module at one Australian university. Thematic analysis was employed to analyze interview transcripts. Four themes emerged: professional understanding, patient-centeredness, comparison with other interprofessional education activities, and overcoming geographical boundaries. Students were overwhelmingly positive about their learning experiences and the value of the module in assisting their understandings of the roles of other health professionals. Online approaches to interprofessional education have the potential to enhance learning and overcome geographical and logistical issues inherent in delivering face-to-face interprofessional education. Furthermore, our design approach allowed students to watch how other health professionals worked in a way that they were unable to achieve in clinical practice.
4.Louder than words: power and conflict in interprofessional education articles, 1954-2013
From: Med Educ
CONTEXT: Interprofessional education (IPE) aspires to enable collaborative practice. Current IPE offerings, although rapidly proliferating, lack evidence of efficacy and theoretical grounding.
OBJECTIVES: Our research aimed to explore the historical emergence of the field of IPE and to analyse the positioning of this academic field of inquiry. In particular, we sought to investigate the extent to which power and conflict - elements central to interprofessional care - figure in the IPE literature.
METHODS: We used a combination of deductive and inductive automated coding and manual coding to explore the contents of 2191 articles in the IPE literature published between 1954 and 2013. Inductive coding focused on the presence and use of the sociological (rather than statistical) version of power, which refers to hierarchies and asymmetries among the professions. Articles found to be centrally about power were then analysed using content analysis.
RESULTS: Publications on IPE have grown exponentially in the past decade. Deductive coding of identified articles showed an emphasis on students, learning, programmes and practice. Automated inductive coding of titles and abstracts identified 129 articles potentially about power, but manual coding found that only six articles put power and conflict at the centre. Content analysis of these six articles revealed that two provided tentative explorations of power dynamics, one skirted around this issue, and three explicitly theorised and integrated power and conflict.
CONCLUSIONS: The lack of attention to power and conflict in the IPE literature suggests that many educators do not foreground these issues. Education programmes are expected to transform individuals into effective collaborators, without heed to structural, organisational and institutional factors. In so doing, current constructions of IPE veil the problems that IPE attempts to solve.
From: Front Public Health
Transformational learning is the focus of twenty-first century global educational reforms. In India, there is a need to amalgamate the skills and knowledge of medical, nursing, and public health practitioners and to develop robust leadership competencies among them. This initiative proposed to identify interdisciplinary leadership competencies among Indian health practitioners and to develop a training program for interdisciplinary leadership skills through an Innovation Collaborative. Medical, nursing, and public health institutions partnered in this endeavor. An exhaustive literature search was undertaken to identify leadership competencies in these three professions. Published evidence was utilized in searching for the need for interdisciplinary training of health practitioners, including current scenarios in interprofessional health education and the key competencies required. The interdisciplinary leadership competencies identified were self-awareness, vision, self-regulation, motivation, decisiveness, integrity, interpersonal communication skills, strategic planning, team building, innovation, and being an effective change agent. Subsequently, a training program was developed, and three training sessions were piloted with 66 participants. Each cohort comprised a mix of participants from different disciplines. The pilot training guided the development of a training model for building interdisciplinary leadership skills and organizing interdisciplinary leadership workshops. The need for interdisciplinary leadership competencies is recognized. The long-term objective of the training model is integration into the regular medical, nursing, and public health curricula, with the aim of developing interdisciplinary leadership skills among them. Although challenging, formal incorporation of leadership skills into health professional education is possible within the interdisciplinary classroom setting using principles of transformative learning.
6. Interprofessional Education Using a Palliative Care Simulation
From: Nurse Educ.
This quasi-experimental pretest-posttest study measured self-efficacy, attitudes toward physician-nurse collaboration, and interprofessional competencies as outcomes of a palliative care simulation. Based on experience level, teams of participants, 1 consisting of nursing/medical students and the other of nursing/medical health care professionals, completed a palliative care simulation as part of their education. Self-efficacy and attitudes toward physician-nurse collaboration were measured before and after simulation. Interprofessional competency was measured during the simulation. The results revealed a significant improvement in the previously mentioned measures, and interprofessional competency scores varied by profession and evaluator.
From: Health and Interprofessional Practice
METHODS: A two-stage cluster sample of 470 US family medicine and 205 pediatric residency programs was used. A random sample of 30% (N=140) of family medicine and 29% (N=60) of pediatric residency programs were randomly selected. Of these, 42 programs (21%) invited residents to participate. Residents (N=95, 28%) completed an online questionnaire regarding oral health training in residency. Statistical analysis included frequencies and Spearman’s rank correlations.
RESULTS: Eighty-three percent of family medicine and pediatric residents combined reported receiving oral health education. Clinical experiences involving oral healthcare were frequently reported (77%, n=75); however, IPE with an oral health professional was limited. Both groups indicated they provided anticipatory guidance regarding regular dental visits and toothbrushing “very often” and avoiding bottles at bedtime “often.” Residents reported performing dental caries assessments “often” and applying fluoride varnish “occasionally.” For family medicine residents, moderate correlations (p ≤ 0.01) were found between hours of oral health education and providing anticipatory guidance. For pediatric residents, a moderate correlation (p < 0.01) was found between hours of oral health education and assessing teeth for demineralization.
8. Evidence-based development in nurse-led interprofessional practice
From: Nursing Management
Team-based care is often described as the best way to provide health care. However the effective use of teams in primary care is not yet prevalent in the US and nurse-led interprofessional collaborative teams are rare. Over the past three years the US Department of Health and Human Services has put great emphasis on the development of nurse-led interprofessional teams and this article describes the development of one such team in a primary care setting and the evidence base behind it.
From: J Healthc Manag
Implementing interprofessional collaborative practices in primary care is challenging, and research about its facilitating factors remains scarce. The goal of this participatory action research study was to better understand the driving forces during the early stage of the implementation process of a community-driven and patient-focused program in primary care titled "TRANSforming InTerprofessional cardiovascular disease prevention in primary care" (TRANSIT). Eight primary care clinics in Quebec, Canada, agreed to participate by creating and implementing an interprofessional facilitation team (IFT). Sixty-three participants volunteered to be part of an IFT, and 759 patients agreed to participate. We randomized six clinics into a supported facilitation ("supported") group, with an external facilitator (EF) and financial incentives for participants. We assigned two clinics to an unsupported facilitation ("unsupported") group, with no EF or financial incentives. After 3 months, we held one interview for the two EFs. After 6 months, we held eight focus groups with IFT members and another interview with each EF. The analyses revealed three key forces: (1) opportunity for dialogue through the IFT, (2) active role of the EF, and (3) change implementation budgets. Decision-makers designing implementation plans for interprofessional programs should ensure that these driving forces are activated. Further research should examine how these forces affect interprofessional practices and patient outcomes.
10. Implications of the Patient-Centered Medical Home for Nursing Practice
From: J Nurs Adm
OBJECTIVE: The experiences of RNs and licensed practical nurses (LPNs) implementing a patient-centered medical home (PCMH) in the Department of Veterans Affairs (VA) primary care clinics were examined to understand model implications for nursing practice and professional identity.
BACKGROUND: National implementation of the PCMH model, called patient-aligned care teams (PACTs) in VA, emphasizes areas of nursing expertise, yet little is known about the effect of medical homes on the day-to-day work of nurses.
METHODS: As part of a formative evaluation to identify barriers and facilitators to PACT implementation, we interviewed 18 nurses implementing PACT.
RESULTS: Challenges to nurse's organizational and professional roles were experienced differently by RNs and LPNs in the following areas: (1) diversified modes of care and expanded clinical duties, (2) division of labor among PACT nurses, and (3) interprofessional status in the team.
CONCLUSIONS: Healthcare managers implementing PCMH should consider its inherent cultural and practice transformations.
From: Am J Pharm Educ
OBJECTIVE: To describe an interprofessional communication course in an academic health sciences center and to evaluate and compare interpersonal and interprofessional communication self-efficacy beliefs of medical, nursing, and pharmacy students before and after course participation, using Bandura's self-efficacy theory as a guiding framework.
DESIGN: First-year nursing (n=36), first-year medical (n=73), and second-year pharmacy students (n=83) enrolled in an interprofessional communication skills development course voluntarily completed a 33-item survey instrument based on Interprofessional Education Collaborative (IPEC) core competencies prior to and upon completion of the course during the fall semester of 2012.
ASSESSMENT: Nursing students entered the course with higher interpersonal and interprofessional communication self-efficacy beliefs compared to medical and pharmacy students. Pharmacy students, in particular, noted significant improvements in communication self-efficacy beliefs across multiple domains postcourse.
CONCLUSION: Completion of an interprofessional communications course was associated with a positive impact on health professions students' interpersonal and interprofessional communication self-efficacy beliefs.
12. A critical appraisal of instruments to measure outcomes of interprofessional education
From: Med Educ
CONTEXT: Interprofessional education (IPE) is believed to prepare health professional graduates for successful collaborative practice. A range of instruments have been developed to measure the outcomes of IPE. An understanding of the psychometric properties of these instruments is important if they are to be used to measure the effectiveness of IPE.
OBJECTIVES: This review set out to identify instruments available to measure outcomes of IPE and collaborative practice in pre-qualification health professional students and to critically appraise the psychometric properties of validity, responsiveness and reliability against contemporary standards for instrument design.
METHODS: Instruments were selected from a pool of extant instruments and subjected to critical appraisal to determine whether they satisfied inclusion criteria. The qualitative and psychometric attributes of the included instruments were appraised using a checklist developed for this review.
RESULTS: Nine instruments were critically appraised, including the widely adopted Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS). Validity evidence for instruments was predominantly based on test content and internal structure. Ceiling effects and lack of scale width contribute to the inability of some instruments to detect change in variables of interest. Limited reliability data were reported for two instruments. Scale development and scoring protocols were generally reported by instrument developers, but the inconsistent application of scoring protocols for some instruments was apparent.
CONCLUSIONS: A number of instruments have been developed to measure outcomes of IPE in pre-qualification health professional students. Based on reported validity evidence and reliability data, the psychometric integrity of these instruments is limited. The theoretical test construction paradigm on which instruments have been developed may be contributing to the failure of some instruments to detect change in variables of interest following an IPE intervention. These limitations should be considered in any future research on instrument design.
Start the Conversation
Every registered user can comment on website content.
Please login or register to comment