Using the modified Delphi technique to develop a framework for interprofessional education during international electives in health professions training institutions in Sub-Saharan Africa.

Background: International electives provide a learning platform where interprofessional education and collaborative practice (IPECP) skills can be cultivated. However, hardly any frameworks to guide the implementation of interprofessional education (IPE) during international electives, especially in the context of low-income settings have been published. To address this gap, this study used the modified Delphi approach to develop an IPE framework guide for international electives to be used by health professions training institutions in Sub-Saharan Africa. Methods: A rapid literature review and a study among students and faculty in four African health professional training institutions were done to inform the process. This was followed by the modified Delphi technique that used three Delphi rounds with a panel of eight experts to build consensus on the final framework for IPE during international electives. The level of consensus was set at ≥70% on each of the statements in all rounds. Results: Out of the 52 statements in round 1 (n = 37, 71%) reached consensus while (n = 15, 29%) of the statements did not reach consensus and were discussed in round 2. Round 2 led to 42 statements to be utilized for round 3. In round 3, all statements (42) reached a consensus and an IPE framework to guide the implementation of international electives was developed. The framework consists of three sections. Section one highlights the various IPECP competencies to be gained by learners in the areas of teamwork, interprofessional communication, roles and responsibilities of interprofessional collaborative practice, values and ethics of interprofessional collaboration, and reflection and evaluation of oneself and the team. Section two gives guidance on the structuring of the IPE international electives in health professional training institutions. This includes subsections on operational/institutional needs, acculturation considerations, teaching strategies, assessment strategies, mode of delivery, and public health considerations. Section three consists of the various practical guides and approaches that health professional training institutions could use according to what works best in their setting. Conclusion: The modified Delphi technique was an adequate approach to aid the development of an IPE framework to guide implementation during international electives in various health professional training institutions.

Experiences of faculty and students regarding a locally developed framework for implementing interprofessional education during international electives in Sub-Saharan Africa.

BACKGROUND: Given that there are hardly any comprehensive frameworks to guide institutions on approaches to use as they implement interprofessional education and collaborative practice during international electives, we developed and piloted a framework to address this gap. The purpose of this study, therefore, was to explore the experiences of faculty and students regarding the use of the developed interprofessional education and collaborative practice framework during international electives. METHODS: This was an exploratory qualitative study. The study participants included faculty and students from four health training universities in Africa who participated in the pilot of international electives guided by the framework developed. Deductive thematic analysis was used to analyze the data. The codes were categorized as per the major themes. RESULTS: The major themes regarding the framework included (1) The Strengths, (2) Weaknesses, (3) Opportunities, and (4) Threats. All participants perceived the framework as useful and appropriate to enable the acquisition of interprofessional education and collaborative practice skills objectives set. The framework's duration of the elective was seen as a weakness with the need for an increment in the duration. The opportunities the framework presented included: acting as a starting point to structure and implement interprofessional education across various training institutions in Africa, advancing research, and networking opportunities to share the best practices. The main threat included siloed training where the current training curriculum of the students does not have opportunities that allow the students to study with, from, and about each other. CONCLUSIONS: The framework developed to guide the implementation of interprofessional education and collaborative practice during international electives is feasible and enabled students to achieve the interprofessional education and collaborative practice objectives set while appreciating the transcultural similarities and differences in another country.

Interprofessional education during international electives: Perceptions of health professions students from selected institutions in Africa.

Although international electives provide important opportunities for the development of interprofessional education and collaboration practice skills, there is limited literature that describes students' perceptions in various training institutions in Africa. This study aimed to address this gap by establishing the student's perceptions of interprofessional education during international electives from four African health professional training universities. This was a cross-sectional quantitative study. Data were collected online using the Readiness for Interprofessional Learning Scale from 135 student participants. Linear regression and multilinear regression were used to establish relationships between socio-demographic characteristics and the student's perception of interprofessional education during international electives. There was a high overall positive perception (76 SD± 8.1) among the student participants of interprofessional education during international electives. Almost all the students (88.9% n = 120) thought interprofessional education during international electives would help them become better team workers during future practice and enhance their communication skills. There were high mean scores regarding positive perceptions of teamwork and collaboration (39.5 SD± 4.9), positive professional identity 17.6 (SD± 2.6), and understanding roles and responsibilities (7.4 SD± 2.0). There is a generally positive perception of interprofessional education during international electives among health professions students from various African university institutions.

Interprofessional teamwork, quality of care and turnover intention in geriatric care: A cross-sectional study in 55 acute geriatric units.

BACKGROUND AND OBJECTIVES: The complex health problems of older persons require that health professionals closely work together, in particular when an acute decline necessitates admission at an acute geriatric unit. These working conditions may cause additional stress in staff. This study aims to identify the relation between interprofessional teamwork, the quality of care and turnover intention in acute geriatric units. DESIGN, SETTING, PARTICIPANTS AND METHODS: Perceptions of interprofessional teamwork, quality of care and turnover intention among team members of 55 acute geriatric units were measured using validated questionnaires. A multilevel linear regression model was built for quality of care and logistic regression for turnover intention, with random intercept for acute geriatric unit. RESULTS: The overall response rate was 60%. Of the 890 respondents, 71% were nursing professionals, 20% allied health professionals, 5% physicians, and 4% administrative staff. Twenty-three percent reported poor to fair quality of care in their unit; 19% was not sure that patients or families had been given enough means to organise care after discharge. Fifteen percent reported turnover intention (18%, 8%, 9% and 11% among nursing professionals, allied health professionals, physicians and administrative workers respectively, p = 0.005). Higher perceived interprofessional teamwork was related to higher quality of care (estimated coefficient 0.05, p < 0.001) and lower turnover intention in nursing professionals only (estimated OR 0.94, p < 0.001). CONCLUSION: Creating a care environment of good interprofessional teamwork can help acute geriatric units to retain nursing professionals in the job and achieve higher quality of care.

A Typology of Interprofessional Teamwork in Acute Geriatric Care: A Study in 55 units in Belgium.

OBJECTIVES: To explore the quality of interprofessional teamwork in acute geriatric care and to build a model of team types. DESIGN: Cross-sectional multicenter study. SETTING: Acute geriatric units in Belgium. PARTICIPANTS: Team members of different professional backgrounds. MEASUREMENTS: Perceptions of interprofessional teamwork among team members of 55 acute geriatric units in Belgium were measured using a survey covering collaborative practice and experience, managerial coaching and open team culture, shared reflection and decision-making, patient files facilitating teamwork, members' belief in the power of teamwork, and members' comfort in reporting incidents. Cluster analysis was used to determine types of interprofessional teamwork. Professions and clusters were compared using analysis of variance. RESULTS: The overall response rate was 60%. Of the 890 respondents, 71% were nursing professionals, 20% other allied health professionals, 5% physicians, and 4% logistic and administrative staff. More than 70% of respondents scored highly on interprofessional teamwork competencies, consultation, experiences, meetings, management, and results. Fewer than 55% scored highly on items about shared reflection and decision-making, reporting incidents from a colleague, and patient files facilitating interprofessional teamwork. Nurses in this study rated shared reflection and decision-making lower than physicians on the same acute geriatric units (P < .001). Using the mean score on each of the six areas, four clusters that differed significantly in all areas were identified using hierarchical cluster analysis and scree plot analysis (P < .001). CONCLUSION: Interprofessional teamwork in acute geriatric units is satisfactory, but shared reflection and decision-making needs improvement. Four types of interprofessional teamwork are identified and can be used to benchmark the teamwork of individual teams.

Utilizing the "Plan, Do, Study, Act" Framework to Explore the Process of Curricular Assessment and Redesign in a Physical Therapy Education Program in Suriname.

PURPOSE: To describe how a multinational team worked together to transition a physical therapy (PT) educational program in Paramaribo, Suriname, from a Bachelor level to a Master of Science in Physical Therapy (MSPT) level. The team was made up of PT faculty from Anton De Kom Universiteit van Suriname (AdeKUS), the Flemish Interuniversity Council University Development Cooperation (VLIR-UOS) leadership, and Health Volunteers Overseas volunteers. In this case study, the process for curricular assessment, redesign, and upgrade is described retrospectively using a Plan, Do, Study, Act (PDSA) framework. METHOD: PT educational programs in developing countries are eager for upgrade to meet international expectations and to better meet community health-care needs. An ongoing process which included baseline assessment of all aspects of the existing bachelor's program in PT, development of a plan for a MSPT, implementation of the master's program, and evaluation following implementation is described. CONCLUSION: Curricular assessment and upgrade in resource-limited countries requires the implementation of process-oriented methods. The PDSA process is a useful tool to explore curricular development. The international collaboration described in this paper provides an example of the diligence, consistency, and dedication required to see a project through and achieve success while providing adequate support to the host site. This project might provide valuable insights for those involved in curricular redesign in similar settings.

Development and validation of a questionnaire to self-assess the quality of interprofessional team meetings in primary and community healthcare.

In the context of a quality assurance policy, a regional network initiated a project to measure the quality of interprofessional consultation meetings. A questionnaire was evaluated on content validity by 48 stakeholders: healthcare professionals, representatives from healthcare organizations, interprofessional consultation meeting coordinators, and representatives from patient organizations. A revision resulted in two subscales (each consisting of 16 items) for assessing process and outcome aspects of interprofessional consultation meetings. After validating the instrument, it was used in a hands-on test by individuals and in a pilot series of team-based self-assessments. Responses were used to analyse reliability and consistency of the subscales and the items, and to reveal first indications of relative weaknesses and strengths in interprofessional consultation meetings. Results point out that the subscales, now part of the Interprofessional Practice and Education Quality Scales (IPEQS), can be useful for self-assessment of the quality of such meetings in primary and community healthcare, but maybe also in other areas of interprofessional collaboration.

The perceived quality of interprofessional teamwork in an intensive care unit: A single centre intervention study.

This article describes a study that evaluated the quality of teamwork in a surgical intensive care unit and assessed whether teamwork could be improved significantly through a tailor-made intervention. The quality of teamwork prior to and after the intervention was assessed using the Interprofessional Practice and Education Quality Scales (IPEQS) using the PROSE online diagnostics and documenting system, which assesses three domains of teamwork: organisational factors, care processes, and team members' attitudes and beliefs. Furthermore, team members evaluated strengths and weaknesses of the teamwork through open-ended questions. Information gathered by means of the open questions was used to design a tailor-made 12-week intervention consisting of (1) optimising the existing weekly interdisciplinary meetings with collaborative decision-making and clear communication of goal-oriented actions, including the psychosocial aspects of care; and (2) organising and supporting the effective exchange of information over time between all professions involved. It was found that the intervention had a significant impact on organisational factors and care processes related to interprofessional teamwork for the total group and within all subgroups, despite baseline differences between the subgroups in interprofessional teamwork. In conclusion, teamwork, and more particularly the organisational aspects of interprofessional collaboration and processes of care, can be improved by a tailor-made intervention that takes into account the professional needs of healthcare workers.

Interprofessional and transdisciplinary teamwork in health care.

The article focuses on the need for and the characteristics and positive consequences of interdisciplinary teamwork in health care. Interprofessional collaboration is an important element in total quality management. Factors that determine the success of team work are described, such as a management that promotes openness and an administrative organization that promotes interdisciplinary consultation. Other factors have to do with leadership, shared goals and values, meeting management and planning skills, communication, and also the (degree of) knowledge and the (quality of) perception of competences of other health care workers. The shared care plan is stressed as an important tool. In this, the joint planning of goals for intervention and care is essential. Health care workers with different professional knowledge and background have to harmonize their intervention plan according to the competences and goal settings of the other team members. The core of effective interprofessional teamwork is the presence of interprofessional competences such as these. A brief description of the components and performance criteria of the competence of interprofessional collaboration is given.

Cross-linguistic analysis of vocabulary in young children: spanish, dutch, French, hebrew, italian, korean, and american english.

The composition of young children's vocabularies in 7 contrasting linguistic communities was investigated. Mothers of 269 twenty-month-olds in Argentina, Belgium, France, Israel, Italy, the Republic of Korea, and the United States completed comparable vocabulary checklists for their children. In each language and vocabulary size grouping (except for children just learning to talk), children's vocabularies contained relatively greater proportions of nouns than other word classes. Each word class was consistently positively correlated with every other class in each language and for children with smaller and larger vocabularies. Noun prevalence in the vocabularies of young children and the merits of several theories that may account for this pattern are discussed.