Teaching interprofessional collaboration among future healthcare professionals.

Healthcare has become more complex in recent years. Such complexity can best be addressed by interprofessional teams. We argue that to ensure successful communication and cooperation in interprofessional teams, it is important to establish interprofessional education in health-related study programs. More precisely, we argue that students in health-related programs need to develop interprofessional competencies and a common language, experience interprofessional contact, build inclusive identities and establish beliefs in the benefit of interprofessional diversity. We give examples how these goals can be implemented in interprofessional education. We also discuss challenges and future avenues for respective research healthcare professionals.

20 Years of ICF-International Classification of Functioning, Disability and Health: Uses and Applications around the World.

The International Classification of Functioning Disability and Health (ICF) was approved in 2001 and, since then, several studies reported the increased interest about its use in different sectors. A recent overview that summarizes its applications is lacking. This study aims to provide an updated overview about 20 years of ICF application through an international online questionnaire, developed by the byline authors, and sent to each World Health Organization Collaborating Centers of the Family of International Classifications (WHO-FIC CCs). Data was collected during October 2020 and December 2021 and descriptive content analyses were used to report main results. Results show how, in most of the respondent countries represented by WHO-FIC CCs, ICF was mainly used in clinical practice, policy development and social policy, and in education areas. Despite its applications in different sectors, ICF use is not mandatory in most countries but, where used, it provides a biopsychosocial framework for policy development in health, functioning and disability. The study provides information about the needs related to ICF applications, that can be useful to organize targeted intervention plans. Furthermore, this survey methodology can be re-proposed periodically to monitor the use of the ICF in the future.

Avoiding the Banality of Evil in Times of COVID-19: Thinking Differently with a Biopsychosocial Perspective for Future Health and Social Policies Development.

The COVID-19 pandemic provides the opportunity to re-think health policies and health systems approaches by the adoption of a biopsychosocial perspective, thus acting on environmental factors so as to increase facilitators and diminish barriers. Specifically, vulnerable people should not face discrimination because of their vulnerability in the allocation of care or life-sustaining treatments. Adoption of biopsychosocial model helps to identify key elements where to act to diminish effects of the pandemics. The pandemic showed us that barriers in health care organization affect mostly those that are vulnerable and can suffer discrimination not because of severity of diseases but just because of their vulnerability, be this age or disability and this can be avoided by biopsychosocial planning in health and social policies. It is possible to avoid the banality of evil, intended as lack of thinking on what we do when we do, by using the emergence of the emergency of COVID-19 as a Trojan horse to achieve some of the sustainable development goals such as universal health coverage and equity in access, thus acting on environmental factors is the key for global health improvement.

Interprofessional service-learning: cutting teeth and learning to crawl.

An interprofessional community-based service-learning initiative, supporting early childhood development in an impoverished community, was launched on a South African university's rural training platform. The study aimed to determine how this learning experience influenced students' interprofessional person-centered practice. An interpretative qualitative approach was followed. In-depth focus group discussions with dietetic (n = 15), medical (n = 24) and occupational therapy (n = 6) students were conducted before they left for a rural training site, directly afterward and again six months later. The findings indicated that most students had a limited experience of interprofessional collaborative practice (IPCP) beforehand. Afterward, those demonstrating developmental learning reported increased knowledge about their own roles, a deeper understanding of the roles of other professions and a realization of the importance of IPCP. Different reactions were related to students' profession, attitude and insight, and other interprofessional experiences during the placement. Contact with service users in the community, additional interprofessional clinical activities and shared living spaces are likely to further enhance students' competencies in IPCP. A lack of interprofessional role modeling in the academic hospital, where most students returned to, hindered them to continue following an interprofessional, person-centered approach. Longer, synchronized rotations on a decentralized platform may be beneficial to inculcate competencies related to IPCP.

The value of interprofessional education in identifying unaddressed primary health-care challenges in a community: a case study from South Africa.

Many countries rely on community health workers (CHWs) at a primary health care (PHC) level to connect individuals with needs to health professionals at health-care facilities, especially in resource-limited environments. The majority of health professionals are centrally based in facilities with little to no interaction with communities or CHWs. Stellenbosch University (South Africa), included interprofessional home visits in collaboration with CHWs as part of students' contextual PHC exposure in a rural community to identify factors impacting on the health of patients and their families. The aim of this study was to determine the impact of this interprofessional student service-learning initiative on identifying and addressing health-care challenges of households known to CHWs. Active physical, social and attitudinal factors were identified and recorded using a standardized paper case report form. Data were anonymized, captured and categorized for analysis. The frequency and proportion of each type of active problem and referral were calculated. The collaborative team identified many unaddressed health and social issues during their visits. Their exposure to communities at a PHC level offered benefits of experiential learning and provided insight into community needs, as well as offering services to enhance the current health-care system.

Exposing an interprofessional class of first years to an underserved community contributed to students' contextualisation of the determinants of health.

Students often find the primarily theoretical, classroom-based teaching of Public Health early on in undergraduate health professions curricula boring, failing to see its relevance for their future careers. An innovative approach to this challenge, based on social constructivist theory, was introduced at a South African university. First-year students were divided into interprofessional groups to visit an underserved community. In preparation for this experience, groups gathered information on "their" community after attending lectures/workshops. The objective of this study was to determine how exposing an interprofessional class of first years to an underserved community, contributed to students' contextualisation of the determinants of health. A mixed method methodology was used. Data were generated by analysing 40 randomly selected reflective reports and an online questionnaire (completed by 85% of the class) following the community visit. Data showed that it is after this first-hand exposure that students had a deeper affective-cognitive realisation of health inequity and was able to better contextualise the impact of determinants of health on individuals and communities. This community visit gave students a better grasp of what is needed to collaborate interprofessionally in addressing health inequity and served as intrinsic motivation to develop as change agents.

International Classification of Functioning, Disability and Health: Catalyst for interprofessional education and collaborative practice.

Patient-centred and community-based care is required for promotion of health equity. To enhance patient-centred interprofessional care, the World Health Organization recommends using the framework of the International Classification of Functioning, Disability and Health (ICF). Stellenbosch University's Interprofessional Education and Collaborative Practice (IPECP) strategy has promoted using ICF since 2010. Undergraduate medical students on rural clinical placements are expected to use ICF in approaching and managing patients. Students' ability to develop interprofessional care plans using ICF is assessed by a team of preceptors representing various health professions. This study explored the experiences of medical students and their preceptors using ICF in IPECP, and how patients perceived care received. Associative Group Analysis methodology was used to collect data for this study. In total, 68 study participants were enrolled of which 37 were medical students, 16 preceptors and 15 patients. Students found ICF enabled a patient-centred approach and reinforce the importance of context. Patients felt listened to and cared for. Preceptors, obliged to use ICF, came to appreciate the advantages of interprofessional care, promoting mutually beneficial teamwork and job satisfaction. The value of integrating IPECP as an authentic learning experience was demonstrated as was ICF as a catalyst in pushing boundaries for change.