Team climate and patients' perception of primary healthcare attributes in Brazil: a cross-sectional study.

Team climate and attributes of primary healthcare (PHC) are key elements for collaborative practice. Few researchers have explored the relationship between team climate and patients' perceptions of PHC. This study aimed to assess the association between team climate and patients' perceptions of primary healthcare attributes. A quantitative approach was adopted. In Stage 1, Team climate was assessed using Team Climate Inventory in 118 Family Health Strategy (FHS) teams at a PHC setting. In Stage 2, Patients' perceptions of PHC attributes were assessed using the Primary Care Assessment Tool (PCATool) in a sample of 844 patients enrolled in teams studied in Stage 1. Cluster analysis was used to identify team climate groups. The analysis used multilevel linear regression models. Patients assigned to teams with the highest team climate scores had the highest PHC attributes scores. Patients who reported affiliation at the team level had the highest PCATool scores overall. They also scored higher on the attributes of comprehensiveness and coordinated care compared to patients with affiliation to the health unit. In conclusion, patients under the care of FHS teams exhibiting a more favorable team climate had more positive patient perceptions of PHC attributes.

Collective leadership to improve professional practice, healthcare outcomes and staff well-being.

BACKGROUND: Collective leadership is strongly advocated by international stakeholders as a key approach for health service delivery, as a response to increasingly complex forms of organisation defined by rapid changes in health technology, professionalisation and growing specialisation. Inadequate leadership weakens health systems and can contribute to adverse events, including refusal to prioritise and implement safety recommendations consistently, and resistance to addressing staff burnout. Globally, increases in life expectancy and the number of people living with multiple long-term conditions contribute to greater complexity of healthcare systems. Such a complex environment requires the contribution and leadership of multiple professionals sharing viewpoints and knowledge.  OBJECTIVES: To assess the effects of collective leadership for healthcare providers on professional practice, healthcare outcomes and staff well-being, when compared with usual centralised leadership approaches. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, five other databases and two trials registers on 5 January 2021. We also searched grey literature, checked references for additional citations and contacted study authors to identify additional studies. We did not apply any limits on language. SELECTION CRITERIA: Two groups of two authors independently reviewed, screened and selected studies for inclusion; the principal author was part of both groups to ensure consistency. We included randomised controlled trials (RCTs) that compared collective leadership interventions with usual centralised leadership or no intervention. DATA COLLECTION AND ANALYSIS: Three groups of two authors independently extracted data from the included studies and evaluated study quality; the principal author took part in all groups. We followed standard methodological procedures expected by Cochrane and the Effective Practice and Organisation of Care (EPOC) Group. We used the GRADE approach to assess the certainty of the evidence. MAIN RESULTS: We identified three randomised trials for inclusion in our synthesis. All studies were conducted in acute care inpatient settings; the country settings were Canada, Iran and the USA. A total of 955 participants were included across all the studies. There was considerable variation in participants, interventions and measures for quantifying outcomes. We were only able to complete a meta-analysis for one outcome (leadership) and completed a narrative synthesis for other outcomes. We judged all studies as having an unclear risk of bias overall. Collective leadership interventions probably improve leadership (3 RCTs, 955 participants). Collective leadership may improve team performance (1 RCT, 164 participants). We are uncertain about the effect of collective leadership on clinical performance (1 RCT, 60 participants). We are uncertain about the intervention effect on healthcare outcomes, including health status (inpatient mortality) (1 RCT, 60 participants). Collective leadership may slightly improve staff well-being by reducing work-related stress (1 RCT, 164 participants). We identified no direct evidence concerning burnout and psychological symptoms. We are uncertain of the intervention effects on unintended consequences, specifically on staff absence (1 RCT, 60 participants).  AUTHORS' CONCLUSIONS: Collective leadership involves multiple professionals sharing viewpoints and knowledge with the potential to influence positively the quality of care and staff well-being. Our confidence in the effects of collective leadership interventions on professional practice, healthcare outcomes and staff well-being is moderate in leadership outcomes, low in team performance and work-related stress, and very low for clinical performance, inpatient mortality and staff absence outcomes. The evidence was of moderate, low and very low certainty due to risk of bias and imprecision, meaning future evidence may change our interpretation of the results. There is a need for more high-quality studies in this area, with consistent reporting of leadership, team performance, clinical performance, health status and staff well-being outcomes.

Interprofessional education in the Dentistry curriculum: Analysis of a teaching-service-community integration experience.

INTRODUCTION: Interprofessional education (IPE) offers relevant theoretical, conceptual and methodological approaches to the development of effective teamwork competencies. OBJECTIVE: To analyse an interprofessional experience of teaching-service-community integration carried out at a public university in the South of Brazil. METHODS: A case study with a qualitative approach was carried out. The study's participants were thirty-eight undergraduate dental students who attended the IPE activity between 2012 and 2019. Data collection was developed in two sequential steps that included the application of an online instrument and semi-structured interviews. The textual material was interpreted by content analysis, considering Kirkpatrick's evaluation levels (reaction, learning and behaviour). RESULTS: In the reaction level, students highlighted the contents provided by the National Curricular Guidelines regarding public health system and teamwork, as well as the pedagogical teaching proposal by tutoring groups, which stimulated students' autonomy. It was observed that the learning was geared towards the development of collaborative teamwork competencies and cultural competencies. In the behaviour level, students perceived positive changes in their attitudes and behaviours towards patients, focused on needs related to life conditions, realising that dentists may work within a team. The elective/optional nature of the experience allied with the absence of other IPE activities in the curricular grid showed to be challenging. CONCLUSION: IPE in undergraduate education presented positive results related to the reaction, learning and behaviour of dental students. We recommend the inclusion of interprofessional activities of teaching-service-community integration in Dentistry curricular structure to complement uniprofessional education.

Interprofessional practices and readiness for interprofessional learning among health students and graduates in Rio Grande do Sul, Brazil: a cross-sectional study.

This paper reports on a cross-sectional study performed with 370 students and graduates from 15 undergraduate health courses in a public university in Rio Grande do Sul, Brazil. The objective was to identify interprofessional education (IPE) curricular experiences and to evaluate the readiness for IPE among students and graduates who have attended a practical experience of IPE (Integrative Module) compared with undergraduate students who did not. The dimensionality and reliability of the Portuguese-validated expanded version of the Readiness for Interprofessional Learning Scale (RIPLS) with 40-items were also evaluated. This version of RIPLS was validated with 32 items. Cronbach's alpha values of the three factors of the scale were: Factor 1 α = 0.89, Factor 2 α = 0.47 and Factor 3 α = 0.83. IPE initiatives were identified in the undergraduate curricula mainly in the practical experience (Integrative Module) (47.5%), curricular placements (29.8%) and extracurricular activities (29.5%). Students and graduates who participated in the Integrative Module demonstrated greater readiness for IPE than students who did not attend. This study suggested that shared experiences among different undergraduate courses are associated with positive attitudes and greater availability of students and graduates for interprofessional learning and work. Future studies including the psychometric analysis of the Portuguese-validated expanded RIPLS are recommended.

Interprofessional team member's satisfaction: a mixed methods study of a Chilean hospital.

INTRODUCTION: The health organizations of today are highly complex and specialized. Given this scenario, there is a need for health professionals to work collaboratively within interprofessional work teams to ensure quality and safe care. To strengthen interprofessional teamwork, it is imperative that health organizations enhance strategic human resources management by promoting team member satisfaction. OBJECTIVE: To analyze the satisfaction of members in interprofessional teams and to explore interpersonal relationships, leadership, and team climate in a hospital context. METHODOLOGY: This study is an explanatory sequential mixed methods (quantitative/qualitative) study of 53 teams (409 professionals) at a university hospital in Santiago, Chile. The first phase involved quantitative surveys with team members examining team satisfaction, transformational leadership, and team climate. Social network analysis was used to identify interactions among team members (cohesion and centrality). The second phase involved interviews with 15 professionals belonging to teams with the highest and lowest team satisfaction scores. Findings of both phases were integrated. RESULTS: Significant associations were found among variables, and the linear regression model showed that team climate (ß = 0.26) was a better predictor of team satisfaction than team leadership (ß = 0.17). Registered nurse was perceived as the profession with the highest score on the transformational leadership measure (mean = 64), followed by the physician (mean = 33). Team networks with the highest and lowest score of team satisfaction showed differences in cohesion and centrality measures. Analysis of interviews identified five themes: attributes of interprofessional work; collaboration, communication, and social interaction; interprofessional team innovation; shared leadership; and interpersonal relationship interface work/social. Integration of findings revealed that team member satisfaction requires participation and communication, common goals and commitment for patient-centered care, clear roles and objectives to support collaborative work, and the presence of a transformational leader to strengthen well-being, dialog, and innovation. CONCLUSIONS: Results have the potential to contribute to the planning and decision-making in the field of human resources, providing elements to promote the management of health teams and support team member satisfaction. In turn, this could lead to job permanence especially where the local health needs are more urgent.

The relationship between team climate and interprofessional collaboration: Preliminary results of a mixed methods study.

Relational and organisational factors are key elements of interprofessional collaboration (IPC) and team climate. Few studies have explored the relationship between IPC and team climate. This article presents a study that aimed to explore IPC in primary healthcare teams and understand how the assessment of team climate may provide insights into IPC. A mixed methods study design was adopted. In Stage 1 of the study, team climate was assessed using the Team Climate Inventory with 159 professionals in 18 interprofessional teams based in São Paulo, Brazil. In Stage 2, data were collected through in-depth interviews with a sample of team members who participated in the first stage of the study. Results from Stage 1 provided an overview of factors relevant to teamwork, which in turn informed our exploration of the relationship between team climate and IPC. Preliminary findings from Stage 2 indicated that teams with a more positive team climate (in particular, greater participative safety) also reported more effective communication and mutual support. In conclusion, team climate provided insights into IPC, especially regarding aspects of communication and interaction in teams. Further research will provide a better understanding of differences and areas of overlap between team climate and IPC. It will potentially contribute for an innovative theoretical approach to explore interprofessional work in primary care settings.

Contributions of team climate in the study of interprofessional collaboration: A conceptual analysis.

The concept of team climate is widely used to understand and evaluate working environments. It shares some important features with Interprofessional Collaboration (IPC). The four-factor theory of climate for work group innovation, which underpins team climate, could provide a better basis for understanding both teamwork and IPC. This article examines in detail the common ground between team climate and IPC, and assesses the relevance of team climate as a theoretical approach to understanding IPC. There are important potential areas of overlap between team climate and IPC that we have grouped under four headings: (1) interaction and communication between team members; (2) common objectives around which collective work is organised; (3) responsibility for performing work to a high standard; and (4) promoting innovation in working practices. These overlapping areas suggest common characteristics that could provide elements of a framework for considering the contribution of team climate to collaborative working, both from a conceptual perspective and, potentially, in operational terms as, for example, a diagnostic tool.

[Time standards of nursing in Primary Health Care: an observational study]. / Padrões de tempo médio das intervenções de enfermagem na Estratégia de Saúde da Família: um estudo observacional.

OBJECTIVE: To determine time standards for interventions and activities conducted by nursing professionals in Family Health Units (FHU) in Brazil to substantiate the calculation of work force. METHOD: This was an observational study carried out in 27 FHU, in 12 municipalities in 10 states, in 2013. In each unit, nursing professionals were observed every 10 minutes, for eight work hours, on five consecutive days via the work sampling technique. RESULTS: A total of 32,613 observations were made, involving 47 nurses and 93 nursing technicians/assistants. Appointments were the main intervention carried out by nurses, with a mean time of 25.3 minutes, followed by record-keeping, which corresponded to 9.7%. On average, nursing technicians/assistants spent 6.3% of their time keeping records and 30.6 intervention minutes on immunization/vaccination control. CONCLUSION: The study resulted in standard times of interventions carried out by the FHU nursing team, which can underpin the determination of nursing staff size and human resource policies. Furthermore, the study showed the panorama of interventions currently employed, allowing for the work process to be reviewed and optimized.

Teamwork in nursing: restricted to nursing professionals or an interprofessional collaboration?

OBJECTIVE: To understand the nursing professionals' conceptions of teamwork and their elements. METHOD: A qualitative study conducted in an oncological hospital using a semi-structured interview with 21 nursing professionals. RESULTS: Two conceptions emerged from the accounts: teamwork restricted to nursing professionals and teamwork with interprofessional collaboration with particular importance for interactive dimensions: communication, trust and professional bonds, mutual respect and recognition of the other's work, collaboration, and conflict, with this last subcategory considered as an obstacle to teamwork. CONCLUSION: Nursing conceives teamwork as an interprofessional practice, which is a result of the quality of interaction among professionals from different areas and involves the recognition and handling of conflicts. OBJETIVO: Compreender as concepções dos profissionais de enfermagem sobre trabalho em equipe e seus elementos constituintes. MÉTODO: Pesquisa qualitativa, realizada em hospital oncológico, por meio de entrevista semiestruturada com 21 profissionais de enfermagem. RESULTADOS: Duas concepções emergiram dos relatos, trabalho em equipe circunscrito à enfermagem e trabalho em equipe com colaboração interprofissional, com destaque para dimensão interativa: comunicação, confiança e vínculo, respeito mútuo e reconhecimento do trabalho do outro, colaboração e conflito. Esta última subcategoria foi apontada como obstáculo para o trabalho em equipe. CONCLUSÃO: A enfermagem concebe majoritariamente o trabalho em equipe como ação interprofissional, e isto decorre da qualidade da interação entre os profissionais das diferentes áreas e o reconhecimento e manejo de conflitos.

Cross-cultural adaptation of the Readiness for Interprofessional Learning Scale in Brazil. / Adaptação transcultural e validação da Readiness for Interprofessional Learning Scale no Brasil.

Objective Conduct a cross-cultural adaptation of the expanded version of the 29-items Readiness for Interprofessional Learning Scale (RIPLS) into Brazilian Portuguese. Method Five steps were adopted: three translations, synthesis, three back-translations, assessment by an expert committee, and pre-test. Validation comprised 327 students from 13 undergraduate health courses from a public university. Parallel analyses were conducted using the R software and factor analysis using Exploratory Structural Equation Modeling. Results 1 9 12 16 10 11 17 19 21 24 25 29 Conclusion Evidences were found relating to the validity of the RIPLS version in Brazilian Portuguese in its application in the national context.

Interprofessional education and collaborative practice in Primary Health Care. / Educação interprofissional e prática colaborativa na Atenção Primária à Saúde.

Objective To understand the perceptions of professors, health care providers and students about the articulation of interprofessional education with health practices in Primary Health Care. Method To understand and interpret qualitative data collection, carried out between 2012 and 2013, through semi-structured interviews with 18 professors and four sessions of homogeneous focus groups with students, professors and health care providers of Primary Health Care. Results A triangulation of the results led to the construction of two categories: user-centered collaborative practice and barriers to interprofessional education. The first perspective indicates the need to change the model of care and training of health professionals, while the second reveals difficulties perceived by stakeholders regarding the implementation of interprofessional education. Conclusion The interprofessional education is incipient in the Brazil and the results of this analysis point out to possibilities of change toward collaborative practice, but require higher investments primarily in developing teaching-health services relationship.

[Management of basic health units in municipalities of different size: profile and management instruments]. / Gerência de unidade básica de saúde em municípios de diferentes portes: perfil e instrumentos gerenciais utilizados.

OBJECTIVE: To identify the characteristics of managers and their use of management instruments in primary care and to analyze differences in these features among municipalities of different sizes. METHOD: The present cross-sectional descriptive study was conducted at 108 basic health units from 21 municipalities in northern Paraná, Brazil. The data were collected using a semi-structured questionnaire during the second half of 2010. RESULTS: Most managers had graduate degrees and were female and nurses. The managers from the small municipalities were younger, their payment was lower, and they had less work experience. The use of management instruments was expressive for both the organization and work management; however, the instruments were used less in the small municipalities. CONCLUSION: The managers were committed to their role; it is recommended that policies and guidance should be formulated at the federal and state levels to support small municipalities.

[Integrative review: concepts and methods used in nursing]. / Revisão integrativa: conceitos e métodos utilizados na enfermagem.

UNLABELLED: Integrative review (IR) has an international reputation in nursing research and evidence-based practice. This IR aimed at identifying and analyzing the concepts and methods recommended to undertaking IR in nursing. Nine information resources,including electronic databases and grey literature were searched. Seventeen studies were included. The results indicate that: primary studies were mostly from USA; it is possible to have several research questions or hypotheses and include primary studies in the review from different theoretical and methodological approaches; it is a type of review that can go beyond the analysis and synthesis of findings from primary studies allowing exploiting other research dimensions, and that presents potentialities for the development of new theories and new problems for research. CONCLUSION: IR is understood as a very complex type of review and it is expected to be developed using standardized and systematic methods to ensure the required rigor of scientific research and therefore the legitimacy of the established evidence.

Interprofessional approach to fall prevention in hospital care.

OBJECTIVE: To understand the perception and experience of health professionals regarding fall prevention practices in hospital inpatient units. METHOD: This is a qualitative exploratory and descriptive case study based on the Canadian framework of interprofessional competences. Data was collected from two focus groups, with different health professionals in each group, and thematic content analysis was used. RESULTS: Five categories were drawn up which showed intense convergence between the participants of the two focus groups, within the context of fall prevention practices: communication between professionals and patients/carers for fall prevention, interprofessional communication for fall prevention, clarification of roles for fall prevention, health education about risk and fall prevention and continuing education for fall prevention. CONCLUSION: Teamwork and collaborative practice are important for achieving good results in the prevention of falls in hospital care, but for this to happen, health professionals need to acquire the necessary competences for collaborative action.

Team climate and job satisfaction in a mobile emergency service: a multilevel study.

OBJECTIVE: to investigate the relationship between team climate and job satisfaction among professionals working in mobile pre-hospital care. METHOD: this is a quantitative, correlational study carried out in a mobile pre-hospital care service in the São Paulo Metropolitan Region. The participants were 95 professionals, allocated to 40 teams, who answered three questionnaires: sociodemographic/labor data, Team Climate Scale and S20/23 Job Satisfaction Scale. Descriptive statistics and multilevel linear models were used for the analysis, including moderation effects. The Backward method was used to ascertain the order of significance. RESULTS: in the models, the relationships between satisfaction with hierarchical relationships and the factor "support for new ideas" moderated for men and "task orientation" for women were significant. For satisfaction with the physical environment, "working hours" and "participation in the team" were significant and, for intrinsic satisfaction, the regime, working hours and the factors "team objectives", "participation in the team" and "support for new ideas" remained significant, as did the moderation effect between length of service, "participation in the team" and "support for new ideas". CONCLUSION: team climate is influenced by job satisfaction in a heterogeneous way and the moderating effect of this relationship is associated with gender and length of service. BACKGROUND: (1) There was a positive perception of the team climate and job satisfaction. BACKGROUND: (2)The team climate influenced job satisfaction in a heterogeneous way. BACKGROUND: (3) The moderating effect of this relationship was associated with gender and working hours. BACKGROUND: (4) The working regime and working hours directly affected intrinsic satisfaction.

[Interprofessional education: training for healthcare professionals for teamwork focusing on users]. / Educação interprofissional: formação de profissionais de saúde para o trabalho em equipe com foco nos usuários.

The theoretical constructs of interprofessional education (IPE) are analyzed based on two reviews of the literature, taking the context of training for healthcare professionals in Brazil into consideration. Three types of training are identified: uniprofessional, multiprofessional and interprofessional, with predominance of the first type. The first occurs among students of the same profession, in isolation; the second occurs among students of two or more professions, in parallel without interaction; and the third involves shared learning, with interaction between students and/or professionals from different fields. The distinction between interprofessionalism and interdisciplinarity is highlighted: these refer to integration, respectively, of professional practices and disciplines or fields of knowledge. Through the analysis presented, it is concluded that in the Brazilian context, IPE (the basis for collaborative teamwork) is still limited to some recent initiatives, which deserve to be investigated.

Telehealth use in primary healthcare collaborative interprofessional practice: protocol for a scoping review.

INTRODUCTION: Telehealth is a growing topic, with potential to improve access to primary healthcare. However, there is a lack of knowledge regarding how telehealth could facilitate interprofessional collaboration that is recommended to strengthen the comprehensive approach of primary healthcare. The objective is to identify the characteristics and applications of telehealth services related to the interprofessional collaborative practice of primary healthcare professionals. METHODS AND ANALYSIS: This review will cover studies including as target population those health professionals who work in telehealth services; as concept, telehealth in relation to collaborative interprofessional practice; and as context, primary healthcare. A scoping review will be carried out according to the Joanna Briggs Institute methodology. Databases to be searched include MEDLINE, CINAHL, Embase, Eric, Scopus, LILACS and Web of Science. All identified records will be grouped, duplicates will be removed, titles and abstracts will be selected by two independent reviewers, and the full text of selected articles will be evaluated in detail. A data extraction tool developed by the reviewers will be used for data extraction. The results will be presented in data map format in a logical way, in a diagram or in a tabular format, accompanied by a descriptive summary. ETHICS AND DISSEMINATION: No ethical approval is required for this study. A manuscript based on this scoping review will be submitted to a journal and we hope it will contribute to scientific knowledge on the interprofessional field and key research findings will be sent to key events on interprofessional practice and education. SYSTEMATIC REVIEW REGISTRATION: This scoping review was registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/2BV8D).

Interprofessional collaboration in primary health care from the perspective of implementation science. / A colaboração interprofissional na atenção primária à saúde na perspectiva da ciência da implementação.

The objective was to analyze the perceptions of primary health care (PHC) workers about interprofessional collaboration from the perspective of implementation science. This is a qualitative study that used in-depth interview as a data production technique. Interviews were conducted with 15 workers (three community health agents, one nursing assistant, three nurses, three managers, three physicians, and two nursing technicians) from basic health units in the Municipality of São Bernardo do Campo, São Paulo State, Brazil. The interview plan was based on three domains of the Consolidated Framework for Implementation Research (CFIR). Thematic content analysis was used. In the interprofessional collaboration characteristics domain, respondents highlighted the complexity, and its possible influence, as to the implementation and sustainability of this practice. In the inner setting domain, factors that influence interprofessional collaboration were identified, namely: how the time allocated to formal communication/team meetings is used; social interactions between professionals; and leadership characteristics, such as feedback, autonomy and participation in decisions. In the individuals characteristics domain, participants noted interprofessional collaboration geared to quality of care and the need for integration between knowledge centers. Thus, measures to enhance the quality of communication, collective team building and leadership can contribute to improve interprofessional collaboration in PHC and leverage its impacts on health care.

O objetivo foi analisar as percepções de trabalhadores da atenção primária à saúde (APS) sobre a colaboração interprofissional na perspectiva da ciência de implementação. Trata-se de estudo qualitativo que utilizou a entrevista em profundidade como técnica de produção de dados. Foram entrevistados 15 trabalhadores (três agentes comunitários de saúde, um auxiliar de enfermagem, três enfermeiros, três gerentes, três médicos e dois técnicos de enfermagem) de unidades básicas de saúde no Município de São Bernardo do Campo, São Paulo, Brasil. O roteiro da entrevista baseou-se em três dimensões do Quadro Conceitual Consolidado para Pesquisa de Implementação (CFIR; Consolidated Framework for Implementation Research). Foi realizada análise de conteúdo temática. Na dimensão características da colaboração interprofissional, os entrevistados destacaram a complexidade, e sua possível influência, na implementação e sustentabilidade dessa prática. Na dimensão cenário interno, foram identificados fatores que influenciam a colaboração interprofissional: como se utiliza o tempo destinado a comunicação formal/reuniões de equipe; interações sociais entre os profissionais; e características da liderança, como feedback, autonomia e participação nas decisões. Na dimensão características dos indivíduos, os participantes destacaram a colaboração interprofissional direcionada para a qualidade do cuidado e a necessidade de integração entre os núcleos de saberes. Assim, ações para aperfeiçoar a qualidade da comunicação, a construção coletiva em equipe e o aprimoramento da liderança podem contribuir para melhorar a colaboração interprofissional na APS e potencializar seus impactos na atenção à saúde.

El objetivo fue analizar las percepciones de los trabajadores de atención primaria de salud (APS) sobre la colaboración interprofesional desde la perspectiva de la ciencia de implementación. Se trata de un estudio cualitativo que utilizó la entrevista en profundidad como técnica de producción de datos. Fueron entrevistados 15 trabajadores (tres agentes comunitarios de salud, un auxiliar de enfermería, tres enfermeros, tres gerentes, tres médicos y dos técnicos de enfermería) de unidades básicas de salud en el Municipio de São Bernardo do Campo, São Paulo, Brasil. La guía de la entrevista se basó en tres dimensiones del Marco Consolidado para la Investigación sobre la Implementación (CFIR; Consolidated Framework for Implementation Research). Se realizó un análisis de contenido temático. En la dimensión característica de la colaboración interprofesional, los entrevistados destacaron la complejidad y la posible influencia en su implantación y sostenibilidad. En la dimensión escenario interno, fueron identificados factores que influencian en la colaboración interprofesional: cómo se utiliza el tiempo destinado a la comunicación formal/reuniones de equipo; las interacciones sociales entre los profesionales, y las características del liderazgo, como feedback, la autonomía y la participación en las decisiones. En la dimensión de las características de los individuos, los participantes destacaron la colaboración interprofesional orientada a la calidad de la atención y la necesidad de integración entre los núcleos de saberes. Así, las acciones para mejorar la calidad de la comunicación, la construcción colectiva en equipo y la mejora del liderazgo pueden contribuir para mejorar la colaboración interprofesional en la APS y mejorar sus impactos en la atención a la salud.

Preceptorship contributions to the development of clinical and managerial skills in nursing residency.

OBJECTIVES: to analyze the experience of resident nurses with preceptorship contributions to the development of common clinical and managerial skills acquired in pedagogical projects. METHODS: exploratory qualitative research developed in two stages: document analysis of pedagogical projects and semi-structured interviews with residents. Content analysis was carried out based on the framework of the nurse's work process and skills. RESULTS: the pedagogical projects of the three programs foresee the development of common skills, mostly clinical and only two managerial skills. The 22 residents reported the contributions of preceptorship in the development of competences centered on clinical practice, focusing on technical procedures disjointed from clinical reasoning and the managerial dimension of the nurse's work. FINAL CONSIDERATIONS: it is necessary to train preceptors and involve all social actors linked to residency programs to expand preceptorship potential.