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1.
J Intensive Care Med ; 39(4): 320-327, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-37812739

RESUMEN

INTRODUCTION: The Fundamental Critical Care Support Course (FCCS) is a standardized multidisciplinary program designed to educate participants on the basics of identification and management of patients with critical illness. Our objective was to evaluate the effect of FCCS participation on confidence in the assessment and management of critically ill patients and attitudes towards multidisciplinary education and interprofessional care in a multidisciplinary group of participants. METHODS: Participants enrolled in the FCCS course from May 2018 to November 2019 were solicited to participate in a series of surveys evaluating their course experience and confidence in critical care. Attitudes towards multidisciplinary education and interprofessional care were evaluated using the Student Perceptions of Interprofessional Clinical Education-Revised Instrument version 2 (SPICE-R2) tool. A prospective pre- and post-design with a self-report survey including retrospective pre-training assessment and a 3-month follow-up was conducted. Statistical analysis was performed using descriptive statics and non-parametric methods. RESULTS: 321 (97.9%) of the course participants enrolled in the study and completed the confidence survey and SPICE-R2 tool pre-course. Nurses (113, 35.4%) and physicians (110, 34.4%) made up the largest groups of participants, although physician assistants and paramedics were also well represented. Confidence in recognition and management of critical illness significantly improved across all studied domains after course completion, with the mean total confidence score improving from 32.96 pre-course to 41.10 post-course, P < 0.001. Attitudes towards multidisciplinary education and interprofessional care also improved (mean score 41.37 pre-course vs 42.71 post-course, P < 0.001), although pre-course numbers were higher than expected which limited the significance to only certain domains. DISCUSSION: In a multidisciplinary group, completion of FCCS training led to increased confidence in all aspects of critical illness measured. A modest increase in attitudes regarding multidisciplinary education and interprofessional care was also demonstrated. Further study is needed to assess whether this increased confidence translates to improvements in patient care and outcomes.


Asunto(s)
Enfermedad Crítica , Educación Interprofesional , Humanos , Enfermedad Crítica/terapia , Estudios Prospectivos , Estudios Retrospectivos , Actitud del Personal de Salud , Cuidados Críticos
2.
Palliat Med ; 38(4): 457-470, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38634232

RESUMEN

BACKGROUND: Advance care planning in dementia includes supporting the person and their family to consider important goals of care. International research reports the importance of psycho-social-spiritual aspects towards end of life. AIM: To develop a multidimensional international palliative care goals model in dementia for use in practice. DESIGN: International Delphi study integrating consensus and evidence from a meta-qualitative study. The Delphi panel rated statements about the model on a 5-point agreement scale. The criteria for consensus were pre-specified. SETTING/PARTICIPANTS: Seventeen researchers from eight countries developed an initial model, and 169 candidate panellists were invited to the international online Delphi study. RESULTS: Panellists (107; response 63.3%) resided in 33 countries. The model comprised four main care goals: (1) Comfort ensured; (2) Control over function maintained; (3) Identity protected and personhood respected and (4) Coping with grief and loss-person and caregiver supported. The model reflects how needs and care goals change over time with the progression of dementia, concluding with bereavement support. The first version of the model achieved a consensus after which it was slightly refined based on feedback. We did not achieve a consensus on adding a goal of life prolongation, and on use of the model by people with dementia and family themselves. CONCLUSION: A new palliative care goals model for people with dementia and their families includes relationship aspects for use by professionals and achieved a consensus among a panel with diverse cultural background. The position of life prolongation in relation to palliative care goals needs further research.


Asunto(s)
Planificación Anticipada de Atención , Demencia , Humanos , Cuidados Paliativos , Consenso , Objetivos , Técnica Delphi
3.
Artículo en Inglés | MEDLINE | ID: mdl-38411869

RESUMEN

Despite collaboration among different professions being recognized as fundamentally important to contemporary and future healthcare practice, the concept is woefully undertheorized. This has implications for how health professions educators might best introduce students to interprofessional collaboration and support their transition into interprofessional, collaborative workplaces. To address this, we engage in a conceptual analysis of published collaborative, interprofessional practices and conceptual understandings in theatre, as a highly collaborative art form and industry, to advance thinking in the health professions, specifically to inform interprofessional education. Our analysis advances a conceptualization of collaboration that takes place within a work culture of creativity and community, that includes four modes of collaboration, or the ways theatre practitioners collaborate, by: (1) paying attention to and traversing roles and hierarchies; (2) engaging in reciprocal listening and challenging of others; (3) developing trust and communication, and; (4) navigating uncertainty, risk and failure. We conclude by inviting those working in the health professions to consider what might be gleaned from our conceptualization, where the embodied and human-centred aspects of working together are attended to alongside structural and organizational aspects.

4.
BMC Geriatr ; 24(1): 633, 2024 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-39054433

RESUMEN

BACKGROUND: Delirium is a neuropathological syndrome that is characterised by fluctuating impairments in attention, cognitive performance, and consciousness. Since delirium represents a medical emergency, it can be associated with adverse clinical and economic outcomes. Although nursing home residents face a high risk of developing delirium, health care professionals in this field appear to have limited knowledge of delirium despite the critical role they play in the prevention, diagnosis, and treatment of delirium in nursing homes. OBJECTIVE: The purpose of this realist review is to develop an initial programme theory with the goal of understanding how, why, and under what circumstances educational interventions can improve the delirium-specific knowledge of health care professionals in nursing homes. METHODS: This realist review was conducted in accordance with the RAMESES (Realist And Meta-narrative Evidence Synthesis: and Evolving Standards) guidelines and includes the following steps: (1) search strategy and literature review; (2) study selection and assessment; (3) data extraction; (4) data synthesis; and (5) development of an initial programme theory. It also included stakeholder discussions with health care professionals recruited from nursing home care, which focused on their experiences with delirium. RESULTS: From a set of 1703 initially identified publications, ten publications were included in this realist review. Based on these publications, context-mechanism-outcome configurations were developed; these configurations pertained to (1) management support, (2) cognitive impairments among residents, (3) familiarity with residents, (4) participatory intervention development, (5) practical application, (6) case scenarios, (7) support from experts and (8) relevance of communication. CONCLUSIONS: Educational interventions aimed at improving the delirium-specific knowledge of health care professionals should feature methodological diversity if they are to enhance health care professionals' interest in delirium and highlight the fundamental contributions they make to the prevention, diagnosis, and treatment of delirium. Educational interventions should also take into account the multidimensional contextual factors that can have massive impacts on the relevant mode of action as well as the responses of health care professionals in nursing homes. The identification of delirium in residents is a fundamental responsibility for nursing home staff. TRIAL REGISTRATION: This review has been registered at Open Science Framework https://doi.org/10.17605/OSF.IO/6ZKM3.


Asunto(s)
Delirio , Casas de Salud , Humanos , Delirio/terapia , Delirio/prevención & control , Delirio/diagnóstico , Personal de Salud/educación , Conocimientos, Actitudes y Práctica en Salud , Competencia Clínica
5.
Int J Qual Health Care ; 36(2)2024 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-38809751

RESUMEN

The purpose of this paper is to describe the implementation and outcomes of a unique traumatic brain injury (TBI) screening initiative serving the community, with a focus on underserved populations. Idaho's definition of underserved populations includes people living in rural/frontier areas, people experiencing homelessness or intimate partner violence, people with co-occurring disorders, and people with cultural and/or linguistically diverse backgrounds. The goals of screenings are to help participants gain awareness about the likelihood of having experienced a TBI, bridge the gap in TBI reporting, and provide needed support to underserved populations in a rural state. Our work represents a cross-sectional study. Beginning in 2014, TBI screenings were conducted by the Institute of Rural Health within a public health university with several internal and external partners, as well as grant funding for work. Trained interprofessional health students and/or members of the Institute of Rural Health performed TBI screenings using the Ohio State University TBI Identification Method-Interview Form. Those who screened as likely experiencing a TBI received resources for care and follow-up telephone calls. Data were collected on the number of individuals screened and their results and reported using descriptive statistics. From 2014 to 2022, a total of 1333 individuals were screened at 23 different community events across Idaho. Over 30% of screened individuals reported a history of head or neck injury, primarily due to falls and being hit by objects. The majority of identified cases of TBI were characterized by no loss of consciousness or <30 min of unconsciousness. Screenings targeting underserved populations showed higher TBI prevalence. Targeting underserved populations proved valuable in identifying TBI cases. The collaborative and interprofessional approach of this screening is unique and highlights the potential to address complex health issues effectively. These findings offer valuable insights for others implementing TBI screening programs in community settings.


Asunto(s)
Lesiones Traumáticas del Encéfalo , Tamizaje Masivo , Población Rural , Humanos , Lesiones Traumáticas del Encéfalo/diagnóstico , Estudios Transversales , Femenino , Masculino , Adulto , Tamizaje Masivo/métodos , Idaho , Persona de Mediana Edad , Poblaciones Vulnerables , Adolescente , Anciano , Adulto Joven
6.
Med Teach ; : 1-13, 2024 Jun 03.
Artículo en Inglés | MEDLINE | ID: mdl-38828523

RESUMEN

The provision of optimum health care services requires collaboration of health care professionals in integrated interprofessional (IP) teams. This guide addresses the practical aspects of establishing and delivering pre-licensure IP programs to prepare graduates of health professional programs to work in teams and wider collaboration, and consequently enhance the quality of health care. The main updated IP frameworks are presented to highlight commonalities that represent the essential competencies and outcomes of programs implementing interprofessional education (IPE). We discuss how these may be adapted to the local context, and present examples of models of implementation to guide the initial steps of establishing similar programs. Examples of pre-licensure IP practice-based learning, such as community-based, simulation-based, student-run and led clinics, and interprofessional training wards, and post-licensure interprofessional learning (IPL), are described. We consider assessment of IPL along the continuum of learning IP. This guide also emphasises the need to tailor faculty development programs for local contexts and consider factors affecting sustainability such as funding and accreditation. We finish with the governance of IP programs and how global IP networks may support interprofessional practice-based learning from development to delivery.

7.
Med Teach ; 46(3): 323-329, 2024 03.
Artículo en Inglés | MEDLINE | ID: mdl-37688778

RESUMEN

Dedicated Interprofessional Training Units (ITUs) in hospital wards are one way to prepare healthcare students for Interprofessional patient-centered care. Based on theoretical foundations, research, and our lived experiences of successes as well as failures, we propose 12 tips on how to prepare, implement, and sustain a dedicated ITU, combining the Grol & Wensing model for planning change with the Self-determination Theory of motivation. Start with a steering group, with a dedicated project leader, to translate awareness of the need for an ITU into wider awareness and motivation among stakeholders, with the ITU being a solution to authentic problems. Create shared ownership by jointly formulating feasible educational goals and starting with a pilot to provide opportunities for change. Motivate all stakeholders by stimulating their autonomy, interprofessional competence as well as relatedness to each other, in line with the Self-determination Theory. Confirm the value of the ITU at all stages and embed the ITU in the organizational strategy.


Asunto(s)
Relaciones Interprofesionales , Estudiantes , Humanos , Competencia Clínica , Objetivos , Hospitales
8.
Med Teach ; : 1-16, 2024 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-38466936

RESUMEN

PURPOSE: The purpose of this scoping review is to assess the literature on allied health professions escape rooms (AHPERs), investigating their common purposes and practices, and the trends in scholarship. METHODS: This scoping review followed PRISMA-ScR guidelines to assess the size and scope of evidence in the literature, categorize common purposes and practices, and explore trends in AHPER scholarship. Two reviewers developed a review protocol, collected literature using a search strategy aligned with inclusion criteria, and charted review results. RESULTS: The literature search yielded 6,170 articles. After the final review, 34 unique records met inclusion criteria. Studies were conducted in the United States, Spain, Australia, France, Brazil, and Canada. Most escape rooms reported participants, team size, puzzle type, and outcomes, but few used causal research designs, primarily using pre-post with no control designs. AHPERs represent an increasingly popular pedagogical approach. AHPERs tend to be simply structured, patient themed, and convey either disciplinary or interprofessional lessons. Generally, AHPERs were self-reported as effective and satisfying, but scholarship supporting AHPERs was insufficient in design for causal claims. CONCLUSION: Developers and scholars may benefit from considering frameworks and guidelines for consistent creation and increased trustworthiness in the AHPER practice and knowledge base. Where AHPER scholars can increase attention to learning outcomes, and plan scholarly works in advance of the escape room, the AHPER body of knowledge will increase.

9.
Adv Physiol Educ ; 2024 Aug 08.
Artículo en Inglés | MEDLINE | ID: mdl-39116393

RESUMEN

Why, after enduring the grueling demands of medical school and successfully completing the pre-clinical curriculum, must students further burden themselves with 4-8 weeks of exam preparation for the licensing exam instead of engaging in meaningful, real-world experiences? The relentless focus on licensing exams like the USMLE Step 1 and COMLEX-USA Level 1 diverts attention from activities that truly matter, such as direct patient care, community service, research, and interprofessional education. Tens of thousands of medical students are confined to weeks of isolated study, reviewing comprehensive resources such as textbooks, online courses, and question banks on content already covered and tested during the pre-clinical curriculum. This represents a significant time sink that could otherwise be used to enhance clinical skills, empathy, and social responsibility. Hands-on clinical experiences are essential for developing practical skills and building strong patient-doctor relationships, while community service fosters social responsibility. Research engagement is crucial for medical advancements, and interprofessional education and global health initiatives broaden students' perspectives. Despite being viewed as competency measures, these licensing exams are repetitive and focus on already-mastered content, failing to justify their extensive time demands. We argue for a reassessment of the necessity of these exams, advocating for an education system that prioritizes real-world experiences. This shift would foster competent, empathetic, and socially conscious healthcare professionals, poised to make a significant societal impact.

10.
Artículo en Inglés | MEDLINE | ID: mdl-38407528

RESUMEN

BACKGROUND: Persons with aphasia (PWA) experience a number of communicative and social-emotional challenges. Reported experiences of PWA include but are not limited to, being misunderstood, isolated, frustrated, and infantilised. AIMS: The aim of this pilot study, involving a Life Participation Approach to Aphasia (LPAA), conducted over the course of 2 years, was to understand community perceptions of aphasia while PWA engaged in an interprofessional treatment program involving speech and drama therapy. METHODS & PROCEDURES: The interprofessional treatment program involved PWA participating in a therapeutic theatre program using the CoActive Therapeutic Theater (CoATT) while also receiving speech-language therapy. Each year, the PWA performed a different, original therapeutic theatre production for a public audience, at the culmination of their interprofessional treatment program. In this paper, we share data obtained from perspectives of audience members who witnessed the theatre production and aphasia education during the first year of the study and friends and family of PWA who participated in the therapeutic theatre process during the second year of the study. OUTCOMES & RESULTS: Responses from audience members who participated in aphasia education and witnessed the therapeutic theatre performance by the PWA during the first year, indicated an increased knowledge of aphasia. Friends and family members of PWA who witnessed their loved ones engaging in the CoATT process through interprofessional treatment, in the second year, reported that their loved ones benefited from the CoATT process, which was distinct from other therapeutic processes to their knowledge and that they were impacted by watching their loved one perform. CONCLUSIONS & IMPLICATIONS: These initial findings create footing towards understanding impact of therapeutic theatre in combination with speech-language therapy in the lives of PWA. They help us to obtain an initial appreciation of how therapeutic theatre and aphasia education help connect PWA and their community. WHAT THIS PAPER ADDS: What is already known on this subject Caregivers and communities at large play a significant role in and substantially impact the recovery of their loved ones (Dalemans et al., 2010; Grawburget et al., 2013; Kniepmann & Cupler, 2014) with aphasia. However, existing research suggests that persons with aphasia (PWA) are often misunderstood, isolated and infantilised by their communities. What this paper adds to existing knowledge The findings of our study reveal that friends, families and extended communities of PWA gain a positive and deep understanding of challenges experienced by PWA through therapeutic theatre supported by speech language therapy, based in a new CoActive Therapeutic Theatre (CoATT) model. This PWA community also agrees that therapeutic theatre in combination with speech-language therapy provides confidence and camaraderie between PWAs and strengthen connection between all constituencies. These results support the need for interprofessional intervention within the framework of a Life Participation Approach to Aphasia (LPAA). What are the potential or actual clinical implications of this work? Treatment paradigms that bring PWAs in contact with their communities using an LPAA approach can increase confidence and social engagement for PWAs potentially leading to better outcomes for their individual speech-language therapy as well as create means of educating communities about PWA, and their stories.

11.
BMC Med Educ ; 24(1): 93, 2024 Jan 26.
Artículo en Inglés | MEDLINE | ID: mdl-38279163

RESUMEN

BACKGROUND: Community-based interprofessional education (CBIPE) has been proven effective in enhancing the interprofessional competencies of medical and health professional students. However, there is a lack of evaluation on the impact of experiential CBIPE among undergraduate medical and health promotion students in Thailand. Therefore, the objective of this study is to assess the influence of CBIPE learning on the collaborative competencies of these students. METHODS: A one-group pre-posttest design in 193 (152 medical students and 41 health promotion) students were involved in the CBIPE program, later divided into 12 groups. Data was collected by direct observations of mentors using the Interprofessional Collaborative Competencies Attainment Survey (ICCAS). The Wilcoxon matched-pairs signed-rank test was conducted to evaluate the effectiveness of the CBIPE program. RESULTS: A total of 175 (90.67%) completed ICCAS and satisfaction questions before and after the CBIPE program. The mean age of respondents was 20.29 ± 1.63 years; 60.57% were women and 39.43% were men. The results showed a significant increase in collaborative competencies before and after the 2-week course. Gender-stratified analysis showed an improvement after CBIPE training for all subscales in women, while the communication, collaboration, conflict management, and functioning team skills segment score was significantly higher in the post-assessment among men. CONCLUSION: The implementation of CBIPE learning was successful in enhancing collaborative competencies among both medical and health promotion students. These findings will provide valuable insights for the design and improvement of CBIPE learning programs in other universities.


Asunto(s)
Relaciones Interprofesionales , Estudiantes de Medicina , Masculino , Humanos , Femenino , Adolescente , Adulto Joven , Adulto , Educación Interprofesional , Encuestas y Cuestionarios , Promoción de la Salud
12.
BMC Med Educ ; 24(1): 334, 2024 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-38528513

RESUMEN

BACKGROUND: In the context of increasingly intricate healthcare systems, professionals are compelled to collaborate within dynamically changing interprofessional teams. Moreover, they must adapt these collaborative processes to effectively and efficiently manage the evolving complexity of care needs. It remains unclear how professionals determine care complexity and relate this complexity to their preferences for interprofessional collaboration (IPC). This study investigated the relationships between care complexity, professionals' perceived complexity and IPC preferences, and examined the variation in individual and team characteristics of IPC-practices across different levels of complexity in paediatric care. METHODS: In an online questionnaire, 123 healthcare professionals working at an academic tertiary children's hospital scored their perceptions of complexity and preferences for IPC. They also selected family and various professions as members of the interprofessional (IP-) team based on thirteen patient cases. We employed conjoint analysis to systematically model the complexity of case descriptions across the five domains of the International Classification of Functioning, Disability and Health (ICF). Additionally, we applied social network analysis to identify important professions, crucial connectors and influential professions in the IP-team, and to describe the cohesiveness of IP-teams. RESULTS: Modelled case complexity, professionals' perceived complexity and IPC preferences were positively associated. We found large inter-individual variations in the degree of these associations. Social network analysis revealed that the importance and influence of professions was more equally distributed when case complexity increased. Depending on the context and complexity of the case, different professions (e.g. medical doctors, social professionals, extramural professionals) were considered to be more crucial connectors within the IP-team. Furthermore, team cohesion was positively associated with modelled and perceived care complexity. CONCLUSIONS: In conclusion, our study contributes to the existing knowledge by integrating task-specific insights and broadening the use of conjoint and social network analysis in the context of IPC. The findings substantiate the contingency theory that relates characteristics of IPC to care complexity, offering quantified insights into how IP-teams adapt to situational needs. This understanding of relationships and variations within IPC holds crucial implications for designing targeted interventions in both clinical and health profession education contexts. Consequently, it contributes to advancements in healthcare systems.


Asunto(s)
Conducta Cooperativa , Relaciones Interprofesionales , Humanos , Niño , Personal de Salud , Atención a la Salud , Grupo de Atención al Paciente , Red Social
13.
BMC Med Educ ; 24(1): 857, 2024 Aug 09.
Artículo en Inglés | MEDLINE | ID: mdl-39123155

RESUMEN

BACKGROUND: Collaborative practice in primary health care increases care quality and security. In France, primary health care professionals increasingly work together. The link between general practitioners (GPs) and community pharmacists (CPs) is an important element. Nevertheless, effective collaboration between GPs and CPs is difficult to develop and formalize. Interprofessional education has been identified as a necessary step to prepare "collaborative practice-ready professionals". We aimed to identify the interprofessional training needs of last-year GP and CP students to develop interprofessional collaborations. METHOD: We conducted an analysis of training needs using a method inspired by occupational didactics. We collected data through individual semidirective interviews with CPs and GPs in 2022. At each stage we aimed to identify the elements of the occupational didactics to deduce the training needs in the form of a frame of reference: apparent competencies, emblematic situations and acting characteristics. We conducted an initial deductive thematic analysis to identify the apparent competencies of the two professions, the emblematic situations in which these competencies are used, and the acting characteristics used in these situations. We made an inductive categorization to define the collaborative competence and the families of situations and to model the actions of this GP-CP collaboration. RESULTS: We defined the competency "to collaborate effectively in an interprofessional setting in order to respond to care issues in one's territory" expressed in various professional situations. We described it by three capacities based on two interacting dynamics: one-off exchanges and structured collaborations. Various communication tools facilitate the implementation of these interactions. We modeled the actions of the GP-CP collaboration in the form of a conceptual map. CONCLUSION: The collaboration between the CP and the GP implements a competency that could be integrated into their professional referential. This competency, entitled "collaborating effectively in interprofessional settings to respond to care issues in one's territory", is expressed in a variety of professional situations. It is based on two parallel and interacting dynamics: one-off exchanges and a dynamic of lasting collaboration. This study thus lays the groundwork for the development of this collaborative skill among general practice and pharmacy residents.


Asunto(s)
Conducta Cooperativa , Médicos Generales , Educación Interprofesional , Relaciones Interprofesionales , Farmacéuticos , Humanos , Médicos Generales/educación , Competencia Clínica , Francia , Investigación Cualitativa , Masculino , Femenino , Evaluación de Necesidades
14.
BMC Med Educ ; 24(1): 602, 2024 May 31.
Artículo en Inglés | MEDLINE | ID: mdl-38822320

RESUMEN

BACKGROUND: The role of effective interprofessional teamwork is especially vital in the Neonatal Intensive Care Unit (NICU) where infants facing emergency situations are admitted. Proper neonatal resuscitation, facilitated by comprehensive resuscitation training, can significantly decrease the mortality rates associated with neonatal asphyxia and respiratory failure. This study aimed to develop a simulation-based interprofessional education (IPE) programme for medical staff working in a nursery and NICU and to assess its effectiveness on teamwork, communication skills, clinical performance, clinical judgement, interprofessional attitudes, and education satisfaction. METHODS: Through a demand survey, neonatal resuscitation was selected as the theme, and an IPE team comprised of one doctor and two nurses was formed. The education programme consisted of three sessions lasting a total of 140 min: two simulation exercises and one theoretical education session. Data were collected from 18 nurses working in the nursery and NICU and 9 doctors working in the paediatrics department. RESULTS: A comparison of the metrics before and after applying simulation-based IPE programmes revealed teamwork (Z=-2.67, p = .008), communication skills (Z=-2.68, p = .007), clinical performance (Z=-2.52, p = .012), clinical judgement (Z=-4.52, p < .001), and interprofessional attitude (Z=-3.64, p < .001) to have significantly improved. Education satisfaction scores were 4.73 points on average out of a maximum of 5. The simulation-based IPE programme was effective in improving the teamwork, communication, and clinical performance of resuscitation teams, individual clinical judgement, and interprofessional attitude. CONCLUSIONS: Simulation-based IPE is effective for enhancing teamwork, team communication, clinical judgement skills, and clinical performance in neonatal resuscitation. This programme has the potential to contribute to the improvement of patient safety and the quality of neonatal care. Additional studies are needed to longitudinally examine the effects of the programme on patient safety and quality of neonatal care.


Asunto(s)
Comunicación , Unidades de Cuidado Intensivo Neonatal , Grupo de Atención al Paciente , Resucitación , Entrenamiento Simulado , Humanos , Recién Nacido , Resucitación/educación , Competencia Clínica , Educación Interprofesional , Relaciones Interprofesionales , Femenino , Masculino , Actitud del Personal de Salud , Adulto
15.
BMC Med Educ ; 24(1): 711, 2024 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-38956587

RESUMEN

BACKGROUND: Many health science curricula have integrated behavioral modification techniques in their plans. Motivational Interviewing is one such technique. Educational interventions to promote Motivational Interviewing have had limited success. Integrating simulation-based learning in health science curricula might offer a platform whereby students can train in well controlled environments with increased authenticity, provision of standardized experiences and the capacity for immediate feedback to participants. Using motivational interviewing as an exemplar, the purpose of this study was to assess the impact of a simulation-based reflective e-training program on knowledge, attitudes, and confidence in Motivational Interviewing among healthcare practitioners from diverse healthcare disciplines. A secondary aim was to explore whether self-reflection can promote reflective learning. METHODS: This was a mixed-method study design. Fifteen participants from different health disciplines were included in the quantitative phase of the study, the simulated interview, and the reflective assignments while five participated in the focus group. Pre and post tests were used to examine the effect of training on knowledge, attitudes, and confidence in Motivational Interviewing. Assessment of Motivational Interviewing Treatment Integrity [MITI] scores in a simulation-based scenario was used. A qualitative content analysis of a focus group provided a more in-depth understanding of the participants experiences. Excerpts from reflective assignments were analyzed using Transformative Learning Theory concepts. RESULTS: A Wilcoxon test showed that the training elicited a change in confidence in performing Motivational Interviewing [Z= -2.766, p = 0.006], median scores increased from 29 to 34. A quarter of technical scores and half of the relational scores indicated good competence. Participants reflected content transformation through feelings of empowerment and satisfaction when they were successful in engaging and motivating clients. Process transformation was evident in reflections on how to improve core skills specifically reflective listening. Reflections on Motivational Interviewing spirit related values showed premise transformation, which may indicate attitude changes. CONCLUSION: A simulation-based e-training program on Motivational Interviewing represents an important educational modality for training in the health disciplines. Results of this study provide evidence supporting the integration of reflective simulation-based e-training into the education curricula of health disciplines in MI and beyond.


Asunto(s)
Entrevista Motivacional , Entrenamiento Simulado , Humanos , Proyectos Piloto , Femenino , Masculino , Personal de Salud/educación , Competencia Clínica , Curriculum , Adulto , Grupos Focales , Conocimientos, Actitudes y Práctica en Salud
16.
BMC Med Educ ; 24(1): 198, 2024 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-38413950

RESUMEN

BACKGROUND: Creating an inclusive interprofessional teaching and learning community can enhance student engagement and ultimately develop essential graduate attributes (GA) (also known as generic, transferable, core, soft, work-ready or nontechnical skills). The early practical development of GA within a diverse space is essential in health profession education, as students experience the transition to clinical training as challenging. AIM: This paper describes the conceptualization and implementation of an inclusive interprofessional curriculum focused on GA development in the preclinical years. METHODS: A phased multimethod research design was applied. Phase 1 focused on the conceptualization of a preclinical GA development curriculum through a consensus-seeking process among all staff in the School of Health and Rehabilitation Sciences (N = 36). Subsequently, in Phase 2, quantitative and qualitative data were gathered from participating first-year students (N = 135) as an early curricular implementation review. Descriptive statistical analyses for quantitative and thematic analyses for qualitative data were performed. RESULTS: During Phase 1, five themes were identified (Ethics, Professionalism, General principles for interventions, Organizations and institutions, Management) informing preclinical curriculum development. Forty-one first-year students (30%) participated in Phase 2. The majority of participants (87%) indicated that they had a positive learning experience during Phase 2. Students expressed that engagement was encouraged (83%) within a space of mutual respect (83%), with interprofessional groups assisting in building "a trusting environment and a supportive one". Students indicated they "liked that it [module] wasn't just about one topic", as it concretized that "there is more to being a healthcare professional that just treating people". CONCLUSION: GA development provides an invaluable opportunity for interprofessional engagement. Creating a diverse and inclusive curricular space through multimodal and interprofessional training, GA training was transformed to be more practical and future-focused, creating a positive learning experience. Future research should focus on the longer-term impact of this practical, preclinical GA development during the transition of these students into the clinical training space.


Asunto(s)
Aprendizaje , Estudiantes , Humanos , Universidades , Sudáfrica , Curriculum , Atención a la Salud , Relaciones Interprofesionales
17.
BMC Med Educ ; 24(1): 220, 2024 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-38429678

RESUMEN

BACKGROUND: Incorporating interprofessional collaboration within healthcare is critical to delivery of patient-centered care. Interprofessional Education (IPE) programs are key to promoting such collaboration. The 'Public Health Service' (PHS) in France is a mandatory IPE initiative that embodies this collaborative spirit, bringing together students from varied health undergraduate training programs-nursing, physiotherapy, pharmacy, midwifery, and medicine- in a common training program focused on primary prevention. The aim of the study was to assess the experience and attitudes of students in the five health training programs regarding the interest of IPEs in the PHS. METHODS: A cross-sectional survey was administered to 823 students from the 2022-2023 cohort at a French university. The questionnaire was designed with 12 Likert-scale questions specifically created to evaluate the students' experiences, knowledge, and attitudes focused on IPE during the practical seminars, school interventions, and the overall PHS. Additionally, an open-ended question was utilized to gather qualitative data. Statistical analyses assessed satisfaction levels across undergraduate training programs, while thematic analysis was applied to the qualitative responses. RESULTS: Within the surveyed cohort, 344 students responded to the survey. The findings showed that students were satisfied with the interprofessional collaboration, both in practical teaching sessions (75% satisfaction) and in primary prevention projects conducted in schools (70% satisfaction), despite their having faced challenges with coordination. Pharmacy students, in particular, highlighted the need for adjustments in program scheduling. The qualitative feedback underscored the positive value of IPE, notwithstanding the organizational difficulties stemming from different academic timetables. CONCLUSION: The student feedback indicated a high level of satisfaction with the interprofessional work carried out in both the practical teaching and the primary prevention projects. To further enhance the educational impact and address the scheduling complexities, it is recommended that program refinements be made based on student feedback and pedagogical best practices.


Asunto(s)
Relaciones Interprofesionales , Estudiantes , Humanos , Estudios Transversales , Curriculum , Atención a la Salud
18.
BMC Med Educ ; 24(1): 175, 2024 Feb 23.
Artículo en Inglés | MEDLINE | ID: mdl-38395883

RESUMEN

BACKGROUND: While the importance of interprofessional education in medical training has been well-established, no specific framework has been used uniformly or shown to be most effective in the creation of interprofessional education (IPE) sessions. Further, prior studies have demonstrated that students have preferences for the design of these experiences. In this study, we sought to understand medical student preference for interprofessional teammates and motivations for this choice. METHODS: In this single-institution, cross-sectional analysis of the Duke IPE Clinic, participating students from September 2019-March 2020 completed a voluntary electronic survey that queried preferences for which health professions students (Doctor of Physical Therapy (DPT), Accelerated Bachelor of Science in Nursing (ABSN), Nurse Practitioner (NP), Pharmacy, and Physician's Associate (PA)) they would want to work with, and the motivating reason. Preferences and reasons were compared between first-year medical students (MS1s) and third- and fourth-year medical students (MS3s/MS4s). RESULTS: In total, 132 students participated. We found that MS1s most preferred interprofessional teammates with a more similar area of study (PA, NP), whereas MS3s/MS4s most preferred classmates with a less similar area of study (pharmacy, DPT, ABSN). MS1 students frequently selected their first-choice preference because the profession seemed most similar, while MS3/MS4 students often selected their first-choice preference because the profession seemed most different. CONCLUSIONS: Medical students earlier in training have more interest in working with professions they view as similar whereas senior students prefer to work with professions they view as more different. This information is important for designing educational IPE opportunities.


Asunto(s)
Estudiantes del Área de la Salud , Estudiantes de Medicina , Humanos , Estudios Transversales , Educación Interprofesional , Curriculum , Relaciones Interprofesionales
19.
BMC Med Educ ; 24(1): 255, 2024 Mar 08.
Artículo en Inglés | MEDLINE | ID: mdl-38459445

RESUMEN

INTRODUCTION: Healthcare services face significant challenges due to the aging population, increasing complexity of health issues, and a global shortage of health professionals. Health professions education needs to adapt and develop with healthcare services' needs. Interprofessional education and patient partnership are two trends that are increasingly being reinforced. Health professions students worldwide are expected to acquire competencies in interprofessional collaboration through undergraduate and postgraduate studies. Developing interprofessional collaborative skills in clinical placements is crucial. This study aims to explore two patients' meetings with an interprofessional student team and better understand how the patient can participate actively in the students´ learning processes. METHODS: This is a small single-case study. Two patients participated. Data was generated through participant observation and qualitative interviews. A practical iterative framework for qualitative data analysis inspired the analysis. RESULTS: The patients observed and reflected on the interprofessional students' learning process and felt responsible for contributing to their learning. The patients contributed to students' learning by making themselves available for practicing and sometimes giving feedback. They considered it a win-win situation to be involved in the interprofessional learning activity as they perceived being taken seriously by the students when addressing their problems and experienced positive outcomes for their situation, such as better physical functioning and adjustments to assistive devices. Patients emphasized the importance of learning collaboration between health professionals and how this could contribute to them feeling safer as patients. DISCUSSION: This study highlights the importance of including patients in interprofessional students' learning processes. Patients' active participation in interprofessional clinical placements can empower them, improve their self-efficacy, and potentially shift the power dynamic between patients and healthcare professionals. The study emphasizes the importance of the patient perspective in future research on interprofessional education in clinical settings. The study also highlights the need for clinical supervisors to facilitate patient involvement in interprofessional clinical placements and reinforce patients' feedback for the student team. CONCLUDING COMMENTS: Overall, this study contributes to the growing body of research on interprofessional education and patient partnership and emphasizes the importance of including patients in health professions education.


Asunto(s)
Estudiantes del Área de la Salud , Humanos , Anciano , Aprendizaje , Investigación Cualitativa , Personal de Salud , Relaciones Interprofesionales , Empleos en Salud/educación
20.
BMC Med Educ ; 24(1): 381, 2024 Apr 08.
Artículo en Inglés | MEDLINE | ID: mdl-38589952

RESUMEN

BACKGROUND: Interprofessional education (IPE) is essential for healthcare students to collaborate effectively in multidisciplinary teams. This study aimed to identify the effect of IPE programmes in nursing care and oral healthcare on dental and nursing students' perceptions of interprofessional collaboration. METHODS: The study included 101 third-year dental and 98 fourth-year nursing students. The participants were divided into mixed-professional groups of four (2 dental and 2 nursing students). They participated in nursing care and oral healthcare training programmes that included student-on-student training and discussion groups. Questionnaires regarding perceptions of interprofessional collaboration were distributed to the participants before and after the programmes to compare the programmes before and after and between the dental and nursing students. The Wilcoxon signed-rank test and chi-square test were used to compare the data. RESULTS: Data from 79 dental students (42 males and 37 females) and 89 nursing students (4 males and 85 females) who completed both questionnaires were used for the comparisons. Perceptions of the differences between the approaches of different health professionals to nursing care, the roles of other professionals, and the need for multiprofessional collaboration improved significantly among both dental and nursing students after the programmes. Although the perception of their ability to communicate with unfamiliar or new people improved significantly only among the nursing students, other perceptions of their ability to communicate did not improve for either group. More dental students than nursing students chose nursing trainings as good programmes to participate in with other professional students, while more nursing students than dental students chose oral care trainings as good programmes. Many students commented that they learned about nursing and oral healthcare skills as well as the importance of teamwork and communication with other professionals. Seven students commented that they were more motivated to become dentists and nurses. CONCLUSIONS: This study showed that IPE programmes for nursing care and oral healthcare might be effective at helping students understand other professionals and promoting multiprofessional collaboration. However, further studies are needed to develop IPE programmes to improve attitudes and abilities related to interprofessional communication skills.


Asunto(s)
Estudiantes de Enfermería , Masculino , Femenino , Humanos , Educación Interprofesional , Actitud del Personal de Salud , Aprendizaje , Relaciones Interprofesionales
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