Behavioural outcomes of interprofessional education within clinical settings for health professional students: A systematic literature review.

Interprofessional education facilitates collaborative practice, which promotes high-quality patient care and patient safety. Interprofessional education (IPE) experiences within clinical settings provide an opportunity for the development of interprofessional collaborative practice competence. The aim of this systematic review was to review the literature evaluating interprofessional education for health professional students within clinical settings and summarize the behavioral outcomes. Databases searched were PubMed, Embase, Scopus, Web of Science, Taylor & Francis Online, ERIC and PsycINFO. Full-text articles were independently screened by two reviewers and included if agreed. Outcomes were analyzed using Kirkpatrick's model modified for IPE. Studies with behavioral change outcomes were analyzed and synthesized using narrative methods. Included studies provided evidence that IPE experiences in clinical settings can enable students to develop and integrate interprofessional collaborative practice competencies, across diverse types of settings. Key tasks enabling students to achieve these learning outcomes included synchronous patient consultations, collaborative development of integrative health-care plans outside of patient consultations, and participation in socialization with health-care teams. There were limitations in the methodological design of the included studies, with limited use of comparator groups and validated tools, high usage of self-report data and serious risk of bias identified across all quantitative included studies. In conclusion, high-quality research designed to measure the construct of behavioral change is lacking. Such research could further investigate the key tasks in IPE experiences in clinical settings that are necessary for students to develop the range of required collaborative practice competencies and integrate these. This could provide clarification regarding if and how this could be achieved across different types of clinical placements.

A systematic review critically appraising quantitative survey measures assessing power dynamics among multidisciplinary teams in acute care settings.

By valuing the knowledge of each discipline holistic patient-centered care can be achieved as decisions arise from expertise rather than established hierarchies. While healthcare has historically operated as a hierarchical power structure (i.e., some voices have more influence), these dynamics are rarely discussed. This review addresses this issue by appraising extant quantitative measures that assess multidisciplinary team (MDT) power dynamics. By identifying psychometrically sound measures, change agents can uncover the collective thought processes informing power structures in practice and develop strategies to mitigate power disparities. Several databases were searched. English language articles were included if they reported on quantitative measures assessing power dynamics among MDTs in acute/hospital settings. Results were synthesized using a narrative approach. In total, 6,202 search records were obtained of which 62 met the eligibility criteria. The review reveals some promising measures to assess power dynamics (e.g., Interprofessional Collaboration Scale). However, the findings also confirm several gaps in the current evidence base: 1) need for further psychometric and pragmatic testing of measures; 2) inclusion of more representative MDT samples; 3) further evaluation of unmatured power dimensions. Addressing these gaps will support the development of future interventions aimed at mitigating power imbalances and ultimately improve collaborative working within MDTs.

Embedding Interprofessional Education in Clinical Settings: Medical and Dental Student Perceptions of a Patient Interview-Storytelling Experience.

PROBLEM: Interprofessional education (IPE) is valued but difficult to deliver, given logistical and other barriers. Centering IPE around patients and grounding it in authentic practice settings are challenging within early undergraduate medical education. APPROACH: This intervention facilitated student-patient conversations to elicit patient reflections on the health care professionals who keep them healthy and care for them when they are unwell. After being introduced to the Interprofessional Education Collaborative (IPEC) core competencies, first-year medical (n = 127) and dental (n = 34) students conducted a brief semistructured patient interview, using an interview card with guiding questions, during a precepted outpatient clinic session in March-May 2021. Students transcribed patients' stories and wrote their own reflections on the interview card. These reflections were used as a stimulus for a class IPE discussion. The authors employed a pragmatic qualitative research approach to explore what students learned about interprofessional collaboration from reflecting on patients' stories. OUTCOMES: Of the 161 students, 158 (98%) completed an interview card. Sixteen health professions were represented in patients' stories. The patients' stories prompted students to recognize and expand their understanding of the IPEC competencies. Students' responses reflected synthesis of the competencies into 3 themes: students value patient-centered holistic care as the goal of interprofessional collaboration; students reflect emerging professional and interprofessional identities in relating to patients, teams, and systems; and students appreciate interprofessional care is complex and challenging, requiring sustained effort and commitment. NEXT STEPS: Next steps include continuing to integrate patient voices through structured conversations across the undergraduate and graduate medical education spectrum and adapting the model to support conversations with other health professionals engaged in shared patient care. These experiences could foster ongoing deliberate reflection by students on their professional and interprofessional identity development but would require investments in student time and faculty development.

Navigating interprofessional boundaries: Midwifery students in Canada.

The literature on professional socialization focuses on how students adopt and internalize professional identities and values, and assumes that boundary work is essential to learning how best to practice their profession. However, a focus on boundary work in the context of midwifery training - which is embedded in the gendered and hierarchical landscape of maternity care - is lacking. Thus, this article examines how Canadian student-midwives learn to navigate and negotiate interprofessional boundaries. Grounded in a symbolic interactionist approach, it draws on 31 semi-structured qualitative interviews from a mixed-methods national study on midwifery retention, explores how midwifery students make sense of the tensions among midwives, physicians, and nurses, and describes what strategies they utilize when navigating boundaries. Our analysis, based in constructivist grounded theory, revealed that participants learned about interprofessional tensions in clinical placement encounters via direct or indirect interactions with other healthcare professionals, and that strategies to navigate these tensions included educating others about midwifery training and adopting a learner identity. This article proposes that the process of professional socialization enables to reshape professional boundaries and that students are not only learners but also agents of change. These findings may yield practical applications in health education by highlighting opportunities for improving interprofessional collaborations.

A Cytomegalovirus (CMV) Case Study to Promote Interprofessional Learning (IPL) Between Audiology and Biomedical Science Students in Higher Education.

Modern and effective patient care requires specialist healthcare professionals working together. Interprofessional learning (IPL) seeks to provide opportunities for different healthcare disciplines to learn with, from and about each other. This study focused on the delivery and evaluation of a cytomegalovirus (CMV) case study workshop to facilitate IPL between two Health and Care Professions Council (HCPC) regulated courses: Biomedical Science and Audiology. The 2 h online workshop consisted of 1) defining the roles, responsibilities and skills of the two healthcare professions, 2) the structure of the Biomedical Science and Audiology departments, 3) routes to HCPC registration, 4) core curriculum of both degree programmes and 5) interpreting interdisciplinary data related to a CMV patient case. The workshop was interactive, with the virtual learning environment promoting peer discussions and the use of online polling. Student responses were collected through an online questionnaire. A total of 108 respondents completed a post-event survey and Mann-Whitney U tests revealed there were no significant differences in the responses between the two student cohorts in response to each of the survey statements (p > 0.05). A total of 82.4% of students agreed that they need to know the role of other healthcare professionals for their future practice, whilst 84.2% agreed that the CMV case study was a good format to facilitate effective IPL. A total of 93.5% of respondents recognised the importance of both professions in diagnosing a patient with CMV. Thematic analysis identified four common themes, including appreciation of shared roles, recognition of similarities in registration pathways, working together to provide holistic patient care and the role of clinicians in the patient journey. This novel collaboration between Biomedical Science and Audiology facilitated effective IPL whilst meeting the interprofessional education HCPC requirements. Collaborative working is an essential component of delivering effective patient care and allied healthcare degrees need to provide opportunities within their curriculum to foster this. We hope this study encourages other higher education institutes to expand and develop their current IPL activities to include a broader spectrum of healthcare courses.

Comparison of students' readiness from six health education programs for interprofessional learning in Vietnam: a cross-sectional study.

BACKGROUND: Interprofessional education (IPE) is expected to help prepare undergraduate health profession students to collaborate with other healthcare professionals in realising quality of care. Studies stress the necessity of students' readiness for interprofessional learning (IPL) in view of designing IPE programs. The present study aims to determine students' IPL-readiness and looks at related differences in students enrolled in different programs and at different phases in their educational program. METHODS: A cross-sectional survey study was set up among 1139 students from six health programs at HueUMP, using the Readiness for Interprofessional Learning Scale (RIPLS). Statistical analysis was performed using Kruskal-Wallis H and Mann-Whitney U tests. RESULTS: The overall mean RIPLS score was 68.89. RIPLS scores significantly differed between programs and between phases in the educational programs. Medical students presented a lower readiness level for IPL than students from other programs. In contrast to a significant increase in RIPLS scores of students in the clinical phase in Vietnamese traditional medicine, medicine, and pharmacy, a decrease in RIPLS scores was observed in students in the clinical phase in odonto-stomatology. CONCLUSIONS: The differences could be related to differences in educational programs and the study phases in a particular program. These results offer insights to direct the design and implementation of IPE in health education curricula and especially underscore the need to provide IPE throughout the curriculum.

How to improve newly qualified midwives' transition-into-practice. A Delphi study.

BACKGROUND: In the Netherlands, newly qualified midwives start work as registered midwives without any formal transition support. Research shows that newly qualified midwives do not feel sufficiently confident and competent in their work during the period following graduation. This could impact the quality of care provided by newly registered midwives. The aim of this study is to seek consensus with stakeholders concerning viable components of support for newly qualified midwives working in midwifery care in the Netherlands. METHODS: A Delphi study was conducted among maternity care stakeholders in the Netherlands. During two rounds, sixteen statements derived from a theoretical framework of organizational socialization theory and previous studies were assessed (round 1, n = 56; round 2, n = 52). Stakeholders (N = 61) were invited and completed an online questionnaire that included spaces for opinions and remarks. RESULTS: Stakeholders agreed about an introductory support period for newly qualified midwives, involving performance feedback and regional-level backup from fellow midwives during shifts. They further agreed on the responsibilities of established professionals that they should support newcomers in practice and provide mentoring or group coaching, although they face organizational barriers for supporting newcomers. CONCLUSIONS: Stakeholders found consensus upon several components of support at the workplace. In addition, a stable work environment seemed less important in their opinion while previous research suggests otherwise. Practice organisations need to improve the employment conditions and support for newly qualified midwives to ensure the quality of midwifery care is guaranteed.

Possibilidades de integração entre a fonoaudiologia e a nutrição com base em produções nacionais / Possibilities of integration between speech therapy and nutrition based on national productions / Posibilidades de integración entre la terapia del lenguaje y la nutrición a partir de las producciones nacionales

Introdução: A atuação interdisciplinar entre a fonoaudiologia e a nutrição colabora para um atendimento mais integral entre os usuários da saúde, fato que demonstra a importância de pesquisar suas correlações. Objetivo: O objetivo deste estudo foi verificar se existe integração entre a atuação do fonoaudiólogo e do nutricionista, identificando as publicações existentes, as especialidades contempladas, bem como a atuação dos profissionais nos diferentes ciclos de vida e níveis de atenção à saúde. Metodologia: Foram analisados 3.551 artigos eletrônicos disponíveis eletronicamente dos periódicos CODAS, CEFAC, Distúrbios da Comunicação e Audiology Communication Research, entre os anos de 2013 e 2022, por meio de um Protocolo de Classificação de Artigos. Resultados: Dentre as publicações analisadas, 274 (7,7%) integram a Fonoaudiologia e a Nutrição, especialmente na Especialidade da Motricidade Orofacial (n=124; 26,9%), no Ciclo Vital Infantil (n=132; 43%) e no Nível de Atenção Secundário (n=97; 35,4%). Conclusão: Concluiu-se que existe interface entre as duas profissões, porém, ainda é necessário fortalecer a atuação nos diferentes ciclos de vida. Além disso, incentivar a prática profissional em outros níveis de atenção, especialmente na primária, para prevenção dos distúrbios alimentares e promoção da alimentação saudável entre usuários do sistema de saúde.

Introduction: Interdisciplinary performance between speech therapy and nutrition contributes to a more integral care among health users, a fact that demonstrates the importance of researching their correlations. Objective: The purpose of this study was to verify if there is integration between the performance of the speech therapist and nutritionist, identifying the existing publications, the specialities contemplated, as well the performance of professionals in different life cycles and levels of health care. Methods: 3.551 electronic articles were analyzed, in the electronic journals CODAS, CEFAC, Distúrbios da Comunicação and Audiology Communication Research, between the years 2013 and 2022, through an Article Classification Protocol. Results: Among the analyzed publications, 274 (7,7%) integrate Speech Language and Hearing Sciences and Nutrition, especially in orofacial motricity (n=124; 26,9%), Children's Life Cycle (n=132; 43%), and secondary care level (n=97; 35,4%). Conclusion: it was concluded that there is an interface between the two professions, although it is still necessary to strengthen the performance in the different life cycles. Furthermore, to encourage professional practice at other levels of care, especially in the primary, to prevent nourishment disorders and promote healthy eating among users of the health system

Introducción: El rendimiento interdisciplinario entre la terapia del habla y la nutrición contribuye a una atención más integral entre los usuarios de la salud, un hecho que demuestra la importancia de investigar sus correlaciones. Objetivo: El objetivo de este estudio fue verificar si existe integración entre la terapia del habla y la nutricionista, identificando las publicaciones existentes, las especialidades contempladas, así como la actuación de los profesionales en diferentes ciclos de vida y niveles de atención a la salud. Métodos: Fueron analizados 3.551 artículos electrónicos, en las revistas electrónicas CODAS, CEFAC, Distúrbios da Comunicação y Audiology Communication Research, entre los años 2013 a 2022, a través de un Protocolo de Clasificación de Artículos. Resultados: Entre las publicaciones analizadas, 274 (7,7%) integran terapia del habla y Nutrición, especialmente en motricidad orofacial (n=124; 26,9%), Ciclo de Vida Infantil (n=132; 43%), y secundaria nivel asistencial (n=97; 35,4%). Conclusións: Se concluyó que existe una interfaz entre las dos profesiones, aunque aún es necesario fortalecer el desempeño en los diferentes ciclos de vida. Además, incentivar la práctica profesional en otros niveles de atención, especialmente en el primario, para prevenir trastornos de la alimentación y promover la alimentación saludable entre los usuarios del sistema de salud.

An Interactive Online Interprofessional Opioid Education Training Using Standardized Patients.

Introduction: Opioid pain management is complex and requires a collaborative approach. To prepare health professions students to care for patients who have chronic pain, we developed an interprofessional education (IPE) session for delivery using a virtual platform that featured a standardized patient (SP) interaction. Methods: The SP case highlighted a patient on opioids for chronic low back pain resulting from a car accident. Despite no improvement in pain or function, the patient continued taking opioids and developed behaviors that could represent opioid misuse. During the synchronous, online session, interprofessional teams of students interviewed an SP and collaborated to develop a holistic care plan to address the patient's pain and potential opioid misuse. The session evaluation included pre- and postsession surveys. Results: Over 750 students from medicine, pharmacy, nursing, and social work programs participated in the virtual IPE sessions during a single year. Students rated the session positively. Matched survey responses suggested improved confidence in knowledge and skills, and learning through Zoom was rated favorably. Discussion: We successfully implemented a synchronous online IPE session involving SP interactions that allowed students to practice team-based care of a patient with chronic pain who was taking opioids. Based on the success of this IPE session, including the success of the online delivery model, future IPE sessions will continue virtually.

Proximity and information sharing in hospitals and nursing homes: Development of an instrument assessing health personnel's perceptions of proximity and information sharing with kitchen personnel.

Healthcare services are becoming increasingly specialized, potentially hampering interprofessional care. To provide holistic treatment and care, different professions and departments need to share information. Healthcare services also include support services, such as institutional food services, and health personnel and kitchen personnel need to share information about food and patients to serve food adapted to the patients' nutritional needs. Healthcare institutions mainly use formal information-sharing systems, but informal communication is considered more suitable for exchanging complex information. Physical and social proximity may facilitate informal information sharing across different professions and units. We aimed to develop and test an instrument for assessing health personnel's perceptions of physical and social proximity to, and information-sharing practices with, kitchen personnel and to describe associations between physical and social proximity and information-sharing practices. A survey questionnaire measuring proximity and information-sharing practices was developed and distributed to 368 health personnel. Scale analyses were performed to test the psychometric properties of the measures included in the questionnaire. MANOVA and regression analyses were run to assess associations between proximity and information-sharing practices. The results indicated reasonable validity of the measures, and both physical and social proximity were associated with increased informal information sharing.

Development and implementation of a virtual "collaboratory" to foster interprofessional team-based learning using a novel faculty-student partnership.

BACKGROUND: Safe and efficient healthcare demands interprofessional collaboration. To prepare a practice-ready workforce, students of health professions require opportunities to develop interprofessional competencies. Designing and delivering effective interprofessional learning experiences across multiple professions is often hampered by demanding course loads, scheduling conflicts, and geographical distance. To overcome traditional barriers, a case-based online interprofessional collaboratory course was designed for professions of dentistry, nursing, occupational therapy, social work and public health using a faculty-student partnership model. AIM: To build a flexible, web-based, collaborative learning environment for students to actively engage in interprofessional teamwork. METHODS: Learning objectives addressed Interprofessional Education Collaborative (IPEC) core competency domains of Teamwork, Communications, Roles/Responsibilities, and Values/Ethics. Four learning modules were aligned with developmental stages across the case patient's lifespan. Learners were tasked with producing a comprehensive care plan for each developmental life stage using interprofessional teamwork. Learning resources included patient and clinician interviews, discussion board forums, elevator pitch videos, and interprofessional role modelling. A mixed methods quality improvement approach integrated the pre and post IPEC Competency Self-Assessment Tool with qualitative student feedback. RESULTS: In total, 37 learners participated in the pilot. IPEC Competency Assessment Interaction domain mean scores increased from 4.17/5 to 4.33 (p = 0.19). The Values domain remained high (4.57/5 versus 4.56). Thematic analysis highlighted five core themes for success: active team engagement, case reality, clear expectations, shared team commitment, and enjoyment. CONCLUSIONS: A faculty-student partnership model was feasible and acceptable for designing and implementing a virtual, interprofessional team-based course. Using a quality improvement cycle fast-tracked improvements to course workflow, and highlighted strategies for engaging students in online team-learning.

Three-Stage Assessment as Reverse Innovation in Interprofessional Student Clinical Rotations.

Social determinants of health are increasingly recognized as important factors in individual and public health outcomes and are therefore of interest to both health care systems and medical schools. However, teaching holistic assessment strategies during clinical education remains a challenge. This article reports on the experiences of American physician assistant students who completed an elective clinical rotation in South Africa. In particular, the students' training and practice with 3-stage assessment is highlighted as an example of a reverse innovation practice that could be incorporated in interprofessional health care education models in the United States.

Polyphonic perspectives: a focus group study of interprofessional staff's perceptions of music therapy at an inpatient unit for children in mental health care.

PURPOSE: In an inpatient unit for children in mental health care, a variety of services are provided through interprofessional collaborations. Music therapy is a relatively recent proposition in this context, but there is increasing acceptance for music therapy as a therapeutic method. However, there is limited knowledge about music therapy in this field, and this study aims to address this research gap. METHOD: Through focus group interviews with staff at an inpatient unit in mental health care for children, this article explores interprofessional perspectives of music therapy. A thematic analysis with an inductive approach informed by constructivist grounded theory was used in the analysis of the interviews. FINDINGS: Several dimensions were involved in the findings, concerning the children and the interprofessional collaboration. The two main categories that emerged were: "What music therapy offers the children" and "What music therapy contributes to the interprofessional understanding of the children". CONCLUSION: The interprofessional perspectives of music therapy revealed potentials for emotion regulation, and experience of identity and freedom for the children. As part of the integrated services, music therapy provided a new perspective of the child and enhanced relationship between the child and the health services.

Effects of student-led drama on nursing students' attitudes to interprofessional working and nursing advocacy: A pre-test post-test educational intervention study.

BACKGROUND: Nursing educators need to equip students to work in interprofessional teams and advocate for patients in increasingly integrated health and social care settings. Drama-based education has been used in nursing to help students understand complex concepts and practices, including communication, empathy, and patient safety. However, few studies have evaluated drama-based education to promote understanding of interprofessional care and advocacy, and none have involved student-led drama where students create dramatic performances to support learning. OBJECTIVES: To examine the effects of student-led drama on student nurses' attitudes to interprofessional working and advocacy. DESIGN: Pre-test post-test educational intervention study. SETTINGS: Public university in Scotland. PARTICIPANTS: 400 undergraduate student nurses enrolled on a 15-week module focussed on health and social care integration and interprofessional working. METHODS: Students completed paper questionnaires at the start (n = 274, response rate: 80.1 %) and end (n = 175, 63.9 %) of the module. Outcome measures were the validated Attitudes Towards Healthcare Teams Scale (ATHCTS) and Protective Nursing Advocacy Scale (PNAS). Change in mean ATHCTS and PNAS scores were assessed using paired samples t-tests, with Cohen's d to estimate effect size. RESULTS: ATHCTS scores significantly increased from 3.87 to 4.19 (p < 0.001, d = 0.52). PNAS scores increased from 3.58 to 3.81 (p < 0.001, d = 0.79), with significant improvements in the 'acting as an advocate' (4.18 to 4.51, p < 0.001, d = 0.81) and 'environmental and educational influences' subscales (3.79 to 4.13, p < 0.001, d = 0.75). Statements focussed on promoting holistic, dignified care and enabling health professionals to be responsive to emotional and financial needs of patients, showed greatest change. CONCLUSIONS: Education based on plays created and performed by student nurses led to significant improvements in student nurses' attitudes towards interprofessional working and nursing advocacy. Student-led drama should be embedded in nursing curricula to enable students to understand the realities and complexities of health and social care integration and interprofessional working.

Challenges of interprofessional geriatric practice in home care settings: an integrative review.

This integrative review identified challenges for interprofessional home care and provided recommendations for improving geriatric home care. A search of six databases identified 982 articles; 11 of them met the review's eligibility criteria and were included in the review. Quality appraisal of the included studies was performed using two tools (Critical Appraisal Skills Program for Qualitative Research and Mixed Methods Appraisal Tool), and their overall methodological quality was found to be satisfactory. After applying D'Amour et al.'s framework, four "challenge" themes emerged: (1) lack of sharing, (2) lack of partnership, (3) limited resources and interdependency, and (4) power issues. Recommendations included providing practical multidisciplinary training guided by a standardized model, establishing streamlined communication protocols and a communication platform reflecting the actual needs of users by involving them in its design, and asking interprofessional team members to commit to home care planning and to cultivate a collaborative culture and organizational support.

Struggling with the governance of interprofessional elderly care in mandated collaboratives: a qualitative study.

BACKGROUND: Governing interprofessional elderly care requires the commitment of many different organisations connected in mandated collaboratives. Research over a decade ago showed that the governance relied on clan-based mechanisms, while lacking formal rules and incentives for collaborations. Awareness and reflection were seen as first steps towards progression. We aim to identify critical governance features of contemporary mandated collaboratives by discussing cases introduced by the healthcare professionals and managers themselves. METHODS: Semi-structured interviews (n = 24) with two regional mandated collaboratives took place from November 2019 to November 2020 in the Netherlands to learn more about critical governance features. The interviews were thematically analysed by the project team (authors) to synthesise the results and were subsequently validated during a focus group. RESULTS: Critical governance features of interorganisational activities in mandated collaboratives include the gradual formulation of shared vision and clear client-centred goals, building trust and acquaintanceship for the advancement of an open collaborative culture, establishing a non-extreme formalised governance structure through leadership, mutual trust and innovation support and facilitating information exchange and formalisation tools for optimal elderly care. CONCLUSION: Trust and leadership form the backbone of interorganisational functioning. Interorganisational functioning should be seen in light of their national embedment and resources that are (being made) available, which makes them susceptible to constant change as they struggle with balancing between critical features in a fluid and intermingled governance context. The identified critical features of (contemporary) mandated collaboratives may aid in assessing and improving interprofessional functioning within integrated elderly care. International debate on governance expectations of mandated collaboratives may further contribute to sharpening the roles of both managers and healthcare professionals.

The effect of organizational belonging and profession on clinicians' attitudes toward supporting vaginal birth and interprofessional teamwork-a cross-sectional study.

INTRODUCTION: The aim of this study was to investigate the effect of organizational belonging and profession on clinicians' attitudes toward supporting vaginal birth and interprofessional teamwork in Swedish maternity care. MATERIAL AND METHODS: The study used a cross-sectional design, with a web-based survey sent to midwives, physicians and nurse assistants at five labor wards in Sweden. The survey consisted of two validated scales: the Swedish version of the Labor Culture Survey (S-LCS), measuring attitudes toward supporting vaginal birth, and the Assessment of Collaborative Environments (ACE-15), measuring attitudes toward interprofessional teamwork. Two-way ANOVA was conducted to assess the main effect of and interaction effect between organizational belonging and profession for the different subscales of the S-LCS and the ACE-15, together with Tukey's honest significant difference post-hoc analysis and partial eta squared to determine effect size. The relation between the subscales was assessed using the Pearson's correlation analysis. RESULTS: A total of 539 midwives, physicians and nurse assistants completed the survey. Organizational belonging significantly influenced attitudes toward supporting vaginal birth and interprofessional teamwork, with the largest effect for Positive team culture (F = 38.88, effect size = 0.25, p < 0.001). The effect of profession was strongest for the subscale Best practices (F = 59.43, effect size = 0.20, p < 0.001), with midwives being more supportive of strategies proposed to support vaginal birth than physicians and nurse assistants. A significant interaction effect was found for four of the subscales of the S-LCS, with the strongest effect for items reflecting the Unpredictability of vaginal birth (F = 4.49, effect size = 0.07, p < 0.001). Labor ward culture (unit microculture) specifically related to supporting vaginal birth was strongly correlated to interprofessional teamwork (r = 0.598, p < 0.001). CONCLUSIONS: In the current study, both organizational belonging and profession influenced attitudes toward supporting vaginal birth and interprofessional teamwork. Positive team culture was positively correlated to an organizational culture supportive of vaginal birth. Interventions to support vaginal births should include efforts to strengthen teamwork between professions, as well as considering women's values, preferences and informed choices.

Interprofessional collaboration in a community virtual ward: A focus group study.

BACKGROUND: The problem of a lack of nurses is expected to worsen in the future. With an ever-increasing number of elderly patients with multimorbidity and a shortage of healthcare professionals, primary care must innovatively organise their services to offer more sustainable healthcare services. Organising healthcare services in a community virtual ward has been found to improve the quality of life for vulnerable elderly populations. AIM: The aim of the study was to explore healthcare professionals' experiences of interprofessional collaboration in care for patients with multimorbidity in a community virtual ward in the Norwegian context. METHODS: Focus group interviews were conducted in this qualitative exploratory study. A purposive sample of 17 healthcare professionals working in a community virtual ward in Norway was interviewed. Data were analysed using thematic analysis. RESULTS: The study results show that healthcare professionals recognise a need for patient involvement in the community virtual ward to offer more sustainable healthcare services at home. Furthermore, the results show how healthcare professionals experience the use of assessment tools and whiteboard meetings as useful tools for facilitating interprofessional collaboration. The study results also describe how interprofessional and holistic follow-up with patients with multimorbidity contributes to increased focus on health promotion in the community virtual ward. CONCLUSION: We found that interprofessional collaboration in community virtual wards may be a sustainable way of organising healthcare services for patients with multimorbidity living at home. Interprofessional collaboration with a patient-centred and health promotion approach, seems to increase the quality of the follow-up for patients with multimorbidity living at home. Additionally, mutual interprofessional trust and respect seems to be essential for making use of the unique expertise of different professions in the follow-up for patients with multimorbidity. In the future, both the patient's voice and opinion of their next of kin should be considered in the development of more sustainable homecare services.

'Not the last resort': The impact of an interprofessional training care home initiative on students, staff, and residents.

This paper reports on an innovative interprofessional education (IPE) initiative conducted in three care homes across Greater Manchester in the United Kingdom (UK). Students from a variety of professions including nursing, physiotherapy, social work, podiatry, counseling, and sports rehabilitation worked collaboratively in the homes to address the residents' individual goals. We found that care homes provided students with many opportunities for interprofessional working and learning. Through better understanding the dimensions of different perspectives and approaches, students improved their education and transformed their perceptions of aged care. Having a diverse range of professionals allowed staff to gain insight into the latest evidence-based practice and address the multiple needs of the residents more holistically. Residents gained an enriched sense of meaning and purpose in their daily life by engaging in fulfilling and meaningful activities. The complexities of undertaking an IPE initiative in this setting are also considered and we conclude by proposing important avenues for future research.

A student-led Geriatric Assessment Clinic: Interprofessional education with an older adult population.

Healthcare students have expressed a need for more education on the aging adult population. Interprofessional education (IPE) is a well-known educational model intended to increase students' knowledge, skill, and abilities to use evidence-based practice for improved patient outcomes. At a Midwestern, urban-based university, we have implemented an interprofessional, student-led Geriatric Assessment Clinic in order to allow students in six health professions (including medicine, nutrition, occupational therapy, physical therapy, social work, and speech language pathology) to practically apply their skills in the aging adult population while learning to work with other healthcare professionals. This holistic clinic is free of cost to the aging adults who participate in it. The following article discusses the purpose, implementation, benefits, and limitations of such a clinic as it relates to both the patients who attend and the students who participate.