Learning together to work together: interprofessional education for students in a primary care setting in chile.

BACKGROUND AND OBJECTIVES: Interprofessional teamwork and collaboration are considered key elements for improving patient outcomes; however, few reports of interprofessional education experiences in primary care directed to students are found in the literature. We describe an educational program in primary care for medical, nursing, and psychology students and report the findings of their perceptions of learning. METHODS: To develop team-working skills and learn family-oriented collaborative care in primary care, the authors designed an interprofessional educational course in Santiago, Chile. Medical, nursing, and psychology students, in their last year of training, formed four groups and conducted weekly home visits or behavioral health counseling sessions. A family physician, nurse practitioner, social worker, and psychologist supervised each clinical activity in their area of expertise. After the clinical encounters, students and preceptors discussed comprehensive health plans and reflected on the interprofessional experience of care. At the end of the course the students evaluated the course and the methodology using quantitative and qualitative methods. RESULTS: A total of 72 students participated in the course (58 medical, eight nursing, six psychology students) from October 2009 to December 2010. The students ranked high global satisfaction, high achievement of course objectives, and high approval of the methodology used with quantitative and qualitative measurements. CONCLUSIONS: This interprofessional course for medical, nursing, and psychology students generated positive experiences for the participants. More research is needed to support interprofessional education programs in primary care.

Bridging Prevention and Health: Exploring Community Perceptions of Intimate Partner Violence in Rural Honduras.

This qualitative study rooted in community-based participatory research principles utilized semi-structured interviews with 2 focus groups (n=9) with female healthcare volunteers (FCVs) and 3 male key informants who were community leaders (MCLs). The study aimed to examine how a rural Honduran community defines and responds to intimate partner violence (IPV) in order to lay the foundation for future interventions. Based on grounded theory, the authors assessed for common themes across transcripts. Authors found that a number of participants denied the existence of IPV. Perspectives on the causes and definitions of IPV varied between FCVs and MCLs. All participants affirmed the need for intervention and many participants mentioned healthcare and legal systems as potential venues to ameliorate IPV. The results highlight potentially important differences between FCV and MCL perspectives that may inform future interventions. Findings suggest health-care workers can play a role in IPV prevention and intervention in rural Honduras.

Barriers and enablers to becoming abortion providers: the reproductive health program.

BACKGROUND AND OBJECTIVES: Despite abortion being one of the most common procedures undergone by women of reproductive age in the United States, the number of abortion providers has been declining for the last 20 years. We sought to assess the long-term impact of the Reproductive Health Program (RHP), a national elective abortion training program for primary care abortion providers that operated from 1999-2005. METHODS: We conducted a mixed-methods cross-sectional study of 220 former RHP trainees. Participants were interviewed over the phone and asked a series of questions about their training at RHP, their current practice, abortion provision since RHP, and enablers and barriers to abortion provision. RESULTS: More than half of respondents (58.8%) have provided any abortions since RHP; more have provided medical abortions (56.5%) than surgical abortions (47.1%). Of respondents who have provided abortions, most have performed more than 50 surgical (87.5%) or medical (77.1%) abortions since RHP and had provided an abortion in the last 3 months (67.5%, 70.8%). More than 90% of abortion providers reported having liability insurance that covers abortion, colleague support, ease of obtaining medications and/or equipment, reimbursement, and administrative and/or staff support at the site where they provide abortions. Relative to providers, the greatest barriers reported by non-providers were lack of skills, concerns about liability, and difficulty obtaining supplies. CONCLUSIONS: Our findings suggest that the RHP model of elective training can yield a substantial percentage of abortion providers. We also describe enablers and barriers to provision once trainees are in practice, highlighting the importance of continued support after training is completed.