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1.
N Z Med J ; 132(1505): 14-28, 2019 Nov 08.
Artículo en Inglés | MEDLINE | ID: mdl-31697660

RESUMEN

AIMS: New Zealanders dying in public hospitals or hospices are increasingly being discharged and admitted-to-die in aged residential care (ARC) facilities as hospitals and hospices struggle to meet demand. This study sought to investigate how care is delivered to patients admitted-to-die in an ARC facility. METHODS: A mixed-methods case study including a clinical notes review of seven patients who died in one ARC facility within three months of admission and a focus group with ARC facility staff and visiting professionals from other organisations. RESULTS: The clinical notes review showed a high burden of palliative care symptoms that constituted specialist palliative care, provided by ARC staff plus professionals from other organisations. Focus group data showed those involved were willing, but expressed significant concern about lack of structure and funding. CONCLUSIONS: As our increasing and aging population reaches end-of-life, New Zealand hospitals/hospices will not be able to provide ongoing specialist palliative care and admission-to-die in ARC facilities may be a viable alternative. However, ARC facilities are not set up or staffed to provide specialist palliative care of those admitted-to-die. A specific model of care that is funded appropriately is required.

2.
J Interprof Care ; : 1-8, 2019 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-31750747

RESUMEN

Interprofessional education (IPE) programs for pre-registration health science students are largely offered within one institution including different schools or faculties. Sometimes in small or regional institutions where there are limited student numbers or few professional training programs, or where larger institutions do not offer particular professional programs, it may be necessary to partner with other institutions to offer IPE. This study sought to explore teacher perspectives of forming inter-institutional partnerships to deliver IPE, in particular, to identify the elements that influence the formation of partnerships. An interpretive descriptive approach was used to thematically analyze data from three focus groups with teachers (n = 21) working in three different partnerships to deliver IPE to students in Wellington, New Zealand. Two main themes were identified which enabled the development of a model of partnership, with a continuum of complexity depending on whether institutions were on the same page and whether the partnership formed to join an existing IPE program or to create a new IPE program. Forming inter-institution partnerships is a pragmatic solution to providing IPE with benefits to all taking part. Our work showed that time, effort, working with complexity, and ability to stay on the same page are necessary elements for building successful partnerships and all need to be taken into account when planning inter-institution partnerships.

3.
Trials ; 20(1): 464, 2019 Jul 29.
Artículo en Inglés | MEDLINE | ID: mdl-31358022

RESUMEN

BACKGROUND: The rates of pre-diabetes and type 2 diabetes mellitus are increasing worldwide, producing significant burdens for individuals, families, and healthcare systems. In New Zealand, type 2 diabetes mellitus and pre-diabetes disproportionally affect Maori, Pacific, and South Asian peoples. This research evaluates the efficacy, acceptability, and economic impact of a probiotic capsule and a prebiotic cereal intervention in adults with pre-diabetes on metabolic and mental health and well-being outcomes. METHODS: Eligible adults (n = 152) aged 18-80 years with pre-diabetes (glycated haemoglobin 41-49 mmol/mol) will be enrolled in a 2 × 2 factorial design, randomised, parallel-group, placebo-controlled trial. Computer-generated block randomization will be performed independently. Interventions are capsulated Lactobacillus rhamnosus HN001 (6 × 109 colony-forming units/day) (A) and cereal containing 4 g ß-glucan (B), placebo capsules (O1), and calorie-matched control cereal (O2). Eligible participants will receive 6 months intervention in the following groups: AB, AO1, BO2, and O1O2. The primary outcome is glycated haemoglobin after 6 months. Follow-up at 9 months will assess the durability of response. Secondary outcomes are glycated haemoglobin after 3 and 9 months, fasting glucose, insulin resistance, blood pressure, body weight, body mass index, and blood lipid levels. General well-being and quality of life will be measured by the Short-Form Health Survey 36 and Depression Anxiety Stress Scale 21 at 6 and 9 months. Outcome assessors will be blind to capsule allocation. An accompanying qualitative study will include 24 face-to-face semistructured interviews with an ethnically balanced sample from the ß-glucan arms at 2 months, participant focus groups at 6 months, and three health professional focus groups. These will explore how interventions are adopted, their acceptability, and elicit factors that may support the uptake of interventions. A simulation model of the pre-diabetic New Zealand population will be used to estimate the likely impact in quality-adjusted life years and health system costs of the interventions if rolled out in New Zealand. DISCUSSION: This study will examine the efficacy of interventions in a population with pre-diabetes. Qualitative components provide rich description of views on the interventions. When combined with the economic analysis, the study will provide insights into how to translate the interventions into practice. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12617000990325. Prospectively registered on 10 July 2017.

4.
J Child Health Care ; : 1367493519847030, 2019 May 19.
Artículo en Inglés | MEDLINE | ID: mdl-31104474

RESUMEN

Young people in New Zealand have high morbidity but low service utilization rates. Dedicated youth services 'Youth One Stop Shops' provide 'wraparound' health and social care. However, little is understood about how staff within these services interact with each other or with external agencies to provide this specialist care. This article reports on volume and type of internal and inter-agency health and social service staff-staff interactions, to better understand elements of potential collaboration in day-to-day practice. An observational, case-study approach was utilized. Four dedicated youth services recorded data over three-month periods about a selected number of high-use clients. Youth service staff recorded all interactions with colleagues within their organization and staff from external services. A large volume of non-patient contact work was revealed, with a high proportion of 'complex/involved' interactions recorded. The range and diversity of external agencies with which youth service staff interacted with to meet the needs of young people was extensive and complex. The focus on 'information sharing' and 'complex/involved' interactions demonstrates a well-coordinated, wraparound service delivery model. Current funding formulae take inadequate account of the volume of non-patient contact work that youth services provide for high-needs young people.

5.
Health Soc Care Community ; 27(4): 1019-1030, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-30806000

RESUMEN

Worldwide, a growing burden of health and social issues now affect young people. Interagency collaboration and the "integration" of health and social care services are advocated to address the increasingly complex needs of at-risk youth and to reduce barriers to accessing care. In New Zealand, Youth-One-Stop-Shops (YOSSs) provide integrated health and social care to young people with complex needs. Little is known about how YOSSs facilitate collaborative care. This study explored the collaboration between YOSSs and external agencies between 2015 and 2017 using a multiple case study method. This paper reports qualitative focus group and individual interview data from two of four case sites including six YOSS staff and 14 external agency staff. Results showed participants regarded collaboration as critical to the successful care of high needs young people and were positive about working together. They believed YOSSs provided effective wraparound collaborative care and actively facilitated communication between diverse agencies on behalf of young people. The main challenges participants faced when working together related to the different "world views" and cultures of agencies which can run contrary to collaborative practice. Despite this, some highly collaborative relationships were apparent and staff in the different agencies perceived YOSSs had a lead role in co-ordinating collaborative care and were genuinely valued and trusted. However without the YOSS involvement, collaboration between agencies in relation to young people was less frequent and rarely went beyond limited information exchange. Establishing and maintaining trusting interpersonal relationships with individual staff was key to successfully negotiating agency differences. The study confirms that collaboration when caring for young people with high needs is complex and challenging, yet agencies from diverse sectors value collaboration and see the YOSS integrated wraparound approach as an important model of care.

6.
Clin Teach ; 16(5): 519-524, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30560577

RESUMEN

BACKGROUND: Cancer care is typically delivered by a range of health professionals, and is frequently a uniprofessional pre-registration clinical placement. A workplace-based, 6-hour interprofessional education (IPE) pilot on cancer care, led by clinical tutors, was undertaken in a New Zealand hospital, accompanied by an external evaluation. The pilot involved a cohort of 21 dietetic, medicine, pharmacy, physiotherapy and radiation therapy students. The aim of the evaluation was to determine student and tutor reactions to IPE, and any changes in perceptions and attitudes. METHODS: The evaluation used focus groups to collect data: two student groups and one tutor group. Focus groups were audio-recorded, transcribed; the content was coded and then analysed. RESULTS: Both students and tutors reported benefits from having IPE in the workplace environment, with cancer care seen as a suitable topic. Students reported a better understanding of professional roles, skills and the provision of collaborative care, and suggested other professions should be included in future IPE. Patient selection needed to be better tailored for physiotherapy students to ensure uniform relevance. As a result of competing demands, tutors found that they needed an 18-month lead time to establish the IPE programme. Tutors felt that the programme had gone relatively smoothly and that they had benefitted from forming closer interpersonal relationships, but noted considerable unanticipated and unremunerated preparation time. DISCUSSION: This short workplace-based IPE programme elicited a positive student and tutor response, but highlighted the need for improvements: broadening the topic area, targeted patient selection, including more professions and providing administrative support for tutors. Cancer care was generally seen as a suitable topic.

7.
Artículo en Inglés | MEDLINE | ID: mdl-30175532

RESUMEN

Social networks are informal relationships often with social ties and voluntary or mandatory obligations that can positively support a patient with multimorbidity. This exploratory study sought insights into the social networks of New Zealand people with multimorbidity and also the work of those nominated as providing significant support. Ten participants were recruited from general practice as part of an education programme in which health professional students discussed living with multimorbidity and completed a social network template together with patients. Each patient nominated an individual from their social network whom they considered provided significant support. A researcher interviewed each supporter about their experience of providing support, and their view of the patient's social network. Significant supporters included three classified as 'lay' supporters (sister, wife and daughter) and seven classified as 'professional' supporters (exercise physiologist, general practitioners, nurse, medical specialists). The activities described by supporters was classified according to Vassilev et al.'s expansion of Corbin and Strauss's 1985 classification of work in chronic illness, including the categories of "illness," "everyday" and "emotional" work. Irrespective of whether supporters were lay or professional, they gave examples of each category. While this is expected of lay supporters, it is not expected of professional supporters who are typically viewed as undertaking illness work. Lay supporters described a complex array of activities sometimes impacting on their own personal well-being, making them more akin to meeting the formal definition of being a carer, while professional supports gave objective yet professionally invested descriptions. The work of lay and professional supporters is complementary in the provision of support for those with multimorbidity. Consideration should be given to the role of lay supporters and to their own needs if they are to be able to sustain their support work with patients.

8.
BMJ Open ; 8(1): e018510, 2018 01 21.
Artículo en Inglés | MEDLINE | ID: mdl-29358432

RESUMEN

INTRODUCTION: Interprofessional practice is recognised as an important element of safe and effective healthcare. However, few studies exist that evaluate how preregistration education contributes to interprofessional competencies, and how these competencies develop throughout the early years of a health professional's career. This quasiexperimental study will gather longitudinal data during students' last year of preregistration training and their first 3 years of professional practice to evaluate the ongoing development of interprofessional competencies and the influence that preregistration education including an explicit interprofessional education (IPE) programme may have on these. METHODS AND ANALYSIS: Participants are students and graduates from the disciplines of dentistry, dietetics, medicine, nursing, occupational therapy, oral health, pharmacy and physiotherapy recruited before their final year of study. A subset of these students attended a 5-week IPE immersion programme during their final year of training. All data will be collected via five written or electronic surveys completed at 12-month intervals. Each survey will contain the Attitudes Towards Health Care Teams Scale and the Team Skills Scale, as well as quantitative and free-text items to explore vocational satisfaction, career trajectories and influences on these. Students who attend the IPE programme will complete additional free-text items to explore the effects of this programme on their careers. Quantitative analysis will compare scores at each time point, adjusted for baseline scores, for graduates who did and did not participate in the IPE programme. Associations between satisfaction data and discipline, professional setting, location and IPE participation will also be examined. Template analysis will explore free-text themes related to influences on career choices including participation in preregistration IPE. ETHICS AND DISSEMINATION: This study has received approval from the University of Otago Ethics Committee (D13/019). Results will be disseminated through peer-reviewed publications, conferences and stakeholder reports. Findings will inform future IPE developments and health workforce planning.


Asunto(s)
Selección de Profesión , Personal de Salud/educación , Relaciones Interprofesionales , Grupo de Atención al Paciente , Práctica Profesional , Actitud del Personal de Salud , Humanos , Estudios Longitudinales , Nueva Zelanda , Proyectos de Investigación , Encuestas y Cuestionarios
9.
J Prim Health Care ; 10(3): 258-266, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-31039940

RESUMEN

INTRODUCTION For patients with multimorbidity to live well, they need the support of not only health professionals but family, friends and organisations. These social networks provide support, potentially enabling the formation of a Community of Clinical Practice approach to multimorbidity care. AIM This study aimed to explore general practice knowledge of the social networks of patients with multimorbidity. METHODS Social network maps were completed by both patients and general practice. The social network maps of 22 patients with multimorbidity were compared with corresponding social network maps completed by general practice staff. RESULTS In 60% (13/22) of the patients, general practice staff held a high or moderate knowledge of individual patients' social networks. Information on social networks was recalled from staff memory and not systematically recorded in patients' electronic health records. DISCUSSION Social network information is not routinely collected, recorded or used by general practice to understand the support available to patients with multimorbidity. General practice could take an active role in coordinating social network supporters for certain patient groups with complex multimorbidity. For these groups, there is value in systematically recording and regularly updating their social network information for general practice to use as part of a coordinated Community of Clinical Practice.

10.
J Comorb ; 7(1): 64-78, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29090190

RESUMEN

BACKGROUND: The increase in multimorbidity or co-occurring chronic illnesses is a leading healthcare concern. Patients with multimorbidity require ongoing care from many different professionals and agencies, and often report a lack of integrated care. OBJECTIVE: To explore the daily help-seeking behaviours of patients with multimorbidity, including which health professionals they seek help from, how professionals work together, and perceptions and characteristics of effective interprofessional, interagency multimorbidity care. DESIGN: Using a case study observational research design, multiple data sources were assembled for four patients with multimorbidity, identified by two general practitioners in New Zealand. In this paper, two case studies are presented, including the recorded instances of contact and communication between patients and professionals, and between professionals. Professional interactions were categorized as consultation, coordination, or collaboration. RESULTS: The two case studies illustrated two female patients with likely similar educational levels, but with different profiles of multimorbidity, social circumstances, and personal capabilities, involving various professionals and agencies. Engagement between professionals showed varying levels of interaction and a lack of clarity about leadership or care coordination. The majority of interactions were one-to-one consultations and rarely involved coordination and collaboration. Patients were rarely included in communications between professionals. CONCLUSION: Cases constructed from multiple data sources illustrate the complexity of day-to-day, interprofessional, interagency multimorbidity care. While consultation is the most frequent mode of professional interaction, targeted coordinated and collaborative interactions (including the patient) are highly effective activities. Greater attention should be given to developing and facilitating these interactions and determining who should lead them.

11.
Scand J Caring Sci ; 31(4): 850-858, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28124508

RESUMEN

BACKGROUND: With more care taking place in the home, family carers play an important role in supporting patients. Some family carers undertake technical health procedures generally managed by health professionals in hospital settings (e.g. managing a tracheostomy or enteral feeding). AIM: To explore how family carers learn to manage technical health procedures in order to help health professionals better understand and support this process. DESIGN AND METHODS: A grounded theory study using data from interviews with 26 New Zealand family carers who managed technical health procedures including nasogastric or gastrostomy feeding, stoma care, urinary catheterisation, tracheostomy management, intravenous therapy, diabetes management and complex wound dressings. Most (20 participants) were caring for their child and the remaining six for their spouse, parent or grandparent. Following grounded theory methods, each interview was coded soon after completion. Additional data were compared with existing material, and as analysis proceeded, initial codes were grouped into higher order concepts until a core concept was developed. Interviewing continued until no new ideas emerged and concepts were well defined. FINDINGS: The core concept of 'wayfinding' indicates that the learning process for family carers is active, individualised and multi-influenced, developing over time as a response to lived experience. Health professional support was concentrated on the initial phase of carers' training, reducing and becoming more reactive as carers took responsibility for day-to-day management. CONCLUSION: Wayfinding involves self-navigation by carers, in contrast to patient navigator models which provide continuing professional assistance to patients receiving cancer or chronic care services. Wayfinding by carers raises questions about how carers should be best supported in their initial and ongoing learning as the management of these procedures changes over time.


Asunto(s)
Cuidadores/educación , Familia/psicología , Teoría Fundamentada , Servicios de Atención de Salud a Domicilio , Adulto , Cuidadores/psicología , Niño , Femenino , Humanos , Aprendizaje , Masculino , Nueva Zelanda , Padres
12.
J Prim Health Care ; 9(1): 29-33, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29530185

RESUMEN

INTRODUCTION Interprofessional education (IPE) aims to prepare learners to work in collaborative health-care teams. The University of Otago, Wellington has piloted, developed and expanded an IPE programme since 2011. An interprofessional teaching team has developed alongside this programme. AIMS This study aimed to understand the development of a university-based interprofessional teaching team over a 4-year period and generate insights to aid the development of such teams elsewhere. METHODS Two semi-structured audio-recorded educator focus groups were conducted at key times in the development of the IPE programme in 2011 and 2014. The programme focused on long-term condition management and involved students from dietetics, medicine, physiotherapy and radiation therapy. Focus group transcripts were independently analysed by two researchers using Thematic Analysis to identify broad themes. Initial themes were compared, discussed and combined to form a thematic framework. The thematic framework was verified by the education team and subsequently updated and reorganised. RESULTS Three key themes emerged: (i) development as an interprofessional educator; (ii) developing a team; and (iii) risk and reward. Teaching in an interprofessional environment was initially daunting but confidence increased with experience. Team teaching highlighted educators' disciplinary roles and skill sets and exposed educators to different teaching approaches. Educators perceived they modelled team development processes to students through their own development as a team. Interprofessional teaching was challenging to organise but participation was rewarding. Programme expansion increased the risks and complexity, but also acted as a stimulus for development and energised the teaching team. DISCUSSION Interprofessional teaching is initially challenging but ultimately enriching. Interprofessional teaching skills take time to develop and perspectives of role change over time. Educator team development is aided by commitment, understanding, enthusiasm, leadership and trust.

13.
J Prim Health Care ; 9(1): 47-55, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29530187

RESUMEN

INTRODUCTION Standing orders are used by many general practices in New Zealand. They allow a practice nurse to assess patients and administer and/or supply medicines without needing intervention from a general practitioner. AIM To explore organisational strategic stakeholders' views of standing order use in general practice nationally. METHODS Eight semi-structured, qualitative, face-to-face interviews were conducted with participants representing key primary care stakeholder organisations from nursing, medicine and pharmacy. Data were analysed using a qualitative inductive thematic approach. RESULTS Three key themes emerged: a lack of understanding around standing order use in general practice, legal and professional concerns, and the impact on workforce and clinical practice. Standing orders were perceived to extend nursing practice and seen as a useful tool in enabling patients to access medicines in a safe and timely manner. DISCUSSION The variability in understanding of the definition and use of standing orders appears to relate to a lack of leadership in this area. Leadership should facilitate the required development of standardised resources and quality assurance measures to aid implementation. If these aspects are addressed, then standing orders will continue to be a useful tool in general practice and enable patients to have access to health care and, if necessary, to medicines without seeing a general practitioner.

14.
J Prim Health Care ; 9(2): 153-161, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29530227

RESUMEN

INTRODUCTION Multimorbidity impacts on patients' health and wellbeing, but relationships experienced within social networks can support people to live well. AIM This study sought to elicit the views of New Zealanders with multimorbidity about their social networks and the views of their nominated supporters. METHODS Ten patients with multimorbidity and their nominated supporters each independently recorded their views of the patient's social network on a five-concentric-circle template, indicating supporting role and importance to each patient. Sets of patients' and nominated supporters' templates were compared followed by comparing matched pairs of patient-supporter templates. Nominated supporters' views about the patients' networks and why they were nominated were collated. RESULTS Three patients nominated family members as supporters and seven nominated health professionals. Nominated family members identified a greater range of supporters than nominated health professionals. Nominated family members perceived that they played an integral role, whereas health professionals were less comfortable viewing relationships with patients in this way. Family members were not surprised to be nominated as supporters, and some described a considerable burden of care. Health professionals described themselves as coordinators of support and having positive relationships with patients. DISCUSSION Patients with multimorbidity have rich and diverse social networks. They view partners, family and health professionals as providing significant support. Family members are more aware of their role and have a deeper understanding of other network members than health professionals. Further research is needed on the use of social networks in clinical practice to support the health and wellbeing of those with multimorbidity.

15.
Qual Health Res ; 27(7): 1060-1068, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-27217290

RESUMEN

Case study research is a comprehensive method that incorporates multiple sources of data to provide detailed accounts of complex research phenomena in real-life contexts. However, current models of case study research do not particularly distinguish the unique contribution observation data can make. Observation methods have the potential to reach beyond other methods that rely largely or solely on self-report. This article describes the distinctive characteristics of case study observational research, a modified form of Yin's 2014 model of case study research the authors used in a study exploring interprofessional collaboration in primary care. In this approach, observation data are positioned as the central component of the research design. Case study observational research offers a promising approach for researchers in a wide range of health care settings seeking more complete understandings of complex topics, where contextual influences are of primary concern. Future research is needed to refine and evaluate the approach.


Asunto(s)
Estudios Observacionales como Asunto/métodos , Proyectos de Investigación , Humanos , Estudios Observacionales como Asunto/normas , Atención Primaria de Salud/organización & administración , Autoinforme/normas
16.
J Interprof Care ; 30(6): 787-794, 2016 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-27797634

RESUMEN

Interprofessional collaboration (IPC) is known to improve and enhance care for people with complex healthcare and social care needs and is ideally anchored in primary care. Such care is complex, challenging, and often poorly undertaken. In countries such as Canada, the United Kingdom, the Netherlands, Australia, and New Zealand, primary care is provided predominantly via general practices, where groups of general practitioners and nurses typically work. Using a case study design, direct observations were made of interprofessional activity in three diverse general practices in New Zealand to determine how collaboration is achieved and maintained. Non-participant observation of health professional interaction was undertaken and recorded using field notes and video recordings. Observational data were subject to analysis prior to collection of interview data, subsequently gathered independently at each site. Case-specific themes were developed before determining cross-case themes. Cross-case themes revealed five key elements to IPC: the built environment, practice demographics and location, practice business models, shared goals, and team structure and climate. The combination of elements at each practice site indicated that strengths in one area helped offset challenges in others. The three practices (cases) collectively demonstrated the importance of an "all of practice" commitment to collaborative practice so that shared decision-making can occur.


Asunto(s)
Conducta Cooperativa , Relaciones Interprofesionales , Atención Primaria de Salud , Australia , Canadá , Humanos , Países Bajos , Nueva Zelanda , Grupo de Atención al Paciente , Reino Unido
17.
N Z Med J ; 129(1440): 55-63, 2016 Aug 19.
Artículo en Inglés | MEDLINE | ID: mdl-27538039

RESUMEN

AIM: As cancer treatments become more effective, increasing numbers of cancer patients seek long-term support from general practice. This study aimed to canvass the perspective of GPs on issues around continuity of care for these patients. METHODS: In this qualitative study purposive sampling was used to invite a range of New Zealand GPs from urban and rural communities in the Greater Wellington and Otago/Southland areas to participate. A total of 34 GPs took part in three semi-structured individual interviews and six focus groups. RESULTS: Six main themes emerged; the participating GPs noted they wanted more involvement in their patients' cancer journeys but were not always clear of their place in relation to cancer specialists and other health care providers. They saw cancer as a chronic condition to be managed long term. They mentioned the breast cancer and palliative care models as examples to be followed. Poor communication and barriers for patients in accessing GP care were seen as areas for improvement. CONCLUSION: Participating GPs felt that the current cancer care pathway could be improved with a better understanding of their own role and through improved communication with patients, cancer specialists and other health professionals.


Asunto(s)
Comunicación , Continuidad de la Atención al Paciente/normas , Accesibilidad a los Servicios de Salud/normas , Neoplasias/terapia , Relaciones Médico-Paciente , Adulto , Anciano , Actitud del Personal de Salud , Enfermedad Crónica , Femenino , Grupos Focales , Médicos Generales , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Nueva Zelanda , Investigación Cualitativa
18.
J Dent Educ ; 80(6): 677-85, 2016 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-27251349

RESUMEN

The aim of this study was to explore how dental students involved in an experiential interprofessional education (IPE) program in New Zealand made sense of engaging in this unfamiliar learning environment. Qualitative data gathered from students during group interviews were analyzed to better understand how they assessed the IPE experience. Interviews were audiorecorded and transcribed before analysis of students' comments was undertaken, using constant comparison analysis and taking an inductive approach to the initial coding. Once each of the investigators had gone through his or her own transcripts, they reviewed each other's coding and agreed-upon categories before applying the 3-P model of student learning. Over a three-year period (2012-14), 16 focus groups were conducted with students from multiple health professions. In total, 24 dental students participated. Six categories of comments made in the focus groups were identified: expectations and realizations; not practicing; trade-offs/losses; learning with, from, and about each other; becoming open to a different clinical experience; valuing dental students' participation in IPE; and learning about what dentists do. From these categories, three main themes emerged: becoming a dentist, negotiating IPE experience, and valuing dentistry. The 3-P model highlighted the complexity of IPE, and the challenges suggested that dental students may need extra preparation prior to participating in IPE programs.


Asunto(s)
Actitud del Personal de Salud , Curriculum , Relaciones Interprofesionales , Estudiantes de Odontología/psicología , Grupos Focales , Humanos , Nueva Zelanda
19.
J Interprof Care ; 30(3): 355-61, 2016 May.
Artículo en Inglés | MEDLINE | ID: mdl-27152540

RESUMEN

It is important to understand what an interprofessional education (IPE) experience means to students and what makes it meaningful so that optimal use can be made of IPE opportunities and resources. This article reports qualitative data from a larger study evaluating an 11-hour IPE programme which focused on long-term condition management. Qualitative analysis aimed to explore students' perspectives of the programme. Forty-one students from dietetics, medicine, physiotherapy, and radiation therapy were invited to participate in interprofessional focus groups. Data gathered from 34 students who participated in two focus groups were analysed inductively using thematic analysis. Three key themes emerged related to (i) learning, (ii) perceived long-term professional benefits, and (iii) the structure and content of the programme. Participants considered the programme to be a valuable learning opportunity with direct relevance to their future clinical careers. Findings indicated that providing students with an opportunity to learn about each other should be prioritised within IPE programmes and that this process should be student-led. This may help students to effectively learn with and from each other. Students perceived active learning activities, including interviewing a patient in their home and presenting findings to their peers, to be particularly valuable.


Asunto(s)
Actitud del Personal de Salud , Conducta Cooperativa , Personal de Salud/educación , Relaciones Interprofesionales , Estudiantes del Área de la Salud/psicología , Adulto , Femenino , Grupos Focales , Humanos , Aprendizaje , Masculino , Nueva Zelanda , Grupo de Atención al Paciente/organización & administración , Adulto Joven
20.
BMC Med Educ ; 16: 154, 2016 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-27233631

RESUMEN

BACKGROUND: The transition from student to health practitioner at entry-to-practice is complex, requiring critical acquisition of collaborative practice skills. In rural communities where health need is multidimensional, there is potential for multiple intentional collaborative learning objectives to be met concurrently. A five-week, rurally-located, clinically-based interprofessional programme was introduced as a transition-to-practice rotation for final-year, pre-registration health professional students in the professions of dentistry, dietetics, medicine, nursing, pharmacy and physiotherapy. The programme integrated learning objectives in four related domains: interprofessional practice; hauora Maori (Maori health); rural health; long-term condition management. This study investigated student learning experiences over the first two complete years of the programme, comparing responses from participating students with those from a cohort of non-participating peers. METHODS: Using a pre and post quasi-experimental design, respondents from two successive student year cohorts completed questionnaires at the start and end of their final year. Additional survey data were collected from participating students at the end of each rotation. RESULTS: 131 students participated in the programme during 2013-2014. Participating student respondents (55/131;42 %) reported being significantly better prepared than a cohort of 56 non-participating colleagues in many aspects of their understanding of and knowledge about each of four key learning domains. 94 % (123/131) of programme participants completed end-of-rotation questionnaires. Positive from the outset (mean 5-point Likert scale scores between 3 and 5; 5 = most positive), student satisfaction further increased across all domains in the second year (mean 5-point Likert scale scores between 4 and 5). CONCLUSIONS: At entry-to-practice level, multiple learning objectives, including indigenous health learning, can be met simultaneously in the clinical context within an integrated, rotational programme. Rural settings are highly suitable for delivering such programmes if well supported.


Asunto(s)
Empleos en Salud/educación , Relaciones Interprofesionales , Servicios de Salud Rural/normas , Estudiantes del Área de la Salud , Actitud del Personal de Salud , Estudios de Cohortes , Conducta Cooperativa , Personal de Salud , Humanos , Nueva Zelanda , Grupo de Atención al Paciente , Rol del Médico , Aprendizaje Basado en Problemas , Investigación Cualitativa , Encuestas y Cuestionarios
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