Our approach to developing communities of practice to foster research capacities for the adult social care workforce.

Background: Efforts to build and foster adult social care research in England have historically encountered more challenges to its growth and expansion compared with health research, with a sector facing significant barriers in facilitating research activity due to a lack of resourcing, poor valuation or understanding of the profile of social care research. The landscape for supporting research in adult social care has been rather bleak, but in recent years there has been recognition of the need to foster a research community. The National Institute for Health and Care Research in England have committed to investing in social care research capacity by funding six adult social care partnerships, with one based in Southeast England. Process developing Communities of Practice COPs: Three large online networking events were held in the first year of the project to engage managers and practitioners from the local authority and from the wider adult social care sector. These took place in July and November 2021, with a last event in March 2022. Two COPs were identified, following an ordering and thematising process of feedback from the networking events, of: (a) Supporting people with complex needs throughout the lifespan, and (b) Enhancing, diversifying and sustaining the social care workforce. Whilst it would be premature to identify their long-term impacts, through the facilitation of 20 COP meetings held so far, alongside the engagement platforms and enrichment resources, these have provided a space for regular communication in the sector, knowledge sharing and networking between COP members. Conclusions: The COP framework offers a collaborative approach to initiating research from the grass-roots level in adult social care. This paper focuses on how the COP model offers great promise for knowledge-exchange providing a forum to generate and disseminate knowledge around social care in our two COP domains.

Social care research looks into how care and support is delivered enabling people to continue to be independent, keep their dignity and help them achieve a better quality of life. The social care sector is responsible for delivering services and are provided by local authorities, third or private sector organisations. Research in adult social care is important to help the social care workforce understand which approaches and interventions work and how to improve the quality of care and support. However, there are barriers with setting up and running a research study in the social care sector, including limited dedicated time for the social care workforce to do research, accessing participants through providers, commissioners or unpaid carers, and due to the fragmented nature of the sector, difficulties in facilitating or supporting research. There are few opportunities for the social care workforce to develop their skills and experiences to undertake their own research. In order to help the social care workforce foster a culture of research and learning, we have used a well-known group learning and sharing framework called Communities of Practice (COPs) to help generate a culture of research involving all providers and users of social care. We developed the COPs by inviting them to three online networking events to identify what topics of research are important to providers and users. Their ideas were then put into themes and discussed, and two areas were finally decided upon for the COPs of: (a) Supporting people with complex needs throughout the lifespan, and (b) Enhancing, diversifying and sustaining the social care workforce. The COPs provide a place for users and providers to meet and discuss what research is important to them to identify some potential solutions to the problems encountered in adult social care.

Intraprofessional learning: Dentistry and oral health students' readiness and experience.

INTRODUCTION: Intraprofessional learning is a promising approach to enhance teamwork and patient care. This mixed-method study aimed to assess the readiness and experience of dental and oral health students toward intraprofessional learning. METHODS: Dental and oral health students were paired alternatively in a clinician and assistant role in a pediatric clinical setting. The Readiness for Interprofessional Learning Scale was adapted for a pre- and post-survey. Focus groups were conducted to elicit the students' shared learning experience. RESULTS: Approximately 50% of dental and oral health students participated in the pre- and post-survey. Pre-test findings revealed similar attitudes toward intraprofessional practice for both groups. However, a statistically significant lower score (p < 0.022) for the oral health students in the post-test suggested a less positive attitude toward their experience. Qualitative results indicated that dental students acquired a better understanding of the clinical scope of oral health students, and they learned clinical skills and behavior management from their counterparts. Conversely, oral health students experienced a hierarchical lack of collegiality and reciprocity from dental students, which may have contributed to their lower post-test score. Despite this, some oral health students gained more confidence in their roles and abilities within the intraprofessional team. Overall, dental students valued this learning experience more and desired more intraprofessional opportunities. CONCLUSION: Both groups of dental and oral health students had similar readiness levels to enter intraprofessional practice, appreciated the intraprofessional experience, and gained an increased appreciation for the collaborative approach to patient care. Intraprofessional learning during training may assist with developing collegiality across the dental professions in practice.

Development and Validation of a New Tool to Measure Performance Knowledge and Communication Skill of Multidisciplinary Health Science Learners on Radiation Emergency Preparedness and Response Management.

OBJECTIVE: The purpose of the study was to design, develop, and validate a newer tool on radiation emergency preparedness responses (RadEM-PREM IPE tool) to measure communication, knowledge, performance skills in multidisciplinary health science learners. METHODS: The study design is a prospective, single centric, pilot study. Five subject experts designed, analyzed, and selected items of the instrument for relevant content and domain. Psychometrics that the tool assessed were content validity, internal consistency, test-retest reliability, and intraclass correlation coefficient. Twenty-eight participants completed test-retest reliability for validation of 21 sorted out items calculated percentage of agreement >70% I-CVI/UA (item content validity index with universal acceptability) and S-CVI/UA (scale content validity index with universal agreement method). RESULTS: Items with percentage agreement >70% and I-CVI over 0.80 were kept, ranged from 0.70 to 0.78 were revised, and below 0.70 were rejected. Items with kappa values ranging from 0.04 to 0.59 were revised and ≥0.74 were retained. Internal consistency assessed using Cronbach's alpha was 0.449. Positive correlation between attitude and communication (r = 0.448), between performance and communication (r = 0.443) were statistically significant at 0.01 level. Overall, intraclass correlation coefficient for all the measures is 0.646, which is statistically significant at 0.05 level (P < 0.05). CONCLUSIONS: Study concludes that the RadEM-PREM IPE tool would be a new measuring tool to assess knowledge, performance, and communication skills of interprofessional radiation emergency response team learner's evaluation.

A 3-year qualitative evaluation of interprofessional team-based clinical education at an Australian dental school.

PURPOSE/OBJECTIVES: This article describes a qualitative evaluation of interprofessional (IP) team-based treatment planning (TBTP) involving dentistry, oral health therapy, dental prosthetics, and dental technology students at the Griffith University School of Dentistry and Oral Health (DOH). Using the same data from a recently published article that looked solely at the quantitative evaluation of TBTP, this article focuses on the qualitative evaluation of TBTP. This evaluation explores the contextual meaning related to the previously published aspects of TBTP that contributed positively toward oral health students' IP clinical learning and identifies themes reflecting students' IP clinical experience. METHODS: Thematic analysis of transcripts from nine focus groups, comprised of 46 final year students and open-ended questions collected from 544 students through an online instrument from 2012 to 2014, explored the question: "What is the contribution of IP student team-based processes on students' perceptions of IP learning and practice at DOH?" RESULTS: Responses from online participants and student focus groups revealed three major themes: useful role learning, communication confidence, and pro-active collaborative teamwork. Throughout each of these themes, students stated they possessed a confidence in collaborating with other oral health students as exhibited through an understanding of profession-specific and IP roles, self-assurance in communicating, and teamwork skills. CONCLUSION: Aspects of TBTP that contributed positively toward students' IP clinical learning and practice were meaningfully identified.

Interprofissionalidade e terapia ocupacional: percepção dos participantes do Programa de Aprimoramento Profissional em um serviço de reabilitação / Interprofessionality and occupational therapy: perception of the Professional Improvement Program's interns in a rehabilitation service

Resumo O Centro de Estudos e Pesquisas em Reabilitação "Prof. Dr. Gabriel O. S. Porto" (CEPRE) participou do Programa de Aprimoramento (PAP)2 para profissionais não médicos da área da saúde entre 1994 e 2019. O objetivo deste estudo foi conhecer e verificar a ocorrência da interprofissionalidade e o papel da terapia ocupacional entre os participantes do PAP atuantes no CEPRE. Esta é uma pesquisa descritiva, qualitativa com a participação de 18 aprimorandos das áreas de fonoaudiologia, pedagogia, psicologia, serviço social e terapia ocupacional que ingressaram nos PAPs realizados no CEPRE em 2018. Os dados foram coletados por meio de entrevistas semiestruturadas, contendo perguntas fechadas e abertas, que abordaram questões referentes às experiências e vivências no PAP. Essas entrevistas foram registradas em áudio e posteriormente transcritas. Optou-se pela análise de conteúdo para examinar os dados. Os resultados apontaram que o aprimoramento profissional contribuiu positivamente para a ocorrência do conhecimento sobre outras áreas, especialmente a terapia ocupacional, oportunizado através de aulas interdisciplinares. A análise de conteúdo revelou que os momentos compartilhados foram importantes para a ocorrência da prática interprofissional centrada no paciente com enfoque na integralidade, e que esse espaço fortaleceu ainda mais o trabalho.

Abstract The "Prof. Gabriel O. S. Porto" Center for Studies and Research in Rehabilitation (CEPRE) participated in the Professional Improvement Program (PAP) for non-medical health professionals from 1994 to 2019. This study aimed to understand and assess the occurrence of interprofessionality and the role of occupational therapy among the PAP participants working at CEPRE. This descriptive, qualitative research involved 18 interns from the areas of speech therapy, education, psychology, social service, and occupational therapy who joined PAP at CEPRE in 2018. Data were collected through semi-structured interviews that included both closed and open questions addressing experiences and insights during PAP. These interviews were audio recorded and later transcribed. The data were assessed by content analysis. The results showed that professional improvement positively influenced knowledge about other areas, especially occupational therapy, which was facilitated through interdisciplinary classes. The content analysis revealed that shared moments were important for the occurrence of patient-centered interprofessional practice with a focus on comprehensiveness, and that this space further strengthened the overall work.

Shared Learning Utilizing Digital Methods in Surgery to Enhance Transparency in Surgical Innovation: Protocol for a Scoping Review.

BACKGROUND: Surgical innovation can lead to important improvements in patient outcomes. Currently, information and knowledge about novel procedures and devices are disseminated informally and in an unstandardized way (eg, through social media). This can lead to ineffective and inefficient knowledge sharing among surgeons, which can result in the harmful repetition of mistakes and delay in the uptake of promising innovation. Improvements are needed in the way that learning in surgical innovation is shared through the development of novel, real-time methods, informed by a contemporary and comprehensive investigation of existing methods. OBJECTIVE: The aim of this scoping review is to explore the application of existing digital methods for training/education and feedback to surgeons in the context of performing invasive surgical procedures. This work will (1) summarize existing methods for shared learning in surgery and how they are characterized and operationalized, (2) examine the impact of their application, and (3) explore their benefits and barriers to implementation. The findings of this scoping review will inform the development of novel, real-time methods to optimize shared learning in surgical innovation. METHODS: This study will adhere to the recommended guidelines for conducting scoping reviews. A total of 6 different searches will be conducted within multiple sources (2 electronic databases, journals, social media, gray literature, commercial websites, and snowball searches) to comprehensively identify relevant articles and data. Searches will be limited to articles published in the English language within the last 5 years. Wherever possible, a 2-stage study selection process will be followed whereby the eligibility of articles will be assessed through the title, abstract, and full-text screening independently by 2 reviewers. Inclusion criteria will be articles providing data on (1) fully qualified theater staff involved in performing invasive procedures, (2) one or more methods for shared learning (ie, digital means for training/education and feedback), and (3) qualitative or quantitative evaluations of this method. Data will be extracted (10% double data extraction by an independent reviewer) into a piloted proforma and analyzed using descriptive statistics, narrative summaries, and principles of thematic analysis. RESULTS: The study commenced in October 2021 and is planned to be completed in 2023. To date, systematic searches were applied to 2 electronic databases (MEDLINE and Web of Science) and returned a total of 10,093 records. The results of this scoping review will be published as open access in a peer-reviewed journal. CONCLUSIONS: This scoping review of methods for shared learning in surgery is, to our knowledge, the most comprehensive and up-to-date investigation that maps current information on this topic. Ultimately, efficient and effective sharing of information and knowledge of novel procedures and devices has the potential to optimize the evaluation of early-phase surgical research and reduce harmful innovation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/37544.

Training to Promote Empathic Communication in Graduate Medical Education: A Shared Learning Intervention in Internal Medicine and General Surgery.

Background: Empathic communication skills have a growing presence in graduate medical education to empower trainees in serious illness communication. Objective: Evaluate the impact, feasibility, and acceptability of a shared communication training intervention for residents of different specialties. Design: A randomized controlled study of standard education v. our empathic communication skills-building intervention: VitalTalk-powered workshop and formative bedside feedback using a validated observable behavioral checklist. Setting/Subjects: During the 2018-2019 academic year, our intervention was implemented at a large single-academic medical center in the United States involving 149 internal medicine and general surgery residents. Measurements: Impact outcomes included observable communication skills measured in standardized patient encounters (SPEs), and self-reported communication confidence and burnout collected by surveys. Analyses included descriptive and inferential statistics, including independent and paired t tests and multiple regression model to predict post-SPE performance. Results: Of residents randomized to the intervention, 96% (n = 71/74) completed the VitalTalk-powered workshop and 42% (n = 30/71) of those residents completed the formative bedside feedback. The intervention demonstrated a 33% increase of observable behaviors (p < 0.001) with improvement in all eight skill categories, compared with the control who only showed improvement in five. Intervention residents demonstrated improved confidence in performing all elicited communication skills such as express empathy, elicit values, and manage uncertainty (p < 0.001). Conclusions: Our educational intervention increased residents' confidence and use of essential communication skills. Facilitating a VitalTalk-powered workshop for medical and surgical specialties was feasible and offered a shared learning experience for trainees to benefit from expert palliative care learning outside their field.

A national survey to map IPE in Ireland.

Interprofessional education (IPE) in Ireland is at an early stage. Currently, there is no data to reflect the amount and type of IPE occurring across the Island of Ireland. To support IPE implementation, data is needed on existing IPE which will identify gaps and foundations on which to build. We designed a cross-sectional, online, anonymous survey to map geographical IPE locations, IPE setting, and type of IPE offered. Results were analyzed by exporting raw data to Microsoft Excel. The survey was completed by 21 participants. Over half of participants (n = 12) came from two professions: physiotherapy and speech and language therapy. Participants were from 4 counties (from a potential 32): Cork, Dublin, Galway, and Limerick. There were twice as many university educator participants (n = 14) as compared to clinical educators (n = 7). Shared modules and guest lectures from other professions were frequent methods of shared learning. At university level the most frequent IPE activity was interprofessional problem-based learning/case study. At clinical sites students interact with a range of qualified professionals and have limited opportunities to work with students from other professions. This may impact the range of collaborative work skills developed and thus readiness for workforce entry.

Knowledge and insights from a maturing international clinical quality registry.

Since 2017, the TrueNTH Global Registry (TNGR) has aimed to drive improvement in patient outcomes for individuals with localized prostate cancer by collating data from healthcare institutions across 13 countries. As TNGR matures, a systematic evaluation of existing processes and documents is necessary to evaluate whether the registry is operating as intended. The main supporting documents: protocol and data dictionary, were comprehensively reviewed in a series of meetings over a 10-month period by an international working group. In parallel, individual consultations with local institutions regarding a benchmarking quality-of-care report were conducted. Four consensus areas for improvement emerged: updating operational definitions, appraisal of the recruitment process, refinement of data elements, and improvement of data quality and reporting. Recommendations presented were drawn from our collective experience and accumulated knowledge in operating an international registry. These can be readily generalized to other health-related reporting programs beyond clinical registries.

A 3-year quantitative evaluation of interprofessional team-based clinical education at an Australian dental school.

PURPOSE/OBJECTIVES: Clinical educational challenges led to the Griffith University School of Dentistry and Oral Health (DOH) introducing interprofessional team-based treatment planning (TBTP). This paper evaluates the interprofessional contribution made to student clinical learning and experience among dentistry, oral health therapy, dental prosthetics, and dental technology students. METHODS: A mixed methodology approach targeting 845 students collected data annually employing a prevalidated online instrument from 2012 to 2014 to answer the question: "What is the contribution of interprofessional student team-based processes on students' perceptions of interprofessional practice at DOH?" RESULTS: A representative study sample with a 64.4% response rate (N = 544) reported TBTP creating a supportive environment for interprofessional clinical learning. Significant improvements in learning shared across disciplines indicated improvements in mutual respect, understanding roles, and constructive communication enhancing teamwork. There were increasing significant correlations between shared learning and positive clinical experiences from 2012 (r = .642, p < .000) to 2013 (r = .678, p < .000) and 2014 (r = .719, p < .000). A combination of TBTP predictors accounted for 53% of the variance in clinical learning and experience in 2014 compared to 40% in 2012. CONCLUSION: Learning with other students, developing teamwork abilities, improved communication skills, and respect for other oral health professions were aspects of TBTP that positively impacted clinical learning and practice at DOH. Further study would assist to determine specific elements that made the greatest contribution to student learning experiences.

Strengths and Challenges of Implementing a Learning Collaborative in the Ryan White HIV/AIDS Program.

Learning collaboratives (LCs) are a popular tool for supporting collaboration and shared learning among health programs. Many variations of LCs have been reported in the literature. However, descriptions of key LC components and implementation lack standardization, making it hard to compare and contrast different LC approaches. To advance the field's understanding of how primary elements of LCs are implemented, we describe the implementation of an LC in the Ryan White HIV/AIDS Program using a recently established taxonomy of four primary elements of LCs-innovation, social systems, communication, and time. Additionally, we explain the strengths and challenges we encountered with regard to each of these elements when implementing this LC. We then offer recommendations to others on how to leverage LC facilitators and mitigate challenges in future projects. This information can guide other programs to replicate beneficial practices and avoid pitfalls in future LC projects.

Perspectives Against Racism: educational and socialization efforts at the departmental level.

The current heightened social awareness and anxiety triggered by escalating violence against Black Americans in the United States demands a safe space for reflection, education, and civil discourse within the academic setting. Too often there is an unmet need paired with a collective urgent desire to better understand the chronic existing structural, social, educational, and health inequities affecting disadvantaged populations, particularly Black Americans. In this perspective, the authors provide insight into a shared learning approach that provided a forum to discuss Perspectives Against Racism (PAR). Unlike existing top-down approaches, faculty, trainees, and staff were engaged in leading a series of focused discussions to examine unconscious bias, promote awareness of implicit biases, and reflect on individual and collective roles and responsibilities in working toward becoming antiracist. An existing 1-h graduate elective seminar course was dedicated to creating a space for learning, discussion, and exchange of ideas related to the experience and existence of racism (personal and institutional/systemic). A goal of each session was to go beyond didactics and identify mechanisms to implement change, at the level of the individual, department, and institution. This perspective of the shared experience may provide an adaptable framework that can be implemented in an academic setting at the departmental, center, or institutional level.

A Novel Mixed-Methods Platform Study Protocol for Investigating New Surgical Devices, with Embedded Shared Learning: Ibra-net Breast Lesion Localisation Study.

INTRODUCTION: New medical devices must have adequate research, such that outcomes are known, enabling patients to be consented with knowledge of the safety and efficacy of the device to be implanted. Device trials are challenging due to the learning curve and iterative assessment of best practice. This study is designed to pilot a national collaborative approach to medical device introduction by breast surgeons in the UK, using breast localisation devices as an exemplar. The aim is to develop an effective and transferable surgical device platform protocol design, with embedded shared learning. METHODS AND ANALYSIS: The iBRA-net localisation study is a UK based prospective, multi-centre platform study, comparing the safety and efficacy of novel localisation devices with wire-guided breast lesion localisation for wide local excision, using Magseed® as the pilot intervention group. Centres performing breast lesion localisation for wide local excision or excision biopsy will be eligible to participate if using one of the included devices. Further intervention arms will be added as new devices are CE marked. Outcomes will be collected via an online database. The primary outcome measure will be identification of the index lesion. Participating surgeons will be asked to record shared learning events via online questionnaires and focus group interviews to inform future study arms. ETHICS AND DISSEMINATION: The study will aim to collect data on 950 procedures for each intervention (Magseed® and wire localisation) from UK breast centres over an 18-month period. Shared learning will be prospectively evaluated via thematic analysis to refine breast localisation technique and to promote early identification of potential pitfalls and problems. Results will be presented at national and international conferences and published in peer reviewed journals. REGISTRATION: This is a UK national audit registered with Manchester University NHS Foundation Trust. HIGHLIGHTS: This protocol outlines a novel methodology for a collaborative national platform study to collate safety and efficacy data on new medical devices. Improved registration and audit of new medical devices is a major theme of the Cumberlege report of the Independent Medicines and Medical Devices Safety Review.We outline a protocol for a UK based multi-centre prospective audit to investigate the safety and efficacy of new surgical devices for breast lesion localisation. The study will run as a platform study using wire localisation as a control group and Magseed® as the first intervention arm.The protocol is designed for additional bolt-on intervention arms for other localisation devices, such as Hologic Localizer™ and Savi Scout®, when they become available to the European market. This will enable comparison of these devices to datasets already collected on wire and Magseed® localisation.The study includes a novel shared learning methodology using iterative online database reporting and surgical interviews to centrally distribute information on learning events, critical governance issues and recommended protocols for future use.

A community of practice in dental education: A phenomenon of newcomers becoming oldtimers.

OBJECTIVES: Community of practice (CoP) members develop cooperative learning history with shared cases, techniques, and concepts. A 2020 study was designed to explore participants' perceptions toward learning in the dental education CoP. METHODS: The Institutional Review Board exempted (AZ #1355) study involved an incidental population of third- and fourth-year dental students (N = 285) and resulted in a 43.5% response rate. The online Community of Practice Assessment Scale, consisted of Likert-style, check box items, and one open-ended question. Survey responses were categorized as Strongly Agree (1), Agree (2), No opinion (3), Disagree (4), and Strongly Disagree (5). Univariate analyses and descriptive statistics were used to analyze study variables (domain, community, and practice). RESULTS: Overall the learning domain is most strongly perceived by participants with mean scores ranging from 1.59 to 1.61. Responses assessing practices within the CoP had mean scores ranging from 1.72 to 1.90. Similarly, responses assessing the community ranged from 1.65 to 1.81. "Builds Knowledge and Shared Learning" was the characteristic participants most strongly agreed as beneficial with a 1.58 mean score. Participants agree that the CoP "Captures and Stores Tacit and Explicit Knowledge" with a mean score of 1.90. There was a 25.6% response rate to the open-ended question. Two themes evolved: the need for calibration and more shared learning. CONCLUSION: Based on study results, participants strongly agreed or agreed in opinions about CoP learning resources (faculty, staff, technology, and other students) benefitting their learning. The CoP provides an optimal environment for preparing competent new dental professionals.

[Debriefing in pediatric emergency care]. / Debriefing in der Kindernotfallversorgung: Grundlage für die Verbesserung der Patientenversorgung.

Communication errors and system problems negatively impact teamwork and shared decision-making and can cause patient harm. However, regular debriefings after critical events positively impact teamwork and patient outcome in pediatric emergency care. Team reflection promotes learning, helps teams to improve and to minimize errors from being repeated in the future. Nevertheless, debriefings in daily practice have not yet become a standard quality marker. Reasons include lack of time, lack of experienced debriefers and lack of support from the key stakeholders. Debriefings can take place at different timepoints with variable duration as needed. Due to the global pandemic, virtual debriefings or hybrid events with a mix of virtual and in-person participation are not only currently relevant but may perhaps also be of future relevance. Debriefings should focus on collaborative learning and future-oriented improvements. Not only life-threatening events but also potentially critical situations such as routine intubations warrant debriefings. Debriefing scripts promote a structured approach and allow even inexperienced moderators to navigate all relevant aspects. In addition to areas of challenge, debriefings should also explore and reinforce positive performance to facilitate learning from success. Debriefers should discuss not only obvious observable accomplishments, but also motivations behind key behaviors. This strategy promotes needs-based learning and focuses on solutions. Helpful strategies include specific questioning techniques, genuine interest and a positive safety culture.

Attitudes of dental and chiropractic students towards a shared learning programme-An interprofessional learning model.

INTRODUCTION: Interprofessional learning (IPL) is the first stage towards the goal of interprofessional collaborative care. To enhance IPL experience, the School of Dentistry, International Medical University developed an IPL model based on the core competencies and the learning outcomes for dental and chiropractic students in their second and fourth year, respectively. The model was based on experiential learning and adult learning theories in addition to Miller's framework for clinical competencies. METHODS: The programme was developed as a student-centred, collaborative approach to achieve the learning outcomes for dental and chiropractic students. Second-year dental students (n = 46) and chiropractic students (n = 23) in their fourth year participated in the programme. The focus of the programme was to address the prevention of work-related musculoskeletal disorders (WMSDs) amongst dental students and to provide the chiropractic students with the opportunity to assess and identify risk factors for WMSDs in the dental setting. The readiness for interprofessional learning scale (RIPLS) questionnaire was completed prior to the interprofessional education programme and once again afterwards to determine dental and chiropractic students' awareness of roles and responsibilities of the other profession, and their attitudes to interprofessional education and teamwork. RESULTS: Dental and chiropractic students showed similar levels of readiness for shared learning. The results of this study suggest that the IPL programme contributed to the development of the students' positive perceptions towards the positive professional identity and the roles of other healthcare professionals. CONCLUSION: This study provides initial support for the integrated interprofessional learning experiences within the school. The results of the study will shape future curricula changes to further strengthen interprofessional education and subsequent interprofessional collaborative care.

Formação para o cuidado interprofissional: ressignificando a prática de saúde em tempos de pandemia / Formación para el cuidado interprofesional: resignificación de la práctica de salud en tiempos de pandemia / Education for interprofessional care: redefining health practices in pandemic times

A pandemia de Covid-19 exigiu a adequação das atividades práticas em saúde para o formato on-line, sendo esse um desafio maior para os cursos com currículos interprofissionais. Este artigo relata a experiência de uma turma do módulo Clínica Integrada: produção de cuidado, do Eixo Trabalho em Saúde, da Universidade Federal de São Paulo - campus Baixada Santista, no formato de atividades domiciliares especiais, ressaltando como as competências interprofissionais foram desenvolvidas nessa nova perspectiva. Em oito encontros síncronos aproximamos os estudantes da realidade do serviço de saúde por meio de trocas com profissionais e usuários do serviço. Discutimos a experiência de aprender sobre cuidado, inclusive nesse contexto da pandemia e as mudanças dela advindas. Conseguimos alcançar os objetivos educacionais do módulo e desenvolver as competências para a prática interprofissional colaborativa, ainda que algumas tenham sido mais incipientes. (AU)

La pandemia de Covid-19 hizo necesario adecuar las actividades prácticas en salud para el formato online, siendo este un desafío mayor para los cursos con currículos interprofesionales. Este artículo relata la experiencia de un grupo del módulo Clínica Integrada: producción de cuidado, del eje Trabajo en Salud, de la Universidad Federal de São Paulo -campus Baixada Santista- en el formato de actividades domiciliares especiales, subrayando cómo las competencias interprofesionales fueron desarrolladas en esta nueva perspectiva. En ocho encuentros sincronizados, aproximamos los estudiantes a la realidad del servicio de salud a partir de intercambios con profesionales y usuarios del servicio. Discutimos la experiencia de aprender sobre cuidado, incluso en este contexto de la pandemia y los cambios que ella trajo. Conseguimos alcanzar los objetivos educativos del módulo y desarrollar las competencias para la práctica interprofesional colaborativa, aunque algunas hayan sido más incipientes. (AU)

The Covid-19 pandemic has changed the practical activities in health care to online education, a major challenge for health courses with interprofessional curriculums. This article reports on the experience of a group from Integrated Clinic Module: care production, part of the Work in Health axis, at the Federal University of São Paulo, Baixada Santista campus, using the format of special home activities, highlighting how interprofessional competencies were developed in this new perspective. In eight synchronous meetings, we brought students closer to the reality of the health service through exchanges with providers and service users. We discussed the experience of learning about care, especially in this pandemic context, and the changes it brought. We managed to achieve the module's educational objectives and develop the skills for collaborative interprofessional practice, although some were incipient. (AU)

A pharmacist-led prospective antibiotic stewardship intervention improves compliance to community-acquired pneumonia guidelines in 39 public and private hospitals across South Africa.

INTRODUCTION: Pharmacists in low-middle-income countries (LMIC) are few and lack antibiotic stewardship (AS) training. The ability was assessed of non-specialised pharmacists to implement stewardship interventions and improve adherence to the South African community-acquired pneumonia (CAP) guideline in public and private hospitals. METHODS: This was a multicentre, prospective cohort study of adult CAP patients hospitalised between July 2017 and July 2018. A CAP bundle was developed of seven process measures (diagnostic and AS) that pharmacists used to audit compliance and provide feedback. CAP bundle compliance rates and change in outcome measures [mortality, length of stay (LOS) and infection-related (IR)-LOS] during pre- and post-implementation periods were compared. RESULTS: In total, 2464 patients in 39 hospitals were included in the final analysis. Post-implementation, overall CAP bundle compliance improved from 47·8% to 53·6% (confidence interval [CI] 4·1-7·5, p<0·0001), diagnostic stewardship compliance improved from 49·1% to 54·6% (CI 3·3-7·7, p<0·0001) and compliance with AS process measures from 45·3% to 51·6% (CI 4·0-8·6, p<0·0001). Improved compliance with process measures was significant for five (2 diagnostic, 3 AS) of seven components: radiology, laboratory, antibiotic choice, duration and intravenous to oral switch. There was no difference in mortality between the two phases, [4·4%(55/1247) vs. 3·9%(47/1217); p=0·54], median LOS or IR LOS 6·0 vs. 6·0 days (p=0·20) and 5·0 vs. 5·0 days (p=0·40). CONCLUSION: Non-specialised pharmacists in public and private hospitals implemented stewardship interventions and improved compliance to SA CAP guidelines. The methodology of upskilling and a shared learning stewardship model may benefit LMIC countries.

Intraprofessional education with dental hygienists: The post training impact on dentists.

PURPOSE/OBJECTIVES: Generally, dental and dental hygiene (DH) students are educated separately. When these students are educated together, studies show improvements in teamwork and understanding of their distinct roles. This longitudinal study was conducted to see if intraprofessional education (IntraPE) between dental and DH students can impact dentists in practice. Specifically, this study examined the attitudes of graduates from the University of Washington School of Dentistry (UWSOD), some of whom participated in the Regional Initiative in Dental Education (RIDE) program. The RIDE program, designed to meet the needs of underserved populations, combines courses of 8 first-year dental students with 30-36 Eastern Washington University DH students. METHODS: In 2018, all 409 UWSOD dentists from 2012-2017, including 48 RIDE and 361 non-RIDE dentists, were invited to participate in this study. Attitudes toward teamwork and roles and responsibilities were assessed using qualitative and quantitative measures. The RIDE and non-RIDE responses were compared and tested using t-tests for statistical significance. RESULTS: A total of 77 responses were analyzed with a response rate of 54% (n = 26) for RIDE and 14% (n = 51) for non-RIDE. Results show the RIDE program improved attitudes toward DH in practice. There was a statistically significant difference between the groups in understanding roles and responsibilities, but not teamwork. The majority of non-RIDE dentists (n = 26, 51%) felt their education would have benefited from formal IntraPE. CONCLUSION: To improve attitudes, dental schools should consider formal partnerships between dental and DH programs, specifically in clinical settings.

Building institutional resilience in the context of climate change in Aurora, Philippines.

The role of local government units (LGUs) in disaster resilience is crucial for a hazard-prone country such as the Philippines. Although the country has its own institutional framework on disaster risk reduction, a number of issues limit LGUs' potential to perform its role. This study focused on building institutional resilience of LGUs towards building climate risk resilience in Aurora, Philippines by engaging key actors in the formulation of Local Climate Change Action Plans (LCCAP). The study adopted the shared learning process from the Climate Resilience Framework (CRF) to strengthen partnership and implement capacity building activities, aimed at developing the Climate and Disaster Risk Assessment (CDRA) and LCCAP beyond compliance. An institutional capacity assessment was administered through a survey involving 87 members of the Technical Working Group (TWG) from eight municipalities and provincial government. Institutional capacity was measured using 70 indicators representing access rights and entitlements, information flows, decision-making processes, application of new knowledge, capacity to anticipate risk, capacity to respond, as well as capacity to recover and change. Data were analyzed using descriptive statistics. Both Spearman Correlation and Cramer's V determined the interrelationship between socio-demographic variables and institutional characteristics. Results revealed that the LGUs performed better in risk response and management. A strong correlation between expertise and position vis-à-vis all resilient institution metrics was also observed, while gender is moderately correlated with all parameters except access rights and entitlements. Three key areas, not adequately articulated in current literature, need to be improved to enhance institutional resilience towards climate and disaster risks, namely: staffing and human resource; access to financial support from other sources; and development of knowledge management systems.