Post-discharge interventions to enhance coping skills for survivors of stroke and their caregivers: a scoping review protocol.

OBJECTIVE: This scoping review aims to map the use of post-discharge interventions to enhance coping skills for adult stroke survivors and their informal caregivers. INTRODUCTION: Evidence shows that when stroke survivors and their informal caregivers are provided with post-discharge coping training, their outcomes improve. There is also evidence that healthcare providers currently focus on medication compliance and deliver little to no instruction on post-discharge coping interventions. As a result, more than 40% of stroke survivors and informal caregivers report a lack of awareness and access to community-based coping training once discharged from the hospital setting. INCLUSION CRITERIA: This scoping review will map the delivery modes, intervention types, locations, leadership and settings of current coping interventions for community-dwelling adults 18 years or older living with the effects of stroke and their informal caregivers. This review will be restricted to studies published in English that include interventions that are not reimbursed as part of United States healthcare coverage. METHODS: The search will include CINAHL, Cochrane Library, Embase, JBI Evidence Synthesis, MEDLINE, PEDro, PLoS, PsycINFO, and Web of Science. In addition, smaller health-related databases, stroke and rehabilitation journals, gray literature and stakeholder organization websites will be searched. A three-step search strategy will be utilized, including use of citation software to manage search results and de-duplication, abstract review and full-text review by two reviewers. Details of included studies will then be imported into information management software. The resulting map will be displayed in tabular form along with a narrative summary.

Kolb's Experiential Learning Theory as a Theoretical Underpinning for Interprofessional Education.

It is imperative to incorporate education on interprofessional competencies into the curriculum of healthcare provider students in order to meet the individual program accreditation standards. However, what is missing is a theoretical foundation for the education. The purpose of this paper was to examine if the qualitative data from a mixed-methods study using low-fidelity simulation of a case study that demonstrated changes in interprofessional attitudes and behaviors in healthcare provider students aligned with Kolb's Experiential Learning Theory (ELT). First-year students (n=515) from 8 professional healthcare programs participated in the 90-minute study which included a scripted scenario of the patient care rounding process. Using thematic analysis, the qualitative results demonstrated a significant alignment with the four stages of Kolb's ELT. Based on the results of this study, ELT appears to provide a solid theoretical underpinning for the education through which to teach interprofessional competencies to healthcare provider students.

Teaching Collaboration Competencies to Healthcare Provider Students Through Simulation.

PURPOSE: Although interprofessional collaboration has been proven to reduce the number of errors, few programs have incorporated interprofessional training into their programs. The purpose of this study was to determine if attitudes and observed collaborative behaviors among an interprofessional group of students improved or increased following an intervention that included a didactic session on the process of collaboration, a low-fidelity simulation of interprofessional patient care rounds, and facilitated debriefing sessions. METHODS: In this mixed-methods study, two scales from the TeamSTEPPS™ Teamwork Attitudes Questionnaire (TAQ) were used as a pre- and post-test to assess attitude and behavior changes in students. Qualitative data were also collected via semi-structured interviewing and observation. RESULTS: Students (n=515) from eight professional healthcare programs participated in the study. Statistical significance (p<0.001) was reached in 10 of the 12 TAQ questions, indicating that attitudes towards teamwork and collaboration improved substantially. All observed collaborative behaviors increased between 3 to 18% pre- to posttest. Students reported that the intervention taught them about other provider roles and gave them the language they needed to collaborate. CONCLUSIONS: Low-fidelity scripted simulation of patient care rounds is a cost-effective and time-efficient method to teach interprofessional collaboration simultaneously to large groups of students in diverse healthcare professional programs.

Working Together Toward a Common Goal: A Grounded Theory of Nurse-Physician Collaboration.

Working together toward a common goal is an empirically derived theory that can guide education and practice to improve patient outcomes while saving money and lives. Grounded theory was used to explore nurses' and physicians' experiences with collaboration in order to understand the process intrinsically.

A contemporary method to teach collaboration to students.

This pilot study examined the effectiveness of an interprofessional educational intervention in which nursing and medical students were taught collaboration skills through low-fidelity simulation. The intervention included didactic content on the process of collaboration, followed by a simulation of the patient care rounding process. The TeamSTEPPS® Teamwork Attitudes Questionnaire (T-TAQ) was administered as a pre- and posttest to seven students who participated in the simulation. Anecdotal and observational data were also collected. Statistically significant differences (p<0.05) were found in three of the five core areas of the T-TAQ: team structure, situation monitoring, and communication. Collaborative behaviors were demonstrated, and anecdotal comments reported by the students revealed an appreciation of the overall experience. These findings suggest that low-fidelity simulation is a valuable and cost-effective method to teach interprofessional educational skills, such as collaboration. These skills are essential to professional practice in the clinical setting.

Interdisciplinary collaboration for healthcare professionals.

Interdisciplinary collaboration has the capacity to affect both healthcare providers and patients. Research has shown that the lack of communication and collaboration may be responsible for as much as 70% of the adverse events currently reported. The purpose of this article is 2-fold: to examine factors that may influence interdisciplinary collaboration and consequently patient outcomes and to examine the relationship between interdisciplinary collaboration and King's theory of goal attainment as a theory to support the phenomenon of interdisciplinary collaboration.