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1.
Hum Resour Health ; 19(1): 9, 2021 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-33413464

RESUMEN

BACKGROUND: Healthcare is a complex sociolegal setting due to the number of policymakers, levels of governance and importance of policy interdependence. As a desirable care approach, collaborative practice (referred to as interprofessional education and collaborative practice (IPECP)) is influenced by this complex policy environment from the beginning of professionals' education to their initiation of practice in healthcare settings. MAIN BODY: Although data are available on the influence of policy and law on IPECP, published articles have tended to focus on a single aspect of policy or law, leading to the development of an interesting but incomplete picture. Through the use of two conceptual models and real-world examples, this review article allows IPECP promoters to identify policy issues that must be addressed to foster IPECP. Using a global approach, this article aims to foster reflection among promoters and stakeholders of IPECP on the global policy and law environment that influences IPECP implementation. CONCLUSION: IPECP champions and stakeholders should be aware of the global policy and legal environment influencing the behaviors of healthcare workers to ensure the success of IPECP implementation.

2.
J Athl Train ; 2021 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-33432331

RESUMEN

CONTEXT: To enhance the quality of patient care, it is important that athletic trainers integrate the components of the core competencies (CCs; evidence-based practice [EBP], patient-centered care [PCC], health information technology [HIT], interprofessional education and collaborative practice [IPECP], quality improvement [QI], professionalism) as a part of routine clinical practice. It is unclear in what ways, if any, athletic training students (ATSs) are integrating CCs throughout patient encounters (PEs) during clinical experiences. OBJECTIVE: To describe which professional behaviors associated with the CCs were implemented by ATSs during PEs that occurred during clinical experiences. DESIGN: Multi-site, panel design. SETTING: 12 professional athletic training programs (ATPs; 5 Bachelor, 7 Master's). PATIENTS OR OTHER PARTICIPANTS: 363 ATSs from the ATPs that used E*Value software to document PEs during clinical experiences participated in this study. MAIN OUTCOME MEASURES: During each PE, ATSs were asked to report if professional behaviors reflective of five of the CCs occurred (professionalism CC was excluded). Summary statistics, including means (SD), counts, and percentages were tabulated for the professional behaviors of each core competency. RESULTS: Data from 30,630 PEs were entered during the study period. Professional behaviors related to EBP were the most frequently incorporated during PEs (74.3%, n=22773), followed by QI (72.3%, n=22147), PCC (56.6%, n=17326), HIT (35.4%, n=10,857), and IPECP (18.4%, n=5627). CONCLUSIONS: It is unsurprising that EBP and PCC behaviors were two of the most frequently incorporated CCs during PEs due to the emphasis of these competencies during the past several years. It is surprising that ATSs did not incorporate behaviors related to HIT in 65% of PEs, nor did they include behaviors related to IPECP in 82% of PEs. These findings suggest that directed efforts are needed to ensure ATSs are provided opportunities to incorporate professional behaviors related to the CCs during clinical experiences.

3.
J Contin Educ Health Prof ; Publish Ahead of Print2021 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-33433130

RESUMEN

INTRODUCTION: The conceptual framework of One Health (OH) provides a strategy for promoting collaboration across the nexus of animal, human, and environmental health, which is essential for tackling emerging disease threats, such as COVID-19. However, there is no accreditation requirement for OH to prepare students across the professions for collaborative practice. This study aimed to explore the perspectives of faculty across the medical, veterinary, and public health programs about the need, opportunities, and challenges of developing OH in the curricula. METHODS: In this qualitative study, faculty across the three disciplines were invited to participate in audio-recorded, focus group interviews. Recordings were transcribed verbatim and analyzed using inductive and deductive thematic analysis. RESULTS: All participants recognized the need for OH as a critical concept for preparing students for collaborative practice. Opportunities were identified for shared learning and research across the disciplines, particularly through the use of interprofessional education. The lack of an accreditation mandate for OH in the medical curriculum was perceived to be the greatest challenge, leading to an anticipation of significant resistance among medical educators and students. DISCUSSION: Successful development of OH in all three curricula is vital to prepare students for current and future threats to global health. The role of accreditation bodies in ensuring medical, veterinary, and public health curricula prepare students for these threats is crucial. Implications for practice include strategies for persuading medical educators and medical students to embrace OH in the curriculum and promote a culture of shared learning.

4.
Lang Speech Hear Serv Sch ; 52(1): 1-3, 2021 Jan 19.
Artículo en Inglés | MEDLINE | ID: mdl-33464974

RESUMEN

Purpose African American English (AAE) speakers often face mismatches between home language and school language, coupled with negative attitudes toward AAE in the classroom. This forum, Serving African American English Speakers in Schools Through Interprofessional Education & Practice, will help researchers, parents, and school-based practitioners communicate in ways that are synergistic, collaborative, and transparent to improve educational outcomes of AAE speakers. Method The forum includes a tutorial offering readers instructions on how to engage in community-based participatory research (Holt, 2021). Through two clinical focus articles, readers will recognize how AAE develops during the preschool years and is expressed across various linguistic contexts and elicitation tasks (Newkirk-Turner & Green, 2021) and identify markers of developmental language disorder within AAE from language samples analyzed in Computerized Language Analysis (Overton et al., 2021). Seven empirical articles employ such designs as quantitative (Byrd & Brown, 2021; Diehm & Hendricks, 2021; Hendricks & Jimenez, 2021; Maher et al., 2021; Mahurin-Smith et al., 2021), qualitative (Hamilton & DeThorne, 2021), and mixed methods (Mills et al., 2021). These articles will help readers identify ways in which AAE affects how teachers view its speakers' language skills and communicative practices and relates to its speakers' literacy outcomes. Conclusion The goal of the forum is to make a lasting contribution to the discipline with a concentrated focus on how to assess and address communicative variation in the U.S. classroom.

5.
Med Educ ; 2021 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-33440040

RESUMEN

OBJECTIVES: Interprofessional education (IPE) aims to provide students with the opportunity to develop and demonstrate the team working behaviors and skills that will lead to positive patient outcomes. This systematic review aims to identify and critically appraise the assessment tools used after a pre-licensure IPE intervention and provide guidance on which tool to use according to the focus of the intervention. METHODS: In July 2019, the following electronic databases were searched: MEDLINE, ERIC, CINHAL, EMBASE, NEXUS website. All studies involving pre-licensure healthcare students exposed to an IPE intervention, and undertook an assessment measuring student knowledge, skills, behavior, or change in organizational practice or a benefit to patients were included. Studies that used tools relying on self-assessment only were excluded. Constructive alignment of the IPE intervention with the assessment was evaluated and quality assessment of the studies and critical appraisal of the validity evidence for the tools was undertaken. RESULTS: From 9502 returned studies, 39 studies met the inclusion criteria and were analyzed. These were rated as good in terms of methodological quality. Acquisition of knowledge was the most commonly assessed outcome, mainly with pre/post knowledge tests, followed by behavior change, which was measured by a range of validated tools. Patient benefit was defined as change in clinical effectiveness, patient safety or patient satisfaction. Constructive alignment of the IPE aim with the assessment was limited due to issues with study reporting. Tools measuring behavior change demonstrate mixed adherence to quality standards around reliability, validity and scales and scoring. CONCLUSIONS: Various methods have been used to identify change following IPE, however choosing the most appropriate tool to support and align with the aim of the IPE intervention is crucial. We have critically appraised the available tools and offered an indication of their quality. This has informed the production of a decision aid to support the selection of the appropriate IPE assessment tool depending on the purpose of the intervention. More studies using these tools in rigorous study designs are required to substantiate the evidence base.

6.
Gerontol Geriatr Educ ; : 1-19, 2021 Jan 14.
Artículo en Inglés | MEDLINE | ID: mdl-33446079

RESUMEN

This paper presents the design, delivery, and preliminary evaluation of a gerontological learning-to-performance program. An interprofessional educational team sought to integrate leading clinical and educational practices into Team Essentials to engage long-term care teams in learning to improve performance. Although the association between skilled, trained staff and quality of care is well-established in research, how best to engage learners from an increasingly diverse workforce is less well understood. This paper outlines the context, framework, methods, and preliminary evaluation of the program. Data from participant surveys, interviews, and field notes suggest that program content and delivery positively impacted participants. Four major themes emerged: Enabling engagement through experiential learning; Valuing reciprocity in long-term care training; Creating meaningful change through significant learning; and, Fostering sustained practice change through leadership involvement. The paper concludes with implications for LTC workforce training.

7.
Radiography (Lond) ; 2021 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-33446407

RESUMEN

INTRODUCTION: This study aimed to examine Diagnostic Radiography (DR) students' perceptions and attitudes towards the Health Collaboration Challenge (HCC), as an interprofessional learning opportunity. METHODS: DR students participated in the HCC, an annual intensive interprofessional collaboration and assessment activity involving case-based learning. Students' attitudes towards Interprofessional Education (IPE) were measured using a modified version of the Interprofessional Socialisation and Valuing Scale (ISVS-21) and a bespoke questionnaire with items relating to the HCC. Subsequent focus groups explored students' experience of IPE within the HCC context. RESULTS: Survey results (n = 30) suggested a mostly positive attitude towards IPE alongside other health care students, acknowledging the value of interprofessional teams in patient health care. Qualitative themes from focus group participants (n = 8) revealed that DR students, while appreciating the value of shared-decision making, found the HCC assessment distracting. Challenges included the intensive nature of the HCC, roles that DR students undertook in addressing assessment criteria, case complexity and opportunities for DR students to showcase their knowledge. CONCLUSION: Results suggest that the intensive and assessable nature of the HCC can overshadow the value of IPE for DR students, and immersive or staggered approaches to IPE could better align with DR professionals' unique role within the patient care spectrum. IMPLICATIONS FOR PRACTICE: Revised IPE models for DR students could include a more immersive environment, conducted over a longer period of time, with meetings at semi-regular intervals to promote an interprofessional-focus over a task-focus approach.

8.
J Interprof Care ; : 1-4, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-33451254

RESUMEN

Healthcare professions faculty at a private Midwestern university designed an Interprofessional Education (IPE) Week, consisting of 12 different interprofessional learning activities over the span of one week. The purpose of the study was to determine students' perceptions toward interprofessional healthcare, as measured by the Student Perceptions of Interprofessional Clinical Education-Revised (SPICE-R), one week before and one week after the events to determine if the type of learning activity - more passive, didactic-type events or active learning events - impacted outcomes. Of the over 400 students representing predominantly athletic training, nursing, occupational therapy, and physical therapy programs who attended IPE Week, a total of 190 health professions students completed the pre- and post-IPE Week SPICE-R. Students who attended an active learning activity had a statistically significant increase in all three factors of the tool (interprofessional teamwork and team-based practice, roles/responsibilities for collaborative practice, and patient outcomes from collaborative practice) while students who attended more passive didactic type events only showed a statistically significant increase in roles/responsibilities and patient outcomes. This study demonstrates the utility of an IPE Week on student perceptions and highlights the potential importance of active interprofessional learning offerings.

9.
Nurse Educ Today ; 98: 104745, 2021 Jan 09.
Artículo en Inglés | MEDLINE | ID: mdl-33454658

RESUMEN

BACKGROUND: When healthcare professionals collaborate and communicate well, patients have better health outcomes. Nursing students need to learn interprofessional team skills before they graduate to succeed. Nurse educators are responsible for preparing students to function in interprofessional teams. However, many nursing programs, especially ones with fewer resources, struggle to teach interprofessional collaboration. Experts agree that the first step in implementing interprofessional education is to provide educators with faculty development. Despite this, little is known about if and how nurse educators are prepared to teach interprofessional concepts. OBJECTIVES: The purpose of this study was to explore nurse educator experiences regarding their preparation to teach interprofessional education and to explore how their preparation influenced their teaching. DESIGN: A qualitative multiple case study approach was used to gather information regarding nurse educators' preparation to teach interprofessional education. Data were gathered from interviews and educational documents. SETTINGS: This study involved three different undergraduate RN programs located in the Western United States. PARTICIPANTS: Data was gathered from three educators from each of the three different undergraduate nursing programs, for a total of nine participants. METHODS: Interview transcripts and educational documents were thematically analyzed using the Interprofessional Education Collaborative's core competencies as a framework. RESULTS: None of the educators had participated in any type of formal faculty development to prepare them to teach interprofessional collaboration. Most had an incomplete understanding of interprofessional collaborative practice. Few were aware of the resources available to help them incorporate interprofessional collaboration into their curriculum. Although there were isolated instances where participants taught students communication or teamwork concepts, none of the programs explored had any formal interprofessional education in their curricula. CONCLUSIONS: This study's findings support the need for faculty development if leaders expect nursing educators to teach interprofessional collaboration to students.

10.
J Interprof Care ; : 1-11, 2021 Jan 12.
Artículo en Inglés | MEDLINE | ID: mdl-33435773

RESUMEN

Student-led clinics provide a unique opportunity for interprofessional education as part of the education of future allied health professionals. A rapid review was conducted to determine the benefits to allied health students participating in interprofessional education in student-led clinics. Studies were included if they took place within a student-led clinic, reported on outcomes for students and where the clinic involved interprofessional education for students from either two or more allied health professions, or one allied health and one nursing student. Results were analyzed using a descriptive qualitative approach. Five themes were identified: (a) understanding of own role and scope of practice; (b) understanding of the role and scope of practice of other professions; (c) individual benefits to the students; (d) impact on patient-centered care; and (c) understanding of how to work in an interprofessional team. These benefits indicate that student-led clinics are a suitable setting for the delivery of interprofessional education to allied health students. More research is needed that considers the long-term impact on these student outcomes following students' entry into the healthcare profession, as well as on the impact of specific components of the interprofessional education models on student outcomes.

11.
J Interprof Care ; : 1-10, 2021 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-33438485

RESUMEN

Measuring the effectiveness of interprofessional education (IPE) experiences is essential but challenging. Surveying learners before (pretest) and after (posttest) an IPE experience may result in minimal change due to response shift bias. Retrospective pretest/posttest assessment may ameliorate response shift bias but may also result in inflated change scores due to social desirability bias. We studied a cohort of 675 students from 12 health professions who completed the Interprofessional Attitudes Scale (IPAS) within the 4 weeks before (pretest) and the 3 weeks after (posttest) an IPE forum and completed the Interprofessional Collaborative Competency Attainment Survey (ICCAS) within the 3 weeks after the forum as a retrospective pretest/posttest. We found higher scores on the pretest IPAS than the retrospective pretest ICCAS and greater change in scores on the ICCAS than the IPAS, indicating potential response shift and social desirability biases. Furthermore, we found few significant correlations between change scores in subscales of the two tests, but a high number of strong and significant correlation among the ICCAS subscale change scores. Our results indicate the timing of pretest administration may impact change scores or that subscales of IPAS may be more unique than those of ICCAS. These findings suggest that educators should consider the potential impact of response shift and social desirability biases when interpreting results of the IPAS and ICCAS in response to an IPE learning experience.

12.
Curr Pharm Teach Learn ; 13(2): 169-176, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33454075

RESUMEN

Background Interprofessional education (IPE) and training in community settings is not commonly described in the literature. Studies primarily focus on clinical education of interprofessional teams in clinical practice and primary care. This is a description of a longitudinal, collaborative interinstitutional IPE project that engages community partners (CP) while delivering core IPE competencies. Interprofessional Education Activity: Twenty-seven students from five universities representing ten healthcare academic programs participated in the project. Participating CP were non-profit agencies developed to meet the needs of specific vulnerable, underserved populations. Students were divided into teams and then paired with CP. This was a six-month project, with students committing to 30 hours over two semesters. At the end of the project, students presented project deliverables to CP, faculty collaborative and other students. Interprofessional education collaborative (IPEC) domains were qualitatively assessed and students completed the Interprofessional Socialization and Valuing Scale (ISVS) at the beginning and conclusion of the project. Students provided written reflections at the conclusion of the project. Faculty completed the Team Observed Structured Clinical Encounter (TOSCE). Discussion" Twenty-seven students (100%) students completed the project and twenty-one students (77.8%) completed the evaluation tools. Students demonstrated a statistically significant difference between pre- and post-project ISVS total scores (5.81 +/- 0.64 vs. 6.51 +/- 0.37). Teamwork, communication skills, and increased comfort with those from other professions were common themes in the student reflections. Implications: Community-based IPE provides a venue for healthcare professionals to engage and partner with community organizations. This project demonstrates an effective inter-institutional, interprofessional method of delivering IPE.

13.
Public Health Nurs ; 2021 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-33410560

RESUMEN

OBJECTIVES: Five nationally representative U.S. federal data sources consistently showed the link between poverty and poor health outcomes. To determine the modality effective in teaching students about poverty and health, this study compared the attitudes toward poverty of students participating in the Community Action Poverty Simulation (CAPS) and the poverty table-top simulation (Dwell™). METHODS: In this quasi-experimental study, undergraduate and graduate nursing students and physical therapy students participated in either CAPS or a table-top simulation (TTS) depending on their semester of enrollment in the relevant course. The Undergraduate Perception of Poverty Tracking Survey (UPPTS) was administered before and after each simulation. RESULTS: The analysis included 118 matched pairs. Using MANOVA tests, the authors found no group difference in the overall change of attitude after the simulations (p = .232). However, by the subscale analyses, TTS significantly increased students' willingness to help (p = .008, η2  = 0.058) and their empathy toward those living in poverty (p = .039, η2  = 0.039). CONCLUSION: TTS participants had more elements of improvement, but both modalities were found to change participants' attitudes.

14.
Artículo en Inglés | MEDLINE | ID: mdl-33389364

RESUMEN

Interprofessional education (IPE) is defined as educational activities involving trainees from two or more professions learning about, from, and with each other with the goal of building team-based collaboration skills. The degree to which psychology trainees are involved in IPE is unknown. A national survey was distributed to gather information regarding the nature and prevalence of IPE experiences and psychology trainees' perceived competence in collaboration skills. Participant responses (n = 143) are presented overall and by training level. Some respondents reported no IPE activities in their training, especially trainees earlier in their training. Highest rated competencies were in acting with honesty and integrity and developing/maintaining mutual respect and trust of other professions. Lowest rated were in giving feedback to others and managing differences in opinion. More research related to the nature and impact of IPE on psychology trainees is critical.

15.
Anat Sci Educ ; 14(1): 32-42, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32282126

RESUMEN

Interprofessional attitudes existing between healthcare disciplines can negatively impact communication and collaboration in the clinical setting. While human anatomy is a topic central to healthcare trainees, the potential of the anatomy laboratory to minimize negative interprofessional attitudes has yet to be characterized. This study aimed to assess the effects of an anatomy interprofessional near-peer learning activity (AIP-NPLA) on medical and nursing students' interprofessional attitudes at McGill University. The authors employed a convergent parallel mixed methods study to explore participants' AIP-NPLA experiences. The Attitudes to Health Professionals Questionnaire (AHPQ) was used pre- and post-AIP-NPLA to assess participants' attitudes toward their own and their counterpart profession. In addition, a focus group was held immediately following the AIP-NPLA to explore participants' experiences and interprofessional perceptions. Quantitative results using a principal components analysis demonstrated significant changes in nursing students' responses between pre- and post-AIP-NPLA scoring, rating the medical profession as being more caring overall. Medical students' responses pre- and post-AIP-NPLA demonstrated no significant differences. Qualitative results also suggested a breakdown of negative attitudes, an increased understanding of inter- and intra-professional roles, and the importance of interprofessional collaboration and mutual learning for their careers. These findings revealed that attitudes among healthcare trainees may be positively restructured in the anatomy laboratory, allowing for collaborative care to predominate in current and future clinical practices.

16.
J Dent Educ ; 85(1): 7-10, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32761621

RESUMEN

In 2000, David Satcher wrote, Oral Health in America: A Report of the Surgeon General, and stated that "oral health means much more than healthy teeth," and he challenged all health providers to step up and be a part of the improvement of the nation's oral health status. Over the past few decades, the heightened awareness of these oral health inequities within the United States has resulted in public policy stakeholders and scholars, similarly calling for the improvement of the nation's oral health status. Satcher also suggested that saliva may provide clues to a patient's overall health and a possible predictor of systemic disease. There have been several articles that have demonstrated an increased risk of systemic diseases with circulating inflammatory mediators, a reduction in treatment cost for pregnant women who received treatment for their clinically diagnosed periodontal disease. Health profession education has responded to the call for transforming the health system by developing graduates who are capable for working in an environment designed to improve the overall health of patients. Therefore, this article examines why oral health professionals have a significant opportunity to contribute to the improvement overall health of patients and participate in healthcare transformation.


Asunto(s)
Salud Bucal , Enfermedades Periodontales , Prestación de Atención de Salud , Femenino , Personal de Salud , Estado de Salud , Humanos , Masculino , Embarazo , Estados Unidos
17.
Nurs Educ Perspect ; 42(1): 36-38, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-31851137

RESUMEN

ABSTRACT: This innovative pilot study used the Critical conversations: The NLN Guide for Teaching Thinking monograph to promote critical conversation during debriefing in an interprofessional education group setting following a disaster preparedness simulation. Interprofessional health care students (n = 120) participated in the Debriefing Assessment for Simulation in Healthcare survey as well as four focus groups to understand student perspectives related to the Context, Content, and Course format used to cocreate meaning related to the simulation experience. Findings revealed that use of this method promoted critical dialogue underscored by self-efficacy, critical reflection, safety, group size, and interdisciplinary learning.


Asunto(s)
Aprendizaje , Estudiantes de Enfermería , Humanos , Relaciones Interprofesionales , Proyectos Piloto , Estudiantes
18.
Nurs Educ Perspect ; 42(1): 46-48, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-32028377

RESUMEN

ABSTRACT: Public health departments exemplify interprofessional collaboration. Nursing and public health education students are required to complete practicum hours or an internship respectively in community health, yet placements at health departments are limited and competitive. This study evaluated the effects of an interprofessional education intervention on community health nursing and health education students' current interprofessional awareness and understanding, and intent to collaborate interprofessionally. Results showed that the majority of participants felt that their interprofessional awareness, understanding, and intent to collaborate increased. This intervention helped bring an example of the health department experience to students and demonstrate its interprofessional nature.


Asunto(s)
Internado y Residencia , Salud Pública , Conducta Cooperativa , Humanos , Relaciones Interprofesionales , Encuestas y Cuestionarios
19.
Curr Pharm Teach Learn ; 13(1): 19-28, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33131613

RESUMEN

INTRODUCTION: Collaborative practice improves patient outcomes and is a needed student skill. An interprofessional education and collaborative practice (IPECP) program was developed using community pharmacies, clinics, and emergency departments. This study's purpose was to assess student pharmacists' team attitudes and skill development after the IPECP using team observed structured clinical encounters (TOSCEs). METHODS: Nineteen pairs of fourth-year pharmacy and second-year physician assistant students practiced together in a community pharmacy (two days) and clinic or emergency department (two days). They completed TeamSTEPPS training and two team modules. Assessments included TOSCEs and pre/post attitude surveys. RESULTS: Students significantly increased all TOSCE domain skills with pre- to post-mean score (SD) of: team communications 3.0 (0.5) to 4.1 (0.5), collaboration 2.8 (0.6) to 4.0 (0.5), roles and responsibilities 2.4 (0.4) to 3.8 (0.5), patient-centered care 2.8 (0.5) to 4.1 (0.6), conflict management 2.8 (0.5) to 4.1 (0.6), team functioning 2.7 (0.6) to 3.9 (0.6), and global performance 2.8 (0.6) to 4.0 (0.5). Afterwards, students reported positive attitudes about team-based patient care. All students stated the experience increased patient and healthcare professional communication skills and understanding of patient problems, and decreased errors. Most students (84%) agreed team care increased interventions compared to individually provided care. Most students (84%) thought the experience was worthwhile, and 68% agreed the IPECP program should be continued. CONCLUSIONS: This study supports that IPECP can be conducted in a community pharmacy and clinic or emergency department to improve student team skills as evidenced by documented team skills development during TOSCEs.

20.
Palliat Med Rep ; 1(1): 270-279, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33274342

RESUMEN

Palliative care relies on a team approach to manage the complex needs of patients and families living with serious illness. This article describes an interprofessional team's aim to develop an interactive online curriculum in palliative care, with an emphasis on interprofessional education (IPE). The aim of the program is to address the need for formalized interprofessional palliative care education. The interdisciplinary team identified the need for formalized education efforts within our clinical space. To address the need, the team designed an online curriculum based in the core competencies of palliative care and IPE. A new model was established, with the themes of learning about "people," learning the "job," and learning "respect." The team followed the plan-do-study-act model to guide their process. The newly developed interprofessional online curriculum was utilized by palliative care trainees from various disciplines and levels of education. Pre- and post-tests to measure the knowledge, behavior, attitudes, and skills needed for teamwork and core palliative care competencies were completed. Forty-three medical and nursing students, undergraduate and graduate, completed the pretest, and 32 students completed the post-test. Results indicate that learners are growing in interprofessional skills and attitudes, but not in formalized knowledge of palliative care as a result of their clinical experience. Results suggest that more formalized knowledge may need to be provided to learners who come to this clinical experience, which could be delivered through the online curriculum. The knowledge survey should also be re-evaluated for clarity and content.

21.
GMS J Med Educ ; 37(7): Doc84, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33364363

RESUMEN

Objective: The contact restrictions caused by the Covid-19 pandemic fundamentally limit patient-centered teaching. To realize a patient-oriented education in the block training "Internal Medicine" at the University Hospital Halle (Saale) despite the challenges, the already established teaching module "Interprofessional Teleconsultation" was adapted. The short article outlines the interprofessional teaching module including first evaluation results and describes the adapted block training. Method: In the "Internal Medicine" block training, students in a lecture hall navigated a telepresence system, which was accompanied by a physician across the ward and conducted an anamnesis via video and audio transmission without actual patient contact. Results: Students, physicians, and patients were open-minded about this form of communication during the Covid-19 pandemic and quickly got accustomed to the use of the telepresence system. To be able to react to technical challenges (e.g. unstable connection between the communication partners), a careful preparation of the lecturers is necessary. Conclusion: In using a telepresence system, patient-oriented teaching of students in the block training "Internal Medicine" can be ensured with low-threshold technical effort during the Covid-19 pandemic. The telepresence system allows for the involvement of patients into teaching while adhering to the necessary hygiene measures. Despite technical challenges, the teaching format based on telepresence is suitable as an alternative to face-to-face teaching if actual patient contact is not possible.


Asunto(s)
/epidemiología , Educación a Distancia/organización & administración , Educación Médica/organización & administración , Medicina Interna/educación , Telemedicina/organización & administración , Comunicación , Humanos , Educación Interprofesional/organización & administración , Pandemias
22.
Nurse Educ Today ; 97: 104704, 2020 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-33352353

RESUMEN

OBJECTIVE: To explore the educational methods used in the cancer training of undergraduate students in health sciences. DESIGN: Integrative review with a systematic methodology was performed to obtain a comprehensive picture of the variety of educational methods used in cancer training. DATA SOURCES: A search was performed in the PubMed, CINAHL, PsycINFO and Cochrane databases for the period 2008-2020. REVIEW METHODS: The Critical Appraisal Skills Program (CASP) was used to assess the quality of included studies. Three reviewers extracted data and did quality appraisal. RESULTS: A total of 40 articles referring to cancer training in medicine and nursing were included in the review; no articles referring to other health disciplines were found. The main educational methods used were expository methods, case studies, exercises and problems, problem-based learning, learning contracts and project-oriented learning. CONCLUSION: This review shows the need to combine educational methods so that health sciences students acquire competency (knowledge, skill, attitude) for comprehensive cancer care. There is a gap in the training of undergraduate nursing students to provide person/family centered care in oncology. To improve the training and professional practice of future health professionals, interprofessional education and the involvement of people with cancer in simulation education are recommended.

23.
Nurse Educ Today ; 97: 104673, 2020 Nov 26.
Artículo en Inglés | MEDLINE | ID: mdl-33310247

RESUMEN

BACKGROUND: In recent years, interprofessional education has been described as an opportunity for all healthcare professionals to enhance nursing quality by learning together and about one another. Determining perceptions and readiness of nurses regarding interprofessional education is important for effective education planning. OBJECTIVES: The aim of the study is to determine readiness for interprofessional learning and perceptions of interdisciplinary education of nursing students. DESIGN: Descriptive and cross-sectional study. SETTINGS: Nursing departments of public universities, in three different cities in Turkey. METHODS: This study was conducted with 738 third- and fourth-year nursing students. The data of the study was collected using "Student Information Form", "Readiness for Inter-professional Learning Scale (RIPLS)", and "Interdisciplinary Education Perception Scale (IEPS)". The data was analyzed using descriptive statistics, Student's t-test, Kruskal-Wallis test, one-way analysis of variance (ANOVA), and correlation. RESULTS: Mean age of the students was 21.56 ±â€¯1.48, and the majority (72.9%) were women. Of the students, 58.9% chose their profession willingly, 56% chose the department as their first choice, 41.2% wanted to receive education with other healthcare students, and 84% reported having prior teamwork experience. Students' mean total scores of RIPLS and IEPS were respectively 69.78 ±â€¯11.32 and 69.19 ±â€¯16.62. There was a statistically significant difference between RIPLS mean scores and choosing the occupation willingly, order of choice, being satisfied with the choice of department, and willingness to study with other healthcare students, and between IEPS mean scores and choosing the occupation willingly, order of choice and being satisfied with the department choice (p < 0.05). CONCLUSION: Nursing students in three different cities had good readiness levels for interprofessional education and perception levels of interdisciplinary education, and differed according to certain demographical qualities. In addition, there was a positive relationship between readiness of inter-professional education, and perceptions of the students.

24.
Front Public Health ; 8: 602957, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33363094

RESUMEN

Objective: The silent epidemic of oral diseases disproportionately affects disadvantaged communities, especially the elderly who have complex needs for healthcare. This study was to evaluate a pilot oral health interprofessional program that provided hands-on experiences for students across four disciplines: dentistry, medicine, nursing, and pharmacy. Methods: The 8-weeks program was built on four pedagogical principles: care, critical thinking, communication, and collaboration coupled with the 4Ms model: what matters, medication, mentation, and mobility. The curriculum contained four scenarios of a dental complication in an elderly: Alzheimer's Disease, oral cancer, Parkinson's Disease, and stroke. A mixed-methods approach was used to evaluate this pilot program. Results: The average score of knowledge and attitude has increased from 2.94 to 4.39 (p < 0.05) on a 5-point Likert scale. The qualitative responses also showed that students became more confident in practicing within the Age-Friendly health system. Discussion: By the end of the program, all students recognized the significance of the interprofessional program to improve their knowledge and skills to work with professionals across disciplines. Two key features that contributed to the success of the program were (1) an interprofessional education that increased students' awareness of other types of services and (2) four scenarios that allowed students to solve the case and gain hands-on experience. Conclusion: An interprofessional education may equip students with competence to address the health of geriatric patients. Materials used in this study could be shared and adapted to prepare learners for other scenarios that require interprofessional team practice.

25.
Educ Prim Care ; : 1-9, 2020 Dec 29.
Artículo en Inglés | MEDLINE | ID: mdl-33375910

RESUMEN

Interprofessional collaboration (IPC) is vital to primary care. Improving IPC requires cooperation between medical and other healthcare professionals. Transprofessional role plays can enhance the quality of IPC; thus, in this study, we conducted transprofessional role plays, based on existing theories regarding IPC and medical education, with healthcare professionals in primary care. As a study design, the realist approach was used to clarify the effectiveness of transprofessional role plays. Five Likert-scale questionnaires regarding the competency of IPC were used to assess the change in perception of medical and care professionals through educational intervention. The realist approach was employed for the clarification of contexts, mechanisms and outcomes of transprofessional role play using one-on-one interview data. Sixty-two medical care professionals participated in the transprofessional role plays, and 31 participants were interviewed. The difference in the score of the competency scale of IPC was statistically significant in all six competencies (p-value <0.001). Three context, mechanism and outcome theories were clarified from the qualitative analysis of the interviews: reflection on others, realisation of own roles and driving humanistic relationship. Additionally, contextual factors, the mechanisms that facilitated them and the clarified outcomes were identified. Ultimately, in this realist evaluation transprofessional role plays proved to be effective in driving IPC in primary care through improving compassion and reliability across professions. The constant provision of the role play and mutual discussion of each professional's role can facilitate effective IPC in primary care.

26.
Artículo en Inglés | MEDLINE | ID: mdl-33377286

RESUMEN

INTRODUCTION: The goal of this study was to update understanding of the current roles and responsibilities of certified nurse-midwives (CNMs) in the education of resident physicians. Three subaims were to (1) examine the involvement of CNMs in the education of residents in obstetrics and gynecology and family medicine, (2) examine the typology of CNMs' collaboration with residents, and (3) describe CNMs' opinions regarding their educational roles and responsibilities. METHODS: This descriptive study used an electronic survey sent to CNMs involved in the education of medical residents. Survey participants were identified using an online directory of CNMs involved in academic midwifery practices in the United States. Survey items included both closed-ended and open-ended questions to generate quantitative and qualitative data, respectively. RESULTS: Of the 146 CNMs invited to participate, surveys were received from 85, a response rate of 58%. Seventy of the respondents fit inclusion criteria of working with family medicine and obstetrics and gynecology resident physician programs. Most of the midwives' educational roles included informal mentorship of residents, supervision and consultation of intrapartum care, and caring for either their own or residents' patients. All respondents agreed that incorporating CNMs into clinical teams and faculty roles improves resident education. The majority of respondents desired a greater degree of involvement in resident education, with 57% preferring a blended interaction model. DISCUSSION: The majority of CNM respondents reported a preference to have greater involvement in the education of residents. Although CNMs desire a blended interaction or fully integrated model of collaboration with resident physicians, the current state of CNM involvement does not fulfill this degree of collaboration. Opportunities exist for further research, including surveys of resident physicians who work with CNMs, leaders in midwifery, residency program directors, and policy makers.

27.
Eur J Dent Educ ; 2020 Dec 02.
Artículo en Inglés | MEDLINE | ID: mdl-33269533

RESUMEN

PURPOSE/OBJECTIVES: Baseline IPE perceptions for dental students were gathered prior to the implementation of a 2-year formalised IPE curriculum at a US institution. The goal was to establish a baseline of student perceptions and, in the future, continue to track student IPE perception data with IPE engagement as one measure of outcomes. The purpose of this paper is to analyse two dental student cohort perceptions of IPE after engaging in a 2-year longitudinal curriculum. METHODS: First- and second-year students were required to participate in a 2-year IPE curriculum. As a requirement of the curriculum, students were asked to complete a validated IPE assessment, the Student Perceptions of Interprofessional Clinical Education-Revised instrument, version 2 (SPICE-R2). Students completed the SPICE-R2 survey, using a retrospective pretest/post-test design, after engaging in the 2-year curriculum. RESULTS: Sixty-four students in cohort 2017 and 70 students in cohort 2018 completed the entire SPICE-R2. Statistically significant positive changes (p < .05) were found in both dental student cohorts after engagement in the 2-year longitudinal IPE curriculum. CONCLUSION(S): A longitudinal IPE curriculum has the potential to impact student IPE perceptions. Additional longitudinal multi-institutional research is needed to determine best practices in delivery and learning.

28.
JAMA ; 324(24): 2557-2558, 2020 12 22.
Artículo en Inglés | MEDLINE | ID: mdl-33351034
30.
Prim Health Care Res Dev ; 21: e58, 2020 12 10.
Artículo en Inglés | MEDLINE | ID: mdl-33298234

RESUMEN

AIM: To explore district nurses and general practitioners (GPs) interaction in a case seminar when discussing nutritional care for patients in palliative phases cared for at home and to construct a theoretical model illuminating the professionals' main concern. BACKGROUND: Nutritional care for people who are frail and older requires collaboration between nurses and physicians in primary health care. However, both collaboration and knowledge need to be improved, and there is a lack of continuing interprofessional education to meet these needs. We therefore developed an interprofessional educational intervention about nutritional care for patients in palliative phases of disease that was adapted to primary home health care and ended with a case seminar. The case seminar discussions gave us the opportunity to study micro-level interactions between district nurses and GPs in a learning context. METHODS: Grounded theory method was used to construct a theoretical model of the interactions between district nurses and GPs as they discussed an authentic case. FINDINGS: A substantive grounded theory that illuminates how district nurses and GPs interacted, negotiating responsibility for nutritional care for patients in palliative phases cared for at home. The theory is described in a tentative theoretical model that delineates factors that facilitate interprofessional dialogue and lead to interprofessional learning, or block such dialogue and learning. The theoretical model illuminates the importance of a distinction between uniprofessional and interprofessional dialogue in interprofessional educational interventions. It suggests that interprofessional learning was generated directly from the interaction between district nurses and GPs in the case seminar discussions. The model can be used to promote better teamwork and collaboration in caring; for example, as a basis for reflection in collaborative and interprofessional learning interventions and as a tool for facilitators and teachers.

31.
Artículo en Inglés | MEDLINE | ID: mdl-33322181

RESUMEN

Homecare nurses manage patients with extreme homecare dependence through interprofessional collaboration. The quality of the collaboration depends on situations, and the difficulties of homecare nurses are complicated in rural settings because of a few healthcare resources. This study determined rural homecare nurses' difficulties during interprofessional collaboration in providing seamless patient care. Focus groups, followed by one-on-one interviews, were conducted with 13 rural homecare nurses working in rural Japan. Using thematic analysis, four themes were extracted: collaboration with physicians, the collaboration with the government, the collaboration with care workers, and the collaboration among hospital nurses. Rural homecare nurses have difficulties in their working relationships with other professionals, with vague definitions of each professional's roles and responsibilities, and with information-sharing. Interprofessional education and information-sharing should respect rural professional and cultural backgrounds. Respect can accomplish mutual understanding among professional care, leading to seamless patient care in rural home care.

32.
J Dent Hyg ; 94(6): 56-64, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33376123

RESUMEN

Purpose: Inadequate prenatal oral health education in dental hygiene (DH) curricula can negatively impact patient care by graduating clinicians lacking competence in the provision of care for this population. The purpose of this study was to assess the knowledge, opinions, and willingness of DH students to provide oral care services to pregnant patients before and after participating in a prenatal oral health educational program (pOHP).Methods: Senior DH students were invited to complete a baseline and post-program survey to evaluate their experiences in the pOHP at the University of North Carolina, Chapel Hill. All senior DH students attended a one-hour lecture on prenatal oral health guidelines and practices prior to their clinical rotation in the pOHP. Each survey consisted of items on knowledge, confidence, and attitudes related to screening, counseling, and willingness to provide oral care services to pregnant patients.Results: Over a period of three years, 93 DH students (n=93) completed both the baseline and post-program surveys for a 96.8% response rate. Participants reported gains in knowledge and confidence for screening and counseling pregnant patients. Post-program survey respondents agreed that dental providers should deliver oral health counselling to pregnant women (99%, n=93) and perform an oral health examination during prenatal care (99%, n=92). Nearly all of the respondents, (98%; n=90) reported they are likely to take care of pregnant women upon graduation and deliver preventive oral health messaging to this population (98%, n=91).Conclusion: Dental hygiene student participants in a prenatal oral health program (pHOP) demonstrated positive trends in increasing knowledge and confidence in screening and counseling pregnant patients in the dental setting. Inclusion of a clinical experience played an influential role in changes in knowledge regarding the safety of care during pregnancy, indicating a need for both didactic and clinical immersion opportunities to enhance cognitive and affective transformations.


Asunto(s)
Salud Bucal , Higiene Bucal , Actitud del Personal de Salud , Curriculum , Higienistas Dentales , Femenino , Educación en Salud Dental , Promoción de la Salud , Humanos , Embarazo
33.
PLoS One ; 15(12): e0243378, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33290422

RESUMEN

Due to the recent emphasis on the importance of interprofessional education (IPE) in healthcare fields, interest in IPE introduction is increasing in South Korea. The purpose of this study was to examine the differences in perceptions of medical, nursing, and pharmacy students regarding IPE. Also, the study aimed at identifying the priority rankings of educational needs by analyzing the differences between students' perceptions of the importance level and the present level for each interprofessional competency. A cross-sectional study was carried out using a survey. A total of 1,500 questionnaires were distributed, of which 1,084 were returned (response rate, 72.3%). The participants were 559 medical, 393 nursing, and 96 pharmacy students. The questionnaire comprised items on the students' perception of IPE and their interprofessional competency. The questionnaire comprised 12 items on their IPE perception and 9 items on their interprofessional competency. These items were developed by examining the content validity by medical educational specialists and conducting a factor analysis for verification. Data were analyzed using the t-test and ANOVA, and Borich's formula was used to calculate the rank of educational needs.89.6% did not know the meaning of IPE. The difference in students' perception of IPE was not significant by grade. Further, the level of IPE perception was higher for female than male students and for students who knew the meaning of IPE than those who did not. The nursing students' perception of the importance, preference, and effectiveness of IPE was the highest, whereas medical students' perception was the lowest. All students perceived their present level to be lower than the importance level for each interprofessional competency. Interprofessional communication skills (6.791) were highly necessary for students. These results will serve as baseline information for developing IPE programs in South Korea.

34.
Artículo en Inglés | MEDLINE | ID: mdl-33337531

RESUMEN

INTRODUCTION: Hypertension (SBP/DBP > 130/80 mmHg) is a leading risk factor for cardiovascular disease worldwide. AIM: To determine the prevalence of hypertension in a homeless community during an interprofessional education (IPE)-based health fair. METHODS: Homeless participants were recruited between August 2019-September 2019. Faculty, nursing, and pharmacist students, educated 477 participants, aged 18-80 years, on the risk factors associated with untreated hypertension. Then, participants self-completed the consented demographic survey questionnaire. Finally, the sitting blood pressure (BP) was recorded three times based on a standardized procedure, using Omron BPN monitor with cuff. RESULTS: Seven pharmacy students, nine nursing students, two registered nurses, five registered pharmacists, and two medical doctors collaboratively provided health education to the homeless community and screened their sitting BP. 390/477 (81.8%) of participants satisfied the inclusion criteria. Participants (54.7%) of the reported education level was at the high School level or less. More than the half of the participants (average age of 51 ± 13 years) had hypertension (median SBP/DBP ≥ 130/82.7 mmHg), respectively. The prevalence of hypertension for the overall cohort was 61.52% (95% CI, 56.59-66.35). Age (p value = 0.000) was significantly associated with hypertension based on the binary logistic analysis. CONCLUSION: This study demonstrated a high prevalence of hypertension in the homeless community in Long Beach, California with high risk of cardio-vascular events or strokes. This works sheds new light on an issue of major public health significance and points to the need for fostering IPE community-based health fairs intervention program for the US homeless population.

35.
Women Birth ; 2020 Oct 22.
Artículo en Inglés | MEDLINE | ID: mdl-33268297

RESUMEN

BACKGROUND AND PROBLEM: In Australia, interprofessional education has been embedded into pre-registration course accreditation standards. Little is known about Australian midwifery and medical students experiences of interprofessional learning when the focus is on emergency scenarios during birth. AIM: This study aimed to evaluate student experience of Interprofessional Simulation-Based Learning workshops focused on emergency scenarios with midwifery and medical students. METHODS: This was a descriptive, exploratory study of an educational activity designed to enhance inter-professional and collaborative learning between Bachelor of Midwifery students and Bachelor of Medicine students at a Simulation Centre in Sydney, Australia. A pre and post survey design enabled data collection before and after the 6-h simulation-based workshop. FINDINGS: A total of 45 students attended two interprofessional simulation learning days, 14 were midwifery students and 31 medical students. Students disclosed a level of apprehension in the pre workshop survey and ambivalence towards the values of collaborative simulation-based learning. Following the workshop students reported that the workshop enhanced their ability to work collaboratively in practice. Both student cohorts commented on a perceived power imbalance and a sense of each profession having to 'prove' their knowledge levels. Students stated that learning to work together in a safe environment allowed them to develop an appreciation for each other's scope of practice and responsibilities in an emergency situation. CONCLUSION: This form of collaborative learning has the potential to improve new graduate experience in the workplace, especially during emergency situations, and ultimately improve care for women and babies.

36.
J Allied Health ; 49(4): 235-245, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33259567

RESUMEN

Interprofessional education (IPE) has grown in popularity in recent years, but much work remains to be done regarding its evaluation and longitudinal impact, as well as in codifying the attributes of IPE that prepare learners for "collaboration-ready" practice. The present study sought to assess collaboration skill retention or change among graduating seniors who completed an introductory IPE course in 2017, comparing present collaboration skill levels to past levels before and directly after the introductory IPE course using the Self-Assessed Collaboration Skills (SACS) instrument. Additionally, further validation of a collaboration skills instrument was conducted, and qualitative data were gathered to identify collaboration-relevant curricular design elements and generate feedback for continuous program improvement. A final sample of 106 respondents from a variety of professions provided quantitative data, while 91 provided qualitative data. Results suggested that participants retained collaboration skills over the course of their undergraduate education (i.e., 2020 levels as compared to pre-IPE levels in 2017), that IPE evaluation instrumentation requires more cross-contextual and cross-institutional validation, and that students recognize the value in intentional IPE course sequencing for clinical practice. The findings from this study contribute to the further enhancement of IPE outcomes assessment and the design of IPE experiences for fostering collaboration skills among health professional students.

37.
Front Public Health ; 8: 606394, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33344406

RESUMEN

Competencies in health policy and advocacy should be developed by all health professionals to effectively advance their professions but also effectively collaborate in interprofessional teams to improve public health. However, the COVID-19 epidemic presents a challenge to reaching students of health professions through face-to-face offerings. To meet this need, the University of South Florida College of Public Health developed asynchronous and synchronous online health policy and advocacy modules delivered to an interprofessional group of students pursuing health careers. After learning policy and advocacy material individually through a self-paced online curriculum, faculty gathered the students for a synchronous online event where they formed collaborative groups. In interprofessional teams, students prepared and presented advocacy briefs that were critiqued by the faculty. Post-event evaluation results showed that most students strongly agreed that the interprofessional event was very effective, and they all would recommend the program to other students. Universities and colleges educating students of health professions can take advantage of the technologies employed to keep students safe in the COVID-19 pandemic and still reach students effectively with interprofessional health policy and advocacy content.


Asunto(s)
Instrucción por Computador/métodos , Defensa del Consumidor/educación , Personal de Salud/educación , Política de Salud , Educación Interprofesional/organización & administración , Pandemias , Realidad Virtual , Adulto , Curriculum , Femenino , Florida , Humanos , Relaciones Interprofesionales , Masculino , Persona de Mediana Edad , Adulto Joven
38.
Educ. med. (Ed. impr.) ; 21(6): 386-396, nov.-dic. 2020. tab, graf
Artículo en Español | IBECS-Express | IBECS | ID: ibc-ET2-7769

RESUMEN

La asistencia sanitaria centrada en el paciente es la clave para una atención humana a la persona y a su familia. La práctica colaborativa en equipos interprofesionales resulta imprescindible para alcanzar una atención sanitaria de calidad. La universidad tiene la responsabilidad de preparar a sus graduados para trabajar en equipos interprofesionales. Una enseñanza/aprendizaje centrada en la persona, fundamentada en las competencias que definen la educación interprofesional, es clave para que nuestros estudiantes reconozcan la necesidad del trabajo colaborativo. Este artículo detalla un proyecto docente de educación interprofesional de la Universidad de Navarra, donde estudiantes de las facultades de medicina, enfermería y farmacia aprenden juntos y de manera gradual, las claves de cómo trabajar en equipo


Patient-centered healthcare is the key to humane care for the person and their family. Collaborative practice in interprofessional teams is essential to achieve quality healthcare. The University has the responsibility to prepare its graduates to work in interprofessional teams. A person-centered teaching-learning, based on the competences that define interprofessional education, is key for our students to recognize the need for a collaborative work. This article details a teaching project on interprofessional education at the University of Navarra, where students from medical, nursing school nad pharmacy gradually learn together the keys of a teamwork

39.
J Interprof Care ; : 1-6, 2020 Dec 08.
Artículo en Inglés | MEDLINE | ID: mdl-33290114

RESUMEN

Interprofessional trust is essential for effective team-based care. Medical students are transient members of clinical teams during clerkship rotations and there may be limited focus on developing competency in interprofessional collaboration. Within a pediatric clerkship rotation, we developed a novel simulation activity involving an interprofessional conflict, aiming to foster trusting interprofessional relationships. Active participants included a nurse educator and a medical student participant, with additional students using a checklist to actively observe. The debrief focused on teaching points related to interprofessional competencies and conflict resolution. Students completed a written evaluation immediately following the simulation. Descriptive statistics were used to analyze Likert-type scale questions. Conventional content analysis was used to analyze open-ended responses. Two hundred and fourteen students participated in the simulation between June 2018-June 2019. Most students indicated that the simulation was effective (86%) and improved their confidence to constructively manage disagreements about patient care (88%). Students described anticipated changes in practice including developing their role on the interprofessional team as a medical student, developing a shared mental model, and establishing a shared goal. Our findings suggest that simulation-based learning may present an opportunity for developing interprofessional trust in academic health centers.

40.
J Interprof Care ; : 1-9, 2020 Dec 08.
Artículo en Inglés | MEDLINE | ID: mdl-33290117

RESUMEN

Diabetes mellitus and periodontal disease are among the most frequently occurring conditions that have a substantial effect on the global health economy. The literature regarding medical professionals' knowledge of the bidirectional link between diabetes mellitus and periodontal disease has not been analyzed systematically. The review aimed to investigate the knowledge and understanding of physicians and specialists regarding the two-way relationship between diabetes mellitus and periodontal disease and their approach to referring their patients for a dental consultation. An electronic search of PubMed and Google Scholar databases was conducted to review the studies that assessed knowledge and understanding of medical professionals regarding the relationship between diabetes mellitus and periodontal disease. Data from 13 included studies involved 4,027 participants: 3,256 primary care physicians and 771 medical specialists. Just over 50% of the medical professionals had an understanding of oral health and/or periodontal disease. Over one-third of medical professionals were ignorant of the relationship between oral health and diabetes mellitus. Only 30% reported ever referring their patients for an oral health assessment. Another key finding of the investigation was the absence of interprofessional collaborative care between medical and dental professionals while managing patients with diabetes mellitus. Medical professionals with an integrated knowledge of elementary oral health education and training could play a central role in the timely diagnosis and management of periodontal disease in patients living with diabetes mellitus.

41.
Eval Health Prof ; : 163278720978814, 2020 Dec 09.
Artículo en Inglés | MEDLINE | ID: mdl-33291994

RESUMEN

Interprofessional education (IPE) occurs when members of more than one health or social care profession learn interactively together to improve interprofessional collaboration and health care delivery. Interprofessional experiences provide students with the skills and knowledge needed to work in a collaborative manner; however, there is no review on the outcome measures used to assess the effectiveness of IPE learning. The current systematic review examined the outcome measures used to assess interprofessional learning during student clinical experiences. An electronic search of databases retrieved trials of health professional students who completed an IPE intervention during a student clinical experience. Methodological quality of twenty-five studies meeting the inclusion criteria published between 1997 and 2018 was scored independently by two raters using the Physiotherapy Evidence Database and the Confidence in the Evidence from Reviews of Qualitative Research tool. The Interdisciplinary Education Perception Scale was used most frequently to assess interprofessional learning during a student clinical experience. This review provides a summary of outcome measures for educators to consider for evaluation of interprofessional activities during student clinical placements and serves to inform future conversations regarding the use and development of outcome measures to provide evidence for student achievement of IPE objectives and competencies.

42.
Gerontol Geriatr Educ ; : 1-9, 2020 Dec 03.
Artículo en Inglés | MEDLINE | ID: mdl-33269658

RESUMEN

This paper presents a valuable activity to teach health professions students - the interprofessional geriatric case competition. This program brought together students from multiple health professions to design and present a comprehensive care plan using a simulated complex geriatric patient case. Student participants demonstrated beginning skills in interprofessional collaboration based on the IPEC competencies. The case competition provides a positive, engaging experience to introduce health professions students to geriatric principles and develop their readiness for collaborative interprofessional practice. The competition could be conducted virtually, providing a supplement to on-site education.

43.
BMC Health Serv Res ; 20(1): 1124, 2020 Dec 04.
Artículo en Inglés | MEDLINE | ID: mdl-33276789

RESUMEN

BACKGROUND: Interprofessional education in childhood cancer is a multifaceted field involving multiple healthcare professionals with general and specialised knowledge and skills. Complex treatment, care and rehabilitation require continuous professional development and maintenance of healthcare professionals' competencies in their field of expertise. However, limited knowledge exists in comparing interprofessional and monoprofessional education. Only a few randomised studies have evaluated the effectiveness and efficiency of interprofessional education. The objective of this single-centre, investigator-initiated cluster randomised trial is to study the effect of interprofessional versus monoprofessional case-based learning on healthcare professionals' knowledge of gastrointestinal side effects and attitudes towards team collaboration. METHODS: This study will randomise healthcare professionals to participate in either the experimental interprofessional group or the control monoprofessional group of case-based learning. The topic of the case-based intervention will be gastrointestinal side effects, one of six categories identified in a three-round Scandinavian Delphi study as relevant for interprofessional education in childhood cancer. The primary outcome is the self-reported questionnaire Assessment of Interprofessional Team Collaboration Scale. Secondary outcomes are measured by the self-reported questionnaires Readiness for Interprofessional Learning Scale Questionnaire, Safety Attitudes Questionnaire, and knowledge will be evaluated using a multiple-choice quiz. Participants will receive the self-reported questionnaires about 2 weeks before and 1 month after the intervention. On the day of the intervention, participants will answer a multiple-choice quiz before and after the case-based learning. Linear mixed models will be used to compare differences between the two groups in mean scores postintervention, adjusting for preintervention scores. DISCUSSION: This study will provide insight into the differences between interprofessional and monoprofessional case-based learning and how it affects healthcare professionals' knowledge of gastrointestinal side effects and attitudes towards team collaboration. TRIAL REGISTRATION: The intervention was registered at Clinical Trials.gov : NCT04204109 on December 102,019 and with the National Committee on Health Research Ethics: H-19087506 December 112,019 and the Danish Data Protection Agency: P-2019-637 October 152,019.

44.
BMC Med Educ ; 20(Suppl 2): 455, 2020 Dec 03.
Artículo en Inglés | MEDLINE | ID: mdl-33272300

RESUMEN

Interprofessional education (IPE) is a critical approach for preparing students to enter the health workforce, where teamwork and collaboration are important competencies. IPE has been promoted by a number of international health organisations, as part of a redesign of healthcare systems to promote interprofessional teamwork, to enhance the quality of patient care, and improve health outcomes. In response, universities are beginning to create and sustain authentic and inclusive IPE activities, with which students can engage. A growing number of health professionals are expected to support and facilitate interprofessional student groups. Designing interprofessional learning activities, and facilitating interprofessional groups of students requires an additional layer of skills compared with uniprofessional student groups. This article outlines the key points for planning and practicing interprofessional facilitation within the classroom and clinical setting.

46.
Artículo en Inglés | MEDLINE | ID: mdl-33369528

RESUMEN

Sudden cardiac arrest (SCA) is one of the leading causes of death in adults around the world. And in some patients, SCA is followed by a return of spontaneous circulation (ROSC) and remain unresponsive. International guidelines recommend therapeutic hypothermia within 4 hours of ROSC for patients' survival. A medium-sized tertiary teaching hospital in the Midwestern United States was not achieving the recommendations of therapeutic hypothermia therapy. A root cause analysis identified multiple factors contributed to therapy delay. In March 2019, this hospital embarked on a 6-month trial of an intravascular targeted temperature management (ITTM) system to meet the recommendations. Donabedian's model guided the trial and included patients who suffered an SCA, with ROSC and remained unresponsive. Descriptive analysis was completed to compare the patients before and after the trial. The trial included interprofessional education of the ITTM system, policies, orders, and new process for initiating the therapy. A total of nine patients were included in the trial and with an average time to target temperature was 3.28 hours compared with 8.81 hours before the trial. The trial demonstrated ITTM was successful in meeting the recommendations. Paired with the promising research on the system's effectiveness, we have demonstrated that intravascular cooling can be implemented to reach the international recommendations. These reductions in treatment delays may prompt improved outcomes for individuals in the post-SCA population.

47.
Med Educ ; 2020 Dec 14.
Artículo en Inglés | MEDLINE | ID: mdl-33316124

RESUMEN

OBJECTIVES: In response to the observations that interprofessional education (IPE) is seemingly atheoretical or under-theorised, this quantitative research seeks to uncover students' motivational mechanisms which could explain their behavioral and collaborative outcomes using self-determination theory (SDT). While SDT has been studied in various contexts, its applicability to IPE remains underexplored. This study aims to integrate a new perspective in understanding students' motivation in IPE by exploring how the fulfillment of a need for sense of autonomy, competence, and relatedness is linked to desirable IPE outcomes. METHODS: Utilising quantitative methods, we involved 255 healthcare students in Hong Kong from the medical, nursing, and pharmacy disciplines enrolled in IPE anticoagulation therapy module. They were invited to respond to the Psychological Need Satisfaction Questionnaire and other measures as part of the post-test. RESULTS: Sense of autonomy emerged as the strongest positive predictor of behavioral (collective dedication, behavioral engagement) and collaboration outcomes (team effectiveness, goal achievement). There were no significant program-level differences across these outcomes except for behavioural engagement for which nursing students had a higher perception than medicine students. CONCLUSIONS: We were able to demonstrate that SDT is a meaningful framework in understanding behavioral and collaboration outcomes in IPE. The major theoretical contribution of this study refers to the ability of students' motivation to explain variance in their behavioral outcomes. That is, sense of autonomy consistently predicted team effectiveness, collective dedication, behavioral engagement, and goal achievement. Autonomous motivation among a sample of healthcare students can explain behavioral outcomes. Theoretical, methodological, and practical implications are discussed.

48.
BMC Med Educ ; 20(1): 499, 2020 Dec 09.
Artículo en Inglés | MEDLINE | ID: mdl-33298029

RESUMEN

BACKGROUND: With funding from the United States Health Resources Service Administration (HRSA), a consortium of health professional training institutions from Africa developed HIV-specific, interprofessional, team-based educational resources to better support trainees during the transition period between pre-service training and professional practice. METHODS: Ten faculty members representing nine medical and nursing schools in sub-Saharan Africa (SSA) developed a training package of modules focused on core clinical, public health, interprofessional education (IPE), and quality improvement (QI) domains related to HIV service delivery. Curriculum development was informed by a rapid needs assessment of existing tools and future needs for HIV education across 27 SSA health professions training institutions. A total of 17 modules were developed, targeted at newly qualified health care professionals to be taught in a series of two-day workshops meant to complement existing institution specific HIV-curricula. RESULTS: Between April and July 2019, a comprehensive case-based HIV training package was developed to support trainees in transition from pre-service training to independent professional practice. Each module, addressing different elements of interprofessional practice, was intended to be delivered in an interprofessional format. Thus far, 70 health professions training institutions in 14 countries have implemented the program; 547 educators facilitated STRIPE workshops, with a total of 5027 learners trained between September 2019 and September 2020. CONCLUSIONS: To our knowledge this is the first IPE HIV-specific curriculum explicitly focused on enhancing the quality of training provided to graduating health care professionals working in SSA. The collaborative, cross-institutional, interprofessional approach to curriculum development provides a benchmark for how best-practice approaches to education can be disseminated in SSA.

49.
Ann Am Thorac Soc ; 2020 Dec 17.
Artículo en Inglés | MEDLINE | ID: mdl-33332994

RESUMEN

RATIONALE: Mechanically ventilated ICU patients are often managed to maximize blood oxygen levels, yet hyperoxemia may be deleterious to some. Little is known about how ICU providers weigh tradeoffs between hypoxemia and hyperoxemia when managing acute respiratory failure. OBJECTIVE: To define ICU providers' mental models for managing oxygenation for patients with acute respiratory failure and identify barriers and facilitators to conservative oxygen therapy. METHODS: In two large, US, tertiary care hospitals, we performed semi-structured interviews with a purposive sample of ICU nurses, respiratory therapists, and physicians. We assessed perceptions of oxygenation management, hyperoxemia and conservative oxygen therapies, audio recording and transcribing interviews verbatim. We analyzed transcripts for representative themes using an iterative thematic analysis approach. RESULTS: We interviewed 10 nurses, 10 respiratory therapists, 4 fellows and 5 attending physicians before reaching thematic saturation. Major themes included perceptions of hyperoxemia, attitudes towards conservative oxygen therapy and aspects of titrated oxygen therapy implementation. Many providers did not recognize the term "hyperoxemia", while others described a poor understanding; several stated they never encounter hyperoxemia clinically. Concerns about hyperoxemia varied: some providers believed that typical ventilation strategies emphasizing progressive lowering of fraction of inspired oxygen mitigated worries about excess oxygen administration, while others maintained that hyperoxemia is harmful only to patients with chronic lung disease. Almost all interviewees expressed familiarity with lower oxygen saturations in chronic obstructive pulmonary disease. Cited barriers to conservative oxygen therapy included concerns about hypoxemia, particularly among nurses and respiratory therapists, perceptions that hyperoxemia is not harmful, and lack of clear evidence supporting conservative oxygen therapy. Interviewees suggested that interprofessional education and convincing clinical trial evidence could facilitate uptake of conservative oxygenation. CONCLUSIONS: This study describes attitudes toward hyperoxemia and conservative oxygen therapy. These preferences and uncertain benefits and risks of conservative oxygen therapy should be considered during future implementation efforts. Successful oxygen therapy implementation most likely will require: (1) improving awareness of hyperoxemia's effects, (2) normalizing lower saturations in patients without chronic lung disease, (3) addressing engrained beliefs regarding oxygen management and oxygen's safety, and (4) utilizing interprofessional education to obtain buy-in across providers and inform the ICU team.

50.
MedEdPORTAL ; 16: 11054, 2020 Dec 11.
Artículo en Inglés | MEDLINE | ID: mdl-33324754

RESUMEN

Introduction: To achieve high-quality, patient-centered care, teaching programs across health professions must prepare their learners to work in effective teams. We created a simulation activity to formatively assess interprofessional objectives in graduating medical, nursing, and pharmacy students. This simulation also gave learners an opportunity to practice clinical airway resuscitation skills. Methods: The simulation featured a decompensating adult asthmatic with a chief complaint of shortness of breath and a final diagnosis of severe asthma exacerbation and respiratory failure. Students completed a prebrief to formulate a plan and then interacted with a mannequin. Faculty led a debriefing and completed assessments of the team's performance. The students completed a questionnaire assessing their own and the team's performance. Results: Four sessions were held over a 2-year period. A total of 91 graduating students participated in the activity: 33 from Baylor College of Medicine, 26 from University of Houston College of Pharmacy, and 28 from Texas Woman's University Nelda C. Stark College of Nursing. Postsession questionnaire data demonstrated very good overall team performance and good individual performance. Student comments demonstrated an understanding of the importance of teamwork and thoughtful reflection on their own areas for improvement. All students rated the activity as valuable and effective. Multirater assessments of the students found that most met three of the four objectives. Discussion: This activity allows for real-time formative assessment with a focus on roles, communication, and managing difficult situations. The debriefing demonstrates the students' understanding of interprofessional goals in providing effective patient-centered care.

51.
J Palliat Med ; 2020 Dec 16.
Artículo en Inglés | MEDLINE | ID: mdl-33326309

RESUMEN

Background: Health care providers (HCPs) require ongoing training and mentorship to fully appreciate the palliative care needs of children. Project ECHO® (Extension for Community Healthcare Outcomes) is a model for delivering technology-enabled interprofessional education and cultivating a community of practice among HCPs who care for children with life-limiting illness. Objectives: To develop, implement, and evaluate the Project ECHO model within the pediatric palliative care (PPC) context. Specific objectives were to evaluate (1) participation levels, (2) program acceptability, (3) HCP knowledge changes, (4) HCP self-efficacy changes, and (5) perceived practice changes after six months. Intervention: An interprofessional PPC curriculum was informed by a needs assessment. The curriculum was delivered through monthly virtual 90-minute TeleECHO sessions (didactic presentation and case-based learning) from January 2018 to December 2019. The program was freely available to all HCPs wishing to participate. Design: A mixed-methods design with repeat measures was used. Surveys were distributed at baseline and six months to assess outcomes using 7-point Likert scales. Descriptive and inferential statistical analyses were conducted. The study was approved by the Research Ethics Board at the Hospital for Sick Children. Results: Twenty-four TeleECHO sessions were completed with a mean of 32 ± 12.5 attendees. Acceptability scores (n = 43) ranged from 5.1 ± 1.1 to 6.5 ± 0.6. HCPs reported improvements in knowledge and self-efficacy across most topics (11 out of 12) and skills (8 out of 10) with demonstrated statistical significance (p < 0.05). Most participants reported positive practice impacts, including enhanced ability to provide PPC in their practice. Conclusion: Project ECHO is a feasible and impactful model for fostering a virtual PPC-focused community of practice among interprofessional HCPs.

52.
Korean J Med Educ ; 32(4): 317-327, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33296575

RESUMEN

PURPOSE: The purposes of this study were to describe the development and implementation of an interprofessional simulation-based education (IPSE) for undergraduate nursing and medical students, their perceptions of the impact of IPSE, and identify their changes in attitudes toward each other's health professions after participating in IPSE in South Korea. METHODS: This study used a qualitative descriptive design. A purposive sample of 43 third-year medical students and a convenient sample of 44 fourth-year nursing students participated in a 2-day IPSE program that consisted of ice-breaking and patient safety activities, and 4-hour three interprofessional team-based high-fidelity simulation education sessions. Data were collected through reflective journal after the IPSE program and keywords before and after the IPSE program, and were analyzed using the content analysis and word cloud analysis. RESULTS: Three themes emerged: "positive experience" with understanding roles and responsibilities and learning by doing in simulation environments being reported. In the second theme, "positive learning outcomes" participants reported enhancing collaboration and confidence in communication skills. The final theme "benefits to patients of interprofessional collaborative practice" included high quality of care and patient safety. Before the IPSE experience, most medical students perceived the nurse as nightingale and syringe, and nursing students perceived the doctor as order, expert, and knowledge. After their IPSE experience, both nursing and medical students viewed each other as colleagues. CONCLUSION: These results suggest that the use of high-fidelity team-based simulation in IPE is effective in practicing and developing undergraduate nursing and medical students' interprofessional collaboration through hands-on experience.

53.
Korean J Med Educ ; 32(4): 329-341, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33296576

RESUMEN

PURPOSE: Effective and efficient health services require efforts to increase collaboration among health professionals. One of the barriers to effective collaboration is stereotypes. Stereotypes represent perceptions or perspectives about a person or group of people. This study aims to explore the perceptions of health professional students and practitioners regarding stereotypes. METHODS: This was a qualitative study using a phenomenology approach. A sample of health professions students from both preclinical and clinical stages, as well as health practitioners, was selected using a maximum variation sampling method. Primary data collection was conducted through focus group discussions. Data obtained were analyzed using thematic analysis. A total of nine focus group discussions were conducted. RESULTS: Four themes were identified from this study, including the types of stereotypes, factors affecting stereotype formation, the implications of stereotypes, and how to overcome stereotypes. Stereotype formation was affected by the lack of understanding of other health professions' roles, hierarchical culture, personal experience in receiving healthcare, and community view. Stereotypes among health professionals created obstacles to healthcare team communication and reduced self-confidence in certain health professionals. These stereotypes may be overcome through competency development and knowledge sharing among professionals as well as through education on other health care professionals' roles and competencies so that each profession possessed similar goals for patient safety. CONCLUSION: Both positive and negative stereotypes negatively affected collaboration. Stereotypes were greatly affected by multifactorial causes. Therefore, understanding other professions' roles and conducting interprofessional education are important to overcome stereotypes.

54.
Creat Nurs ; 26(4): 225-231, 2020 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-33273125

RESUMEN

BACKGROUND: Burnout among health-care professionals is a growing problem having a sizeable impact on patient safety and health care as a whole. High levels of resilience in health-care professionals have been associated with safer care environments, improved health outcomes, higher quality care, and improved caregiver well-being and mental health. Resilience education can improve personal and professional resilience. OBJECTIVE: The goal of this project was to evaluate a resilience education program to improve measures of burnout and resilience in health-care professionals. DESIGN: A quantitative cross-sectional pretest/posttest design was used. SETTING: The resilience education program was implemented in a large, not-for-profit health-care system in the southeastern United States. METHODS: Participants completed the Copenhagen Burnout Inventory (CBI) and The Connor-Davidson Resilience Scale-25 (CD-RISC-25) immediately before the workshop and 2 weeks afterward. Participants also completed an evaluation survey one day after the education. RESULTS: Scores on the CD-RISC-25 showed statistically significant increases in resilience qualities after the education. Although not statistically significant, burnout as measure by CBI scores decreased following the workshop. CONCLUSION: A relatively short educational program can positively impact resilience and burnout levels in health-care professionals. Positive outcomes included successful learning outcomes and increased resilience qualities.

55.
Creat Nurs ; 26(4): 256-262, 2020 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-33273131

RESUMEN

BACKGROUND: Currently, about 40 million people in the United States live in poverty, one of the most significant social determinants of health. Nurses and social workers must understand the effect of living in poverty on their clients' health and quality of life. PURPOSE: Nurses and social workers will encounter persons living in poverty. Therefore, beginning in their undergraduate education, health professions students must be aware of their attitudes towards poverty and how poverty affects health. METHODS: The Community Action Poverty Simulation was conducted with nursing and social work students at a small liberal arts institution. The Attitudes toward Poverty-Short Form (ATP-SF) and Beliefs Related to Poverty and Health (BRPH) tools were used pre- and postsimulation to assess students' attitudes about poverty and beliefs about the relationship between poverty and health. An emotional response plan was created to address participants' emotional responses by providing a separate space on-site and information about future resources. RESULTS: The ATP-SF showed a significant overall difference (p < .001) between pre- and postsimulation surveys, indicating a shift toward a structural explanation of poverty; the BRPH showed that participants believed poverty is the result of illness and inability to work (p < .01). CONCLUSION: This study supports poverty simulation use to promote awareness of attitudes towards those living in poverty and how poverty impacts health. Recommendations include using more community resource volunteers with first-hand poverty experience, allowing students to role-play adults or older teens in the simulation, and including other health professions students.

56.
J Multidiscip Healthc ; 13: 1537-1544, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33209033

RESUMEN

Background: Collaborative interprofessional practice improves health outcomes. Interprofessional education (IPE) is essential in improving this collaboration and the quality of care. Although the majority of IPE research focuses on students, the delivery of IPE requires multiple levels of support within educational institutions, particularly teaching staff that are positive about and advocate for IPE. This study explored the attitudes of teaching staff towards interprofessional collaboration across a range of professions in Health at King Saud University, Saudi Arabia. Methods: A pre-test post-test design was used with 53 teaching staff from the Health Colleges, King Saud University, before and after an interprofessional development workshop. A 12-item, 3-subscale version of the IEPS was used to evaluate changes in the 3-subscales "competency and autonomy", "perceived need for cooperation" and "perception of actual cooperation". Results: This study involved teaching staff from medicine, nursing, pharmacy, dentistry, applied medical science and emergency medical services. Results showed positive attitudes towards IPE, including competency and autonomy, the need for cooperation, and the perception of actual cooperation. The analysis also showed a statistically significant effect of subscale 1 (competency and autonomy) was produced between the pre- and post-workshop training. Conclusion: Interprofessional collaboration across the Health Colleges is an essential component of IPE, just as IPE is an integral component of interprofessional collaborative practice. The findings provided a baseline, as well as an incentive, for further development in IPE, from policy through to practice, across the Health Colleges. Findings also showed teaching staff having a positive attitude towards interprofessional collaboration. Further research is needed on tools for measuring IPC across university hierarchies and disciplines, as well as on enablers of IPE (and not just barriers).

57.
Clin Imaging ; 72: 58-63, 2020 Nov 14.
Artículo en Inglés | MEDLINE | ID: mdl-33217671

RESUMEN

RATIONAL: While radiology residents must participate in a scholarly project per Accreditation Council for Graduate Medical Education (ACGME) Program Requirements, some residency programs may lack a well-thought out, cohesive approach to research that incorporates the residents' perspective. Our objective was to improve the radiology resident research experience with resident-led initiatives. MATERIAL AND METHODS: An annual resident research survey was created and distributed to 28 radiology residents in December 2018. Following the survey, a newly formed resident research committee developed a six-step strategic framework of resident-led initiatives to promote research and scholarly activity within the department: Reflect, Recruit, Regroup, Revive, Recognize, and Review. Outcomes of this framework were evaluated with the second annual resident research survey in December 2019. RESULTS: Our institution identified areas of improvement on the 2019 survey after the implementation of the six-step initiatives upon comparison to the 2018 survey. A greater number of residents reported that they had adequate or somewhat adequate resources for research within the department in 2019 (95.2% [20/21]) in comparison to 2018 (70.6% [12/17]) (p = 0.03). A greater percentage of residents found available research projects engaging/interesting in 2019 (80.9% [17/21]) compared to 2018 (70.6% 12/17) (p = 0.49). The most commonly reported departmental resources needed to encourage research on the 2019 survey were dedicated research time (26.9%, 18 out of 67 total responses) and mentorship/encouragement from the faculty (19.4%, 13/67). CONCLUSION: With a specific framework and appropriate departmental support, resident-led initiatives can improve the research experience within the radiology department from the residents' perspective.

58.
Rural Remote Health ; 20(4): 5785, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33220701

RESUMEN

INTRODUCTION: New Zealand (NZ) faces an ongoing shortage of rural medical professionals. In an effort to increase interest in rural practice, both of the medical schools in NZ offer rural immersion programs as well as rural entry pathways. The aim of this study was to compare the effect of long (>33-week) rural immersion with a short (5-week interprofessional) rural immersion or no rural immersion on the career location intentions of NZ medical students. METHODS: This observational study used linked data from the Commencing Medical Students Questionnaire (CMSQ) and Exit Questionnaire (EQ), collected between 2011 and 2017 as part of the Medical Schools Outcomes Database project, along with information on whether or not a student undertook a rural immersion program. The main outcome measure was EQ career location intention (Rural (population 100 000)). The explanatory variables were rural immersion (long, short, none), age, ethnicity, background, CMSQ career location intention, gender, specialisation preferences and interest in rural medicine. In addition to univariate analysis, data were used to build a multinomial model to determine relative associations of these variables with the outcome. RESULTS: Full data were available for 1367 NZ medical students (47% of all students during the time period). Of these, 17.4% had undertaken a long or short rural immersion program. In univariate analysis, age was the only variable that did not significantly predict EQ rural intention outcome. In the multivariate model, rural immersion was a significant independent predictor of EQ career location intention. Students taking a long rural immersion were 6.4 and 4.4 times more likely to select a Rural or Regional intention, respectively, than those with no rural immersion. This strong effect on rural intentions was seen regardless of background. CMSQ career location intention, background, ethnicity, rural club membership and preference for general practice were also significant predictors. While short rural immersion did not have an independent effect, this finding should be interpreted with caution given the smaller number of students and the response rate. CONCLUSIONS: Long rural immersion is highly beneficial for increasing interest in rural work, increasing the likelihood that medical students will intend to work outside an urban setting. Students who signal an early rural intention are strong candidates for such programs later in their course, regardless of their background. A three-category classification for geographic background and career location intention permitted a more detailed understanding of the interplay among demographic variables and rural immersion in influencing career intentions. Following cohorts into their postgraduate years is needed to ascertain if these career location intentions persist.

59.
Nurs Outlook ; 2020 Nov 19.
Artículo en Inglés | MEDLINE | ID: mdl-33220911

RESUMEN

BACKGROUND/PURPOSE: An innovative care coordination program was developed to enhance wellness among low-income older adults living in subsidized apartment buildings and to provide rich interprofessional education experiences for health professions students. METHOD: Program effectiveness for the residents was measured through an evaluation of participation, services used, and healthcare utilization. Educational effectiveness was measured through a change in health concepts and perceptions of interprofessional practice. FINDINGS: Health care utilization among participating residents showed an 8.6% reduction in emergency department visits and 9.8% reduction in hospital admissions. Students demonstrated improved knowledge in motivational interviewing (p = .02); diabetes (p = .02); hypertension (p≤.01); and frailty (p≤.01). Changes in students perception of interprofessional practice were significant in two areas; Teamwork and Collaboration (p≥.00); and Person Centeredness (p = .00). DISCUSSION: This care coordination model may be an effective approach to reduce care resource utilization among medically complex lower income older adults and provides a rich interprofessional learning experience for students.

60.
J Adv Nurs ; 2020 Nov 22.
Artículo en Inglés | MEDLINE | ID: mdl-33222216

RESUMEN

AIM: The aim of this study was to explore and understand the interprofessional collaboration preparation processes implemented by clinical tutors and students, in various professions, involved in interprofessional education experiences. DESIGN: A constructivist grounded theory approach. The study was carried out between 2015-#2017. METHOD: Semi-structured interviews were conducted with a total of ten undergraduate students and the seven clinical tutors who supervised them from three undergraduate courses in a university of applied sciences and arts in Switzerland. Students were sampled during their clinical placement. Data were analysed and coded using constant comparative analysis with the support of Nvivo 10 software. RESULTS: A substantive theory "Practicing contextual models of interprofessional care" was generated. It explains how the whole process takes place, the tutor-student interactions, and how together they gradually build models of interprofessional care, linked to their clinical context and to the patients/families who are part of it. CONCLUSION: The process describes a journey to comprehensively explain the roles played by the two main actors (student and tutor) who build a relationship of interaction. IMPACT: This theory provides an understanding of the complex process set up by students and how they are prepared for collaboration with other professionals. Its importance is mainly expressed in the educational field because it reveals a different vision from the one present so far and enables a thorough reflection from the pedagogical point of view. Teachers will be able to observe and approach the students' training curricula from a different point of view by evaluating any changes to favour it and rethink the organizational and training models of current programs.

61.
J Interprof Care ; : 1-7, 2020 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-33222563

RESUMEN

Interprofessional education (IPE), as preparation for interprofessional practice (IPP), is essential for quality, coordinated, outcome-focussed patient care. To develop capacity for IPP in future healthcare practitioners, IPE needs to be developed within curriculum and applied within authentic settings. The study aims were threefold: (a) determine if an established type 2 Diabetes Mellitus (T2DM) exercise and healthy lifestyle program could be replicated and delivered at a satellite health precinct; (b) report on changes in students' attitudes to IPP in response to involvement in the program; (c) explore the perceptions of students in response to participation in the program whilst on placement. This paper reports on the quantitative changes in perceptions of IPE as measured by the SPICE-R2 instrument and a qualitative analysis of the student reflection of participating in IPP. Thirty-five students, from 4 health professions, participated in the study. The quantitative outcomes showed significant improvement in the perceptions of IPE (p <.01), including significant improvements understanding of roles and responsibilities, teamwork, and patient outcomes (p <.01). The qualitative analysis included a subset of 18 students who participated across two focus groups, highlighting four key themes: (a) health students reported varied initial experience with, and understanding of IPE; (b) the IPE program enabled students to see the value of teamwork for patient care; (c) IPE enhanced role clarity amongst the students, and (d) the IPE program provided an authentic learning experience, best suited to final year students. Our findings reinforced the value of a partnership between higher education and health services to deliver IPP care and learning, student valuing of the importance of IPE as part of authentic learning, and need for a scaffolded approach toward IPE is needed across health curriculums, and clinical placement to ensure all students can develop IPE capabilities that will enable them to work together to deliver the best healthcare to clients.

62.
J Interprof Care ; : 1-7, 2020 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-33222588

RESUMEN

National and international organizations are increasingly focused on interprofessional education in health-related fields to address complex and emerging health issues. One public health concern is the impact of adverse childhood experiences (ACEs). At one public university in Appalachia, faculty of nursing, public health, and social work collaborated to develop an interprofessional course at the undergraduate and graduate levels that focus on ACEs, trauma, and resiliency literature as well as interprofessional collaboration and evidence-based prevention and treatment. In this paper, the faculty detail the approach undertaken to develop this interprofessional course, lessons learnt and key resources.

63.
Eur J Dent Educ ; 2020 Nov 22.
Artículo en Inglés | MEDLINE | ID: mdl-33222374

RESUMEN

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.

64.
MedEdPORTAL ; 16: 11021, 2020 11 13.
Artículo en Inglés | MEDLINE | ID: mdl-33204842

RESUMEN

Introduction: New medical interns face a steep learning curve as they must manage complex medical scenarios, many of which they have only seen before in a classroom setting. To ameliorate these challenges, medical schools are increasingly including courses designed to address the transition from student to doctor. One of the biggest challenges for new interns is learning to triage and manage nursing pages, so we designed a mock paging program incorporated within our fourth-year transitions course. Methods: We developed a database of clinical scenarios to occur via telephone between a nurse and a medicine intern. Throughout the 2-week course, these cases were administered to 40 fourth-year medical students by Master's level nursing students and nurse evaluators. The nurses used checklists to evaluate medical student management and communication, and at the end of the phone encounter students received immediate feedback. We used an observational prospective design, using a within subjects method with repeated measures. Results: Data from a total of 216 phone calls were analyzed for 36 students. No statistically significant improvement of checklist scores was observed. Substantial interrater reliability was observed for the four observed cases with a Fleiss-Kappa of .76. Student comments indicated the activity was helpful for preparing them to answer pages. Discussion: Our paging program offered students the chance to simulate being on call, as well as the opportunity to receive immediate feedback. It did not show improvement in checklists across time. Limitations included a small sample size and few common variables across the cases.

65.
BMC Med Educ ; 20(1): 467, 2020 Nov 25.
Artículo en Inglés | MEDLINE | ID: mdl-33238957

RESUMEN

BACKGROUND: Interprofessional collaboration is increasingly important in healthcare, but interprofessional education (IPE) faces challenges, such as different study programmes with varied schedules and campuses. These challenges can be met, in part, by using web-based virtual patients (VPs) as a tool in IPE. However, demands for relevant patient presentations and clinical practice increase when VPs are used by students from different programmes. The aim of this study was to improve the presentation of professional perspectives regarding nurses and physicians and their collaboration in order to increase the clinical authenticity of existing VPs. METHODS: Clinical observations were conducted to gain familiarity with the context. Semi-structured interviews were performed with individual nurses and physicians with experience of patients with leg ulcers. The interviews were recorded, transcribed and analysed using thematic analysis. RESULTS: The clinical observations exposed a lack of interprofessional collaboration in practice with regard to patients with leg ulcers. The interview analysis resulted in two themes: Clinical care and Organizational structure. The theme Clinical care included nursing with a holistic approach to the patient and awareness of the patient's well-being, including nutrition and home situation. The theme Organizational structure revealed a lack of teamwork in primary care. The interviewees stressed learning together and sharing responsibility, and they emphasised the importance of implementing interprofessional learning in the education of nurses and physicians in order to stimulate future teamwork. The VP should offer a broad medical history so that healthcare students are made aware of how a disease can affect the patient's social situation, and thereby illustrate the importance of interprofessional collaboration. The information should also be comprehensive and clear, leading to a diagnosis, so the student can gain clinical knowledge and build a foundation for discussion of treatment. CONCLUSIONS: Interviews and observations in clinical practice can be used to enhance authenticity in VPs for interprofessional learning. A thorough look at authentic clinical environments can enrich and improve educational settings using VPs, and it can highlight the challenges students can encounter in clinical care of the patient and in an organisation with regard to interprofessional collaboration.

66.
BMC Med Educ ; 20(1): 476, 2020 Nov 26.
Artículo en Inglés | MEDLINE | ID: mdl-33243233

RESUMEN

BACKGROUND: Effective collaboration and communication among health care team members are critical for providing safe medical care. Interprofessional education aims to instruct healthcare students how to learn with, from, and about healthcare professionals from different occupations to encourage effective collaboration to provide safe and high-quality patient care. The purpose of this study is to confirm the effectiveness of Interprofessional education by comparing students' attitudes toward interprofessional learning before and after simulation-based interprofessional education, the perception of teamwork and collaboration between physicians and nurses, and the self-reported competency differences among students in interprofessional practice. METHODS: The survey responses from 37 5th-year medical students and 38 4th-year nursing students who participated in an interprofessional education program were analyzed. The Attitude Towards Teamwork in Training Undergoing Designed Educational Simulation scale, the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration, and the Interprofessional Education Collaborative competency scale were used for this study. The demographic distribution of the study participants was obtained, and the perception differences before and after participation in interprofessional education between medical and nursing students were analyzed. RESULTS: After interprofessional education, student awareness of interprofessional learning and self-competency in interprofessional practice improved. Total scores for the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration did not change significantly among medical students but increased significantly among nursing students. Additionally, there was no significant change in the perception of the role of other professions among either medical or nursing students. CONCLUSIONS: We observed an effect of interprofessional education on cultivating self-confidence and recognizing the importance of interprofessional collaboration between medical professions. It can be inferred that exposure to collaboration situations through Interprofessional education leads to a positive perception of interprofessional learning. However, even after their interprofessional education experience, existing perceptions of the role of other professional groups in the collaboration situation did not change, which shows the limitations of a one-time short-term program. This suggests that efforts should be made to ensure continuous exposure to social interaction experiences with other professions.

67.
Med Sci Educ ; : 1-8, 2020 Nov 23.
Artículo en Inglés | MEDLINE | ID: mdl-33251039

RESUMEN

The Virginia Tech Carilion School of Medicine (VTCSOM) is a 4-year allopathic medical school in Roanoke, VA. The curriculum is organized into four learning domains: basic science, clinical science, research, and interprofessionalism (IPE). A recent curriculum renewal effort allowed the school to embark upon a redesign of the IPE learning domain to incorporate new core content from health systems science (HSS). We describe how our unique approach to IPE is being preserved as we innovate to produce graduates who are future thought leaders and "systems citizens," prepared to deliver patient care with an expanded knowledge of the health systems in which they will eventually practice.

68.
J Interprof Care ; : 1-8, 2020 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-33190512

RESUMEN

The goal of health professional education programs is to produce competent graduates, with an ability to work collaboratively as effective healthcare team members. We explored the reflections of students and clinical facilitators, in response to participation in a structured interprofessional education (IPE) clinical placement program. In our qualitative study we used an exploratory case study design. In our analysis, we highlight the benefits of interprofessional practice. Key themes identified by students included: limited opportunities to engage in IPE across their course; lack of clarity around IPE; value of IPE for students, practitioners, and patient outcomes; and need for IPE opportunities to be integrated into placements. Key themes identified by the clinical facilitators included: being reminded of the value of IPE for students and patients; preparation for IPE placements need to be embedded in curricula; coordination and communication of IPE learning activities need to be clear for staff and students; and IPE should continue as part of the broader clinical education agenda. Our findings reinforce the notion that students and clinical facilitators value the importance of IPE for student learning within the clinical placement setting. The outcomes offer valuable insights for universities and hospital and health care contexts for setting up and implementing IPE activities, and we provide recommendations for improving ongoing IPE efforts within clinical placement setting.

69.
J Interprof Care ; : 1-3, 2020 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-33190541

RESUMEN

This short report focuses on student feedback relating to the use of online group wikis as a means of a summative assessment intended to foster skills in collaborative practice for a large interprofessional education (IPE) module. Electronic feedback from 112 (72.2% response rate) students suggested wikis were a key area of the module. Open text comments relating to the wikis were extracted and categorized initially as positive or negative, with sub-themes then identified within these two broad categories. Findings showed that students valued the experience of a novel type of assessment but felt the amount of work required was too great. We concluded that digital capabilities need to be part of the developmental skill set of students. This raises important issues for further research to consider whether wikis themselves as a computer supported collaborative learning tool are appropriate for large scale IPE delivery.

70.
J Interprof Care ; : 1-10, 2020 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-33190553

RESUMEN

This qualitative study explores the ideas and experiences of interprofessional collaboration (IPC) among health professionals in rural public hospitals and to propagate its normalization into practice by identifying existing or suggested solutions. The literature focuses largely on the barriers and facilitators to IPC in metropolitan areas and there is room to identify more practical responses for implementing solutions. Semi-structured interviews were conducted with 13 healthcare professionals (October 2018-March 2019). Interviews were audio-recorded, transcribed and underwent thematic analysis to identify themes derived from the dataset. Using the lens of the Normalization Process Theory (NPT) allowed for amalgamation of participant ideas and identification of solutions to implement IPC in practice. Participants' definitions of IPC and Interprofessional Teamwork were incongruous with the current literature, however when provided with formal definitions, participants agreed that they both participated and observed IPC with varying degrees of success. Factors influencing this success included good working relationships and positive workplace cultures, having an understanding of each professions' roles and needs and the hierarchy of professions in conjunction with attitudes of senior healthcare professionals. Solutions to improved IPC and its normalization included induction processes and informal introductions, formalized interprofessional interactions, interprofessional education and positive leadership, such as the 'assertive followership model'. Analyzed in the framework of the normalization process theory, this research shows that IPC is increasingly becoming a coherent, integrated aspect of the healthcare system but there is room for improvement, and cognitive participation in IPC varies across healthcare professionsals. In order to facilitate the normalization process, program and policy makers, hospital administrations and professional associations could consider formalized interprofessional team interactions, formalizing IPC through simple introductions, interprofessional education and positive leadership. Future research could explore through the NPT specific areas of care that benefit from IPC implementation such as community aged-care.

71.
J Interprof Care ; : 1-7, 2020 Nov 15.
Artículo en Inglés | MEDLINE | ID: mdl-33190562

RESUMEN

There are many reports that pharmacotherapy has been optimized to ensure collaboration between physicians and pharmacists. Various scales assess the relationship between physicians and pharmacists as well as medical students and pharmacy students. The Scale of Attitudes Toward Physician-Pharmacist Collaboration (SATP2C) can be applied not only to the physician-pharmacist relationship but also to the medical-pharmacy student relationship. As there is no Japanese version of the SATP2C, we developed one and examined its psychometric properties. SATP2C scores were measured before and after interprofessional education (IPE) to verify responsiveness. The scale showed confirmed reliability: Cronbach's alphas were 0.79 for Responsibility and Accountability, 0.68 for Shared Authority, and 0.67 for Interdisciplinary Education. Pre and post-IPE, each mean subscale score increased: Responsibility and Accountability, 0.7 ± 0.4; Shared Authority, 0.2 ± 0.3; and Interdisciplinary Education, 0.3 ± 0.2. Although the total score increased (1.2 ± 0.7), this was non-significant. The Japanese version of the SATP2C can be considered, at least initially, to have reached an acceptable level of reliability and validity. The new measure is currently the only scale in Japan that can evaluate attitudes toward physician-pharmacist collaboration regarding IPE. Further studies are needed to confirm responsiveness pre- and post-IPE.

72.
BMC Complement Med Ther ; 20(1): 348, 2020 Nov 17.
Artículo en Inglés | MEDLINE | ID: mdl-33203398

RESUMEN

BACKGROUND: Integrating complementary medicine into medical care promotes patient-oriented care. A well-informed and collaborative professional healthcare team is essential for effective and patient-safe implementation of these methods. At present, the skills for patient counseling, therapy and care regarding complementary medicine vary among the professional groups involved. Professionals generally feel that they are not sufficiently qualified in this area. Curricular concepts for Complementary and Integrative Medicine (CIM) are virtually non-existent in undergraduate interprofessional training. The aim of this study is to initiate a consensus-building process between various experts (professionals, students, patient and faculty representatives) in order to identify which topics should be the focus of such a curriculum. METHODS: A three-round Delphi study was carried out from March 2018 to March 2019 to compile the experience and knowledge of experts in the field of integrative patient care and interprofessional education. Sixty-five experts from Germany and German-speaking Switzerland with various professional backgrounds and experiences were asked to name general content, therapy methods and treatment reasons which should be addressed in interprofessional seminars. In the subsequent rounds these were rated on a seven-point Likert scale. The ratings were assigned to relevance groups and discussed in a final workshop in July 2019. RESULTS: The response rates for the three rounds were 76% (n = 50), 80% (n = 40) 90% (n = 36); and 21% (n = 11) for the final workshop. The experts suggested that topics could be aligned along the most common treatment reasons such as insomnia, generalized pain, fatigue and back pain. However, it is important that students also receive an overview of the evidence base for different therapeutic concepts, especially in the field of classical natural medicine, acupuncture and mind-body medicine, and that they get an overview of the effects and interactions of frequently used procedures. CONCLUSION: Consensus was reached among the various experts on the most important topics for an interprofessional CIM curriculum. The systematic evaluation of the topics in this study can help to create a curriculum that achieves a high level of acceptance among teachers, lecturers and students, and thus facilitates implementation at universities and medical faculties.

73.
BMC Med Educ ; 20(1): 424, 2020 Nov 12.
Artículo en Inglés | MEDLINE | ID: mdl-33183276

RESUMEN

BACKGROUND: Practice-based interprofessional education (IPE) is essential to prepare students for collaborative working. Pockets of practice-based IPE are integrated into healthcare curriculums in some regions. Yet practice-based IPE is not globally valued as a key element of healthcare curriculums. As students and clinical educators are key stakeholders, this study presents a case example of their experiences in a country where practice-based IPE is at an emergent stage. Their experiential knowledge generated important insights into how practice-based IPE is perceived. This learning can be applied, both locally and further afield, by those seeking to embed practice-based IPE in their placement curriculums. METHODS: A qualitative case study was conducted at a school of allied health and partner placement sites in Ireland. Data collection comprised two participant observations, 13 interviews and 12 document analyses. Inductive thematic analysis and deductive framework analysis, underpinned by activity theory and Hofstede's cultural dimensions, informed data analysis and interpretations. RESULTS: Participants are grappling to establish the value of practice-based IPE, illustrated in three themes: clarifying the concept of practice-based IPE, mapping IPE activities and diversifying interprofessionalism. First, ambiguous conceptualisation of why and how to implement practice-based IPE was identified. Highlighting how practice-based IPE improved patient care and safety created a clear rationale for implementation. It was also helpful to demonstrate how adaptations to existing practice education models, rather than entirely new models, could achieve high-quality practice-based IPE. Second, the positioning of practice-base IPE in the placement curriculum was unclear. Overt mapping of practice-based IPE activities onto learning outcomes within assessment tools enhanced its value within practice education. Third, varying levels of professional engagement were noted, perpetuating stereotypes. Creating diverse educator networks and embedding practice-based IPE in organisational strategy may incentivise engagement across a greater range of professions. CONCLUSIONS: Implementing these recommendations could enhance the value of practice-based IPE and optimise student preparation for collaborative working. Practice-based IPE remains a complex model and the trajectory of embedding in healthcare curriculums will differ globally.

74.
J Leg Med ; 40(2): 265-278, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33137280

RESUMEN

Medical students and educators recognize that preparing the next generation of health leaders to address seemingly intractable problems like health disparities should include advocacy training. Opportunities to acquire the knowledge and skills needed to effectively advocate at the policy level to promote systems-, community-, and population-level solutions are a critical component of such training. But formal advocacy training programs that develop and measure such skills are scarce. Even less common are interprofessional advocacy training programs that include legal and policy experts to help medical students learn such skills. This 2016-2017 pilot study started with a legislative advocacy training program for preclinical medical students that was designed to prepare them to meet with Capitol Hill representatives about a health justice issue. The pilot assessed the impact of adding an interprofessional education (IPE) dimension to the program, which in this case involved engaging law faculty and students to help the medical students understand and navigate the federal legislative process and prepare for their meetings. Results from the pilot suggest that adding law and policy experts to advocacy-focused training programs can improve medical students' advocacy knowledge and skills and increase their professional identity as advocates.

75.
BMC Med Educ ; 20(1): 398, 2020 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-33129339

RESUMEN

BACKGROUND: Interprofessional Education (IPE) is now included in curricula in universities worldwide. It is known that there are differences in attitudes towards IPE among students, but less is known regarding how students' personalities and learnings styles correspond with those attitudes. The aim of this study was to investigate whether personality traits and learning styles have any impact on medical students' attitudes towards IPE. METHODS: Seventy nine medical students in their 9th term (63% females, mean age 29 years) were questioned regarding their attitudes towards IPE according to the Interdisciplinary Education Perception Scale questionnaire, the Kolb's learning style and Big Five Inventory questionnaires. For all three instruments we used the Swedish translated versions. RESULTS: When investigated with a logistic regression, adjusting for age and gender, there were no significant associations between Big Five inventory, Kolb's learning style and IEPS, except for the Reflective-Pragmatic learning style that was moderately associated with a higher IEPS score. CONCLUSION: There was no clear correlation between personality, learning style and attitude towards IPE as measured by the IEPS among medical students in our study population. Further investigations would benefit from a combination of qualitative and quantitative design.

76.
J Dent Educ ; 2020 Nov 23.
Artículo en Inglés | MEDLINE | ID: mdl-33230834

RESUMEN

PURPOSE: The purpose of this study was to evaluate the effectiveness of an annual oral-systemic health interprofessional education (IPE) clinical simulation and case study experience with nurse practitioner/midwifery (NP/MW), dental (DDS), medical (MD), and pharmacy (PharmD) students. METHODS: The Interprofessional Collaborative Competency Attainment Scale (ICCAS) was used to measure students' self-reported attainment of interprofessional competencies before and after the IPE experience. Pre- and post-test surveys were completed by NP/MW, DDS, MD, and PharmD student cohorts from 2017 to 2019. Students also had the opportunity to provide qualitative feedback about their experience at post-test. Data were collected from IPE faculty facilitators to assess their perception of the value of the Teaching Oral-Systemic Health (TOSH) program. RESULTS: Student ICCAS results demonstrated statistically significant improvement in self-reported interprofessional competencies among all types of students across all 3 years (P < 0.001); qualitative student comments reflected positive experiences with the TOSH program. Survey data from IPE faculty facilitators supported the value of the IPE experience for all students. CONCLUSIONS: The findings demonstrate the effectiveness of the TOSH program in using oral-systemic health as a clinical exemplar to develop interprofessional competencies. The 2017-2019 data reinforce the credibility of scaling the TOSH model for developing interprofessional competencies with students from different health professions.

77.
J Clin Pediatr Dent ; 44(4): 249-255, 2020 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-33167019

RESUMEN

OBJECTIVE: To determine changes in knowledge, attitudes, and practices of primary care physicians (PCPs) regarding fluoride varnish (FV). STUDY DESIGN: Fifty-four PCPs at an urban medical center in New York completed a pre-intervention survey. A pediatric dental resident provided an hour-long educational lecture and a hands-on demonstration regarding FV application. Six months later, PCPs were sent a post-intervention survey via electronic mail. RESULTS: Fifty-four PCPs participated in the pre-survey and FV training and 48% completed the post-survey. Prior to the FV training, 57% of PCPs knew that FV application by medical practitioners was reimbursable for children under 6-years-old and 2% of PCPs were applying FV. Post FV training, 62% of PCPs reported applying FV. Pre and post survey, barriers to FV application was not enough hands-on training (43% to 15% respectively) and not enough time (50% to 85% respectively). CONCLUSIONS: Post FV training, PCPs' knowledge, attitudes and practices in regard to FV changed. Interprofessional education may be one approach to increasing FV application participation.


Asunto(s)
Fluoruros Tópicos , Médicos de Atención Primaria , Actitud del Personal de Salud , Niño , Fluoruros , Humanos , New York , Encuestas y Cuestionarios
78.
Int J Med Educ ; 11: 240-244, 2020 Nov 06.
Artículo en Inglés | MEDLINE | ID: mdl-33170147

RESUMEN

Objectives: The purpose of this study is to investigate the relationship between medical student readiness for interprofessional learning and interest in community medicine prior to incorporating community-oriented interprofessional education into the curriculum. Methods: A questionnaire was administered to students at Nagasaki University School of Medicine in Japan during each of three consecutive years (N=2244). The Readiness for Interprofessional Learning Scale (RIPLS) was administered in addition to a questionnaire to evaluate interest in community medicine. The Kruskal-Wallis and Steel-Dwass tests were used to determine differences between school years. Correlation between the RIPLS score and interest in community medicine was evaluated with Spearman's rank correlation coefficient. Relationships between RIPLS score and demographic parameters, and interest in community medicine were evaluated with multiple linear regression analysis. Results: Eighty-four percent (1891/2244) of students responded. The RIPLS score was highest in school year 1, followed by year 6, year 5, year 3, and years 4 and 2. Interest in community medicine correlated with the RIPLS score (rs = 0.332, p < 0.001), but less in year 1 (rs = 0.125, p = 0.002) than in other years. RIPLS score was significantly associated with gender, age, school year, interest in community medicine, but not the year that the survey was conducted. Conclusions: Community-oriented interprofessional education has the potential to improve attitudes towards interprofessional learning. When introducing this promising education into the curriculum from year 1, attracting students' interest in community medicine should be considered.

79.
Complement Ther Med ; 54: 102542, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33183661

RESUMEN

OBJECTIVES: Physicians and other health professionals like nurses, physiotherapists and midwives should be prepared to work in a patient-centred and team-based manner through appropriate interprofessional training. This includes consideration of patients' preferences for complementary treatment methods, as well as reflection of one's own professional role and that of the others. The CanMEDS Physician Competency Framework is an established instrument that describes the competencies of health professionals in seven roles. We investigated which role competencies should be addressed in an undergraduate interprofessional curriculum on Complementary and Integrative Medicine. DESIGN: In a Delphi study, an interprofessional expert group evaluated the relevance of the CanMEDS role competencies (n = 49) and the respective individual competencies (n = 30) on a seven-point Likert scale. For analysis, we assigned the competencies according to the ratings, to four groups of relevance (consensus: >80 %) and compared the proportions of individual competencies classified as relevant within the seven role competencies. RESULTS: The role Medical Expert was rated as highly relevant for all individual competencies. For the roles Professional, Collaborator, Communicator and Scholar, all or most individual competencies were rated at least as relevant. For the roles Leader or Health Advocate all individual competencies were rated as not relevant. CONCLUSIONS: In order to improve healthcare including complementary treatment options, it is initially of great importance to impart expert and communication skills in undergraduate interprofessional training in addition to improving teamwork. The acquisition of management and consulting skills could only be given priority in a later phase of training.

80.
J Interprof Care ; : 1-10, 2020 Nov 23.
Artículo en Inglés | MEDLINE | ID: mdl-33228425

RESUMEN

Return-to-academics (RTA) for student-athletes with mild traumatic brain injury (mTBI) is crucial, but relatively understudied compared to return-to-play (RTP). The transient and unpredictable nature of symptoms surrounding mTBI often results in underreporting of neurocognitive symptoms, leading to a greater susceptibility for repeated TBIs, as well as posing impediments to the process of RTA. Athletic Trainers (ATs) and Speech-Language Pathologists (SLPs) are in a unique position to help student-athletes achieve a safe, timely, and effective RTA following mTBI. They typically work in middle/high schools and collegiate-level academic settings and often serve as members of concussion management teams. Compared to other allied health professions, ATs and SLPs are relatively new professions with evolving scopes of practice. Despite established guidelines and recommendations for their scope of practice in treating student-athletes with mTBI, there is a lacuna in research regarding their individual and collaborative roles in achieving RTA. The current scoping review was conducted with the main goal of exploring published literature pertaining to the roles of ATs and SLPs in achieving RTA for student-athletes with mTBI. Current implications, recommendations for integrating pre-service interprofessional education (IPE) experiences, and future directions for AT-SLP collaborations are discussed.

81.
Artículo en Inglés | MEDLINE | ID: mdl-33206271

RESUMEN

Practice-based interprofessional education (IPE), a key feature in developing a collaboration-ready workforce, is poorly integrated in healthcare curriculums. This study aimed to synthesise educator perspectives on implementing practice-based IPE and develop recommendations to inform sustainable practice-based IPE. An ethnographic case study was carried out at a school of allied health. Data collection involved six observations, 11 interviews and a review of eight documents. Reflexive thematic analysis, informed by Normalisation Process Theory, established two key themes. First, we found that strategic planning is needed, with a coherent implementation agenda and planned reflection on activities. Second, building partnerships with placement partners was identified as essential. This can be achieved by supporting and championing practice-based IPE activities developed by placement sites and establishing how university and clinical educators can work collaboratively to deliver sustainable practice-based IPE. These conditions create a favourable environment for normalising practice-based IPE in healthcare curriculums, benefitting students, patients, and the overall healthcare service.

82.
Med Educ ; 2020 Nov 28.
Artículo en Inglés | MEDLINE | ID: mdl-33247454

RESUMEN

OBJECTIVES: In response to the observations that interprofessional education (IPE) is seemingly atheoretical or under-theorised, this quantitative research seeks to uncover students' motivational mechanisms which could explain their behavioural and collaborative outcomes using self-determination theory (SDT). While SDT has been studied in various contexts, its applicability to IPE remains underexplored. This study aims to integrate a new perspective in understanding students' motivation in IPE by exploring how the fulfilment of a need for sense of autonomy, competence and relatedness is linked to desirable IPE outcomes. METHODS: Utilising quantitative methods, we involved 255 health care students in Hong Kong from the medical, nursing and pharmacy disciplines enrolled in IPE anticoagulation therapy module. They were invited to respond to the Psychological Need Satisfaction Questionnaire and other measures as part of the post-test. RESULTS: Sense of autonomy emerged as the strongest positive predictor of behavioural (collective dedication, behavioural engagement) and collaboration outcomes (team effectiveness, goal achievement). There were no significant program-level differences across these outcomes except for behavioural engagement for which nursing students had a higher perception than medicine students. CONCLUSIONS: We were able to demonstrate that SDT is a meaningful framework in understanding behavioural and collaboration outcomes in IPE. The major theoretical contribution of this study refers to the ability of students' motivation to explain variance in their behavioural outcomes. That is, sense of autonomy consistently predicted team effectiveness, collective dedication, behavioural engagement and goal achievement. Autonomous motivation among a sample of health care students can explain behavioural outcomes. Theoretical, methodological and practical implications are discussed.

83.
Gerontol Geriatr Educ ; : 1-15, 2020 Nov 09.
Artículo en Inglés | MEDLINE | ID: mdl-33161893

RESUMEN

Increasing life expectancy, concepts of patient well-being, and the multiplicity of needs of the geriatric population, demand contribution, and collaboration of physicians, dentists, psychologists, pharmacists, and other allied health disciplines, to provide quality care to patients. Interprofessional education (IPE) is an approach to education that improves collaboration among health professionals and it can aid in better management of geriatric patients. Communication and cooperation affect health care performance and hence, influence patient outcomes. Currently, each of the disciplines mentioned has customized undergraduate and/or postgraduate training in geriatric care. Though a uni-disciplinary educational approach increases knowledge and skills of individual professions separately, IPE offers significant advantages. IPE seeks to have students learning together, as well as from each other to develop exemplary collaborative practice. The World Health Organization (WHO) has proposed that IPE will ensure optimum health care. However, IPE is yet to find its proper place in dental education. It would help dental students to develop a positive attitude toward geriatric patients and increase their empathy and efficiency in the management of these patients. This manuscript seeks to highlight the concept of interprofessional education (IPE) in gerodontology and develop recommendations for implementation of IPE in India.

84.
Healthcare (Basel) ; 8(4)2020 Oct 22.
Artículo en Inglés | MEDLINE | ID: mdl-33105607

RESUMEN

BACKGROUND: In 2010, the World Health Organization issued a clarion call for action on interprofessional education and collaboration. This call came forty years after the concept of interprofessional collaboration (IPC) was introduced. AIM: To conduct an integrative review of interprofessional collaboration in health care education in order to evaluate evidence and build the case for university support and resources and faculty engagement, and propose evidence-based implications and recommendations. SEARCH STRATEGY: A literature search was conducted by an interprofessional faculty from a college of nursing and health sciences. Databases searched included CINAHL, Medline, Eric, Pubmed, Psych Info Lit., and Google Scholar. Keywords were interdisciplinary, interprofessional, multidisciplinary, transdisciplinary, health care team, teamwork, and collaboration. Inclusion criteria were articles that were in the English language, and published between 1995 and 2019. REVIEW METHODS: Thirteen interprofessional team members searched assigned databases. Based on key words and inclusion criteria, over 216,885 articles were identified. After removing duplicates, educational studies, available as full text were reviewed based on titles, and abstracts. Thirty-two articles were further evaluated utilizing the Sirriyeh, Lawton, Gardner, and Armitage (2012) review system. Faculty agreed that an inclusion score of 20 or more would determine an article's inclusion for the final review. Eighteen articles met the inclusion score and the data was reduced and analyzed using the Donabedian Model to determine the structure, processes, and outcomes of IPC in health care education. RESULTS: Structure included national and international institutions of higher education and focused primarily on undergraduate and graduate health care students' experiences. The IPC processes included curricular, course, and clinical initiatives, and transactional and interpersonal processes. Outcomes were positive changes in faculty and health care students' knowledge, attitudes, and skills regarding IPC, as well as challenges related to structure, processes, and outcomes which need to be addressed. Implications/Recommendations/Conclusions: The creation of a culture of interprofessional collaboration requires a simultaneous "top-down" and "bottom-up" approach with commitment by the university administration and faculty. A university Interprofessional Strategic Plan is important to guide the vision, mission, goals, and strategies to promote and reward IPC and encourage faculty champions. University support and resources are critical to advance curricular, course, and clinical initiatives. Grassroots efforts of faculty to collaborate with colleagues outside of their own disciplines are acknowledged, encouraged, and established as a normative expectation. Challenges to interprofessional collaboration are openly addressed and solutions proposed through the best thinking of the university administration and faculty. IPC in health care education is the clarion call globally to improve health care.

85.
Int J Integr Care ; 20(3): 16, 2020 Sep 28.
Artículo en Inglés | MEDLINE | ID: mdl-33041733

RESUMEN

Research into interprofessional collaboration (IPC) has predominantly focused on health care and specialized care settings, but there is an increasing interest in interprofesssional 'teams around the child' in community-based settings. We conducted a realist synthesis of empirical studies into IPC between youth professionals, often in regular community settings, to explore barriers and facilitators of IPC. Included studies were coded with an elaborated scheme to chart the focus of studies and to identify moderators and context-mechanism-outcome configurations of IPC. Professional and normative integration was the main focus of the included studies. Most studies emphasized the challenges of IPC in practice, like unclear roles of self and others, lack of trust and inadequate communication. Other perceived barriers are excluding others in the planning of interventions, taking ownership of plans (vs. sharing) and different modes of communication. Interprofessional education, co-location of staff, acting as a mediator in the team, organising formal and informal meetings, conflict resolutions, self-sacrifice, and conceptualizing practice were perceived as facilitators of IPC. Future IPC research into community-based settings should include all professional stakeholders and the children and their families to evaluate outcomes at both interprofessional and clinical level.

86.
J Multidiscip Healthc ; 13: 1143-1155, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33116560

RESUMEN

Background: Interprofessional education (IPE) is suggested as a good means to prepare future healthcare professionals for collaborative work in interprofessional teams enabling them to solve complex health problems. Previous studies have advocated experiential IPE, including community-based IPE (CBIPE). This study aims to evaluate a CBIPE programme by exploring the students' perception toward CBIPE design and toward groups' teamwork. Methods: To identify students' perceptions of teamwork, the Interprofessional Teamwork Evaluation questionnaire was administered to 254 students of medical, nursing and midwifery programme. Three uni-professional focus group (FG) discussions were conducted to analyse the students' perception of the design of community-based education and underlying reasons for teamwork. Results: FGs reported three aspects that influence skills development in collaborative practice among students that shed light on why midwifery and nursing students held less positive perceptions of communication and mutual support: 1) communication gap due to lack of confidence, 2) contrasting ways of thinking affect communication in decision-making, and 3) the leadership culture in the health services. Conclusion: A CBIPE programme was successfully implemented at Universitas Islam Sultan Agung. It demonstrated that students in the health professions can develop skills in collaborative practice despite having some problems with communication and mutual support.

87.
J Multidiscip Healthc ; 13: 1223-1234, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33116567

RESUMEN

Purpose: Modern healthcare is delivered by teams of multidisciplinary professionals. Conflicts have been widely reported between these professionals in Nigeria. Furthermore, the health system is frequently crippled by industrial actions by trade unions representing these professionals. This study aimed to shed light on the complexities of factors perceived to cause workplace conflicts, including the extent to which these are thought to link to industrial action. Materials and methods: Focus group discussions and in-depth interviews were conducted with nurses, doctors, and medical laboratory scientists who work in multiprofessional settings giving a total of 41 participants. Results were analyzed within the framework of the social identity theory. Results and conclusions: The dominant themes that emerged as barriers to teamwork include professional hierarchy, role ambiguity, and poor communication. At the same time, the health sector leadership and remuneration were the main themes concerning industrial actions. The salience of professional identities was also demonstrated, providing a link between interprofessional conflict in the workplace and competitive industrial actions by trade unions representing health professionals. The implications for educational and clinical practice and the need for interprofessional education are discussed.

88.
PLoS One ; 15(10): e0239853, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33057435

RESUMEN

BACKGROUND: Mobilization of intensive care patients is a multi-professional task. Aim of this study was to explore how different professions working at Intensive Care Units (ICU) estimate the mobility capacity using the ICU Mobility Score in 10 different scenarios. METHODS: Ten fictitious patient-scenarios and guideline-related knowledge were assessed using an online survey. Critical care team members in German-speaking countries were invited to participate. All datasets including professional data and at least one scenario were analyzed. Kruskal Wallis test was used for the individual scenarios, while a linear mixed-model was used over all responses. RESULTS: In total, 515 of 788 (65%) participants could be evaluated. Physicians (p = 0.001) and nurses (p = 0.002) selected a lower ICU Mobility Score (-0.7 95% CI -1.1 to -0.3 and -0.4 95% CI -0.7 to -0.2, respectively) than physical therapists, while other specialists did not (p = 0.81). Participants who classified themselves as experts or could define early mobilization in accordance to the "S2e guideline: positioning and early mobilisation in prophylaxis or therapy of pulmonary disorders" correctly selected higher mobilization levels (0.2 95% CI 0.0 to 0.4, p = 0.049 and 0.3 95% CI 0.1 to 0.5, p = 0.002, respectively). CONCLUSION: Different professions scored the mobilization capacity of patients differently, with nurses and physicians estimating significantly lower capacity than physical therapists. The exact knowledge of guidelines and recommendations, such as the definition of early mobilization, independently lead to a higher score. Interprofessional education, interprofessional rounds and mobilization activities could further enhance knowledge and practice of mobilization in the critical care team.


Asunto(s)
Ambulación Precoz/normas , Adhesión a Directriz/estadística & datos numéricos , Personal de Salud/psicología , Unidades de Cuidados Intensivos/normas , Posicionamiento del Paciente/normas , Adulto , Femenino , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/normas , Humanos , Masculino , Persona de Mediana Edad , Guías de Práctica Clínica como Asunto , Encuestas y Cuestionarios
89.
Medicine (Baltimore) ; 99(43): e22562, 2020 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-33120744

RESUMEN

Simulation and Objective Structured Clinical Examination assessment of learners can teach clinical skills proficiency in a safe environment without risk to patients. Interprofessional simulation-based education (IPSE) contributes to a transformation in students' understanding of teamwork and professional roles. Long term outcomes for stimulation and IPSE sessions, are less well studied. We hypothesized that a progressive interprofessional education simulation program incorporating both faculty and interprofessional student collaboration would improve medical students' knowledge retention, comfort with procedural skills, positive teamwork and respectful interaction between students.An Obstetrics and Gynecology IPSE for medical and nursing students (NS) was developed in collaboration between a school of medicine and a school of nursing from 2014 to 2017. By 2017, content includedFrom 2014 to 2016, medical students completed attitude, knowledge, and perception surveys both pre and immediately post simulation, at 4 months, and 8 months. In 2017; all students completed self-assessments and received faculty-assessments.The program trained 443 medical and 136 NS. Medical students' knowledge, comfort, and interest increased significantly post simulation. Outcome scores decreased but were still significantly improved at 4 months but nearly dissipated by 8 months. There were no significant differences between medical and NS self-assessment or faculty-assessment scores regarding IUD insertion, cervical examination, or contraception quiz scores. Medical students' birth simulation self-assessment versus faculty-assessment scores were 8.6 vs 8.9, P < .001.Simulation improved students' short-term medical knowledge, comfort, and perception with some long-term persistence at 4-8 months. Medical and NS learned obstetrics and gynecology skills in a collaborative environment and in role-specific situations. Medical students had the opportunity to learn from NS. Positive teamwork and respectful interaction occurred between the students.


Asunto(s)
Ginecología/educación , Obstetricia/educación , Entrenamiento Simulado , Estudiantes de Medicina , Estudiantes de Enfermería , Actitud del Personal de Salud , Competencia Clínica , Estudios de Cohortes , Conducta Cooperativa , Curriculum , Educación de Pregrado en Medicina , Educación en Enfermería , Humanos , Relaciones Interprofesionales
90.
AORN J ; 112(5): 471-477, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33113198

RESUMEN

Simulation can be an effective tool for educating health profession students and can enhance interprofessional education by involving roles across multiple disciplines. Perioperative nurse educators at one institution used a five-part branching simulation of preoperative, intraoperative, and postoperative events for a single patient undergoing a procedure to introduce RN first assistant (RNFA) students to their role in the perioperative environment. The simulation participants included student RN anesthetists, a surgeon, an RN circulator (played by an actor), and a standardized patient. The objectives for this simulation were to assess the implementation of the didactic RNFA curriculum and to enhance the RNFA students' transition into their role in the perioperative setting. The simulation and multiple debriefings reinforced the concepts of role acquisition, surgical conscience, closed-loop communication, and interprofessional collaboration. Perioperative nurse educators can use this type of educational activity to teach these concepts to their students.

91.
Worldviews Evid Based Nurs ; 17(6): 412-417, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33001572

RESUMEN

BACKGROUND: Evidence-based practice and ethics should not be taught as isolated concepts. Instead, it is imperative to prepare students with the knowledge needed to practice ethical, evidence-based decision-making in health care. PURPOSE: The purpose of this project was to describe how a mock hospital ethics committee meeting impacted students' learning about the use of evidence to support ethical decision-making in health care. METHOD: A mock hospital ethics committee was convened for 121 students from schools of nursing, social work, law, and medicine. RESULTS: Thematic content analysis showed a positive impact on nursing students' learning of ethics, group dynamics, discipline-specific responsibilities, and EBP. LINKING EVIDENCE TO ACTION: This interprofessional education experience showed students how evidence and ethics can be used to guide and support practice priorities, responsibilities, and decisions on resource utilization and treatment to enable optimal outcomes for patients and organizations.

92.
Artículo en Inglés | MEDLINE | ID: mdl-33017345

RESUMEN

Although healthcare is always changing, the Inpatient Rehabilitation Facility (IRF) has indispensable and enduring roles in patient care, medical education and research. For patients with complex medical and functional limitations, IRF-level care fosters recovery and community re-integration, and plays a strategic role in optimizing healthcare transitions from acute and to post-acute settings. It is an incomparable and distinct zone for interprofessional education: The healthcare system is dependent on the IRF as the epicenter for instruction to healthcare professionals on how to care for patients with complex rehabilitation needs. As healthcare evolves, patients' increasing medical complexity requires ongoing research focused on patients' evolving healthcare needs. The IRF alone offers the requisite infrastructure to support such discovery. In this Association of Academic Physiatrists (AAP) Position Paper, we provide a fresh perspective on the value proposition of the IRF and advocate for this unique clinical environment as a critical component of contemporary healthcare.

94.
BMC Med Educ ; 20(1): 388, 2020 Oct 27.
Artículo en Inglés | MEDLINE | ID: mdl-33109173

RESUMEN

BACKGROUND: Interprofessional collaborative practice (IPCP) is increasingly recognised as being crucial for the provision of holistic care and optimising health outcomes among older adults, many with multiple complex health problems. However, little is known about the challenges of facilitating this in practice. Therefore, this study explores these issues from the perspective of different healthcare professionals and how this might inform interprofessional education curricula. METHODS: Sixteen different healthcare professionals working in a variety of aged care (acute, rehabilitative and community) settings were invited to participate in individual semi-structured in-depth interviews designed to: (i) explore the meaning of IPCP; (ii) explore the facilitators of and barriers to IPCP; and (iii) examine the opportunities and challenges in interprofessional gerontological education. All interviews were tape-recorded and transcribed verbatim with thematic analysis conducted by two independent researchers. RESULTS: Three major themes emerged from the interviews: the need for IPCP; role preparedness, scope and liability; and strategies for interprofessional education. Respondents shared a common belief that IPCP improves the quality of life of older adults in both hospital and community settings by improving person-centred coordinated care and decision making in care planning. However, respondents perceived major barriers to IPCP to be lack of knowledge about healthcare professionals' scope of practice, lack of training in interprofessional collaboration, professional culture and stereotypes, and liability issues. Suggested approaches to overcome these barriers included innovative teaching and learning approaches, engaging students early on in the curriculum of health professional degree programmes, and enhancing collaborative effective communication in health and social care settings. CONCLUSIONS: It is anticipated that these findings will be used to inform the development of a new interprofessional gerontological education curriculum that aims to enhance students' competence in IPCP.

95.
Artículo en Inglés | MEDLINE | ID: mdl-33113055

RESUMEN

The imperative for all healthcare professionals to partake in quality improvement (QI) has resulted in the development of QI education programs with participants from different professional backgrounds. However, there is limited empirical and theoretical examination as to why, when and how interprofessional and multiprofessional education occurs in QI and the outcomes of these approaches. This paper reports on a qualitative collective case study of interprofessional and multiprofessional education in three longitudinal QI education programs. We conducted 58 interviews with learners, QI project coaches, program directors and institutional leads and 135 h of observations of in-class education sessions, and collected relevant documents such as course syllabi and handouts. We used an interpretive thematic analysis using a conventional and directed content analysis approach. In the directed content approach, we used sociology of professions theory with particular attention to professional socialization, hierarchies and boundaries in QI, to understand the ways in which individuals' professional backgrounds informed the planning and experiences of the QI education programs. Findings demonstrated that both interprofessional and multiprofessional education approaches were being used to achieve different education objectives. While each approach demonstrated positive learning and practice outcomes, tensions related to the different ways in which professional groups are engaging in QI, power dynamics between professional groups, and disconnects between curricula and practice existed. Further conceptual clarity is essential for a more informed discussion about interprofessional and multiprofessional education approaches in QI and explicit attention is needed to professional processes and tensions, to optimize the impact of education on practice.

96.
BMC Med Educ ; 20(1): 360, 2020 Oct 13.
Artículo en Inglés | MEDLINE | ID: mdl-33050898

RESUMEN

BACKGROUND: Arguably, Medical School curricula are deficient in learning opportunities related to the safe and effective use of medicines, in particular antimicrobials. Infection management is complex and multidisciplinary, and learning opportunities should reflect these principles. Aligned to the complexity of the subject matter, simulation and interprofessional based teaching are methods that can foster the collaborative skills required of future healthcare professionals. There have been calls to develop these methods in the teaching of safe prescribing and the management of infections; however, reports of such studies are limited. METHODS: We developed an interprofessional education (IPE) conference for second year undergraduate medical and pharmacy students based in the North East of England. We considered contact theory in the design of three small group interprofessional workshops, on the broad themes of antimicrobial stewardship, infection management and patient safety. A mixed methods approach assessed students' attitudes towards IPE, barriers and facilitators of learning, and perceived learning gains. Qualitative data from workshop evaluation forms were analysed thematically, while quantitative data were analysed descriptively and differences between medical and pharmacy cohorts analysed using unpaired two-tailed t-tests. RESULTS: 226/352 students returned the workshop evaluation forms (66% of pharmacy students, 62% of medical students). 281/352 students responded to a series of Likert scale questions on the value of interprofessional education (88% of pharmacy students, 70% of medical students). Students reported acquisition of knowledge and skills, including concepts and procedures related to infection management and antimicrobial prescribing, and the development of problem-solving and critical evaluation skills. Students reflected on their attitude towards interprofessional collaboration. They reported a greater understanding of the roles of other healthcare professionals, reflected on the importance of effective communication in ensuring patient safety, and were more confident to work in interprofessional teams after the conference. CONCLUSIONS: A robust IPE event, theoretically underpinned by contact theory and developed collaboratively, achieved interprofessional learning at scale and helped develop healthcare professionals willing to collaborate across disciplines. The resources, and evaluation insights based on the 3P (presage, process, and product) model of learning and teaching, will be of value to other educators who seek to develop theoretically-sound IPE interventions.

97.
Curr Pharm Teach Learn ; 12(12): 1484-1490, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33092779

RESUMEN

BACKGROUND AND PURPOSE: Nutrition and lifestyle modifications are effective interventions in tackling many chronic diseases, including cardiovascular diseases. However, healthcare professionals are not sufficiently trained in nutrition and lifestyle education. To address this gap, we established an interprofessional, team-based framework to train healthcare professional students on healthy nutrition and culturally competent dietary coaching and motivational interviewing. EDUCATIONAL ACTIVITY AND SETTING: Twelve doctor of pharmacy students from California Health Sciences University and three dietetic students from California State University, Fresno enrolled in this training program. Three pre-/post-surveys and one post-reflection worksheet were utilized to assess progress in student learning, including knowledge about obesity, confidence in coaching/mentoring families, perception of healthy nutrition, dietary habits, and interprofessional collaborative competencies. FINDINGS: Quantitative data and reflection worksheet thematic analysis revealed improvement in learner outcomes in the majority of the assessed areas. Students' knowledge about obesity and mentoring skills improved by 32%, knowledge about program curriculum improved by 167%, dietary habits improved by 28% and interprofessional competencies improved by 9%-34%. Thematic analysis of interprofessional educational reflection worksheets indicated positive reaction to the program, enhanced interprofessional outcomes, and potential application of acquired knowledge and skills on family and future patients. SUMMARY: Success of this interprofessional, team-based study encourages expanding the program to enroll more students from various healthcare specialties, including medical and nursing. This framework can be easily adapted by other healthcare programs to prepare healthcare providers to work interprofessionally and effectively include basic nutrition and lifestyle recommendations in disease management and preventive care.

98.
MedEdPORTAL ; 16: 10974, 2020 10 07.
Artículo en Inglés | MEDLINE | ID: mdl-33083534

RESUMEN

Introduction: As more practices move to patient-centered medical home (PCMH) models, future health care professionals must train to work in collaborative settings. We implemented a 3-hour workshop for multidisciplinary trainees on the PCMH principles of access and continuity based on the EFECT framework (eliciting a patient-centered narrative, facilitating an interprofessional team discussion, evaluating the clinical evidence, creating a shared care plan, and tracking outcomes). Methods: Participants included internal medicine residents and medical, physician assistant (PA), and clinical psychology students. The workshop incorporated reflective activities identifying patient and provider health care delivery priorities, plus a PCMH presentation and group activities focusing on access and continuity. Evaluations were analyzed qualitatively and quantitatively. Results: The workshop had 39 participants (seven physicians, one PA, one educator, one psychologist, three staff, nine residents, one PA student, one psychology extern, and 15 medical students). On a 0-10 Likert scale (0 = don't agree at all, 10 = completely agree), learners reported higher knowledge of PCMH principles (M = 8.8), feeling better prepared for PCMH work (M = 8.6), and having obtained real-world skills (M = 8.3). Open-ended responses describing the workshop's take-home message included the role of patient-centeredness in clinical redesign, the value of the multidisciplinary team in optimizing access and continuity, and how to use a quality improvement approach for access and continuity. Discussion: This workshop increased PCMH-related knowledge and encouraged discussion of professional roles within the team. Learners recognized the benefits of team-based rather than provider-centric approaches to access and continuity.

99.
PLoS One ; 15(10): e0240835, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33085695

RESUMEN

BACKGROUND: Interprofessional Education (IPE) aims to improve students' attitudes towards collaboration, teamwork, and leads to improved patient care upon graduation. However, the best time to introduce IPE into the undergraduate curriculum is still under debate. METHODS: We used a mixed-methods design based on a sequential explanatory model. Medical students from all six years at the University of Bern, Switzerland (n = 683) completed an online survey about attitudes towards interprofessional learning using a scale validated for German speakers (G-IPAS). Thirty-one medical students participated in nine semi-structured interviews focusing on their experience in interprofessional learning and on the possible impact it might have on their professional development. RESULTS: Women showed better attitudes in the G-IPAS across all years (p = 0,007). Pre-clinical students showed more positive attitudes towards IPE [Year 1 to Year 3 (p = 0.011)]. Students correctly defined IPE and its core dimensions. They appealed for more organized IPE interventions throughout the curriculum. Students also acknowledged the relevance of IPE for their future professional performance. CONCLUSIONS: These findings support an early introduction of IPE into the medical curriculum. Although students realise that interprofessional learning is fundamental to high-quality patient care, there are still obstacles and stereotypes to overcome. TRIAL REGISTRATION: ISRCTN 41715934.


Asunto(s)
Actitud del Personal de Salud/etnología , Educación Interprofesional/tendencias , Estudiantes de Medicina/psicología , Adulto , Conducta Cooperativa , Curriculum/tendencias , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Educación Interprofesional/métodos , Relaciones Interprofesionales , Masculino , Grupo de Atención al Paciente , Rol Profesional , Encuestas y Cuestionarios , Adulto Joven
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