Application of an adapted relationship scale for assessing the occurrence of six different relationships as perceived by seven health care professions in Northern Italy.

Interprofessional working relationships can influence the quality of collaborative practices, with consequences for patient safety outcomes. This article reports findings of an adapted relationship scale comprising six different relationship types, ranging from hostile to collegial, between seven health-care professions: physicians, nurses, dieticians, occupational therapists, physiotherapists, speech therapists, and psychologists. Survey data were gathered within amixed-method study aiming to explore the current status quo of interprofessional collaboration in aHealth Trust, located in Northern Italy. An online questionnaire was completed by 2,238 health professionals achieving aresponse rate of 44%. The working relationship element was answered by 1,897 respondents. The results of the survey are used as abasis for recommending strategies for advancing interprofessional collaboration in the Trust. Descriptive statistics were used to examine relationship-types, with frequency of occurrence considered. The non-parametric Mann Whitney and Kruskal Wallis tests were used to explore relationship differences among groups defined by sociodemographic variables. Participants reported overall positive relationships with other health professions. We noted variability in the occurrence of different relationship-types amongst the health professions. In particular, the six professions viewed their relationships with doctors more negatively than physicians who reported amore positive perception of their relationships with the six professions.

Perceptions of collaborative relationships between seven different health care professions in Northern Italy.

This article presents quantitative findings from a mixed method study that aimed to explore the status quo of interprofessional collaboration (IPC) in a Health Trust, located in a trilingual region in Northern Italy. The survey targeted seven health professions (physicians, nurses, dieticians, occupational therapists, physiotherapists, speech therapists, and psychologists). The survey was distributed online to more than 5,000 health professionals and completed by 2,238. This paper presents results on the frequency of collaboration as well as data from a multiple-group measurement scale for assessing IPC. Descriptive statistics were calculated for continuous variables while categorical data were analysed as counts and percentages. Pearson's Chi-square test and Fisher's exact test were calculated while Mann Whitney and Kruskal Wallis tests were applied to analyse statistical differences in IPC between groups according to sociodemographic variables. In general, our survey data showed that participants, perceived IPC in a positive way, even if the analysis indicated heterogeneity in the level of collaboration expressed. We also found that not all professions had an opportunity to collaborate with others. In addition, we found evidence to suggest that the way health care is organised impacted on perceptions of collaboration between the health professionals in this study. This study provides an initial insight into the perceived levels of IPC within a North Italian context. As such, it offers an account of the strengths and weaknesses of IPC from seven different professional groups based in this region of Europe.

Applying interprofessional Team-Based Learning in patient safety: a pilot evaluation study.

BACKGROUND: Interprofessional education (IPE) interventions are not always successful in achieving learning outcomes. Team-Based Learning (TBL) would appear to be a suitable pedagogical method for IPE, as it focuses on team performance; however, little is known about interprofessional TBL as an instructional framework for patient safety. In this pilot-study, we aimed to (1) describe participants' reactions to TBL, (2) observe their achievement with respect to interprofessional education learning objectives, and (3) document their attitudinal shifts with regard to patient safety behaviours. METHODS: We developed and implemented a three-day course for pre-qualifying, non-medical healthcare students to give instruction on non-technical skills related to 'learning from errors'. The course consisted of three sequential modules: 'Recognizing Errors', 'Analysing Errors', and 'Reporting Errors'. The evaluation took place within a quasi-experimental pre-test-post-test study design. Participants completed self-assessments through valid and reliable instruments such as the Mennenga's TBL Student Assessment Instrument and the University of the West of England's Interprofessional Questionnaire. The mean scores of the individual readiness assurance tests were compared with the scores of the group readiness assurance test in order to explore if students learned from each other during group discussions. Data was analysed using descriptive (i.e. mean, standard deviation), parametric (i.e. paired t-test), and non-parametric (i.e. Wilcoxon signed-rank test) methods. RESULTS: Thirty-nine students from five different bachelor's programs attended the course. The participants positively rated TBL as an instructional approach. All teams outperformed the mean score of their individual members during the readiness assurance process. We observed significant improvements in 'communication and teamwork' and 'interprofessional learning' but not in 'interprofessional interaction' and 'interprofessional relationships.' Findings on safety attitudes and behaviours were mixed. CONCLUSION: TBL was well received by the students. Our first findings indicate that interprofessional TBL seems to be a promising pedagogical method to achieve patient safety learning objectives. It is crucial to develop relevant clinical cases that involve all professions. Further research with larger sample sizes (e.g. including medical students) and more rigorous study designs (e.g. pre-test post-test with a control group) is needed to confirm our preliminary findings.

A multiple-group measurement scale for interprofessional collaboration: Adaptation and validation into Italian and German languages.

This article presents a study that aimed to validate a translation of a multiple-group measurement scale for interprofessional collaboration (IPC). We used survey data gathered over a three month period as part of a mixed methods study that explored the nature of IPC in Northern Italy. Following a translation from English into Italian and German the survey was distributed online to over 5,000 health professionals (dieticians, nurses, occupational therapists, physicians, physiotherapists, speech therapists and psychologists) based in one regional health trust. In total, 2,238 different health professions completed the survey. Based on the original scale, three principal components were extracted and confirmed as relevant factors for IPC (communication, accommodation and isolation). A confirmatory analysis (3-factor model) was applied to the data of physicians and nurses by language group. In conclusion, the validation of the German and Italian IPC scale has provided an instrument of acceptable reliability and validity for the assessment of IPC involving physicians and nurses.

The state of interprofessional collaboration in Northern Italy: a mixed methods study.

Health care systems are facing continual reorganizations in response to scientific and technological innovations as well as financial constraints. Simultaneously the rising prevalence of chronic diseases call for a kind of health care organization in which interprofessional collaboration (IPC) functions on a high level. This article describes a research project that aims to generate an empirical account of the current state of IPC in the South Tyrolean Health Trust, located in a bilingual region in northern Italy. The study will employ a sequential mixed methods' design. A survey will be followed by individual and focus group interviews. An innovative aspect of the study is that it will include participants from six different health professions (dieticians, nurses, occupational therapists, physicians, physiotherapists, and speech therapists). Qualitative data analysis will draw on the negotiated order/structural ordering approach and on the social world/arena perspective. The results are expected to generate specific recommendations to improve IPC in the South Tyrolean Health Trust and inform further research.

'Fighting for care': parents' perspectives of children's palliative care in South Tyrol, Italy.

BACKGROUND: Children's palliative care in Italy develops comparatively slowly. Recent legislation is enabling, but foundational research exploring parental experiences and perceptions is lacking. AIM: To investigate the experiences and perceptions of parents in South Tyrol, Italy regarding caring for a child with a life-threatening or life-limiting illness. DESIGN: A mixed qualitative design incorporated both an online survey and parent interviews. Using purposive sampling, 13 parents undertook 9 interviews and 7 parents completed the survey. RESULTS: The authors highlight a major parental theme describing difficult relationships with health services requiring them to 'fight the system' for services. DISCUSSION: The authors raise a disturbing possibility that such 'fighting the system' is now so widely recognised worldwide that it cannot be considered to be accidental. CONCLUSION: The authors recommend the establishment of a specialist, dedicated paediatric palliative care service in South Tyrol with the international recognised values and operating standards that would render such parental 'fighting' unnecessary.

Evaluating Measurement Properties of the Adapted Interprofessional Collaboration Scale through Rasch Analysis.

This study aimed to evaluate the validity and reliability of the German and Italian versions of the Interprofessional Collaboration Scale (IPC scale) by applying a Rasch analysis. Data were gathered from 1182 nurses participating in a cross-sectional study in northern Italy. The scale demonstrated good reliability (Cronbach's alpha = 0.92). Item polarity of all 13 items was positive, indicating good construct validity. However, revising one item would further improve the validity of the scale. Item stability was confirmed for work experience, workplace, age range, the language version, and gender. The analysis, applying a non-classical test theory, confirmed that the IPC scale is a valid and reliable instrument to measure interprofessional collaboration between nurses and physicians.

Improving lecture skills: a time-efficient 10-step pedagogical consultation method for medical teachers in healthcare professions.

BACKGROUND: Staff development initiatives proposed over the past few decades have, for the most part, suggested training environments such as workshops, short courses and seminar series. However, for many healthcare professionals, lecturing constitutes an ancillary activity, and a full-time occupation in the healthcare industry makes participation in such time-consuming programmes difficult to envision. AIM: To develop and offer for critical review a time-efficient pedagogical consultation method to improve lecture skills for medical teachers of healthcare professions. METHODS: Medical education literature was reviewed for factors known to facilitate successful pedagogical consultations. The result of this research was used to define the procedure of a consultation methodology. In subsequent trial runs, the consultation procedure was tested with eight healthcare professionals hired for lecturing in bachelor courses of healthcare professions. RESULTS: The key elements of successful pedagogical consultations were isolated in the literature, and a 10-step consultation method was developed based on specific methodological components. Eight trial runs indicated feasibility, time-efficiency and effectiveness of the method. CONCLUSION: The pedagogical consultation method presented here can help teachers to improve their lecture skills. It is a feasible model which can be easily adopted by medical educators to support staff development activities.

Interprofessional team-based learning in basic sciences: students' attitude and perception of communication and teamwork.

OBJECTIVES: To explore whether a team-based learning strategy applied to an interprofessional course on basic science changes students' perception of communication and teamwork skills and attitudes as related to interprofessional learning. METHODS: A mixed-methods approach was utilized. The participants were selected through an opportunity sample of 33 first-semester anatomy students from occupational therapy and orthoptics programs. Students completed an interprofessional questionnaire before and after the course. The data were analyzed descriptively. Fourteen students were selected randomly for group interviews. Qualitative data was interpreted using thematic analyses. RESULTS: The pre-test scores for 'communication and teamwork skills' and 'interprofessional learning' were high with mean values of 26.58 and 34.24, respectively. The post-test scores were 27.30 and 34.27, respectively, indicating no relevant changes in students' perception and attitudes. Qualitative data suggested that team-based learning represents a valid strategy to encourage communication and teamwork skills but revealed a lack of interprofessional exchange during the course. Students reported that classroom activities must require the professional knowledge of all participating groups in order to prevent a negative attitudinal shift towards interprofessional education in the later years of their studies. CONCLUSIONS: Implementing team-based learning in basic sciences can encourage communication and teamwork among students. Mixed classes can help socialize students of different professional groups, although they carry a risk of a negative attitudinal shift towards interprofessional education. Whether, and in what ways, effective interprofessional exchange during the teaching of basic sciences can be achieved needs further investigation.

Combining traditional anatomy lectures with e-learning activities: how do students perceive their learning experience?

OBJECTIVE: The purpose of this study was to investigate how students perceived their learning experience when combining traditional anatomy lectures with preparatory e-learning activities that consisted of fill-in-the-blank assignments, videos, and multiple-choice quizzes. METHODS: A qualitative study was conducted to explore changes in study behaviour and perception of learning. Three group interviews with students were conducted and thematically analysed. RESULTS: Data was categorized into four themes: 1. Approaching the course material, 2. Understanding the material, 3. Consolidating the material, and 4. Perceived learning outcome. Students appreciated the clear structure of the course, and reported that online activities encouraged them towards a first engagement with the material. They felt that they were more active during in-class sessions, described self-study before the end-of-term exam as easier, and believed that contents would remain in their memories for a longer time. CONCLUSIONS: By adjusting already existing resources, lectures can be combined fairly easily and cost-effectively with preparatory e-learning activities. The creation of online components promote well-structured courses, can help minimize 'student passivity' as a characteristic element of lectures, and can support students in distributing their studies throughout the term, thus suggesting enhanced learning. Further research work should be designed to confirm the afore-mentioned findings through objective measurements of student learning outcomes.