Student experiences of interprofessional simulation: Findings from a qualitative study

Interprofessional simulation provides healthcare profession students an opportunity to collaborate in a team. The purpose of this study was to examine student perspectives of an interprofessional simulation experience within the fields of nursing, physical therapy, nutrition, and social work. An exploratory case study design was employed, using open-ended interview questions post-simulation to generate information about the student’s perceptions of the experience. Based on the content analysis of reflection articles submitted by 100 students across professions, three themes emerged from the data: increased understanding of the role of other professionals, increased sense of confidence and ability to improve patient outcomes, and increased appreciation for inter-professional simulation as a valuable learning experience. Participants felt a sense of comfort in working as a team, which in turn fostered confidence in their own role. This is an important finding, as confidence in one’s own role in conjunction with increased willingness to work in a team is a powerful force for changing the ways in which professions interact with one another. Interprofessional simulation is a teaching strategy that shows great promise for promoting teamwork among the healthcare professions.     

Physicians’ perceptions of the role of the dental hygienist in interprofessional collaboration: a pilot study

ABSTRACT

Shifts in healthcare models, and greater numbers of patients seeking care, has encouraged professional organizations to recommend collaborative healthcare teams. In the realm of oral health, the American Dental Hygienists’ Association (ADHA) and the Commission on Dental Accreditation (CODA) have set recommendations that interprofessional collaboration (IPC) be emphasized in the profession. The purpose of this study was to determine physicians’ perceptions of the role of the dental hygienist in IPC. A pilot study utilizing a nonprobability sampling method which included a purposive sample of 30 licensed physicians was conducted. The survey addressed: personal experiences with a dental hygienist, dental hygienists’ roles working in collaboration with physicians, experiences with IPC, benefits of working with dental hygienists, barriers, and demographics. The majority (77.7%) supported the concept that dental hygienists have the necessary education and are important in IPC. Over 77.7% indicated dental hygienists would add value to a medical practice. Time and transfer of data were identified as primary obstacles in working collaboratively with dental hygienists. Findings revealed dental hygienists have the necessary education to be valuable members of IPC teams. Future research is needed to broaden the scope of studies among dental hygienists and other members of IPC teams.     

Interprofessional education and service learning: a model for the future of health professions education

Abstract

The implementation of interprofessional education for healthcare professionals has been lackluster, at best, since it was recommended by the Institute of Medicine. There have been various attempts in institutions of higher learning to meet this goal with mixed results. Herbert Wertheim College of Medicine, Florida International University has developed the Green Family NeighborhoodHELP? (GFNHelp) program to meet this challenge. GFNHelp is an interprofessional, longitudinal, service-learning program for healthcare students. Through participation in this program medical students team up with students from other professions, such as nursing, social work, and law, and collaborate to improve health outcomes for medically underserved families in the community. This educational program emphasizes the Core Competencies of the Interprofessional Education Collaborative through community-based service-learning, allowing student teams to engage firsthand and address the impact of social determinants on health.     

Interprofessional immersion: Use of interprofessional education collaborative competencies in side-by-side training of family medicine,pharmacy, nursing,and counselling psychology trainees

While supported by the Affordable Care Act, in the United States, interprofessional training often takes place after healthcare providers graduate and are practicing in the field. This article describes the implementation and evaluation of an interprofessional training for graduate-level healthcare trainees. A group of interprofessional healthcare faculty provided a weeklong interprofessional immersion for doctoral-level healthcare trainees (n = 24) in Pharmacy, Counselling Psychology, Nursing, and Family Medicine residents. Healthcare faculty and staff from each profession worked side-by-side to provide integrated training utilising the Interprofessional Education Collaborative core competency domains. Trainees were placed into small teams with representatives from each profession; each team observed, learned, and practiced working within teams to provide quality patient care. Qualitative and quantitative data were collected to identify the effect of the training on trainees’ self-reported team skills, as well as the extent to which the trainees learned and utilised the competencies. The results suggest that after completing the training, trainees felt more confident in their ability to work within an interprofessional team and more likely to utilise a team-based approach in the future.     

Essential features influencing collaboration in team-based non-specific back pain rehabilitation: Findings from a mixed methods study

The aim of the study presented in this article was to explore how professionals, without guidelines for implementing interprofessional teamwork, experience the collaboration within team-based rehabilitation for people with back pain and how this collaboration influences their clinical practice. This study employed a mixed methods design. A questionnaire was answered by 383 participants and 17 participants were interviewed. The interviews were analysed using content analysis. The quantitative results showed that the participants were satisfied with their team-based collaboration. Thirty percent reported that staff changes in the past year had influenced their clinical practice, of which 57% reported that these changes had had negative consequences. The qualitative findings revealed that essential features for an effective collaboration were shared basic values and supporting each other. Furthermore, aspects such as having enough time for reflection, staff continuity, and a shared view of the team members’ roles were identified as aspects which influenced the clinical practice. Important clinical implications for nurturing and developing a collaboration in team-based rehabilitation are to create shared basic values and a unified view of all team members’ roles and their contributions to the team. These aspects need to be emphasised on an ongoing basis and not only when the team is formed.     

Best practice interprofessional stroke care collaboration and simulation: The student perspective

Interprofessional practice (IPP) is the accepted standard of care for clients following a stroke. A brief, embedded and evidence-based IPP team simulation was designed to address stroke care knowledge and IPP competencies for students within limited curriculum space. Each team was required to construct a collaborative care plan for their patient during the simulation and submit the care plan for evaluation of best practice stroke care knowledge and implementation with evidence of interprofessional collaboration (IPC). A total of 302 students (274 on-site, 28 by distance technology) representing four professions comprised of 55 teams took part in this experience. Post-simulation, voluntary and anonymous programme evaluations were completed using the standardised interprofessional collaborative competency assessment scale (ICCAS) and open-ended free-text responses to five questions. There was a significant improvement for all pre–post ratings on the ICCAS regardless of profession or previous interprofessional experience. Additionally, the open-ended responses indicated perceived changes to role clarification, communication, and teamwork. The combined interpretation of the programme evaluation results supports interprofessional team simulation as an effective and efficient learning experience for students regardless of previous interprofessional experience, and demonstrated positive changes in stroke best-practice knowledge and IPC competencies.     

Linking integrative medicine with interprofessional education and care initiatives: Challenges and opportunities for interprofessional collaboration

Although the fields of interprofessional education and collaboration (IPE/IPC) and integrative medicine (IM) are both recognised and clearly advancing as of late, a curious paradox exists: IPE/IPC and IM are both concerned with communicating about and attempting to resolve differences between healthcare professions with the fundamental goal of improving patient outcomes, yet they have remained quite distinct fields of research. This disconnect could be due to the fact that one field deals with integration within the general paradigm of biomedicine (IPE/IPC), while the other addresses integration across paradigms (IM). It is an opportune time for a critical comparison between the two. First, the main themes of IM are summarised as they are reflected in the IM literature. Second, a comparative analysis is presented focusing on the significant similarities and differences between IPE/IPC and IM. The final section addresses the question: What key learning areas from IM could benefit and enhance IPE/IPC?     

Complexity,collective learning and the education of interprofessional health teams: Insights from a university-level course

This paper describes a collaborative action research project carried out by the author and the instructors of a large university-level interprofessional health team course. The research focused on introducing new complexity science-based ideas about collective learning to the course's pedagogy and curriculum, and tracking resultant changes in both thinking and practice. A number of insights emerged from the research, including a deeper understanding of collective learning in interprofessional contexts, a questioning of the meaning of consensus within teams, and the identification of a special role for trust in interprofessional relationships. One significant practical change in the course curriculum, which related to these insights, is also described.     

Interprofessional teamwork in decentralized child welfare in The Netherlands: A comparison between the cities of Amsterdam and Utrecht

The recent transformation of child welfare in the Netherlands has improved opportunities for interprofessional working. We compared two models of teamworking within newly established interprofessional teams in the cities of Amsterdam and Utrecht, conducting a secondary analysis of semi-structured interviews collected through three broader research projects. Respondents include seventeen interprofessional team members (six from Utrecht, eleven from Amsterdam), representing a variety of teams across city, as well as two policymakers from Utrecht and one from Amsterdam. Team members were approached using convenience sampling, policymakers were purposively recruited. In different rounds of open and focused coding, we found that differences in team organization between the two cities have led to differences in the quality of interprofessional teamworking. Teamworking is best developed in Utrecht partly because team members are recruited and employed by a single organization. This has enabled a more careful process of selection and team composition than in Amsterdam, where a delegation approach entailed fragmentation as well as the risk of divided loyalty between team and mother organization. In addition, while the development of interprofessional teamwork in Utrecht is served by certain structures, teams in Amsterdam have suffered from an imbalance between freedom and structure, causing insecurity amongst staff and reduced chances of interprofessional integration. Despite the apparent success of the Utrecht model of interprofessional teamworking, interprofessional collaboration across team boundaries might suffer from the fact that teams in Utrecht, unlike in Amsterdam, do not comprise representatives of relevant partner organizations.     

Contributions of team climate in the study of interprofessional collaboration: A conceptual analysis

The concept of team climate is widely used to understand and evaluate working environments. It shares some important features with Interprofessional Collaboration (IPC). The four-factor theory of climate for work group innovation, which underpins team climate, could provide a better basis for understanding both teamwork and IPC. This article examines in detail the common ground between team climate and IPC, and assesses the relevance of team climate as a theoretical approach to understanding IPC. There are important potential areas of overlap between team climate and IPC that we have grouped under four headings: (1) interaction and communication between team members; (2) common objectives around which collective work is organised; (3) responsibility for performing work to a high standard; and (4) promoting innovation in working practices. These overlapping areas suggest common characteristics that could provide elements of a framework for considering the contribution of team climate to collaborative working, both from a conceptual perspective and, potentially, in operational terms as, for example, a diagnostic tool.     

Teaching interprofessional teamwork in medical and nursing education in Norway: A content analysis

The notions of interprofessional education and interprofessional teamwork have attained widespread acceptance, partly because lack of teamwork has been tentatively linked to adverse incidents in healthcare. By analyzing data from 32 educational institutions, this study identifies the status of interprofessional teamwork in all nursing and medical education in Norway. The study programs issued by the 32 educational institutions were subject to content analysis, distilling the ambitions and goals for teaching interprofessional teamwork. Study program coordinators were approached and asked to what degree interprofessional teamwork was actually introduced in lecturing and clinical training. Results indicate that the medical and nursing schools clearly aspire to teach interprofessional teamwork and that this has largely been achieved when it comes to theoretical teaching. Although three of the four medical programs have integrated interprofessional teamwork into their clinical training, there is a gap in the nursing programs where introduction of interprofessional teamwork in clinical training has been limited. Current challenges are related to organizational issues (e.g. lack of institutional collaboration), practical difficulties (e.g. finding time to bring students of various professions together) and possibly managerial issues (e.g. lack of strategic perspective and change management).     

Leadership of interprofessional health and social care teams: a socio-historical analysis

reeves s., macmillan k. & van soeren m. (2010) Journal of Nursing Management 18, 258–264
Leadership of interprofessional health and social care teams: a socio-historical analysis Aim The aim of this paper is to explore some of the key socio-historical issues related to the leadership of interprofessional teams. Background Over the past quarter of a century, there have been repeated calls for collaboration to help improve the delivery of care. Interprofessional teamwork is regarded as a key approach to delivering high-quality, safe care. Evaluation We draw upon historical documents to understand how modern health and social care professions emerged from 16th-century crafts guilds. We employ sociological theories to help analyse the nature of these professional developments for team leadership. Key issues As the forerunners of professions, crafts guilds were established on the basis of protection and promotion of their members. Such traits have been emphasized during the evolution of professions, which have resulted in strains for teamwork and leadership. Conclusions Understanding a problem through a socio-historical analysis can assist management to understand the barriers to collaboration and team leadership. Implications for nursing management Nursing management is in a unique role to observe and broker team conflict. It is rare to examine these phenomena through a humanities/social sciences lens. This paper provides a rare perspective to foster understanding – an essential precursor to effective change management.     

The role of interprofessional collaboration for intimate partner violence in psychiatric care: A research and development project

In Finland, policy requirements have demanded providers to work collaboratively together with regard to intimate partner violence (IPV). This research and development project seeks to identify efficient tools for stopping IPV. The project included staff training to recognize and respond to IPV, the development of a research-based guideline for use in the care situations of victims and perpetrators and the integration of the guideline into practices and staff development. Networking was developed during the project through interprofessional and multiagency collaboration, whereas appraisal information was collected at different stages of the process. This paper focuses on the issues of interprofessional collaboration, and uses psychiatric care as an example. There is some evidence that interprofessional interventions reduce the cost of patient care and improve the quality of IPV services. That is why it is important to discuss these issues and solve possible problems arising in interprofessional patient care.     

Exploring the nature of interprofessional collaboration and family member involvement in an intensive care context

Abstract

Little is known about the nature of interprofessional collaboration on intensive care units (ICUs), despite its recognition as a key component of patient safety and quality improvement initiatives. This comparative ethnographic study addresses this gap in knowledge and explores the different factors that influence collaborative work in the ICU. It aims to develop an empirically grounded team diagnostic tool, and associated interventions to strengthen team-based care and patient family involvement. This iterative study is comprised of three phases: a scoping review, a multi-site ethnographic study in eight ICUs over 2 years; and the development of a diagnostic tool and associated interprofessional intervention-development. This study’s multi-site design and the richness and breadth of its data maximize its potential to improve clinical outcomes through an enhanced understanding of interprofessional dynamics and how patient family members in ICU settings are best included in care processes. Our research dissemination strategy, as well as the diagnostic tool and associated educational interventions developed from this study will help transfer the study’s findings to other settings.     

Student perceptions towards interprofessional education: Findings from a longitudinal study based in a Middle Eastern university

The Lebanese American University Interprofessional Education (LAU IPE) Steps Framework consists of a five-step workshop-based series that is offered throughout the curriculum of health and social care students at an American university in Lebanon. The aim of the present study was to report students’ perceptions of their readiness for interprofessional learning before and after completing the IPE steps, their evaluations of interprofessional learning outcomes, as well as their satisfaction with the learning experience as a whole. A longitudinal survey design was used: questionnaires were completed by students before IPE exposure and after each step. The results showed that before IPE exposure, students’ perceptions of their readiness for interprofessional learning were generally favourable, with differences across genders (stronger professional identity in females compared to males) and across professions (higher teamwork and collaboration in pharmacy and nutrition students compared to other professions and lower patient centredness in nursing students compared to others). After participation in the IPE steps, students showed enhanced readiness for interprofessional learning and differences between genders and professions decreased. Participants were satisfied with the learning experience and assessment scores showed that all IPE learning outcomes were met. The LAU IPE Steps Framework may be of value to other interprofessional education course developers.     

Nursing emotion work and interprofessional collaboration in general internal medicine wards: a qualitative study

Title. Nursing emotion work and interprofessional collaboration in general internal medicine wards: a qualitative study Aim. This paper is a report of a study to examine nursing emotion work and interprofessional collaboration in order to understand and improve collaborative nursing practice. Background. Nursing standards identify collaborative practice as necessary for quality patient care yet many nurses are often reluctant to participate in interprofessional teams. Strategies intended to improve participation often fail which suggests that the factors underpinning nurses’ disinclination towards interprofessional collaboration have yet to be understood. The concept of emotion work has not been applied to nursing interprofessionalism, and holds the potential to improve collaborative practice. Nursing emotion work is defined as the management of the emotions of self and others in order to improve patient care. Methods. Qualitative data were collected in 2006 using non‐participant observation, shadowing and semi‐structured interviews with nursing, medical and allied professionals in the general internal medicine wards of three hospitals in urban Canada. Findings. Nurses’ collaborations with other professionals are influenced by emotion work considerations. The establishment and maintenance of a nursing esprit de corps, corridor conflicts with physicians, and the failure of the interdisciplinary team to acknowledge the importance of nursing’s core caring values are important factors underpinning nurses’ interprofessional disengagement. Conclusion. Longstanding emotion work issues must be addressed before nurses will engage collaboratively. We suggest improving nursing collaboration through the refining of holistic nursing information, and reflections on practice by all interprofessional team members.     

Views from the field: Medical student experiences and perceptions of interprofessional learning and collaboration in rural settings

Exploring the perceived environment where students are educated, as well as where they practice, is particularly important for educators and practitioners working in situations of interprofessional rural and remote health. In this study, we explored the perceptions of undergraduate medical students regarding interprofessionalism across their four-year undergraduate program which focuses on rural health. A thematic content analysis of the text-data was conducted on a convenience sample of 47 student responses to essay questions across four cohorts of a four-year undergraduate medical program. The medical program has an explicit social accountability mandate for responsiveness to the needs of a rural population and thus students have multiple opportunities to experience interprofessional education and collaboration in rural contexts. Participants reported (a) blurring and flexibility of roles in a primarily positive manner, (b) participating in unstructured interprofessional learning and collaboration, (c) experiencing the importance of social connections to interprofessional collaboration and learning, and (d) realisations that interprofessional collaboration is a means of overcoming barriers in rural areas. We discuss our findings using the socio-material perspective of complexity theory. These findings may be used to inform undergraduate programs in re-defining, re-creating, developing, and fostering interprofessional learning opportunities for medical students in rural communities as well as to support clinical faculty through ongoing professional development.