Journal of Research in Interprofessional Practice and Education (JRIPE)
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Measuring Behaviour as Outcome of Interprofessional Interventions: A Review of a Recent Tool Inventory.
No full textBackground: This article discusses a recently developed inventory of questionnaires by a former working group of the Canadian Interprofessional Health Collaborative (CIHC) to promote interprofessional (IP) intervention (education and practice) and program evaluation. The classification of questionnaires into six outcome levels revealed an unusually large number focusing on behavioural outcomes. Behavioural outcomes are key measures for evaluating IP interventions, and we decided to further explore the design of questionnaires in this inventory.Methods and Findings: The data presented in this article are based on a systematic search and review of questionnaires published in peer-reviewed journals between 2000 and 2010 that evaluate outcomes related to interprofessional education and collaborative practice. The review was used to construct an inventory that placed questionnaires into six outcome levels: attitudes; knowledge, skills, and abilities; collaborative behaviour of providers at the workplace; collaboration as part of organizational practice; patient satisfaction with collaboration, and provider satisfaction with collaboration. We took a closer look at the subgroup of measures on collaborative behaviour of providers (Level 3 Outcome). We found that the questionnaires included in Level 3 measure a range of competencies. The wording of the subscale items was at times difficult to interpret. While some statements can be clearly attributed to measuring behaviour, others could be seen as measuring some sort of attitudes, beliefs, or knowledge. Since subscale items tended to be a combination of indicators, it was difficult to attribute questionnaires to one particular level.Conclusions: Designing questionnaires for evaluating outcomes from IP interventions is a challenge, especially when behavioural competencies are of interest. We would welcome more attention paid to the input of potential users in questionnaire construction, who are mostly left with little guidance on how to interpret the questions. Triangulation of methods to supplement the current focus on subjective outcome evaluations from IP interventions would also enhance this research
"Walking the Walk”: Promoting Competencies for Interprofessional Learning through Team Meetings—A Case Study
Get PDFBackground: Interprofessional learning is a key aspect of improving team-based healthcare. Core competencies for interprofessional education (IPE) activities have recently been developed, but there is a lack of guidance as to practical application. Methods and Findings: Cancer Forum is a weekly multi-professional meeting used as the case study for this report. Power was identified as a critical issue and six questions were identified as the basis for a structured reflection on the conduct of Cancer Forum. Results were then synthesised using Habermas’ delineation of learning as instrumental, normative, communicative, dramaturgical, and emancipatory. Power was a key issue in identified obstacles to inter professional learning. Leadership emerged as a cross-cutting theme and was added as a seventh question. The emancipatory potential of interprofessional learning benefited from explicit consideration of the meeting agenda to promote competencies of sharing role knowledge, teamwork and communication. Modelling of required skills fulfils a dramaturgical and normative role. Conclusions: The structured reflection tool highlighted the relationship between power and IPE competencies. It was essential to walk the walk as well as talk. The process followed provides a practical guide for using team meetings to promote interprofessional learning competencies and thereby improving patient care
Confident, Credible but Lonely – Outcomes Following Postgraduate Interprofessional Education in Rehabilitation
Get PDFBackground: Interprofessional education aims to enhance health service delivery. This study examined whether health professionals changed their clinical practice after completing a postgraduate interprofessional qualification in rehabilitation. Methods & Findings: All graduates of postgraduate qualifications in rehabilitation at University of Otago were invited to complete a questionnaire. Thirteen participants were purposively selected for further in-depth interviews. Questionnaire data were summarized using descriptive statistics. Qualitative responses from questionnaires and interview transcripts were explored using thematic analysis. The survey response rate was 24% (77/315 students). Postgraduate study was reported to have had a positive impact on professional attitudes and commitment to learning (81%), to enhance interdisciplinary collaboration (79%), and to promote change in service delivery (40%). Themes identified from questionnaire responses were: 1) increased confidence, 2) enhanced credibility, and 3) widened view of rehabilitation. Analysis of the interviews identified three contrasting themes: 1) isolation hampers momentum, 2) managers and clinical leaders do not value postgraduate qualifications, 3) implementing change required postgraduate study plus persistence. Conclusions: Educators and employers of health professionals should be aware of the benefits of postgraduate interprofessional education for health professionals and healthcare delivery. Employers should recognize and value these benefits and support health professionals to apply new skills in their clinical practice
Interprofessional Collaboration Led by Health Professional Students: A Case Study of the Inter Health Professional Alliance at Virginia Commonwealth University
Get PDFBackground: Internationally recognized health experts have identified the need for an interdisciplinary approach to meet the healthcare needs of the 21st century, but academic institutions have been slow to take action. In response, eight health professional students at Virginia Commonwealth University developed a student-led organization, the Inter Health Professionals Alliance (IHPA), to foster a collaborative, interdisciplinary environment among health professional students.Methods and Findings: The eight students utilized a participatory action research approach to identify 1) an understanding behind the motivation for developing IHPA and 2) the core benefits of group involvement. Four benefits were identified: the development of knowledge and skills, interprofessional networks, professional competence, and role clarity. The case study demonstrated that students can engage in interdisciplinary collaboration from a student-initiated approach and likely improve the care of future patients. Drawing on personal experiences, IHPA board members outline five pieces of wisdom to aid fellow students in the development of student-led interdisciplinary organizations.Conclusions: With enthusiasm and support, students can transform their educational experiences to meet the healthcare needs of the twenty-first century
Transdisciplinary Screening and Intervention for Nutrition, Swallowing, Cognition and Communication: A Case Study
No full textBackground: Transdisciplinary health research and clinical practice is supported by numerous Australian health workforce documents and the broader transdisciplinary research literature. This research assessed the impact of early screening and limited intervention for nutrition, swallowing, cognition, and communication deficits in medical admissions in a large metropolitan hospital. Methods and Findings: Validated screening tools were selected and consensus for interventions were obtained by dietetic and speech pathology disciplines. Intensive training was undertaken to familiarize staff members with the screening documents and project scope. Ethics approval was obtained. Participants included 179 patients aged ≥65 years admitted to the emergency department or medical unit. The project significantly reduced referral time to both disciplines, and time to full assessment in dietetics but not speech pathology. Results found 43% of patients were malnourished or at risk of malnutrition, and 14 patients had oral intake ceased due to swallowing difficulties.Conclusions: This study has demonstrated that transdisciplinary screening and intervention may work within dietetics and speech pathology, providing an innovative extension to practice. Further alternatives using this model include the use of allied health assistants or less-experienced clinicians, while opportunities exist for transdisciplinary practices within other healthcare disciplines
Translating Research into Practice: Impact of an Interprofessional Diabetes Education Model on Patient Health Outcomes
No full textBackground: Patient education programs encouraging diabetes self-management can improve clinical outcomes and lessen diabetes complications. This study implemented an innovative interprofessional student-led diabetes self-management and health promotion program for an underserved population and demonstrated an improvement in participant clinical outcomes and students’ understanding of interprofessional aspects of diabetes care.Methods and Findings: This community-based program was implemented at two sites that serve medically underserved individuals. Students from five health career professions led educational sessions designed to demonstrate critical components of diabetes self-management. The six-month longitudinal program covered topics within the Alphabet Strategy, including Advice, Blood pressure, Cholesterol, Diabetes control, Dental care, Diet, Eye care, Foot care, and Guardian drugs. Participants completed surveys evaluating diabetes knowledge, understanding of diabetes care, and health behaviours. Clinical values were collected before and after the program. Student surveys assessed their understanding of diabetes self-management. Upon completion of the program, all assessments were repeated to determine if there were improvements in outcomes. Thirty-eight participants and thirty students completed the study. There were significant improvements in participants’ diabetes knowledge, understanding of diabetes management, and clinical outcomes. There were significant improvements in the students’ ability to educate patients about foot care, eye care, and guardian drugs, as well as increased awareness of the role of each health profession in diabetes care.Conclusions: This interprofessional health promotion model showed significant improvements in patient and student outcomes. This innovative student-led program could be implemented in other settings and for the management of other chronic diseases
Community Partnership Interprofessional Program as Pedagogy: Process Outcomes and Faculty Impressions
Get PDFBackground: Since 1992, East Tennessee State University (ETSU) has augmented traditional health professions curricula with community-based, experiential learning through the Community Partnership Interprofessional Rural Health Program. The program was expanded in 2005 by including more interprofessional faculty, students, and community partners. Interprofessional teams of students and faculty work with community organizations to identify health needs and assets and implement health education programs or services.Methods and Findings: Course process outcomes were compiled from a survey of section reports and presentations. Faculty impressions of being involved in the course were gathered through conducting interviews with five interprofessional faculty. From 2005–2011, community partners included individuals, groups, and organizations within seven counties in Tennessee. Forty programs and services have been implemented through the program during the past seven years. Faculty reported the main reasons for being involved are their interests in interprofessional education and working in communities. Faculty also cited 12 different types of teaching strategies (pedagogical approaches) employed through the course.Conclusions: The Community Partnership Interprofessional Rural Health Program at ETSU is a testing ground for the unique combination of communitybased learning and interprofessional health education. Study findings demonstrate how the course has benefited faculty, students, and communities
What Does Collaborative Practice Mean Within Mental Health Care?: A Qualitative Study Exploring Understandings and Proposing a Definition.
Get PDFBackground: Despite frequent appearances in service documents, the concept ofcollaborative practice is ill defined in mental health practice. The purposes of this pilot study were to gain insight into professionals’ conceptual and practical understandings of collaborative mental health practice (CMHP), to use these insights to develop a proposed definition, and to inform the development of a collaborative practice assessment tool.Methods and findings: This pilot study involved semi-structured interviews with four mental health professionals who have knowledge of a service model that endorses collaborative practice as a service principle. Thematic analysis of interview data revealed the importance of contextualized collaborative practice, a shared belief in the importance of equalized communication with clients, and concerns about the impacts of structural disincentives on collaborative practice. Using Habermas’ theory of communicative action, the findings were applied to develop a proposed definition of CMHP. The main limitations of the study relate to small sample size; however, efforts have been expended to ensure rich data were collected from all participants.Conclusion: These findings illustrate the importance of context-sensitive team formation and shared philosophical understandings regarding collaborative practice, which both provide a foundation for CMHP to improve client outcomes. Further research is required to build upon the proposed definition of CMHP, as well as the assessment tool that is suggested within the article
Interprofessional Collaboration in Ontario’s Family Health Teams: A Review of the Literature
Get PDFBackground: In Ontario, 200 interprofessional Family Health Teams (FHTs) have been established since 2005 to improve primary healthcare access, patient outcomes, and costs. High levels of interprofessional collaboration are important for team success; however, effective team functioning is difficult to achieve. FHTs are in their infancy, and little is known about the determinants that have influenced the quality of team collaboration or the outcomes that FHTs have achieved. The objective of this article is to examine current knowledge regarding FHT team functioning.Methods and Findings: A search of the literature resulted in eleven articles for final analysis, which were primarily qualitative in nature. A narrative synthesis of study findings was completed. A number of common challenges to interprofessional collaboration were identified. Nevertheless, patients and providers described improved healthcare access, greater satisfaction, and enhanced quality of healthcare using a FHT approach. Collaboration was fostered by effective leadership, communication, outcome evaluation, and training for both professionals and patients alike.Conclusions: Ontario FHTs have generated improvements in healthcare access and outcomes. Collaborative team functioning, while present, has not reached its full potential. Supportive public policy, education for patients and providers, and evaluation research is needed to advance FHT functioning
“The Power of Many Minds Working Together”: Qualitative Study of an Interprofessional, Service-Learning Capstone Course
Get PDFBackground: An interprofessional faculty group analyzed a critical reflection assignment of students in a service-learning practicum interprofessional education (IPE) course. Students were from ten programs: physical therapy, occupational therapy, nuclear medicine technology, radiation therapy, athletic training, nursing, investigative medical science, cytotechnology, nutrition and dietetics, and clinical laboratory science. Research questions investigated what the assignments revealed about students’ application of beliefs, emotions, and behaviours, and if course objectives were met.Methods and Findings: This qualitative study retrospectively analyzed one critical reflection from the course conducted in 2011. Researchers selected a stratified sample of 40 assignments from a population of 278. Nine major themes emerged: achieving IPE outcomes, engaging in team process, learning culture/community engagement, being client/patient centred, becoming aware of behaviours, experiencing barriers, articulating beliefs, connecting with course objectives, and expressing emotions.Conclusions: In an IPE practicum course, transformative learning was evident. Students articulated beliefs, emotions, and behaviours related to interprofessional teamwork. Students expressed detailed understanding of team processes. For future research, critical reflection assignments were useful to assess student beliefs, emotions, and behaviours in a practicum course. We suggest studying practice among health professionals who have experienced IPE compared with those who have not had IPE in their professional curricula