Journal of Research in Interprofessional Practice and Education (JRIPE)
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The Experience of GP Surgeons in Western Canada: The Influence of Interprofessional Relationships in Training and Practice
Get PDFBackground: Challenges to the sustainability of rural healthcare in Canada demands innovative solutions to human resources shortages in rural communities.One solution is to support generalists with enhanced skills to meet some of the surgical needs of rural residents. Despite favourable outcomes, generalist surgical care is becoming a vanishing option due to the lack of interprofessional support garnered in education and practice.Methods and Findings: Data were gathered through semi-structured interviews with 28 general practitioner surgeons (GPS) face-to-face and 12 GPS over the telephone. Interview participants articulated four themes, including their beliefs about GP surgery, the context of interprofessional relationships between general surgeons and GPS, and qualities of and barriers to interprofessional practice.Conclusions: The importance of establishing positive interprofessional relationships within healthcare in relation to quality of care, outcomes, and system efficiency demands addressing interprofessional challenges at a macro (systems) and micro (personal interaction) level
Law and Psychiatry Seminar: An Advanced Intervention in Interprofessional Education and Attitudinal Improvement
Get PDFBackground: The tenuous relationship between psychiatrists and lawyers does not serve mental health patients in conflict with the law or society well. The characteristic miscommunication that occurs, though premised on differential pedagogical constructs, presents an opportunity to intervene from the pre-licensure educationalstage with the hope of positively affecting future practice.Methods: Law students and psychiatric residents were brought together to interact with each other and with instructors from the two fields through the Law and Psychiatry interprofessional seminar series. We examined the attitudes and perceived co-operation of learners in this seminar in comparison to a control group of law students (Human Rights class) who did not have any interprofessional interaction.Findings: Learners in the interprofessional seminar series reported more positive attitudes toward members of the other profession after completing the course. Additional positive changes in the level of perception of and actual co-operation with the other profession were noted with high satisfaction among participants.Conclusions: Learning activities that can foster positive interactions with and understanding of other professions may improve relations and collaboration in interprofessional education. The potential impact and benefit for the patient and the system are worthwhile
Outcomes of a Multiprofessional Educational Intervention in Evidence-Based Practice
Get PDFBackground: Education is a commonly used intervention in the development of evidence-based practice (EBP). The aim of this study was to evaluate the outcome of an educational intervention on healthcare professionals’ perceived skills in finding, reviewing, and using research evidence in clinical practice. A further aim was to identify potential determinants for the outcome.Methods and Findings: A three-day course in EBP was designed for registered nurses, medical social workers, physiotherapists, occupational therapists, and dieticians. The Developing Evidence-Based Practice Questionnaire (DEBP) questionnaire was administered before and six months after the intervention (N = 274). Non-parametric statistics were used. The results showed an overall effect on ability to find research evidence (p = .0005) and ability to review research evidence (p = .0005), whereas there was no overall effect on use of research evidence in clinical practice (p = .18). However, some subgroups showed a significant improvement over time, for example, those whose profession was nursing or midwifery and those who had experience using evidence-based practice prior to the educational intervention.Conclusions: The results showed that a three-day course in EBP improved the participants’ ability to find and review research evidence, but it did not have an overall effect on the use of research evidence in clinical practice
Physician and Nurse Perspectives of an Interprofessional and Integrated Primary Care-Based Program for Seniors
Get PDFBackground: In Canada, primary care practitioners provide the majority of care for elderly patients. Increasing volume and complexity of care compounded by a shortage of specialized geriatric services has lead to problems of fragmented, inefficient,and often ineffective service for this population. Integrated models that bridge primary and secondary care have emerged as a major theme in health reform to address such challenges for care of the elderly. Although primary care practitioners are important stakeholders necessary for successful uptake and sustainability of such integrated models, this perspective has been largely unexplored. Methods and Findings: We used a qualitative thematic approach to bring forward front-line perspectives of nurses and physicians who referred their patients to a newly developed integrated, multidisciplinary program for seniors that was introduced into their primary care clinic. Referrers experienced improved care processes, improved quality of care, as well as an enhanced experience when managing their elderly patients. Unclear assignment of roles and responsibilities created confusion for referring practitioners and their patients.Conclusions: Understanding benefits, limitations, and changes to front-line practitioner experience provides insight into important factors contributing to buy-in and sustainability of integrated programming for the elderly in this setting
Using a Common Vision of Partners in Care to Enhance Hospital Collaborative Relationships
Get PDFBackground: Collaborative care is a philosophy that guides the work of interdisciplinary teams, patients, and their families internationally. Hospital organizations must create and cultivate environments to meet customer, health policy, and legislative mandates for improved collaborative care. This study aimed to inform and aid cultural change related to collaborative care relationships with the goal of improving the quality of care.Methods and Findings: A critical ethnography using mixed methodologies was conducted at a mid-sized non-acute hospital in Ontario, Canada. This article presents Phase 3 of a three-phase study that engaged senior leaders (SLs) in interviews about customer service and collaborative relationships. Phase 3 findings were triangulated with prior Phase 1 study results from healthcare providers (HCPs) and Phase 2 results from mid-level leaders (MLLs). The combined findings from all three phases formed a description of the organization’s culture (self-awareness, congruency, and health), explicated five organizational tensions, and generated questions and innovative change ideas to advance growth toward a shared vision of “partners in care.”Conclusions: A shared conceptual model of partners in care emerged from the shared conversations held in the research focus groups and interviews over the three phases in the study. Organizational questions, tensions, and possibilities were revealed to advance the culture of collaboration with patients, families, and staff. Innovations were identified and implemented to enhance collaborative practice
Exploring Social Media’s Potential in Interprofessional Education
Get PDFSocial media applications such as Facebook, Twitter, and blogs have become part of mainstream society and are currently being used throughout health professions education. The asynchronous nature and conversational aspects of social media permit learners to collaborate with and learn from others in different fields. Interprofessional education (IPE) is a growing paradigm in health professions schools for a variety of reasons, including the desire to teach future practitioners how to communicate with each other and engage in collaborative care. Due to the interdisciplinary nature of IPE curricula, those programs must overcome numerous logistical barriers to be successful. Finding suitable times and locations for interprofessional students to meet and arranging opportunities for them to collaborate on healthcare issues are just two of the logistical impediments to IPE implementation. Fortunately, the asynchronous, conversational, and collaborative aspects of social media applications enable them to facilitate interprofessional communication and alleviate some of the time and space issues. In this article, we describe in further detail the merits of social media relevant to IPE, provide specific examples of how social media can be used to enhance aspects of IPE programs, and make a call for further research in this area
Improving Understanding of Teaching Strategies Perceived by Interprofessional Learning (IPL) Lecturers to Enhance Students’ Formulation of Multidisciplinary Roles: An Exploratory Qualitative Study
Get PDFBackground: Interprofessional Learning (IPL) is an educational process intended to equip health and social care students with appropriate knowledge, skills, and attitudes for effective interprofessional working. By and large, the literature review highlighted in this article has shown that IPL is a worthwhile pursuit, with some studies highlighting conflicts over best teaching methods to use. In response, the aim of this exploratory research was to improve understandings of teaching strategies perceived by IPL lecturers to enhance students' formulation of multidisciplinary roles.Methods: An exploratory qualitative study was carried out. Semi-structured interviews were conducted, with a purposive sample of 4 consenting IPL lecturers. The objectives of the study were to extend understandings of strategies believed to enhance or inhibit students' accurate assimilation of Allied Health Professional (AHP) roles, to nurture awareness of potential obstacles that may inhibit successful delivery of IPL, to promote insight into what constitutes quality delivery of IPL, and to identify potential topics for further research.Findings: Five themes emerged from the data: (1) IPL lecturers hold contrasting viewpoints about the need for IPL; (2) improved understanding of roles is directly proportional to time spent with AHPs; (3) perspectives differ about when and where IPL should be taught; (4) stereotyping and negative attitudes inhibit accurate role construction; and (5) positive role modelling by lecturers is important.Conclusions: This article acts in a conscience-raising manner and highlights five key areas of lecturers' understandings about how to effectively deliver IPL. This nurtured awareness will be used to develop and evaluate new implementations in IPL and education.  
Implementing and Sustaining a Rural Interprofessional Clinical Education Program
Get PDFBackground: After a successful pilot project introducing interprofessional (IP) clinical education in a rural hospital, expansion to other rural hospitals was attempted. Despite enthusiasm for the pilot project and funding, the university-based project team had difficulty persuading administrators and staff to become involved or to maintain the project. Of 9 institutions, 2 implemented and sustained the project for more than 2 years, 2 initiated but dropped it, and 5 declined.Methods and Findings: A qualitative, interpretive description study was conducted to identify facilitators and barriers to implementing an IP clinical education program in rural settings. Semi-structured interviews were conducted with representatives of organizations that sustained the project, dropped out, or never participated.Using the National Health Service Sustainability Model we identified the staff, organization, and process factors that affected the program implementation. Three staff roles were required for success: sponsor, champion, and gatekeeper. Organizational factors included infrastructure to identify participants and perceived project enhancement of organizational values. Process factors included organizational benefits, compatible priorities, and adaptability.Conclusions: Introduction of IP education to rural institutions requires complex combined factors. However, continuation of the project at two sites demonstrates that when IP education is valued and sustainability factors are present, staff will maintain it. 
Patients’ Messages as Educators in an Interprofessional Health Education Program
Get PDFBackground: Patients have traditionally played a passive role in health professional education. Health Mentors Programs are new, innovative interprofessional education initiatives that involve "health mentors" (volunteer community patient educators), who share their experiences navigating the healthcare system with an interprofessional team of four health professional students. The purpose of this research was to explore what motivated the patient educators to participate in the Dalhousie Health Mentors Program and what messages they wanted to instill in health professional students.Methods: Data were collected through seven semi-structured focus groups (N = 29) and one individual interview (N = 1), which were recorded and transcribed verbatim. Qualitative inductive thematic analysis was used to identify key themes.Findings: Our study demonstrated that patients want to play an active role in educating health professional students with the hope of improving the healthcare system. The mentors wanted to convey to the students the importance of interprofessional collaboration, understanding patients are people first, listening to patients, and understanding the visible and invisible impacts of living with chronic conditions.Conclusions: If we expect our students to become competent in providing interprofessional, patient-centred care, it is important that we provide opportunities for patients to be actively involved in health professional education, as they have important messages that cannot be taught from a textbook