Collaborative Health Care Research Articles

TEAMs go VR—validating the TEAM in a virtual reality (VR) medical team training

BackgroundInadequate collaboration in healthcare can lead to medical errors, highlighting the importance of interdisciplinary teamwork training. Virtual reality (VR) simulation-based training presents a promising, cost-effective approach. This study evaluates the effectiveness of the Team Emergency Assessment Measure (TEAM) for assessing healthcare student teams in VR environments to improve training methodologies.MethodsForty-two medical and nursing students participated in a VR-based neurological emergency scenario as part of an interprofessional team training program. Their performances were assessed using a modified TEAM tool by two trained coders. Reliability, internal consistency, and concurrent validity of the tool were evaluated using intraclass correlation coefficients (ICC) and Cronbach’s alpha.ResultsRater agreement on TEAM’s leadership, teamwork, and task management domains was high, with ICC values between 0.75 and 0.90. Leadership demonstrated strong internal consistency (Cronbach’s alpha = 0.90), while teamwork and task management showed moderate to acceptable consistency (alpha = 0.78 and 0.72, respectively). Overall, the TEAM tool exhibited high internal consistency (alpha = 0.89) and strong concurrent validity with significant correlations to global performance ratings.ConclusionThe TEAM tool proved to be a reliable and valid instrument for evaluating team dynamics in VR-based training scenarios. This study highlights VR’s potential in enhancing medical education, especially in remote or distanced learning contexts. It demonstrates a dependable approach for team performance assessment, adding value to VR-based medical training. These findings pave the way for more effective, accessible interdisciplinary team assessments, contributing significantly to the advancement of medical education.

Internal bordering and debordering in urban humanitarian health care

ABSTRACT Current literature on internal bordering has suggested understanding health care as a key migration control field. This article takes a closer look at the humanitarian medical offices in Frankfurt am Main, Germany, and patients from Romania and Bulgaria in precarious life circumstances. It addresses the strategies identified in the accounts of frontline workers beyond the mere provision of access to free and anonymous medical attention. Based on 16 interviews with medical staff, social workers and administrative officers, two approaches emerged. One clearly strives for the formalisation of the human right to health care in close collaboration with, or by challenging the local bordering actors; the other insists on bypassing any point of contact with them, focusing exclusively on informal and direct solutions. The interviews showcase how the resulting strategies can contribute to internal bordering and debordering on an urban scale, and affect the individuals’ trajectories as patients and as migrants.

Current status and influencing factors of protective motivation for body mass management during pregnancy.

Excessive weight gain, obesity, or insufficient weight gain during pregnancy can adversely affect both the mother and her offspring. This study aims to investigate the relationship between pregnant women's self-perception and beliefs and their body weight management during pregnancy. A cross-sectional survey involving 350 pregnant women in Changsha City was conducted from July to September 2023. Instruments included a sociodemographic data sheet, protective motivation questionnaire for pregnancy body quality management, and scales measuring body image, anxiety, self-efficacy, and social support. Univariate analysis and multiple linear regression were employed to identify factors influencing protective motivation for body quality management during pregnancy. The average score of the protective motivation questionnaire was 124 (SD = 13.07), suggesting a need for enhanced weight management. Key factors influencing protective motivation included household income, cooperation with healthcare workers, sources of pregnancy information, midnight snacking habits, prepregnancy exercise, body image, and self-efficacy (P < 0.05). The study highlights significant factors influencing pregnant women's motivation for body quality management. These include economic status, healthcare collaboration, information accessibility, lifestyle habits, and psychological factors. The findings underscore the need for healthcare professionals to integrate these factors into pregnancy care programs to improve body quality management.

The right care in the right place: a scoping review of digital health education and training for rural healthcare workers

BackgroundDigital health offers unprecedented opportunities to enhance health service delivery across vast geographic regions. However, these benefits can only be realized with effective capabilities and clinical leadership of the rural healthcare workforce. Little is known about how rural healthcare workers acquire skills in digital health, how digital health education or training programs are evaluated and the barriers and enablers for high quality digital health education and training.ObjectiveTo conduct a scoping review to identify and synthesize existing evidence on digital health education and training of the rural healthcare workforce.Inclusion criteriaSources that reported digital health and education or training in the healthcare workforce in any healthcare setting outside metropolitan areas.MethodsWe searched for published and unpublished studies written in English in the last decade to August 2023. The databases searched were PubMed, Embase, Scopus, CINAHL and Education Resources Information Centre. We also searched the grey literature (Google, Google Scholar), conducted citation searching and stakeholder engagement. The JBI Scoping Review methodology and PRISMA guidelines for scoping reviews were used.ResultsFive articles met the eligibility criteria. Two case studies, one feasibility study, one micro-credential and one fellowship were described. The mode of delivery was commonly modular online learning. Only one article described an evaluation, and findings showed the train-the-trainer model was technically and pedagogically feasible and well received. A limited number of barriers and enablers for high quality education or training of the rural healthcare workforce were reported across macro (legal, regulatory, economic), meso (local health service and community) and micro (day-to-day practice) levels.ConclusionsUpskilling rural healthcare workers in digital health appears rare. Current best practice points to flexible, blended training programs that are suitably embedded with interdisciplinary and collaborative rural healthcare improvement initiatives. Future work to advance the field could define rural health informatician career pathways, address concurrent rural workforce issues, and conduct training implementation evaluations.Review registration numberOpen Science Framework: https://doi.org/10.17605/OSF.IO/N2RMX.

The Googling Effect on patient co-creation in physiotherapy service exchange

We study the process of value co-creation in physiotherapist-patient relationships and the underlying mechanisms of this process. We present the Googling Effect Model outlining the relationship between patients' pre-encounter online information search and their commitment to compliance in physiotherapy service exchange. We tested the model on a sample of physiotherapy service patients (n = 446) in the United States. We analyzed the collected responses using the partial least squares method, using SmartPLS 4.0. Our study contributes to the existing body of knowledge in several ways. We developed and tested the Googling Effect Model. Doing so adds to the healthcare literature on value co-creation in physiotherapy. The Googling Effect Model increases the predictive value of the Service-Dominant Logic as it outlines the mechanism underlying value co-creation in healthcare, including the role and importance of pre-encounter online information search in collaborative healthcare. Moreover, the findings illustrate how the underlying mechanism through which pre-encounter online information search affects commitment to compliance differs between men and women and different ethnic groups. These findings can be used to create an environment that increases service engagement and commitment to compliance by accounting for patients’ gender and ethnicity.

Evaluation of implementation of evidence-based public health training in sub-Saharan Africa.

The Collaboration for Evidence-based Healthcare and Public Health in Africa (CEBHA+) developed and offered a course on evidence-based public health (EBPH) in five sub-Saharan African (SSA) countries to enhance individual and institutional capacity. This study aims to assess, compare and learn from implementing the CEBHA+ EBPH course using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and Practical, Robust, Implementation and Sustainability Model (PRISM). This study involved CEHBA+ partner universities in five countries in SSA. We developed a framework that draws on signalling questions for RE-AIM and PRISM dimensions. Country teams reflected on, discussed and mapped unique experiences. Using this framework, we then elicited common themes across countries and distilled country-specific experiences through virtual discussions. Across countries, 130 public health practitioners, researchers and students completed the course (Reach). The course increased EBPH knowledge and skills and the capacity to teach EBPH and resulted in immediate opportunities for applying skills (Effectiveness). Hybrid offering in two countries presented challenges regarding Internet connectivity and hybrid discussions. Facilitators had previous training in teaching EBPH. While learning material was the same across countries, the content was adapted to represent local public health priorities (Implementation, Adoption). Course materials have informed other related training leading to spin-offs (Maintenance). Institutionalisation is dependent on external funding. Strengthening EBPH capacity across contexts is feasible. Curricula containing both core and contextualised elements create an authentic learning environment. Formal evaluations should be embedded within capacity-strengthening initiatives. This is the first study evaluating EBPH training in SSA using an implementation science lens, offering learning about context-relevant adaptations that assist with plans for sustainability and scale.

Collaboration in Healthcare: Implications of Data Sharing for Secondary Use in the European Union.

The European healthcare sector is transforming toward patient-centred and value-based healthcare delivery. The European Health Data Space (EHDS) Regulation aims to unlock the potential of health data by establishing a single market for its primary and secondary use. This paper examines the legal challenges associated with the secondary use of health data within the EHDS and offers recommendations for improvement. Key issues include the compatibility between the EHDS and the General Data Protection Regulation (GDPR), barriers to cross-border data sharing, and intellectual property concerns. Resolving these challenges is essential for realising the full potential of health data and advancing healthcare research and innovation within the EU.

What influences the implementation of clinical guidelines related to enteral nutrition in the intensive care unit: A mixed-methods systematic review.

To systematically evaluate and analyse literature concerning the factors influencing the implementation of clinical practice guidelines related to enteral nutrition in the adult intensive care unit. Guidelines serve as crucial tools for guiding clinical practice. However, a significant gap persists between current clinical practice and guidelines pertaining to enteral nutrition. It is essential to identify the reasons behind this disparity to foster clinical transformation. A mixed-methods systematic review. A systematic search was conducted across PubMed, Embase, Medline, Cochrane, PsycINFO and CNKI databases to identify impediments and facilitators to the implementation of ICU clinical practice guidelines related to enteral nutrition. The types of studies included quantitative, qualitative and mixed-methods studies. The search spanned from January 2003 to January 2024 and was updated in May 2024. The quality assessment of the included literature was conducted using the Mixed-Methods Study Evaluation Tool (MMAT). Data analysis was performed using a data-based convergent integration approach. The protocol for this study was prospectively registered (PROSPERO2023, CRD42023483287). Twenty papers were finally included, and 65 findings were extracted, integrating a total of three categories, Category 1: healthcare provider factors, including three sub-themes: knowledge of guideline-related knowledge and awareness of guideline application; social/professional roles and identity domains; beliefs, attitudes and self-efficacy; collaboration, Category 2: practice environments, including two sub-themes: environmental factors and resource areas; systems and behavioural norms, Category 3: patient values and nutritional support preferences including two sub-themes: patient disease status and value orientation. Healthcare professionals should analyse obstacles and facilitators to guideline implementation from multiple perspectives, strengthen healthcare collaboration, improve education and training systems, correct misperceptions and increase awareness of evidence-based practice.

One Health in two countries: The politics of transdisciplinary healthcare collaboration in Canada and the United States.

The One Health perspective highlights the potential synergies between the human, animal, and environmental health sciences, especially in an era of budget shortfalls, climate change, and emerging infectious diseases of zoonotic origin. Canadian physicians and veterinarians arguably lay the foundation of One Health in the late 19th century, when they pioneered the study of "comparative medicine" in Montreal, but they fell into disciplinary silos before World War I to the lasting detriment of the Canadian population. This article explores both the advantages and impediments to cross-disciplinary healthcare collaboration in Canada, highlighting the country's vast size, sparse population, and political decentralization in particular, and offers a number of policy recommendations that would allow the country to reclaim its rightful role as a leader in the One Health movement.

A Cyber Risk Assessment Approach to Federated Identity Management Framework-Based Digital Healthcare System.

This paper presents a comprehensive and evidence-based cyber-risk assessment approach specifically designed for Medical Cyber Physical Systems (MCPS)- and Internet-of-Medical Devices (IoMT)-based collaborative digital healthcare systems, which leverage Federated Identity Management (FIM) solutions to manage user identities within this complex environment. While these systems offer advantages like easy data collection and improved collaboration, they also introduce new security challenges due to the interconnected nature of devices and data, as well as vulnerabilities within the FIM and the lack of robust security in IoMT devices. To proactively safeguard the digital healthcare system from cyber attacks with potentially life-threatening consequences, a comprehensive and evidence-based cyber-risk assessment is crucial for mitigating these risks. To this end, this paper proposes a novel cyber-risk assessment approach that leverages a three-dimensional attack landscape analysis, encompassing existing IT infrastructure, medical devices, and Federated Identity Management protocols. By considering their interconnected vulnerabilities, the approach recommends tailored security controls to prioritize and mitigate critical risks, ultimately enhancing system resilience. The proposed approach combines established industry standards like Cyber Resilience Review (CRR) asset management and NIST SP 800-30 for a comprehensive assessment. We have validated our approach using threat modeling with attack trees and detailed attack sequence diagrams on a diverse range of IoMT and MCPS devices from various vendors. The resulting evidence-based cyber-risk assessments and corresponding security control recommendations will significantly support healthcare professionals and providers in improving both patient and medical device safety management within the FIM-enabled healthcare ecosystem.

An Artificial Intelligence (AI)-Integrated Approach to Enhance Early Detection and Personalized Treatment Strategies in Lung Cancer Among Smokers: A Literature Review.

Lung cancer (LC) is a significant global health issue, particularly among smokers, and is characterized by high rates of incidence and mortality. This comprehensive review offers detailed insights into the potential of artificial intelligence (AI) to revolutionize early detection and personalized treatment strategies for LC. By critically evaluating the limitations of conventional methodologies, we emphasize the innovative potential of AI-driven risk prediction models and imaging analyses to enhance diagnostic precision and improve patient outcomes. Our in-depth analysis of the current state of AI integration in LC care highlights the achievements and challenges encountered in real-world applications, thereby shedding light on practical implementation. Furthermore, we examined the profound implications of AI on treatment response, survival rates, and patient satisfaction, addressing ethical considerations to ensure responsible deployment. In the future, we will outline emerging technologies, anticipate potential barriers to their adoption, and identify areas for further research, emphasizing the importance of collaborative efforts to fully harness the transformative potential of AI in reshaping LC therapy. Ultimately, this review underscores the transformative impact of AI on LC care and advocates for a collective commitment to innovation, collaboration, and ethical stewardship in healthcare.

Role of ChatGPT and Gemini in the Urology Field: A Case-Based Study

Introduction The healthcare sector is witnessing a transformation with the advent of artificial intelligence (AI), exemplified by ChatGPT and Gemini AI. These AI systems emulate human conversation and provide accurate medical responses. This study explores their integration into medical decision-making in the urology field. Methods The study presented a collection of 20 medical case scenarios, carefully crafted and revised by a team of authors in the field of urology. Each case was presented to ChatGPT and Gemini in September of 2023, and their responses were recorded and analyzed. Results Both AI tools displayed varying accuracy in diagnoses and management recommendations. ChatGPT failed in identifying congenital penile curvature, while Gemini succeeded. Conversely, ChatGPT excelled in recommending a management plan for renal artery aneurysms. Gemini outperformed in explaining iodinated contrast material toxicity. Both struggled with a bladder prolapse prevention question. Conclusion AI integration in urology is promising but has limitations. AI provides valuable insights but cannot replace human expertise. Research is vital to improve AI's role in urology. Clinicians should view AI suggestions as supplements to their judgment, fostering collaborative healthcare decisions.

Implementation of a practice model for inpatient psychiatric clinical pharmacist practitioners with prescriptive authority at a veterans health care facility.

Clinical pharmacists play a valuable role on collaborative health care teams, especially in the field of mental health. However, there is a need to explore innovative practice models that optimize their potential in providing comprehensive medication management in inpatient psychiatric settings. This report aims to describe the implementation of a practice model using an inpatient psychiatric clinical pharmacist practitioner performing comprehensive medication management. The implementation of a practice model using a psychiatric clinical pharmacist practitioner was a feasible way to deliver comprehensive medication management and other clinical services in an inpatient psychiatric setting amid staffing challenges. Whereas limitations such as resource constraints must be considered, the success of this model highlights the value of a versatile psychiatric clinical pharmacist practitioner. These findings might offer insight to other health care facilities considering a similar approach to provide mental health care through the use of a psychiatric clinical pharmacist practitioner.

It Does Not Add Up: A Mixed-Methods Study of Collaborative Healthcare Networks

It Does Not Add Up: A Mixed-Methods Study of Collaborative Healthcare Networks

Depression Is Associated with a Higher Risk of Mortality among Breast Cancer Survivors: Results from the National Health and Nutrition Examination Survey-National Death Index Linked Study.

Breast cancer (BC) and depression are globally prevalent problems. Numerous reviews have indicated the high prevalence of depression among BC survivors. However, the long-term impact of depression on survival among BC survivors has not been well explored. For this investigation, we aimed to explore the relationship between BC, depression, and mortality from a national random sample of adult American women. Data from the U.S. National Health and Nutrition Examination Survey (years 2005-2010) were linked with mortality data from the National Death Index up to December 31st, 2019. A total of 4719 adult women (ages 45 years and older) were included in the study sample with 5.1% having breast cancer and more than a tenth (12.7%) having depression. The adjusted hazard ratio (HR) for all-cause mortality risk among those with BC was 1.50 (95% CI = 1.05-2.13) compared to those without BC. In the adjusted analysis, the risk of all-cause mortality was highest among women with both depression and BC (HR = 3.04; 95% CI = 1.15-8.05) compared to those without BC or depression. The relationship between BC and mortality was moderated by cardiovascular diseases, anemia, smoking, age, PIR, and marital status. Our analysis provides vital information on factors that could be helpful for interventions to reduce mortality risk among those with BC and depression. In addition, given the higher risk of mortality with co-occurring BC and depression, collaborative healthcare practices should help with widespread screening for and treatment of depression among BC survivors.

Federated semi-supervised representation augmentation with cross-institutional knowledge transfer for healthcare collaboration

In the healthcare field, cross-institutional collaboration can fasten medical research progress. Vertical federated learning (VFL) addresses data heterogeneity across multiple medical institutions while ensuring medical data privacy, thereby enhancing the accuracy of disease diagnoses and treatments. However, traditional VFL only benefits from aligned samples, thereby limiting its applicability due to constrained sample sizes, and a large amount of non-aligned data remains untapped, resulting in wasted data. To exert full leverage on the value of all data obtained from medical institutions, this paper proposes a federated healthcare collaborative framework based on semi-supervised representation augmentation mechanism with cross-institutional knowledge transfer (CrossKT-FRA). Specifically, the developed method comprises three steps. First, the federated representations of shared data (aligned data) among medical institutions are extracted through efficient vertical federated representation learning (FRL) methods. Second, the federated knowledge contained in federated representations and potential labels derived through recurrent learning assist local shared data representations in performing supervised augmented learning. Finally, the federated knowledge is transferred indirectly from the representation augmentation module for shared data to the unsupervised representation augmentation module for local private data (non-aligned data). The experimental results show the effectiveness of the proposed knowledge transfer mechanism, whether applied independently or used to enhance VFL on medical datasets. Our findings contribute to a deeper theoretical understanding of VFL, further facilitating the utilization of high-value medical data. By promoting cross-institutional and cross-disciplinary collaboration in healthcare data sharing, our study enhances the quality efficiency of medical services, thereby accelerating the development of interdisciplinary medical research. Code is available at https://github.com/LieLieLieLieLie/CrossKT-FRA.

Healthcare collaboration intervention: Pre-post study

Background: Effective interprofessional collaboration between health professionals is correlated with improving the quality of health services and patient safety, for example, Program Pengendalian Resistensi Antibiotik (PPRA). Objective: This research aims to determine the effect of educational PPRA on the knowledge and motivation of healthcare professionals in interprofessional collaboration practices. Methods: The research is quasi-experimental, with one group pre-post using a knowledge questionnaire (questionnaire 1) and a motivation questionnaire (questionnaire 2). The respondents were health professionals at Husada Utama Hospital. This research involved 74 respondents: two doctors, three pharmacists, 41 nurses, five midwives, ten pharmacist assistants, and 13 laboratory assistants. Results: The analysis of the effect of providing education on health professionals’ knowledge level showed a significant improvement in good categories before and after education, with 55.4% before and 73% after (Sig. = 0.025, p &lt; 0.05). The analysis of the level of motivation showed that moderate categories grew insignificantly before and after education, with 39.19% before and 47.30% after (Sig = 0.599, p &gt; 0.05). Conclusion: This research concluded that PPRA education's effect on health workers' knowledge and motivation in interprofessional collaboration at Husada Utama Hospital has increased knowledge and motivation.

Intersectoral Collaboration in Healthcare: an Overview of International Practices

Background. Health promotion and universal health coverage are among the functions of any healthcare system which include public, private and voluntary organizations providing health services to the population. However, healthcare actors cannot single-handedly ensure the accessibility of medical care to all individuals. It is intersectoral interactions that could improve the capabilities, performance and efficiency of healthcare system. Objective. To consider the possibilities of intersectoral collaboration in healthcare through the relevant examples of the implementation of intersectorality in healthcare practices. Materials and methods. Common research methods with the content analysis of international scientific articles as the main one were applied. The practices of intersectoral interaction for ensuring public health promotion and access to medical care were identified and collected from all analyzed articles. Results. Intersectoral collaboration might be carried out between various departments and authorities, educational and civil society organizations, commercial companies and other entities. The performance and efficiency of intersectoral collaboration are achieved using the specially developed tools. The international practice of intersectoral collaboration on public health protection issues has many great examples of interactions facilitating the accomplishment of different goals, such as accessibility of medical care, prevention of noncommunicable diseases, and health emergency response.

Healthcare professionals’ perspectives on oral health care in acute stroke patients: a qualitative study

BackgroundStroke is a major public health problem, with the disabilities of the patients increasing their risk of poor oral health. Currently, in Ghana and Nigeria, no guideline exists for oral health care in stroke patients, while most of our acute stroke care settings have no documented protocol.AimThis study sought to understand the perspectives of healthcare professionals in Ghana and Nigeria about oral healthcare in acute stroke patients.MethodsA qualitative inductive approach was employed to explore healthcare professionals’ perspectives. After obtaining informed consent, in-depth interviews were conducted among doctors, nurses, and physiotherapists using semi-structured question guides. Participants’ responses were audiotaped for transcription and analysis. Interviews were conducted until data saturation was reached. Data were analyzed thematically to generate themes and sub-themes using an inductive approach.The resultsTwenty-five (25) health care professionals (HCP) aged 25–60 years with a mean age of 36.2 ± 4.2 years were interviewed. There were 15 (60.0%) males and 10 (40.0%) females. HCP included nurse practitioners 14 (56.0%), medical doctors 7 (28.0%), and physiotherapists 4 (16.0%). The HCP demonstrated adequate knowledge of stroke and considered oral health important for esthetic and clinical reasons. They, however, reported being unable to give it the required attention due to inadequate collaboration between the various professional cadres, insufficient equipment, and a skewed focus on other clinical needs of the acute stroke patients.ConclusionsThe findings indicate that HCPs perceived oral health care as very important among patients with acute stroke. However, they reported a lack of collaboration and integration of oral health care in routine stroke care as a major impediment.

A Pharmacist Clinician Model as part of a collaborative clinical workforce: A philosophical critique

The term ‘clinician’ is not reserved for any healthcare professional group. However, there is a general acceptance that a clinician would have the knowledge, skills and behaviours to enable them to clinically assess and manage a patient autonomously. The expectation, in a modern collaborative healthcare system, is that this work would be completed as a part of a planned and integrated multi-disciplinary care delivery structure, where any given clinician delivers a devolved element of that patient's care. Forthcoming changes to regulation and professional development pathways in the UK will have a profound impact on pharmacist professional identity and practice. From 2026, all new UK pharmacist registrants will have full independent prescribing rights. A paradigm shift is expected to enable the development of a Pharmacist Clinician Model, incorporating pharmaceutical care needs with wider clinical assessment, diagnostic, and clinical management responsibilities. Consideration is given to this model and its implications. Changes to regulation, policy, education, and the governance required to deliver safe and effective pharmacist clinicians are outlined. A philosophical critique on the nature of being a clinician, and the differentiation of pharmacist clinician roles compared to other healthcare professions, is given. A further examination of the projected risks and expected benefits of this transformative practice model are then explored.