Effective Collaborative Practice Research Articles

Attitude and perception of medical and nursing undergraduates and faculty towards simulation-enhanced interprofessional education at an institute in India

Background The need for interprofessional education (IPE) has been recognized on the basis of compromised patient care due to ineffective communication and teamwork among healthcare providers. Using Simulation to enhance IPE has been advocated to achieve the competencies required for effective interprofessional collaborative practice. However, the implementation of this powerful tool and its integration into Indian medical education are a relatively recent development, gradually gaining momentum in recent years. Purpose This study was undertaken to assess the attitudes and perceptions of a group of Indian medical and nursing undergraduates and faculty towards simulation-enhanced interprofessional education (Sim-IPE) before introducing this module at the institute. Methods A descriptive correlational design was conducted using the KidSIMTM ATTITUDES scale on a convenient sample of 82 students and faculty of medical and nursing colleges. Results The total scores for the 30-item questionnaire revealed an overall positive attitude towards IPE and Simulation as a learning modality. Analysis of variance tests revealed lesser scores for students when compared to faculty. Conclusions A positive attitude towards Sim-IPE by students and faculty is promising, and it is the first step towards integrating Sim-IPE into the undergraduate curriculum in India.

Unpacking the perceptions and experiences of student facilitators in interprofessional education: a qualitative study

ABSTRACT Enhancing health professional students’ effective learning and collaborative practice requires a deep understanding of strategies for facilitating interprofessional learning. While faculty members and clinical preceptors are recognized as facilitators in interprofessional education (IPE), there is limited knowledge about the impact of student facilitators’ engagement in IPE. Accordingly, this study aims to explore the perceptions and experiences of student facilitators in IPE. Thirteen student facilitators were recruited to lead an interprofessional learning program, and they were subsequently invited to participate in one-on-one interviews. An interview guide was developed to explore their motivations, expectations, engagement, effectiveness, and achievements in IPE facilitation. Thematic analysis was conducted using MAXQDA software to analyze the student facilitators’ experiences and perceptions. Eight interviewees from various disciplines, including Medicine, Nursing, Pharmacy, Speech and Hearing Sciences, and Social Work, took part in the study. The findings revealed that student facilitators highly valued their IPE facilitation experience, which aligned with their expectations and led to the creation of social networks, increased confidence, improved understanding of other professions, and the development of lifelong skills. Furthermore, the student facilitators demonstrated cognitive and social congruence by establishing a relaxed learning environment, displaying empathetic and supportive behaviors, and using inclusive language to engage IPE learners in group discussions. This study provides a comprehensive understanding of the role of student facilitators in IPE, contributing to the evolving literature on IPE. A conceptual framework was developed to explore the entire facilitation experience, encompassing the motivations and expectations of student facilitators, their engagement and effectiveness, and the observed achievements. These findings can inform the development of peer teaching training in IPE and stimulate further research in identifying relevant facilitator competencies for optimal delivery of IPE.

Promoting effective interprofessional collaborative practice in the primary care setting: recommendations from Queensland physiotherapy private practitioners.

Physiotherapy private practitioners represent a growing proportion of Australia's primary care workforce; however, they face significant barriers in integrating seamlessly within interprofessional teams. Historically, the landscape of primary care in Australia has been one where many physiotherapists work in monoprofessional private practice facilities at dispersed locations, potentially limiting collaborative and coordinated care. The aim of this study was to investigate strategies recommended by physiotherapists to promote effective interprofessional collaborative practice (IPCP) within the Australian private practice setting. Using interpretive description as the guiding methodological framework, semi-structured interviews were conducted with 28 physiotherapists in 10 private practice sites in Queensland, Australia. Data analysis produced three themes that characterised physiotherapy private practitioners' recommendations to improve IPCP: (a) the need for improved funding and compensation, particularly addressing the limitations of the Medicare Chronic Disease Management program; (b) the development of integrated and secure digital communication systems to facilitate better information exchange; and (c) prioritising professional development and training to enhance collaboration. This research lays the groundwork for informed policy making to advance person-centred care and support the integration of services in the Australian healthcare system. The findings from this study indicate that promoting effective IPCP in physiotherapy private practice requires a comprehensive strategy that addresses systemic funding and compensation issues, enhances digital communication systems and optimises interprofessional education and training.

Can Implementing New Services Organization Models to Better Meet the Needs of Young People Bring About Practice Changes? Analysis of an Experiment in Québec.

The research question addressed in this article is: Can implementing new services organization models to better meet the needs of young people bring about practice changes? More precisely, we examine the effects of a new model called Aire Ouverte (AO) which is implemented gradually across Quebec since 2019. This new model involves public sector and community organizations. To grasp practices' change, we use cultural historical activity theory (CHAT) and employ a qualitative approach. Beyond a precise description of work activities, we gained an inside view of how the actors involved represented their practice and context. Our results show that practice changes seen by actors are in line with the object of the intervention, that is, responding rapidly to the expressed needs of young people. The development of new tools, flexible functioning, strengthening of interprofessional and intersectoral collaboration, involvement of young people in decision-making, all should contribute to improving response to their needs. This being said, a critical look at practice changes reveals a challenge in aligning the design and objective of AO with the needs of some young people. We noted also a poor alignment of effective collaborative practices between levels of care and the practices sought from intersectoral collaboration.

Why we need a concept to describe collaborative support instead of labelling children as demanding: perspectives from Finland

In this article, we draw on our research and expertise in a problematic concept of ‘demanding special support children’ in Finnish early childhood and basic education, and the scarce international research, to propose a concept regarding multidisciplinary and collaborative support for children. Our conceptualisation shifts the focus away from children’s deficits to effective collaborative practices surrounding the child. This can facilitate comprehensive support practices without labelling children as ‘demanding’ based on their disabilities.

Supportive leadership and job satisfaction at the European Court of Auditors

This article draws on theories of person–organisation fit and leadership behaviour to explore how supportive leadership is related to communication practices, collaborative working practices and performance management practices and how these three practices, in turn, relate to public servants’ job satisfaction. A model of supportive leadership's direct and indirect effects on employees’ job satisfaction is empirically tested using responses to a survey administered to the European Court of Auditors (ECA) staff. The findings show that communication and collaborative working practices mediate the relationship between supportive leadership and job satisfaction. Supportive leadership positively relates to performance management practices, but these practices have no significant association with job satisfaction. While addressing a theoretical void in the field, this study also makes an empirical contribution by unveiling how a professional European public audit institution manages its human resources and the means it uses. Points for practitioners Elaborating on the relationship between leadership behaviour and person–organisation fit in the context of a supranational public entity helps to explain what motivates public servants. The relationship between supportive leadership and public servants’ job satisfaction is mediated by two organisational practices: communication and collaborative working practices. Transparent performance management practices do not mediate the relationship between supportive leadership and job satisfaction. Public sector organisations with professional staff can centre their human resource management around effective communication and collaborative working practices to ensure greater employee satisfaction in the workplace.

Facilitators of effective interprofessional collaborative practice for physiotherapy private practitioners: An interpretive descriptive study

IntroductionDespite the growing presence of physiotherapy private practitioners within Australia's health care workforce, little is known about their perspectives of interprofessional collaborative practice (IPCP). The aim of this study was to explore the facilitators of IPCP from the perspective of Australian physiotherapy private practitioners. MethodsSemi-structured interviews were conducted with 28 physiotherapists and 64 h of observation was completed in 10 private practice sites in Queensland, Australia. Interview and observation data were pooled and analysed using reflexive thematic analysis. ResultsData analysis produced four main themes and three sub-themes that characterised physiotherapists’ perspectives on the facilitators of IPCP: (a) close physical proximity (integrated team membership; co-location; interior architecture); (b) technological advancements; (c) complex client presentations; and (d) positive professional reputation. ConclusionThis study provides valuable insights into the facilitators of IPCP from the perspective of physiotherapy private practitioners. Emphasising close physical proximity of multiple health practitioners, leveraging technological innovations, recognising the value of IPCP for clients with chronic and complex care needs, and cultivating positive professional reputations can promote effective IPCP for physiotherapy private practitioners. The findings from this research may be used to guide the development of innovative strategies that will support robust and sustainable models of IPCP in the physiotherapy private practice setting.

Inter-professional collaboration and associated factors among nurses and physicians in specialized public hospitals, the northwest, Ethiopia: mixed method multi-centered cross-sectional study

ObjectiveThe study aimed to investigate inter-professional collaboration and associated factors among nurses and physicians working in referral and teaching hospitals in the Northwest and Ethiopia in 2022.MethodThis study used a concurrent (quantitative cross-sectional and phenomenological qualitative) design from September to October 2022. A structured, self-administered nurse-physician collaborative scale questionnaire was used to collect quantitative data from 279 nurses and 87 physicians. A simple random sampling technique was used to select participants. The magnitude of the association was measured using the odds ratio at a 95% confidence interval and was statistically significant at a p-value less than 0.05 using binary logistic regression analysis. Qualitative data were collected from nine key informants via focused interviews or semi-structured in-depth interviews and analyzed using ATLAS.ti version 7.0.7 software via narratives using the thematic analysis method.ResultAccording to the study’s findings, a greater number (43.4%) of the respondents had ineffective collaboration during their professional activities. In the final model of multivariable analysis, unsatisfactory organizational support, poor professional support, and poor interpersonal support were all independently associated with ineffective collaboration. The qualitative findings identified poor communication, a lack of professionalism, and failure to adhere to professional duties as barriers to nurse-physician collaboration.ConclusionIn this study, nurse-physician collaboration was less than expected; thus, the large number of participants had ineffective collaborations. Potential predictors of decreased effective nurse-physician collaboration included dissatisfaction with organizational support, poor professional support, and poor interpersonal support. This outcome emphasizes the importance of improving nurse-physician collaboration by enhancing organizational, professional, and interpersonal factors to form effective collaborative practice. The qualitative finding supports the quantitative study, which showed ineffective collaboration. The authors recommended that there is a need to empower interprofessional collaboration among nurses and physicians through the creation of a conducive and safe working environment.

Collaborations to Support Employment Outcomes of Youth With Disabilities

The unemployment and underemployment of transition-age youth with disabilities represents a major barrier to full participation in the range of adult life activities. The lack of participation in employment has a negative effect on their physical health, mental health, and overall quality of life. The state-federal vocational rehabilitation (VR) program is the largest program in the United States focused on helping individuals with disabilities achieve employment in support of independent living and community integration of persons with disabilities. However, in addition to VR programs, there are a number of public and private agencies focused on employment of transition-age youth with disabilities. In recognition of the multiple stakeholders and supports, the Workforce Innovation and Opportunities Act of 2014 (WIOA) emphasizes the need for collaboration between VR programs and other agencies and providers. The purpose of this study was to conduct a scoping review to identify effective collaborative practices for improving transition to work of transition-age youth with disabilities. Through a methodical review of the literature, 31 articles were identified that met the research protocol criteria. Findings from this scoping review are provided along with implications for efforts to promote collaboration between VR programs and other entities.

Multidisciplinary team healthcare professionals' perceptions of current and optimal acute rehabilitation, a hip fracture example A UK qualitative interview study informed by the Theoretical Domains Framework.

To understand multidisciplinary team healthcare professionals' perceptions of current and optimal provision of acute rehabilitation, perceived facilitators and barriers to implementation, and their implications for patient recovery, using hip fracture as an example. A qualitative design was adopted using semi-structured telephone interviews with 20 members of the acute multidisciplinary healthcare team (occupational therapists, physiotherapists, physicians, nurses) working on orthopaedic wards at 15 different hospitals across the UK. Interviews were audio-recorded, transcribed verbatim, anonymised, and then thematically analysed drawing on the Theoretical Domains Framework to enhance our understanding of the findings. We identified four themes: conceptualising a model of rehabilitative practice, which reflected the perceived variability of rehabilitation models, along with facilitators and common patient and organisational barriers for optimal rehabilitation; competing professional and organisational goals, which highlighted the reported incompatibility between organisational goals and person-centred care shaping rehabilitation practices, particularly for more vulnerable patients; engaging teams in collaborative practice, which related to the expressed need to work well with all members of the multidisciplinary team to achieve the same person-centred goals and share rehabilitation practices; and engaging patients and their carers, highlighting the importance of their involvement to achieve a holistic and collaborative approach to rehabilitation in the acute setting. Barriers and facilitators within themes were underpinned by the lack or presence of adequate ways of communicating with patients, carers, and multidisciplinary team members; resources (e.g. equipment, staffing, group classes), and support from people in leadership positions such as management and senior staff. Cornerstones of optimal acute rehabilitation are effective communication and collaborative practices between the multidisciplinary team, patients and carers. Supportive management and leadership are central to optimise these processes. Organisational constraints are the most commonly perceived barrier to delivering effective rehabilitation in hospital settings, which exacerbate silo working and limited patient engagement.

Examining the views of nurses working in gynecology and obstetrics clinics on collaborative practice

We aimed to reveal the attitudes and perceptions of a group of nurses toward collaborative work and the barriers to collaborative practice. At the end of the study, we obtained four main themes: leadership in health services, interpersonal interaction factors, cooperation in patient care, standardization. The nurses emphasized the critical elements of respect, relationships and communication as components of effective collaborative practice. As a result, it was stated that the practice of cooperation between doctors and nurses is weak and there are some difficulties and obstacles.

Key state‐level policy elements governing pharmacist collaborative practice

AbstractThe American College of Clinical Pharmacy previously published a white paper in 2015, “Collaborative Drug Therapy Management and Comprehensive Medication Management,” as well as position statements on collaborative drug therapy management (CDTM) in 1997 and 2003. Although significant federal and state legislation addressing collaborative practice has evolved and expanded throughout the United States since then, variability in state‐level policy remains a barrier for effective collaborative practice. Collaborative practice facilitates the delivery of comprehensive medication management by clinical pharmacists and enhances team‐based care. State governments are the primary entities that determine the scope of practice for health professionals. As such, state‐level policy plays a crucial role in enabling or impeding the implementation of advanced pharmacist services and effective CDTM. Almost all states currently enable pharmacist prescriptive authority in some form. In 2017, the National Alliance of State Pharmacy Associations and the National Association of Boards of Pharmacy issued joint recommendations outlining model elements of state policies for statewide protocol authority and pharmacist prescribing.

Assessment of interprofessional collaborative practice components of perioperative teams

Objective: The purpose of this study was to conduct a hospital workforce survey of nurses to determine what interprofessional collaborative practice components they have in place at their worksites. The findings could indicate what is needed to create, expand, and maintain an effective interprofessional collaborative practice environment.Methods: The study used a random sample of working perioperative nurses who were members of a national perioperative registered nurse association database and had interprofessional collaborative practice training either by continuing medical education or micro credentialing. These nurses were sent two surveys to assess their worksite presence of interprofessional components. These validated surveys assess an organization’s capacity to have an interprofessional collaboration by examining the workplace environment, environmental mechanism, and institutional support of interprofessional collaboration.Results: Interprofessional collaboration within the perioperative worksite setting exists in most of the structures in place. However, urban sites were more likely to lack supportive components that build, evaluate, and continuously create interprofessional teams.Conclusions: There was an uneven implementation of the interprofessional collaboration components. The components vary by site, with urban hospitals having few components resulting in a more asymmetrical interprofessional team. The study’s findings indicate a need for an assessment of worksite interprofessional collaboration to ensure all components are in place and for evaluation and improvement of interprofessional collaboration.

The VOTIS, part 2: Using a video-reflexive assessment activity to foster dispositional learning in interprofessional education

ABSTRACT Effective interprofessional collaborative practice (IPCP) requires a new way of working characterized by distributed leadership skills, shared decision-making, and the adoption of uniprofessional and interprofessional identities. Health professional educators are tasked with preparing clinicians for IPCP through interprofessional education (IPE). Numerous IPE teaching interventions have been developed, ranging in length from hours to semesters, designed to introduce students to interprofessional ways of working – usually evaluated in terms of student satisfaction, perceptions of other disciplines and conceptual knowledge. However, working interprofessionally also requires integrating dispositional knowledge into one’s emerging interprofessional habits and values. In this paper, we describe a learning activity, inspired by a new video-reflexive methodology, designed to foster dispositional learning of interprofessional skills using a video-based assessment tool: the Video Observation Tool for Interprofessional Skills (VOTIS). Based on focus group and interview data, we suggest the activity’s usefulness in fostering conceptual, procedural and dispositional knowledge, as well as reflexive feedback literacy. Overall, our qualitative evaluation of the VOTIS suggests the merits of drawing on video-reflexive methodology and pedagogical theory to re-imagine IPE as a dynamic process, requiring the development of interprofessional skills that must be appropriated into students’ emerging (inter)professional identities.

The physician perspective on pharmacist-physician collaboration and trust

BackgroundHealth care has shifted to focus less on individual practitioners and more on providing interprofessional and collaborative patient care. A strong working relationship among pharmacists and physicians is imperative for patient care and safety. ObjectivesThe objective of this research was to examine physician perspectives of the relationship between physicians and pharmacists, specifically evaluating the qualities and actions necessary for pharmacists to establish trust to provide the best quality of patient care. MethodsSemistructured qualitative key informant interviews were conducted with 11 physicians. Questions were designed to gather information about the physicians’ experiences with pharmacists and perceived barriers and opportunities for building trust and collaboration. The Unified Theory of Trust and Collaboration was used as a theoretical framework. ResultsThe ability to cooperate was the most important aspect identified by all 11 physicians in creating effective collaboration along with respect, knowledge, communication, and trust. Common barriers identified with the pharmacist-physician relationship were the lack of identity, rapport, knowledge, positive attitude, and communication. ConclusionBuilding trust and narrowing the gaps of communication are crucial in achieving effective collaborative practice among health professionals. Pharmacists and physicians must have the capability to cooperate with one another, understand the common moral responsibility they share, recognize the implications of their personal behavior on their professional relationships, and focus on their scope of practice without crossing boundaries. Through positive behaviors of civility, communication, adaption, and mutual respect in their individual roles, pharmacists and physicians can enhance their relationship and practice collaboratively.

Flexible Facilitation: Coaching and Modelling to Support Inclusive Education

The practices of education, such as separate and resource placements, pull-out services, scripted intervention programmes, an emphasis on diagnoses, and behaviorist discipline practices, are not conducive to the goals of inclusive education. This study demonstrates how one instructional coach worked to disrupt traditional special education practices and guide special educators towards the use of more effective research-based instructional strategies and collaborative practices to promote inclusion. Using Robert Stake’s intrinsic case study methodology, we explored the perceived roles of coaching and modelling to promote inclusion through the lens of one coach who modelled methods for the special education teachers in multiple general education classrooms. The following themes emerged from the multiphase analysis of data collected throughout the coaching project: coaching as flexible facilitation, coaching as recognition of existing good practice, coaching pedagogical decision-making, coaching instructional reflectivity, and coaching collaborative partnerships. Coaching and modelling for special educators are recommended for promoting inclusive education as they embrace the complexity of changing classroom practice and can enhance collaborative instructional practice.

Teamwork in Health Care Services Delivery in Nigeria: A Mixed Methods Assessment of Perceptions and Lived Experiences of Pharmacists in a Tertiary Hospital.

BackgroundLack of teamwork is the bane of weak and ineffective health care systems in many countries. This study examined the perceptions and lived experiences of pharmacists working in a Nigerian government-owned (public) multispecialty tertiary hospital regarding teamwork in their workplace.MethodsA sequential explanatory mixed methods study using phenomenological approach of inquiry, was conducted among pharmacists with experience in multidisciplinary health care provision in a public tertiary hospital in Nigeria. Questionnaires with 16 close-ended questions based on a Likert scale, which scored from strongly disagree (1) to strongly agree (5), were administered. The mean (M) scores were determined using SPSS Version 20; M ≥ 3.00 indicated agree, while M < 3.00 disagree. Subsequently, focus group discussions were conducted, and the audio recorded responses transcribed and subjected to thematic analysis using NVivo 11.ResultsSome participants (50%) had worked for 5–10 years in the hospital’s Department of Pharmacy, 25% (11–20 years), and 16.7% (21–30 years). Participants agreed that effective teamwork leads to positive patient outcomes (M = 3.67) and is in the public’s interest (M = 4.25). However, they disagreed that their workplace supports teamwork (M = 2.33), effective interprofessional collaborative practices exist in the hospital (M = 1.08), and their remuneration reflects their worth to the organization (M = 2.33). Doctors’ dominance and claim of ownership of patients, allied professionals’ attitudes and ignorance of pharmacists’ roles, salary disparity, poor communication, and defective leadership style among others were identified as impediments to teamwork.ConclusionThe hospital pharmacists demonstrated positive disposition towards teamwork, and agreed that effective teamwork would improve health care delivery. However, they identified some factors that hinder interprofessional teamwork in the hospital. Principles and practices of teamwork should be incorporated into the curriculum of each discipline; interdisciplinary collaborative practices, health system structure, institutional policies and leadership should be strengthened to enhance teamwork.

Radiography students achieving competencies through structured interprofessional education

IntroductionInterprofessional education (IPE) takes place when representatives of at least two professions work and learn together, about and from each other to provide optimal healthcare. For the successful implementation of an IPE programme, conceptualisation, planning, and operationalisation and coordination among the various professions is crucial, to assist students to obtain the desired competencies of such a programme. The purpose is to investigate if a structured IPE programme assisted radiography students to achieve competencies. MethodsAn online questionnaire was compiled from literature and completed by radiography students who participated in a structured, three-week-long IPE programme. The questionnaire was mainly quantitative (using a Likert scale), though it also consisted of qualitative elements (open-ended questions). A Fischer’s Exact test was used to compare the responses of three different year groups. ResultsFeedback from the radiography students (n=63) indicated that they achieved this IPE programme’s specific competencies: role clarification, interprofessional communication, teamwork, person-centered care and values and ethics. There was good correlation between the feedback from all three year groups. The feedback on the open-ended questions correlated with the quantitative feedback, though some students felt excluded, as there was little reference to their particular profession in the simulation session of the IPE programme. ConclusionThe results of the study indicate that radiography students achieved the prescribed competencies of a structured IPE programme. The results provide insight into ways to improve the IPE programme. A recommendation emanating from the results of this study is that, to improve the experience of all healthcare professions students, structured IPE programmes have to promote inclusive teaching and learning. Implications for practiceRadiography students that participate in a structured IPE programme develop competencies necessary for effective collaborative clinical practice.

Development of a Japanese version of the Self-assessment Scale of Interprofessional Competency (JASSIC)

ABSTRACT This study aimed to develop a Japanese version of the Self-assessment Scale of Interprofessional Competency (JASSIC), which consists of six domains: Patient-/Client-/Family-/Community-Centered, Interprofessional Communication, Role Contribution, Facilitation Relationship, Reflection, and Understanding of Others. Validity of JASSIC was confirmed through a four-step process consisting of expert discussion, cognitive debriefing, feasibility, and statistical analysis. Confirmatory factor analysis (CFA) was performed by testing the correlation between the sum scores of JASSIC and the Assessment of Interprofessional Team Collaboration Scale-II(AITCS-II). First, 24 items were created through discussions among physicians, a nurse, a medical educator, and an information sociologist. Second, the items were modified by cognitive debriefing of a physician, nurse, pharmacist, occupational therapist, and social worker. Third, we provided the developed JASSIC for professionals at Hospital X (n = 139) and revised the wording and composition of the items. Finally, CFA among professionals at Hospital Y (n = 153) identified a 6-domain structure (GFI: 0.847, AGFI: 0.782, RMSEA: 0.088). Cronbach’s alpha was 0.92, and the correlation coefficient with AITCS-II was 0.72. Ongoing research into JASSIC will promote effective interprofessional collaborative practice not only in Japan but also other countries which share a similar culture and system.

Interprofessional education between dentistry and pharmacy students: delivery, barriers and facilitating implementation.

Interprofessional education (IPE) between dentistry and pharmacy students is an approach to teach effective collaborative practice between a team of future health care providers. It relies on the support and motivation of students, staff and professionals to implement a variety of educational strategies and might involve evaluating student progression before and after delivery. Many barriers exist towards the implementation of IPE between dentistry and pharmacy health disciplines and outlining experiences across educational/clinical practice settings and possible solutions would assist in reducing those walls to realization. Implementation of IPE between pharmacy and dentistry undergraduate programs might lead to improved workplace collaborations and reduce medication errors, adverse events and increase in cross-referrals. Interprofessional education within undergraduate training forms the first steps towards reducing the burden on health care systems by enabling effective collaboration to improve patient outcomes. This narrative review describes IPE strategies used between pharmacy and dentistry undergraduate disciplines to enable collaboration, discusses the barriers and facilitators towards implementing IPE, and future directions for IPE education between these two disciplines.