Implications For Interprofessional Practice Research Articles

“You never stop being a social worker:” Experiences of pediatric hospital social workers during the acute phase of the COVID-19 pandemic

ABSTRACT The COVID-19 pandemic has wrought widespread devastation upon children and families across the United States, widening existing health disparities and inequities that disproportionately affect communities of color. In health care settings specifically, social work is the key workforce tasked with responding to patient and family psychosocial needs, both of which have increased substantially since the emergence of COVID-19. There is a need to understand ways in which hospital social workers’ roles, responsibilities, and integration within interprofessional teams have evolved in response to these challenges. In this qualitative study, focus groups were conducted with 55 social workers employed across multiple settings in a large, urban, pediatric hospital in Spring 2020. Thematic analyses revealed salient superordinate themes related to the pandemic’s impact on social work practice and social workers themselves, institutional facilitators and impediments to effective social work and interprofessional practice, and social work perspectives on future pandemic recovery efforts. Within each theme, a number of interrelated subthemes emerged elucidating nuances of telehealth adoption in the context of remote work, the salience of social determinants of health, and the critical role of social work in social justice oriented pandemic preparedness and response efforts. Implications for interprofessional practice and the profession at large are discussed.

A scoping review of community paramedicine: evidence and implications for interprofessional practice

ABSTRACT Community paramedicine (CP) is an evolving method of providing community-based health care in which paramedics function outside of their traditional emergency response roles in order to improve access to primary and preventive health care and to basic social services. Early evidence indicates that CP programs have contributed to reducing health care utilization and improving patient outcomes leading some to call for a transformation of EMS into value-based mobile healthcare fully integrated within an interprofessional care team. The purpose of this scoping review was to understand the evidence base of CP in order to inform the further evolution of this model of care. Following the PRISMA extension for Scoping Reviews, 1,163 titles were screened by our research team. Eligibility criteria were publication in English after January 1, 2000; description of a CP program located in a Western nation; and inclusion of a discussion of outcomes. Twenty-nine publications met the criteria for inclusion. The literature was varied in terms of study design, program purpose, and target audience. The lack of rigorous, longitudinal studies with control groups makes rendering conclusions as to the value and effectiveness of CP programs difficult. Further, the extent to which community paramedics operate within interprofessional teams remains unclear. However, some programs demonstrated improvement in both health services and patient outcomes. As stakeholders continue to explore the potential of CP, results of this review highlight the importance of further investigation of outcomes, the professional identity of the community paramedic, and the role of the community paramedic on interprofessional teams.

A Family-Centered Feeding Intervention to Promote Food Acceptance and Decrease Challenging Behaviors in Children With ASD: Report of Follow-Up Data on a Train-the-Trainer Model Using EAT-UP.

This research note outlines the usefulness of Easing Anxiety Together with Understanding and Perseverance (EAT-UP), a train-the-trainer, family-centered feeding intervention, for promoting food acceptance of children with autism spectrum disorder (ASD). This report is a follow-up on a pilot study (n = 4) of the EAT-UP intervention previously completed by the same authors. Participants were 3 families of children with ASD receiving services from an outpatient department of a larger rehabilitation hospital in the northeastern United States. Three professionals working with the families were also recruited and trained by the first author, a speech-language pathologist experienced with the EAT-UP method. Initial assessment was followed by a baseline period for each participant. An individual mealtime plan was drafted for each family. Data on acceptance of less preferred food and the presence of challenging mealtime behaviors were recorded using direct observation and pre-, mid-, and postintervention measures and questionnaires. All children demonstrated increased food acceptance and dietary diversity and decreased challenging behaviors. Caregivers reported decreases in the frequency of problem behaviors and in the number of problem mealtime behaviors. Measures of procedural fidelity increased from 50% to 100% for registered behavior technicians and parents over the course of the EAT-UP intervention period. EAT-UP is an effective model for training professionals who work with families of children with ASD and challenging mealtime behavior. Implications for interprofessional practice and research are discussed.

Mapping Collective Sensemaking in Communication: The Interprofessional Patient Case Review in Acute Care Rounds

Mapping Collective Sensemaking in Communication: The Interprofessional Patient Case Review in Acute Care Rounds

Participation in an Interprofessional Health Fair: Student Perceptions of Teamwork and the Role of Faculty

INTRODUCTION Development of interprofessional skills is increasingly recognized as a critical component in the preparation of health professionals. The purpose of this study was to evaluate the impact of preparation and participation in an interprofessional educational experience on health professions students’ perceptions of teamwork and communication skills. METHODS Survey responses from students (n=120) with different levels of involvement in an interprofessional health fair were analyzed. Levels of involvement included four groups: a control group, a peer instruction group, a faculty instruction group, and a group who was involved in both planning and implementation of the health fair. RESULTS The analysis demonstrated faculty-guided preparation prior to participation in an IPE experience is crucial for optimizing students’ abilities to work as a team. CONCLUSION Implementation of an interprofessional health fair can positively affect students’ perceptions of working as a team. However, a lack of faculty-led training can negatively impact the IPE experience for the student. Received: 06/30/2015 Accepted: 11/13/2015 © 2015 Roofe et al. This open access article is distributed under a Creative Commons Attribution License, which allows unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Implications for Interprofessional Practice • When properly prepared, students can benefit from participation in interprofessional health fair. • Faculty involvement can positively impact the IPE experience for students. H IP & Participation in an Interprofessional Health Fair ORIGINAL RESEARCH 2(4):eP1085 | 2 Introduction The World Health Organization defines Interprofessional Education (IPE) as “when students from two or more professions learn about, from, and with each other to enable effective collaboration and improve health outcomes” (World Health Organization [WHO], 2010). One method that has been widely employed for providing students with an opportunity for an interprofessional educational experience is the implementation of an interprofessional health fair (Agarwal, Wong, Sarfaty, Devaiah, & Hirsch, 2015; Bridges, Abel, Carlson, & Tomkowiak, 2010; Diwan, Perdue, Lee, & Grossman, 2015; Haber, Spielman, Wolff, & Shelley, 2014; Hope et al., 2005; Kolomer, Quinn, & Steele, 2010; Odegard et al., 2009; Towle, Godolphin & Kline, 2015). However, as the IPE experience concept has evolved, comparisons of different experiences have proven difficult, typically due to the broad range of outcomes approaches used, diversity in models, and somewhat limited descriptions of learning objectives (Davidson, Smith, Dodd, Smith, & O’Loughlan, 2008). The purpose of this study was to provide evidence regarding the use of an interprofessional health fair as a method for IPE and evaluate the impact of different levels of preparation and participation in the interprofessional health fair on students’ perceptions of teamwork and communication skills.

Attitudes toward Healthcare Teamwork between Osteopathic Medical Students in an Interprofessional or Intraprofessional Clinical Education Program

Attitudes toward Healthcare Teamwork between Osteopathic Medical Students in an Interprofessional or Intraprofessional Clinical Education Program

Oral Health and Interprofessional Education Experiences in Family Medicine and Pediatric Residency

INTRODUCTION Prevention of dental diseases in children requires interprofessional education (IPE) and care coordination between oral health professionals and primary care providers; however, the extent of preparation of medical residents and its impact on their provision of preventive oral health services in clinical practice requires further investigation. METHODS A two-stage cluster sample of 470 US family medicine and 205 pediatric residency programs was used. A random sample of 30% (N=140) of family medicine and 29% (N=60) of pediatric residency programs were randomly selected. Of these, 42 programs (21%) invited residents to participate. Residents (N=95, 28%) completed an online questionnaire regarding oral health training in residency. Statistical analysis included frequencies and Spearman’s rank correlations. RESULTS Eighty-three percent of family medicine and pediatric residents combined reported receiving oral health education. Clinical experiences involving oral healthcare were frequently reported (77%, n=75); however, IPE with an oral health professional was limited. Both groups indicated they provided anticipatory guidance regarding regular dental visits and toothbrushing “very often” and avoiding bottles at bedtime “often.” Residents reported performing dental caries assessments “often” and applying fluoride varnish “occasionally.” For family medicine residents, moderate correlations (p ≤ 0.01) were found between hours of oral health education and providing anticipatory guidance. For pediatric residents, a moderate correlation (p < 0.01) was found between hours of oral health education and assessing teeth for demineralization. CONCLUSION Increased effort is needed to meet national recommendations for educating family medicine and pediatric residents regarding oral healthcare for children, including increased IPE involving oral health professionals. Received: 05/25/2015 Accepted: 08/28/2015 Published: 10/22/2015 © 2015 Bailey et al. This open access article is distributed under a Creative Commons Attribution License, which allows unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. H IP & Oral Health and Interprofessional Education ORIGINAL RESEARCH 2(3):eP1081 | 2 Introduction Oral health is a vital component of overall health and, therefore, the responsibility of pediatricians. Accordingly, the American Academy of Pediatrics (AAP) recommends pediatricians play an integral role in children’s oral health by providing preventive oral health services including anticipatory guidance, oral health screenings and assessments, and fluoride varnish applications during well-child visits (AAP, 2014). This recommendation applies not only to pediatricians but to other primary care providers (PCP), such as family physicians, nurse practitioners, and physician assistants (PA) (National Interprofessional Initiative on Oral health [NIIOH], 2011). In 2014, the U.S. Preventive Services Task Force (USPSTF) recommended PCP prescribe fluoride supplementation to children beginning at 6 months of age if they reside in areas with suboptimal fluoride concentration in the drinking water and provide fluoride varnish applications to all children beginning at eruption of the first tooth (USPSTF, 2014). In support of these recommendations, medical insurers are requir-ed to reimburse providers under the Affordable Care Act (ACA) for services assigned a grade A or B by the USPSTF. This reimbursement includes fluoride varnish applications for children ages 0-5 years (Kaiser Family Foundation [KFF], 2014). These national children’s oral health initiatives coincide with the recent emphasis on integrating interprofessional education (IPE) opportunities across the healthcare professions to improve the health of the nation and overall quality of care (Institute of Medicine [IOM], 2011). IPE opportunities involving oral health experts such as dental hygienists, dentists, and/or dental professional students are integral to effectively train PCP to de-liver preventive oral health services to children. Little is known about IPE opportunities involving dental professionals in family medicine and pediatric residencies. Patients of all ages experience needless dental diseaserelated pain and expense, in part, because their PCP has not been trained to provide preventive oral health services (NIIOH, 2009). The general health status of children and adolescents can be improved by prevention and early intervention of oral diseases, including dental caries, before they develop into more complicated Implications for Interprofessional Practice

The social context of career choice among millennial nurses: implications for interprofessional practice

Health human resource and workforce planning is a global priority. Given the critical nursing shortage, and the fact that nurses are the largest group of healthcare providers, health workforce planning must focus on strategies to enhance both recruitment and retention of nurses. Understanding early socialization to career choice can provide insight into professional perceptions and expectations that have implications for recruitment, retention and interprofessional collaboration. This interpretive narrative inquiry utilized Polkinghorne’s theory of narrative emplotment to understand the career choice experiences of 12 millennial nurses (born between 1980 and 2000) in Eastern Canada. Participants were interviewed twice, face-to-face, 4 to 6 weeks apart prior to commencing their nursing program. The narratives present career choice as a complex consideration of social positioning. The findings provide insight into how nursing is perceived to be positioned in relation to medicine and how the participants struggled to locate themselves within this social hierarchy. Implications of this research highlight the need to ensure that recruitment messaging and organizational policies promote interprofessional collaboration from the onset of choosing a career in the health professions. Early professional socialization strategies during recruitment and education can enhance future collaboration between the health professions.

The role of nurse practitioners in hospital settings: implications for interprofessional practice

Expansion of the nurse practitioner (NP) role worldwide indicates a need to understand how the role functions in interprofessional healthcare teams. Through the adoption of a mixed methods approach that gathered on-site tracking and observation, self-recorded logs of consultations and focus group interviews of team members and NPs, we describe the extent of role activity and the nature of interprofessional practices of 46 NPs and their team members in nine hospital sites across the province of Ontario, Canada. Findings outline the nature of the NP role activities, which largely focused on providing clinical care, with the support of their team, to a range of patients across the study settings. We discuss how ‘embedding’ the NP in this way appears to contribute to utilization of expertise of all professions as well as enabling team members to promote evidence-based practices. We argue that the use of NPs augments interprofessional role utilization through their desire to consult with a range of professionals and the capacity to perform holistic care for patients that is not limited to traditional nursing boundaries.

How Medical Students Conceptualize Disability: Implications for Interprofessional Practice and Education

Background: This study explored whether medical students at a Canadian university conceptualize health and disability from a biomedical or biopsychosocial perspective. The World Health Organization's (WHO) International Classification of Functioning, Disability and Health (ICF) served as the theoretical basis for this exploration.Methods: A written survey was administered to capture medical students' conceptualizations of health and disability. The survey included questions explicitly related to the constructs of universalism, nonlinearity, social and environmental factors, personal factors, participation, aspects of language and biopsychosocial health perspectives. The survey was also designed to include both theoretical and scenario-based questions related to biopsychosocial concepts of disability. The survey was distributed to and completed by a senior medical school class at a Canadian university.Results: In total, 82 out of 131 medical students completed the survey. Observed trends suggested that for theory-based questions, respondents exhibited close agreement with biopsychosocial perspectives of health and disability. Scenariobased questions resulted in more variability among respondents compared to theory-based questions. When students who previously had been introduced to the ICF were compared with students who had not, those familiar with the ICF more consistently exhibited a biopsychosocial perspective of health and disability; however these differences were not statistically significant.Conclusion: Overall, senior medical students in this study were generally found to conceptualize disability using a biopsychosocial orientation. This result was more pronounced among students who were previously familiar with the ICF. Interestingly, a biopsychosocial orientation was not consistently maintained for scenario-based questions for all respondents. Our current healthcare climate requires that the concept of health move beyond a biomedical perspective to a more holistic biopsychosocial perspective. This change in perspective is of particular importance as movement towards team-based models of care continues to gain momentum. Closing conceptual and language-based gaps related to concepts of health and disability among all healthcare professionals is pertinent to improvinginterprofessional collaboration and service provision. The ICF presents a framework and language that is relevant across all health professions. Increased use of the ICF in health professional education and training could significantly contribute to increased interdisciplinary success.

Demographic and referral patterns of people detained under Section 136 of the Mental Health Act (1983) in a south London Mental Health Trust from 2005 to 2008

This study aimed to retrospectively examine demographic and referral data for all detainees under Section 136 of the Mental Health Act (1983) at a 'place of safety' in one London Mental Health Trust over a three-year period. Data were collected for 887 consecutive detentions and indicated a clear over-representation of black detainees compared with their representation in the local population. A high proportion of detentions (41.2%) did not result in hospital admission. Implications for practice and service user experience should be considered as long as Section 136 remains an entry point to mental health services for many black people. There are implications for interprofessional practice where Mental Health Trust resources are expended supporting Section 136 detentions in which no hospital treatment follows.

The Social Pedagogues in Western Europe—some implications for European interprofessional care

The nature of the Social Pedagogue profession and its historical development are examined with particular emphasis placed on its role of integrating specialist groups in the fields of social care and social education. Some implications for interprofessional practice in a European context are identified.