Interprofessional Networks Research Articles

Interprofessional Collaboration Led by Health Professional Students: A Case Study of the Inter Health Professional Alliance at Virginia Commonwealth University

Background: Internationally recognized health experts have identified the need for an interdisciplinary approach to meet the healthcare needs of the 21st century, but academic institutions have been slow to take action. In response, eight health professional students at Virginia Commonwealth University developed a student-led organization, the Inter Health Professionals Alliance (IHPA), to foster a collaborative, interdisciplinary environment among health professional students.Methods and Findings: The eight students utilized a participatory action research approach to identify 1) an understanding behind the motivation for developing IHPA and 2) the core benefits of group involvement. Four benefits were identified: the development of knowledge and skills, interprofessional networks, professional competence, and role clarity. The case study demonstrated that students can engage in interdisciplinary collaboration from a student-initiated approach and likely improve the care of future patients. Drawing on personal experiences, IHPA board members outline five pieces of wisdom to aid fellow students in the development of student-led interdisciplinary organizations.Conclusions: With enthusiasm and support, students can transform their educational experiences to meet the healthcare needs of the twenty-first century.

The Power of Music in Medicine and Health Care: International Association for Music & Medicine Thailand, July 3-6, 2012

The Power of Music in Medicine and Health Care is the leading theme of the second International Conference of Music & Medicine to be held in Thailand, July 3-6, 2012. A dedicated group of members and associates of the International Association for Music & Medicine (IAMM) are working tirelessly to ensure a superb experience for every delegate. With 3 enticing keynote addresses, and more than 40 papers from presenters traveling from 18 countries of the globe, this promises to be an exciting event for intercultural learning, and interprofessional networking. All are welcome. See more at www.iammthailand.com.

OntoStoria2: A shared representation and a web-based tool for the collaboration of services providers

Today, enterprises have to be customer and service oriented in order to adapt themselves to a more and more competitive and evolving context. Their innovators actors of the innovation have to collaborate in order to anticipate the customers' needs. To do so, they work as a virtual team a remote and inter-professional network and try to describe services situations, to detect lacks and opportunities, and to propose the design of adapted solutions. Based on the service literature and the discussions of the Service Science Management and Engineering SSME discipline, we conceive the service as a dynamic configuration of heterogeneous entities: a “Service System”. We then suggest formalizing it with a mereological ontology collective classes instead of distributive classes of processual entities processes instead of substances in order to highlight its dynamic dimension. The Service System acts as an intermediary object aiming at the innovators' cooperation and creativity during a co-design phase. Its modelling reveals all the possible experiences within a situation through the identification of the relationships between processual entities. A co-modelling process and a web-based tool are currently tested upstream of the services design process of a French telecom operator. This operator's process and experiments are good examples.

On the road: Medical students’ experiences on paramedic placements

Background: Undergraduate students’ in several Australian medical courses undertake short placements with Paramedics to increase their awareness of biopsychosocial factors affecting health, provide opportunities to apply knowledge and clinical skills in health contexts and to develop inter-professional knowledge.Aim: The purpose of this study was to provide the first report of medical students experiences on Paramedic placements, by identifying the opportunities and range of clinical activities they experienced, and to seek feedback to improve placements.Methods: Students (n = 33, 72% response rate) completed an 11-question post-placement survey requiring Likert-scale responses with open-ended questions requiring narrative responses.Results: Students employed communicative, observational and basic clinical skills ‘on the job’ during the placement. They had exposure to a range of experiences from non-emergency patient transfers to violence and intoxication, trauma, suicide and death. Students witnessed the importance of different individuals as well as the importance of the inter-professional network in delivering pre-hospital care. Overall, students were over-confident of their abilities, but found the placements to be valuable learning opportunities that met the intended outcomes.Conclusion: Suggested improvements include better orientation, management of expectations and debriefing, shifts with a higher rate of call outs, direct clinical teaching and introduction of a ‘patient journey’ approach to the placement.

A critical realist model of complexity for interprofessional working

This paper presents a theoretical model of complexity for considering issues relevant to interprofessional working. The need for such a model is introduced with reference to the literature on collaboration and integration in health and social care, particularly in children's services. It is argued that interprofessional working is often seen as a response to complexity, but that current models fail to build an appreciation of complex causality into their approach to addressing needs through targeted interventions. The alternative offered here is a critical realist model based on Bhaskar's domains of reality, focusing on the implications of open systems, complex causality and contingency. These ideas are used to examine some of the issues and dilemmas typically encountered by interprofessional networks in coming together to work on complex cases.

Discussing Fertility Preservation Options With Patients With Cancer

IN JUNE 2006, THE AMERICAN SOCIETY OF CLINICAL ONcology published a series of recommendations on fertility preservation for patients with cancer, concluding that “To preserve the full range of options, fertility preservation approaches should be considered as early as possible during treatment planning.” These guidelines reflect the greater attention that has been given in recent years to the fertility complications that can occur as a result of cancer treatment (eg, chemotherapies and radiation). Other professional and collaborative societies, including the Oncofertility Consortium, Fertile Hope, the American Academy of Pediatrics, and the American Society for Reproductive Medicine, also have developed best-practice guidelines and educational resources to provide patients and physicians with the most recent research on fertility preservation treatments. Investigators within the field of oncofertility have examined how patients with a cancer diagnosis learn about the potential of cancer-related infertility, including how such patients weigh fertility preservation options. In understanding this information exchange and medical decision, researchers and best-practice guidelines have looked to the patient-physician relationship, particularly those relationships between patients and oncologists, as the primary opportunity for patients to become aware of potential fertility complications related to cancer treatment. However, a distressing information gap has been identified in which oncologists often do not discuss the issue of possible infertility with patients prior to initiating potentially damaging cancer treatments. Research (including studies of men and women patients and of patients diagnosed when younger than 18 years) has consistently shown that patients diagnosed with cancer do not routinely discuss cancer-related infertility with their physicians. This information gap severely limits the ability of patients with cancer to take proactive steps to help safeguard their future fertility potential prior to fertility-compromising cancer treatments (TABLE). In light of these findings, researchers have begun to examine factors that may have prevented this exchange of information between patient and oncologist. Some research has suggested that oncologists may not be aware of bestpractice guidelines, including ASCO recommendations, and that their knowledge on the topic may not be up to date. The lack of interprofessional networks with reproductive endocrinologists and fertility preservation facilities may further hinder oncologists from raising the issue. Another inhibiting factor is the nature of the relationship between patient and oncologist. For example, Rieker et al have suggested that oncologists may be more likely to discuss sperm banking with patients with whom they share a perceived similar status (eg, highly educated patients). Physicians have reported that certain patient characteristics can influence the likelihood that they would discuss fertility preservation, including a patient’s prognosis, sex, parenting status, marital status, age/pubertal status, ability to pay for such treatments, and even whether a patient is homosexual or is infected with human immunodeficiency virus. The inability of cancer survivors to become parents is an increasing concern within the oncofertility community, and, as the above research suggests, some patient groups may have less access to fertility preservation options prior to cancer treatment. More research is needed to identify additional constituents who may be missing this information, and best-practice guidelines would benefit from highlighting potentially vulnerable groups and suggesting strategies to meet their unique fertility concerns. Research is needed to examine the conditions under which this sensitive issue is effectively discussed in the clinical setting. Among patients who do discuss potential infertility, many feel their concerns are not adequately addressed. The topic of fertility preservation may be understated when it is presented along with myriad other potential adverse effects. Additionally, more effective educational materials may be required to help facilitate these conversations. Researchers also should consider how other health care professionals can be integrated into these discussions, along with an understanding of what fertility concerns may remain fol-

地域における多職種ネットワーク構築に向けた課題

地域における多職種ネットワーク構築に向けた課題

Innovations and networks: the case of mental health care reforms in Belgium

This article discusses mental health care reforms in Belgium from an interorganisational perspective. In 2007 a three year experiential government programme was launched seeking for alternative organisation models in mental health care, labeled as 'care circuits' and 'networks'. The target population is 'persons with chronic and complex mental disorders'. This article reports some of the observations based of an ongoing evaluation process. The research evaluates the plan and implementation processes of these collaboration and networking models (the TP). The qualitative approach aims at developing, testing and refining insights in the dynamics of developing collaboration and networks by exploring the complex and dynamic interaction among context, mechanism, and outcome. The article uses insights form health care innovation literature, interorganisational network theories and literature on organisational fields. Health care innovations take place in a complex multi-agent environment. The implementation (adopting and sustaining) of health services innovations is influenced both by 'external' and 'internal' processes and barriers. The public sector context of mental health care includes 'external' influences by multiple stakeholder through values, power plays, regulations and normative frameworks. The development of interprofessional collaboration and interorganisational networks develops thus in an organisational field. An organisational field is complex, heterogeneous, multi-layered and dynamic. Organisations and actors in the field act on the basis of their interests and respond strategically to institutional pressures. Fields also shape the discourse, norms and structures in ways that match their individual interests and objectives. We found plenty of indications in the mental health reform programme. But the research also urges to develop that further insights into the question whether and under what conditions networks and collaborations between different types of organisations actually are effective. The issue of network governance should be elaborated upon.

The road to collaboration: Developing an interprofessional competency framework

In the absence of an interprofessional competency framework in Canada, the College of Health Disciplines (CHD) at the University of British Columbia developed a universally applicable framework. This article discusses the development of the “BC Competency Framework for Interprofessional Collaboration”. Building on a Health Canada funded initiative through the Interprofessional Network of British Columbia (In-BC), the CHD compared and contrasted existing competency frameworks and consulted curriculum and IP experts throughout British Columbia. The resulting framework is designed to inform curriculum development for health and human service professionals throughout the continuum of learning, starting with pre-licensure education and extending into continuing professional development. The framework will serve as a foundation for future curriculum reform by health and human service educators, practitioners and decision-makers throughout BC and will contribute to the competency literature in Canada.

Promoting interprofessional education in health sector within the European Interprofessional Education Network

According to a common definition, interprofessional education (IPE) is described as “occasions when two or more professions learn from and about each other to improve collaboration and the quality of care”. The Leonardo project under the name European Interprofessional Education Network (EIPEN) in health and social care, has been dealing with the challenges of interprofessional education. The EIPEN project tries to develop a transnational network of universities and employers in the six participating countries and at the same time to promote good practices in interprofessional learning and teaching in health and social care. IPE provides opportunities for students and practitioners to learn with, from and about each other during qualifying and post-qualifying training and in their practice. IPE in health and social care includes the education and training of practitioners in human and animal medicine, dentistry, nursing, physiotherapy, occupational therapy, pharmacy and all other health professions including public and environmental health and health promotion, and social work. The outcomes of the EIPEN Project will provide means, material and guidelines for the enhancement of professional education in the multi-disciplinary field of Health Informatics. The methodology on the development of the Greek Interprofessional Network was based on a series of workshops aiming to document the educational process in healthcare institutes and universities followed by the assessment of the needs for the development of an interprofessional environment. The outcomes will provide means, material and guidelines for the enhancement of professional education in the multi-disciplinary field of Health Informatics.

Is Public Health Ready for a Professional Practice Framework?

To develop a framework for professional practice for a large urban public health unit in Canada. The project involved a literature search, key informant interviews, an environmental scan and focus groups. Analysis and synthesis led to recommendations for the development of discipline-specific Professional Practice Leaders (PPL) and an Interprofessional Practice Leaders Network. The latter meets to discuss cross-cutting practice issues and is chaired by the chief executive officer of the health unit, the Medical Officer of Health. The one-year evaluation has demonstrated that this initiative has worked well in practice. It is a flexible framework which provides new leadership opportunities and gives staff valuable input into decision-making on practice issues. It is also a more efficient use of staff resources, including a comprehensive approach to solving problems and in breaking down silos between programs. Communication and collaboration between disciplines has increased. The initiative was evaluated successfully after the pilot year. In going forward areas to review include the time allotment for the PPL, communication between the PPL, the respective Program Director and the entire department, and expanding professional development opportunities for the PPL.

The state of readiness of student health professionals for web-based learning environments

The health professions are increasing the placement of students within working environments in other institutions and the community. The aim of this study was to assess the readiness for online and web-based learning of future health professionals at the University of Sheffield prior to the establishment of a national web-based Inter-professional Learning Network (WILeN). A link to a short survey was distributed to the Medical Faculty at Sheffield and 191 valid responses were received. Only 62 per cent of students had access to an Internet-connected computer at home. Most students (95.8%) checked their e-mail every few days or more, with slightly less (82.8%) using the web frequently. Relevant technologies were often never used, including internet relay chat, message forums and video conferencing. However, 66 per cent of students had used computer aided learning packages. Future use of online continuing professional education material is likely to be limited.