Interprofessional Practice Research Articles

Comparing the implementation of advanced access strategies among primary health care providers

ABSTRACT The advanced access (AA) model is among the most recommended innovations for improving timely access in primary health care (PHC). Originally developed for physicians, it is now relevant to evaluate the model’s implementation in more interprofessional practices. We compared AA implementation among family physicians, nurse practitioners, and nurses. A cross-sectional online open survey was completed by 514 PHC providers working in 35 university-affiliated clinics. Family physicians delegated tasks to other professionals in the team more often than nurse practitioners (p = .001) and nurses (p < .001). They also left a smaller proportion of their schedules open for urgent patient needs than did nurse practitioners (p = .015) and nurses (p < .001). Nurses created more alternatives to in-person visits than family physicians (p < .001) and coordinated health and social services more than family physicians (p = .003). During periods of absence, physicians referred patients to walk-in services for urgent needs significantly more often than nurses (p = .003), whereas nurses planned replacements between colleagues more often than physicians (p <.001). The variations among provider categories indicate that a one-size-fits-all implementation of AA principles is not recommended.

Building Collaborative Capacity in Early Intervention Preservice Providers Through Interprofessional Education.

Interprofessional practice within early intervention is underscored by policy, research, and recommended practices. The purpose of this study was to explore the impact of a brief interprofessional training on preservice speech-language pathology, early intervention/early childhood special education, physical therapy, and occupational therapy students' knowledge, beliefs, and attitudes about teaming and collaboration. Students' satisfaction with and perspectives of the training were also examined. A one-group, pretest-posttest design was used to examine differences in 36 students' knowledge, attitudes, and beliefs around interprofessional practice after the training. Descriptive approaches were used to analyze student satisfaction data and focus group data in order to evaluate student perceptions of the interprofessional training. A paired-samples t test showed preservice students demonstrated increased scores in self-perceived ability, value, and comfort in working with others after the training institute. Descriptive analyses illustrated students gained a richer knowledge and appreciation for other disciplines and perceived the practice of interprofessional collaboration as a valuable learning experience. The interprofessional training procedures, evaluation of impacts, and future directions are discussed.

Interprofessional education during international electives: Perceptions of health professions students from selected institutions in Africa

ABSTRACT Although international electives provide important opportunities for the development of interprofessional education and collaboration practice skills, there is limited literature that describes students’ perceptions in various training institutions in Africa. This study aimed to address this gap by establishing the student’s perceptions of interprofessional education during international electives from four African health professional training universities. This was a cross-sectional quantitative study. Data were collected online using the Readiness for Interprofessional Learning Scale from 135 student participants. Linear regression and multilinear regression were used to establish relationships between socio-demographic characteristics and the student’s perception of interprofessional education during international electives. There was a high overall positive perception (76 SD± 8.1) among the student participants of interprofessional education during international electives. Almost all the students (88.9% n = 120) thought interprofessional education during international electives would help them become better team workers during future practice and enhance their communication skills. There were high mean scores regarding positive perceptions of teamwork and collaboration (39.5 SD± 4.9), positive professional identity 17.6 (SD± 2.6), and understanding roles and responsibilities (7.4 SD± 2.0). There is a generally positive perception of interprofessional education during international electives among health professions students from various African university institutions.

Student Learning about Poverty and Interprofessional Practice from an Interprofessional Poverty Simulation: A Qualitative Analysis

ABSTRACT Six interprofessional (IP) poverty simulations were conducted at a mid-sized university from 2017 through 2019. Fifteen participants from five majors were interviewed to explore experiences, emotions, thoughts, attitudes, and applications to practice after the simulations. Themes related to poverty included empathy, thinking differently about poverty, demonstrating humility/respect, knowing/teaching resources, and profession-specific applications to practice. Interprofessional-related themes included the importance of the IP team, communication, and roles and responsibilities. The study found reflection with classroom and clinical content integration was critical to the participants’ learning and transformation process.

INTERPROFESSIONAL COLLABORATION AND TEAMWORK PRACTICES IN POST-OPERATIVE WOUND CARE MANAGEMENT AT HOSPITAL OF BANDA ACEH

The practice of surgical wound care requires teamwork of wound nurses and interprofessional collaboration in developing quality wound care procedures. The purpose of this study was to determine the relationship between interprofessional collaboration practices and nurse teamwork on the quality of wound care management in postoperative patients at RSUD Dr. Zainoel Abidin Banda Aceh (RSUDZA) in 2022. This research is a quantitative study with a correlative approach by making cross-sectional observations with a sample size of 52 nurses in 6 inpatient rooms at the Regional General Hospital dr. Zainoel Abidin (RSUDZA) Banda Aceh. Data collection was carried out by distributing questionnaires to respondents. The practice of interprofessional collaboration and team work of nurses in RSUDZA are mostly in the fairly good category and most are in the moderate level. However, there was a significant relationship between Interprofessional collaborative practice and the quality of postoperative wound care management (p = 0.0001) and there was a significant relationship between Team Nurse Practice and the quality of postoperative wound care management (p = 0.014). The conclusion of the study was that there was a relationship between the medical team's interprofessional collaborative practice and the nurse's teamwork practice with the quality of postoperative wound care management in the postoperative inpatient ward of RSU dr. Zainoel Abidin Banda Aceh. it is suggested that there is an increase in collaboration practices, teamwork and better management of surgical wound care in the service.

The Primary Care Transformation Executive Fellowship to Develop Community Health Center Leaders.

Although many primary care providers from community health centers recognize health disparities and work to transform healthcare, skill gaps and limited support may hinder their ability to be change agents. The Primary Care Transformation Executive (PCTE) Fellowship at A.T. Still University School of Osteopathic Medicine in Arizona (ATSU-SOMA) seeks to address these barriers by providing professional development and support to primary care providers interested in leading change in the nation's health centers. The PCTE Fellowship is a structured, one-year interprofessional learning experience that emphasizes topics such as healthcare transformation, interprofessional practice, leadership development, and systems thinking. Quantitative and qualitative evaluation of the program was accomplished through surveys and semi-structured interviews throughout the fellowship. Feedback from 18 fellows showed perceived improvements in knowledge and skills related to the various curricular topics, increased engagement in leadership activities, and career advancement. Fellows developed practice and quality improvement projects and successfully implemented the projects within their health systems, addressing observed disparities. Professional development and directed support for primary care providers can enhance their engagement in healthcare transformation and advance health equity.

Home Parenteral Nutrition for Children: What Are the Factors Indicating Dependence and Mortality?

Parenteral nutrition (PN) in children with short bowel syndrome is crucial and lifesaving. Taking care of such patients requires interprofessional practice and multiple team resource management. Home PN (HPN) usage allows patients and families to live regular lives outside hospitals. We share our experiences for the last two decades and identify the risk factors for complications and mortality. A retrospective study of HPN patients was conducted between January 2000 and February 2022. Medical records of age, body weight, diagnosis, length of residual intestines, HPN period, central line attempts, complications, weaning, and survival were collected and analyzed. The patients were classified as HPN free, HPN dependent, and mortality groups. A total of 25 patients received HPN at our outpatient clinic, and one was excluded for the adult age of disease onset. There were 13 patients (54.1%) who were successfully weaned from HPN until the record-enroled date. The overall mortality rate was 20.8% (five patients). All mortality cases had prolonged cholestasis, Child Class B or C, and a positive Pediatric End-Stage Liver Disease (PELD) score. For HPN dependence, extended resection and multiple central line placement were two significant independent factors. Cholestasis, Child Class B or C, and positive PELD score were the most important risk factors for mortality. The central line-related complication rate was not different in all patient groups. The overall central line infection rate was 1.58 per 1000 catheter days. Caution should be addressed to prevent cholestasis and intestinal failure-associated liver disease during the HPN period, to prevent mortality. By understanding the risks of HPN dependence and mortality, preventive procedures could be addressed earlier.

Comparing outcomes of an innovative interprofessional student placement model to standard placement models in rural healthcare settings

ABSTRACT This unique study investigated the educational and service delivery impacts of a team-based, innovative model of interprofessional education (IPE) namely the Rural Interprofessional Education and Supervision (RIPES) model on participating students, clinical educators, and their workplaces, in rural Australian healthcare settings. Participating professions included dietetics, occupational therapy, physiotherapy, and speech pathology. Outcomes from the RIPES model were compared with regular uni-professional placement models. A multi-site, pre-post, comparative design was used. The main data collection measures included were the Students Perceptions of Interprofessional Clinical Education – Revised scale, the Interprofessional Socialization and Valuing Scale, and time-usage data. The RIPES model resulted in significant improvement in students’ beliefs, behaviors, and attitudes that underpin interprofessional socialization and collaborative practice in healthcare settings. Importantly, students were able to benefit from the RIPES learning activities without compromising their contact time with patients. Clinical educators spent significantly more time in non-patient contact activities than the uni-professional group. This important work was undertaken in response to previous calls to address a gap in IPE models in rural areas. It involved students from multiple professions and universities, measured impacts on multiple stakeholders, and followed international best practice interprofessional education research recommendations.

Palliative care integration in the intensive care unit: healthcare professionals’ perspectives – a qualitative study

ObjectivesThe complex care needs and high mortality of critically ill patients in intensive care unit (ICU) warrants a team approach. While studies have affirmed the integral role of palliative care...

Practitioner perceptions of interprofessional practice (IPP) in small rural communities: An exploratory, qualitative study

The quality of life and the economic viability of rural communities are dependent on high-quality healthcare, which can result from interprofessional practice (IPP) that employs the IPEC Core Competencies. Health profession students can acquire these competencies during supervised clinical education experiences. Since little is known about IPP in rural areas, researchers conducted focus groups in four small communities to gain perceptions of health care providers and administrators about how IPP is operationalized in rural healthcare systems. Data were coded and analyzed using a complex dynamic systems model for team effectiveness. Respondents identified the presence of several requisite components of IPP. Absent was evidence of explicit strategies for continuous quality improvement of team processes and team responsibility for improving population health. Using a complex dynamic system model to evaluate rural IPP could identify and promote the acquisition of knowledge and skills associated with IPP and assist academic and clinical educators in developing curricular content to prepare students to learn the competencies to effectively promote the delivery of IPP in underserved rural communities.

Health in All Education: A Transdisciplinary Learning Outcomes Framework

Historical and recent population health issues necessitate the goal of educating and preparing a transdisciplinary workforce with population health knowledge and competence to be able to develop, implement, and evaluate innovative and feasible solutions that not only address multifaceted community health problems downstream but also to be able to predict and prevent those factors that contribute to an inequitable health burden upstream. To identify where population health education is already shared among multiple disciplines, the Centers for Disease Control and Prevention's Academic Partnerships to Improve Health program conceptualized the Health In All Education initiative that was implemented in partnership with the Association for Prevention Teaching and Research. The purpose of the initiative was to (1) show the importance of integrating population health principles into higher-education transdisciplinary practices; (2) discuss examples of Centers for Disease Control and Prevention collaboration with disciplines related to public health (i.e., economics, environmental engineering, health informatics, health law and policy, social work, liberal education in general education); and (3) explore opportunities to promote transdisciplinary learning to prepare for collaborative, interprofessional practice in population health. This article introduces the Health in All Education Learning Outcomes Framework, a set of shared population health concepts identified on the basis of discipline-representative consensus. The following domains were identified as having transdisciplinary applicability on the basis of established public health curricula, competency, and learning outcome models: determinants of health, evidence-based approaches, population health focus, interprofessional practice, community collaboration, environmental health, occupational health, global health, diversity/cultural competence, health systems, finance and budgeting, and health law and policy.

Effect of interprofessional education on cadaver dissection seminar.

In 2010, WHO published a "Framework for action on interprofessional education and collaborative practice." Interprofessional education (IPE) is now being conducted in various ways. We have been holding cadaver dissection seminars to provide opportunities for medical students, nursing students, and nurse practitioner (NP) students to learn together. In this study, we investigated the effect of learning about IPE in cadaver dissection seminars. The seminars were held for 5days each in 2021 and 2022 (the number of days of participation was arbitrary). In the seminars, teams of 3-5 participants with the same theme collaborated to dissect a single donated cadaver. Teams were made up of participants with different departments: 29 medical students, 12 NP students, and 20 nursing students participated in the seminar, and participants were surveyed before and after the seminars. The Readiness for Interprofessional Learning Scale (RIPLS) scores before and after the dissection seminar increased significantly overall. The scores of medical and nursing students increased significantly, but those of NP students did not significantly change. In terms of the number of days of participation, a significant increase in scores was found for participants who participated for ≥ 2days. Overall, a significant positive correlation was found between intrinsic motivation to learn and RIPLS scores. For medical students, a significant negative correlation was noted between extrinsic motivation and RIPLS scores. Cadaver dissection seminars conducted by medical, nursing, and NP students demonstrated IPE learning effect on medical students and undergraduate nursing students.

Integrating an innovative social work practice into a pediatric dental residency program

Summary This article describes the implementation and outcomes of a social work program in a university pediatric dental clinic serving low-income families. The goal was to decrease barriers to dental care access, decrease appointment failure, and improve interprofessional practice (IPP). Funding was obtained through a foundation to hire a social worker and two interns, and cover program costs. A survey identified barriers families faced to obtain and complete pediatric dental care. Residents, dental students, and faculty make referrals to the social workers who intervene to help families overcome challenges for their children's care. Findings The program started in January 2019 and outcomes are reported through June 2021. The largest barriers families identified were lack of a pediatric dentist near home accepting public insurance (91%), the dentist who saw their child only did exams and cleanings but not fillings (84%), and need for specialized dental care (77%). Five hundred and eleven families were referred to the social workers, most commonly for resources, information or other referrals (30.5%), dental insurance lapse (14.9%), caregiver guidance on oral health (10.6%), mental health concerns (10.4%), and poor treatment compliance (9.6%). Social workers provided 424 interventions, mostly about information regarding community resources (26.8%), transportation issues (15.9%), and telephone consults (14.2%). Appointment failure rates decreased from 17% to 13.5%, while the cancelation rate decreased from 19.2% to 14.3% from January 2019 to June 2021, respectively. Applications Social workers helped decrease barriers to pediatric dental care, improve attendance to dental appointments, and enhance IPP for pediatric dental residents, students, and faculty.

Program evaluation of a new interprofessional geriatrics curriculum for advanced practice nursing and master of social work learners

ABSTRACT The Indiana Geriatrics Workforce Enhancement Program (GWEP) implemented a new longitudinal geriatrics curriculum for advanced practice registered nurse (APRN) and master of social work (MSW) learners to prepare them for interprofessional collaborative practice in the care of older adults. This paper reports program outcomes of a novel longitudinal interprofessional geriatrics curriculum involving immersive learning for these learners. Outcomes are described in terms of learner reaction, modification of attitudes/perceptions, acquisition of knowledge/skills, behavior change, impact on the organization, and impact on the patient or client using the Freeth/Kirkpatrick evaluation model. Program participation influenced graduates’ knowledge of and their perceived ability to participate in team care and job selection in geriatric-focused positions.

The effect of interprofessional simulation practice on collaborative learning: A randomized controlled trial

ABSTRACT This study examined the effect of simulation on readiness for collaborative practice and learning using a randomized-controlled trial design that used the same education protocol with interprofessional and uniprofessional groups. The sample consisted of 43 students from four different majors. The students were assessed with the Readiness for Interprofessional Learning Scale, and a care plan measurement instrument. The interprofessional group showed a small increase (0.1 ± 0.43; p = .02) in readiness for teamwork and collaboration; the uniprofessional group showed a smaller increase for teamwork and collaboration (0.04 ± 0.31; p = .04) and for patient-centred care (0.0 ± 0.35; p = .01). The enriching work of interprofessional learning was evident within the care plan activity, suggesting that interprofessional simulation is an effective learning method for interprofessional education.

Celebrating the Culture of Interprofessional Collaboration in Athletic Training

Celebrating the Culture of Interprofessional Collaboration in Athletic Training

Interprofessional team-based education: A comparison of in-person and online learner experiences by method of delivery and health profession.

Building capacity for teamwork, communication, role clarification and recognition of shared values is essential for interprofessional healthcare workforce development. Requirements to demonstrate interprofessional practice competencies have coincided with pivots to online delivery. Comparison of in-person and online delivery models for interprofessional education is important for future curriculum design. This article presents an evaluation of in-person and online delivery modes for interprofessional team-based education and compares learner experiences across different health professions. Students from 13 health professions (n=2236) participated between Spring 2020 and Fall 2021. In-person and online delivery models were compared, assessing learner perceptions of efficacy for interprofessional practice, using reflective pre-post responses to the Interprofessional Collaborative Competency Attainment Scale (ICCAS). Mean ICCAS scores improved for in-person and online delivery (0.79 vs 0.66), with strong effect (Cohen's D 2.03 and 1.31 respectively; p<0.001). Statistically significant differences were observed across professions, although all experienced ICCAS score improvements. Logistical benefits were evident for online delivery. In-person and online interprofessional team-based education can provide valuable learner experiences for large student cohorts from multiple professions. ICCAS score differences should be weighed against potential logistical benefits of online delivery. Timing of delivery and determinants of differences in student response across professions warrant evaluation for future curriculum design.

Interprofessional Education and Collaborative Practice in Health: The production of the common as a resistance device to the capitalistic subjectivation mode.

Interprofessional Education and Collaborative Practice in Health: The production of the common as a resistance device to the capitalistic subjectivation mode.

University teachers’ experience of students interprofessional education: Qualitative contributions from teachers towards a framework

BackgroundHealth and social care professionals need to be equipped to work together. Universities have a duty of care to their students to incorporate interprofessional education into the curricula. Here, we present findings from focus groups to delve deeper into the issues previously identified. MethodThree focus group interviews with teachers were conducted—two in Norway and one in the UK. FindingsWe identified four themes: Organizational commitment. Values related to students’ interprofessional and collaborative practice. Professional identity and commitment to collaborative practice. Challenges with implementing interprofessional education. Discussion and conclusionEducators continue to agree that interprofessional education is important, but the findings highlight the ongoing divide and uncertainty as to what to do and when to equip students for interprofessional collaboration. The educators call for the organization to show commitment and leadership so that stakeholders can come together to develop an Interprofessional education curriculum that students can sign up to. Time is of the essence, and a framework may help us here, especially if we can embrace the concept of social innovation and cocreate.

INSTRUMENTOS UTILIZADOS NA AVALIAÇÃO DA CAPACIDADE FUNCIONAL, FRAGILIDADE E SARCOPENIA EM IDOSOS: REVISÃO INTEGRATIVA

ABSTRACT Objective: to analyze the knowledge produced in the scientific literature on the instruments used to assess functional capacity, frailty, and sarcopenia in older adults. Method: integrative literature review, in the Cinahl, MEDLINE/PubMed, Embase, Web of Science and Scopus databases, from 2012-2021. Data were extracted: authors, year, country of publication, type of study, sample characteristics, objective, results, and instruments. In addition, the methodological quality and level of evidence were assessed. Results: The final sample included 13 articles. The most used instruments were Lawton and Brody Index for functional capacity assessment; conceptual model of the frailty phenotype; and the conceptualization and diagnosis of the European Working Group on Sarcopenia. Conclusion: The scientific evidence demonstrated the importance of using instruments to screen for these conditions that can interfere with the health of the elderly population, reinforcing the need to strengthen interprofessional care practices.