Interprofessional Discussions Research Articles

An investigation of “agreement” in the context of interprofessional discussion online: A “netiquette” of interprofessional learning?

This article suggests that “agreement” is a predominant feature of online discussions amongst undergraduate health and social care professionals, which is an area of concern. The context for the research is an online interprofessional learning pathway completed by ∼2,800 students each year. The concept of agreement, how and why it is reached and what it indicates in an online interprofessional group is examined. The underpinning educational rationale for instigating online interprofessional dialogue was the potential to provide a powerful interface for bringing together students across a wide range of professional groups, which is necessary to promote interprofessional learning. Discourse analysis was used to analyze digital texts of interaction in online forums. The discussion forum discourse shows evidence of increased interprofessional knowledge and understanding, as well as capacity for interprofessional dialogue. Discussions were largely characterized by agreement, although some disagreement was evident. These findings support previous research in online dialogue. However, they are interpreted in an interprofessional context as constituting a specific type of “netiquette” in relation to the participants and their identification with professional discourses and to the learning activities that shaped discussions. The research has significance for teachers, researchers, and practitioners involved in promoting interprofessional learning through online discussion forums.

Poverty Perceptions of Social Workers and Physicians in Israel

This qualitative study comparing poverty perceptions of social workers (SWs) and primary care physicians (PCPs) employed in Israel's public services found that both attributed the poverty of their own clients to similar causes—individualistic, structural, fate, and policy—but differed in most of their perspectives and moral imperatives. The PCPs tended to be more angry, skeptical, and accusatory than the SWs, who were more forbearing and accepting. Both believed that those in a position to work should, but only PCPs held that they should work for any salary. With respect to policy, PCPs looked at the macro, SWs at the micro. The findings suggest that it might be more fruitful to keep inter-professional discussions on the poor and poverty pragmatic, rather than theoretical and principled.

Canadian Society of Plastic Surgeons

Team communication is essential to patient safety, and research suggests that poor or insufficient communication is a primary cause of medical errors. Strong team communication may be facilitated through the use of communication protocols that are standardized within an organization or team. This presentation will describe a research program - “Team Talk” -which has implemented and evaluated preoperative briefings to structure interprofessional discussions among surgeons, anesthesiologists, and nurses prior to surgical procedures. Results will include the team briefing’s impact on team communication failure rates and collaborative work processes, followed by a discussion of challenges and lessons learned. LEARNING OBJECTIVES: At the end of this presentation, audience members will be able to: Understand the relationship between team communication and patient safety Explain how preoperative team briefings can impact communication breakdowns and work processes Appreciate the facilitators and barriers to implementing new communication routines in the operating room. Can J Plast Surg. 2008 Summer; 16(2): 97–125. » EF02 The Burned Face: Acute Care and Reconstruction Can J Plast Surg. 2008 Summer; 16(2): 97–98. EF02 The Burned Face: Acute Care and Reconstruction R Spence Copyright and License information ► Copyright © 2008, Pulsus Group Inc. All rights reserved Abstract OBJECTIVES: Understand recent advances in acute care of the burned face. Understand an approach to the analysis and reconstruction of severe facial burn deformities. Understand techniques used personally in the reconstruction of total and subtotal facial reconstruction. OUTLINE: Advances in Treatment of Acute Burns of the Face Determination of depth of burn Usual criteria – make most diagnoses Laser Doppler Imaging Superficial burn – topical treatment Deep burn – excision and grafting Thick split-thickness skin grafts IntegraTM synthetic dermis Burn Reconstruction of the Head and Neck Problems in Facial Burn Reconstruction Scarcity of donor sites, esp. in large burns. Leave deforming donor sites. Require multiple operations. Beyond skill, patience, and/or courage of most reconstructive surgeons. Fundamental Principles Gillies Principles Aesthetic units (Gonzalez–Ulloa) Matching of skin qualities (e.g. color, texture, thickness) (Gonzalez–Ulloa, Edgerton & Hanson) Optimize use of original facial skin. Ideal Facial Reconstruction System: Reliable and reproducible. Provides economy of tissue. Results in adequate well-matched skin. Minimizes donor site deformity. Minimizes hospital stay and operations. Within the skill and patience of most reconstructive surgeons. Use of patient’s own tissues – no rejection/immunosuppression. The Story Expanded full-thickness skin grafts Expanded transposition flap The Algorithm Distinct regions of the face Peripheral Resurface large areas with skin with similar qualities to facial skin. Flap better than skin graft. Central Reconstruct fine architectural structures. Resurface with thin skin well-matched in qualities. Flap generally too thick for resurfacing. Combination of Peripheral and Central Shoulder/Chest skin available – expanded transposition flap provides both flap for peripheral and FTSG for central deformities Shoulder/Chest skin not available – expand available normal skin and resurface with expanded FTSG. Techniques: Skin Grafts Full-thickness skin grafts – Workhorse Defatting – drum dermatome technique Neck contracture releases Central portion of the face Lower lip-chin resurfacing Upper lip – aesthetic units Nose Peripheral areas when local skin not available for flaps Split thickness skin grafts Eyelids Upper – dynamic Lower – static Forehead Miscellaneous Composite Grafts Philtrum reconstruction Nasal ala reconstruction Ear reconstruction Conchal transposition flap Prosthetics Tissue expanders Scalp Direct for advancement flap To develop skin for FTSG Expanded transposition flaps

BIOÉTICA Y EJERCICIO PROFESIONAL DE LA ODONTOLOGÍA

Odontology faces important ethical dilemmas: interaction patient-odontologist; access to dental health; consciousness about population's needs, among others. All of these attract discussion and have to be treated according to ethics. This paper wants to show that bioethics, as an open alternative based upon dialogue and comprehension of evidences, will provide tools to find ethical answers for dilemmas and for inter-disciplinary and inter-professional discussions.

Perspectives and practice: speech and language therapy student views of an interprofessional learning experience

AbstractThis article describes a work‐place interprofessional learning experience for Speech and Language Therapy (SLT) students in an acute hospital, using an innovative model of Speech and Language Therapy students learning with students and qualified professionals from other disciplines. The experience was evaluated via a feedback form, use of the Readiness for Interprofessional Learning Scale (RIPLS) and group discussion. The study details feedback on the sessions, with participants reporting greatest benefit in terms of teamwork and collaboration. Student and tutor reflections on the learning experience are outlined and related to broader issues surrounding interprofessional learning in work‐place settings.

An interprofessional problem-based learning course on rehabilitation issues in HIV

This study examined students' perceptions of their learning through participation in an interprofessional problem-based course on rehabilitation and HIV. Students representing five health professions participated in an eight-week tutorial course. Qualitative analysis of journals that the students completed throughout the course, and of interviews of the students at completion of the course, revealed that they valued their learning experience. Students gained an appreciation of the roles of others and developed a sense of confidence through justifying their professional role. Through the interprofessional discussions, students were able to increase the breadth and depth of their learning and also gained a rehabilitation perspective. Learning related to HIV and rehabilitation is ideally suited to an interprofessional, problem-based environment.

An interprofessional problem-based learning course on rehabilitation issues in HIV

This study examined students' perceptions of their learning through participation in an interprofessional problem-based course on rehabilitation and HIV. Students representing five health professions participated in an eight-week tutorial course. Qualitative analysis of journals that the students completed throughout the course, and of interviews of the students at completion of the course, revealed that they valued their learning experience. Students gained an appreciation of the roles of others and developed a sense of confidence through justifying their professional role. Through the interprofessional discussions, students were able to increase the breadth and depth of their learning and also gained a rehabilitation perspective. Learning related to HIV and rehabilitation is ideally suited to an interprofessional, problem-based environment.

Examining Ethics in Practice: health service professionals’ evaluations of in-hospital ethics seminars

This article reviews practitioners' evaluations of in-hospital ethics seminars. A qualitative study included 11 innovative in-hospital ethics seminars, preceded and followed by interviews with most participants. The settings were obstetric, neonatal and haematology units in a teaching hospital and a district general hospital in England. Fifty-six health service staff in obstetric, neonatal, haematology, and related community and management services participated; 12 attended two seminars, giving a total of 68 attendances and 59 follow-up evaluation interviews. The 11 seminars facilitated by an ethicist addressed the key local concerns of staff about the social and ethical consequences of advances in genetics and their impact on professional policies and practice. Seminar agendas were drawn from prior interviews with 70 staff members. During evaluation interviews, participants commented on general aspects that they had enjoyed, how the sessions could be improved, timing, the mix of participants, the quality of the facilitation, whether sessions should be more challenging, after-effects of sessions, and interest in attending seminars and contacting the ethicist in future. Participants valued the increased interprofessional understanding and coherent discussion of many pressing issues that addressed important though seldom discussed ethical questions. The seminars worked well in the different hospitals and specialties.

Ethical discussion groups as an intervention to improve the climate in interprofessional work with the elderly and disabled

Due to social policy reforms in Sweden, professionals with a social and a medical education work together. Reported conflicts within municipal elderly and disabled care, related to professional training, sometimes result in a deteriorated work climate. As an attempt to improve the work climate in interprofessional groups, an intervention study was set up in four 'experimental dwellings' where staff participated in systematic ethical group discussions. Four similar dwellings were used as reference. Work climate was studied before and after the intervention using a questionnaire measuring sense of coherence, job satisfaction, and burnout among the staff. High scores at baseline with no significant differences after the intervention. That staff had high coping capacity, were satisfied and did not experience burnout. The small observed changes after intervention indicate that the intervention did not lead to the expected improvement of work climate, but might also result from the chosen scales inability to measure complex social processes. The importance of interprofessional discussions about everyday skills and values is stressed.

Using bioscience knowledge in nursing: actions, interactions and reactions.

This paper draws on empirical data from a study undertaken to explore the outcomes of the applied physiology component of a post-registration diploma in nursing (DN). Most students completing the DN were utilizing their new bioscience knowledge in clinical practice, and reported increased participation in interprofessional discussions and team decisions. Respondents found themselves better able to monitor and evaluate doctors' decisions and this led to friction with some medical colleagues. However, the strongest resistance came from senior nurses, very few of whom had completed advanced nursing courses in bioscience and who were generally unwilling to allow respondents to develop new roles. General managers were also perceived as a major barrier to change. There is little evidence of tangible benefits to the nurses themselves: most saw the DN qualification as a way of protecting their status as professional nurses in the face of managerially driven organizational change, rather than as a route to occupational advancement.

Differences in type of mitochondrial DNA (mtDNA) between donors and recipients do not affect pregnancy rates after transfer of rat embryos

The very nature of the Patient-Centered Medical Home (PCMH) necessitates new instructional models that prepare learners for the roles they will have to assume in these transformed primary care practices. In this manuscript we describe a new instructional framework that seeks to blend the goals of patient-centered care and inter-professional education, and can be implemented in existing training environments while practice transformation continues to proceed. We propose a 5-step process, the EFECT framework, which is simultaneously a sequence of tasks for effective patient care and a guide for the learners and faculty in teaching and evaluating that care delivery. These steps include: (1) Eliciting a patient-centered narrative, (2) Facilitating an inter-professional team discussion, (3) Evaluating clinical evidence, (4) Creating a shared care plan, and (5) Tracking outcomes. We then report preliminary descriptive outcomes from the first EFECT pilot. Our proposed framework supports learners' abilities to construct a patient-centered narrative from multiple professional perspectives as the basis for developing an evidence-based, integrated care plan between the patient and the inter-professional care team and deliberately following up on outcomes. We present this framework to stimulate a process for creating new curricula and evaluative tools to measure and promote learner functioning in medical home environments.

The Helping Professions Group

At Queen's University an extramural interprofessional discussion group, involving students and faculty members from medicine, nursing, theology, education, and law, has been meeting since February 1977. The discussions center on actual persons and problems with implications for a number of professional groups. This format provides an alternative opportunity for learning and may enhance personal growth and the development of interpersonal skills. It seems to meet certain needs which are not fulfilled by the more traditional university programs.