Interprofessional Interactions Research Articles

Nurses' Descriptions of Interdisciplinary Interactions in Stroke and Geriatric Rehabilitation Units: A Case Example of the Registered Practical Nurse.

To analyse how nurses describe their interactions with other interdisciplinary team members within stroke and geriatric rehabilitation. A secondary analysis of cross-sectional ethnographic interview data was conducted using Elo and Kyngäs' (2008) deductive content analysis. Between April 12 and July 25, 2022, semi-structured interviews were conducted with 31 registered practical nurses recruited through convenience sampling from three tertiary hospital sites in Southwestern Ontario. Interview transcripts were reviewed to identify described interactions between nurses and interdisciplinary team members and were coded for: who were the interdisciplinary team member(s) involved; what content was addressed; and where, when, and why the interaction occurred. Categories representing how nurses describe their interactions with interdisciplinary team members were as follows: (1) arising from the unique roles owned by either the nurse or interdisciplinary team member(s); (2) requiring open communication to achieve patient goals and improve patient care; (3) occurring within what is perceived to be either the therapists' or nurses' physical space; and (4) contributing to supportive team environments that are mutually beneficial. While nurses view other interdisciplinary team members as 'owning' certain roles and physical spaces within rehabilitation, they also recognised their 'owned' spaces and roles. Unique contributions of all team members were valued as necessary to provide holistic, person-centred patient care and positive team-based support. Nurses' descriptions of their interactions with interdisciplinary team members demonstrated their essential contributions to team-based patient care and acknowledged nurse contributions to the rehabilitation process for patients. Findings elucidate the nature of interprofessional interactions and 'ownership' within the rehabilitation process. Results are beneficial for policymakers, educators, and healthcare organisations aiming to optimise the nursing role within rehabilitation spaces. The Consolidated Criteria for Reporting Qualitative Research Checklist (COREQ). No patient or public contribution.

Health professional students’ emotional responses to effective and ineffective teamwork

Introduction: Pre-registration students learn interprofessional competencies for effective teamwork through interprofessional education (IPE), yet they do not always see effective teamwork in the clinical workplace or experience it in IPE learning activities. In this study, we explored: (1) what students recall of experiences of interprofessional teamwork interactions in workplace settings or in IPE learning activities and (2) what and how they describe the emotion attached to these experiences. Methods: A pre- and post-test survey design was used, which included qualitative questions administered before and after a clinical workplace-based cancer and life-limiting illness IPE activity for two cohorts of students. We surveyed students about teamwork experiences in both workplace and IPE learning activities and how they felt about them emotionally. A content and thematic analysis was undertaken, the latter using a process adapted from Attride-Stirling (2001). Results: For the before-IPE responses, 31 out of 50 students in the two cohorts responded (62%), and for the after-IPE responses, 29 out of 50 in the two cohorts responded (58%). There were two global themes: (1) students readily recognise both effective and ineffective teamwork and (2) ineffective teamwork experiences can evoke strong emotional responses. Conclusion: Students’ emotional responses from being involved in or observing effective and ineffective teamwork may influence their future engagement in interprofessional teamwork and IPE activities.

Implementation of Project ECHO in a university health network: contrasting and comparing experiences across health conditions through a qualitative approach in a Canadian tertiary care centre

ObjectivesThe objective of this study was to compare and contrast the experiences of interdisciplinary attendees (spokes) and experts (hub members) from three Extension for Community Healthcare Outcomes (ECHO) programmes: hepatitis...

Person-centred care in the context of higher education – a discourse analysis based on interviews with programme directors

BackgroundAs person centred care (PCC) is being implemented globally, higher educational institutions (HEI) have begun to play a crucial part in enabling this transition. In Sweden, however, the delivery of PCC is inconsistently implemented in medicine, nursing, occupational therapy, and physiotherapy study programmes. This inconsistency is partly the result of a lack of a national strategy across HEI. Program directors are responsible for the PCC content of their programs, so their views influence how PCC is taught. Using interviews with programme directors in higher education, we aim to deepen the understanding of the preconditions needed to implement PCC by exploring discourses and identifying subject positions of how PCC is taught and learned.MethodsWe performed a discourse analysis based on interviews with program directors in the above-mentioned national study programmes. A discourse can be seen as a struggle over identity. The subject position – i.e., discourses designate positions for persons to occupy as subjects – guided our analysis and identification of the subject positions of the teacher and the student in teaching and learning PCC.ResultsThis study unfolded in two main antagonistic aspects with respect to teaching and learning PCC, resulting in four subject positions for the teacher and four corresponding subject positions for the students. First, the teacher and student were given a subject position as change agents towards a more egalitarian healthcare and were assigned a subject position to cope with a practical reality they could not change. Second, the teacher and student were assigned a subject position that embodied profession-specific identities, navigating and valuing these boundaries. Simultaneously, both teachers and students assumed a subject position that required interprofessional interaction and co-creation for teaching and learning PCC.ConclusionThis study demonstrates the discursive tension surrounding the implementation of PCC in HEI, and the findings can serve as a basis for creating future relevant and high-quality learning activities. The process of negotiating diverse and co-existing perspectives as well as building interprofessional trust when incorporating PCC into higher education is essential and requires further exploration.

Exploring the influence of rural longitudinal multidisciplinary student placements on interprofessional education and collaborative practice in South Africa

Background. Training health professions students along the continuum of care on the distributed training platform (DTP) is increasingly being adopted by universities across Africa to promote the development of responsive healthcare professionals. Interprofessional collaboration to meet patient needs is an integral part of this ideal. Multidisciplinary student placement on the DTP (MDTP) provides opportunities for interprofessional education (IPE). Stellenbosch University offers longitudinal undergraduate student placement at two rural MDTPs in South Africa. Objective. The objective of this study was to explore the perceived IPE opportunities in Worcester and Upington in South Africa. Methods. Sixteen purposively selected undergraduate students from five-degree programmes who trained in Upington or Worcester were individually interviewed in 2022 using a qualitative case study research design. Inductive thematic analysis was conducted in reflection with an independent researcher, after which data were deductively analysed using the definition of IPE to guide data coding and theme development. Results. The value of curricular IPE activities and the need for co-curricular IPE activities focused on holistic patient care were noted. Extracurricular themes related to purposive co-ordination of accommodation, transport and social activities to promote interprofessional interaction were noted. Conclusion. It is not always possible to purposively design IPE activities on rural MDTPs owing to financial and human resource constraints. This study offers insight into curricular, co-curricular and extracurricular facilitators for IPE in the design of learning opportunities and logistics on rural MDTPs. Recommendations for the development of future MDTPs are presented.

Navigating competing tensions: A qualitative study of experiences and perceptions of leadership among emergency medicine doctors.

Emergency medicine (EM) doctors are often required to manage a diverse set of complex challenges; navigating direct patient care, systemic issues and inter-professional interactions. Leadership is well recognised as crucial in optimising both the delivery and the quality of patient care. There is a clear need to gain greater understanding of the reality of EM leadership through exploring doctors' experience and perception of leadership in EM, yet there is a paucity of research focusing on this area. The objective of the present study was to explore the research question: 'What are the experiences and perceptions of leadership by EM doctors?' This single-site qualitative study was undertaken using semi-structured in-depth individual interviews to collect data. Interviews were audio recorded, transcribed and de-identified. Reflexive thematic analysis was performed by the research team with the aid of DelveTool software. Our sample included nine participants incorporating consultants and registrars. Three major themes were identified: (i) situational tensions, (ii) relational tensions and (iii) leadership style tensions. Each of these was further explored with subthemes discussed separately. Leadership within the ED is complex and multifaceted, with doctors required to navigate many competing tensions. The present study highlighted key areas for future leadership development, including situational awareness, emotional intelligence and a fluid approach to leadership styles. The present study provides an important step towards enhancing the development of targeted leadership training for EM doctors.

Developing a fall prevention program in an inpatient spinal cord injury rehabilitation unit: A participatory action research study.

Spinal cord injury is a lifelong disability necessitating early management of falls during inpatient admissions. However, there is a paucity of research on fall prevention and management in Spinal cord injury rehabilitation. This study aimed at developing a fall prevention program in an inpatient rehabilitation Spinal cord injury unit. A participatory action research approach utilizing a before-and-after, mixed-method design was employed for this study. The study was performed at Rofaydeh Rehabilitation Hospital in Tehran, Iran, from 2021 to 2022. the study implemented Cohen's four-stage model, encompassing the design of a change program, action, observation and evaluation, and feedback stages. A purposeful sampling method was utilized to select 19 nurses and members of the rehabilitation team from the hospital, ensuring maximum diversity. Data collection involved semi-structured interviews, focus groups, and a checklist for fall prevention measures. Qualitative content analysis, alongside descriptive (frequency, mean, and standard deviation) and inferential statistics (paired t-tests and Chi-square tests), were employed for data analysis. The study adhered to COREQ guidelines. Falls were most common among patients aged fifty years or older (P = 0.026). Throughout the study period, men were more likely to experience falls than women (P = 0.01). Preventive interventions have led to significant improvements in indicators of patient monitoring and care, patient education, and environmental safety, as demonstrated by a paired-sample t-test (P<0.001). Moreover, factors contributing to patients' falls included "shortcomings in fall prevention policies" and "lack of knowledge and participation among patients and caregivers." Changes implemented in the Spinal Cord Injury unit involved enhancing interprofessional interactions, conducting educational workshops for patients and their companions, and identifying high-risk patients. These findings indicate a significant decrease in the incidence of falls following the intervention (P = 0.02). The study found that a multifaceted intervention can increase knowledge about fall risks and substantially reduce both falls and associated minor injuries.

Women's Experiences of Consultation: Negotiating Conflicting Models of Birth

The purpose of this study was to understand how midwifery client experiences are affected by interprofessional interactions during consultation between physicians and midwives. Ten midwifery clients from Southern Ontario who had experienced at least one consultation during their midwifery care participated in semi-structured interviews. The findings from the interviews suggest that women experience a conflict between biomedical knowledge and embodied knowledge, and between the hierarchy of physician-centred care and woman-centred care during the act of consultation. The interviews demonstrate that divergent professional philosophies may represent a significant barrier to interprofessional practice.

Pharmacy students' interprofessional experience and performance in advanced pharmacy practice experience rotations amid COVID-19 pandemic.

Interprofessional education (IPE) is essential in pharmacy training, providing students with vital collaborative skills for real-world healthcare. Advanced Pharmacy Practice Experience (APPE) is integral to IPE, allowing students to apply their knowledge in diverse healthcare settings. The COVID-19 pandemic has disrupted healthcare education and raised concerns about its impact on IPE during APPE rotations. Our study investigates the pandemic's influence on pharmacy students' interprofessional interactions and APPE performance. To assess the interprofessional experiences of fourth-year pharmacy students before and during the COVID-19 pandemic in the context of APPE. This retrospective observational study examined the experiences of P4 pharmacy students in the United States during APPEs before and during the pandemic. We employed electronic surveys with 21 questions to gauge interactions and interprofessional team effectiveness, employing Likert scale response options. We compared responses between the 2019-2020 and 2020-2021 APPE rotations using statistical tests. Our study encompassed 83 and 86 students for the 2019-2020 and 2020-2021 APPE rotations, respectively, achieving a 100% response rate. Amid the pandemic, written communications between pharmacy students and healthcare providers in general medicine rotations increased, while in-person engagement decreased. Pre-COVID, students reported higher colleague referrals and greater interprofessional utilization during ambulatory care rotations. COVID-19 shifted interactions from in-person to written communication between pharmacy students and healthcare providers. Students reported decreased satisfaction with their interprofessional experiences. This research offers insights into the changing landscape of pharmacy education, helping students prepare for evolving challenges in healthcare delivery and education.

Perceptions on Medical Professionalism Among Future Healthcare Professionals: A Mixed Method Study.

Background Accreditation councils across the world constantly examine policies and practices in professionalism in their medical curriculum. The National Medical Commission (NMC) in India has recognized the pressing need to reform and include professionalism in its undergraduate curriculum. Objectives The objective of this study was to explore the perspectives of medical and nursing students on professional behavior, suitable teaching-learning methods, and assessment strategies for curriculum integration. Methodology The study utilized a concurrent triangulation mixed method design, collecting both qualitative and quantitative data simultaneously to gain a comprehensive understanding of medical and nursing students' perceptions of professionalism. It included 83 final-year undergraduate medical students and 42 final-year undergraduate nursing students. The approval of the Institutional Review Board of Meenakshi Medical College Hospital & Research Institute was obtained. A semi-structured questionnaire consisting of demographic characteristicsand opinions regarding academic professional behavior, teaching-learning, and evaluation of professionalism was used. Perceptions regarding the meaning of professionalism, behavior of professionalism to be emphasized in teaching, and pressing challenges of professionalism were explored. Students were also asked to rank the best behavior associated with professionalism. Frequency and percentages were used for descriptive statistics. Means and standard deviations were calculated for continuous variables. An unpaired t-test was used to determine a statistically significant difference between the means in the two groups. The quantitative data was analyzed with R programming and content analysis was performed for the qualitative data using ATLAS.ti qualitative data analysis software. Results Unexplained/unauthorized absence from academic activities (2.39 ± 1.553), not following the timeline (2.41 ± 1.560), making fun of patients and peers (2.16 ± 1.619), cheating in the exams (2.37 ± 1.651), and inebriation (2.39 ± 1.666) were unacceptable behaviors by undergraduate medical students compared with nursing students. Clinical experience (1.54 ± 0.857) and role models (1.74 ± 0.935) were the highly acceptable methods of teaching professionalism and interprofessional interactions (1.58 ± 0.650) and awards (1.98 ± 1.100) were the most common suggestions to improve the course curriculum by both groups. Community/field activity (1.78 ± 0.860) and clinical examination (1.89 ±1.123) were the most preferred methods of evaluation of professionalism. According to the students, dedication, honesty, respect, and self-improvement were identified as the best behaviors associated with professionalism. Conclusions The study revealed that students had a wide range of perspectives about professionalism. Different unprofessional acts were acceptable to students. The causes of these perspectives need to be explored and resolved to promote professionalism. Students identified the need for strong positive role models and frequent clinical experiences, along with improved interprofessional interactions and awards to improve teaching and learning professionalism. Community/field activity was the preferred assessment method proposed by the students. Medical institutions must promote these components in curriculum, faculty development, and clinical settings to foster the development of professionalism among students.

Ovarian cancer management in an ESGO ovarian cancer center of excellence: a systematic case study of the interprofessional and interdisciplinary interaction

PurposeWith growing knowledge about ovarian cancer over the last decades, diagnosis, evaluation and treatment of ovarian cancer patients have become highly specialized, and an individually adapted approach should be made in each woman by interdisciplinary cooperation. The present study aims to show the variety and extent of medical specialties involved at our institution according to the European Society of Gynecologic Oncology (ESGO) Quality indicators (QI).MethodsA woman, diagnosed with high-grade ovarian cancer, International Federation of Gynecology and Obstetrics (FIGO) class IVb was selected for a single case observational study. The observation period (total = 22d) comprised preoperative diagnostic procedures, including imaging, the in-patient stay for cytoreductive surgery, and the postoperative course and case discussion at our interdisciplinary tumor board. Data were obtained by self-reporting and by patient file review.ResultsPatient tracking demonstrated an interdisciplinary cooperation of 12 medical specialties [62 physicians (63% male, 37% female)], 8 different types of nursing staff [n = 59 (22% male, 78% female)], and 9 different types of perioperative/administrative staff (n = 23; male 17,4%, female n = 19, 82,6%). Contact with the patient was direct (n = 199; 76%) or without face-to-face interaction (n = 63; 24%).ConclusionThe present study demonstrates the high diversity of physicians and the affiliated medical staff, as well as interdisciplinary intersections within teams of a specialized hospital. Matching the ESGO QIs, this report underlines the requirement of an adequate infrastructure for the complex management of advanced ovarian cancer patients.Future prospective studies are warranted to evaluate the specific procedures and actions to optimize the interprofessional and interdisciplinary workflows.

Learning to Communicate Together: Perspectives on an Interdisciplinary Experience Among Nursing and Physical Therapist Assistant Students

BackgroundInterprofessional communication is imperative to quality patient care and improved outcomes as well as a requirement of nursing education programs, however, gaps exist between theory and practice. Often, students are not exposed to interprofessional interactions until later in the program when simulation experiences are offered or a clinical opportunity arises. Sample29 Bachelor of Science in Nursing and three physical therapist assistant students ranging in age from 18-35 years. MethodAn interdisciplinary communication role-play simulation among second year Bachelor of Science in Nursing students and first year physical therapist assistant students was implemented utilizing a situation-background-assessment-recommendation structured communication tool to facilitate and organize their communication. ResultsA total of 15 out of 32 students reported an increase in confidence to communicate with other healthcare professionals after participation in the simulation. ConclusionThis experience provided evidence of the effectiveness of a collaborative simulated experience improving undergraduate nursing students’ understanding and confidence with interprofessional communication prior to a clinical opportunity.

Cohort assessment of medical and pharmacy student interprofessional attitudes at an academic medical centre from baseline to programme completion

Background: Interprofessional interactions between pharmacy and medical students have been emphasised by accreditation standards. This study aimed to document medical and pharmacy student cohorts’ baseline and longitudinal interprofessional attitudes across four years of pre-licensure education. Methods: Student cohorts shared two structured interprofessional learning experiences within the first two years, then unstructured/variable learning experiences during the final two years. The 27-item Interprofessional Attitudes Scale comprising five subscales was administered upon programme entry, then towards the end of each programme year. Results: Baseline response rates were 73.5% and 90% for 136 medicine and 57 pharmacy students, respectively; pharmacy student responses were significantly higher for teamwork, roles, and responsibilities and significantly lower for interprofessional biases subscales. Longitudinal medical and pharmacy student responses only showed a significant increase in interprofessional biases, while medical student responses showed significant decreases in teamwork, roles, responsibilities, and community-centredness. Conclusion: Compared to pharmacy students, baseline responses from medical students confirm significantly lower scores for teamwork, roles, and responsibilities on programme entry, which may further decrease by the end of the first pre-clinical year. Though significant subscale changes mirrored the completion of structured pre-clinical interprofessional curricula and/or clinical education for both student cohorts, further research is needed secondary to study limitations.

Exploring pathways to optimise care in malignant bowel obstruction (EPOC): Protocol for a three-phase critical realist approach to theory-led intervention development for shared decision-making.

Malignant bowel obstruction is a distressing complication of cancer, causing pain, nausea and vomiting, and often has a poor prognosis. Severe and rapidly developing symptoms, a lack of robust clinical guidelines and the need for multidisciplinary input make treatment decision-making challenging. Sharing decision-making with people with malignant bowel obstruction and their caregivers can be difficult, and inconsistent communication creates serious deficiencies in care by amplifying patients' distress and uncertainty. Little attention has been paid to the implicit influences on this process-for example, the role of discipline-related norms and the beliefs of decision-makers. This study will explore how these processes work and develop interventions to improve shared decision-making. Exploring Pathways to Optimise Care (EPOC) is a three-phase study set within a critical realist framework: (i) realist review, to develop explanatory theory describing collaborative decision-making in the management of malignant bowel obstruction; (ii) an in-depth interview study using modified grounded theory to explore the active ingredients of this collaboration in practice settings; and (iii) the presentation to stakeholders (practitioners, patients and caregivers) of integrated results from Phase I (theory developed from the literature) and Phase II (theory developed from current practice) as a basis for intervention mapping. We aim to produce recommendations to address the challenges, and to develop a set of tools to (i) aid interaction around shared decision-making and (ii) aid interprofessional interaction around the management of this condition. Registration details: The realist review is registered with PROSPERO (CRD42022308251).

What is impacting clinical pharmacists’ participation in an interprofessional ward round: a thematic analysis of a national survey

ABSTRACT The ward round (WR) is an important opportunity for interprofessional interaction and communication enabling optimal patient care. Pharmacists’ participation in the interprofessional WR can reduce adverse drug events and improve medication appropriateness and communication. WR participation by clinical pharmacists in Australia is currently limited. This study aims to explore what is impacting clinical pharmacists’ participation in WRs in Australian hospitals. A self-administered, anonymous national survey of Australian clinical pharmacists was conducted. This study describes the outcomes from qualitative questions which were analyzed thematically in NVivo-2020 according to Braun and Clarke’s techniques. Five themes were constructed: “Clinical pharmacy service structure”, “Ward round structure”, “Pharmacist’s capabilities”, “Culture” and “Value”. A culture supportive of pharmacist’s contribution with a consistent WR structure and flexible delivery of clinical pharmacy services enabled pharmacists’ participation in WR. Being physically “absent” from the WR due to workload, workflow, and self-perception of the need for extensive clinical knowledge can limit opportunities for pharmacists to proactively contribute to medicines decision-making with physicians to improve patient care outcomes. Bidirectional communication between the interprofessional team and the pharmacist, where there is a co-construction of each individual’s role in the WR facilitates consistent and inter-dependent collaborations for effective medication management.

Speech-language pathologist, physical therapist, and occupational therapist experiences of interprofessional collaborations

ABSTRACT Interprofessional collaboration among speech-language pathology, physical therapy, and occupational therapy is considered to promote best practice in rehabilitation as it can enhance efficiency, patient outcomes, and clinician and patient satisfaction. Although clinician experiences with interprofessional collaboration have been studied in each of the rehabilitation professions separately, limited research has been conducted on the shared attitudes or experiences across speech-language pathology, physical therapy, and occupational therapy. The purpose of this study was to understand speech-language pathologist, physical therapist, and occupational therapist experiences of interprofessional collaborations. We conducted an exploratory cross-sectional online survey study. The survey included Likert-scale questions and open-ended questions that probed clinicians’ general experiences with interprofessional practice and views and beliefs regarding barriers and facilitators to interprofessional collaboration. Responses from 213 clinician respondents were analyzed using descriptive quantitative methods and a qualitative content analysis. The results revealed overlap in attitudes and experiences across speech-language pathology, physical therapy, and occupational therapy about barriers and benefits to interprofessional collaboration. Perceived respect differed among the professions, with speech-language pathologists more frequently reporting that their role is often misunderstood or undervalued by other rehabilitation professionals. These results may guide future research focused upon the predictors of successful interprofessional collaborations and interactions.

Giving Life to Learning Through Rural Maternal Health Immersion Experiences.

Recruiting, retaining, and educating nursing students is essential to meet the growing need for nurses in rural communities. A nursing school enhanced its prelicensure education in rural and public health nursing, and interprofessional care by expanding experiential learning opportunities. To describe longitudinal community health-based rural immersion experiences for prelicensure nursing students. A prospective, correlational design evaluated students' knowledge and confidence in understanding rural characteristics, confidence in achieving public health nursing, and interprofessional education competencies. Fourteen prelicensure nursing students participated in rural maternal health immersion experiences and reported being more confident (21/27 items) than knowledgeable (18/27) in understanding rural characteristics. Over 85% reported competency in interprofessional interactions, and there was a significant difference in confidence in achieving public health nursing competencies between the beginning and end of the immersion. Using immersion experiences may be effective in enhancing students' knowledge, confidence, and competency in rural and public health, and interprofessional care.

Investigating Causes of Medical Errors in Intensive Care Units in Iran: A Cross-sectional Study.

Medical errors cause disability and mortality in intensive care units (ICUs). We aimed to determine the occurrence and causes of medical errors in the ICUs of Iran. In this cross-sectional study, data from the family complaint files referred to The disciplinary authority of Iran Medical Council was retrospectively reviewed to explore the causes of medical errors. Statistical analysis was performed in SPSS Version 26.0. A total of 293 complaint files were referred to the disciplinary commission from 2014 to 2019, of which 95 files were related to medical errors in ICUs. The median age of patients was 62 years (46-74 years) and 52 (54.7%) patients were men. Also, 37 (38.9%) patients had decreased levels of consciousness and 42 (42.2%) patients had cardiovascular disease. A total of 40 (42.1%) patients experienced a single medical error and 55 (57.9%) patients experienced more than 1. Causes of medical errors in patients were physician's or nurse's negligence in 53 (55.8%) patients, weak interaction of physician and nurse with the patient and family members in 11 (11.6%) patients, weak interprofessional interaction among physicians in 7 (7.4%) patients, equipment and structure of ICUs in 7 (7.4 patients, nature of ICUs and patients in 6 (6.3%) patients, weak physician-nurse interprofessional interaction in 5 (5.2%) patients) patients, low attention of the physician and the nurse to medication safety in 6 (6.3%) patients. Patient safety is impacted by a variety of medical mistakes. Interprofessional strategies can be developed and put into action to mitigate medical errors in ICUs.

FINCA - a conceptual framework to improve interprofessional collaboration in health education and care.

The health care system in Germany and in many other countries is facing fundamental challenges due to demographic change, which require new integrated care concepts and a revision of the collaboration between health care professions in everyday clinical practice. Internationally, several competency framework models have been proposed, but a framework that explicitly conceptualizes collaborative activities to improve interprofessional problem-solving competency in health care is still missing. Such a framework should define contextual, person-related, process-related, and outcome-related variables relevant to interprofessional problem solving in health care. Against this background, we present a conceptual framework to improve interprofessional collaboration in health education and care (FINCA) developed with scientific consideration of empirical data and various theoretical references. FINCA reflects an interprofessional learning and interaction process involving two persons from different health care professions and with different individual learning prerequisites. These two initially identify a problem that is likely to require interprofessional collaboration at some point. FINCA acknowledges the context of interprofessional learning, teaching, and working as well as its action-modifying context factors. We follow the reasoning that individual learning prerequisites interact with the teaching context during learning activities. At the heart of FINCA are observable collaborative activities (information sharing and grounding; negotiating; regulating; executing interprofessional activities; maintaining communication) that can be used to assess individuals' cognitive and social skills. Eventually, the framework envisages an assessment of the outcomes of interprofessional education and collaboration. The proposed conceptual framework provides the basis for analysis and empirical testing of the components and variables it describes and their interactions across studies, educational interventions, and action-modifying contexts. FINCA further provides the basis for fostering the teaching and learning of interprofessional problem-solving skills in various health care settings. It can support faculty and curriculum developers to systematize the implementation and improvement of interprofessional teaching and learning opportunities. From a practical perspective, FINCA can help to better align curricula for different health professions in the future. In principle, we also see potential for transferability of the framework to other areas where different professions collaborate.

On the edge of decision-making in trauma care: A focus group study on radiographers’ experiences of interprofessional collaboration

IntroductionThe temporary trauma teams in trauma alerts consist of a diverse group of unique professionals requiring interprofessional collaboration and coordination to achieve efficient, high-quality care. The uncertain situation and complex care environment impose high demands on team dynamics such as individual attitudes and team behaviours. Within interprofessional teams, interaction and coordination reflect the collective success of collaboration and the achievement of goals. Interactions with radiographers have increased in trauma teams given computed tomography's prominent role in providing crucial knowledge for decision-making in trauma care. This study aimed to explore radiographers' experiences of interprofessional collaboration during trauma alerts. MethodThe study was designed with focus group methodology, including 17 radiographers participating in five focus groups, analysed with an inductive focus group analysis. ResultsAn overarching theme, “On the edge of decision-making”, emerged along with three sub-themes: “Feeling included requires acknowledgement”, “Exclusion precludes shared knowledge”, and “Experience and mutual awareness facilitate team interaction”. ConclusionsInterprofessional collaboration from the radiographer's perspective within trauma teams requires a sense of inclusion and the ability to interact with the team. Exclusion from vital decision-making obstructs radiographers' comprehension of situations and thereby the interdependence in interprofessional collaboration. Implications for practiceCommon platforms are needed for knowledge sharing and team practices, including radiographers’ areas of responsibility and relational coordination to foster interprofessional relationships. Through these means interdependence through awareness and shared knowledge can be facilitated on trauma teams.