Interprofessional Practice Research Articles

Perceptions on transitioning from impairment-based to occupation-based practice in public healthcare within KwaZulu-Natal

Introduction:Holistic healthcare service delivery requires rehabilitation personnel to consider all the components of health that influence the client's quality of life. However, there is limited literature on approaches to implementing rehabilitation services within South African public healthcare. This study explored rehabilitation personnel's (such as occupational therapists, speech therapists, physiotherapists) use of occupation-based practice impairment-based practice and the barriers and facilitators associated with their practice choice.
 Methods: A qualitative research design was conducted through semi- structured interviews (13 participants), a focus group (4 participants) and community mapping. Purposive sampling was utilised to select participants in the iLembe district, KwaZulu-Natal, South Africa. Data were analysed using deductive thematic analysis.
 Findings: Three themes emerged from the study; Attitudes towards impairment-based practice, Reflections on OBP, and The way forward. The need to focus on all the components of health rather than just the disease and the benefits of using the occupation-based practice approach were highlighted. Additionally, different factors required to implement holistic rehabilitation services and the barriers to OBP were identified.
 Conclusion: Although the study identified OBP benefits, various barriers associated with its implementation were identified. Rehabilitation personnel, community stakeholders, and clients must work together to improve OBP implementation in public healthcare by combating the barriers identified in the study.
 Implications for practice
 This study has implications for rehabilitation service implementation in the iLembe district public healthcare sector. OBP was perceived to have more quality of life and health outcomes, which leads to implications for practice. There is a need to transition from the medical model with approaches only focusing on body structures and functions into approaches that consider all the components of health, such as the OBP. Even though there are barriers towards OBP implementation, rehabilitation personnel can still promote its implementation through inter-professional practice, continuous professional development and health promotion. Furthermore, there are implications for undergraduate programmes to equip undergraduates with the skills to implement OBP within under-resourced facilities.

Identical Instruction May Lead to Divergent Learning Outcomes: A Comparison of Changes in Learner Attitudes Towards Interprofessional Practice Following an Interprofessional Education Program

Identical Instruction May Lead to Divergent Learning Outcomes: A Comparison of Changes in Learner Attitudes Towards Interprofessional Practice Following an Interprofessional Education Program

Nurse-Led Care Coordination in a Transitional Clinic for Uninsured Patients With Diabetes.

The purpose of this article is to inform the reader of the practice of the registered nurse care coordinator (RNCC) within an interprofessional, nurse-led clinic serving uninsured diabetic patients in a large urban city. This clinic serves as a transitional care clinic, providing integrated diabetes management and assisting patients to establish with other primary care doctors in the community once appropriate. The clinic uses an interprofessional collaborative practice (IPCP) model with the RNCC at the center of patient onboarding, integrated responsive care, and clinic transitioning. Interprofessional, nurse-led clinic for uninsured patients with diabetes. Interprofessional models of care are strengthened using a specialized care coordinator. Care coordination is a key component in case management of a population with chronic disease. The RNCC, having specialized clinical expertise, is an essential member of the interdisciplinary team, contributing a wide range of resources to assist patients in achieving successful outcomes managing diabetes. Transitional care coordination, moving from unmanaged to managed diabetes care, is part of a bundled health care process fundamental to this clinic's IPCP model. In a transitional clinic setting, frequent interaction with patients through onboarding, routine check-ins, and warm handoff helps support and empower the patient to be engaged in their personal health care journey.

Improving self-efficacy in behavioral health through interprofessional education.

Interprofessional education (IPE) is important in preparing health profession students to practice in a workforce dependent on teamwork and collaboration. Many health profession students graduate without ever having active shared learning experiences in the academic setting. Opportunities for students to participate in activities that promote self-efficacy in competencies related to interprofessional collaborative practice are essential. The purpose of the project was to assess health profession students' perception of self-efficacy related to the core competencies of IPE. The project used a pre/post quantitative survey research design comprising a sample of students enrolled in clinical practicums in behavioral health care settings. Using standardized patients, students participated in timed simulated encounters. Participants ( n = 36) completed the 16-item Interprofessional Education Collaborative Competency Self-Assessment Tool on conclusion of the learning activity. Survey responses were scored on a 5-point Likert-type scale, with high scores indicating a stronger level of agreement of perceived self-efficacy. On the postsurvey, most items were rated as "agree" or "strongly agree." Item means ranged from 4.64 to 4.81. A positive association was found between students' self-efficacy and the utilization of standardized patients within an interprofessional experiential learning activity. The intervention contributed to improving self-efficacy in interprofessional competencies related to collaborative interaction and values.

Readiness of Interprofessional Education on Maternal Health of Medical and Dental Students: A Mixed-Methods Study

Background: The high mortality rate and various health problems for maternal are of great concern in Indonesia. Oral and dental health of maternal receives less attention from both patients and health workers. The need for collaborative practices between doctors and dentists to optimize the health care of maternal. Interprofessional education is prepared to form medical and dental practitioners who are ready to interprofessional collaboration practice. Therefore, careful preparation is needed so that the learning process goes well and produces the desired results.This study aims to analyze the readiness of interprofessional education on maternal health among medical and dental students.Methods: This study was used mix methods. The cross-sectional quantitative method uses the questionnaire of readiness interprofessional learning scale (RIPLS) which has been modified and validated by Tyastuti (2014), containing 3 sub-scales. The qualitative method uses case studies with focus group discussions of student representatives.Results: There were 139 medical students and 49 dentistry students, both of whom had good readiness respectively 65,51 and 66,45 with a p value of 0,175. There was no significant difference in IPE readiness between the two. Good IPE readiness shows the development of teamwork, a good impression of IPE. However, there are problems that must be corrected such as bad attitudes and perceptions as well as problems in the field during home visits.Conclusion: Medical students and dental students have good readiness for maternal health of IPE, proven to give a good impression and establish teamwork. However, it still needs improvement to be even better.

Interprofessional Collaborative Practice in Professional and Residency Athletic Training Programs: A Report from the Association of Athletic Training Education Research Network

Context Interprofessional collaborative practice (IPCP) is a required component of athletic training education, yet more needs to be learned about how professional and residency programs integrate IPCP into their curricula. Objective Identify current strategies used in the integration, assessment, and quality of IPCP clinical experiences in athletic training programs. Design Cross-sectional survey. Patients or Other Participants Forty-two of the 288 (14.6% response rate) invited individuals participated. All reported being faculty members affiliated with a professional or residency athletic training program. Data Collection and Analysis The IPCP implementation and assessment was e-mailed to all accredited professional and residency program directors to evaluate: (1) institutional or organizational support for and integration of IPCP; (2) faculty, learner, or preceptor preparation for IPCP engagement; and (3) tools for assessment and quality of IPCP experiences. Survey instrumentation was validated through peer and expert review. Descriptive statistics were calculated for quantitative data, and open coding was used to analyze open-ended questions. Results Respondents reported favorable support from their institution or organization (administrative, financial, and organizational structure) to integrate IPCP experiences. The most common methods for IPCP implementation included clinical simulations (n = 22, 22.9%), grand rounds (n = 13, 13.5%), morbidity and mortality conferences (n = 3, 3.1%), journal clubs (n = 6, 6.3%), direct patient care (n = 14, 14.9%), and intentional clinical education experiences (n = 28, 29.2%). Respondents reported formal IPCP training for faculty (n = 7, 16.7%) and learners (n = 23, 54.8%) but not for preceptors (n = 25, 73.5%). While programs assess their learners’ IPCP experiences (n = 25, 59.5%), the quality of those experiences is not formally captured (n = 19, 45.2%). Conclusion(s) Interprofessional collaborative practice experiences within athletic training education continue to evolve. As such, in this study, we highlight the need for formalized training in IPCP for faculty, learners, and preceptors. Additionally, program faculty should consider implementing quality assessments of IPCP experiences to assess the quality and degree to which learners experience interprofessional collaboration.

Perception Of Socialization In Interprofessional Practice Among Healthcare Professionals At Tertiary Healthcare Facility

Objective: To analyze the perceptions of health care professionals from a variety of fields (Anesthesia, Radiology, Gynecology, Surgery, and Orthopedics) on inter-professional socialization in a clinical setting to determine any potential disparities between educational training and to identify gaps. Method: After obtaining ethical approval and informed consent, a cross-sectional study was conducted from April to June 2023 on 150 Healthcare professionals (Residents of Anesthesiology, Radiology, Gynaecology & Obstetrics, General Surgery and Orthopedics) working at CMH/PEMH. Consecutive non-probability sampling was utilized to collect the data. A close-ended questionnaire with interprofessional socialization and valuing scale was administered to the participants, providing proper instructions through hard copy and Google Forms. Data was analyzed by using SPSS version 25. Descriptive statistics were applied. Results: Study results revealed that participants developed a recognition of the advantages of inter-professional collaboration with the highest score of valuing patient-centred care followed by self-perception of team responsibility and the lowest score of comfort in working with others. Conclusion: This research gives a unique perspective on the experiences of health science professionals from various fields (Anesthesiology, Gynecology, Orthopedics, Radiology, and Surgery) in Interprofessional socialization. Keywords: Interprofessional Socialization and Valuing Scale, Interprofessional Education, Healthcare professionals

Interprofessional education for the next 50 years

Over the past two decades, there have been important changes to interprofessional education in Australia and New Zealand. Interprofessional education has slowly shifted from peripheral, small-scale education activities attended by volunteer students to become an expectation of many health professional courses to meet accreditation requirements and community expectations of a collaborative healthcare system. In Australia, interprofessional education curricula have been facilitated by increased accreditation expectations and a series of national large-scale funded projects. However, despite declarations of intent and direction, strategic implementation of nationwide recommendations has not been achieved. In New Zealand, large-scale funding has not been available to facilitate the implementation of interprofessional education in the professional courses. Instead, interprofessional education initiatives have been driven by a small group of champions. Furthermore, efforts to achieve the World Health Organization’s (2010) vision of interprofessional education across the education spectrum—to ensure the future and current health workforce have the competencies for interprofessional collaboration—have been hampered in our region by the focus on interprofessional education within tertiary education. This paper outlines the transnational status of interprofessional education and the role of the Australian and New Zealand Association for Health Professional Educators (ANZAHPE) and the Australasian Interprofessional Practice and Education Network (AIPPEN) in progress to date. We conclude with several suggestions for future interprofessional education across our two countries.

Interprofessional practice and person-centred care: moral contexts and ethical conflicts in the US and Canada

Health and social care services and systems increasingly promote both interprofessional practice and person-centred care. This discussion first examines the clinical and community-based contexts for providing interprofessional practice and person-centred care through the lens of personal, interpersonal, interprofessional and organisational values. Emerging conflicts among values are highlighted using the concept of moral distress, with examples from US and Canadian settings. The comparison then moves to the systems level, examining different US and Canadian contexts for improving the quality and reducing the cost of care. Finally, implications and applications are presented, focusing on interrelationships among the individual, interprofessional team and organisation.

The potential role of occupational therapy in the treatment of avoidant/restrictive food intake disorder.

Most individuals with avoidant/restrictive food intake disorder (ARFID) never receive treatment, and treatment needs far exceed the current capacity of mental health services. Occupational therapy (OT) focuses on enhancing function in daily activities, including eating and feeding. Given OT's rich history in mental health and pediatric feeding disorder treatment, we spotlight the potential role of OT in ARFID treatment, current knowledge, and opportunities for future research. Through a preliminary exploratory inquiry involving a review of current literature and clinical practice, we investigated OT's current involvement, knowledge, and interprofessional collaborative practice gaps in ARFID treatment. While many occupational therapy practitioners (OTPs) engage in ARFID treatment, interventions lack rigorous evaluation, and there is limited evidence defining OT's distinct role in interprofessional ARFID treatment. OTPs are uniquely positioned to provide interventions for individuals with ARFID across the lifespan, though research is needed to evaluate the efficacy of OT interventions. Future research suggestions include standardizing OT approaches to ARFID treatment and conducting single-case experiments and randomized controlled trials to compare OT approaches with alternative methods. Recommendations to address practice gaps include enhancing ARFID education for OT students and practitioners and fostering a greater understanding of OT's role on the interprofessional team. PUBLIC SIGNIFICANCE: Individuals with ARFID face barriers to eating that impact their health and function. On a multidisciplinary team, OTPs can treat diverse client populations by identifying and addressing barriers to daily participation, such as physical impairments, trauma history, and environmental barriers. More research is needed to evaluate the efficacy of OT practices in ARFID treatment.

Outcomes of an Interprofessional Opioid Training Program for Graduate Students in Nursing and Social Work

ABSTRACT Social workers and other behavioral health professionals trained to provide prevention, treatment, and recovery services for opioid use disorders (OUD) remain urgently needed in the U.S. particularly in states with widespread health professional shortage areas. To help mitigate this workforce gap, faculty in social work and nursing at a public university in Alabama developed and piloted an innovative HRSA-funded interprofessional traineeship to prepare graduate-level nursing and social work students to assess and treat opioid use disorders (OUD). The yearlong traineeship included specialized coursework on evidenced-based practice in addictions, interprofessional telemedicine and simulation training, and multi-semester field practica in outpatient treatment settings. Impact of the pilot training was evaluated using a pre-experimental one group design. Baseline and post-training surveys assessed knowledge, attitudes, and skills related to OUD and interprofessional practice and perceived program impact. Significant increases were observed for trainees’ self-reported knowledge, attitudes, and skills. Moreover, at graduation students reported that the traineeship had improved their abilities to interact with underserved populations, collaborate interprofessionally, and understand ethical issues in SUD treatment as well as enhancing their professional competence, clinical problem-solving, and health workforce skills. Findings suggest that the interprofessional training program may prepare social work and nursing graduate students to effectively serve clients with OUD and help to address a critical workforce gap in medically underserved communities.

When interprofessionalism also involves the patient: how to provide good healthcare beyond care

The prevalence of aging-related chronic diseases makes it necessary to change organizational structures. In order to facilitate the transformation of health systems, interprofessional care teams, patient engagement, and collaborative practice will be necessary. Patient-centered interprofessional care is a process based on the collaborative relationship between healthcare professionals, patients and caregivers, as a useful strategy to “develop a shared understanding of the problem and generate a mutually acceptable assessment and management of the care plan”. Everything must take place on a collaborative level, always respecting the different skills. Although the literature provides preliminary information to support the benefits of the patient-centered approach, transformational leadership and an organizational culture are needed to foster learning, research, and the implementation of innovative models to patient care. Furthermore, in the Italian healthcare reality, the aspects of practicability and “sustainability” of this model of care should be considered and the key elements, mechanisms and stages of development necessary for its possible implementation should be better defined.

The interprofessional practice experiences of final-semester prelicensure BSN students completing clinical immersion: A descriptive qualitative study

BackgroundThe goal of interprofessional practice experiences in health professions programs is to develop interprofessional collaborative practice skills. PurposeThe purpose of the study was to explore the meaning final-semester Bachelor of Science in Nursing students attributed to interprofessional practice experiences during clinical immersion. MethodsThe theoretical framework for this descriptive qualitative study was experiential learning theory. A sample of 12 participants was drawn from final-semester prelicensure Bachelor of Science in Nursing students at a college of nursing at a public research university. Data were collected through one-on-one semi-structured interviews and analyzed through inductive thematic analysis. ResultsThe analysis yielded four themes: professional and interprofessional identity, working with team members, communication practices, and trusting relationships. Patterns across themes were clinical environment culture, nursing school preparation, nurse preceptor role, fear/concern/worry, and night shift. ConclusionConsistency in preceptors, welcoming clinical environments, and opportunities to practice communicating with team members contributed to interprofessional collaborative practice skill development and improved perceptions of readiness for practice. Academic and clinical educators may use findings to (a) identify immersion placements for interprofessional practice experiences, (b) design curricula reflective of interprofessional practice, (c) advance teaching strategies to promote interprofessional practice, and (d) create learning environments that aid in professional and interprofessional identity formation.

The effectiveness of chronic disease management planning on self-management among patients with diabetes at general practice settings in Australia: a scoping review

BackgroundMedicare provides significant funding to improve, encourage and coordinate better practices in primary care. Medicare-rebated Chronic Disease Management (CDM) plans are a structured approach to managing chronic diseases in Australia. These chronic disease care plans are intended to be a vehicle to deliver guideline-based / evidence-based care.. However, recommended care is not always provided, and health outcomes are often not achieved. This scoping review aimed to identify the specific components of CDM plans that are most effective in promoting self-management, as well as the factors that may hinder or facilitate the implementation of these plans in general practice settings in Australia.MethodA comprehensive search was conducted using multiple electronic databases, considering inclusion and exclusion criteria. Two reviewers independently screened the titles and abstracts of the identified studies via Covidence, and the full texts of eligible studies were reviewed for inclusion. A data extraction template was developed based on the Cochrane Effective Practice and Organization of Care Group (EPOC) to classify the intervention methods and study outcomes. A narrative synthesis approach was used to summarize the findings of the included studies. The quality of the included studies was assessed using the JBI Critical Appraisal Checklist.ResultsSeventeen articles were included in the review for analysis and highlighted the effectiveness of CDM plans on improving patient self-management. The findings demonstrated that the implementation of CDM plans can have a positive impact on patient self-management. However, the current approach is geared towards providing care to patients, but there are limited opportunities for patients to engage in their care actively. Furthermore, the focus is often on achieving the outcomes outlined in the CDM plans, which may not necessarily align with the patient’s needs and preferences. The findings highlighted the significance of mutual obligations and responsibilities of team care for patients and healthcare professionals, interprofessional collaborative practice in primary care settings, and regular CDM plan reviews.ConclusionSelf-management support remains more aligned with a patient-centred collaboration approach and shared decision-making and is yet to be common practice. Identifying influential factors at different levels of patients, healthcare professionals, and services affecting patients’ self-management via CDM plans can be crucial to developing the plans.

Perceptions of interprofessional collaborative practice in South Africa: A systematic review.

Interprofessional education (IPE) and interprofessional collaborative practice (IPCP) were developed to address the health needs of communities through collaborative practice across healthcare disciplines. The impact of IPE on IPCP and clinical service delivery in South Africa is not evident, possibly because of the lack of IPCP experiences among healthcare professionals. International literature reports facilitators and barriers of IPCP implementation, but there was a need to filter the evidence to identify literature from the South African context regarding the perceptions of healthcare workers' perceived barriers and facilitators of IPCP. South African literature. A systematic review was conducted to synthesise evidence from articles published between January 2017 and December 2021. Only qualitative studies targeting health professionals in South Africa who had been exposed to IPCP were included. Consistent with Preferred Reporting Items for Systematic reviews and Meta-Analysis, a multi-database search yielded 424 articles, which were screened for relevance and appraised for quality using the Critical Appraisal Skills Programme (CASP) tool. A thematic synthesis of the findings was conducted by applying ethical principles. Synthesis of barriers and enablers for IPCP implementation in the South African context included key aspects of healthcare systems, management and team leadership. The integration of IPCP into clinical practice in South Africa is still limited as healthcare professionals operate in silos. Recommendations of this study include greater integration of services combined with competent management and visionary leadership, together with the incorporation of IPE into undergraduate professional training programmes.

Benefits of a ‘Psy-Curriculum’ for Theorising Interprofessional Practice Provision of School Support Services

Abstract School-based support services (SSS) professionals include social workers, counsellors and pastoral care teachers who assess and intervene upon issues affecting students’ well-being and academic success. However, SSS are seldom foregrounded in the psycho-socialisation processes of schooling, particularly as a site of interprofessional practice. Drawing on observational fieldwork in three Hong Kong schools, this study illustrates how SSS professionals assess and intervene upon an assemblage of risk concerns: students’ behaviours, afflictions and academic performance. By advancing the concept of psy-curriculum, this study examines the historical and structural conditions that shape contemporary SSS provision. Crucially, the psy-curriculum bridges the clinical practices of SSS with issues that concern inequity and anti-oppressive practice. This has implications for theorising the provision of interprofessional practice in schools, and the intersectoral policies (education, social welfare and health/mental health) that shape how SSS enact particular psychosocial interventions to support students.

Playing well with others: lessons from theatre for the health professions about collaboration, creativity and community

Despite collaboration among different professions being recognized as fundamentally important to contemporary and future healthcare practice, the concept is woefully undertheorized. This has implications for how health professions educators might best introduce students to interprofessional collaboration and support their transition into interprofessional, collaborative workplaces. To address this, we engage in a conceptual analysis of published collaborative, interprofessional practices and conceptual understandings in theatre, as a highly collaborative art form and industry, to advance thinking in the health professions, specifically to inform interprofessional education. Our analysis advances a conceptualization of collaboration that takes place within a work culture of creativity and community, that includes four modes of collaboration, or the ways theatre practitioners collaborate, by: (1) paying attention to and traversing roles and hierarchies; (2) engaging in reciprocal listening and challenging of others; (3) developing trust and communication, and; (4) navigating uncertainty, risk and failure. We conclude by inviting those working in the health professions to consider what might be gleaned from our conceptualization, where the embodied and human-centred aspects of working together are attended to alongside structural and organizational aspects.

Facilitators and barriers of empathetic behaviour in physiotherapy clinical practice: A qualitative focus group study

BackgroundEmpathy is an essential competence of a person-centered approach, and a recognisable ability for providing physiotherapy quality healthcare. Empathetic communication enhances the improvement of patient outcomes and their experience of treatment. ObjectiveThe aim of the study was to present further insights considering facilitators and barriers of an empathetic communication between patients and physiotherapists. MethodsA qualitative focus group study was designed according to COREQ guidance for qualitative studies. Two focus groups were conducted. The first group included six patients and two individuals from non-governmental organizations, whereas three physiotherapists, two academic physiotherapist personnel and two undergraduate physiotherapy students participated in the second group. Both groups were audio recorded, and all data was verbatim transcribed for coding thematic analysis. Results9 themes were revealed regarding empathetic facilitators (qualities of good communication, relationship building, interprofessional collaborative practice, positive environment, love for the healthcare profession and professionalism), while 8 themes were revealed regarding barriers (challenging situations, working conditions, burn out, depreciation of empathetic communication, lack of training, lack of professionalism, lack of personal development and health professionals’ own personal problems). Conclusion(s)The enhancement of empathy can be accomplished in a trustworthy relationship between patient and clinicians where the development of proficient communication skills are prioritized. However, hindering factors associated with health professionals, patients and the health system should be surmounted. Ethical approval number339-ΣΕ8/10-1-2020.

The Virtual Geriatric Assessment Interdisciplinary Team Project: Interprofessional Geriatric Training Against the Backdrop of COVID-19.

Interprofessional geriatric education programs enhance trainees' knowledge of older adults, and the valuable contributions health and social care practitioners make to their well-being when specialists work collaboratively. In response to the 2020 COVID-19 pandemic restrictions, in-person geriatric interprofessional education (IPE) programs were redesigned for virtual delivery. Nineteen virtual programs were held between September 2020 and December 2022. Of the 369 health and social care trainees who participated, 67.2% completed both pre- and post-program surveys. Survey instruments included the Interprofessional Collaborative Competency Attainment Survey (ICASS), which measures perceptions associated with patient-centered, team-based, collaborative care. Significant differences were obtained across ICASS domains, including communication, conflict management/resolution, and team functioning, suggesting that virtual programs may enhance attitudes and perceived abilities for interprofessional collaborative practice. Furthermore, participants' perceived understanding of older adult needs improved, as did their interest in geriatrics. Results illustrate that virtual geriatric interprofessional (IP) programs may be viable alternatives to in-person opportunities.

Occupational therapy practitioners’ experiences with interprofessional collaborative practice

ABSTRACT Although occupational therapists engage as part of interprofessional healthcare teams, explicit investigation into their experiences of interprofessional collaborative practice (IPCP) has not been explored. This study evaluated occupational therapists in the United States experiences of IPCP with additional inquiry into which healthcare professionals occupational therapy practitioners interact with and how they engage in collaboration, during IPCP. An exploratory cross-sectional study was conducted using an online survey; 142 occupational therapy practitioners responded. Quantitative data were analyzed using descriptive and bivariate analyses; open-ended responses underwent consensual qualitative analysis. Participants reported most often engaging in IPCP with physical therapists, speech-language pathologists, nurses, physicians, and case managers, although variations in the top five professions were evident between practice settings. In addition, 82% of the respondents reported either feeling prepared or very prepared for IPCP after completing their pre-licensed educational programs. Two qualitative themes have emerged to describe key education-oriented and practice-oriented interprofessional experiences. To further enhance engagement in and preparedness for IPCP, occupational therapy professionals, and students may benefit from interprofessional training that involves the professions most often encountered during clinical practice. This type of learning could foster an understanding of communication and teamwork, thus enhancing readiness to participate in the IPCP team upon transition to practice.