Interprofessional Working Research Articles

Collaboration between instructional designers and subject matter experts in digital transformation projects

The rapid adoption of online learning during the Covid-19 pandemic and digital transformation associated with new tools and technologies has driven the demand for interprofessional collaboration within the education sector. It is now commonplace for Instructional Designers (IDs) and Learning Technologists (LTs) to work alongside Subject Matter Experts (SMEs) when creating online learning content. Although the professional practice of an ID may vary, the collaborative approach to working with SMEs is similar across sectors. Typically, the role of the SME is to impart expert domain knowledge, skills or behaviours. An ID captures this information and creates a learning experience using pedagogical expertise and design skills. This relationship is not without friction and can be complex and challenging to navigate. Research often focuses on the experiences of SMEs and suggests a simple resolution to avoid conflict; clearly define each agent’s role in writing. However, this is not a clear-cut solution. Detailed guidance for IDs is lacking, and conflicts still exist. This study aimed to gain a deeper insight into the interprofessional working relationship between IDs and SMEs. A series of semi-structured interviews were conducted, which looked through the lens of relational working theory and focused on the perspective of the ID. Key themes were identified and aligned with the core concepts of the relational working framework. Findings show that a communication breakdown can negatively impact a project, resulting in power struggles and the delivery of subpar content. The discussion highlights how the application of the relational working framework could be used to strengthen and ease tensions between SMEs and IDs.Keywords: instructional designers; subject matter experts; relational working theory; relational working framework; digital transformationPart of the Special Issue Teaching practices in times of digital transformation <https://doi.org/10.21428/8c225f6e.ac86609b>

Nursing actions in Primary Health Care to lesbian and bisexual women

Objective: to investigate the actions of nurses in regard to lesbian and bisexual women in the context of the National Policy for the Integral Health of Lesbians, Gays, Bisexuals, Cross-Dressers and Transgender Persons. Methods: qualitative study involving 25 nurses from the Family Health Strategy, contacted via electronic means. We applied a form containing sociodemographic data and an investigation of actions in primary health care, as well as a thematic content analysis. Results: we found there are professional capacitation activities, embracing of demands, and enhanced interprofessional work. Nonetheless, there were shortcomings in the knowledge regarding health care towards lesbian and bisexual women. Conclusion: there are still prejudices, difficulty to access, and little attendance of lesbian and bisexual women in health services, as well as a deficit in the support to health actions and lack of monitoring. Contributions to practice: the importance of the scientific, professional, and social experiences stand out, regarding the need to humanize the care to lesbian and bisexual women. It is a supporting material for researchers and nursing professionals, enabling them to direct their care to a holistic and integral care to be provided to these women, in addition to being an encouragement to further comparative studies.

Extending the dialogic space: developing interprofessional expertise through a student-created podcast

ABSTRACT Teachers must relate to practitioners from a range of professions, which represent different, sometimes conflicting, perspectives on teaching and learning. Thus, student teachers must develop the expertise to understand, challenge and make constructive use of the perspectives of other professionals. From a socio-cultural perspective, this study investigates how a student-created podcast emerges as an arena and genre for interprofessional work in teacher education. Interaction analysis was used to examine student teachers’ engagement with perspectives provided by professionals from the ed-tech sector. The results demonstrate how the student-created podcast affords dialogic spaces for developing interprofessional expertise in teacher education.

Interprofessional collaboration experience among healthcare professionals providing emergency obstetric and neonatal care in Rwanda. A qualitative descriptive case study

IntroductionInterprofessional collaboration (IPC) is essential in all health care services delivery including maternity care, particularly in emergency obstetric and neonatal care (EmONC). Ideally, the obstetric team would work together in dynamic and complex situations to deliver quality care and achieve optimal patient outcomes. The current study explored IPC experience among healthcare providers working in maternity service and providing EmONC in Rwanda. The purpose was to understand from clinicians’ perspectives the benefits and barriers to achieving effective collaboration while managing EmONC. MethodA qualitative descriptive case study was conducted in five district hospitals in the Northern province of Rwanda. The study involved 25 healthcare professionals, including nurses, midwives, medical doctors, and non-physician anesthetists working in maternity units from selected district hospitals. FindingsParticipants highlighted several benefits of effective IPC, such as reducing maternal and neonatal mortality and morbidity, reducing stress, and better-quality service delivery in general. However, participants expressed challenges to successful IPC related to power relation issues affecting communication and other IPC competencies. Also, a stressful work environment characterized by a shortage of staff and lack of necessary resources was identified as a barrier to effective IPC. Conclusionand recommendations: IPC is an important aspect to consider in delivering quality EmONC since failure in effective IPC can lead to compromised patients’ outcomes and increased stress among healthcare providers. Therefore, it is imperative that policymakers, health professional educators, and clinicians identify strategies to improve interprofessional working relationships and contribute to quality obstetric and neonatal care in order to achieve the best maternal and neonatal-related sustainable development goals in Rwanda.

Organ Donation and Transplantation: Contributions of Professionals on Interprofessional Work in Programs

Objective: This study aimed to identify the contributions for improvement in the interprofessional working relationship pointed out by professionals involved in organ and tissue procurement and transplantation programs. Method: exploratory study with a quanti-qualitative approach conducted over a period of 21 months, with the participation of health professionals invited to complete an online questionnaire on the Google form platform. After collection, the quantitative data were organized and analyzed descriptively, and the qualitative data were categorized and submitted to content analysis. Results: 130 health professionals participated in the study, 84% were female, of which 64% said they were white, between 41-59 years old, and 31% had worked for more than 15 years in the programs. The categories identified were: working conditions; appreciation of non-medical professionals; psychological support to professionals and funding for training of professionals pointed out as improvements in the work relationship in the programs. Conclusion: the study identified that working conditions and greater valorization of the interprofessional team allied to offering psychological support to professionals are necessary and important strategies, and may bring impacts on the satisfaction of professionals, on mental health, in addition to improvements in work processes, impacting transplantation rates.

Insights Into Learning Among Physical Therapy, Medical, and Nursing Students Following a Simulation-Based, Interprofessional Patient Safety Course.

As the need for a strong interdisciplinary approach in the delivery of healthcare services becomes increasingly vital, interprofessional education (IPE) is essential to equip healthcare professionals of the future to deliver better care. IPE encounters using simulation-based education can be a powerful tool in inculcating pre-professional students with foundational tools for successful interprofessional work. This qualitative study explores the learning that occurs during IPE encounters that include nursing, physical therapy, and medical students. The results of this work highlight how important IPE encounters are in uncovering and changing cross-disciplinary notions about knowledge, skills, role, and team contributions. Specifically, our analysis demonstrated that there are common misunderstandings about contemporary roles, knowledge, and skills of physical therapists among both nursing and medical students that can be corrected in IPE encounters. Results also demonstrated that careful planning can bolster opinions of the value of activities embedded as part of a larger course. Moreover, planning and attention to the specific educational needs of all students may prevent any group feeling that their educational needs were not fully met across all disciplines. The findings support the consideration that IPE can be an important method to instill foundational interprofessional knowledge, skills, and attitudes to promote a foundation from which to establish strong career-long interprofessional collaborations. It is important to lay foundational interprofessional skills and appreciation of the 'other' in pre-licensure curricula, but these efforts should not be limited to only pre-licensure programs and need also to be included as part of on-going professional development education, especially as healthcare education, roles, and responsibilities evolve.

Knotworking — not working: Interprofessional collaboration and co-figuration of pre-service special education teachers

ABSTRACT The growing expectations and demands for teacher education highlight the need to provide future teachers with more knowledge and to prepare teachers as expert collaborators who can learn from each other. This qualitative case study based on video-recorded reflective assignments investigated how Finnish pre-service special education teachers’ experiences in relational interprofessional work within institutional boundary spaces – the so-called knotworking – contributed to the evolution of their professional agency. The results indicate that interprofessional collaboration during teacher education was challenging and orienting themselves as students was the principal way teachers negotiate their role within boundaries.

Interdisciplinary Education Involving Chronic Pain Management: The Way Forward

Through evidence-based research and practice, interdisciplinary/interprofessional pain management is becoming the leading treatment structure for patients suffering with chronic pain conditions. Interdisciplinary assessment and management of patients incorporate different healthcare disciplines working together under ‘one roof’ to manage their patients in a collaborative and team-based manner. As such, understanding how to work within an interdisciplinary framework, entails educational resources to pass on the knowledge surrounding interprofessional clinical work. There are numerous philosophies and theories underlying why and how interdisciplinary education should be administered in addition to the reasons why these approaches appear to be of benefit. Ultimately, with reference to chronic pain management, interdisciplinary education combining students from different healthcare fields in one class is suggested to enhance the learning experience and ultimate goal of eventually providing their patients` with the best possible pain outcomes following intervention.

Patient care, integration and collaboration of physician associates in multiprofessional teams: A mixed methods study.

The aim of the study was to explore the physician associate role in patient care, integration and collaboration with team members, within the hospital setting. Convergent mixed methods case study design. Questionnaires with some open-ended questions and semi-structured interviews were analysed with descriptive statistics and thematic analysis. Participants included 12 physician associates, 31 health professionals and 14 patients/relatives. Physician associates provide effective, safe and, importantly, continuity of care and patients received patient-centred care. Integration into teams was variable, and there was a lack of knowledge about the physician associate role amongst staff and patients. Views towards physician associates were mostly positive, but support for physician associates differed across the three hospitals. This study further consolidates the role of physician associates to multiprofessional teams and patient care and emphasises the importance of providing support to individuals and teams when integrating new professions. Interprofessional learning throughout healthcare careers can develop interprofessional working within multiprofessional teams. Leaders in healthcare will see that clarity about the role of physician associates must be given to staff members and patients. Employers and team members will see the need to properly integrate new professions and team members within the workplace and to enhance professional identities. The research will also impact on educational establishments to provide more interprofessional training. There is no patient and public involvement.

Effects of student-led drama on nursing students' attitudes to interprofessional working and nursing advocacy: A pre-test post-test educational intervention study

BackgroundNursing educators need to equip students to work in interprofessional teams and advocate for patients in increasingly integrated health and social care settings. Drama-based education has been used in nursing to help students understand complex concepts and practices, including communication, empathy, and patient safety. However, few studies have evaluated drama-based education to promote understanding of interprofessional care and advocacy, and none have involved student-led drama where students create dramatic performances to support learning. ObjectivesTo examine the effects of student-led drama on student nurses' attitudes to interprofessional working and advocacy. DesignPre-test post-test educational intervention study. SettingsPublic university in Scotland. Participants400 undergraduate student nurses enrolled on a 15-week module focussed on health and social care integration and interprofessional working. MethodsStudents completed paper questionnaires at the start (n = 274, response rate: 80.1 %) and end (n = 175, 63.9 %) of the module. Outcome measures were the validated Attitudes Towards Healthcare Teams Scale (ATHCTS) and Protective Nursing Advocacy Scale (PNAS). Change in mean ATHCTS and PNAS scores were assessed using paired samples t-tests, with Cohen's d to estimate effect size. ResultsATHCTS scores significantly increased from 3.87 to 4.19 (p < 0.001, d = 0.52). PNAS scores increased from 3.58 to 3.81 (p < 0.001, d = 0.79), with significant improvements in the ‘acting as an advocate’ (4.18 to 4.51, p < 0.001, d = 0.81) and ‘environmental and educational influences’ subscales (3.79 to 4.13, p < 0.001, d = 0.75). Statements focussed on promoting holistic, dignified care and enabling health professionals to be responsive to emotional and financial needs of patients, showed greatest change. ConclusionsEducation based on plays created and performed by student nurses led to significant improvements in student nurses' attitudes towards interprofessional working and nursing advocacy. Student-led drama should be embedded in nursing curricula to enable students to understand the realities and complexities of health and social care integration and interprofessional working.

‘Not the last resort’: The impact of an interprofessional training care home initiative on students, staff, and residents

ABSTRACT This paper reports on an innovative interprofessional education (IPE) initiative conducted in three care homes across Greater Manchester in the United Kingdom (UK). Students from a variety of professions including nursing, physiotherapy, social work, podiatry, counseling, and sports rehabilitation worked collaboratively in the homes to address the residents’ individual goals. We found that care homes provided students with many opportunities for interprofessional working and learning. Through better understanding the dimensions of different perspectives and approaches, students improved their education and transformed their perceptions of aged care. Having a diverse range of professionals allowed staff to gain insight into the latest evidence-based practice and address the multiple needs of the residents more holistically. Residents gained an enriched sense of meaning and purpose in their daily life by engaging in fulfilling and meaningful activities. The complexities of undertaking an IPE initiative in this setting are also considered and we conclude by proposing important avenues for future research.

Comunicação interprofissional e participação do usuário na Estratégia Saúde da Família

Abstract This study deals with collaborative competencies to strengthen teamwork and interprofessional collaboration in Primary Health Care services, supported by the framework of the health work process, interprofessional work and competencies. Its objective is to understand the conceptions and experiences of professionals from the Family Health Strategy teams regarding the core collaborative competencies: interprofessional communication and patient-centered care. This is an exploratory and interpretative qualitative study. A secondary database was used, with 34 interviews conducted with professionals from the teams of three health units located in two municipalities. Thematic content analysis was adopted, with support by the WebQDA software. The findings show the professionals’ understanding of collaborative competencies as complementary and as impossible to being treated independently. Interprofessional communication is recognized as a focus on meeting the user’s health needs, limited by unsatisfactory working conditions. Patient-centered care appears weak, since the sense of user participation prevails as a transfer of responsibility for their care to professionals and in a minority way, as sharing the construction of the care plan.

“I loved it, absolutely loved it” a qualitative study exploring what student podiatrists learn volunteering as part of an interprofessional medical team at a marathon

BackgroundFinal year podiatry students volunteer annually as part of the wider interprofessional medical team at both the Brighton and London Marathon race events, supervised by qualified podiatrists, allied health professionals and physicians. Volunteering has been reported to be a positive experience for all participants and a way of developing a range of professional, transferable, and where appropriate, clinical skills. We sought to explore the lived experience of 25 students who volunteered at one of these events and aimed to: i) examine the experiential learning reported by students while volunteering in a dynamic and demanding clinical field environment; ii) determine whether there were elements of learning that could be translated to the traditional teaching environment in a pre-registration podiatry course.MethodsA qualitative design framework informed by the principles of interpretative phenomenological analysis, was adopted to explore this topic. We used IPA principles to enable analysis of four focus groups over a two-year period to generate findings. Focus group conversations were led by an external researcher, recorded, independently transcribed verbatim and anonymised prior to analysis by two different researchers. To enhance credibility, data analysis was followed by independent verification of themes, in addition to respondent validation.ResultsIn total, five themes were identified: i) a new inter-professional working environment, ii) identification of unexpected psychosocial challenges, iii) the rigors of a non-clinical environment, iv) clinical skill development, and v) learning in an interprofessional team.SummaryThroughout the focus group conversations, a range of positive and negative experiences were reported by the students. This volunteering opportunity fills a gap in learning as perceived by students, particularly around developing clinical skills and interprofessional working. However, the sometimes-frantic nature of a Marathon race event can both facilitate and impede learning. To maximize learning opportunities, particularly in the interprofessional environment, preparing students for new or different clinical settings remains a considerable challenge.

KNOWLEDGE AND ATTITUDES OF BACCALAUREATE SOCIAL WORK STUDENTS ABOUT INTERPROFESSIONAL COLLABORATION IN CANADA

Although interprofessional collaboration is a common expectation in social work employment, interprofessional education has not been a robust feature of baccalaureate social work preparation in Canada. There is also a dearth of research on the topic. These gaps are problematic because social workers with baccalaureate degrees are often employed in interprofessional teams in various health care settings in Canada. To address this gap in knowledge, this mixed methods study explores attitudes toward interprofessional collaboration of social work students in a Canadian undergraduate university. Also, the study evaluates the students’ knowledge acquisition of interprofessional competencies after a single interprofessional education event. Findings indicate a positive change in students’ attitudes and enhanced knowledge of the interprofessional care competencies. The study contributes to the limited body of research on interprofessional education of baccalaureate-level social work students in Canada. It also shows the power of a single interprofessional experiential event in benefiting professional education of future social work professionals.

Public health reimagined

AbstractThis essay offers a critical assessment and reflection on the field of public health based on policy directions and themes gleaned from the historical story of John Snow and the Broad Street pump in 19th century London and recent international responses to Covid‐19. Dominant public health strategies, especially for infectious disease emergencies, demonstrate a persistent tendency towards authoritarian claims about science that marginalise concerns about human rights, showing disregard for interprofessional and partnership working, antipathy toward critical voices and a retreat into old ideas about death and dying as medical failure. There is also neglect of the fundamental importance of social relationships as a primary source of health and well‐being. Recommendations for a more positive approach for the future of public health are made. These include restoration of, and recommitment to, partnership working with communities, experiential literacy, the prioritising of social support and incentives over negative sanctions, and the acknowledgement and support of end‐of‐life experiences as a focus for special and overdue public health attention. These suggestions advocate for the application of ‘new’ public health priorities to address and rebalance the limitations of the old, usual approach.

Current Status and Challenges of Interprofessional Work to Promote Independence in Excretion among Older People Requiring Care and Living in Provincial Cities;

Current Status and Challenges of Interprofessional Work to Promote Independence in Excretion among Older People Requiring Care and Living in Provincial Cities;

Characteristics of Interprofessional Work in Special Nursing Home Unit Care Extracted From Multidisciplinary Focus Group Discussions

Characteristics of Interprofessional Work in Special Nursing Home Unit Care Extracted From Multidisciplinary Focus Group Discussions

School Nurse Perspectives of Working with Children and Young People in the United Kingdom during the COVID-19 Pandemic: An Online Survey Study.

School nurses are public health specialists with an integral role in the safeguarding of children and young people. This study gathered information about school nurses' approaches to overcome practice restrictions as a result of COVID-19. A cross-sectional survey was administered to school nurses across the United Kingdom. Quantitative data were analysed descriptively. Qualitative data (free-text responses to open-ended questions) were analysed using reflexive thematic analysis. Seventy-eight participant responses were included in the analysis. Quantitative data highlighted increased workloads; decreased contact with service users; and difficulties in identifying safeguarding needs and working with known vulnerable children. Through qualitative data analysis, five themes were identified: a move from preventive to reactive school nursing; professional challenges of safeguarding in the digital context; the changing nature of inter-professional working; an increasing workload; and reduced visibility and representation of the child. The findings call for advocacy by policymakers and professional organisations representing school nurses to enable this professional group to lead in the evolving public health landscape; for commissioning that recognises the school nurse as a specialist public health practitioner; and for sufficient numbers of school nurses to respond to the emergent and ongoing health needs of children and young people.

Using the PDCA cycle to uncover sources of mental health disparities for Hispanics.

The Hispanic population is growing rapidly in U.S. rural states, yet limitations in Spanish-speaking behavioural health providers are a barrier to accessing care. In Montana, a new immigrant destination, mental health disparities may not yet be fully understood. We describe an interprofessional approach of nurses and engineers using the Plan-Do-Check-Act (PDCA) cycle to identify disparities in mental health access in a Hispanic community in a rural state. We recruited a community advisory board to inform researchers about potential disparities and to design interventions. The Plan phase consisted of naming the problem and its root causes. Researchers and a community advisory board created flowsheets and diagrams to uncover personal, environmental, political, and procedural contributors to poor mental health outcomes. The Do phase included implementation of a community screening for depression and anxiety. The Check phase revealed 43 mental health screenings where 21% screened positive for depression and 16% screened positive for anxiety. We made 16 referrals to a mental health intervention study. The Act phase led to plans for regular implementation of the health fairs and a study designed to provide Spanish-language mental health services. The success of our interprofessional work provides an example of how the PDCA cycle can be used to uncover potential causes for poor health outcomes and design and evaluate interventions targeted to mitigate those outcomes.

Programa de entrenamiento basado en TeamSTEPPS® mediante simulación clínica en profesionales de cuidados intensivos: un estudio con metodología mixta

IntroductionThe Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) programme has been shown to improve interprofessional work among healthcare professionals by enhancing teamwork. Intensive care professionals were trained in this methodology through the course «Simulation Trainer: Improving Teamwork through TeamSTEPPS®». ObjectivesTo analyse the teamwork performance and good practice in simulation of the intensive care professionals attending the course and to explore their perceptions of the training experience carried out during the course. MethodsA cross-sectional descriptive and phenomenological study was carried out using a mixed methodology. The 18 course participants were administered the questionnaires «TeamSTEPPS™ 2.0 Team Performance Observation Tool» to evaluate teamwork performance and «Educational Practices Questionnaire» for good practices in simulation after the simulated scenarios. Subsequently, a group interview was conducted through a focus group with 8 attendees using the Zoom™ videoconferencing platform. A thematic and content analysis of the discourses was carried out using the interpretative paradigm. Quantitative and qualitative data were analysed using IBM SPSS Statistics™ 27.0 and MAXQDA Analytics Pro™, respectively. ResultsBoth the level of teamwork performance (mean = 96.25; SD = 8.257) and good practice in simulation (mean = 75; SD = 1.632) following the simulated scenarios were adequate. The following main themes were identified: satisfaction with the TeamSTEPPS® methodology, usefulness of the methodology, barriers to methodology implementation and non-technical skills improved through TeamSTEPPS®. ConclusionsTeamSTEPPS® methodology can be a good interprofessional education strategy for the improvement of communication and teamwork in intensive care professionals, both at the care level (through on-site simulation strategies) and at the teaching level (through its inclusion in the students’ curriculum).