Multi-professional Training Research Articles

Evaluation of TALK© training for interprofessional clinical debriefing in Latin America

BackgroundHealthcare systems must adapt iteratively in response to external and local challenges while keeping patients and staff safe. Clinical debriefing is a cost-effective contributor to safety culture, facilitating learning and team adaptations that lead to improved processes, patient outcomes, and staff resilience. In the aftermath of the COVID-19 pandemic, an interest has emerged in adopting TALK© to guide clinical debriefing to promote safety, mutual support, and cultural change within healthcare teams in Latin American contexts. AimsTo evaluate the quality and applicability of TALK© debriefing training in Latin American settings and the willingness to debrief after an educational intervention. MethodsRetrospective and descriptive study, examining anonymous data collected over 18 months after completing a “TALK© Debriefing Course for Healthcare Professionals” face-to-face or online. Data collected included participant characteristics, course details, quality and applicability of the intervention, and willingness to debrief. ResultsFive hundred and forty-five participants were enrolled, most from Argentina and Mexico. The overall quality of the intervention scored 19.62/20 points, obtaining 4.86/5 points for applicability. There were no significant differences between virtual and face-to-face sessions.After the intervention, ≥93.76% of participants felt able to engage in clinical debriefing, and 97.06% reported willingness to debrief. ConclusionsDissemination of multi-professional clinical debriefing training in Latin America is feasible and easily scalable. The quality of the educational intervention was rated excellent in both virtual and face-to-face settings, supporting the value of remote educational diffusion. Most participants in this study intervention felt prepared and willing to debrief following the intervention.

Multidisciplinary team training in postpartum hemorrhage: impact on the use of blood products.

Compare the number of puerperal women submitted to blood transfusion before and after the implementation of a care protocol for postpartum hemorrhage (PPH) with multidisciplinary team training. Cross-sectional study in a university hospital, analyzing births from 2015 to 2019, compared the use of blood products before and after the adoption of a PPH protocol with multidisciplinary training. Between 2015 and 2019, there were 17,731 births, with 299 (1.7%) postpartum women receiving blood products and 278 postpartum women were considered for this analysis, 128 (0.7%) at Time 1 and 150 (0.8%) at Time 2. After the multiprofessional team training (T2), there was a difference in the complete use of the PPH protocol (use of oxytocin, misoprostol and tranexamic acid) (T1 = 5.1% x T2 = 49.5%, p≤0.0001). An individual categorized analysis revealed that, in the T2 period, there was lower use of blood component units per patient compared to T1 (Mann-Whitney, p=0.006). It should be noted that at T1 and T2, 54% and 24% respectively received two units of blood products. It is important to highlight that after the multidisciplinary team training for the PPH protocol, the goal of zero maternal death due to hemorrhage was reached. The adoption of a specific protocol for PPH, combined with the training of a multidisciplinary team, had an impact on the ability to identify women at high risk of hemorrhage, resulting in a decrease in the use of blood components.

Neonatal healthcare professionals’ experiences of intact cord resuscitation in the mother´s bed- an interview study

BackgroundIntact cord resuscitation in the first three minutes of life improves oxygenation and Apgar scores. The practise of intact cord resuscitation implies the umbilical cord still being connected to the placenta for at least one minute while providing temperature control and equipment for resuscitation. Healthcare professionals described practical challenges in providing intact cord resuscitation. This study aimed to explore neonatal healthcare professionals’ experiences of providing intact cord resuscitation in the mother’s bed.MethodAn interview study with an inductive, interpretative approach was chosen and analysed according to reflexive thematic analysis by Braun & Clarke. An open interview guide was used and 20 individual interviews with neonatal healthcare professionals were performed. The study was conducted at five level I-III neonatal care units. In Sweden, resuscitation is performed either in or outside the labour room.ResultsThe results contributed insight into the participants’ experiences of prerequisites for providing neonatal care in intact cord resuscitation. The sense of the mother’s vulnerability was noticeable, as the participants reported reducing the risk of exposure to protect and preserve the mother’s integrity. The practical challenges in the environment involved working in a limited space. The desire for multi-professional team training comprised education and training as well as debriefing to manage intact cord resuscitation.ConclusionThe result of the present study highlights the fact that neonatal healthcare professionals’ experiences of providing ICR in the mother’s bed were positive and had significant benefits for the neonate, namely zero separation between the neonate and parents and better physical recovery for the neonate. However, the fact that ICR in the mother’s bed can be challenging in several ways, such as emotionally, managing environmental circumstances and ensuring effective team collaboration. Therefore, it is of the utmost importance that healthcare professionals are given the opportunity to reflect and train together as a team. Future recommendations are to summarize evidence-based knowledge to design guidelines for ICR situation.

The impact of a training intervention on knowledge, confidence and attitudes of professionals in a Community Acquired Brain Injury Service about assistive technology for cognition: a before and after survey

ABSTRACT Assistive Technology for Cognition (ATC) can help people to compensate for cognitive impairments following Acquired Brain Injury (ABI). Examples include mainstream devices such as smartphones, watches and environmental controls, and bespoke devices such as medication devices or specific educational software. Evidence suggests that professional support is key to people successfully adopting ATC, yet low confidence amongst clinicians and perceptions about barriers are often cited as reasons for not recommending ATC in practice. The objectives of this service evaluation were to evaluate the impact of an ATC training opportunity on the knowledge and confidence of staff and to explore staff perspectives of the barriers and enablers to implementation of ATC in practice. A survey was completed by 21 members of a Community Acquired Brain Injury Service before and after participating in an ATC training workshop. Survey findings highlighted that attitudes toward, and confidence with ATC, showed positive change after the training, whilst perceptions about barriers to implementation in practice reduced. Responses also highlighted the perceived importance of education for health professionals, service users and families as key enablers to successful implementation. Multi-professional training is therefore an important part of an implementation strategy for ATC.

Living Networks in Health during the covid-19 pandemic: Evaluation of the multiprofessional training course "Nós da Linha de Frente" in Manaus, Amazonas, Brazil

This article presents the evaluation of the therapeutic intervention course in situations of traumatic loss and grief, offered online by the Universidade do Estado do Amazonas, between April and August 2021, for volunteer professionals. A semi-structured questionnaire with open and closed questions was administered. The analysis of the 55 responses from volunteer professionals and 14 responses from individuals who received the intervention was based on the Kirkpatrick evaluation model. The results demonstrate the theoretical and practical success of the course, with a positive assessment at the reaction, learning, behavior, and results levels, emphasizing collective work and the motivation of the course speakers. The main acquired knowledge pertained to topics related to death and grief care. The behaviors resulting from the course fall within the affective-social and technical-professional domains. Regarding impact, there was a predominance of satisfaction among the individuals who received the intervention, as well as identification of changes brought about by the training.

The importance of simulation-based multi professional training in obstetric anesthesia: an update.

Simulation-based training remains an integral component of medical education by providing a well tolerated, controlled, and replicable environment for healthcare professionals to enhance their skills and improve patient outcomes. Simulation technology applied to obstetric anesthesiology continues to evolve as a valuable tool for the training and assessment of the multidisciplinary obstetric care team. Simulation-based technology has continued to play a role in training and assessment, including recent work on interdisciplinary communication, recognition, and management of obstetric hemorrhage, and support in the low or strained resource setting. The COVID-19 pandemic has accelerated the evolution of simulation-based training away from a reliance on in-situ or high-fidelity manikin-based approaches toward an increasing utilization of modalities that allow for remote or asynchronous training. The evolution of simulation for interdisciplinary training and assessment in obstetric anesthesia has accelerated, playing a greater role in aspects of communication, management of hemorrhage and supporting low or strained resource settings. Augmented reality, virtual reality and mixed reality have advanced dramatically, spurred on by the need for remote and asynchronous simulation-based training during the pandemic.

Educational technology for multidisciplinary training for managing waiting lists for elective patients.

to construct and assess an educational technology for managing patient waiting lists for multidisciplinary training. study supported by Instructional Design - ADDIE model, whose stages of construction of educational technology were developed in the form of a multi-professional training course. Its respective content assessment was carried out by a committee of experts from 2021 to 2022. The analysis occurred based on the proportion of content adequacy with 95% Confidence Interval. seventeen products were created as educational technology learning objects: five storyboards; four videos; three comic books; two pedagogical action plans; a mind map; and a YouTube® playlist. Nine experts assessed content adequacy, which reached 0.89. this educational technology contributes to the performance of professionals who manage waiting lists by reducing inequalities, alleviating differences, in addition to promoting equity in care and good health for patients in the Brazilian Health System.

Supporting maternity teams

The PROMPT Maternity Foundation aims to reduce preventable harm to mothers and babies in maternity care by making effective multi-professional training as widely available as possible

Collecting evidence of validity for an assessment tool for Norwegian medical students’ non-technical skills (NorMS-NTS): usability and reliability when used by novice raters

BackgroundThe NorMS-NTS tool is an assessment tool for assessing Norwegian medical students’ non-technical skills (NTS). The NorMS-NTS was designed to provide student feedback, training evaluations, and skill-level comparisons among students at different study sites. Rather than requiring extensive rater training, the tool should capably suit the needs of busy doctors as near-peer educators. The aim of this study was to examine the usability and preliminary assess validity of the NorMS-NTS tool when used by novice raters.MethodsThis study focused on the usability of the assessment tool and its internal structure. Three raters used the NorMS-NTS tool to individually rate the team leader, a medical student, in 20 video-recorded multi-professional simulation-based team trainings. Based on these ratings, we examined the tools’ internal structure by calculating the intraclass correlation coefficient (ICC) (version 3.1) interrater reliability, internal consistency, and observability. After the rating process was completed, the raters answered a questionnaire about the tool’s usability.ResultsThe ICC agreement and the sum of the overall global scores for all raters were fair: ICC (3,1) = 0.53. The correlation coefficients for the pooled raters were in the range of 0.77–0.91. Cronbach’s alpha for elements, categories and global score were mostly above 0.90. The observability was high (95%-100%). All the raters found the tool easy to use, none of the elements were redundant, and the written instructions were helpful. The raters also found the tool easier to use once they had acclimated to it. All the raters stated that they could use the tool for both training and teaching.ConclusionsThe observed ICC agreement was 0.08 below the suggested ICC level for formative assessment (above 0.60). However, we know that the suggestion is based on the average ICC, which is always higher than a single-measure ICC. There are currently no suggested levels for single-measure ICC, but other validated NTS tools have single-measure ICC in the same range. We consider NorMS-NTS as a usable tool for formative assessment of Norwegian medical students’ non-technical skills during multi-professional team training by raters who are new to the tool. It is necessary to further examine validity and the consequences of the tool to fully validate it for formative assessments.

A53Simulation equipment - What do you have? What do you do with it?

Educators and workforce planners appreciate that clinical skills development and simulation-based learning are key strategic responses to safe and effective service provision and a sustainable workforce. However, some simulation-based experiences require simulators costing tens of thousands of pounds. In order to promote a ‘Once for Scotland’ approach, collaboration is essential to encourage sustainability by enabling sharing of equipment, training materials, processes, procedures and faculty between boards. Although there have been other scoping exercises [1], we believe that this the first to take place at a national level. This scoping exercise aimed to: Establish what equipment is available in the territorial health boards; Clarify the types of skills-based courses being run across NHS Scotland; Connect and encourage collaboration between simulation providers Information was gathered via Teams discussions and questionnaires. The responses were collated into Excel spreadsheets. These have been linked into an application to present the data in a more user-friendly manner online ( Interactive map of simulation resources in Scotland Responses reveal that: All health boards in Scotland have invested in simulation-based learning. There is pioneering work with the establishment of medical and surgical bootcamps as well as national pharmacy simulation. Additional work needs to be carried out to ensure that resources are invested wisely to areas of greatest need and that resources are shared within and between health boards. It is clear where abundant simulation activities are taking place, as well as where there are gaps in equipment and faculty. Distribution of the information gathered will reduce duplication of effort, increase collaboration and encourage the sharing of equipment between health and social care workers across Scotland. It is hoped that this scoping project will support the creation of new relationships between people, not just for their mutual benefit, but for the benefit of the people of Scotland. The results are a first step to providing a detailed inventory of the resources available to help ensure best value for money. We hope to see an increase in the sharing of equipment across Scotland similar to the use of the NES surgical cut suit which was purchased by the Scottish Centre for Simulation and Clinical Human Factors and recently used by the simulation team at NHS Lothian to provide a multi-professional immersive paediatric training session. The plan is to update this database on a regular basis and to widen the results to incorporate all health boards as well as universities. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

Implementation of the Baby-Friendly Hospital & Community Initiatives in Europe: a scoping review

Abstract Background Promotion of and support for breastfeeding is essential for public health, to improve nutrition globally and save the lives of over 800,000 children annually. Since its launch in 1991, the Baby-Friendly Hospital Initiative (BFHI) has been implemented in 150 countries, to promote the ‘ten steps to successful breastfeeding', with the Baby-Friendly Community Initiative (BFCI), arising from the 10th step. Aim To synthesise evidence about BFHI and BFCI implementation in European countries. Methods This scoping review was conducted according to the Joanna Briggs Institute methodology for scoping reviews. Data were charted by country, study design, setting, study population, BFHI steps, study aim and objectives, intervention, results, barriers and enablers to implementation, evidence gaps, and recommendations. Qualitative and quantitative descriptive analyses were undertaken. Results A total of 278 articles were included in the review, of which 60 studies covered the implementation of the BFHI or BFCI in 18 European countries. Most studies were found from the UK (n = 11) Italy (n = 9) and Switzerland, Spain and Turkey (n = 6 each). Most were hospital-only based (n = 48) and most covered all ten steps of the BFHI (n = 44) and fewer BFCI (n = 4). Studies were carried out with health workers (n = 17), mothers (n = 34) and policy makers. Most studies were quantitative (n = 39) with many others designs used. Our charting of results highlights that effective implementation required political commitment, legislative and regulatory underpinning; support at organisational level; ongoing multi-professional leadership, education, training and teamwork, and effective education for women. Conclusions While contextual country-level factors are seen, there are clear patterns underpinning successful BFHI/ BFCI implementation, which can guide effective implementation. Funded by the Irish Research Council and Department of Foreign Affairs Ireland, grant number: COALESCE/2019/89 Key messages • Strong political and professional leadership is required to support the effective implementation of public health initiatives to support breastfeeding. • Ongoing, effective multi-professional education and training is required to support breastfeeding.

Definition, management, and training in impacted fetal head at cesarean birth: a national survey of maternity professionals.

This study assessed views, understanding and current practices of maternity professionals in relation to impacted fetal head at cesarean birth, with the aim of informing a standardized definition, clinical management approaches and training. We conducted a survey consultation including the range of maternity professionals who attend emergency cesarean births in the UK. Thiscovery, an online research and development platform, was used to ask closed-ended and free-text questions. Simple descriptive analysis was undertaken for closed-ended responses, and content analysis for categorization and counting of free-text responses. Main outcome measures included the count and percentage of participants selecting predefined options on clinical definition, multi-professional team approach, communication, clinical management and training. In total, 419 professionals took part, including 144 midwives, 216 obstetricians and 59 other clinicians (eg anesthetists). We found high levels of agreement on the components of an impacted fetal head definition (79% of obstetricians) and the need for use of a multi-professional approach to management (95% of all participants). Over 70% of obstetricians deemed nine techniques acceptable for management of impacted fetal head, but some obstetricians also considered potentially unsafe practices appropriate. Access to professional training in management of impacted fetal head was highly variable, with over 80% of midwives reporting no training in vaginal disimpaction. These findings demonstrate agreement on the components of a standardized definition for impacted fetal head, and a need and appetite for multi-professional training. These findings can inform a program of work to improve care, including use of structured management algorithms and simulation-based multi-professional training.

Training for managing impacted fetal head at caesarean birth: multimethod evaluation of a pilot

BackgroundImplementation of national multiprofessional training for managing the obstetric emergency of impacted fetal head (IFH) at caesarean birth has potential to improve quality and safety in maternity care, but is...

European Cancer Summit 2022 submission for Workforce NetworkInterprofessional education and training in cancer care – a scoping review

BackgroundOver the last decade, there has been increased interest to develop education and training initiatives to improve interprofessional collaboration and practice in the cancer care setting. There is a great variation on programmes and the teaching and learning methods used to implement interprofessional educational programmes. Moreover, there is a variation on the core competences guiding the development of the programmes. (1) Interprofessional health-care teams need to understand how to optimize the knowledge and skills of their members, share case management and provide better health-services to patients, families and the community. Educational and trainging interventions have demonstrated favorable results.The objective of this scoping review is to understand the extent and type of evidence in relation to interprofessional education in cancer care. The purpose was to identify how interprofessional education has been defined and methodology underlying the implementation of such an approach. The review is part of EU funded INTERACT-Europe project. MethodsWe conducted scoping literature review searching in CINAHL, MEDLINE (Ovid), PubMed, PsycInfo and Scopus databases from 2012 till 2022. Studies were included if had a focus on interprofesional education, development of interprofessional collaboration and teamwork through interprofesional, teaching, learning and assessment methods of interprofessional education in oncology setting. ResultsTwenty-four studies out of one hundred and fort nine were included in the review. In the reviewed studies and literature reviews the main concepts were weakly defined. Concepts used were interprofessional education and collaboration, interprofessional learning, team training and interdisciplinary education. Out of twenty four papers only in five description/definition was provided. Inter-specialty training was not used as a concept. Teaching and learning methods applied included lectures, case studies, interactive workshops, audiovisual materials, simulation, and shadowing. ConclusionThe results of this review summarise previous research and will guide the future development of inter-specialty training in cancer care. Multiprofessional, online, and simulation-based communication skills training for healthcare professional trainees can lead to significant changes in motivational beliefs, which are essential to promoting self-regulated learning.To provide optimal eduaction and training, these programs should be evaluated and improved regularly, and evaluation outcomes should include pre- and post-course surveys with a blinded selfperceived competency measures.These findings suggest that interprofessional education and training may enrich the learning experience in multiple ways.

Gestão da qualidade na pandemia de COVID-19: plano de ação da enfermagem

to describe the implementation of a nursing action plan to face the pandemic of COVID 19 in a University Hospital in the state of Rio de Janeiro. Methods: this is an experience report, in which two management tools were used: the Ishikawa Diagram to identify problems and the 5W2H spreadsheet to outline the actions according to the situations presented. four categories were listed in two groups: 1- Actions of the Nurse Manager in the Organization of Logistics, Infrastructure and Care: materials and environment; and 2- Nursing Human Resources Management and Continuing Education: method and human resources. the plan developed showed the role of nursing management, with the search for best care practices, development of protocols, carrying out multi-professional training and management of supplies.

Research on The Training Model of Financial Technology Talents Based on Interdisciplinary and Multi-Professional Integration

With the in-depth development of science and technology, the knowledge life cycle is shortened, and the society has more and more demand for compound talents who master multi-disciplinary and multi-professional knowledge, and it is difficult for traditional training methods such as major and minor, double degree, and large-category training (multi-compound training) to meet the needs of compound talent training in the new era. In view of this, we actively explore the talent training model of interdisciplinary and multi-professional integration, with the goal of exploring a new training model that meets the needs of interdisciplinary, multi-professional integration and innovative industry development, and implement the reform of interdisciplinary and multi-professional integration training and the pilot of multi-master sports personnel in industrial colleges by reconstructing the curriculum system, strengthening practical teaching, innovating training methods and organizational forms, and promoting the reform of financial technology talent training model.

A Managed Care System with Telemedicine Support for Neurological Emergencies.

Telemedicine is frequently used to provide remote neurological expertise for acute stroke workup and was associated with better functional outcomes when combined with a stroke unit system-of-care. We investigated whether such system-of-care yields additional benefits when implemented on top of neurological competence already available onsite. Quality improvement measures were implemented within a "hub-and-spoke" teleneurology network in 11 hospitals already provided with onsite or telestroke expertise. Measures included dedicated units for neurological emergencies, standardization of procedures, multiprofessional training, and quality-of-care monitoring. Intervention effects were investigated in a controlled study enrolling patients insured at 3 participating statutory health insurances diagnosed with acute stroke or other neurological emergencies. Outcomes during the intervention period between November 2017 and February 2020 were compared with those pre-intervention between October 2014 and March 2017. To control for temporal trends, we compared outcomes of patients with respective diagnoses in 11 hospitals of the same region. Primary outcome was the composite of up-to-90-day death, new disability with the need of ambulatory or nursing home care, expressed by adjusted hazard ratio (aHR). We included 1,418 patients post-implementation (55% female, mean age 76.7 ± 12.8 year) and 2,306 patients pre-implementation (56%, 75.8 ± 13.0 year, respectively). The primary outcome occurred in 479/1,418 (33.8%) patients post-implementation and in 829/2,306 (35.9%) pre-implementation. The aHR for the primary outcome was 0.89 (95% confidence interval [CI]: 0.79-0.99, p=0.04) with no improvement seen in non-participating hospitals between post- versus pre-implementation periods (aHR 1.04; 95% CI: 0.95-1.15). Implementation of a multicomponent system-of-care was associated with a lower risk of poor outcomes. ANN NEUROL 2023;93:511-521.

PROTOCOLS FOR MENTAL HEALTH CARE IN PRIMARY-LEVEL SERVICES: SUBSIDIES FOR TRANSFORMING THE ASSISTANCE PROVIDED

Objective: to analyze the repercussions on mental health care due to the implementation of Care Conduct Protocols in a Basic Health Unit from Juiz de Fora (Minas Gerais – Brazil). Method: a historical-social study carried out in 2018, having as direct sources written documents and oral testimonies analyzed according to the assumptions of the Psychiatric Reform. Results: the following categories are presented: a) Reorganization of mental health care through the implementation of Conduct Protocols; b) Referral and counter-referral process between Basic Health Units and specialized mental health care services; and c) Transformation of mental health care. Conclusion: the protocols organized the mental health care network, supporting multiprofessional training, introducing Primary Health Care as a gateway to welcoming, treatment and monitoring in territorial mental health.

131 Shoulder dystocia- overview and update

Introduction: Emergencies in maternity can have devastating consequences. Shoulder dystocia (SD) is arguably the most dreaded obstetric emergency. Already the definition of it troubles the obstetric community, none the less the still debated role of the clinician to mitigate the risk of injury. Aim: To update the knowledge with new evidence regarding Prevention and Management Techniques. To discuss the importance of simulated multi-professional training within maternity units for a better and safer performance and management of SD.

Interprofessional geriatric assessment in nursing home (IgAP): a curricular development in geriatrics.

The hallmark of medical action in geriatrics is the interprofessional treatment of the patient by a multi-professional team consisting of doctors, nurses and therapists with the aim of treating the patients primarily in a way that preserves their function and thereby enabling them to live as independently as possible. Therefore, at the beginning of every geriatric treatment, there is a multiprofessional geriatric assessment of functional abilities. With regard to successful medical action, this necessarily requires all health professions involved to understand geriatric patients and their limitations. Under ideal circumstances, their competencies overlap. From the point of view of the related disciplines, this means to teach working together with the other professions – interprofessionally – and learning from one another in order to effectively collaborate. After comparing the existing education in geriatrics within the Medical Curriculum Munich (MeCuM) with the European catalog of learning objectives for geriatricians (UEMS-GMS), a deficit with regard to geriatric assessment was recognized in the field of multi-professional training. Therefore, the existing geriatric curriculum of the Ludwig Maximilians University (LMU) in Munich should be expanded to include an interprofessional course on geriatric assessment. This project report aims to show the development and implementation of this course. For this purpose, the model for curriculum development according to Kern was used by the planners to establish an interprofessional briefing. Due to its innovative character, the course received public recognition and is the basis for the expansion of interprofessionalism in the sense of professional cooperation in geriatrics. Establishing interprofessionalism in other disciplines and locations is welcome.