Opportunities For Interprofessional Collaboration Research Articles

Perception of the compatibility of Quebec residency program characteristics with the advanced access model: a cross-sectional study

BackgroundThe advanced access (AA) model is among the most recommended innovations for improving timely access in primary care (PC). AA is based on core pillars such as comprehensive planning for care needs and supply, regularly adjusting supply to demand, optimizing appointment systems, and interprofessional collaborative practices. Exposure of family medicine residents to AA within university-affiliated family medicine groups (U-FMGs) is a promising strategy to widen its dissemination and improve access. Using four AA pillars as a conceptual model, this study aimed to determine the theoretical compatibility of Quebec’s university-affiliated clinics’ residency programs with the key principles of AA.MethodsA cross-sectional online survey was sent to the chief resident and academic director at each participating clinic. An overall response rate of 96% (44/46 U-FMGs) was obtained.ResultsNo local residency program was deemed compatible with all four considered pillars. On planning for needs and supply, only one quarter of the programs were compatible with the principles of AA, owing to residents in out-of-clinic rotations often being unavailable for extended periods. On regularly adjusting supply to demand, 54% of the programs were compatible. Most (82%) programs’ appointment systems were not very compatible with the AA principles, mostly because the proportion of the schedule reserved for urgent appointments was insufficient. Interprofessional collaboration opportunities in the first year of residency allowed 60% of the programs to be compatible with this pillar.ConclusionsOur study highlights the heterogeneity among local residency programs with respect to their theoretical compatibility with the key principles of AA. Future research to empirically test the hypotheses raised by this study is warranted.

Amplifying Access: Progress After 1 Year of Over-the-Counter Hearing Aids

Purpose: A number of barriers exist that limit access to hearing aids and services, including high cost, limited number of providers, and patients' perceived lack of need. The traditional model of hearing aid service delivery requires patients to undergo a hearing test, receive a medical evaluation or waiver, and receive a hearing aid fitting from qualified providers, such as a licensed audiologist. In an effort to improve access and affordability, the U.S. Food and Drug Administration recently established a new category of over-the-counter (OTC) hearing aids for adults with perceived mild–moderate hearing loss that can be purchased without the involvement of a professional. The purpose of this Viewpoint article is to reflect on the progress that has been accomplished in the inaugural year of OTC hearing aids. Conclusions: In the last year, hearing aids have become more readily available to consumers online and in stores. A number of companies have entered the OTC hearing aid market, leading to innovative designs and a variety of options for consumers. The regulations governing OTC hearing aids have also spurred increased attention on hearing care and created new opportunities for interprofessional collaboration. In addition, research has illustrated the real-world effectiveness of OTC hearing aids. Still, in some respects, the first year of OTC hearing aids has not met expectations. Evidence points to low adoption as well as misconceptions, including regarding the distinction between OTC and prescription hearing aids. Audiologists can play an important role in addressing misconceptions by increasing their own knowledge of the devices and talking about them with patients and in outreach activities. There are a number of outstanding needs, including to investigate U.S. consumers' satisfaction when using these devices long term and to evaluate the impact of OTC hearing aids in countries outside of the United States.

Exploring Interprofessional Collaboration in Teaching Between Nursing and Physical Therapy.

Integrating interprofessional concepts and competencies in the classroom teaches students to perform successfully in complex interprofessional care environments. There is little information regarding the effects of interprofessional collaboration in education utilizing faculty and students from other disciplines. Satisfaction and Self-Confidence in Learning Survey (SCLS) scores and written responses were collected from 31 nursing students to explore nursing students' perceptions of an interprofessional collaboration in teaching between nursing and physical therapist (PT) educators. Nursing students' SCLS scores were higher on days where PT educators participated in teaching students. Analysis of written responses revealed five themes: appreciation of an outside expert perspective, enhanced self-efficacy with patient mobility skills, opportunity for interprofessional collaboration, satisfaction with the learning experience, and conflicting information. Interprofessional collaboration in teaching resulted in high levels of satisfaction and self-confidence and provided an opportunity to work toward an aspect of core competency for interprofessional collaborative practice. [J Nurs Educ. 2024;63(6):402-404.].

Cognitive adaptation training for forensic psychiatry inpatients with schizophrenia spectrum diagnoses

ABSTRACT Cognitive deficits affect 70–75% of individuals with schizophrenia and significantly impact functioning. Cognitive Adaptation Training (CAT) is an evidence-based compensatory intervention that improves functioning through personalized environmental supports. Research has explored adaptations to CAT for specific contexts and sub-populations. The present study explored the feasibility and preliminary outcome data for CAT adapted for inpatient forensic psychiatry settings (finCAT). This study employed a single group mixed-method design collecting data at baseline, post-intervention, and 2-months follow-up. Forensic psychiatry inpatients with schizophrenia spectrum diagnoses (N = 18) participated. Outcomes included room organization, self-care, goal attainment, and qualitative interviews with patients (n = 4) and staff (n = 4), as well as secondary measures of unit climate and clinician attitudes. Data analyses with repeated-measures ANOVA revealed a significant effect of time on blind-rated room organization, with significant improvements at post-intervention sustained during follow-up. There were no significant changes to self-care ratings or secondary measures. Qualitative themes identified included (1) improvement in patients’ self-care and organization; (2) clinicians’ increased awareness of the relationship between cognitive deficits and functional outcomes; (3) improvements beyond self-care and room organization; and (4) increased opportunities for interprofessional collaboration. These results support the feasibility of adapting CAT for inpatient forensic psychiatry settings.

Interprofessional Image Verification Workshop for Physician and Physics Residents: A Multi-Institutional Experience

Verification of patient position through pretreatment setup imaging is crucial in modern radiation therapy. As treatment complexity increases and technology evolves, physicist-physician collaboration becomes imperative for safe and successful radiation delivery. Despite the importance of both, residency programs lack formal interprofessional education (IPE) activities or structured training for image verification. Here we show the impact of an interprofessional image verification workshop for residents in a multi-institutional setting. The workshop included a lecture by the attending physicist and physician, and hands-on image registration practice by learners (medical physics residents, MP; and radiation oncology residents, RO). All participants filled out pre- and postactivity surveys and rated their comfort from 1 to 10 in (A) selecting what type of imaging to order for a given case and (B) independently assessing the setup quality based on imaging. A paired 1-tailed t test (α=0.05) was used to evaluate significance; Spearman rank correlation coefficient was used to assess correlation of ratings and RO postgraduate year (PGY). Surveys had free-response questions about IPE and image verification activities in residency. A total of 71 residents from 7 institutions participated between 2018 and 2020. Pre- and postsurveys were completed by 50 residents (38RO, 12MP) and showed an increase in (A) from 5.5 ± 2.2 to 7.1 ± 1.6 (P < .001) and in (B) from 5.1 ± 2.3 to 6.8 ± 1.5 (P < .001), with significant increases per subgroup (AΔ, RO=1.8 ± 1.7, P < .001; BΔ, RO=1.9 ± 1.8, P <. 001; AΔ, MP=1.1 ± 1.4, P=.012; BΔ, MP=1.2 ± 1.6, P=.016). RO confidence scores moderately correlated with PGY. Survey responses indicated that image verification training is mostly unstructured, with extent of exposure varying by program and attending; most with little-to-no training. Time constraints were identified as the main barrier. IPE was noted as a useful way to incorporate different perspectives into the process. Formal image verification training increases resident comfort with setup imaging review and provides opportunities for interprofessional collaboration in radiation oncology residency programs.

An integrated, longitudinal Health Equity curriculum to prepare socially responsible healthcare practitioners

Objective To teach learners to identify and recognize structural causes of health disparities, design interventions, and engage in equitable, civil, and compassionate discussions. Background The racial injustices amplified by the COVID-19 pandemic have stressed the importance of educating healthcare practitioners to be advocates for social justice. Structural competency provides a framework for teaching students to be aware of structural causes of health disparities and design interventions to address them. We designed and implemented a ten-week Health Equity curriculum to promote structural competency and reduce implicit bias in healthcare providers. Here, we report on the design, implementation, student performance and student attitudes regarding this curriculum. Methods The Health Equity curriculum was a mandatory component of the Neuropsychiatric Theme for second year Pharmacy students. Students were assigned to subgroups of 5-6 and were distributed across self-identified gender and ethnicity. The curriculum was conducted remotely and consisted of didactic material, asynchronous online discussions, and synchronous Zoom discussions. Didactic material included videos, podcasts, journal articles, and faculty-created lectures. Asynchronous discussions were structured around the didactic content and open-ended prompts were provided to stimulate conversation. Three live discussions provided students with space to discuss the topics in real time. Four main topics were covered: (1) cultural and structural influences on mental health, (2) mental health and LGBTQ populations, (3) homelessness, deinstitutionalization and the mental health system, and (4) a student-identified topic. A survey was administered before and after the curriculum, and topics were assessed in OSCE (Objective Structured Clinical Examination). Results Student responses from pre- and post-surveys will be compared and quantitatively analyzed. A thematic qualitative analysis of student responses to open-ended questions will be conducted and compared. OSCE performance will be assessed for application of what was learned. Conclusion Given the challenges of integrating health disparities education into already impacted curricula, we believe our curriculum presents a rich learning experience with minimal in-class time and has potential for wide dissemination across health professional schools, with the opportunity for interprofessional collaboration. This curriculum has gone through one iteration with one cohort of students. However, given its innovative nature, we will gain insights into student engagement and performance in an online Health Equity curriculum.

Job Satisfaction of School-Based Speech-Language Pathologists in New York State as a Function of Workplace Features

Purpose The number of unfilled speech-language pathologist (SLP) positions in school-based settings remains an ongoing concern, particularly in the most populous states. New York State (NYS) is among those that have been identified to demonstrate a current and predicted unmet need for qualified SLPs. This study examines workplace features that contribute to job satisfaction of school-based SLPs in NYS to better understand which factors affect recruitment and retention. Method Three hundred sixty-six school-based SLPs in NYS responded to a 40-question survey about their workplace characteristics and levels of satisfaction for various job features. Results Respondents reported the highest satisfaction in areas relating to the nature of work with their students and available opportunities for interprofessional collaboration. The most prominent workplace features of concern related to workload amount, limited time to complete required tasks within the work week, and others' understanding of the SLP's role. Conclusions SLPs are generally satisfied with the work itself but challenges about increasing workload and lack of understanding have the potential to lead to attrition. Advocating for a workload analysis, a better understanding of the roles and responsibilities of the school-based SLP, and limits on the number of students served holds promise to improve job satisfaction. In turn, these efforts may both improve retention and lead to increased recruitment to help fill available positions.

Role-Emerging Clinical Placements in a Community-Based HIV Organization: Opportunities for Interprofessional Collaboration: A Case Report

Role-Emerging Clinical Placements in a Community-Based HIV Organization: Opportunities for Interprofessional Collaboration: A Case Report

Challenges and Opportunities for Interprofessional Collaboration within the Post-disaster Psychosocial Support Network in a Terrorism Scenario in the Netherlands: A Network Analysis

Introduction:Post-disaster psychosocial support (PSS) is an indispensable element of disaster management. A variety of studies contributed to the development of guidelines, information about guideline implementation, and evidence-based practice, as well as the status of local PSS planning and delivery systems in different European regions. However, the multi-disciplinary nature of the organization of post-disaster PSS requires interprofessional and inter-organizational collaboration, but is presently insufficient institutionalized on individual, organizational, and governmental levels, locally, within the region, and nationally.Aim:Objective of this research is to map the existing post-disaster PSS network in the Netherlands in the context of a terrorism scenario, and to identify probable collaboration problems rooted in weak ties and lack of alignment between actors at different levels.Methods:Focus groups were organized in Belgium, France, Norway, and the United Kingdom to learn from the inter-agency response to recent terrorist attacks. Next, social network analysis methods were used to analyze the structure of the collaborative network for post-disaster PSS in the Netherlands. A scenario-based questionnaire was distributed amongst relevant stakeholders through snowballing methods. Respondents were asked to identify organizations they collaborate with on different PSS activities during the preparedness, acute, and recovery phase.Results:The international focus groups resulted in valuable lessons for the Dutch PSS network. Data collection for social network analysis is currently in progress. Based on previous research we expect limited ties between disciplines during the preparedness phase and during the “registration of affected persons” in the acute phase. Most of the interactions between agencies will be linked to one-stop-shop service delivery, and less to commemorations and health monitoring.Discussion:Lessons from the focus groups, verification of whether or not the expectations are supported by the social network data, and reflections on opportunities for improvement will be presented at the conference in Brisbane.

Spring EngAGEment: An Interprofessional Collaboration to Enhance Community Interaction and University Education

Purpose Interprofessional education and practices are increasingly recognized as vital to addressing complex health needs, including individuals living with Alzheimer's disease or other associated dementias (AD/OAD). An innovative approach to meet this need is to create a meaningful engagement experience, Spring EngAGEment, following a multidisciplinary patient-centered model to serve individuals with AD/OAD and their care partners in the community and to offer new interprofessional collaboration opportunities for college students and faculty across disciplines in nursing, recreation, and speech-language pathology. The Spring EngAGEment program was developed by lead undergraduate students in an outcome-based program planning course from the Department of Recreation, Parks &amp; Leisure Services and implemented by student volunteers and faculty across the disciplines with ongoing mentorship from the author team and feedback from the local ACT on Alzheimer's team. The program offered community resource booths, gardening, music therapy, and physical activity education as a way to inform individuals with AD/OAD and their care partners on available community resources, increase their mental outlook, and help reduce their isolation and stress. Conclusions This interprofessional practice/interprofessional education experience not only allowed college students to facilitate collaboration with future health care professionals from a variety of disciplines but also provided the participants living with AD/OAD and their care partners with new ideas and strategies to help adjust to their life changes. Program outcomes from event participants with AD/OAD and student volunteers were reported. Lessons identified by the author team are discussed.

PMH58 - A Community-Wide Education Program on Drug Addiction: Stakeholder Knowledge, Beliefs, and Opportunities for Interprofessional Collaboration

Few studies have focused on interdisciplinary efforts to prevent drug misuse and overdose across health systems and communities. Thus, the purpose of this study was to increase health professionals’ and community stakeholders’ knowledge about drug and opioid abuse and ability to collaborate interprofessionally. A quasi-experimental pretest-posttest design was employed using mixed-methods. Prescribers, pharmacists, law enforcement, regulatory agencies, and community members in Alabama were recruited for a day-long, in-person drug addiction and abuse education program via email and online advertisements. Outcomes were measured via online surveys at baseline and post-training. Primary outcome measures included: 1) change in knowledge score (percent correct on a 9-item scale); 2) beliefs regarding the most effective way to address Alabama’s drug abuse problem; and 3) opportunities for interprofessional collaboration. Participants were matched pre and post-training and changes in knowledge score were analyzed using the Wilcoxon Matched-Pairs Signed Rank test. Beliefs about effective solutions and interprofessional collaboration were measured via free-response at post-training and analyzed using qualitative thematic analysis. A total of 838 people attended the education program, most of whom were pharmacists (42.3%) and nurses/physicians (20.2%). Survey completion rates were high at baseline (65.87%, n=552) and post-training (76.61%, n=642). Mean overall knowledge score increased by 20.7% (p <0.0001) from baseline to post-training. The most frequently discussed ways to address Alabama’s drug abuse problem were education of the public/community (n=121, 22.4%) and seeking/prescribing non-opioid treatments for pain (n=120, 22.3%). Most frequently discussed methods for interprofessional collaboration included more joint educational events (n=221, 41.1%) and improved communication channels between health professionals, law enforcement, and state Boards of Medicine/Pharmacy (n=212, 39.4%). This interprofessional education program was effective at increasing participants’ knowledge about drug abuse in Alabama. Key stakeholders supported future studies aimed at improving communication modalities between health professionals, law enforcement, and regulatory agencies.

Time for food - training physiatrists in nutritional prescription

Sub-optimal nutrition is a leading factor in all-cause mortality, the preponderance of non-communicable chronic diseases, and various health conditions that are treated by physiatrists, such as stroke and musculoske-letal disorders. Furthermore, patients with chronic pain have a high prevalence of nutritional deficiencies, and malnutrition has been associated with limited rehabilitation outcomes in elderly patients with hospital-associated deconditioning. Thus, physiatrists may find it valuable to include nutrition in their patient services. However, discussion of nutritional counselling in the physiatry literature is rare. To inform physiatrists about including nutritional counselling as part of the treatment they provide. The paper reviews recommended communication skills, behavioural change strategies, and opportunities for inter-professional collaboration. Further resources to educate physiatrists both in nutritional prescription and in improving their own personal health behaviours are provided. Training physiatrists to address nutrition is a step-wise process, described here.

Medical Providers' Oral Health Knowledgeability, Attitudes, and Practice Behaviors: An Opportunity for Interprofessional Collaboration

ObjectiveEvaluation of current knowledgeability, attitudes, and practice behaviors of medical providers from a large health care system toward oral health was undertaken as a pilot effort to better understand and integrate oral health into the overall health care delivery. MethodsInvitations to complete a 28-question survey, designed in a web-based platform (SurveyMonkey®), were emailed to 1407 medical multispecialty physicians, residents, and nurses within the health system. The questionnaire included sections on provider demographics, oral health knowledgeability and attitudes, and current practice conducting oral health screenings. ResultsA 14% (n = 199/1407) response rate was achieved for survey completion. There were 16% who reported good coverage of oral/dental health topics in their medical training curriculum. Competency level was <30% for identifying tooth decay and oral pathology. There were 95% who reported never applying fluoride varnish in their practice, while >80% answered knowledge-based questions correctly. Frequency rates for dental referral by the medical providers were 32% ‘frequently’ and 68% ‘infrequently.’ Perceptions of optimal frequency for conducting oral health assessment in their professional practices ranged from 69% indicating ‘frequently’ to 25% indicating ‘infrequently.’ ConclusionOverall, positive attitudes were observed toward incorporation of oral health examination into medical practice. The study identified lack of oral health treatment and infrequent referral by medical providers to dental providers. Results support likelihood for acceptance of care models that incorporate a medical/dental team-based approach complemented by oral health training for medical providers to enhance holistic health care delivery. Limitations of this pilot study include potential selection bias and lack of generalizability beyond our institution; further studies are planned in additional settings statewide to validate findings.

Community-based free clinics: opportunities for interprofessional collaboration, health promotion, and complex care management.

Free or outreach clinics offer students the opportunity to work with diverse patient populations. The objective of this study was to describe the demographics and clinical characteristics of a sample of chiropractic patients at a free community-based clinic to assess clinical and educational opportunities for students to work with diverse populations, collaborate with other professions and practice health promotion through patient education. This was a prospective, descriptive cross-sectional study conducted over 2 months. Data on demographics, health status, and health risks were collected from patients and their interns. Of the 158 patients, 50.6% were women and 50.6% African-American, while only 20.9% were employed full-time. Of the 24.7% tobacco users, 48.7% expressed interest in cessation. Of 80.0% overweight or obese patients, 48.8% expressed interest in weight loss. By self-report, 16.5% were diabetic, 10.1% took hypertension medication, 36.7% used prescription pain medication (9.4% opiate use), 33.5% used nonprescription pain medication, and 9.4% were under the care of a mental health professional. This patient population is demographically diverse. A high proportion of patients who used tobacco, or were overweight or obese expressed interest in information on those topics. A substantial proportion reported being under care with a mental health professional. This clinic provides opportunities for students to work with diverse populations, collaborate with other professions, and practice health promotion.

Increasing Nursing Students’ Knowledge of Health Promotion Through Community Engagement

The shift in health care toward primary health care and health promotion requires nurse educators to ensure students learn to practice the skill of health promotion. An ideal way in which to do this is with collaborative partnerships in community settings. The need to practice primary health care as part of an interprofessional team is also a growing trend. This article describes an innovative collaborative partnership with the city school system and nonprofit community partners to provide necessary interprofessional health screenings and health education to underserved community members. Through these partnerships, community health nursing students have the opportunity to participate in health screenings for children enrolled in the preschool program, provide health screenings and health education to healthy working adults, and engage in health promotion with school-age children by teaching the importance of practicing bicycle safety. These programs provide nursing students with unique opportunities for interprofessional collaboration while improving their health promotion, teaching, and communication skills. This approach serves as a model to guide nursing faculty members who need to provide students community health experiences that include health promotion and disease and injury prevention.

Moving from silos to teamwork: integration of interprofessional trainees into a medical home model

As the United States faces an impending shortage in the primary care workforce, interprofessional teamwork training to improve clinic efficiency and health outcomes is becoming increasingly important. Currently there is limited integration of interprofessional training in educational models for health professionals. The implementation of Patient Aligned Care Teams at the Department of Veterans Affairs (VA) has provided an opportunity for interprofessional collaboration among trainee and faculty providers within the VA system. However, integration of interprofessional education is also necessary to train future providers in order to provide effective team-based care. We describe a transportable educational model for health professional collaboration from our experience as a VA Center of Excellence in Primary Care Education, including a complementary novel one-year post-Master’s adult nurse practitioner interprofessional clinical fellowship. With growing recognition that interprofessional care can improve efficiency and outcomes, there is an increasing need for programs that train future providers in collaboration and team-based care.

Linking integrative medicine with interprofessional education and care initiatives: Challenges and opportunities for interprofessional collaboration

Although the fields of interprofessional education and collaboration (IPE/IPC) and integrative medicine (IM) are both recognised and clearly advancing as of late, a curious paradox exists: IPE/IPC and IM are both concerned with communicating about and attempting to resolve differences between healthcare professions with the fundamental goal of improving patient outcomes, yet they have remained quite distinct fields of research. This disconnect could be due to the fact that one field deals with integration within the general paradigm of biomedicine (IPE/IPC), while the other addresses integration across paradigms (IM). It is an opportune time for a critical comparison between the two. First, the main themes of IM are summarised as they are reflected in the IM literature. Second, a comparative analysis is presented focusing on the significant similarities and differences between IPE/IPC and IM. The final section addresses the question: What key learning areas from IM could benefit and enhance IPE/IPC?