Development of a scale to measure health professions students' self-efficacy beliefs in interprofessional learning

Happy Holidays from the Journal of Interprofessional Care!

Great article about the development of a scale to measure health professions students' self-efficacy beliefs in interprofessional learning. 

By Karen Mann (Dalhousie University, Halifax, Nova Scotia, Canada), Judith McFetridge-Durdle (Memorial University, St. John's, Newfoundland, Canada), Lynn Breau (Dalhousie University, Halifax, Nova Scotia, Canada), Joanne Clovis (Dalhousie University, Halifax, Nova Scotia, Canada), Ruth Martin-Misener (Dalhousie University, Halifax, Nova Scotia, Canada), Tanya Matheson (Dalhousie University, Halifax, Nova Scotia, Canada), Hope Beanlands (University of South Australia, Adelaide, Australia), Maria Sarria (Follett Software, Simpsonville, SC, USA)

A need exists for measures to evaluate the impact of interprofessional education (IPE) interventions. We undertook development and evaluation of a scale to measure self-efficacy perceptions of pre-licensure students in medicine, dentistry and health professions. The scale was developed in the context of a project entitled, “Seamless Care: An Experiential Model of Interprofessional Education for Collaborative Patient-Centered Practice”. As self-efficacy perceptions are associated with the likelihood of taking on certain tasks, the difficulty of those tasks, and perseverance in the face of barriers, we reasoned that understanding changes in students' perceptions and their relation to other outcomes was important. A 16-item scale was developed from a conceptual analysis of relevant tasks and the existing literature. Content validity was assessed by six Canadian IPE experts. Pre-licensure students (n = 209) participated in a pilot test of the instrument. Content validity was rated highly by the six judges; internal consistency of the scale (Cronbach's α = 96) and subscales 1 (α = .94) and 2 (α = .93) were high. Principal components analysis resulted in identification of two factors, each accounting for 34% of the variance: interprofessional interaction, and interprofessional team evaluation and feedback. We conclude that this scale can be useful in evaluating IPE interventions.



For more information, read Journal of Interprofessional Care, 

Early Online - December 14, 2011: http://informahealthcare.com/doi/abs/10.3109/13561820.2011.640759

Frequency of nurse–physician collaborative behaviours in an acute care hospital

Interesting article written by: Dawn Marie Nair, (Department of Nursing, Fairfield University, 

Fairfield, CT

, USA); Joyce J. Fitzpatrick (Department of Nursing, Case Western Reserve University, 

Cleveland, OH

, USA); Rita McNulty (Department of Nursing, Case Western Reserve University, 

Cleveland, OH

, USA); Elizabeth R. Click (Department of Nursing, Case Western Reserve University, 

Cleveland, OH

, USA); and Margaret M. Glembocki (Department of Nursing, Oakland University, 

Rochester, MI

, USA).

A new culture bolstering collaborative behavior among nurses and physicians is needed to merge the unique strengths of both professions into opportunities to improve patient outcomes. To meet this challenge it is fundamental to comprehend the current uses of collaborative behaviours among nurses and physicians. The purpose of this descriptive study was to delineate frequently used from infrequently used collaborative behaviours of nurses and physicians in order to generate data to support specific interventions for improving collaborative behavior. The setting was an acute care hospital, and participants included 114 registered nurses and 33 physicians with active privileges. The Nurse–Physician Collaboration Scale was used to measure the frequency of use of nurse–physician collaborative behaviors self-reported by nurses and physicians. The background variables of gender, age, education, ethnicity, years of experience, years practiced at the current acute care hospital, practice setting and professional certification were accessed. In addition to analyzing the frequency of collaborative behaviors, this study compares levels of collaborative behavior reported by nurses and physicians.
For more information, please read the Journal of Interprofessional Care, Early Online: http://informahealthcare.com/doi/abs/10.3109/13561820.2011.637647

The role of interagency collaboration in “joined-up” case management

Interesting article about interagency collaboration, written by Marty Grace (School of Social Sciences and Psychology, Victoria University, 

Melbourne

, Australia), Louise Coventry, (School of Social Sciences and Psychology, Victoria University, 

Melbourne

, Australia),  and Deb Batterham (Hanover Welfare Services, Research and Policy, 

Fitzroy, Melbourne

, Australia).

This article reports on research into the relationships that a group of case managers formed with local service providers in order to deliver integrated, “joined-up” services to young people experiencing homelessness and unemployment in the state of Victoria, Australia. Using a two-part customized survey tool, we explored the number and nature of relationships with other agencies. Two focus group discussions contributed to the interpretation of the survey findings. We found that these case managers maintained many relationships, mostly with housing and employment service providers. These relationships were predominantly cooperative in nature, and most could not easily be characterized as collaborative. Our research supports the view that, in an increasingly complex social service system, other forms of cooperation are usually appropriate for achieving the types of interorganizational relationships that are important to assist shared clients. Furthermore, this research supports the notion of a relationship continuum, finding that ratings of relationship elements were positively correlated with relationship type. This research indicates the importance of considering the pragmatic, contextual and situated practices that comprise interagency relationships, their fitness for purpose and the importance of cooperation for effective service provision.

For more information, please read the Journal of Interprofessional Care, December 6, 2011, Early Online.

Circles of care: A novel tool for interprofessional health education

Very interesting early online article, written by: Sarit Khimdas, Akshay Shetty, Chandheeb Rajakumar, Colin Meyer-Macaulay, Cal Shapiro, Rachit Sheshgiri and Neeraj Patel

(University of Western Ontario, London, Ontario, Canada).

The health care landscape has seen a dramatic change over the last 15 years, with an emphasis on an inter- professional model of health care delivery in a patient-centered context (Thistlethwaite, Moran, & World Health Organization Study Group on Interprofessional Education and Collaborative Practice, 2010). Today’s health professionals are dealing with an increasing number of older and chronically ill patients that has forced us to reevaluate how we deliver care. The interplay between biopsychosocial aspects of chronic health illnesses has led to a more collaborative working relationship between different allied health care professionals, resulting in better patient care.

It has been shown, however, that on entering higher education, students become professionally socialized, poss- ibly creating cognitive and social boundaries between professions that hinder sharing of knowledge (Jacobsen, Fink, Marcussen, Larsen, & Hansen, 2009). Therefore, it is all the more important that the role of interprofessional education takes on an active role within health education curriculum.

Interprofessional education on clinical training wards with exposure to trainees from other health care fields improved awareness of each others disciplinary roles, increased knowledge base of their own roles and fostered greater cooperation between groups, while creating positive attitudes toward other professions (Wijma, 1999). Our group has sought to present an alternative to interprofessional training sessions. Working with the Inter Professional Health Education and Research Department at the University of Western Ontario, we developed an interactive learning board game meant to be played by professionals and students from different allied health care fields in sessions ranging from 1 to 2 hours, titled Circles of Care.

For more information, please read: The Journal of Interprofessional Care, Early Online, December 6, 2011.

A critical realist model of complexity for interprofessional working

A very interesting paper written by Rick Hood, Bedford Hill, 

London

, United Kingdom

Royal Holloway University of London, Criminology and Sociology, 

Egham Hill, Egham, Surrey

, United Kingdom.

This paper presents a theoretical model of complexity for considering issues relevant to interprofessional working. The need for such a model is introduced with reference to the literature on collaboration and integration in health and social care, particularly in children’s services. It is argued that interprofessional working is often seen as a response to complexity, but that current models fail to build an appreciation of complex causality into their approach to addressing needs through targeted interventions. The alternative offered here is a critical realist model based on Bhaskar’s domains of reality, focusing on the implications of open systems, complex causality and contingency. These ideas are used to examine some of the issues and dilemmas typically encountered by interprofessional networks in coming together to work on complex cases.

For more information, please see: Journal of Interprofessional Care, Early online.

Focusing on future learning environments: Exploring the role of space and place for interprofessional education

Great editorial written by Jonas Nordquist, Simon Kitto, Jennifer Peller, Jan Ygge, Scott Reeves.


While space and place have been important units of analysis in studying learning across a number of social science domains (e.g. environmental studies), there has been little research exploring these elements in either the health professions education or the interprofessional education literature (Leander, Phillips & Taylor, 2010). This editorial highlights the importance of acknowledging and beginning to understand the role of space and place in interprofessional education. Specifically, our aim is to initiate a dialogue about how space, place and learning can affect the design and implementation of this type of education. We suggest that understanding the conceptual and practical relationship between space, place and learning is necessary to the construction and reconstruction of learning spaces that aspire to follow interprofessional education principles (e.g. student-centredness, flexibility, interactivity, collaboration and communication).


Many of the points raised in this editorial will be further discussed and debated in an upcoming conference, entitled, Future Learning Environments: How Space Impacts on Learning which will take place the Nobel Forum, KI in Stockholm, Sweden from June 3–5, 2012. This conference aims to gather an interprofessional and interdisciplinary group of academics, designers, architects, clinicians, managers and policymakers to explore key dimensions and issues related conceptualizing, evaluating and theorizing about the use of space, how it impacts on professional and interprofessional learning. Additional information about the conference can be found at: www.ki.se/learningspaces
For more information, please see: Journal of Interprofessional Care, November 2011, Vol. 25, No. 6 , Pages 391-393.

Continuing professional development for interprofessional teams supporting patients in healthcare decision making

Great article on interprofessional teams supporting patients in healthcare decision making   
Beth A. Lown, Jennifer Kryworuchko, Christiane Bieber, Dustin M. Lillie, Charles Kelly, Bettina Berger, and Andreas Loh.


Healthcare professionals and organizations, policy makers, and the public are calling for safe and effective care that is centered on patients’ needs, values, and preferences. The goals of interprofessional shared decision making and decision support are to help patients and professionals agree on choices that are effective, health promoting, realistic, and consonant with patients’ and professionals’ values and preferences. This requires collaboration among professionals and with patients and their family caregivers. Continuing professional development is urgently needed to help healthcare professionals acquire the knowledge, skills, and attitudes necessary to create and sustain a culture of collaboration. We describe a model that can be used to design, implement, and evaluate continuing education curricula in interprofessional shared decision making and decision support. This model aligns curricular goals, objectives, educational strategies, and evaluation instruments and strategies with desired learning and organizational outcomes. Educational leaders and researchers can institutionalize such curricula by linking them with quality improvement and patient safety initiatives.

For more information, please read: Journal of Interprofessional Care, November 2011, Vol. 25, No. 6 , Pages 401-408. 

Interprofessional education about patient decision support in specialty care

Interesting article by Mary C. Politi, Arwen H. Pieterse, Tracy Truant, Cornelia Borkhoff, Vikram Jha, Laura Kuhl, Jennifer Nicolai, and Claudia Goss.

Specialty care involves services provided by health professionals who focus on treating diseases affecting one body system. In contrast to primary care – aimed at providing continuous, comprehensive care – specialty care often involves intermittent episodes of care focused around specific medical conditions. In addition, it typically includes multiple providers who have unique areas of expertise that are important in supporting patients’ care. Interprofessional care involves multiple professionals from different disciplines collaborating to provide an integrated approach to patient care. For patients to experience continuity of care across interprofessional providers, providers need to communicate and maintain a shared sense of responsibility to their patients. In this article, we describe challenges inherent in providing interprofessional patient decision support in specialty care. We propose ways for providers to engage in interprofessional decision support and discuss promising approaches to teaching an interprofessional decision support to specialty care providers. Additional evaluation and empirical research are required before further recommendations can be made about education for interprofessional decision support in specialty care.

For more information, please read: Journal of Interprofessional Care, November 2011, Vol. 25, No. 6 , Pages 416-422.

Simulated interprofessional education: An analysis of teaching and learning processes

Interesting article written by: Mary van Soeren; Sandra Devlin-Cop; Kathleen MacMillan; Lindsay Baker; Eileen Egan-Lee; and Scott Reeves.  

Simulated learning activities are increasingly being used in health professions and interprofessional education (IPE). Specifically, IPE programs are frequently adopting role-play simulations as a key learning approach. Despite this widespread adoption, there is little empirical evidence exploring the teaching and learning processes embedded within this type of simulation. This exploratory study provides insight into the nature of these processes through the use of qualitative methods. A total of 152 clinicians, 101 students and 9 facilitators representing a range of health professions, participated in video-recorded role-plays and debrief sessions. Videotapes were analyzed to explore emerging issues and themes related to teaching and learning processes related to this type of interprofessional simulated learning experience. In addition, three focus groups were conducted with a subset of participants to explore perceptions of their educational experiences. Five key themes emerged from the data analysis: enthusiasm and motivation, professional role assignment, scenario realism, facilitator style and background and team facilitation. Our findings suggest that program developers need to be mindful of these five themes when using role-plays in an interprofessional context and point to the importance of deliberate and skilled facilitation in meeting desired learning outcomes.

For more information, please read: Journal of Interprofessional Care (November 2011), 25 (6), pg. 434-440.

Interprofessional jargon: How is it exclusionary? Cultural determinants of language use in health care practice

Interesting article written by: Carrie Marshall, Jennifer Medves, Debbie Docherty, Margo Paterson (Queen’s University, Kingston, Ontario, Canada)

Language can impact significantly on the ways in which health care professionals relate and provide clinical services, as well as the way in which patients conceptualize their role in the healthcare encounter. The aim of this project was to explore the barriers and challenges to developing a collaborative approach in health care. A hermeneutic research approach was used with a convenience sample of international key informants representing 6 disciplines. A total of 10 individual, semi-structured interviews were conducted. Findings emphasized the need to be more inclusive by avoiding the use of exclusionary jargon so that all members of the health care team, including patients and families, can adopt a collaborative practice orientation.

For more information, please see: Journal of Interprofessional Care, November 2011, Vol. 25, No. 6, Pages 452-453.