Book Review: Communicating in Hospital Emergency Departments

This book outlines the research findings of a three-year project. It effectively draws the reader into wanting to know more, causes the readers to reflect on their own practice, and clearly identifies which actions need to be taken by the readers to improve their practice. This book is written in such a way to achieve all of this.

 

The nine authors outline how seven experienced researchers undertook a research initiative conducted in five emergency departments over a three-year period.

 

The researchers were motivated to conduct the research project by concerns that failures in communication have been identified as “a major cause of adverse events, leading to avoidable patient harm”. The researchers collectively spent 1093.5 hours in the emergency departments and applied qualitative ethnographic methodology. This analysis, together with sociolinguistic and discourse analysis of the spoken interactions between clinicians and patients, enables the researchers to identify key features of successful and unsuccessful interactions between clinicians and patients and also between clinical staff. As a result, the authors identified systemic improvements that could lead to safer practices and improve the quality of patient care.

 

The research clearly examines all aspects of communication between the clinical team working with the patient (including spoken, gestured, written and electronic communication) and is therefore very relevant to readers interested in interprofessional care of patients in emergency departments.

 

The book is presented in seven sections which effectively: outlines the need for good communication, reviews the emergency department environment, examines the patient’s journey through the department, details the communication patterns, looks specifically at the communication of medical information between the patient and the clinical staff, explores strategies for bridging the communication gap, and suggests strategies to promote change in ways of working and communicating.

 

The authors provide detailed descriptions of all aspects of working in emergency departments, and present a series of vignettes and case studies which demonstrate the complexities of communication. The authors then identify key moments where effective communication is at risk. The use of tables, graphs and diagrammatic representations very effectively complements the text, and each chapter includes a comprehensive list of references.

 

This book is an essential text for anyone working in an emergency department, as well as being of interest to interprofessional researchers, educators, practitioners and students internationally. I am pleased to recommend this book to readers who want to improve their working relationships as a health care team or increase their knowledge of communication among interprofessional teams.

 

Reviewed by 

Dawn Forman, Visiting Professor, University of Derby and Chichester University and Adjunct Professor Curtin University and Auckland University of Technology

Communicating in Hospital Emergency Departments by Diana Slade, Marie Manidis, Jeannette McGregor, Hermine Scheeres, Eloise Chandler, Jane Stein-Parbury, Roger Dunston, Maria Herke, Christian M.I.M. Matthiessen

Springer, Heidelberg, New York, Dordrecht, London, 2015, 158 pages Price €99.99 (hard copy) or €83.29 (eBook). ISBN 978-3-662-46020-7

Book Review: Communication Skills in Health and Social Care

Benard Moss is an Emeritus Professor from the Social Work Education and Spirituality department at Staffordshire University. The goal of the textbook is to enhance essential communication skills for students and team members to promote best practice. The textbook is aimed at social workers but reference to probation officers, doctors, nurses, paramedics, teachers, police officers, youth workers, advice workers, and faith community leaders is also included. Moss engages his readers with a witty, easy-to-read style that entices readers to think about each topicthrough practical scenarios. Throughout each chapter activities are incorporated creating an interactive book that allows readers to apply the concepts to practical situations they have or have not yet encountered.

 

Moss highlights important aspects of communication froma variety of situations such as “Breaking Bad News,” “Chairing Meetings,” or “Court Room.” The textbook reviews current research regarding these different topics on professional communication skills in health care settings. Adequate references are used for each section and suggested readings are identified for readers who are interested in learning more about a topic. The textbook refers to situations that occur in England but remains applicable for international interpretation, especially for English speaking regions such as Canada, United States,and Australia.

 

This textbook is designed for individuals who are beginning their journey in people-work to adopt necessary communication skills. Moss refers to people-workers as individuals who provide confidential assistance to individuals. Moss identifies that the textbook is as an overview of adequate communication in the health and social care profession. For individuals who require further understanding in an area of communication, Moss suggests other readings to assist the reader.

 

Each chapter follows a similar organization of topics.Chapters start with a paragraph overview of the general research on a topic, incorporates activities, provides examples of practical situations, and ends with a “Final Thoughts” section to review each of the main concepts. This format allows readers to digest the information.  The activities summarize the previous content and touch on proceeding paragraphs, allowing readers to build on the ideas presented. The examples provide suggested phrases to use in challenging situations to help the reader develop their own repertoire of professional wording. The “Final Thoughts” section brings all the concepts together in a short paragraph reminding readers of the key concepts. Each section ends with a list of other topics covered in the textbook that are directly related to the one discussed linking topics together appropriately.

 

Overall, Moss provides a useful guide for enhanced communication for individuals in the social and health care professions to apply the skills learned in this book to day-to-day interactions. The book is a concise overview that allows professionals to enhance their practice without spending extended time reviewing multiple textbooks. I readily recommend this to students, people-workers, and educators as a useful resource for enhancing collaborative communication.

 

Review by

Lorelle Kerik, Registered Kinesiologist, Lifemark Health Centre

Communication Skills in Health and Social Care (3rd Edition)

Bernard Moss. Thousand Oaks, CA: Sage, 2015

222 pages, $52.95 (paperback) $138.95 (hardcover) – Canadian Dollars

ISBN: 978-1-4739-1276-2

Book Review: Leadership and Collaboration: Further Developments for InterprofessionalEducation

This book aims to provide students, educators and clinicians alike the latest advances in international leadership in interprofessional education, practice and collaboration. Fifteen chapters, written by a variety of authors from different healthcare professions and nine countries combine to produce a very practical guide for readers of all types.

 

Leadership theories are defined and connections are made to collaborative practice. The book highlights the importance of appropriate leadership styles for successful interprofessional collaboration, which results in higher quality patient care and efficiencies. The authors address the increasing need to recognize that health care demands cannot be met without changing how healthcare workers are educated and practice.  

 

Students and educators will discover a well-organized text with useful tables to help navigate the book by country, leadership model or topic.  A directory of additional readings is provided along with numerous references, a list of helpful definitions and a detailed index to assist in furthering one’s learning. Clinicians will find practical examples of implementation of interprofessional collaborative projects in both academic and health care settings, along with the challenges and lessons learned which help guide one's own project development.  

 

The book is divided into three distinct parts allowing readers to access topics as desired.  Part one delineates theoretical frameworks on the development of interprofessional leadership and interprofessional practice internationally, part two is clinical in nature outlining stories of collaborative developments taking place in a variety of countries, and part three provides additional stories of recent innovations both in leadership and interprofessional collaboration.

 

The editors have produced an extremely well organized and structured text. The chapters are authored by different writers offering a variety of writing styles, perspectives, and levels of detail. Overall this book provides an excellent mix of theoretical and practical information linking leadership theories, interprofessional collaboration and healthcare delivery from an international perspective. Contents assist healthcare students, educators and practitioners to address emerging healthcare needs for greater interprofessional collaborative education and practice with the ultimate goal of improving healthcare delivery worldwide.

 

Reviewed by

Shelly Bercovitch, BSc(PT), MHM (candidate), McMaster University, Acting Chief Physiotherapy, The Ottawa Hospital, Ottawa, Canada 

 

Leadership and Collaboration: Further Developments forInterprofessional Education

Dawn Forman, Marion Jones & Jill Thistlethwaite, editors

New York, NY: Palgrave MacMillan, 2015

257 pages, $115.00

ISBN: 978-1-137-43207-0

 

 

 

 

Conference Report: Developing Multiprofessional Health Educators of the Future

“Developing Multiprofessional Health Educators of the Future” was a radical new conference that brought together healthcare workers from across the range of professional backgrounds, levels of experience and educational modalities. It considered multiple good practice initiatives for healthcare educators, trainees and students.  

The conference was planned jointly between the London and the South East Local Education and TrainingBoards (LETB) and was held on 7 July 2015 at the Kia Oval conference centre in London. The organising committee included a healthcare scientist, medical education fellows, nurse educators, Shared Service staff and a HEKSS programme manager. All 300 places were fully booked within weeks of registration opening.

Professor Ian Cumming, Chief Executive of Health Education England, opened the conference. He strongly reiterated the commitment to more multiprofessional training in the future.  This was followed by an inspiring talk by Laura Sherlock, a patient educator from King’s College London, who highlighted the vital role that patients play in clinical education and the need for more meaningful engagement to maximise this resource.  Professor Scott Reeves rounded off the day with a forward-looking summary of the state of interprofessional education and promising avenues for further exploration.

Alongside these exciting keynotes were over ten parallel workshops, face-paced ‘laser-coaching’ and a poster display of a range of successful education projects conducted by delegates.  The very best abstract submissions were selected to present to the whole conference audience, who then voted for their favourite to receive a prize.

The day was a great success and demonstrated the level of enthusiasm for such events that bring together a wide range of professionals to share their passion for clinical education in all its multifarious forms. It is hoped that this will become a regular feature of the clinical education calendar.

 

Book Review: Evidence-Based Practice for Health Professionals: An Interprofessional Approach

While evidence-based practice (EBP) has become an essential component of training in a wide range of healthcare professions, a textbook for beginning practitioners was largely missing. Howlett, Rogo, and Shelton authored Evidence-Based Practice for Health Professionals: An Interprofessional Approach to engage student audiences from rehabilitation, medicine, dentistry, nursing, pharmacy, and public health programs. The text was designed to help readers achieve two objectives: (1) to locate, interpret, evaluate, and apply research to the care of individual patients/consumers; and (2) to effectively communicate research results to consumers, colleagues, and other professionals. The authors’ emphasis is on the knowledge and skills needed to facilitate informed, evidence-based, and patient-centered healthcare decisions.

The text has two parts and 11 chapters. Part I, “Foundations of Evidence-Based Practice,” consists of six chapters. Chapter 1 defines and explains EBP; Chapter 2 provides an overview of research methods; Chapter 3 examines health communication; Chapter 4 illustrates the process of locating relevant evidence; and to conclude, Chapters 5 and 6 review basic descriptive and inferential statistics, respectively. Part II, “Applications of Evidence-Based Practice,” explores how EBP is implemented in different contexts. Chapter 7 introduces readers to epidemiology as it relates to EBP; subsequent chapters depict EBP in assessment and diagnosis (Chapter 8), treatment, examination of harm, and prevention (Chapter 9), and working with the pharmaceutical industry (Chapter 10). Finally, Chapter 11 synthesizes the process of implementation of EBP including detailed simulation of critical appraisal of examples from research studies.

In this text, the process of EBP is broken down into concrete steps, and a variety of tools to work through these steps are presented. For example, evaluation of research evidence to clinical questions is daunting for beginners. To guide this process, the authors present a systematic method in a chart to compare components of the clinical question with components as addressed in the study. Similarly, critical appraisal of trustworthiness of research may appear to be a formidable process to novices. The authors provide worksheets to use for appraising quantitative and qualitative studies composed of questions on various dimensions of research reports that contribute to their overall credibility. These focused steps can guide beginners in EBP in simulating the process of critical analysis of an experienced practitioner. Tools like these can play a vital role in the development of skills and judgment needed for evidence-based clinical decision making.

Due to the rapid pace of scientific and technological advancement, healthcare professionals are increasingly required to locate, appraise, and synthesize most up-to-date information in their daily practice, rather than solely rely on the previously acquired knowledge base. In addition to deciphering the procedure of EBP, this text introduces beginning clinicians to processes of healthcare provision that is based on critical thinking. The versatile tools, in combination with ample case studies dealing with an array of clinical conditions, render this text particularly suitable for experiential approach to training interprofessional teams composed of early career professionals. In conclusion, the text is a unique contribution to the clinical training in healthcare disciplines on multiple dimensions, including EBP and interprofessional care.


Review by: Naoko Yura Yasui, PhD, CRC; Assistant Professor, Department of Rehabilitation Studies, Alabama State University

Evidence-Based Practice for Health Professionals: An Interprofessional Approach
Howlett, B., Rogo, E. J., and Shelton, T. G.
Burlington, MA: Jones & Bartlett; 2014
394 pages; US$86.95
ISBN 9781449652777

Book Review: The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures

Anne Fadiman, the author and narrator of The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Culture, shares the story of Lia Lee, a young Hmong girl with severe epilepsy, to demonstrate the detrimental impact of cultural misunderstanding between families and their doctors. This book alternates with one chapter focusing on Lia’s story and the next educating the reader on Hmong traditions and culture. Fadiman supports her argument by countlessly comparing traditional Hmong healing practices with American medicine, emphasizing the gap between the two and the need for improvement.

Fadiman’s story is targeted at culturally uninformed interdisciplinary members. She foils Lia’s doctors Neil Ernst and Peggy Philp with Jeanine Hilt, Lia’s social worker who is an “incredible patient advocate” (p. 114) for the Lee’s. When the Lee’s first bring Lia to the emergency room for her seizures, the hospital staff is unable to communicate with Foua and Nao Kao about their daughter’s illness. This miscommunication continues with each hospital visit. The lack of translators and individuals educated on Hmong traditions force the American doctors, hospital staff, and social services to view the Lee’s as uncooperative and noncompliant. With the growing Hmong community in Merced, California, the American doctors and hospital staff would have benefitted from learning about the Hmong culture, as this would allow them to understand how and why the Lee’s made some of their questionable decisions regarding Lia’s treatment. The tone expressed by Fadiman is objective and solemn; this allows both the Lee’s and the health professionals involved in Lia’s treatment to rationalize their annoyance, irritation, and frustration with each other to the reader. When Lia experiences her most severe seizure, she suffers brain damage. This tragedy ultimately brings the two parties closer, although it is too late. The closing of the book, aspiringly, fills the reader with hope.

Lia’s brain damage could have been preventable by removing cultural barriers and improving collaboration between families and interdisciplinary teams. Fadiman clearly argues that a mix of traditional healing with western medicine is ideal. She mentions a program called “Bridging the Gap,” which is a cross-cultural education program to train hospital staff to be culturally mindful of patients. The television segment on the Hmong cable channel regarding American hospitals and treatment was another attempt to reduce the cultural miscommunication in Merced. The Nationalities Service of Central California received a grant to integrate western mental health with traditional Hmong practices, and this was an outstanding success. The interaction between doctors and spiritual healers indicated that the interaction between these fields boosted patient morale.

Doctors alone are not enough to cure a patient, especially when culture is the barrier. Fadiman countlessly brings up the sad fact that Lia’s brain damage could have been prevented by communication and strengthened interactions between the doctors and hospital workers, social workers, translators, spiritual healers, and patients. This emotionally captivating book will motivate the reader from any background for advocating cultural awareness among interdisciplinary teams.


Review by: Shannon Sim, Concordia University of Edmonton

The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures
Anne Fadiman
New York: Noonday Press, 1998
341 pages, CA$12.29
ISBN 0374525641 9780374525644

Summary: Adherence to clinical guidelines in heart failure (HF)outpatients: Impact of an interprofessional HF team on evidence-basedmedication use

Clinical systolic heart failure (HF) guidelines specify recommendations for ACE inhibitors (ACEI), angiotensin receptor blockers (ARB) and beta blockers according to doses used in clinical trials. However, many HF patients remain suboptimally treated.

Crissinger and colleagues sought to determine which provider type, between an interprofessional HF team, non-HF cardiologists and primary care physicians (PCP), most optimally manages HF medications and doses. A retrospective chart review was performed on adult patients at an academic county hospital with an ejection fraction ≤40% and a diagnosis of HF, seen by a single provider type (HF team, cardiologist or PCP) at least twice within a 12-month period. 

Utilization rates of any ACEI/ARB and any beta blocker were robust across provider types, though evidence-based ACEI/ARB and beta blocker were greatest from the HF team. Doses of evidence-based therapies dropped markedly in the non-HF team groups. The percent of patients prescribed optimal doses of an evidence-based ACEI/ARB AND beta blocker was 69%, 33% and 25% for the HF team, cardiologists and PCPs, respectively (p < 0.0167). Patients followed by the HF team were more frequently prescribed evidence-based medications at optimal doses. 

The findings of this study support the use of specialized interprofessional HF teams to attain greater adherence to evidence-based recommendations in treating systolic HF.

For more: http://informahealthcare.com/doi/abs/10.3109/13561820.2015.1027334

Summary: E-Learning with virtual teammates: A novel approach tointerprofessional education

The Institute of Medicine identified interprofessional education (IPE) as a key innovation for achieving the triple aim of better care, better outcomes and reduced health care costs. Yet, a shortage of qualified faculty and difficulty with aligning learners’ schedules often prevent sustainable and scalable IPE. 

A virtual IPE intervention was developed to circumvent these barriers and compared to a blended-learning IPE intervention. Djukic and colleagues recently used a pre-test and post-test design with two comparison interventions to test the effects of these IPE interventions on changes in teamwork knowledge, skills and attitudes. The interventions were delivered to pre-licensure learners at a large, metropolitan medical and a nursing school. The study used one-sample and independent-sample t-tests to analyze data from 220 learners who received the blended-learning intervention in 2011 and 540 learners who received the virtual learning intervention in 2012.

Interestingly, study results suggested the students in the blended-learning intervention did not significantly (p < 0.05) outperform the students in the virtual learning intervention for any of the measured outcomes, except for medical students’ attitudes around team value. 

These findings support virtual IPE learning as an effective, scalable, and sustainable solution for imparting foundational teamwork knowledge in health profession students.

For more: http://informahealthcare.com/doi/abs/10.3109/13561820.2015.1030068

Summary: Partnership to promote interprofessional education and practicefor population and public health informatics: A case study

Team-based healthcare delivery models, which emphasize care coordination, patient engagement, and utilization of health information technology, are emerging. To achieve these models, expertise in interprofessional education, collaborative practice across professions, and informatics is essential.

A recent case study by Rajamani and colleagues from informatics programs in the Academic Health Center (AHC) at the University of Minnesota and the Office of Health Information Technology (OHIT) at the Minnesota Department of Health presents an academic–practice partnership, which focuses on both interprofessionalism and informatics. Outcomes include the Minnesota Framework for Interprofessional Biomedical Health Informatics, comprising collaborative curriculum development, teaching and research, practicums to promote competencies, service to advance biomedical health informatics, and collaborative environments to facilitate a learning health system. Partnership success is due to interprofessional connections created with emphasis on informatics and to committed leadership across partners. A limitation of this collaboration is the need for formal agreements outlining resources and roles, which are vital for sustainability. 

This partnership addresses a recommendation on the future of interprofessionalism: that both education and practice sectors be attuned to each other’s expectations and evolving trends. Success strategies and lessons learned from collaborations, such as that of the AHC-OHIT that promote both interprofessionalism and informatics, need to be shared.

For more: http://informahealthcare.com/doi/abs/10.3109/13561820.2015.1029067

Summary: Increasing medical students’ understanding of the role ofoccupational therapists

Understanding the roles and responsibilities of different healthcare professionals allows for collaborative care to occur. 

A recent study by Roberts and Shamus evaluated a student-designed, case-based educational module about the roles and responsibilities of occupational therapists (OTs) designed to increase the knowledge of occupational therapy among medical students. The study used a quasi-experimental, pre-/post-test design.

Independent paired t-tests showed medical students’ mean score on the OT Awareness Education Module at post-test was significantly greater than their mean score at pre-test. Results demonstrated how using an evidence-based approach to design an educational strategy can increase the knowledge of one member of the healthcare team about the role of another within a short period.

This study documented an effective approach for educating future physicians about the roles and responsibilities of occupational therapy as they prepare to make decisions affecting patient care outcomes.

For more: http://informahealthcare.com/doi/abs/10.3109/13561820.2015.1034848

Summary: A pilot study to test the effectiveness of an innovativeinterprofessional education assessment strategy

In a recent quasi-experimental pilot study, Emmert and Cai tested an assessment tool designed to evaluate students' teamwork skills, and assessed the effectiveness of an interprofessional education (IPE) course. 

Participants were health professional students (physical therapy, pharmacy, dental and osteopathic medicine) 24 of whom were second-year students who had previously taken part in an IPE course (experimental group), and 22 of whom were third years that had not (control group). Students interacted with a standardized patient and her son during an asynchronous Team Objective Structured Clinical Exam (TOSCE), after which they were scored on their teamwork skills using newly designed teamwork rating scales.

Cronbach Alpha calculations suggested that the rating scales were reliable when rater scores were aggregated (0.81). Pearson coefficient calculations determined that teamwork scores of live raters and video raters were significantly correlated (p < 0.0001), suggesting good consistency across these raters. The experimental group performed significantly better (p = 0.0003) than the control group, suggesting that the IPE curriculum is successfully equipping students with teamwork skills.

The results of this study contribute to the much needed IPE assessment literature, and suggest that teamwork skills can be taught and effectively assessed using this new rating scale.

For more: http://informahealthcare.com/doi/abs/10.3109/13561820.2015.1025373

Summary: Attitudes of nursing school deans toward interprofessionaleducation in Western Pacific Region countries

A previous survey distributed to medical school deans in the Western Pacific Region (WPR) showed positive attitudes toward collaborative practice and interprofessional education (IPE).

Makino et al.'s recent survey built on this, aiming to clarify the present state of IPE and the attitudes of nursing school deans in the WPR. The modified Attitudes Toward Health Care Teams Scale (ATHCTS) and the modified Readiness of health care students for Interprofessional Learning Scale (RIPLS) were used.

Unexpectedly, the response rate was less than 20%. Deans of nursing schools with IPE courses showed significantly more positive attitudes than those of schools without IPE courses. The mean score of the modified ATHCTS and RIPLS of deans of nursing schools in rural areas were significantly higher than those in urban areas.

Compared with medical schools, nursing schools in the WPR pay less attention to IPE and this may be one of the present characteristics of the region.

For more: http://informahealthcare.com/doi/abs/10.3109/13561820.2015.1027337

Summary: Adherence to clinical guidelines in heart failure (HF) outpatients: Impact of an interprofessional HF team on evidence-based medication use

Clinical systolic heart failure (HF) guidelines specify recommendations for ACE inhibitors (ACEI), angiotensin receptor blockers (ARB) and beta blockers according to doses used in clinical trials. However, many HF patients remain suboptimally treated.

Crissinger and colleagues recently conducted a retrospective chart review to determine which provider type, between an interprofessional HF team, non-HF cardiologists and primary care physicians (PCP), most optimally manages HF medications and doses. The study was performed on adult patients at an academic county hospital with an ejection fraction ≤40% and a diagnosis of HF, seen by a single provider type (HF team, cardiologist or PCP) at least twice within a 12-month period.

Utilization rates of any ACEI/ARB and any beta blocker were robust across provider types, though evidence-based ACEI/ARB and beta blocker were greatest from the HF team. Doses of evidence-based therapies dropped markedly in the non-HF team groups. The percent of patients prescribed optimal doses of an evidence-based ACEI/ARB AND beta blocker was 69%, 33% and 25% for the HF team, cardiologists and PCPs, respectively (p < 0.0167). Patients followed by the HF team were more frequently prescribed evidence-based medications at optimal doses.

Crissinger et al.'s findings support the use of specialized interprofessional HF teams to attain greater adherence to evidence-based recommendations in treating systolic HF.

Read more: http://informahealthcare.com/doi/abs/10.3109/13561820.2015.1027334

Summary: Perceptions of interprofessional clinical simulation among medical and nursing students: A pilot study

Interprofessional education (IPE) is a well-supported concept in medical education and a priority for leadership. How students experience IPE is unclear.

A recent pilot study by Shanahan and Lewis evaluated how medical and nursing students perceived and experienced IPE. Ten medical and 10 nursing students participated in a clinical simulation-based IPE exercise with 2 medical and 2 nursing students per group. Participants completed the KidSIM ATTITUDES questionnaire before and after the exercise. Students provided verbal feedback during the post-exercise debrief.

Study results showed perceptions of the group became more positive with the exercise. With statistical significance across all the domains (relevance of IPE and simulation, communication, situation awareness, and roles/responsibilities), verbal comments were positive. A single clinical simulation-based IPE exercise improved perceptions of IPE among these students.

These results provide further impetus to continue to study IPE for medical and nursing students. The findings also support the inclusion of IPE in medical education.


Read more: http://informahealthcare.com/doi/abs/10.3109/13561820.2015.1027336

Summary: Impact of crisis resource management simulation-based training for interprofessional and interdisciplinary teams: A systematic review

Crisis resource management (CRM) abilities are important for different health care providers to effectively manage critical clinical events.

This study by Fung and colleagues aimed to review the effectiveness of simulation-based CRM training for interprofessional and interdisciplinary teams compared to other instructional methods (e.g., didactics). Interprofessional teams are composed by several professions (e.g., nurse, physician, midwife) while interdisciplinary teams are composed by several disciplines from the same profession (e.g., cardiologist, anaesthesiologist, orthopaedist). 

Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and ERIC were searched using terms related to CRM, crisis management, crew resource management, teamwork, and simulation. Trials comparing simulation-based CRM team training versus any other methods of education were included. The educational interventions involved interprofessional or interdisciplinary healthcare teams. The initial search identified 7456 publications; 12 studies were included. 

Simulation-based CRM team training was associated with significant improvements in CRM skill acquisition in all but two studies when compared to didactic case-based CRM training or simulation without CRM training. Of the 12 included studies, one showed significant improvements in team behaviours in the workplace, while two studies demonstrated sustained reductions in adverse patient outcomes after a single simulation-based CRM team intervention.

Fung and colleagues' findings suggest that CRM simulation-based training for interprofessional and interdisciplinary teams show promise in teaching CRM in the simulator when compared to didactic case-based CRM education or simulation without CRM teaching. Despite this, one must consider that more research is required to demonstrate transfer of learning to workplaces and potential impact on patient outcomes.

Read More: http://informahealthcare.com/doi/abs/10.3109/13561820.2015.1017555

Summary: Interprofessional team meetings: Opportunities for informal interprofessional learning

In their recent study, Gillian Nisbet, Stewart Dunn and Michelle Lincoln explore the potential for workplace interprofessional learning, specifically the learning that occurs between health professionals, as part of their attendance at their regular interprofessional team meetings. While most interprofessional learning research to date has focused on formal structured education programs, this study adds to our understanding of the complexities of the learning processes occurring between health professionals as part of everyday practice. 

Through observations of team meetings and semi-structured interviews, the study found that the interprofessional team meeting provided a practical, time-efficient, and relevant means for interprofessional learning, resulting in perceived benefits to individuals, teams, and patients. The learning process, however, was influenced by members’ conceptions of learning, participation within the meeting, and medical presence. 

Nisbet and colleagues' findings provide a basis for further research to assist health professionals capitalize on informal learning opportunities within the interprofessional meeting.


Read More: http://informahealthcare.com/doi/abs/10.3109/13561820.2015.1016602

Book Review: Where No Doctor Has Gone Before: Cuba’s Place in the Global Health Landscape

Where No Doctor Has Gone Before: Cuba’s Place in the Global Health Landscape

Robert Huish 

Waterloo, ON, Canada: Wilfrid Laurier University Press, 2013

156 pages. $31.65 USD

ISBN: 978-1-55458-833-6

Robert Huish, Assistant Professor at Dalhousie University, Department of International Development Studies, presents an overview of the Cuban health system, the Cuban medical education system, and the government’s effort to provide care beyond its borders.  This is a practical book that gives the historical background of how Cuba has survived decades of economic sanctions to become one of the world leaders in universal health care.  The author examines the different aspects of Cuban health care using credible evidence and a variety of sources including the author’s own experiences in Cuba learning how health care and medical education is delivered. 

The author seeks to show how the Cuban government views health care as a basic human right and refuses to compromise on their investment in human capital to provide primary care to all of its citizens.  The author delivers on this purpose by describing the historical background that led Cuba to use the model of training physicians to bring medical care to many outside of its borders.    

The first few chapters focus on the foundational aspect that health care should start at the community level with a focus on disease prevention and health promotion.  These chapters go into a rich and carefully documented amount of detail describing how health care is actually delivered, how Cuba has been able to use this model of care as a form of foreign policy, and how the country has benefitted from this focus on public health. There are also chapters dedicated to the concepts of Medical Tourism and Health Care Worker Migration.  Cuba’s approach to these topics has left positive imprints on many countries in the Caribbean and Latin America.   

The remaining chapters describe the Cuban medical education system, including the largest medical school in the world, the Latin American School of Medicine, or ELAM.  Medical education is discussed on a student level with multiple examples from student interviews that relate their experience of coming to Cuba to learn medicine for free. The only debt the students have is a moral one: a commitment to return to their countries and serve in the areas of most need.  Nevertheless, the author does not shy away from the challenges ELAM graduates face when returning to their native countries to practice. 

The author has written a very commendable book about how medicine, public health and international health blend together to meet the needs of thousands in Cuba. What is missing for me is how they use interprofessional health care teams as a model of care, a recent model of education for medical personnel.  This book was a pleasure to read. It would be perfect for those in medical education, public health, global health and primary care.  

The author ends the book with the five things he has learned from the Cuban health system.  This “top five” list, if you will, is a skillful reminder of the needs of global health and how a small island country has been able to use health care and education policy to make an impact in some of the worlds most underserved regions.   

Review by: Curt Stilp, Assistant Professor, Oregon Health & Science University