Improving interprofessional practice for vulnerable older people: gaining a better understanding of vulnerability

Interesting article written by: Clare Abley, John Bond, & Louise Robinson


A key focus for professionals working with older people in the community is on those who are vulnerable, although this vulnerability is not well defined. This study sought the views of health and social care professionals and older people on vulnerability, identifying significant differences between professional and older people’’s perspectives. It found that for older people, vulnerability is an emotional response to being in a specific situation, whereas for professionals, the vulnerability of those on their case loads relates to them having certain or a combination of characteristics (physical, psychological and social). The paper concludes that interprofessional care for older people in the community could be improved firstly by asking older people if they ever feel vulnerable and if so, in what situations and secondly by focusing team efforts on addressing the issues raised by older people in response to these questions.


For more information, see: Journal of Interprofessional Care, 
Improving interprofessional practice for vulnerable older people: gaining a better understanding of vulnerability, (September 2011), 25 (5), pg. 359-365.

Translating collaborative knowledge into practice: Findings from a 6-month follow-up study

Interprofessional education and collaboration in health and social care have become significant items on Canada's policy agenda. As a result, they are receiving attention from different levels of government, health services/academic institutions and regulatory bodies (e.g. Cote, Lauzon, & Kyd-Strickland, 2008). To date, however, only a limited number of studies have focused on the longer-term effects interprofessional education can have on individuals' collaborative practices (Barr, Koppel, Reeves, Hammick, & Freeth, 2005). This article provides a report on the findings from a 12-week graduate level course, which aimed to improve participants' knowledge in a range of interprofessional issues (e.g. nature of professional friction) as well as expose learners to key research studies and theories related to this field.

This interprofessional graduate elective course was situated in the masters of nursing program at a university based in Canada. Twenty students were enrolled in the course. They represented two professional groups – nursing and nutrition. Teaching approaches included interactive classroom lectures, student-led and self-directed learning. The course focused on exploring a range of issues relevant to interprofessional education and collaboration, which were discussed by use of the associated empirical and theoretical literature.

Ilona Alex Abramovich (Social Media Administrator)

Read more: Journal of Interprofessional Care, May 2011, Vol. 25 (2): 226-227.

Ilona Alex Abramovich, Sherry Espin, Abigail Wickson-Griffiths, Dale Dematteo, Lindsay Baker, Eileen Egan-Lee, Scott Reeves.

A grounded theory of interprofessional co-learning with residents of a homeless shelter

Great article written by Gayle E. Rutherford:

Clients, patients, families, and communities must be conceived

as partners in care delivery, not just as recipients (D’Amour, D. & Oandasan, I. (2005). Journal of Interprofessional Care, 19(Suppl.), 8–20). Health-care students need an opportunity to understand community member self-determination, partnership, and empowerment (Scheyett, A., & Diehl, M. (2004). Social Work Education, 23(4), 435-450), within the frame of interprofessional education (IPE) where community members are involved as teachers and learners. The aim of this grounded theory research was to determine the conditions that support health-care students to learn with, from, and about community members. This study took place in a shelter for the homeless where nursing and social work students learned interprofessionally along with residents and clients of the shelter. Data were gathered through 7 months of participant observation, interviews, and focus groups. The interprofessional co-learning theory that emerged introduces the three phases of entering, engaging, and emerging, which co-learners experienced at different levels of intensity. This article outlines the conditions that support each of these phases of the co-learning process. This interprofessional co-learning theory provides a basis for further development and evaluation of IPE programs that strive to actively include community members as teachers and learners, experts, and novices together with service providers, students, and faculty members.

For more information read: Journal of Interprofessional Care (September 2011), 25 (5), pg. 352-358, Gayle E. Rutherford.

Interprofessional primary care protocols: A strategy to promote an evidence-based approach to teamwork and the delivery of care

Primary care reform involving interprofessional team-based care is a global phenomenon. In Ontario, Canada, 150 Family Health Teams (FHTs) have been approved in the past few years. The transition to a FHT is complex involving many changes and the processes for collaborative teamwork are not clearly delineated. To support the transition to team-based care in FHTs, a project was undertaken to develop and implement a series of interprofessional protocols in four clinical areas. These interprofessional protocols would contain relevant and evidence-based resources to support both a team and evidence-based approach to care. This paper reports on a qualitative study to examine the process of interprofessional protocol development and pilot implementation. Adopting an exploratory case study approach (Robson, 2002), 36 interviews were conducted with health professionals and community group members who participated in the creation and piloting of the protocols, and with project managers. In addition, observational and documentary data were gathered on the protocol development and implementation processes. The findings from the protocol development stage demonstrate the value of the focus on evidence and team, the process of assessing and targeting FHT needs, inter-organizational and interprofessional sharing, the importance of facilitation and support, and expectations for implementation. The findings from the pilot implementation stage report on the importance of champions and leaders, the implementation strategies used, FHT and organizational factors affecting implementation, and outcomes achieved. Findings are discussed in relation to the knowledge translation and interprofessional literature. Research is ongoing to examine the effectiveness of dissemination of the protocols to FHTs across the province of Ontario and its impact on health care outcomes.

Scott Reeves (Editor-in-Chief)

For more information read: Journal of Interprofessional Care (November 2010), 24 (6), pg. 653-665.

The design of an interprofessional objective structured clinical examination (iOSCE) approach

Developing an iOSCE presents unique challenges. For example, there is a need to balance the inclusiveness of participating professions in each scenario with realism, and the need to ensure that learners have opportunities to demonstrate their different interprofessional skills within scenarios. Nevertheless, this initial work has helped to ensure that the perspectives of the professions involved in the IPE curriculum were captured in a fair and equitable manner. In addition, we found that the modified Delphi process was an effective tool to obtain consensus amongst the professions for the foundational work required for this study. The next steps in this study involve two full-day writing workshops to develop the top five topic themes into clinical scenarios for use in the iOSCE that could accommodate any 5 of the 10 health professions at the study site. Participants will work in small, interprofessional groups led by a facilitator to accomplish this task. An iterative process of scenario review, refinement, pilot testing and evaluation for validity and reliability will be used to address challenges, with the help of clinical subject matter and OSCE experts, confederates (trained actors to role play scenarios), and student volunteers. Finally, a series of focus groups will be held with purposefully selected faculty, students, and standardized patients involved in this process to evaluate their experiences in the development of the iOSCE.

Scott Reeves (Editor-in-Chief)

For more information read: Journal of Interprofessional Care (January 2011), 25 (1), pg. 73-74.

The role of nurse practitioners in hospital settings: implications for interprofessional practice

Expansion of the nurse practitioner (NP) role worldwide indicates a need to understand how the role functions in interprofessional healthcare teams. Through the adoption of a mixed methods approach that gathered on-site tracking and observation, self-recorded logs of consultations and focus group interviews of team members and NPs, we describe the extent of role activity and the nature of interprofessional practices of 46 NPs and their team members in nine hospital sites across the province of Ontario, Canada. Findings outline the nature of the NP role activities, which largely focused on providing clinical care, with the support of their team, to a range of patients across the study settings. We discuss how ‘‘embedding’’ the NP in this way appears to contribute to utilization of expertise of all professions as well as enabling team members to promote evidence-based practices. We argue that the use of NPs augments interprofessional role utilization through their desire to consult with a range of professionals and the capacity to perform holistic care for patients that is not limited to traditional nursing boundaries.

(Scott Reeves, Editor-in-Chief)

For more information read: Mary Van Soeren; Christina Hurlock-Chorostecki; Scott Reeves

Journal of Interprofessional Care (July 2011), 25 (4), pg. 245-251.

A scoping review to improve conceptual clarity of interprofessional interventions

Interprofessional education (IPE) and interprofessional collaboration (IPC) have been identified in health education and health care as playing an important role in improving health care services and patient outcomes. Despite a growth in the amount of research in these areas, poor conceptualizations of these interprofessional activities have persisted. Given the conceptual challenges, a scoping review of the interprofessional field was undertaken to map the literature available in order to identify key concepts, theories and sources of evidence. The objective of this review was to develop a theoretically based and empirically tested understanding of IPE and IPC. A total of 104 studies met the criteria and were included for analysis. Studies were examined for their approach to conceptualization, implementation, and assessment of their interprofessional interventions. Half of the studies were used for interprofessional framework development and half for framework testing and refinement. The final framework contains three main types of interprofessional interventions: IPE; interprofessional practice; and interprofessional organization; and describes the nature of each type of intervention by stage, participants, intervention type, interprofessional objectives, and outcomes. The outcomes are delineated as intermediate, patient, and system outcomes. There was very limited use of theory in the studies, and thus theoretical aspects could not be incorporated into the framework. This study offers an initial step in mapping out the interprofessional field and outlines possible ways forward for future research and practice.

(Scott Reeves, Editor-in-Chief)

For more information read: Scott Reeves; Joanne Goldman; John Gilbert; Joshua Tepper; Ivan Silver; Esther Suter; Merrick Zwarenstein

Journal of Interprofessional Care (May 2011), 25 (3), pg. 167-174.