“Refreshed…reinforced…reflective”: A qualitative exploration of interprofessional education facilitators’ own interprofessional learning and collaborative practice

While there is extensive research examining the outcomes of interprofessional education (IPE) for students, minimal research has investigated how facilitating student learning influences the facilitators themselves. This exploratory case study aimed to explore whether and how facilitating IPE influences facilitators’ own collaborative practice attitudes, knowledge, and workplace behaviours. Sixteen facilitators of an online pre-licensure IPE unit for an Australian university participated in semi-structured telephone interviews. Inductive thematic analysis revealed three emergent themes and associated subthemes characterising participants’ reflexivity as IPE facilitators: interprofessional learning; professional behaviour change; and collaborative practice expertise. Participants experienced interprofessional learning in their role as facilitators, improving their understanding of other professionals’ roles, theoretical and empirical knowledge underlying collaborative practice, and the use and value of online communication. Participants also reported having changed several professional behaviours, including improved interprofessional collaboration with colleagues, a change in care plan focus, a less didactic approach to supervising students and staff, and greater enthusiasm impressing the value of collaborative practice on placement students. Participants reported having acquired their prior interprofessional collaboration expertise via professional experience rather than formal learning opportunities and believed access to formal IPE as learners would aid their continuing professional development. Overall, the outcomes of the IPE experience extended past the intended audience of the student learners and positively impacted on the facilitators as well.     

“Just working in a team was a great experience…” – Student perspectives on the learning experiences of an interprofessional education program

Interprofessional education (IPE) programs aim to improve collaboration between health- and social-care professionals and to optimize clinical outcomes. Such programs are complex to design, and evaluation of effectiveness is difficult. Combining qualitative and quantitative data may provide greater understanding of how a program affects participants and what aspects are influential on attitudes and behavior. This qualitative study used semi-structured interviews and interpretative phenomenological analysis to explore undergraduate student perspectives on what attributes of a 4-week IPE program they considered contributed to a successful learning experience. Due to the fact that the students were not formally assessed, the realistic context of the activities and the quality of the facilitators created an environment where the students felt empowered to interact freely without fear of reproach. Learning the roles of other professions and their contribution to a healthcare team broadened the students' perspectives on healthcare and increased their sense of self-worth and pride in their professions. In addition, being able to identify the relevance of the learning experience to their future practice motivated the students. This information can be used to create optimal learning environments for facilitating the development of successful future healthcare teams.     

Developing a culture of safety: Exploring students’ perceptions of errors in an interprofessional setting

Abstract

Healthcare has a long tradition of silence around mistakes that cause or have the potential to cause harm to a patient, and there is evidence that this culture may be present from the beginning of a health professional’s training. The purpose of this pilot study was to examine a team of interprofessional students’ interactions with a preceptor in a simulation environment. The debriefing explored the students’ reactions and assisted them with how to manage similar situations in the future to improve patient safety. The results showed that the students felt powerless to stop the simulated preceptor from doing harm to the patient, or to even question the preceptor’s unsafe actions. Recommendations for educators include incorporating discussions and interprofessional training about handling mistakes into the curriculum, in the context of patient safety.     

Pharmacy students’ attitudes towards physician–pharmacist collaboration: Intervention effect of integrating cooperative learning into an interprofessional team-based community service

The aim of this study was to evaluate the attitudes towards physician–pharmacist collaboration among pharmacy students in order to develop an interprofessional education (IPE) opportunity through integrating cooperative learning (CL) into a team-based student-supported community service event. The study also aimed to assess the change in students’ attitudes towards interprofessional collaboration after participation in the event. A bilingual version of the Scale of Attitudes Toward Physician–Pharmacist Collaboration (SATP²C) in English and Chinese was completed by pharmacy students enrolled in Wuhan University of Science and Technology, China. Sixty-four students (32 pharmacy students and 32 medical students) in the third year of their degree volunteered to participate in the IPE opportunity for community-based diabetes and hypertension self-management education. We found the mean score of SATP²C among 235 Chinese pharmacy students was 51.44. Cronbach’s alpha coefficient was 0.90. Our key finding was a significant increase in positive attitudes towards interprofessional collaboration after participation in the IPE activity. These data suggest that there is an opportunity to deliver IPE in Chinese pharmacy education. It appears that the integration of CL into an interprofessional team-based community service offers a useful approach for IPE.     

Faculty facilitators’ and standardized family members (SFMs) perceptions of student teamwork during an interprofessional education simulation workshop

ABSTRACT

Standardized patients can be trained to portray standardized family members (SFMs) for interprofessional education (IPE) initiatives to maximize student learning. To date, studies of IPE often focus on student learning outcomes rather than on the feedback and perspectives of SFMs and faculty facilitators (FFs), The purpose of our study was to examine SFMs’ and FFs’ perspectives immediately after participating in an IPE workshop. SFMs and FFs completed a semi-structured questionnaire consisting of open-ended questions to identify positive and challenging aspects of interactions with health professions students during an IPE workshop. A directed content analysis approach was used to assess written feedback (N = 29) from SFMs and FFs. Study findings highlight many similar themes between SFMs and FFs as well as minor differences regarding recognition of emotion and communication transitions. SFMs and FFs both agreed, however, that these are areas for further development by students to improve communication. Our study adds insight into SFMs’ and FFs’ feedback immediately after an IPE workshop.     

‘I cannot be missed yet’: A qualitative study of carers of family members with an intellectual disability about long-term care planning during the COVID-19 pandemic

Background

Family carers of people with an intellectual disability sometimes need to transfer their caregiving tasks for example because of illness or ageing. We examined carers' experiences with long-term care planning and the impact of the COVID-19 pandemic on their intentions to engage in long-term planning in the Netherlands.

Method

Twenty-five semi-structured interviews with family carers of people with an intellectual disability were conducted and 169 answers to an open question were thematically analysed. Data collection took place at three timepoints during 2020 and 2021.

Results

Family carers were recurrently concerned with long-term care planning, especially with finding people to whom they can entrust their tasks. However, they perceived barriers in care planning. The COVID-19 pandemic reinforced awareness of long-term care planning and moved some to action.

Conclusions

The perceived urge to plan by family carers has grown due to the COVID-19 pandemic. The current study provides valuable insights for stakeholders to support them in this.     

‘Different things at different times’: Wellbeing strategies and processes identified by parents of children who have an intellectual disability or who are autistic,or both

Background

Most parents of children with an intellectual disability or who are autistic identify positives in their family life and their own wellbeing, in addition to reported mental health challenges. Several models and interventions have been developed in relation to parent carer wellbeing. Few studies have asked parent carers how they support their own wellbeing.

Method

Adopting an interpretive phenomenological approach this study utilised semi-structured interviews. Seventeen parent carers were asked what supported their emotional wellbeing. Template Analysis was applied to develop themes.

Results

All participants identified factors that supported their wellbeing. Themes included strategies that countered stress (time for themselves, relaxation, ‘parking’ difficulties) and broader wellbeing strategies (finding meaningful life direction, greater understanding of child). An ongoing process of supporting wellbeing by ‘Reorienting and Finding Balance’ appeared central.

Conclusions

Self-identified, multi-dimensional strategies benefit parents' emotional wellbeing and should be considered in the context of support provided to families.     

Development of the ‘Attitudes to Health Professionals Questionnaire’ (AHPQ): A measure to assess interprofessional attitudes

This paper describes the development and preliminary validation of a measure to investigate interprofessional attitudes and how these attitudes change over time. Items for the questionnaire were elicited from ‘construct exercises’ with staff from different Health Schools resulting in a 20-item ‘Attitudes to Health Professionals Questionnaire’ (AHPQ). The questionnaire was completed by first year students from five different health professions. Its structure was evaluated using principal components analysis, the internal consistency was determined and the test-retest reliability assessed. Analysis of these data led to rephrasing/ removal of certain items and a revised form of the AHPQ. The revised AHPQ was completed by a different cohort of students and a preliminary validation was carried out. A solution with two main components labelled ‘caring’ and ‘subservient’ emerged from analysis of the structure of the initial AHPQ, the overall internal consistency was good although the test-retest reliability varied. Preliminary validation of the revised questionnaire suggested significant differences, on both scales, in students' attitudes towards different health professions at the outset of their training. The AHPQ appears to be a useful instrument for the assessment of interprofessional attitudes in the health professions.     

Supervisors’ experiences of undergraduate nursing students’ learning in clinical practice when applying caring and learning as parallel processes in a caritative caring conceptual learning model (Part 2)

The Model for Improvements in Learning Outcomes (MILO) is theoretically grounded and designed to intertwine didactics, pathophysiology and medicine with specific concepts important for learning. The aim was to describe supervisors' experiences of undergraduate nursing students' learning during clinical practice when using MILO. A qualitative and explorative design was used. Seventeen supervisors, thirteen women and four men from different departments at three hospitals in southern Sweden participated. After using the model, data were collected through four focus group interviews with open unstructured interview questions and analysed using inductive latent content analysis. Twelve subcategories, four generic subcategories and one main category emerged. The students developed a questioning approach and were more reflective, open and compliant. Twosomes enhanced learning. Specific documents generated structure and feelings of participation. The supervisors felt that taking the students' pre-understanding into account and a caring approach in the learning environment were valuable for enhanced learning. The students established a caring relationship with the patients and the patients’ perspective became emphasized. Using MILO, intertwining between the natural and the professional became possible; enhanced learning in nursing skills together with a more caritative caring approach towards the patient was revealed. The need of compassion is discussed.     

An exploration of student nurses’ thoughts and experiences of using a video-recording to assess their performance of cardiopulmonary resuscitation (CPR) during a mock objective structured clinical examination (OSCE)

Cardiopulmonary resuscitation (CPR) is an essential skill taught within undergraduate nursing programmes. At the author’s institution, students must pass the CPR objective structured clinical examination (OSCE) before progressing to second year. However, some students have difficulties developing competence in CPR and evidence suggests that resuscitation skills may only be retained for several months. This has implications for practice as nurses are required to be competent in CPR. Therefore, further opportunities for students to develop these skills are necessary. An action research project was conducted with six students who were assessed by an examiner at a video-recorded mock OSCE. Students self-assessed their skills using the video and a checklist. Semi-structured interviews were conducted to compare checklist scores, and explore students’ thoughts and experiences of the OSCE. The findings indicate that students may need to repeat this exercise by comparing their previous and current performances to develop both their self-assessment and CPR skills. Although there were some differences between the examiner’s and student’s checklist scores, all students reported the benefits of participating in this project, e.g. discussion and identification of knowledge and skills deficits, thus emphasising the benefits of formative assessments to prepare students for summative assessments and ultimately clinical practice.     

Implementation of a Registered Undergraduate Student of Nursing (RUSON) program: The nurses’ perspective

ProblemUndergraduate nursing students remain an underutilised workforce within healthcare. This paper explores the establishment of a Registered Undergraduate Students of Nursing (RUSON) model through a university and healthcare partnership.BackgroundNursing continues to adapt to increasingly complex patient populations. Initiatives are needed to enable nurses to focus on patients’ care needs amidst increasing healthcare costs. This study identifies opportunities and strategies for engaging undergraduate nursing students as part of the healthcare workforce through the RUSON model, from the perspective of nurse leaders.AimThis project aimed to explore nurse leaders’ perspectives surrounding implementation of a RUSON model.MethodA qualitative exploratory design was employed for this study. Thematic analysis from a focus group with the nurse leaders was undertaken.FindingsTwo key themes were identified from the analysis, i) Establishing the RUSON; with sub-themes: “Who are RUSONs?”, “You are not on clinical placement” and “The importance of inclusivity” and ii) Benefits of the RUSONs; with sub-themes: “Addressing patient care needs”, “Value to the nursing team” and “Creating future ready employees”. Participants identified barriers that were overcome, subsequently leading to the model being considered advantageous to the clinical environment.DiscussionThe establishment of a RUSON workforce in acute care settings brings with it benefits to the nursing staff and the RUSONs themselves. In order to successfully embed a RUSON model in an organisation, it is important to collaborate with the nursing leadership team in the implementation process.ConclusionA RUSON workforce is an appropriate human resource strategy, both at the immediate point of implementation and longitudinally, as a recruitment strategy for future employment. Successful implementation of a RUSON model requires engagement and collaboration with nursing leaders.     

Patients’ view on health-related aspects of functioning and disability of joint contractures: a qualitative interview study based on the International Classification of Functioning,Disability and Health (ICF)

Abstract

Purpose: The aim of this study was to identify health-relevant aspects of functioning and disability of persons aged 65 years or older with joint contractures, to link the findings to corresponding ICF categories and to describe the patients’ perspective. Methods: We conducted 43 qualitative, semi-structured, face-to-face interviews with affected persons in two different locations (Witten, Munich) and in three different settings. Data were analyzed using the “meaning condensation procedure” and then linked to ICF categories. Results: From all interviews a total of 2499 single meaning-concepts were extracted which were linked to 324 different ICF categories. The participants in all settings mainly reported problems related to “Mobility of a single joint (b710)”, “Sensation of pain (b280)” and problems related to “Walking (d450)”. Almost all participants reported “Products and technology for personal indoor and outdoor mobility and transportation (e120)” as a relevant environmental factor. Conclusions: From the patients’ perspective, joint contractures have an impact on multifaceted aspects of functioning and disability, mainly body functions, environmental factors and activities and participation. The results of this study will contribute to the development of a standard instrument for measuring functioning, disability and health-relevant aspects for patients with joint contractures.

• Implications for Rehabilitation

• Joint contractures are a major cause for the development of disability in older people.

• Patients’ perspectives and their personal experiences have to be considered when assessing the impact of joint contractures.

• The International Classification of Functioning, Disability and Health (ICF) is an appropriate framework for describing the patients’ multifaceted experience of joint contractures.

     

Disappearing in a Female World: Men’s Experiences of Having an Eating Disorder (ED) and How It Impacts Their Lives

The number of men diagnosed with anorexia has increased, men now representing 25% of those with eating disorders (EDs). Research has mainly been quantitative and female focused, with only two qualitative studies exploring the experiences of men. This study focused on the lived experiences of men diagnosed with an ED, and its impact on ‘everyday’ aspects of their lives. Qualitative research adopting narrative interviews was conducted with seven men aged 23–34 years old. Narrative analysis was used to interpret each individual story, with thematic analysis used to explore commonalities across all seven narratives. Four themes were identified, 1) The Final John Doe; 2) Help! I need somebody - Bedlam revisited; 3) Masculinity; 4) Not Working 9 to 5. Narratives highlight the need for further research if men are to receive appropriate mental health care and better understanding and acceptance on the part of society, service providers, employers and men themselves.