Interdisciplinary Professional Practice Leadership within a Program Model: BC Rehab's Experience

In restructuring from a departmental to a program management model, BC Rehab successfully developed the role of professional practice leader to address clinical standards of practice and other concerns related to individual disciplines. A review of the role of professional practice leader is presented. Practice leaders are in a unique position to promote interdisciplinary, client-focused service. Because practice leaders' mandates cross program boundaries, they are able to keep the broad scope and goals of rehabilitation in the forefront, offering a balance to the program-specific perspective. It is imperative for practice leaders to maintain connections to operational and clinical issues to avoid isolation.En délaissant le modèle de gestion de services pour adopter un modèle de gestion de programmes, BC Rehab a réussi à créer le rôle de « chef de file de I'exercice professionnel» dans le domaine des normes cliniques de I'exercice professionnel et autres préoccupations liées aux disciplines individuelles. L'article qui suit examine ce rôle. Un chef de file de I'exercice professionnel occupe une place unique dans la promotion d'un service multidisciplinaire centré sur le client. Comme le mandat du chef de file lui permet de dépasser les limites de programmes particullers, il est en mesure de garder au premier plan la portée générale et les buts de la réadaptation, et faire ainsi contrepoids aux perspectives restreintes aux programmes particullers. Pour éviter I'isolement, le chef de file doit absolument demeurer au courant de I'actualité médicale et administrative.     

An Interdisciplinary Health Team Training Program for School Staff in Minnesota

ABSTRACT: This paper describes an interdisciplinary health team training program for school-based clinic staff in Minnesota. The project sought to improve team functioning, level of practice, and health care services at the school sites. Participants were interdisciplinary staff members from clinics in senior high, middle, and elementary schools. The program consisted of further development in team training knowledge and skills and educational sessions on issues identified by participants. Evaluations indicated participants reported greater knowledge and improved team functioning experiences from the team training. Gains also were shown in knowledge and skills in specific school topic areas such as violence, resiliency, working with resistant families, and self-care. The program could serve as a model for other interdisciplinary school health team training.     

Interdisciplinary Leadership Training Outcomes of Maternal and Child Health-Funded Pediatric Pulmonary Centers

Objectives: To describe career paths, leadership accomplishments, and extent of incorporation of Maternal and Child Health Bureau (MCHB) values into professional activities of all previous long-term trainees. Method: In 1998 the Pediatric Pulmonary Centers (PPCs) completed a Leadership Training Outcomes Survey of all previous long-term trainees. The survey included 1) characteristics, 2) career paths, 3) current professional activities, 4) leadership roles and activities, and 5) career incorporation of MCHB values. Results: There was a 63% response rate (N = 274) from 431 mailed surveys. Most respondents provided clinical care in varied health-related settings. Of the respondents, 44% (N = 120) served mothers, 87% (N = 239) served children, and 78% (N = 214) served children with special health care needs. Forty-seven percent of the mothers and children served were from racial or ethnic minority groups. Ninety-two percent (N = 252) of respondents had conducted training since graduation and 56% (N = 153) had provided technical assistance. Many provided leadership in the acquisition and dissemination of new knowledge through research publication (33%), advocacy (37%), and program administration/oversight (87%). Thirty percent of the respondents (N = 83) had received special recognition awards for professional activities. Conclusions: Most PPC graduates serve families and children as a central aspect of their career, providing or enhancing family-centered, community-based, culturally competent, comprehensive interdisciplinary care.     

The UNC-CH MCH Leadership Training Consortium: Building the Capacity to Develop Interdisciplinary MCH Leaders

This article describes the UNC-CH MCH Leadership Consortium, a collaboration among five MCHB-funded training programs, and delineates the evolution of the leadership curriculum developed by the Consortium to cultivate interdisciplinary MCH leaders. In response to a suggestion by the MCHB, five MCHB-funded training programs—nutrition, pediatric dentistry, social work, LEND, and public health—created a consortium with four goals shared by these diverse MCH disciplines: (1) train MCH professionals for field leadership; (2) address the special health and social needs of women, infants, children and adolescents, with emphasis on a public health population-based approach; (3) foster interdisciplinary practice; and (4) assure competencies, such as family-centered and culturally competent practice, needed to serve effectively the MCH population. The consortium meets monthly. Its primary task to date has been to create a leadership curriculum for 20–30 master’s, doctoral, and post-doctoral trainees to understand how to leverage personal leadership styles to make groups more effective, develop conflict/facilitation skills, and identify and enhance family-centered and culturally competent organizations. What began as an effort merely to understand shared interests around leadership development has evolved into an elaborate curriculum to address many MCH leadership competencies. The collaboration has also stimulated creative interdisciplinary research and practice opportunities for MCH trainees and faculty. MCHB-funded training programs should make a commitment to collaborate around developing leadership competencies that are shared across disciplines in order to enhance interdisciplinary leadership.     

Adolescence as a Critical Stage in the MCH Life Course Model: Commentary for the Leadership Education in Adolescent Health (LEAH) Interdisciplinary Training Program Projects

The Life Course Perspective (LCP), or Model, is now a guiding framework in Maternal and Child Health (MCH) activities, including training, supported by the Health Resources and Services Administration’s Maternal and Child Health Bureau. As generally applied, the LCP tends to focus on pre- through post-natal stages, infancy and early childhood, with less attention paid to adolescents as either the “maternal” or “child” elements of MCH discourse. Adolescence is a distinct developmental period with unique opportunities for the development of health, competence and capacity and not merely a transitional phase between childhood and adulthood. Adequately addressing adolescents’ emergent and ongoing health needs requires well-trained and specialized professionals who recognize the unique role of this developmental period in the LCP.     

Assessing an Interdisciplinary Health Care Model: The Governor's Wellmobile Program

This article assesses the applicability of Bronstein's (2003 Bronstein, L.R. 2003. A model for interdisciplinary collaboration. Social Work, 43(3): 297–306. [Crossref] , [Google Scholar]) generic model of interdisciplinary collaboration in the context of a newly created collaboration providing community-based health care services, the Governor's Wellmobile Program. An analysis of the program's quarterly reports and interviews with faculty and students involved in the collaboration offers an assessment of the model and implications for interdisciplinary social work practice in community health care delivery.     

The Effectiveness of a Sexuality Training Program for the Interdisciplinary Spinal Cord Injury Rehabilitation Team

While there is evidence to support consideration of client sexuality needs in the provision of rehabilitation services to people with spinal cord injury (SCI), the interdisciplinary team rarely receives training in this area. The current study aimed to examine the effectiveness of a consumer-driven sexuality training program in improving staff knowledge, comfort (general and personal) and attitudes. Using a local needs assessment to identify training needs and the Permission, Limited Information, Specific Suggestions and Intensive Therapy (PLISSIT) model as a training framework, a sexuality training program was developed in one Australian SCI service. A randomized controlled trial was conducted and significant improvement was found in all domains for the treatment group – Knowledge(χ²= 46.141, p< 0.001), Comfort (χ²= 23.338, p< 0.001), Approach(χ²= 23.925, p< 0.001) and Attitude (χ²= 15.235, p< 0.001) compared to the control group. Changes were found to be maintained at three month follow-up – Knowledge (Z=−5.116, p< 0.001), Comfort (Z=−3.953, p< 0.001), Approach (Z=−4.103, p< 0.001) and Attitudes (Z=−2.655, p< 0.001). These results support the use of an individualized needs-based sexuality training program in fostering staff knowledge, comfort and attitudinal change in an interdisciplinary SCI rehabilitation service.     

The Experience of Four Individuals with Paraplegia Enrolled in an Outpatient Interdisciplinary Sexuality Program

Spinal cord injury has a significant impact on an individual’s physical, emotional, as well as sexual functioning. Four consecutive males with spinal cord injury were referred to the outpatient spinal cord injury sexuality program at an urban Veterans Affairs Medical Center and seen by an interdisciplinary team comprised of a nurse, physician and psychologist. They felt that their questions had been answered and their emotional well-being had been appropriately addressed in a respectful environment and effective process. Results suggest that availability of continued access to counseling regarding sexually related issues is very important and that patients can benefit from an interdisciplinary approach in addressing functional and emotional needs.     

The Pipeline Training Program in Maternal and Child Health: Interdisciplinary Preparation of Undergraduate Students from Underrepresented Groups

The Preparing Academically Successful Students in Maternal and Child Health (MCH PASS) training program provided financial support and specialized training to occupational therapy (OT) and speech-language pathology (SLP) undergraduate students from underrepresented groups in maternal and child health. The project assisted undergraduate trainees to matriculate into graduate programs in their respective fields and facilitated application into long-term maternal and child health training programs. Sixteen trainees (8 OT and 8 SLP) participated in an undergraduate training program with an emphasis on interdisciplinary teaming, family mentoring, leadership development, public health and population-based research. Instruction occurred in community and classroom settings through didactic instruction and small group discussions. Fifteen of the trainees applied to and were accepted in graduate programs in their respective fields. Two trainees applied to a long-term MCH training program. Students reported increased knowledge about programs that serve women and children, the effects of poverty on health, interdisciplinary teaming and the daily routines of families who have a child with a special health care need. The MCH PASS program provided a unique opportunity for undergraduate students in OT and SLP to learn about public health with an emphasis on maternal and child health. The specialized preparation enabled students to understand better the health concerns of underserved families whose children have special health care needs.     

A Nurse-Led Interdisciplinary Leadership Approach Targeting Pressure Ulcer Prevention in Long-term Care

Mounting evidence suggests that the quality of outcomes in long-term care can be improved by strengthening the leadership behaviors of nurses. Consequently, a reduction in the prevalence and incidence of pressure ulcers (PUs) is thought to be possible through a nurse-led, team-based approach. The purposes of this article were to (1) advocate for greater nurse-led interdisciplinary teamwork focusing on PU prevention and (2) describe how a transformational and practice-based framework can be used to guide the long-term care team to improve PU quality care outcomes. Application of nurse-led, team-conceptualized strategies enables interdisciplinary workers to partner and more effectively participate in PU prevention programs, thus deepening engagement in the organization's overall approach to achieving quality outcomes.     

Interprofessional Leadership Training in MCH Social Work

The need to train health social workers to practice interprofessionally is an essential goal of social work education. Although most health social workers have exposure to multidisciplinary practice within their field work, few social work education programs incorporate interprofessional learning as an integrated component of both course work and field experiences (McPherson, Headrick, & Moss, 2001; Reeves, Lewin, Espin, & Zwaranstein, 2010; Weinstein, Whittington, & Leiba, 2003). In addition, little is written about the kinds of curricula that would effectively promote interdisciplinary training for social work students. These findings are particularly puzzling since there is increasing and compelling evidence that interdisciplinary training improves health outcomes (IOM, 2001). This article describes a social work education program that incorporates an Interprofessional education and leadership curriculum for Maternal and Child Health Social Work (MCHSW) at the University of Maryland's School of Social Work. The University of Maryland's Interprofesisonal Training Model is described along with the components needed to formulate an interdisciplinary learning experience. Various outcomes and lessons learned are discussed.     

Future Directions in Leadership Training of MCH Professionals: Cross-Cutting MCH Leadership Competencies

Leadership in Maternal and Child Health (MCH) requires a repertoire of skills that transcend clinical or academic disciplines. This is especially true today as leaders in academic, government and private settings alike must respond to a rapidly changing health environment. To better prepare future MCH leaders we offer a framework of MCH leadership competencies based on the results of a conference held in Seattle in 2004, MCH Working Conference: The Future of Maternal and Child Health Leadership Training. The purpose of the conference was to articulate cross-cutting leadership skills, identify training experiences that foster leadership, and suggest methods to assess leadership training. Following on the work of the Seattle Conference, we sub-divide the 12 cross-cutting leadership competencies into 4 “core” and 8 “applied” competencies, and discuss this distinction. In addition we propose a competency in the knowledge of the history and context of MCH programs in the U.S. We also summarize the conference planning process, agenda, and work group assignments leading to these results. Based on this leadership competency framework we offer a definition of an MCH leader, and recommendations for leadership training, assessment, and faculty development. Taken as a set, these MCH leadership competencies point towards the newly-emerging construct of capability, the ability to adapt to new circumstances and generate new knowledge. “Capstone” projects can provide for both practice and assessment of leadership competencies. The competency-based approach to leadership that has emerged from this process has broad relevance for health, education, and social service sectors beyond the MCH context.