Interprofessional Experiences and Attitudes Toward Interprofessional Health Care Teams Among Health Sciences Students

This study examined how the interprofessional experience, including education and practice, affects graduate health science students’ attitudes toward interprofessional practice in health care teams. Data were collected from 227 graduate students, using the Attitudes toward Health Care Teams (ATHCT) scale. Both social work and other health science students had positive attitudes toward interprofessional collaboration with regard to its ability to improve the quality of a patient’s care. The results from hierarchical linear regression analyses demonstrated that female students, older students, and students with longer interprofessional practice experiences had more positive attitudes toward interprofessional collaboration in health care teams. Based on these results, implications for interprofessional education are discussed.     

Interprofessional collaboration in the hospital: strategies and meanings

OBJECTIVES: Interprofessional collaboration is widely advocated in health and social care policies. However, existing research provides a relatively poor understanding of how professionals collaborate or the meanings they attach to their collaborative work. This paper aims to contribute to understanding of this activity by providing an in-depth account of interprofessional collaboration on medical wards in a large teaching hospital. METHODS: Ethnographic methods were used, including individual and group interviews with health and social care staff (i.e. doctors, nurses, therapists, social workers; n = 49) and participant observations of ward-based work. RESULTS: The organisation of medical teams, who cared for patients across a number of wards, and the task oriented nature of medical work, limited opportunities for collaboration with other professionals (e.g. nurses, therapists) who were usually based on a single ward. Consequently, collaboration tended to be task-based, terse and formalistic. Staff employed a range of informal and formal communication strategies to overcome these constraints. Professionals also gave contrasting accounts of collaboration: doctors viewed collaboration primarily as an activity involving work with their medical colleagues, whereas other professionals saw it more as an interprofessional activity. CONCLUSIONS: Temporospatial constraints and contrasting notions of 'collaboration' are important factors in shaping the nature of interprofessional collaboration. Policies that promote this activity cannot assume that shared understanding of collaboration exists. They also need to be mindful of the practical constraints that affect collaboration in hospital wards.     

Interprofessional Collaboration in Finnish Residential Child Care: Challenges in Incorporating and Sharing Expertise Between the Child Protection and Health Care Systems

Many children taken into care tend to be in need of psychiatric treatment as well as child protection services, and thus the professional expertise of both systems must be coordinated in their care. However, it is widely known across Europe that collaboration between child protection services and mental health services is not working well and the outcomes for looked-after children are poor. In spite of drastic need for knowledge, interprofessional collaboration between residential workers and mental health practitioners is poorly explored in international research. Most importantly, very little is known about shared expertise in multi-agency teams between these systems. Based on the analysis of interprofessional focus group interviews (eight interviews with 17 practitioners) in Finland, it is claimed that both sides have unrealistic expectations and perceptions of the other professional grouping and its facilities to help high-need children. The study also indicates that the collaboration assumes an equality of status and responsibilities between the professionals that does not always exist amongst residential child care practitioners and mental health professionals. The analysis suggests that the concept of residential child care work itself needs more empirical research to strengthen the interprofessional competencies and enhance child-centred integrated care.     

Interprofessional collaborative alliances: health care educators sharing and learning from each other

The clinical setting in which health care professionals work is interdisciplinary, complex, and outcome-oriented. Interprofessional health care teams in academia should work collaboratively to design educational experiences that provide students with the skills necessary for contending with the complexities of practice. The interprofessional team may also collaborate in research efforts that evaluate the impacts of new educational strategies on student outcomes. This work establishes a collaborative framework, the interprofessional alliance model, that describes the stages and relationships that are established during the process of interprofessional collaboration. The new model is a synthesis of two established models: the five-stage model of collaboration and the alliance model. The authors illustrate the application of their model with a case example that describes the collaborative relationship that emerged among educators in physical therapy and nursing at a single university. The interprofessional alliance model may be used to examine the process of collaborative efforts among health care providers of varied disciplines.     

Serving Families on the Frontline: Challenges and Creative Solutions in Rural Hospice Social Work

Focus on the social service and health care needs of rural dwellers has emerged due to changing demographics and advocacy efforts. All rural health providers are faced with numerous unique challenges. As a valuable part of hospice teams, social workers are well equipped to have an integral role in understanding and addressing the specific challenges in end-of-life care in rural communities. In this study, a Web-based survey was completed by 339 hospice social workers spanning 40 states in the United States. Both quantitative and qualitative methods and data analysis strategies were utilized. The results reveal environmental and cultural challenges impacting social work practice. The results also unveil solutions and suggestions for addressing challenges such as creative use of resources and increased collaboration within the local resident, health care, and social work communities. Implications include potential strategies for enhanced social work practice in rural areas, yielding a quality end-of-life care for individuals and families.     

Interprofessional practice: Social work students’ perspectives on collaboration

ABSTRACT

As the value of interprofessional practice becomes increasingly recognized, it is critical to educate social work students so that they understand the importance of interprofessional practice, and the role that social workers play. The objective of this research was to understand social work students’ experiences, attitudes, and perspectives toward interprofessional practice. A cross-sectional, non-probability convenience sample was used (N = 125), with data collected from students in a large school of social work in New York State in order to understand their experiences in the field and classroom. Results of a linear regression showed that overall, students had positive perspectives on interprofessional collaboration, with one of the strongest predictors being students' positive attitudes toward interprofessional practice. The results also point to students having limited experience in working in interprofessional teams and exposure to training, either on the job or in the classroom. To help students gain more experience and training, fieldwork opportunities in interprofessional practice can be expanded, and more courses can be offered, particularly collaborating with other academic disciplines.     

Examining variables related to successful collaboration on the hospice team

Although social work participation on interdisciplinary teams is long-standing, little research has been done to examine its effectiveness. This study used the Index of Interdisciplinary Collaboration to explore relationships between selected variables and teamwork in the hospice setting.The findings indicate that hospice social workers report a high level of interdisciplinary collaboration with colleagues. Whereas education, hospice census, the presence of other social workers, and quality of care were found to be unrelated to overall levels of collaboration, individual items measuring collaboration proved to be linked with hospice census, the presence of other social workers on the team, and quality of care. Further research is required to investigate other possible related variables and their impact on successful interdisciplinary collaboration and service delivery.     

Educational approaches for preparing social work students for interdisciplinary teamwork on geriatric health care teams.

Interest in teamwork has fluctuated over the last several decades, with recent renewed interest. As social workers become more involved in working with older people in the coming years, their success will hinge on collaboration with other health providers. Schools of social work and clinical sites must address this through the development of educational curricula and clinical programs which prepare social workers to work on interdisciplinary geriatric health care teams. Based on the experience of the national Geriatric Interdisciplinary Team Training (GITT) Program, this article presents an overview of the necessary team skills for social workers, educational methods for teach ing teamwork developed at the GITT sites, and some teaching challenges.     

The use of boundary objects to enhance interprofessional collaboration: integrating complementary medicine in a hospital setting

Because of the inherent complexity of human health, the provision of good quality patient care requires collaboration in multidisciplinary teams. Integrative healthcare provides a unique setting for the study of interprofessional collaboration in the context of power disparities. The research objective was to examine which means and mechanisms were used to facilitate interprofessional collaboration when integrating complementary medicine (CM) into a hospital’s surgical department. Throughout 2010 we conducted a qualitative study in an Israeli public hospital’s surgical department, using observations and 30 in‐depth interviews with managers, surgeons, physicians, nurses, patients and CM practitioners. The sociological concepts of boundary actor and boundary object and the context of power relations served as a framework for this research. This article contributes to the field of interprofessional collaborative care research by: analysing types of collaboration inhibitors – epistemological and social‐structural gaps; pointing to boundary actors who establish interprofessional collaboration in an integrative hospital setting and noting the boundary objects they use; and comparing collaboration levels. The collaboration between CM practitioners and the department’s staff is a loosely coupled system. When coordination was achieved, reaching profound agreements seemed of lesser importance to the parties. Closer collaboration and cross‐fertilisation were found among CM practitioners.     

Improving interprofessional collaboration: The effect of training in nonviolent communication

This article examines the effects of nonviolent communication (NVC) training on the interprofessional collaboration (IPC) of two health and social services sector care teams. The study was conducted in 2013 with two interprofessional teams (N = 9) using a mixed method research design to measure the effects of the training. Individual IPC competency was measured using the Team Observed Structured Clinical Encounter tool, and group competency using the Observed Interprofessional Collaboration tool. A focus group was held to collect participant perceptions of what they learned in the training. Results revealed improvements in individual competency in client/family-centered collaboration and role clarification. Improvements in group competency were also found with respect to teams’ ability to develop a shared plan of action. Data suggests that participants accepted and adopted training content. After the training, they appeared better able to identify the effects of spontaneous communication, more understanding of the mechanisms of empathy, and in a better position to foster collective leadership.     

Tipping the balance: international collaboration in primary health care reorientation

This paper describes a multicountry initiative aimed at TippingThe Balance towards primary health care (TTB). The Alma Ata declaration was the inspiration for the projectwhich has three branches. This paper describes one of these:community participation and skills development. TTB is a collaboration involving primary health care and otherpublic sector workers, educators, researchers and people inlocal communities. Twelve linked projects in five differentcountries are described. Projects have been grouped into fouraction areas: community participation; protection and promotion;inter-sectoral collaboration; reorientation to primary healthcare. Striking similarities existed in relation to health issues inall countries in the TTB project. All project teams focusedon reduction of inequality in health experiences and expectations,and worked for social justice in health care. It is believed that, by all the efforts documented in this paper,TTB teams can make a significant contribution towards socialjustice in their own countries, and also internationally.     

“How Dare You Question What I Use to Treat This Patient?”: Student Pharmacists’ Reflections on the Challenges of Communicating Recommendations to Physicians in Interdisciplinary Health Care Settings

A growing number of pharmacists practice within interdisciplinary health care teams, leading pharmacy educators to place increased emphasis on the development of interprofessional collaboration skills. In the pharmacist–physician relationship, pharmacists’ medication therapy recommendations (MTRs) are a recurrent and significant interprofessional activity, one that can be challenging for both seasoned and student pharmacists. Drawing on in-depth ethnographic interviews with pharmacy preceptors and advanced student pharmacists, we identify and describe an important distinction between pharmacist-initiated MTRs and physician-initiated MTRs as contexts for interprofessional collaboration. We describe and illustrate a range of social, professional, and communication challenges that students experience in each context, as well as some strategies they use to navigate these challenges. Using the theoretical framework of dialectic tensions, we argue that the pharmacist–physician relationship is characterized by a tension between assertiveness and deference. We also offer recommendations to pharmacy preceptors, who can use this article to enhance the experiential education of pharmacists.     

Attitudes of health sciences students towards interprofessional teamwork and education

Relatively little is known about the specific attributes of health professional students which may influence their attitudes towards both interprofessional teamwork and interprofessional education. A survey was distributed to all pre-licensure health professional students from medicine, nursing, pharmacy and social work programmes at our institution. Respondents were asked to rate their attitudes towards interprofessional healthcare teams and interprofessional education using validated and reliable scales reported in the literature. Information on the respondents' gender, profession, year of study and prior experience with interprofessional education was also collected. There was no significant difference between attitudes of medicine and nursing students towards interprofessional teamwork; however, both these student groups report significantly less positive attitudes towards interprofessional teams than pharmacy and social work students. Medicine students reported significantly less positive attitudes towards interprofessional education than nursing, pharmacy and social work students. Female students and senior undergraduate students reported significantly more positive attitudes towards interprofessional teamwork and interprofessional education, while students reporting prior experience with interprofessional education reported significantly more positive attitudes towards interprofessional teamwork. Profession, gender and year of study appear to be attributes which were related to more positive attitudes towards both interprofessional teamwork and education.     

Community care in practice: social work in primary health care

This paper examines the establishment of social work within primary health care settings in Great Britain, following the passage of the National Health Service and Community Care Act in 1990. Although the improvement of relationships between social workers and primary health care teams has been promoted for a number of years, the advent of formal policies for community care has made this a priority for both social services and health. This paper presents interim findings from the evaluation of three pilot projects in Nottinghamshire, Great Britain. These findings are analysed from three linked perspectives. The first is the extent to which structures and organisations have worked effectively together to promote the location of social workers within health care settings. The second is the impact of professional and cultural factors on the work of the social worker in these settings. The third is the effect of interpersonal relationships on the success of the project. The paper will conclude that there is significant learning from each of these perspectives which can be applied to the future location of social workers to primary health care.     

A conceptual framework for interprofessional shared decision making in home care: Protocol for a feasibility study

Background  

Shared decision making (SDM) is fundamental to informed consent and client-centered care. So far, SDM frameworks have been limited to the client-physician dyad, even though care is increasingly delivered by interprofessional (IP) teams. IP collaboration is especially essential in home care, one of health care's most rapidly growing areas. This study will assess whether it is possible to practice SDM in IP home care.     

Communicating With Pediatricians: Developing Social Work Practice in Primary Care

While social work models of interdisciplinary collaboration suggest that communication is important, the research literature on social worker–physician collaboration infrequently considers work with pediatricians or practice outside the hospital setting. A cross-sectional survey was sent to a stratified random sample of social workers to assess their communication satisfaction with pediatricians. The study found that social workers in health settings were more satisfied than those in mental health settings. The implications of this finding for the development of colocated, collaborative care models are discussed.     

Social Work in the Veterans Administration Hospital System: Impact of the Work

Social workers in the Veterans Administration (VA) hospital system are faced with numerous challenges to best address the ongoing health and mental health needs of those who serve in the military. Social workers in the VA system serve diverse roles on the multidisciplinary medical teams and mental health services and are integral to the VA hospital environment. Most social workers feel positive about their work and their contributions to the care of the military. Despite positive feelings about their work, social workers are also prone to compassion fatigue and burnout as the work, especially with returning veterans from Afghanistan/Iraq, often extracts a toll. This article details the experience of social workers in the VA hospital system; it describes the impact of the work on the social workers, noting levels of compassion satisfaction, compassion fatigue, and burnout.     

Social work in the veterans administration hospital system: impact of the work

Social workers in the Veterans Administration (VA) hospital system are faced with numerous challenges to best address the ongoing health and mental health needs of those who serve in the military. Social workers in the VA system serve diverse roles on the multidisciplinary medical teams and mental health services and are integral to the VA hospital environment. Most social workers feel positive about their work and their contributions to the care of the military. Despite positive feelings about their work, social workers are also prone to compassion fatigue and burnout as the work, especially with returning veterans from Afghanistan/Iraq, often extracts a toll. This article details the experience of social workers in the VA hospital system; it describes the impact of the work on the social workers, noting levels of compassion satisfaction, compassion fatigue, and burnout.     

Community Care in Practice

SUMMARY

This paper examines the establishment of social work within primary health care settings in Great Britain, following the passage of the National Health Service and Community Care Act in 1990. Although the improvement of relationships between social workers and primary health care teams has been promoted for a number of years, the advent of formal policies for community care has made this a priority for both social services and health. This paper presents interim findings from the evaluation of three pilot projects in Nottinghamshire, Great Britain. These findings are analysed from three linked perspectives. The first is the extent to which structures and organisations have worked effectively together to promote the location of social workers within health care settings. The second is the impact of professional and cultural factors on the work of the social worker in these settings. The third is the effect of interpersonal relationships on the success of the project. The paper will conclude that there is significant learning from each of these perspectives which can be applied to the future location of social workers to primary health care.