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      Norwegian nursing and medical students’ perception of interprofessional teamwork: a qualitative study

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          Abstract

          Background

          Little is known about the ways in which nursing and medical students perceive and understand their roles in interprofessional teamwork. A 2010 report by the World Health Organization highlights the importance of students’ understanding of teamwork in healthcare, and their ability to be effective team players. This study aims at describing nursing and medical students’ perceptions of interprofessional teamwork, focusing on experiences and recommendations that can be used to guide future educational efforts.

          Methods

          The study uses a qualitative research design. Data were collected from four focus group interviews: two homogenous groups (one with medical students, one with nursing students) and two mixed groups (medical and nursing students).

          Results

          The results show that traditional patterns of professional role perception still prevail and strongly influence students’ professional attitudes about taking responsibility and sharing responsibility across disciplinary and professional boundaries. It was found that many students had experienced group cultures detrimental to team work. Focusing on clinical training, the study found a substantial variation in perception with regard to the different arenas for interprofessional teamwork, ranging from arenas with collaborative learning to arenas characterized by distrust, confrontation, disrespect and hierarchical structure.

          Conclusions

          This study underlines the importance of a stronger focus on interprofessional teamwork in health care education, particularly in clinical training. The study results suggest that the daily rounds and pre-visit “huddles,” or alternatively psychiatric wards, offer arenas suitable for interprofessional training, in keeping with the students’ assessments and criteria proposed in previous studies.

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          Most cited references21

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          Interprofessionality as the field of interprofessional practice and interprofessional education: an emerging concept.

          This paper proposes a new concept and a frame of reference that should permit the development of a better understanding of a phenomenon that is the development of a cohesive and integrated health care practice among professionals in response to clients' needs. The concept is named "interprofessionality" and aims to draw a clear distinction with another concept, that of interdisciplinarity. The utilization of the concept of interdisciplinarity, which originally concerns the development of integrated knowledge in response to fragmented disciplinary knowledge, has caused some confusion. We need a concept that will specifically concern the development of a cohesive practice among different professionals from the same organization or from different organizations and the factors influencing it. There is no concept that focuses clearly on this field. Interprofessionality concerns the processes and determinants that influence interprofessional education initiatives as well as determinants and processes inherent to interprofessional collaboration. Interprofessionality also involves analysis of the linkages between these two spheres of activity. An attempt to bridge the gap between interprofessional education and interprofessional practice is long overdue; the two fields of inquiry need a common basis for analysis. To this end, we propose a frame of reference, an interprofessional education for collaborative patient-centred practice framework. The framework establishes linkages between the determinants and processes of collaboration at several levels, including links among learners, teachers and professionals (micro level), links at the organizational level between teaching and health organizations (meso level) and links among systems such as political, socio-economic and cultural systems (macro level). Research must play a key role in the development of interprofessionality in order to document these linkages and the results of initiatives as they are proposed and implemented. We also believe that interprofessionality will not be pursued without the requisite political will.
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            A systematic review of the effectiveness of interprofessional education in health professional programs.

            The objective of this systematic review was to identify the best available evidence for the effectiveness of university-based interprofessional education for health students. Currently, most health professional education is delivered in a traditional, discipline specific way. This approach is limited in its ability to equip graduates with the necessary knowledge, skills and attitudes for effective interprofessional collaboration and for working as part of a complex health care team. Interprofessional education is widely seen as a way to improve communication between health professionals, ultimately leading to improved patient outcomes. The review included all randomised controlled trials and quasi-experimental studies in which two or more undergraduate or post-graduate health professional groups are engaged in interprofessional education. A three-stage comprehensive search of ten electronic databases as well as grey literature was conducted. Two independent reviewers assessed each paper prior to inclusion using the standardised critical appraisal instruments for evidence of effectiveness developed by the Joanna Briggs Institute. Nine published studies consisting of three randomised controlled trials, five controlled before and after studies and one controlled longitudinal study were included in the review. Student's attitudes and perceptions towards interprofessional collaboration and clinical decision-making can be potentially enhanced through interprofessional education. However, the evidence for using interprofessional education to teach communication skills and clinical skills is inconclusive and requires further investigation. Future randomised controlled studies explicitly focused on interprofessional education with rigorous randomisation procedures, allocation concealment, larger sample sizes, and control groups, would improve the evidence base for interprofessional education. Copyright © 2011 Elsevier Ltd. All rights reserved.
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              Concept analysis of interdisciplinary collaboration.

              The study aims to explore the meaning of interdisciplinary collaboration within the context of health care. Rodgers' Evolutionary View of Concept Analysis was employed to identify attributes, antecedents, and consequences of interdisciplinary collaboration. Utilizing an inductive approach, a systematic review of the literature was undertaken in August 2007 to clarify the current use of interdisciplinary collaboration in health care. Interdisciplinary collaboration is commonly described using the terms problem-focused process, sharing, and working together. The elements that must be in place before interdisciplinary collaboration can be successful are interprofessional education, role awareness, interpersonal relationship skills, deliberate action, and support. Consequences of interdisciplinary collaboration are beneficial for the patient, the organization, and the healthcare provider. A comprehensive definition of interdisciplinary collaboration within the context of health care is presented as an outcome of this analysis. It is recommended that further inquiry in this area focus on the development of valid measures to accurately evaluate interdisciplinary collaboration in health care.
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                Author and article information

                Contributors
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central
                1472-6920
                2014
                14 August 2014
                : 14
                : 170
                Affiliations
                [1 ]Department of Health Studies, University of Stavanger, Stavanger N-4036, Norway
                [2 ]Department of Health Studies, University of Stavanger and Stavanger University Hospital, Stavanger N-4036, Norway
                Article
                1472-6920-14-170
                10.1186/1472-6920-14-170
                4139134
                25124090
                0371d21a-512b-4cfc-98c7-425e0d7668bb
                Copyright © 2014 Aase et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.

                History
                : 7 August 2013
                : 8 August 2014
                Categories
                Research Article

                Education
                interprofessional teamwork,interprofessional education,professional role,content analysis,healthcare,students’ perceptions

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