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      Educação interprofissional: formação de profissionais de saúde para o trabalho em equipe com foco nos usuários Translated title: Interprofessional education: training for healthcare professionals for teamwork focusing on users Translated title: Educación interprofesional: la formación de profesionales de la salud para el trabajo en equipo con enfoque en los usuarios

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          Abstract

          São analisados os constructos teóricos da educação interprofissional com base em duas revisões de literatura, considerado o contexto da formação dos profissionais de saúde no Brasil. Identificam-se três tipos de formação: uniprofissional, multiprofissional e interprofissional, com predomínio da primeira, que ocorre entre estudantes de uma mesma profissão de forma isolada; a segunda, entre estudantes de duas ou mais profissões de forma paralela, sem haver interação, e na terceira há aprendizagem compartilhada, com interação entre estudantes e/ou profissionais de diferentes áreas. Destaca-se a distinção entre interprofissionalidade e interdisciplinaridade, referidas, respectivamente, como a integração das práticas profissionais e das disciplinas ou áreas de conhecimento. Mediante a análise apresentada, conclui-se que no contexto brasileiro, a educação interprofissional, base para o trabalho em equipe colaborativo, ainda está restrita a iniciativas recentes, que merecem estudo.

          Translated abstract

          The theoretical constructs of interprofessional education (IPE) are analyzed based on two reviews of the literature, taking the context of training for healthcare professionals in Brazil into consideration. Three types of training are identified: uniprofessional, multiprofessional and interprofessional, with predominance of the first type. The first occurs among students of the same profession, in isolation; the second occurs among students of two or more professions, in parallel without interaction; and the third involves shared learning, with interaction between students and/or professionals from different fields. The distinction between interprofessionalism and interdisciplinarity is highlighted: these refer to integration, respectively, of professional practices and disciplines or fields of knowledge. Through the analysis presented, it is concluded that in the Brazilian context, IPE (the basis for collaborative teamwork) is still limited to some recent initiatives, which deserve to be investigated.

          Translated abstract

          Fueron analizados los constructos teóricos de la educación interprofesional basado en dos revisiones de la literatura, considerando el contexto de la formación de los profesionales de salud en Brasil. Se identificaron tres tipos de formación: uniprofesional, multiprofesional e interprofesional, con predominio de la primera, que se produce entre los estudiantes de una misma profesión de forma aislada; la segunda, entre los estudiantes de dos o más profesiones de forma paralela, sin existir interacción y, en la tercera existe un aprendizaje compartido, con interacción entre los estudiantes y/o profesionales de diferentes áreas. Se destaca la diferencia entre interprofesionalidad e interdisciplinariedad referidas, respectivamente, como la integración de las prácticas profesionales y de las disciplinas o áreas de conocimiento. A partir del análisis se concluye que en el contexto brasileño, la educación interprofesional base para el trabajo en equipo colaborativo, todavía está restringido a iniciativas recientes, que merecen estudio.

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          Most cited references14

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          Health professionals for a new century: transforming education to strengthen health systems in an interdependent world.

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            Interprofessional collaboration: effects of practice-based interventions on professional practice and healthcare outcomes.

            Poor interprofessional collaboration (IPC) can negatively affect the delivery of health services and patient care. Interventions that address IPC problems have the potential to improve professional practice and healthcare outcomes. To assess the impact of practice-based interventions designed to change IPC, compared to no intervention or to an alternate intervention, on one or more of the following primary outcomes: patient satisfaction and/or the effectiveness and efficiency of the health care provided. Secondary outcomes include the degree of IPC achieved. We searched the Cochrane Effective Practice and Organisation of Care Group Specialised Register (2000-2007), MEDLINE (1950-2007) and CINAHL (1982-2007). We also handsearched the Journal of Interprofessional Care (1999 to 2007) and reference lists of the five included studies. Randomised controlled trials of practice-based IPC interventions that reported changes in objectively-measured or self-reported (by use of a validated instrument) patient/client outcomes and/or health status outcomes and/or healthcare process outcomes and/or measures of IPC. At least two of the three reviewers independently assessed the eligibility of each potentially relevant study. One author extracted data from and assessed risk of bias of included studies, consulting with the other authors when necessary. A meta-analysis of study outcomes was not possible given the small number of included studies and their heterogeneity in relation to clinical settings, interventions and outcome measures. Consequently, we summarised the study data and presented the results in a narrative format. Five studies met the inclusion criteria; two studies examined interprofessional rounds, two studies examined interprofessional meetings, and one study examined externally facilitated interprofessional audit. One study on daily interdisciplinary rounds in inpatient medical wards at an acute care hospital showed a positive impact on length of stay and total charges, but another study on daily interdisciplinary rounds in a community hospital telemetry ward found no impact on length of stay. Monthly multidisciplinary team meetings improved prescribing of psychotropic drugs in nursing homes. Videoconferencing compared to audioconferencing multidisciplinary case conferences showed mixed results; there was a decreased number of case conferences per patient and shorter length of treatment, but no differences in occasions of service or the length of the conference. There was also no difference between the groups in the number of communications between health professionals recorded in the notes. Multidisciplinary meetings with an external facilitator, who used strategies to encourage collaborative working, was associated with increased audit activity and reported improvements to care. In this updated review, we found five studies (four new studies) that met the inclusion criteria. The review suggests that practice-based IPC interventions can improve healthcare processes and outcomes, but due to the limitations in terms of the small number of studies, sample sizes, problems with conceptualising and measuring collaboration, and heterogeneity of interventions and settings, it is difficult to draw generalisable inferences about the key elements of IPC and its effectiveness. More rigorous, cluster randomised studies with an explicit focus on IPC and its measurement, are needed to provide better evidence of the impact of practice-based IPC interventions on professional practice and healthcare outcomes. These studies should include qualitative methods to provide insight into how the interventions affect collaboration and how improved collaboration contributes to changes in outcomes.
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              Equipes de referência: arranjo institucional para potencializar a colaboração entre disciplinas e profissões

              A necessidade de mais colaboração entre disciplinas e profissões é freqüentemente ressaltada em diferentes textos e apontada como possível solução para diversos impasses e questões vividas pelas equipes que atuam em programas e serviços dos setores saúde e educação. No entanto, a discussão sobre a interação disciplinar e profissional tem carecido de avanços em relação ao que foi proposto por Japiassu no Brasil dos anos 1970. Por outro lado, o Sistema Nacional de Saúde (SUS) necessita de propostas que, efetivamente, operacionalizem a integração entre saberes e práticas no âmbito dos serviços. No presente artigo, apresentamos algumas críticas à concepção dominante de colaboração interdisciplinar e interprofissional e apontamos a organização de serviços com base em equipes de referência como forma de estimular e aumentar a colaboração entre disciplinas e profissões.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                reeusp
                Revista da Escola de Enfermagem da USP
                Rev. esc. enferm. USP
                Universidade de São Paulo, Escola de Enfermagem (São Paulo )
                1980-220X
                August 2013
                : 47
                : 4
                : 977-983
                Affiliations
                [1 ] Universidade de São Paulo Brazil
                [2 ] Kings College London UK
                [3 ] Universidade São Paulo
                [4 ] Universidade de São Paulo|Universidade de São Paulo Brasil
                [5 ] Universidade de São Paulo Brazil
                Article
                S0080-62342013000400977
                10.1590/S0080-623420130000400029
                24310699
                fc163735-23f1-41fc-9759-ec794bfd0e9f

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0080-6234&lng=en
                Categories
                NURSING

                Nursing
                Interprofessional relations,Health personnel,Education,continuing,Patient care team,Cooperative behavior,Personal de salud,Educación continua,Relaciones interprofesionales,Grupo de atención al paciente,Conducta cooperativa,Pessoal de saúde,Educação continuada,Relações interprofissionais,Equipe de assistência ao paciente,Comportamento cooperativo

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