There is a widespread emphasis in healthcare delivery on the need for interprofessional collaborative care in order to enhance quality and safety in patient care. Interprofessional learning about collaboration, problem solving and decision-making beyond the confines of individual professions is important for practicing health professionals. As attitude has been found to predict behaviour, a positive attitude by health professionals toward interprofessional teams could positively affect interprofessional team functioning, and subsequently the quality of care provided to the patient. The purpose of this study was to determine whether an interprofessional learning experience would improve attitudes toward interprofessional teams using the Attitudes Toward Health Care Teams Scale. Healthcare professionals attending a new employee orientation completed the Attitudes Towards Health Care Teams (ATHCT) scale before and after an interprofessional education intervention. Results revealed a statistically significant increase in ATHCT scale mean score following the interprofessional education intervention. Findings from this study suggest that interprofessional learning can be an effective means to increase attitudes toward interprofessional teams and potentially contribute to improving interprofessional collaboration in healthcare. / October 2016

ABSTRACT BACKGROUND: The interaction among various health disciplines in a health care team using the IPE approach has received recognition as one of the most effective methods of improving the delivery of healthcare services. The perception and attitude of students toward IPE is considered one of the barriers and challenges to implement interprofessional education. PURPOSE: The aim of this study is to evaluate students’ perceptions toward interprofessional education. METHOD: Data were collected through a descriptive survey using the Readiness for Interprofessional Learning Scale (RIPLS). The survey consisted of 19 items, 5-point Likert scale and grouped into four sub-scales; teamwork and collaboration, negative professional identity, positive professional identity, and roles and responsibilities. The survey was administered to a convenience sample of undergraduate and graduate students who are enrolled in nursing, respiratory therapy, nutrition, physical therapy, and occupational therapy programs at an urban university. The collected data were analyzed using descriptive statistics. RESULTS: The number of participants was two hundred and fifty (n= 250) students from five programs. Physical therapy students accounted for 29.2%; followed by nursing students 28.8%; respiratory therapy students 26.4%; nutrition students 8.4%; and occupational therapy students 7.2%. Female participants accounted for 71.6% of all participants while male participants accounted for 28.4%. Over half of the participants are graduate degree students while 44.4% are undergraduate degree students. Almost one third of participants reported previous IPE experience and two third of participants reported no previous IPE experience. The study findings revealed that participants have positive perception and more agreement toward IPE (M = 81.10, ± 8.16 out of 95 points). The study showed that there is insignificant correlation between age and RIPLS total scores, negative professional identity, positive professional identity, and roles & responsibilities. There is only a significant negative correlation (rs = -0.176; P = 0.008) between students’ age and teamwork & collaboration subscale. Moreover, the study findings revealed that gender and previous IPE experience have no significant effect on students’ perception toward IPE. CONCLUSION: Results indicate that healthcare professional students value interprofessional education and have good perception toward it. Further studies with higher number of participants from various disciplines and level of education are recommended.

As life expectancy rises and the rates of chronic diseases increase, we are challenged to transform our vision of health care, particularly in primary care settings. Options are rethinking team composition, and expanding our understanding of what is needed for well-functioning interdisciplinary teams and effective integration of a wide range of professionals. This case study investigates the factors that impact team functioning with the introduction of a new role by comparing and contrasting perspectives from various professional groups and clients with the aim of better understanding the important elements in facilitating integration of the new role. This study highlights the importance of factors such as the new provider’s familiarity, experience, and qualities in facilitating the other team members’ and clients’ acceptance. In addition, the findings reveal the positive impact that the new provider had on improving the services and in promoting the clients’ adherence to their plan of care.

Class of 2010 Abstract / OBJECTIVES: To evaluate the impact of interprofessional education on the perceptions and attitudes of pharmacy students. METHODS: A remodeled version of the Interdisciplinary Education Perceptions Scale (IEPS) was administered during a regular class time for first, second, and third year students. This adapted IEPS was designed and validated to assess three aspects of interprofessional perceptions: competency and autonomy (sub-scale 1), perceived need for cooperation (sub-scale 2), and perception of actual cooperation (sub-scale 3). Data regarding sex, age, previous health care work experience, and previous degree achievement were also collected. RESULTS: A total of 211 pharmacy students completed the survey (73 first-years, 85 second-years, and 53 third-years). Analysis of variants (one-way ANOVA) was used to analyze the potential difference in perceptions between the three groups of pharmacy students using both the total and sub-scale scores. No statistically significant difference was found between total scores, sub-scale 1, sub-scale 2, or sub-scale 3 with regard to pharmacy school year. There was also no significant difference in perceptions with regard to sex, age, work experience, or degree status for any scale scoring. CONCLUSIONS: Perceptions of interprofessional education did not differ between first-, second-, and third-year pharmacy students at the University of Arizona, College of Pharmacy.

Class of 2010 Abstract / OBJECTIVES: To examine the potential differences in attitudes between the colleges of pharmacy, nursing, medicine, and social work relating to the “Culture and Communication” IPE activity at the University of Arizona in 2007. METHODS: This was a retrospective study comparing the opinions and attitudes of different groups of healthcare students concerning the IPE activity “Culture and Communication” at the University of Arizona. The independent variable in this study was academic discipline: medicine, pharmacy, nursing, law, or social work. The dependent variables were the attitudes and opinions of the effectiveness of this IPE activity on Culture and Communication. RESULTS: A total of 589 questionnaires (medicine=119, pharmacy=89, nursing=77, social work=21) were completed and included in 2007. Overall, students felt the Culture and Communication IPE activity improved their knowledge of how to identify barriers to communication and reduce the likelihood of miscommunication with other healthcare professionals. The percent of students who believed they had a very high understanding of the barriers to effective communication among health care providers increased from 11.3% before the IPE activity to 34.5% after. The percent of students who believed they had a very high knowledge of how to reduce the likelihood of miscommunication increased from 6.6% before the IPE activity to 37.4% after. There were differences between the groups relating to the different questions that the questionnaire focused on. CONCLUSIONS: There were significant differences between the various healthcare professionals relating to the usefulness and effectiveness of the Culture and Communication IPE activities at the University of Arizona. Overall, students seemed to benefit from and enjoy the IPE activity and would recommend having future students participate in the activities. The majority of students felt the Culture and Communication IPE activity was benificial and allowed for the improvement of relationships and attitudes between the health care professions. There were similar responses between the medicine, nursing, pharmacy, and social work students.

Children with serious illnesses experience life disruptions that are of consequence to long-term health and development. The spiritual is integral to health, yet many healthcare providers claim a lack of understanding and comfort with attending to spiritual issues in practice. This hermeneutic phenomenological inquiry explores spirituality as lived by children with cancer and cystic fibrosis and highlights the importance of spirituality in the provision of holistic child healthcare. Four children aged nine to fourteen from each illness group (six males and two females) were interviewed and asked to draw pictures, forming the primary data for interpretation. Conversations with family members were also included in the analysis as supplements to the primary data. Study findings offer insights into children’s lived experiences of the spiritual. They reveal unmet spiritual needs and unique ways of living the spiritual that often went unrecognized by adults. The experiences shared were profound and deeply meaningful, revealing hidden wondering and wisdom that defies contemporary views of how children understand and deal with the complexity of living with serious illness. Findings provide more nuanced understandings of the spiritual that allow for the voices and emotions of children to be heard, revealing a sense of struggle and the need to find meaning in illness with all its disruptions and demands on time and freedom. Findings also reveal the meanings in relationships that sustained children in their efforts to live well with illness. These findings provide possibilities for viewing child health differently—a view that includes the spiritual and its implications—that can lead to a more conscious awareness, wisdom, and sensitivity in practice. Findings offer ways of engaging children in conversations about illness meanings and the spiritual that recognize the complexity in language and the need for alternate strategies to mine the depths of experiences that are often hidden. Because the spiritual does not always wait for experts to arrive, findings are relevant to all healthcare providers and caregivers of ill children. Implications for interprofessional research, education, and practice are also explored, providing possibilities for seeing, exploring, and living the spiritual in our practices of caring for ill children.

Data in the literature consistently shows most of specialty care is provided at large metropolitan, academic medical centers where there is a great enough volume of patients to support specialty providers (The Robert Wood Johnson Foundation, 2016). America occupies over 3.8 million square miles with 72% of the country classified as rural territory by the Department of Agriculture in 2017 with 20% of Americans living where healthcare provider shortages exist (Nationmaster, 2017). Poor maternal health combined with barriers in accessing quality prenatal care, place infants at greater risk for sustaining a Brachial Plexus Birth Injury (BPBI) during the delivery process. BPBI has an incidence of 1/1000 births with the potential for nerve damage to be permanent in 10-18% of cases (Chauhan, S. et al., 2014; Frade et al., 2019). Restriction on the use of telehealth results in reduced access to specialty care. To mitigate the inequities in healthcare, this author applied key concepts found in the literature on effective educational collaborations between specialty providers and community providers to develop an online educational series (Ashburner et al., 2016; Bywood et al., 2013; Careau et al., 2008; Day et al., 2012; González-Espada et al., 2009; Mahnke et al., 2011; Shivji et al., 2011; Ray et al., 2015), for community occupational and physical therapists in gaining important knowledge and competence for caring for children with BPBI in their own communities. This program integrates the positive benefits of building community networks for formal and informal mentoring to decrease provider isolation, to improve efficiency and effectiveness of healthcare for children with BPBIs in rural areas.

This thesis is concerned with communication in interprofessional practice, an issue which is identified as a ‘difficulty’ but ‘essential’ in the literature. The research is based on a case study focusing on the communication between professionals in a series of planning meetings held to support the transition of a child with additional support needs from playgroup into the nursery class of a primary school in Scotland. The study explores the dynamics and complexities of communication through the theoretical frameworks of ethnography of communication and Dewey’s concept of communication as participative action. This joint analysis illustrates the way in which the group worked together to make something in common and the extent of commonality that was needed for them to work actively together. The findings show the interprofessional group functioning as a speech community with a bounding feature of working with the child. The soft-shell of this community illustrates a flexibility of practice and the ability of the group to expand or contract to meet the needs of the child and family. The way in which the participants worked together to agree the outcomes they were working towards is an illustration of Deweyan communication, making something in common between them. This process included the recognition of the competence and responsibility of individual professions. The study demonstrates that the doctors who were members of the interprofessional group were recognised as holding more power than the other members of the group and were bound by the outcomes and procedures of their own profession. This difference affected the dynamics of communication within the interprofessional team. The findings add to our understanding of the complexities of communication in an interprofessional team and show that communication in a Deweyan sense can strengthen the work of an interprofessional group and develop their support for the child or family they are working with.

The purpose of this study is to explore leadership and interprofessional team learning in well-established specialist teams in an academic health care organization. It also illuminates the data with more precise team leadership theories to help advance interprofessional health care practice. Employing an interactionist ethnographic approach, the study focuses on exploring team leaders’ role, their perceptions, meanings, and behaviours within the culture of two teams in the department of nephrology in an academic health care organization. Qualitative data derived from interviews, observations, and documents were gathered over a two-year period to obtain a comprehensive understanding of the workings of the teams. The research is also informed by the experiences of the researcher who had been a member of the department of nephrology under study. Data analysis involved an inductive thematic analysis of observations, reflections, and interview transcripts. The three broad themes of this dissertation reflect the characteristics and activities of leaders of team learning: first, situational team leadership, as a process, affects the social context of interprofessional team-learning relationships, interactions, and activities within the complex culture of an academic health care organization. Second, team learning embodies the collective praxis of its members. The members inform the role of leading learning through the social construction of meaning in dialogue and their reflective practices. Third, effective team leadership ensures the transfer of collective knowledge to students and trainees. Effective leaders also help team members deal with the challenge of learning how to work within a well-established, specialized health care team as community of practice. Such a team has special capabilities that enable interprofessional team learning. Hence, a leader who learns how to use team learning to create new and collective knowledge will be able to create a learning experience for students, trainees, and team members who are focused on interprofessional practice and care. This study offers a contribution to the interprofessional education literature in two ways. First, the study’s use of theoretical perspectives provides new ways of thinking about leaders and learning in interprofessional communities of practice. Second, the study provides a rare empirical in-depth account of, interprofessional team leadership within well-established specialized teams in an academic health care organization.

The purpose of this study is to explore leadership and interprofessional team learning in well-established specialist teams in an academic health care organization. It also illuminates the data with more precise team leadership theories to help advance interprofessional health care practice. Employing an interactionist ethnographic approach, the study focuses on exploring team leaders’ role, their perceptions, meanings, and behaviours within the culture of two teams in the department of nephrology in an academic health care organization. Qualitative data derived from interviews, observations, and documents were gathered over a two-year period to obtain a comprehensive understanding of the workings of the teams. The research is also informed by the experiences of the researcher who had been a member of the department of nephrology under study. Data analysis involved an inductive thematic analysis of observations, reflections, and interview transcripts. The three broad themes of this dissertation reflect the characteristics and activities of leaders of team learning: first, situational team leadership, as a process, affects the social context of interprofessional team-learning relationships, interactions, and activities within the complex culture of an academic health care organization. Second, team learning embodies the collective praxis of its members. The members inform the role of leading learning through the social construction of meaning in dialogue and their reflective practices. Third, effective team leadership ensures the transfer of collective knowledge to students and trainees. Effective leaders also help team members deal with the challenge of learning how to work within a well-established, specialized health care team as community of practice. Such a team has special capabilities that enable interprofessional team learning. Hence, a leader who learns how to use team learning to create new and collective knowledge will be able to create a learning experience for students, trainees, and team members who are focused on interprofessional practice and care. This study offers a contribution to the interprofessional education literature in two ways. First, the study’s use of theoretical perspectives provides new ways of thinking about leaders and learning in interprofessional communities of practice. Second, the study provides a rare empirical in-depth account of, interprofessional team leadership within well-established specialized teams in an academic health care organization.