Implementing an interprofessional narrative medicine program in academic clinics: Feasibility and program evaluation.
Ontology highlight
ABSTRACT:
SUBMITTER: Gowda D
PROVIDER: S-EPMC6382622 | biostudies-literature | 2019 Feb
REPOSITORIES: biostudies-literature
Publications
Implementing an interprofessional narrative medicine program in academic clinics: Feasibility and program evaluation.
Gowda Deepthiman D Curran Tayla T Khedagi Apurva A Mangold Michael M Jiwani Faiz F Desai Urmi U Charon Rita R Balmer Dorene D
Perspectives on medical education 20190201 1
Interprofessional education (IPE) is a critical component of medical education and is affected by the characteristics of the clinical teams in which students and residents train. However, clinical teams are often shaped by professional silos and hierarchies which may hinder interprofessional collaborative practice (IPCP). Narrative medicine, a branch of health humanities that focuses on close reading, reflective writing, and sharing in groups, could be an innovative approach for improving IPE an ...[more]
Similar Datasets
Project description:Retention among academic medicine faculty is problematic, and there has been a decline in the number of physicians pursuing careers in academia. The education of future physicians relies upon physicians who pursue careers in academic medicine. Therefore, efforts must be taken to increase the percentage of physicians who conduct research and/or teach medical trainees. Recognizing this need, the New York Institute of Technology College of Osteopathic Medicine (NYITCOM) established the Academic Medicine Scholars Program ("Scholars Program"), which was designed to prepare outstanding osteopathic medical students for a career in academic medicine. Here we aim to determine the extent to which participants in NYITCOM's Scholars Program go on to pursue research and teaching endeavors during their residency and/or fellowship programs. An anonymous survey was administered to participants in the Scholars Program from 2012 through 2018 and asked about the participants' research and teaching experiences at the following time points: during the Scholars Program, residency, and fellowship, if applicable. Participation in the program led to a significant increase in survey respondents' teaching and research skills and an increased participation in scholarly activity as compared with the national average. The results also demonstrated that the program assisted alumni in securing positions in competitive residency and fellowship programs. As residents and fellows, alumni continued to pursue scholarly endeavors, primarily by publishing abstracts and posters, attending both regional and national conferences, and delivering lectures. We are hopeful that other medical schools will take part in producing capable academic medicine physicians by incorporating a similar program into their curriculum.
| S-EPMC8368134 | biostudies-literature
Project description:Project description: In Germany there is great interest in better preparing learners in the health care professions for interprofessional (IP) collaboration on IP training wards. On the MIA, Mannheim's interprofessional training ward, medical students, nursing apprentices and physiotherapy (PT) trainees learn and practise real patient care in a team under supervision. The concept of the MIA, its implementation and the first evaluation results are reported. During the 2017/18 academic year, 201 medical students, 72 nursing apprentices and 33 PT trainees completed their mandatory placements on the MIA, which they evaluated online at the end of the placement (questions on the organisation of the MIA placement, learning gains, supervision, participant satisfaction, personal insights). The data was analysed according to frequency for each health care profession separately using the Kruskal-Wallis test for comparing the evaluation data between the three participant groups. Results: The response rate was 45% (104 medical students, 16 nursing apprentices, 19 PT trainees). 64% of the medical students considered the placement too short. For 70% of the nursing apprentices, the number of patients to be treated was too high. The supervision by the facilitators was adequate. There were often IP contacts. Professional and IP learning gains were rated high. IP learning took place mainly in personal conversations and on IP ward rounds. IP communication/collaboration was mentioned most often as an important insight gained from the placement. Discussion: The implementation of the MIA concept is considered successful. The learning objectives were achieved. The structured daily routine on the ward with its IP elements promotes IP collaboration and helps to minimise difficulties in the clinical placement, which - often for the first time - demands that the participants manage patient care in an accountable manner. Conclusion: Placements on IP training wards in the education of health care professionals can be a good preparation for practising optimal patient care in the future.
| S-EPMC6737260 | biostudies-literature
Project description:ObjectiveImplementation of patient-reported outcome measures (PROMs) is limited in paediatric routine clinical care. The KidsPRO programme has been codesigned to facilitate the implementation of PROMs in paediatric healthcare settings. Therefore, this study (1) describes the development of innovative KidsPRO programme and (2) reports on the feasibility of implementing PedsQL (Pediatric Quality of Life Inventory) PROM in asthma clinics using the KidsPRO programme.DesignFeasibility assessment study.SettingOutpatient paediatric asthma clinics in the city of Calgary, Canada.ParticipantsFive paediatric patients, four family caregivers and three healthcare providers were recruited to pilot the implementation of PedsQL PROM using KidsPRO. Then, a survey was used to assess its feasibility among these study participants.Main outcome measuresParticipants' understanding of using PROMs, the adequacy of support provided to them, the utility of using PROMs as part of their appointment, and their satisfaction with using PROMs.AnalysesThe quantitative data generated through closed-ended questions was analysed and represented in the form of bar charts for each category of study participants (ie, patients, their family caregivers and healthcare providers). The qualitative data generated through the open-ended questions were content analysed and categorised into themes.ResultsThe experience of using PROMs was overwhelmingly positive among patients and their family caregivers, results were mixed among healthcare providers. Qualitative data collected through open-ended questions also complemented the quantitative findings.ConclusionThe evidence from this study reveals that the implementation of PROMs in routine paediatric clinical care asthma clinics in Alberta is seems to be feasible.
| S-EPMC10649366 | biostudies-literature
Project description:BackgroundInterprofessional communication is fundamental to the delivery of healthcare and can be taught in medical school and other health professional schools through interprofessional education (IPE) activities. Simulation centers have become a predominant location for simulation IPE activities with infrastructure able to support high fidelity activities in a controlled environment. In this secondary analysis of a scoping review conducted on simulation-based IPE, we describe the characteristics of previously reported simulation IPE activities involving undergraduate medical students in a simulation center focused on interprofessional communication.MethodsElectronic searches of PubMed, CINAHL, and ERIC databases in accordance with PRISMA-ScR guidelines were conducted to isolate relevant articles from 2016-2020. In total, 165 peer-reviewed articles met inclusion criteria and data extraction linked to four research questions was applied by one individual and the accuracy was confirmed by a second individual. A secondary analysis was performed to describe what existing approaches for simulation IPE in simulation center settings have been used to explicitly achieve interprofessional communication competencies in undergraduate medical education. A sub-dataset was developed from the original scoping review and identified 21 studies describing simulation IPE activities that took place in dedicated simulation centers, targeted the IPEC interprofessional communication domain, and involved undergraduate medical students.ResultsThough diverse, the majority of simulation IPE activities described high-fidelity approaches involving standardized patients and utilized assessment tools with established validity evidence in IPE activities to measure learning outcomes. A minority of simulation IPE activities were described as hybrid and utilized more than one resource or equipment for the activity and only two were longitudinal in nature. Learning outcomes were focused predominantly on modification of attitudes/perceptions and few targeted higher levels of assessment.ConclusionsEducators charged with developing simulation IPE activities for medical students focused on interprofessional communication should incorporate assessment tools that have validity evidence from similar activities, target higher level learning outcomes, and leverage hybrid models to develop longitudinal simulation IPE activities. Though an ideal environment to achieve higher level learning outcomes, simulation centers are not required for meaningful simulation IPE activities.
| S-EPMC8962252 | biostudies-literature
Project description:Background: Quality Improvement (QI) is the key for every healthcare organization. QI programs may help healthcare professionals to develop the needed skills for interprofessional collaboration through interprofessional education. Furthermore, the role of diversity in QI teams is not yet fully understood. This evaluation study aimed to obtain in-depth insights into the expectations and experiences of different stakeholders of a hospital-wide interprofessional QI program. Methods: This qualitative study builds upon 20 semi-structured interviews with participants and two focus groups with the coaches and program advisory board members of this QI program. Data were coded and analyzed using thematic analysis. Results: Three themes emerged from the analysis: “interprofessional education”, “networking” and “motivation: presence with pitfalls”. Working within interprofessional project groups was valuable, because participants with different experiences and skills helped to move the QI project forward. It was simultaneously challenging because IPE was new and revealed problems with hierarchy, communication and planning. Networking was also deemed valuable, but a shared space to keep in contact after finalizing the program was missing. The participants were highly motivated to finish their QI project, but they underestimated the challenges. Conclusions: A hospital-wide QI program must explicitly pay attention to interprofessional collaboration and networking. Leaders of the QI program must cherish the motivation of the participants and make sure that the QI projects are realistic.
| S-EPMC9408409 | biostudies-literature
Project description:BackgroundThe Accreditation Council for Graduate Medical Education Clinical Learning Environment Review program requires residents to receive training in handoffs, but there is limited information on best practices in implementing handoff training.ObjectiveWe hypothesized that a bundled, standardized approach to handoffs during intern orientation would increase trainee comfort, confidence, and knowledge.MethodsAll incoming internal medicine interns participated in a Care Transitions workshop during orientation that was divided into 3 sections: introduction and handoff videos using the I-PASS handoff tool, small group discussion of case scenarios, and a 1-on-1 handoff simulation with an evaluator. Participants completed pre- and postworkshop surveys. We reviewed handoff documents to assess whether residents continued to report illness severity-a key component of I-PASS-after the intervention.ResultsOver 3 years, 225 of 229 (98%) interns completed the preworkshop survey, and 191 (83%) completed the postworkshop survey. Between 2014 and 2016, the number of incoming interns reporting prior training in handoffs during medical school increased from 45% to 63%. Interns' self-reported comfort with providing effective handoffs and self-reported confidence identifying factors essential to an effective verbal handoff (measured on a 5-point Likert scale) improved significantly after the intervention (P < .05 for all questions and years). During 1 year, written handoffs for 28?498 patients were analyzed, and I-PASS illness severity was documented 99.4% of the time.ConclusionsThe Care Transitions workshop consistently improved comfort, confidence, and knowledge of interns in performing handoffs and resulted in sustained change in handoff documentation.
| S-EPMC6314362 | biostudies-literature
Project description:The authors conducted a prospective longitudinal study from 2009 to 2016 to assess the short and long-term impact of a formal mentorship program on junior faculty satisfaction and productivity. Junior faculty mentees enrolled in the program and junior faculty without formal mentorship were administered surveys before and after the program to assess satisfaction with their mentoring experiences. Long-term retention, promotion, and funding data were also collected. Twenty-three junior faculty mentees and 91 junior faculty controls were included in the study. Mentees came from the Departments of Radiation Oncology and Anesthesia, Critical Care, and Pain Management. After participating in the mentorship program, mentees demonstrated an increase in satisfaction from baseline in five of seven domains related to mentoring, while controls experienced no significant change in satisfaction in six of the seven domains. At long-term follow up, mentees were more likely than controls to hold senior faculty positions (percent senior faculty: 47% vs. 13%, p = 0.030) despite no difference in initial administrative rank. When comparing the subset of faculty who were Instructors at baseline, mentees were more likely to be funded and/or promoted than controls (p = 0.030). A majority of mentees reported that the program strengthened their long-term success, and many maintained their original mentoring relationships and formed new ones, highlighting the strong culture of mentorship that was instilled. Several short-term and long-term benefits were fostered from this formal mentorship program. These findings highlight the potential impact of mentorship programs in propagating a culture of mentorship and excellence.
| S-EPMC6264475 | biostudies-literature
Project description:IntroductionThe effectiveness of mailed fecal immunochemical test outreach might be enhanced through an organized colorectal cancer screening program, yet published real-world experiences are limited. We synthesized the process of implementing a colorectal cancer screening program that used mailed fecal immunochemical test outreach in a large integrated academic-community practice.MethodsData from a pilot mailed fecal immunochemical test program were shared with healthcare system leadership, which inspired the creation of a cross-institutional organized colorectal cancer screening program. In partnership with a centralized population health team and primary care, we defined (1) the institutional approach to colorectal cancer screening, (2) the target population and method for screening, (3) the team responsible for implementation, (4) the healthcare team responsible for decisions and care, (5) a quality assurance structure, and (6) a method for identifying cancer occurrence.ResultsThe Fred Hutch/UW Medicine Population Health Colorectal Cancer Screening Program began in September 2021. The workflow for mailed fecal immunochemical test outreach included a mailed postcard, a MyChart message from the patient's primary care provider, a fecal immunochemical test kit with a letter signed by the primary care provider and program director, and up to 3 biweekly reminders. Patients without a colonoscopy 3 months after an abnormal fecal immunochemical test result received navigation through the program. In the first program year, we identified 9,719 patients eligible for outreach, and in an intention-to-treat analysis, 32% of patients completed colorectal cancer screening by fecal immunochemical test or colonoscopy.ConclusionsReal-world experiences detailing how to implement organized colorectal cancer screening programs might increase adoption. In our experience, broadly disseminating pilot data, early institutional support, robust data management, and strong cross-departmental relationships were critical to successfully implementing a colorectal cancer screening program that benefits all patients.
| S-EPMC10864856 | biostudies-literature
Project description:BACKGROUND: Multisource feedback (MSF) is emerging as a central assessment method for several medical education competencies. Planning and resource requirements for a successful implementation can be significant. Our goal is to examine barriers and challenges to a successful multisite MSF implementation, and identify the benefits of MSF as perceived by participants. METHODS: We analyzed the 2007-2008 field trial implementation of the Assessment of Professional Behaviors, an MSF program of the National Board of Medical Examiners, conducted with 8 residency and fellowship programs at 4 institutions. We use a multimethod analysis that draws on quantitative process indicators and qualitative participant experience data. Process indicators include program attrition, completion of implementation milestones, number of participants at each site, number of MSF surveys assigned and completed, and adherence to an experimental rater training protocol. Qualitative data include communications with each program and semistructured interviews conducted with key field trial staff to elicit their experiences with implementation. RESULTS: Several implementation challenges are identified, including communication gaps and difficulty scheduling implementation and training workshops. Participant interviews indicate several program changes that should enhance feasibility, including increasing communication and streamlining the training process. CONCLUSIONS: Multisource feedback is a complex educational intervention that has the potential to provide users with a better understanding of performance expectations in the graduate medical education environment. Standardization of the implementation processes and tools should reduce the burden on program administrators and participants. Further study is warranted to broaden our understanding of the resource requirements for a successful MSF implementation and to show how outcomes change as MSF gains broader acceptance.
| S-EPMC3244317 | biostudies-other
Project description:BackgroundDue to multimorbidity and geriatric problems, older people often require both psychosocial and medical care. Collaboration between medical and social professionals is a prerequisite to deliver high-quality care for community-living older people. Effective, safe, and person-centered care relies on skilled interprofessional collaboration and practice. Little is known about interprofessional education to increase interprofessional collaboration in practice (IPCP) in the context of community care for older people. This study examines the feasibility of the implementation of an IPCP program in three community districts and determines its potential to increase interprofessional collaboration between primary healthcare professionals caring for older people.MethodA feasibility study was conducted to determine the acceptability and feasibility of data collection and analysis regarding interprofessional collaboration in network development. A questionnaire was used to measure the learning experience and the acquisition of knowledge and skills regarding the program. Network development was assessed by distributing a social network survey among professionals attending the program as well as professionals not attending the program at baseline and 5.5 months after. Network development was determined by calculating the number, reciprocity, value, and diversity of contacts between professionals using social network analysis.ResultsThe IPCP program was found to be instructive and the knowledge and skills gained were applicable in practice. Social network analysis was feasible to conduct and revealed a spill-over effect regarding network development. Program participants, as well as non-program participants, had larger, more reciprocal, and more diverse interprofessional networks than they did before the program.ConclusionsThis study showed the feasibility of implementing an IPCP program in terms of acceptability, feasibility of data collection, and social network analysis to measure network development, and indicated potential to increase interprofessional collaboration between primary healthcare professionals. Both program participants and non-program participants developed a larger, more collaborative, and diverse interprofessional network.
| S-EPMC7786471 | biostudies-literature