Effective interprofessional collaboration in rural contexts : A research protocol
- Mitchell, Rebecca, Paliadelis, Penny, McNeil, Karen, Parker, Vicki, Giles, Michelle, Higgins, Isabel, Parmenter, Glenda, Ahrens, Yvonne
- Authors: Mitchell, Rebecca , Paliadelis, Penny , McNeil, Karen , Parker, Vicki , Giles, Michelle , Higgins, Isabel , Parmenter, Glenda , Ahrens, Yvonne
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Advanced Nursing Vol. 69, no. 10 (2013), p. 2317-2326
- Full Text: false
- Reviewed:
- Description: Abstract AIM: To describe the research protocol that will be used to investigate factors contributing to effective interprofessional practice in a rural context in Australia. BACKGROUND: Interprofessional practice is a key strategy for overcoming rural health challenges; however, our knowledge of interprofessional initiatives and consequences in rural areas is limited. DESIGN: A modified realistic evaluation approach will be used to explore the structures, systems, and social processes contributing to effective interprofessional outcomes. This 'context-mechanism-outcome' approach provides a useful framework for identifying why and how interprofessional practice works in rural contexts. METHOD: Initial propositions regarding the factors that explain effective collaborative practice will be generated through interviews with lead clinicians, policy-makers, and clinician managers. Clinician interviews, document analysis, and multi-participant focus groups will be used as evidence to support, refine, or redevelop the initial propositions. This will allow the development of a model of rural interprofessional practice that will explain how and why collaborative approaches work in rural environments. This study is funded by an Institute of Rural Clinical Services and Teaching grant (January 2010). DISCUSSION: Rural healthcare challenges are well documented; however, studies investigating the nature of interprofessional practice in rural contexts are not common. Rural contexts also present research design, particularly data collection, challenges. This proposed research is one of the first to identify the factors that facilitate or constrain effective interprofessional work in rural settings. This is particularly important, given the continuing workforce shortages and maldistribution and poorer health outcomes in rural communities globally.
Perceptions of shared decision-making in severe mental illness : an integrative review
- Huang, Chongmei, Plummer, Virginia, Lam, Louisa, Cross, Wendy
- Authors: Huang, Chongmei , Plummer, Virginia , Lam, Louisa , Cross, Wendy
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Journal of Psychiatric and Mental Health Nursing Vol. 27, no. 2 (Apr 2020), p. 103-127
- Full Text: false
- Reviewed:
- Description: Accessible SummaryWhat is known about shared decision-making? There is increasing evidence of the positive impact of shared decision-making on health outcomes. There has been little exploration of shared decision-making regarding people diagnosed with serious mental illness from the perspectives of key stakeholders including consumers, families and mental health professionals. What this paper adds to existing knowledge? Consumers show variability in the preference for their involvement. Most stakeholders acknowledge the importance of family involvement. MHPs should share the responsibility and right to facilitate consumer involvement. There is bidirectional association between shared decision-making and therapeutic relationships. The practice of shared decision-making is related to multiple factors, and one main perceived barrier is time. The majority of studies are from Western countries. What are the implications for practice? Elicit consumer preferences and establish a collaborative therapeutic relationship. Encourage and engage families in treatment decision-making. Inter-professional collaboration should be integrated into shared decision-making. It might require lengthier consultation time. Studies in non-Western countries are needed to fully understand the impact of culture on shared decision-making. Shared decision-making (SDM) has been broadly advocated in health services and constitutes an important component of patient-centred care and relationship-based care. To review available literature related to perceptions of key stakeholders about shared decision-making in serious mental illness. An integrative review was conducted through a search of four online databases from January 2012 to June 2019. Forty-six articles were included. Six themes were generated from the data analysis: (a) dynamic preferences for SDM, (b) various stakeholders are rarely involved, (c) SDM is not routinely implemented, (d) multiple facilitators and barriers to SDM, (e) SDM and therapeutic relationships interact, (f) SDM has a promising impact on health outcomes. Overall, most stakeholders have recognized the importance and flexibility of SDM in serious mental illness, although it is not routine in mental health service. Consumer preferences show variability in their involvement. Most stakeholders acknowledged the importance of family involvement to treatment decision-making. There are several significant challenges to practice SDM. It may require extended consultation times and increasing empirical evidence regarding the SDM outcomes, as well as integrating inter-professional collaboration into SDM. Most studies were conducted in Western culture. Mental health nurses should elicit consumer preferences and establish a collaborative therapeutic relationship. Encourage and engage families in treatment decision-making when consumers prefer their families to be involved. Inter-professional collaboration should be integrated into shared decision-making. The practice of shared decision-making might need extended consultation time and more robust evidence about the outcome of shared decision-making. Studies in non-Western cultures are needed to fully understand cultural issues of shared decision-making. IntroductionAimMethodResultsDiscussionImplications for practice
Developing chiropractic students clinical practice skills - elements of best practice : a qualitative exploratory descriptive study
- Authors: Haworth, Navine
- Date: 2021
- Type: Text , Thesis , PhD
- Full Text:
- Description: Background Although chiropractic has 125 years as an established profession, scrutiny of the literature proves that few studies have examined the clinical education of chiropractic students with a call for research from academics. This thesis is significant as it develops knowledge that can inform chiropractic bodies and help them improve an essential component of chiropractic education: clinical skill development. Research Purpose and Aims The purpose of this study was to identify elements of best practices in clinical education by critically examining, exploring and describing the aspects of an exemplar chiropractic clinical program that develops students’ clinical practice skills for transition into practice. This study explored the innovative clinical program of a reputable American chiropractic institution providing a scaffolded clinical program across varied clinical settings, patient populations and amongst other health disciplines. Research Design A six-phase exploratory descriptive qualitative design (EDQD) study was conducted to explore and describe the phenomenon being examined (Flick, 2014). This design enabled the collection of information about perceptions and lived experiences of three stakeholder cohorts: clinical faculty members, students and new graduates. Methods Purposive sampling (of students and clinical faculty members) and snowball sampling techniques (of new graduates) were used to derive the sample. Data were collected in three cycles across a two-year period using in-depth, semi-structured interviews. Interviews were conducted with 15 clinical faculty members and eight new graduates, and semi-structured focus groups were conducted with 20 students. All data were audio recorded, transcribed and thematically analysed using an inductive approach. Findings Chiropractic clinical education programs ought to be developed within a framework that incorporates adult learner principles; situated, social and experiential learning theories. Valued was a student-centred learning experience that includes authentic and diverse clinical placements, supervision and mentoring from multiple clinical educators which enhances students’ access to varied perspectives of clinical practices that contributes to developing clinical skills and professional identity. Business knowledge and entrepreneurial skills was an area of deficiency, which is problematic when the objective is to build graduates’ independence in clinical practice and professional prospects are predominantly private practice (NBCE, 2020). Embedding evidence-based practice within curricula and clinical training for educators and students are necessary to ensure this becomes a part of clinical practice. Conclusion This thesis posits best practice in chiropractic clinical education consists of the following: (a) using a scaffolded longitudinal clinical program, (b) varying clinical placements and case mix, (c) supervision and mentoring from multiple clinical educators, (d) educating the clinical educator, (e) curricula designed around industry standards and desired graduate attributes and capabilities, (f) an evidence-based practice approach in the curricula and clinical context, (g) aligning business skills, knowledge and practices with the professional context and (h) interprofessional learning and practice opportunities. Although this study has made a contribution to scholarly discourse, there remain many gaps in our knowledge where further studies are needed.
- Description: Doctor of Philosophy
- Authors: Haworth, Navine
- Date: 2021
- Type: Text , Thesis , PhD
- Full Text:
- Description: Background Although chiropractic has 125 years as an established profession, scrutiny of the literature proves that few studies have examined the clinical education of chiropractic students with a call for research from academics. This thesis is significant as it develops knowledge that can inform chiropractic bodies and help them improve an essential component of chiropractic education: clinical skill development. Research Purpose and Aims The purpose of this study was to identify elements of best practices in clinical education by critically examining, exploring and describing the aspects of an exemplar chiropractic clinical program that develops students’ clinical practice skills for transition into practice. This study explored the innovative clinical program of a reputable American chiropractic institution providing a scaffolded clinical program across varied clinical settings, patient populations and amongst other health disciplines. Research Design A six-phase exploratory descriptive qualitative design (EDQD) study was conducted to explore and describe the phenomenon being examined (Flick, 2014). This design enabled the collection of information about perceptions and lived experiences of three stakeholder cohorts: clinical faculty members, students and new graduates. Methods Purposive sampling (of students and clinical faculty members) and snowball sampling techniques (of new graduates) were used to derive the sample. Data were collected in three cycles across a two-year period using in-depth, semi-structured interviews. Interviews were conducted with 15 clinical faculty members and eight new graduates, and semi-structured focus groups were conducted with 20 students. All data were audio recorded, transcribed and thematically analysed using an inductive approach. Findings Chiropractic clinical education programs ought to be developed within a framework that incorporates adult learner principles; situated, social and experiential learning theories. Valued was a student-centred learning experience that includes authentic and diverse clinical placements, supervision and mentoring from multiple clinical educators which enhances students’ access to varied perspectives of clinical practices that contributes to developing clinical skills and professional identity. Business knowledge and entrepreneurial skills was an area of deficiency, which is problematic when the objective is to build graduates’ independence in clinical practice and professional prospects are predominantly private practice (NBCE, 2020). Embedding evidence-based practice within curricula and clinical training for educators and students are necessary to ensure this becomes a part of clinical practice. Conclusion This thesis posits best practice in chiropractic clinical education consists of the following: (a) using a scaffolded longitudinal clinical program, (b) varying clinical placements and case mix, (c) supervision and mentoring from multiple clinical educators, (d) educating the clinical educator, (e) curricula designed around industry standards and desired graduate attributes and capabilities, (f) an evidence-based practice approach in the curricula and clinical context, (g) aligning business skills, knowledge and practices with the professional context and (h) interprofessional learning and practice opportunities. Although this study has made a contribution to scholarly discourse, there remain many gaps in our knowledge where further studies are needed.
- Description: Doctor of Philosophy
Exploring interprofessional clinical placements to understand perceptions and outcomes for pre-registration healthcare students
- Authors: Hood, Kerry
- Date: 2021
- Type: Text , Thesis , PhD
- Full Text:
- Description: Background There is an ongoing need for preregistration healthcare students to acquire skills that equip them to collaborate with others for patient-centred care and outcomes. Traditional models of university learning and clinical placement seldom offer students the opportunities to experience interprofessional learning or to ‘test the waters’ of collaborative practice. Aims A range of interprofessional learning opportunities were offered to preregistration healthcare students while on clinical placement in a large metropolitan health service. This research evaluated interprofessional learning opportunities for preregistration healthcare students as preparation for collaborative practice. It also explored the perceived value for student learning of these activities and examined the challenges and opportunities accompanying the design and implementation of the student-led beds model. Methods A mixed methods approach was undertaken. In particular, there was a focus on the experiences of students in an immersive two-week interprofessional placement in which interprofessional student teams worked together to lead the care of inpatients in a variety of clinical settings. This experience enabled students to experience authentic collaborative practice in a real clinical setting. The Theory of Planned Behaviour was used to retrospectively evaluate the findings presented in the published papers. Outcomes This research reflects a journey of student experience of clinical interprofessional learning (IPL), from understanding attitudes to IPL to perceptions of clinical workshops and culminating in the experience of an immersive clinical placement. Outcomes included positive learning experiences and a sense of clarity of professional and interprofessional identity. The model of placement was informed by the international literature, most notably the ‘student-led bed’ model pioneered at Karolinska Institute in Sweden. Despite solid evidence of the usefulness and efficacy of this model, it is yet to be embedded in clinical environments across the world. This research demonstrated that the model can be successfully implemented in a metropolitan health service and may contribute to real behavioural change of our future health professionals
- Description: Doctor of Philosophy
- Authors: Hood, Kerry
- Date: 2021
- Type: Text , Thesis , PhD
- Full Text:
- Description: Background There is an ongoing need for preregistration healthcare students to acquire skills that equip them to collaborate with others for patient-centred care and outcomes. Traditional models of university learning and clinical placement seldom offer students the opportunities to experience interprofessional learning or to ‘test the waters’ of collaborative practice. Aims A range of interprofessional learning opportunities were offered to preregistration healthcare students while on clinical placement in a large metropolitan health service. This research evaluated interprofessional learning opportunities for preregistration healthcare students as preparation for collaborative practice. It also explored the perceived value for student learning of these activities and examined the challenges and opportunities accompanying the design and implementation of the student-led beds model. Methods A mixed methods approach was undertaken. In particular, there was a focus on the experiences of students in an immersive two-week interprofessional placement in which interprofessional student teams worked together to lead the care of inpatients in a variety of clinical settings. This experience enabled students to experience authentic collaborative practice in a real clinical setting. The Theory of Planned Behaviour was used to retrospectively evaluate the findings presented in the published papers. Outcomes This research reflects a journey of student experience of clinical interprofessional learning (IPL), from understanding attitudes to IPL to perceptions of clinical workshops and culminating in the experience of an immersive clinical placement. Outcomes included positive learning experiences and a sense of clarity of professional and interprofessional identity. The model of placement was informed by the international literature, most notably the ‘student-led bed’ model pioneered at Karolinska Institute in Sweden. Despite solid evidence of the usefulness and efficacy of this model, it is yet to be embedded in clinical environments across the world. This research demonstrated that the model can be successfully implemented in a metropolitan health service and may contribute to real behavioural change of our future health professionals
- Description: Doctor of Philosophy
- «
- ‹
- 1
- ›
- »