Preparing interprofessional clinical learning sites : what the literature tells us

Purpose: Infusing an interprofessional perspective into healthcare education in the university setting instils a collaborative approach in the provision of patient-centred care concepts for students. The purpose of this paper is to describe how one Australian health science faculty is modernising their healthcare education curriculum to develop this approach.

Method: As part of the development process, a systematic literature review was undertaken to determine the elements required for the development of interprofessional clinical learning (IPCL) sites, including but not limited to, necessary organisational and professional considerations to effect interprofessional education (IPE).

Results: The results of this review identified four key factors for IPE development: 1) shared culture, 2) support and leadership, 3) strategic facilitation and planning, and 4) effective feedback, evaluation and dissemination of curriculum intent.

Discussion: These elements are discussed in association with curriculum change in this faculty to promote interprofessional collaboration and teaching.

Conclusion: As a result of the review, the modernisation of our IPE curriculum is being underpinned by shared understandings between faculty and clinical site health providers about IPE. Our joint goal is for appropriate preparation and sustainability of IPCL sites.

Interprofessional collaborative practice across Australasia: an emergent and effective community of practice

Individuals involved in fostering interprofessional collaborative practice in health are employed in the education, practice and political arenas. While the need to innovate and develop optimal training and practice is not new, the uniqueness of interprofessional collaborative practice is that it exists across professional backgrounds and transcends traditional hierarchies (entry-level to senior practitioners). As such, alternate models of support are required to assist champions to progress learning and innovation. One such model is a group of educators and practitioners networking across Australasia, resulting in the Australasian Community of Interprofessional Collaborative Practice (ACoIPCP). ACoIPCP is a lively community of practice (CoP) group across Australia and New Zealand, which is abreast of current activity in the relevant arenas and provides members with an avenue to share information and, therefore, respond appropriately to changes in the environment. Membership includes likeminded individuals who work in the area of interprofessional collaboration from a broad range of perspectives in both health education and practice. This paper describes the development of ACoIPCP and its aims, activities and achievements. By developing a community of practice framework in a cross-organisational environment, ACoIPCP members have been able to support one another, share resources, seek feedback and learn with and from one another to foster interprofessional collaborative practice within educational, clinical and political settings. Information about the processes and outcomes of ACoIPCP may provide guidance to others interested in facilitating learning and innovation through a community of practice model.

Refreshed…reinforced…reflective: a qualitative exploration of interprofessional education facilitators' own interprofessional learning and collaborative practice

While there is extensive research examining the outcomes of interprofessional education (IPE) for students, minimal research has investigated how facilitating student learning influences the facilitators themselves. This exploratory case study aimed to explore whether and how facilitating IPE influences facilitators' own collaborative practice attitudes, knowledge, and workplace behaviours. Sixteen facilitators of an online pre-licensure IPE unit for an Australian university participated in semi-structured telephone interviews. Inductive thematic analysis revealed three emergent themes and associated subthemes characterising participants' reflexivity as IPE facilitators: interprofessional learning; professional behaviour change; and collaborative practice expertise. Participants experienced interprofessional learning in their role as facilitators, improving their understanding of other professionals' roles, theoretical and empirical knowledge underlying collaborative practice, and the use and value of online communication. Participants also reported having changed several professional behaviours, including improved interprofessional collaboration with colleagues, a change in care plan focus, a less didactic approach to supervising students and staff, and greater enthusiasm impressing the value of collaborative practice on placement students. Participants reported having acquired their prior interprofessional collaboration expertise via professional experience rather than formal learning opportunities and believed access to formal IPE as learners would aid their continuing professional development. Overall, the outcomes of the IPE experience extended past the intended audience of the student learners and positively impacted on the facilitators as well.

The complexity of social practice : understanding inertia and change in maternity care organizations

Beyond the limited efficiency and economy goals of neoliberal health policy lies the promise of genuine health services reform. In maternity care in particular, recent policy developments have sought to make the management of birth more ‘women-centred and family-friendly’. Interprofessional collaboration and greater consumer participation in policy and decision-making are key means to achieve this goal, but changing the entrenched system of medicalised birth remains difficult. Recent social contestation of maternity care has destabilised but not eradicated pervasive medical hegemony. Further reform requires analysis both of institutionalised patterns of power, and attention to the fluidity and situated knowledge shaping organisational and professional practices. Accordingly, this paper outlines a framework with which to explore the multi-layered social processes involved in implementing organisational and cultural change in maternity care. Analysis of social interventions in health systems, we suggest, can be advanced by drawing on strands from critical organization studies, complexity and critical discourse theories and social practice approaches.

Potential of pharmacists to help reduce the burden of poorly managed cardiovascular risk

Introduction: Rural areas require better use of existing health professionals to ensure capacity to deliver improved cardiovascular outcomes. Community pharmacists (CPs) are accessible to most communities and can potentially undertake expanded roles in prevention of cardiovascular disease (CVD).

Objective: This study aims to establish frequency of contact with general practitioners (GPs) and CPs by patients at high risk of CVD or with inadequately controlled CVD risk factors.

Design, setting and participants: Population survey using randomly selected individuals from the Wimmera region electoral roll and incorporating a physical health check and self-administered health questionnaire. Overall, 1500 were invited to participate.

Results: The participation rate was 51% when ineligible individuals were excluded. Nine out of 10 participants visited one or both types of practitioner in the previous 12 months. Substantially more participants visited GPs compared with CPs (88.5% versus 66.8%). With the exception of excess alcohol intake, the median number of opportunities to intervene for every inadequately controlled CVD risk factor and among high risk patient groups at least doubled for the professions combined when compared with GP visits alone.

Conclusion: Opportunities exist to intervene more frequently with target groups by engaging CPs more effectively but would require a significant attitude shift towards CPs. Mechanisms for greater pharmacist integration into primary care teams should be investigated.

Pharmacists' interprofessional communication about medications in specialty hospital settings

Effective communication between pharmacists, doctors, and nurses about patients' medications is particularly important in specialty hospital settings where high-risk medications are frequently used. This article describes the nature of communication about medications that occurs between pharmacists and other health professionals, including doctors and nurses, in specialty hospital settings. Semistructured interviews with, and participant observations of, pharmacists, nurses, and doctors were conducted in specialty settings of an Australian public, metropolitan teaching hospital. Twenty-one individuals working in the settings of emergency care, oncology care, intensive care, cardiothoracic care, and perioperative care were interviewed. In addition, participant observations of 56 individuals were conducted in emergency care, oncology care, intensive care, and cardiothoracic care. Detailed thematic analysis of the data was performed. Across all of the settings, pharmacy was less visible than medicine and nursing in terms of pharmacists' work performed, pharmacy documentation and resources, and pharmacists' physical visibility. Pharmacists, doctors, and nurses largely worked alongside one another rather than with each other. When collaboration occurred, the professional groups engaged in mostly reactive communication to accomplish specific medication tasks that needed completing. Interprofessional differences in attitudes toward medications and medication management communication behaviors were evident. Pharmacists need to engage in more proactive communication in order to reduce the risk of medication errors occurring.

Evaluating the effectiveness of public health interventions: the role and activities of the Cochrane Collaboration

Public health decision makers, funders, practitioners, and the public are increasingly interested in the evidence that underpins public health decision making. Decisions in public health cover a vast range of activities. With the ever increasing global volume of primary research, knowledge and changes in thinking and approaches, quality systematic reviews of all the available research that is relevant to a particular practice or policy decision are an efficient way to synthesise and utilise research efforts. The Cochrane Collaboration includes an organised entity that aims to increase the quality and quantity of public health systematic reviews, through a range of activities. This paper aims to provide a glossary of the terms and activities related to public health and the Cochrane Collaboration.

Evidence-based paediatric practice and its relation to the Cochrane Collaboration

Focuses on the relation between evidence-based pediatric practice and the Cochrane Collaboration on health care. Formation of the collaboration; Aim of Cochrane Collaboration; Reaction of pediatricians to the collaboration; Ways by which the collaboration ensures its relevance to pediatrics and child health.