OBJECTIVE: The primary objective was to describe the pedagogical approach of conducting 2 Interprofessional Education (IPE) sessions focused on IPE Collaborative (IPEC) Core Competencies in a required pharmacy and nursing didactic course. The secondary objective was to use quantitative and qualitative methods to assess students' self-reported IPE knowledge, skills, and attitudes after the IPE sessions. METHODS: Sessions consisted of active learning exercises with supplemental lectures, emphasizing students work together to find optimal solutions to both clinical and nonclinical problems. Time was allotted for debriefing and discussion. Students completed a post-session reflection with 6 guided questions to collect qualitative themes. Participants also completed the W(e) Learn Interprofessional Program Assessment Scale, a survey designed to assess student perceptions of the interprofessional sessions. We used t tests for comparing scores among relevant subgroups. RESULTS: From 2017-2019, 263 students attended 2 annual IPE sessions in a required, introductory course. Small group didactic activities with faculty-led debriefing were included in each session. A total of 111 students fully completed the scale and average scores were high (Mean = 197.5, SD = 15.96). Thematic analysis of reflections revealed that students recognized teamwork, mutual respect, effective communication, and understanding the roles and responsibilities of the interprofessional team helped improve patient care. CONCLUSION: Including joint IPE sessions in a foundational didactic course was a feasible and successful IPE component. Sessions provided students with experience practicing foundational skills for interprofessional communication and teamwork. Students reported high satisfaction and valued the sessions, as indicated by quantitative surveys and qualitative themes.
BACKGROUND: Interprofessional education (IPE) curricula require approaches that address the needs of learners from multiple professions and levels of clinical experience. Frameworks based in the arts and humanities, which can improve learners' skills in collaborative competencies such as communication and team building, remain limited in IPE. We describe the development, implementation and evaluation of a visual arts-based IPE session for over 400 interprofessional learners. APPROACH: During the 90-min session held in 2021, an art museum educator first guided learners through observations of art works using the Visual Thinking Strategies (VTS) approach. Subsequently, small groups of six to eight interprofessional learners and two trained facilitators explored how their observations were influenced by personal and professional identities and made connections to interprofessional collaborative practice. EVALUATION: Two hundred eleven of the 407 student attendees responded to the post-session survey (52%). Eighty percent of the respondents agreed or strongly agreed that 'the art of observation activity is an effective means of starting discussions with interprofessional teams.' On the Interprofessional Collaborative Competency Attainment Survey, a validated tool assessing changes in interprofessional collaboration-related competencies, there was a significant increase between pre- (M = 45.73, SD = 8.05, p < 0.001) and post-session scores (M = 51.46, SD = 7.97, p < 0.001), using a paired t-test analysis. Qualitative analysis of learners' takeaways identified themes of open-mindedness, hearing other opinions and perspectives, collaboration/teamwork, patient-centeredness and awareness of biases. IMPLICATIONS: Our curricular approach shows how integrating visual arts-based pedagogies into IPE activities with learners from diverse disciplines and clinical experiences is both feasible and helpful for developing collaborative competencies.
Resumo Objetivou-se analisar as contribuições e barreiras enfrentadas pelo Programa de Educação pelo Trabalho para a Saúde (PET-Saúde) Interprofissionalidade, bem como debater elementos necessários à sustentabilidade da Educação Interprofissional (EIP). Pesquisa qualitativa desenvolvida em três unidades acadêmicas de uma instituição pública de ensino superior. Os dados foram coletados pelo Google Meet e analisados pela técnica da análise de conteúdo. Emergiram três categorias temáticas: contribuições do PET-Saúde Interprofissionalidade para a indução de mudanças na formação em Saúde, barreiras que afetaram seu desempenho e sustentabilidade da EIP. A análise indica que O PET-Saúde Interprofissionalidade foi uma experiência importante para pautar o debate da EIP nos cursos de graduação e nos serviços de Saúde. As experiências acumuladas nesse programa constituem um arcabouço que não pode ser desprezado e deverá ser lapidado para fundamentar estratégias sustentáveis que considerem a interprofissionalidade como abordagem na reorientação da formação e qualificação da atenção à saúde. Abstract The aim of this study was to explore the contributions of and barriers faced by the Education through Work for Health Program-Interprofessional Collaboration Program (PET-Saúde Interprofissionalidade) and debate key elements for the sustainability of interprofessional education (IPE). We conducted a qualitative study in three academic units of a public higher education institution. The data were collected via Google Meet and analyzed using content analysis. Three categories emerged during the analysis: contributions of the PET-Saúde Interprofissionalidade to the induction of changes in health training, barriers affecting performance, and sustainability of IPE. The findings indicate that the PET-Saúde Interprofissionalidade made important contributions to pushing forward the debate about IPE in undergraduate degrees and health services. The experiences accumulated during the program provide a framework whose potential should not be underestimated and should be refined to lay the foundation for sustainable strategies that incorporate interprofessional collaboration as an approach to reorienting health training. Resumen El objetivo fue analizar las contribuciones y barreras enfrentadas por PET-Salud Interprofesionalidad, así como discutir elementos necesarios para la sostenibilidad de la Educación Interprofesional (EIP). Investigación cualitativa desarrollada en tres unidades académicas de una institución pública de enseñanza superior. Los datos fueron colectados por Google meet y analizados por la técnica de análisis de contenido. Surgieron tres categorías temáticas: contribuciones de PET-Salud Interprofesionalidad para la inducción de cambios en la formación en salud, barreras que afectaron su desarrollo y sostenibilidad de EIP. El análisis indica que PET-Salud Interprofesionalidad fue una experiencia importante para regir el debate de EIP en los cursos de graduación y en los servicios de salud. Las experiencias acumuladas en ese programa constituyen una estructura que no puede despreciarse y que deberá perfeccionarse para servir de base a estrategias sostenibles que consideren la interprofesionalidad como un abordaje en la reorientación de la formación y calificación de la atención de la salud.
Introducción: La educación interprofesional se enmarca en la tercera gran reforma de la educación sanitaria. Consiste en una docencia basada en sistemas sanitarios, enfocada en competencias locales y globales. Es el sustento de una práctica colaborativa interprofesional que garantice la Atención Médica Integral centrada en el paciente, la familia y la comunidad. Objetivo: Fundamentar la necesidad de la educación interprofesional en la formación de pre y posgrado en Ciencias de la Salud como garantía de una práctica colaborativa interprofesional eficaz que tribute a una Atención Médica Integral sostenible e inclusiva. Método: Se efectuó un estudio documental en idioma inglés y español en diversas bases de datos: Google Académico, SciELO y Red Nacional de Información en Salud (Infomed). Se sistematizaron las informaciones y se efectuaron valoraciones críticas de los autores. Desarrollo: La práctica colaborativa interprofesional ha tenido un ascenso en diferentes escenarios y deviene en condición esencial para la atención de calidad según demanda la sociedad y los sistemas de salud en los últimos años en todo el mundo, y es un requisito necesario para una atención de la salud de calidad y segura. La educación colaborativa interprofesional mejora la coordinación, integración y fusión de saberes útiles entre distintos profesionales de la salud y en la atención social. Se requiere un estrecho nexo entre los ministerios de salud y las instituciones formadoras en función de una educación interprofesional desde el pregrado, posgrado y durante la formación continua. Conclusiones: La educación colaborativa interprofesional en la formación salubrista tributa a una práctica colaborativa interprofesional sostenible. Introduction: Interprofessional education is included in the third major health education reform. It consists of health systems-based teaching, focused on local and global competencies. It is the base of an interprofessional collaborative practice that guarantees a comprehensive health care service for patients, families and the community. Objective: To demonstrate the need for interprofessional education process in undergraduate and postgraduate Health Sciences education as a guarantee of an effective interprofessional collaborative practice that contributes to a sustainable and inclusive comprehensive health care. Method: A documentary research, in English and Spanish, was carried out in several databases: Scopus, SciELO, PubMed/MedLine, Redalyc, Google Scholar and the Infomed portal. The information was systematized and authors gave their critical evaluations. Development: Collaborative interprofessional practice has been increasing in different scenarios and has become an essential condition for quality care service as demanded by society and healthcare systems worldwide in recent years and it is a necessary requirement for quality and health care safety. Collaborative interprofessional education improves coordination, integration and the merging of useful knowledge among different health and social care professionals. A close relationship between ministries of health and training institutions is required for interprofessional education from undergraduate, postgraduate and continuing education. Final considerations: Collaborative interprofessional education in health care education contributes to sustainable interprofessional collaborative practice. Introdução: A educação interprofissional faz parte da terceira grande reforma da educação em saúde. Consiste no ensino baseado em sistemas de saúde, focado em competências locais e globais. É o suporte de uma prática colaborativa interprofissional que garante uma assistência médica integral centrada no paciente, na família e na comunidade. Objetivo: Fundamentar a necessidade da educação interprofissional na graduação e pós-graduação em Ciências da Saúde como garantia de uma efetiva prática colaborativa interprofissional que contribua para uma assistência médica integral sustentável e inclusiva. Método: Estudo documental realizado em inglês e espanhol em diversas bases de dados: Scopus, SciELO, PubMed/MedLine, Redalyc, Google Scholar e Red Nacional de Información en Salud (Infomed). As informações foram sistematizadas e feitas avaliações críticas dos autores. Desenvolvimento: A prática colaborativa interprofissional despontou em diferentes cenários e tornou-se condição essencial para uma assistência de qualidade exigida pela sociedade e pelos sistemas de saúde nos últimos anos em todo o mundo e é requisito necessário para uma assistência de qualidade, com qualidade e segura. A educação colaborativa interprofissional melhora a coordenação, integração e fusão de conhecimentos úteis entre diferentes profissionais de saúde e assistência social. É necessária uma articulação estreita entre os ministérios da saúde e as instituições de formação com base na educação interprofissional desde a graduação, pós-graduação e durante a formação continuada. Considerações finais: A educação colaborativa interprofissional na formação em saúde contribui para uma prática colaborativa interprofissional sustentável.
PURPOSE: This study aims to establish if medical students think it is fair to be assessed by nursing professors in interprofessional education (IPE) and why. METHODS: Eighty-seven third-year medical students who participated in the IPE in 2022 submitted self-reflection essays. They were asked how they perceived the assessors, and 86 medical students responded to content analyses. RESULTS: Sixty-seven students (77.9%) agreed to be assessed by nursing professors. They believed that interprofessional assessment is possible because it is an IPE. They also believed that this was an opportunity to be assessed from various perspectives. Nineteen students (22.1%) objected because the assessment criteria may be different and nursing professors would not understand the learning experiences of medical students. CONCLUSION: Regarding the reasons medical students oppose it, IPE developers should supplement the development of assessment criteria and understand learners' experiences during planning assessment.
OBJECTIVE: To assess the contribution of interprofessional education (IPE) for pre-graduate students from eight study branches. These seminars had patient-partners and caregivers as co-facilitators for reflexive conversations, with educational goals of learning interprofessional communication and involving patients in decision-making. METHODS: A pre/post seminar comparison with 2 questionnaires about the students' professional identity, multidisciplinary collaboration and patients' involvement, and the richness of stakeholders' definitions. RESULTS: 1142 students participated in the course (n = 740 after removing missing data). The results indicate that this type of education helps students feel more confident in their ability to communicate and collaborate (z = -10,204; p < 0,001), involves patients in their care plan (z = -7,996; p < 0,001) and fosters the competence and autonomy of the post-graduate students in their own professional field (z = -10,627; p < 0,001). It also enriches the definition of patients' roles (n = 399; z = -17,276; p < 0,001). CONCLUSION: Including patients-partners and caregivers in IPE enriches the professional identity and increases the self-efficacy of futures caregivers. PRACTICE IMPLICATIONS: This program exposed students to collaborative care practices, can reduce their resistance to this type of practice after graduation by making them more confident in using a structured team approach and recognising its benefits for both patients and caregivers.
The United States (US) National Center for Interprofessional Practice and Education was funded at the University of Minnesota to serve as the National Coordinating Center for Interprofessional Education and Collaborative Practice (IPECP) in the US In 2012, the funders had specific expectations for operationalizing their vision that included scholarship, programs and leadership as an unbiased, neutral convener to align education with health system redesign. While US specific, the National Center benefited from and contributed to the international maturity of the field over the past decade. Through its various services and technology platforms, the National Center has a wide reach nationally and internationally. This perspective provides a unique view of the field in the US with observations and implications for the future.
Abstract
Background
Because of the essential nature of the work of medical laboratory professionals, continuing development in knowledge and skills is indispensable. The study aimed at identifying and prioritizing the development and training needs of medical laboratory professionals in Ghana. This is expected to help in developing focused continuing professional development (CPD) that meets the needs of practitioners as well as the changing medical trends.
Methods
An online cross-sectional survey in February 2022 using a structured questionnaire was conducted. Respondents were asked questions that collected demographic and work-related data about them, their participation, preference, and challenges in being part of CPDs. Finally, a list of topics based on (i) quality management systems, (ii) technical competence, (iii) laboratory management, leadership, and coaching, (iv) pathophysiology, and (iv) data interpretation and research were asked with the option to rate them on a 3-point scale (most, moderate, and least) in order of importance.
Results
A total of 316 medical laboratory professionals participated in the study. Overall, the most frequently selected topics for training based on domains for CPD training and ranking as most important were (i) quality management systems, (mean = 80.59 ± 9.024; 95% CI = 73.04–88.13); (ii) pathophysiology, data interpretation, and research (mean = 78.0 ± 6.973; 95% CI = 73.97–82.03); (iii) technical competence (mean = 73.97 ± 10.65; 95% CI = 66.35–81.59); and (iv) laboratory management, leadership, and coaching (mean = 72.82 ± 9.719; 95% CI = 67.44–78.2). The factors affecting the choice of training needs included the medical laboratory professionals’ current place of work, years in service, the reason for attending CPD activities, the period for attending the last CPD, being in a supervisory role, and the number of staff being supervised. Face-to-face presentations, training workshops, and hands-on workshops were the most preferred modes of CPD delivery with financial implications and workload/time constraints being the main challenges impeding CPD participation.
Conclusion
The identified needs will help in developing CPD programs that address what medical laboratory professionals prioritize as training needs. Stakeholders should incorporate these training needs into future programs and address the challenges highlighted in this study to have more relevant training for medical laboratory professionals.
Abstract
Introduction
In Bangladesh, sexually transmitted infection (STI) services are available for all populations in public health facilities. However, STI services for key populations (KPs) at risk of HIV need specifically designed approaches that are predominantly administered to KPs through donor-supported service centers operated by non-government organizations (NGOs) and community-based organisations (CBOs). However, the steady decline in donor funding warrants a sustainable transition of STI services for the KPs into public health facilities. This article aimed to explore the service availability and readiness of public health facilities to provide STI services for the KPs.
Methods
This qualitative study explored the service availability and readiness of public health facilities in three districts of Bangladesh by adapting the Service Availability and Readiness Assessment tool. We conducted 34 in-depth interviews,11 focus group discussions with KPs, and 29 key-informant interviews with healthcare providers, researchers, programme implementers and policy planners, in addition to series of direct observations at the public healthcare facilities. Data were analysed through thematic analysis, and categorised in relation to the WHO building blocks.
Results
This study revealed that the public health system was generally not ready to serve the KPs’ needs in terms of providing them with quality STI services. The ‘service delivery’ component, which is the most crucial facet of the public health system, was not ready to provide STI services to KPs. Findings also indicated that health workforce availability was limited in the primary and secondary healthcare layers but adequate in the tertiary layer, but needed to be oriented on providing culturally sensitised treatment. Counseling, an essential component of STI services, was neither ready nor available. However, health information systems and a few other components were partially ready, although this warrants systematic approaches to address these challenges.
Conclusion
The findings show that public health facilities are yet to be fully ready to render STI services to KPs, especially in terms of service delivery and human and health resources. Therefore, it is not only integral to mobilize communities towards the uptake of public health services, but health systems need to be prepared to cater to their needs.
Abstract
Background
Building health research capacity in low- and middle-income countries is essential to achieving universal access to safe, high-quality healthcare. It can enable healthcare workers to conduct locally relevant research and apply findings to strengthen their health delivery systems. However, lack of funding, experience, know-how, and weak research infrastructures hinders their ability. Understanding research capacity, engagement, and contextual factors that either promote or obstruct research efforts by healthcare workers can inform national strategies aimed at building research capacity.
Methods
We used a convergent mixed-methods study design to understand research capacity and research engagement of healthcare workers in Tanzania’s public health system, including the barriers, motivators, and facilitators to conducting research. Our sample included 462 randomly selected healthcare workers from 45 facilities. We conducted surveys and interviews to capture data in five categories: (1) healthcare workers research capacity; (2) research engagement; (3) barriers, motivators, and facilitators; (4) interest in conducting research; and (5) institutional research capacity. We assessed quantitative and qualitative data using frequency and thematic analysis, respectively; we merged the data to identify recurring and unifying concepts.
Results
Respondents reported low experience and confidence in quantitative (34% and 28.7%, respectively) and qualitative research methods (34.5% and 19.6%, respectively). Less than half (44%) of healthcare workers engaged in research. Engagement in research was positively associated with: working at a District Hospital or above (p = 0.006), having a university degree or more (p = 0.007), and previous research experience (p = 0.001); it was negatively associated with female sex (p = 0.033). Barriers to conducting research included lack of research funding, time, skills, opportunities to practice, and research infrastructure. Motivators and facilitators included a desire to address health problems, professional development, and local and international collaborations. Almost all healthcare workers (92%) indicated interest in building their research capacity.
Conclusion
Individual and institutional research capacity and engagement among healthcare workers in Tanzania is low, despite high interest for capacity building. We propose a fourfold pathway for building research capacity in Tanzania through (1) high-quality research training and mentorship; (2) strengthening research infrastructure, funding, and coordination; (3) implementing policies and strategies that stimulate engagement; and (4) strengthening local and international collaborations.
INTRODUCTION: Many countries have implemented interprofessional education (IPE) and interprofessional collaborative practice (IPCP), but there is a dearth of information on the state of IPE in Nigeria. We evaluated the attitude of Nigerian pharmacy students and pharmacists towards IPE and IPCP and the perceived barriers to and recommendations for the implementation of IPE and IPCP. METHODS: A cross-sectional survey of 238 community and hospital pharmacists and 765 pharmacy students in Nigeria was conducted with an online questionnaire using the Interprofessional Attitude Scale. Information on the perceived barriers to and recommendations for implementing IPE was also collected. RESULTS: Two hundred and seven pharmacists (87%) and 629 (82.2%) pharmacy students agreed that it is necessary for health profession students to learn together. Perceived barriers to the implementation of IPE and IPCP included professional pride [pharmacists = 51 (21.42%), pharmacy students = 55 (7.19%)], prejudice against other health professions [pharmacists = 35 (14.7%), pharmacy students = 74 (9.67%)], uni-professional training [pharmacists = 5 (2.1%), pharmacy students = 7 (0.92%)], and government policies that discourage IPE and IPCP [pharmacists = 10 (4.2%), pharmacy students = 20 (2.61%)]. Recommendations proposed were the integration of IPE in undergraduate pharmacy curricula, cooperation among health professionals to curb professional rivalry, and the provision of necessary facilities and resources by the government. CONCLUSIONS: Nigerian pharmacists and pharmacy students had positive attitudes towards IPE and IPCP. The perceived barriers to implementing IPE in Nigeria include discouraging government policies. Deliberate and implementable government policies on IPE are needed.
The purpose of this convergent mixed methods interprofessional education (IPE) pilot project was to help health profession students gain valuable insight about the experiences of people living with mental illness, to help them have a better understanding of person-centered care and have greater knowledge about the importance of interprofessional collaboration. A developmental workgroup which consisted of mental health consumers, four interdisciplinary students, and our team developed and implemented a virtual Mental Health World Café IPE event. Twelve other students attended the World Café event. A paired sample t-test was used to examine group differences between pre- and post-test scores for the Interprofessional Socialization and Valuing Scale and the Texas AHEC Survey measures among the four student leaders and the 12 student participants of the virtual Mental Health World Cafe. We conducted individual interviews with the four student leaders and collected reflective journals from the 12 students who attended the World Café event. We examined to what extent the statistically significant quantitative results supported the qualitative results separately for the student leaders and for the student participants of the virtual World Café. We also examined how both the quantitative and qualitative findings aligned with the key components of the Patient-Centered Care in Interprofessional Collaborative Practice Model. While the project allowed the students to reflect upon how they may apply the principles of person-centered care and interprofessional collaboration, the impact of the consumers on the student's experiences was profound and resulted in widespread engagement of the students who attended the event.
RESUMO Objetivo: identificar os elementos das dimensões colaborativas interprofissionais presentes nos projetos institucionais a serem desenvolvidos no Programa de Educação pelo Trabalho para a Saúde. Método: estudo documental de abordagem qualitativa. A fonte documental consiste em cinco projetos de intervenção elaborados por cinco Universidades Federais da região Nordeste para serem desenvolvidos no Programa de Educação pelo Trabalho para a Saúde Interprofissionalidade. Os dados foram coletados e analisados entre julho de 2020 a março de 2021, com aplicação de matriz de coleta, de elaboração própria. Com auxílio de um software, o estudo está alicerçado no referencial de D'Amour para fins de estabelecimento de categorias conforme preconizadas nas etapas estabelecidas por Bardin. Foram assegurados os aspectos éticos para a pesquisa. Resultados: Foram identificados elementos das dimensões colaborativas do modelo de D'Amour nos 5 projetos, tais como: metas e orientação centrada no usuário; convivência mútua; confiança; ferramentas de formalização; intercâmbio de informações; centralidade e liderança; suporte à inovação e conectividade. Considerações finais: os projetos de intervenção elaborados pelas universidades possuem elementos indutores da Colaboração Interprofissional. No entanto, precisam ser melhor explicitadas as intervenções voltadas para a estruturação do atendimento colaborativo e exercício para a liderança. RESUMEN Objetivo: identificar los elementos de las dimensiones colaborativas interprofesionales presentes en los proyectos institucionales que se desarrollarán en el Programa de Educación por el Trabajo para la Salud. Método: estudio documental de enfoque cualitativo. La fuente documental consiste en cinco proyectos de intervención elaborados por cinco Universidades Federales de la región Nordeste de Brasil que se desarrollarán en el Programa de Educación por el Trabajo para la Salud Interprofesionalidad. Los datos fueron recogidos y analizados entre julio de 2020 y marzo de 2021, con aplicación de matriz de recolección y elaboración propia. Con ayuda de un software, el estudio está basado en el referencial de D'Amour para fines de establecimiento de categorías conforme preconizadas en las etapas establecidas por Bardin. Se aseguraron los aspectos éticos para la investigación. Resultados: se identificaron elementos de las dimensiones colaborativas del modelo de D'Amour en los 5 proyectos, tales como metas y orientación centrada en el usuario; convivencia mutua; confianza; herramientas de formalización; intercambio de información; centralidad y liderazgo; apoyo a la innovación y la conectividad. Consideraciones finales: los proyectos de intervención elaborados por las universidades poseen elementos inductores de la Colaboración Interprofesional. Sin embargo, necesitan ser mejor explicitadas las intervenciones dirigidas a la estructuración de la atención colaborativa y el ejercicio para el liderazgo. ABSTRACT Objective: To identify elements from the interprofessional collaborative dimensions in the institutional projects to be developed in the program for education at work for health. Method: Document study with a quantitative approach. The document source includes five intervention projects elaborated by five federal universities from the Brazilian northeast, to be developed in the interprofessional program for education at work for health. Data was collected and analyzed from July 2020 to March 2021, through the application of a collection tool elaborated by the authors. The study, conducted with the aid of software, is based on D'Amour references to establish categories according to the stages elaborated by Bardin. The ethical aspects of the research were guaranteed. Results: We identified elements of the collaborative dimensions of the model by D'Amour in the five projects, such as: goals and user-focused guidance; mutual socialization; trust; formalization tools; information exchange; centrality and leadership; support to innovation and connectivity. Final considerations: intervention projects elaborated by the universities have elements conducive to Interprofessional Collaboration. However, interventions targeted at structuring collaborative care and exercising leadership must be better elaborated.
Abstract
Background
Health practitioner regulation (HPR) systems are increasingly recognized as playing an important role in supporting health workforce availability, accessibility, quality, and sustainability, while promoting patient safety. This review aimed to identify evidence on the design, delivery and effectiveness of HPR to inform policy decisions.
Methods
We conducted an integrative analysis of literature published between 2010 and 2021. Fourteen databases were systematically searched, with data extracted and synthesized based on a modified Donabedian framework.
Findings
This large-scale review synthesized evidence from a range of academic (n = 410) and grey literature (n = 426) relevant to HPR. We identified key themes and findings for a series of HPR topics organized according to our structures–processes–outcomes conceptual framework. Governance reforms in HPR are shifting towards multi-profession regulators, enhanced accountability, and risk-based approaches; however, comparisons between HPR models were complicated by a lack of a standardized HPR typology. HPR can support government workforce strategies, despite persisting challenges in cross-border recognition of qualifications and portability of registration. Scope of practice reform adapted to modern health systems can improve access and quality. Alternatives to statutory registration for lower-risk health occupations can improve services and protect the public, while standardized evaluation frameworks can aid regulatory strengthening. Knowledge gaps remain around the outcomes and effectiveness of HPR processes, including continuing professional development models, national licensing examinations, accreditation of health practitioner education programs, mandatory reporting obligations, remediation programs, and statutory registration of traditional and complementary medicine practitioners.
Conclusion
We identified key themes, issues, and evidence gaps valuable for governments, regulators, and health system leaders. We also identified evidence base limitations that warrant caution when interpreting and generalizing the results across jurisdictions and professions. Themes and findings reflect interests and concerns in high-income Anglophone countries where most literature originated. Most studies were descriptive, resulting in a low certainty of evidence. To inform regulatory design and reform, research funders and governments should prioritize evidence on regulatory outcomes, including innovative approaches we identified in our review. Additionally, a systematic approach is needed to track and evaluate the impact of regulatory interventions and innovations on achieving health workforce and health systems goals.
Abstract
Background
In 2021, South Africa introduced a 6-month internship rotation in family medicine, in the second year of a 2-year internship programme for newly qualified doctors. This was a major change from the previous 3-months training in family medicine, and expanded the training platform to smaller district hospitals and primary health care (PHC) facilities, many of which had never had interns. The medical disciplines in South Africa needed to know if this change in the internship programme was worthwhile and successful. The aim of this study was to assess the new family medicine rotation for medical interns at district health facilities in the Western Cape Province.
Methods
Descriptive exploratory qualitative research included six intern programmes across the province. Purposeful sampling identified a heterogeneous group with maximum variation in experience. Overall, eight interns, four managers, four supervisors and four intern curators were included. Individual semi-structured interviews were audio-recorded and the transcripts were thematically analysed using the framework method and Atlas-ti software.
Results
Four major themes emerged around the varied structure and organisational characteristics of the rotations, the orientation and arrival of interns, their learning during the rotation, and impact on health services. A programme theory was developed that defined the key inputs (i.e. infrastructure, communication, orientation, preparation, prior learning and guidelines), processes (i.e. model of the rotation, clinical training and supervision, clinical teaching), outputs (i.e. more independent decision making, approach to undifferentiated problems, approach to chronic care and continuity, development of procedural skills, approach to sequential coordination of care and referrals, working in a multidisciplinary team and inter-professional learning, integration of multiple competencies, as well as becoming more person and community orientated).
Conclusions
The new rotation in family medicine was positively experienced by most interns, supervisors and managers. It should lead to improved quality of care, better preparation for obligatory community service, and an increased likelihood of considering a career in district level health services. This study will form part of an exploratory sequential mixed methods study that incorporates the key issues into a questionnaire for a descriptive survey of all interns in a subsequent study.
AIM: This study aimed to analyze the effectiveness of the learning outcomes of the interprofessional education (IPE) model for healthcare students. BACKGROUND: Interprofessional education (IPE) is an important teaching and learning model that involves two or more professions engaging or working together to improve the knowledge of healthcare students. However, the specific outcomes of IPE for healthcare students are unclear as only a few studies have reported them. DESIGN: A meta-analysis was conducted to draw broad conclusions on the impact of IPE on healthcare students' learning outcomes. METHODS: The CINAHL, Cochrane Library, EMBASE, MEDLINE, PubMed, Web of Science, and Google Scholar databases were searched for relevant articles in the English language. To investigate the effectiveness of IPE, a pooled estimate of knowledge, readiness for and attitude toward interprofessional learning, and interprofessional competence were analyzed using a random effects model. The methodologies of the studies evaluated were assessed using the Cochrane risk-of-bias tool for randomized trials, version 2. Sensitivity analysis was performed to ensure the rigor of the findings. STATA 17 was used to perform the meta-analysis. RESULTS: Eight studies were reviewed. IPE had a significant positive impact on healthcare students' knowledge (Standardized Mean Difference [SMD]: 0.43; 95% Confidence Interval [CI]: 0.21-0.66). However, its impact on readiness for and attitude toward interprofessional learning and interprofessional competence was nonsignificant and needs further investigation. CONCLUSION: IPE enables students to develop their knowledge of healthcare. This study provides evidence that IPE is a better strategy for enhancing healthcare students' knowledge than traditional/discipline-specific teaching techniques.
Abstract
Learning and working together towards better health outcomes today have become more complex requiring an investigation on how interprofessional education (IPE) and interprofessional collaboration (IPC) practices could be sustained and further developed. Through a sociomaterial perspective, we can better understand IPE and IPC practices by foregrounding the material aspect of learning and working together and examining its relationship with humans and their interactions. This article aimed to examine existing literature that discusses the application of sociomaterial perspectives in IPE and IPC. A scoping review was conducted following Arksey and O’Malley’s framework to explore the extent within the current body of knowledge that discuss how sociomaterial perspective is applied in IPE and IPC practices. A systematic database search was performed in September 2021 to retrieve literature published from 2007 onwards, with forty-three papers meeting the inclusion criteria. These papers included research articles, book chapters, conference papers and commentaries, with the majority originating from Europe. The thematic analysis revealed the following themes: (1) power as a sociomaterial entity shaping IPE and IPC; (2) inclusion of non-health professionals in reimagining IPE and IPC practices, and (3) the critical understanding of sociomateriality. The findings suggest that a sociomaterial perspective can allow for the reimagination of the contemporary and future practices of interprofessionalism.
Abstract
Background
The study aimed to examine the influence of perceived management support on job satisfaction through the mediating role of motivation among family doctors in the Jiangsu province of China.
Methods
Six dimensions of motivation were employed as mediators in the association between perceived management support and job satisfaction in collecting data to analyze the hypothesized relationships in the present study. A total of 600 questionnaires were distributed to family doctors in Jiangsu province. Structural equation model (SEM) in the analysis of a moment structure (AMOS) version 26 software was used to estimate the path coefficients.
Results
Perceived management support has a significant positive relationship with job satisfaction. Motivation had a fully mediated relationship with the association between perceived management support and job satisfaction.
Conclusions
The study's findings suggest motivation is important in enhancing family doctors’ satisfaction and must not be underestimated. It, therefore, offers diverse recommendations for enhancing motivation among healthcare professionals.
Abstract
Background
In September 2022, a new Ebola outbreak was reported in Uganda, East Africa, and 142 confirmed cases, including 19 Healthcare workers (HCWs) reported. Ebola is not endemic in Somalia, but the country is at a reasonable risk of the virus being introduced due to the direct connection with daily flights from Uganda without border health control and prevention activities. Therefore, evaluating HCWs' Knowledge and attitude is crucial since this is the first time being evaluated in Somalia. The study's objective is to evaluate the HCWs' Knowledge and attitude toward the Ebola virus disease in Somalia.
Method
An online self-administrated cross-sectional survey was conducted among HCWs (n = 1103) in all six federal member states of Somalia using a validated, reliable, well-structured questionnaire. Data we analyzed using descriptive statistics and Logistic regression were used to determine sociodemographic characteristics associated with poor Knowledge and negative attitude.
Result
Over one-third (37.3%) of HCWs had poor Knowledge; the mean knowledge score was 7.97 SD ± 2.15. Almost 40.1% of the HCWs had a negative attitude; the mean attitude was 27.81 SD ± 8.06. Low-income HCWs (AOR = 2.06, 95%CI:1.01–4.19), Married HCWs (AOR = 1.39, 95%CI: 1.110–1.963), Midwives (AOR = 2.76, 95%CI: 1.74–4.39), Lab technicians (AOR = 2.43, 95%CI: 1.43–4.14), HCWs work in Jubaland state of Somalia (AOR = 3.69, 95%CI: 2.39–5.70), Galmudug state (AOR = 8.50, 95%CI: 4.59–15.77), Hirshabelle state (AOR = 3.18, 95%CI: 2.15–4.71) were more likely to have poor Knowledge compared to their counterparts. HCWs who work in Hirshabelle state (AOR = 5.44,95%CI: 3.58–8.27), Jubaland state (AOR = 8.47, 95%CI: 4.69–15.29), and Galmudug state (AOR = 4.43, 95%CI: 3.03–6.48) was more likely to have a negative attitude than those working in the Banadir region administration.
Conclusion
Most Somali healthcare workers showed good Knowledge and a positive attitude toward the Ebola virus. The implementation to enhance Knowledge and attitude must specifically focus on low-income HCWs, Midwives, Lab technicalities, and those who work in Hirshabelle, Jubaland, and Galmudug states of Somalia.
BACKGROUND: Quality health services build communities' and patients' trust in health care. It enhances the acceptability of services and increases health service coverage. Quality primary health care is imperative for universal health coverage through expanding health institutions and increasing skilled health professionals to deliver services near to people. Evidence on the quality of health system inputs, interactions between health personnel and clients, and outcomes of health care interventions is necessary. This review summarised indicators, successes, and challenges of the quality of primary health care services. METHODS: We used the preferred reporting items for systematic reviews and meta-analysis extensions for scoping reviews to guide the article selection process. A systematic search of literature from PubMed, Web of Science, Excerpta Medica dataBASE (EMBASE), Scopus, and Google Scholar was conducted on August 23, 2022, but the preliminary search was begun on July 5, 2022. The Donabedian's quality of care framework, consisting of structure, process and outcomes, was used to operationalise and synthesise the findings on the quality of primary health care. RESULTS: Human resources for health, law and policy, infrastructure and facilities, and resources were the common structure indicators. Diagnosis (health assessment and/or laboratory tests) and management (health information, education, and treatment) procedures were the process indicators. Clinical outcomes (cure, mortality, treatment completion), behaviour change, and satisfaction were the common indicators of outcome. Lower cause-specific mortality and a lower rate of hospitalisation in high-income countries were successes, while high mortality due to tuberculosis and the geographical disparity in quality care were challenges in developing countries. There also exist challenges in developed countries (e.g., poor quality mental health care due to a high admission rate). Shortage of health workers was a challenge both in developed and developing countries. CONCLUSIONS: Quality of care indicators varied according to the health care problems, which resulted in a disparity in the successes and challenges across countries around the world. Initiatives to improve the quality of primary health care services should ensure the availability of adequate health care providers, equipped health care facilities, appropriate financing mechanisms, enhance compliance with health policy and laws, as well as community and client participation. Additionally, each country should be proactive in monitoring and evaluation of performance indicators in each dimension (structure, process, and outcome) of quality of primary health care services.
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