Work - Volume 41, issue 3

Article Type: Other

DOI: 10.3233/WOR-2012-1291

Citation: Work, vol. 41, no. 3, pp. 229-231, 2012

Authors: Reeves, Scott | Tassone, Maria | Parker, Katherine | Wagner, Susan J. | Simmons, Brian

Article Type: Research Article

Abstract: Objective: This paper provides an overview of key developments of interprofessional education (IPE) in relation to its evolution over the past 30 years. Methods: A narrative review of the salient IPE literature was undertaken to generate key source materials for this paper. Results: Results are presented in four sections that focus on describing and discussing: the emergence of IPE, different learning/teaching approaches; the evidence base for IPE; organizational elements. In addition, to …help illustrate these developments, we offer a case example of the work currently being undertaken at our own institution, with a focus on how various IPE developments have been integrated into our organizational priorities. Conclusions: Based on the results presented, a series of key conclusions for the future development and implications of IPE are outlined. Show more

Keywords: Interprofessional education, interprofessional collaboration, curriculum development, faculty development

DOI: 10.3233/WOR-2012-1298

Citation: Work, vol. 41, no. 3, pp. 233-245, 2012

Authors: Konrad, Shelley Cohen | Browning, David M.

Article Type: Research Article

Abstract: Theories and traditions emphasizing the centrality of caring have guided the evolution of the healthcare professions. In contemporary practice, creating a therapeutic context in which healing can occur relies not just on the caring dispositions of individual clinicians, but also on the collective relational capacities of interprofessional healthcare teams. This article describes the intersection and complementarity of relational and interprofessional learning approaches to health education, provides exemplars of shared learning models and …discusses the benefits and obstacles to integrating relational and interprofessional philosophies into real world practice. Show more

Keywords: Caring, relational, interprofessional, shared learning, interdisciplinary

DOI: 10.3233/WOR-2012-1295

Citation: Work, vol. 41, no. 3, pp. 247-251, 2012

Authors: Deutschlander, Siegrid | Suter, Esther | Lait, Jana

Article Type: Research Article

Abstract: Objective: This article discusses the strategies and challenges of implementing interprofessional education interventions with students from different disciplines. It reviews two models of interprofessional education in academic prelicensure curricula including the extra-curricular and the crossbar models by considering ease of implementation, program reach and sustainability. It also introduces the interprofessional enhancement approach as an additional curriculum development strategy. Results: The Alberta Interprofessional Education for Collaborative Patient-Centred Practice project used the …Interprofessional Enhancement Approach by integrating course content into existing placement courses for nursing, respiratory therapy, pharmacy, and physiotherapy students. The students conducted their regular discipline-specific placements at various clinical sites in southern Alberta, Canada that were supplemented by three interprofessional strategies: mentoring, workshops and online discussions. The intervention reached over sixty individuals including students, preceptors and faculty. Conclusion: As compared to other approaches (extra-curricular and crossbar models), this approach shows that IP course content can be added to placement courses without restructuring complete curricula. This article intends to initiate further discussions about different IP education models in prelicensure education. Show more

Keywords: Health care education, IP competencies, IP mentoring

DOI: 10.3233/WOR-2012-1293

Citation: Work, vol. 41, no. 3, pp. 253-260, 2012

Authors: Gray, Betsey | MacRae, Nancy

Article Type: Research Article

Abstract: Objective: To create an interprofessional/interdisciplinary education (IPE), pilot course that provided a representative group of students the opportunity to develop a 6 week fall reduction program for a group of elder volunteers who were independently living in the community. The authors describe the processes that occurred for the course and student-led program to be developed. Results: This pilot course provided opportunities for interprofessional student learning, faculty practice and development, and a …program to improve the health of the participants. Sustaining interprofessional collaboration is challenging, primarily due to scheduling difficulties and faculty workloads. Conclusions: More time needs to be devoted to developing the team skills of students, as well as building their knowledge of the contributions each discipline can make to a holistic view of elders. The next phase of this project needs to include pre and post measurement of students' readiness for IPE and elders to more adequately assess the components and effects of the course and program for fall prevention. Show more

Keywords: Interdisciplinary, elder, team, dental hygiene, occupational therapy, nursing, social work

DOI: 10.3233/WOR-2012-1294

Citation: Work, vol. 41, no. 3, pp. 261-267, 2012

Authors: Sheldon, Michael | Cavanaugh, James T. | Croninger, William | Osgood, Wendy | Robnett, Regi | Seigle, Janice | Simonsen, Linda

Article Type: Research Article

Abstract: Objective: Health profession education programs often struggle with barriers to implementing interprofesssional educational (IPE) initiatives, limiting early and consistent exposure of students to core IPE competencies. Few published reports are available to guide the implementation of IPE programs into practice. This article describes a successful and evolving partnership between an independent university and a tertiary care hospital. The IPE goals of this partnership were to expose students to roles of other disciplines in …the complex hospital environment and integrate acute care exposure throughout the Doctor of Physical Therapy and Master of Science in Occupational Therapy curricula. Results: Faculty and students, patients and families, and occupational and physical therapy clinicians participated in a series of learning activities in an acute care setting involving interprofessional teams of students. Activities included observations of OT and PT clinicians providing standard patient care, practice conducting team patient interviews, and interactive treatment planning sessions conducted live via videoconferencing technology between a patient's hospital room and an academic classroom on the university campus. The activities generally were designed to improve student preparedness for working as part of an interprofessional team in an acute care setting. Conclusions: Student and clinician feedback support the early development of student IPE competencies, including the appreciation and understanding of professional roles in the team approach to patient care and the development of effective communication skills. The partnership between the academic institution and tertiary care hospital is an effective vehicle to deliver and sustain IPE educational initiatives in the acute care setting. Current and planned IPE curriculum integration are discussed along with a preliminary analysis of IPE outcomes. Show more

Keywords: Academic-clinical partnership, rehabilitation, occupational therapy, physical therapy, teamwork, acute care

DOI: 10.3233/WOR-2012-1299

Citation: Work, vol. 41, no. 3, pp. 269-275, 2012

Authors: Willis, Joel | Lloyd, Leslie | Jenkins, Wiley

Article Type: Research Article

Abstract: Objective: Millions of Americans fail to receive proper preventative care and/or have poorly managed chronic conditions. The purpose of this study was to determine if local student volunteers could be utilized to assess hypertension in an underserved community. The two primary objectives included first determining if student volunteers could be effectively trained to perform blood pressure screening and if they could then successfully provide such screening door-to-door in a targeted community. Results: Volunteers were …recruited from local universities, trained and skill tested in basic medical techniques and simulated door-to-door interactions. Of 43 initial students, 37 successfully completed written and competency exams. During the two-weekend community engagement, 220 individuals answered door knocks and 80~agreed to screening. Of those without a previous diagnosis of hypertension, 70.9% had an abnormal reading as did 87% of those who had been previously diagnosed with hypertension. This methodology was implemented at minimal cost and was perceived as a benefit by both students and community members. Conclusions: The study scope did not allow longer-term follow up for those with abnormal readings, but did serve as a reminder for those diagnosed with hypertension to monitor their status and as an indication for those undiagnosed that they may need to seek further care. Our findings are important because they show that undergraduate students are a viable source of volunteers for performing medically-related community outreach. Show more

Keywords: Community outreach, blood pressure, volunteers, preventive care

DOI: 10.3233/WOR-2012-1300

Citation: Work, vol. 41, no. 3, pp. 277-284, 2012

Authors: MacRae, Nancy

Article Type: Research Article

Abstract: Objective and participants: This program provides an interprofessional course to students, allowing them to learn together with each other and their elder teachers. Goals: include refining their professional parameters (turf), learning how to successfully collaborate with other professionals (team), and determining how to effectively design intervention plans for elders within their own communities (town). Various methods of evaluation, such as journals, participation in rounds, and OSCEs, used to assess students' …status are described. Results: Both students and faculty gained clearer perceptions of other professions through their work with each other and the ability to more effectively communicate with other profession. Both also learned, through their relationships with their elder teachers, more about how their specific professions' contributions can affect elders and how elders perceive and contribute to their own communities. Conclusions: This program has been a successful venture. The challenge is now to devise a way to provide similar experiences to a larger group of students. Show more

Keywords: Elder, team, dental externs, occupational therapy, physician assistant, physical therapy

DOI: 10.3233/WOR-2012-1296

Citation: Work, vol. 41, no. 3, pp. 285-292, 2012

Authors: Cavanaugh, James T. | Konrad, Shelley Cohen

Article Type: Research Article

Abstract: Objective: To describe the implementation of an interprofessional shared learning model designed to promote the development of person-centered healthcare communication skills. Participants: Master of social work (MSW) and doctor of physical therapy (DPT) degree students. Methods: The model used evidence-based principles of effective healthcare communication and shared learning methods; it was aligned with student learning outcomes contained in MSW and DPT curricula. Students engaged in 3 learning sessions over 2 days. …Sessions involved interactive reflective learning, simulated role-modeling with peer assessment, and context-specific practice of communication skills. The perspective of patients/clients was included in each learning activity. Activities were evaluated through narrative feedback. Results: Students valued opportunities to learn directly from each other and from healthcare consumers. Important insights and directions for future interprofessional learning experiences were gleaned from model implementation. Conclusions: The interprofessional shared learning model shows promise as an effective method for developing person-centered communication skills. Show more

Keywords: Interprofessional education, social work, physical therapy

DOI: 10.3233/WOR-2012-1292

Citation: Work, vol. 41, no. 3, pp. 293-301, 2012

Authors: Morton, Jennifer

Article Type: Research Article

Abstract: Objective: This paper describes a model for interprofessional and transcultural learning established by the author and supported by the University of New England and Ghana Health Mission, Inc. The Model for Interprofessional Immersion in Cultural Settings [1] represents a guiding framework predicated on a conceptual "brick and mortar" process for building cultural proficiency among individuals and within teams. It encompasses social, clinical and behavioral components (brick) and personal desire, cultural humility and …values (mortar). The ``bounty'' aspect of the model is achieved by way of successful student learning outcomes, positive interprofessional and community-based collaborations, and finally, and to be measured over time, favorable patient and population (programmatic) outcomes. Results: In partnership with the Ghana Health Mission, Inc and local community health workers, students and faculty from a range of health professions took part in a cultural-clinical experience known as Transcultural Immersion in Healthcare. The goal of the experience was to advance cultural proficiency and knowledge through intensive cultural immersion. An urban setting in Ghana, located in West Africa served as the setting for this unique experience. Conclusion: The transcultural immersion in healthcare experience achieved its ``bounty'' as seen in the enhanced cultural proficiency of students and faculty, seamless interprofessional communication and collaboration, and provision of primary care and related services to patients and the Ghanaian community. Future research is in development to test the Model for Interprofessional Immersion in Cultural Settings (MIICS) in a variety of other settings and with a cross section of health disciplines. Show more

Keywords: Cultural humility, cultural proficiency, bicultural, interprofessional, framework\vspace{0.3cm}

DOI: 10.3233/WOR-2012-1297

Citation: Work, vol. 41, no. 3, pp. 303-312, 2012

Article Type: Other

DOI: 10.3233/WOR-2012-1301

Citation: Work, vol. 41, no. 3, pp. 313-314, 2012

Authors: Zayas-Cabán, Teresa

Article Type: Research Article

Abstract: Objective: Achieving optimal health outcomes requires that consumers maintain myriad health data and understand how to utilize appropriate health information management applications. This case study investigated four families' health information management tasks in their homes. Participants: Four different families participated in the study: a single parent household; two nuclear family households; and an extended family household. Methods: A work system model known as the balance model was used as a guiding framework for data collection. Data …collection consisted of three stages: (1) primary health information manager interviews; (2) family interviews; and (3) task observations. Results: Overall, families reported 69 unique health information management tasks that took place in nine different locations, using 22 different information storage artifacts. Frequently occurring tasks related to health management or health coordination were conducted in public spaces. Less frequent or more time-consuming tasks, such as researching a health concern or storing medical history, were performed in private spaces such as bedrooms or studies. Conclusions: Similarities across households suggest potential foundational design elements that consumer health information technology application designers need to balance with tailored interventions to successfully support variations in individuals' health information management needs. Show more

Keywords: Case study, balance model, interviews, observations, household

DOI: 10.3233/WOR-2012-1306

Citation: Work, vol. 41, no. 3, pp. 315-328, 2012

Authors: Moen, Anne | Smørdal, Ole

Article Type: Research Article

Abstract: Objective: Everyday challenges to "live well" with a rare disorder, anorectal anomaly, was the starting point to design a social-software environment, called RareICT, to help patients and family members in their everyday, additional un-paid work. Participants: Persons with the rare disorder, family members and health providers were recruited to elaborate challenges to daily living given this condition. Methods: An exploratory study was designed, and we set up a series of participatory design …workshops to explore challenges to everyday living with a rare medical condition. Results: Anorectal anomaly has few visible outward signs, and is often surrounded with secrecies. Findings shed light on efforts to maintain physical functioning, psychosocial and emotional wellbeing. For an affected person to "live well" modifications to everyday routines, along with management work, support work and planning work are required. Accumulating practical strategies, everyday experiences and knowledge, along with virtual access to peers may augment such health maintenance work if integrity, accountability and trust, confidentiality and privacy are maintained. Conclusion: A social-software environment was set up to offer co-evolving content and augment health-related decision-making at home. To evaluate the project will focus on interest in maintaining participation determined and how users benefit from services such as RareICT. Show more

Keywords: Self-care, health maintenance in the home, Web 2.0, wiki, social software, rare diagnoses

DOI: 10.3233/WOR-2012-1303

Citation: Work, vol. 41, no. 3, pp. 329-337, 2012

Authors: Stolee, Paul | Zaza, Christine | Schuehlein, Sheila

Article Type: Research Article

Abstract: Objective: Exercise programs have been found to have substantial benefits for older persons, but implementing these programs with frail homebound seniors is challenging. The project team aimed to evaluate an in-home exercise program for older adults – the Victorian Order of Nurses' for Canada's SMART (Seniors Maintaining Active Roles Together)® (VON SMART®) In-Home Exercise Program– in which the exercises are led by trained volunteers. The majority of volunteers were females who exercise …regularly. Over half of the volunteers were 60 years of age or older, and over half had had prior health or fitness training. Volunteers reported receiving multiple benefits from performing their role as an exercise leader. Participants: From January to August, 2009, a total of 59 volunteers, seven Site Coordinators, and 33 home-bound older (mean age: 80 years; SD: 8.8) clients from eight VON sites and one partner organization participated in the evaluation. Methods: Data collection included pre-post quantitative measures of participants' physical function, satisfaction surveys of participants, follow up semi-structured interviews of participants, feedback surveys of volunteers and site coordinators, and a focus group interview of site coordinators. Results: The Chair Stand test (p< 0.001), the Reaching Forward test (p=0.028), the Activities Balance Confidence Scale (p=0.02), as well as measures of activities of daily living (ADL) inside the home (p=0.001) and outside the home (p=0.009) showed significant improvement. Conclusions: This evaluation showed that the exercises improved participants' strength, flexibility, balance, and ability to perform ADL. This study provides additional evidence of the benefits of in-home exercise for frail seniors, and supports a role for volunteers in delivering these programs. The volunteers reported receiving social benefits of meeting new people, being able to see the difference they helped make in others, as well as personal physical benefits from exercising more. Show more

Keywords: Home exercise, volunteers, frail seniors, physical function

DOI: 10.3233/WOR-2012-1304

Citation: Work, vol. 41, no. 3, pp. 339-354, 2012

Authors: Laszlo, Aniko | Henry, Alexis | Goldsberry, Jean | Lapine, Kimberly

Article Type: Research Article

Abstract: Unemployment is a significant problem among working-age adults with disabilities. The Bristol Employment Collaborative (BEC), one of five Regional Employment Collaboratives in Massachusetts, brings together State agencies, community employment service providers, educational institutions, local businesses, economic development organizations, and people with disabilities to design and implement regional strategies to enhance employment opportunities and outcomes for people with disabilities. Launched in 2009, BEC has developed an innovative model to train people with disabilities …to become personal assistance services workers, a healthcare occupation with high demand. The case study describes the strategic planning process undertaken by BEC partners to develop a certificate program to be offered by the local community college. The first class enrolled in September 2010 and graduated ten weeks later. Innovative approaches such as the one being pursued and developed by the BEC could help address both unemployment for people with disabilities and the labor shortages in the healthcare sector. Show more

Keywords: Personal assistance services (PAS), strategic planning, collaboration, supported education, supported employment

DOI: 10.3233/WOR-2012-1302

Citation: Work, vol. 41, no. 3, pp. 355-360, 2012

Authors: Fu, Maggie | Weick-Brady, Mary | Tanno, Eleanor

Article Type: Research Article

Abstract: Objective: With the rising numbers of elderly populations and those with chronic diseases, the Home Healthcare field has inevitable expanded within the United States. Patients, more specifically home-bound patients, are becoming increasingly dependent on medical technology to help sustain and improve their quality if life. Often times, home care patients, or care recipients, depend on a properly functioning medical device for recovery. As efficient as this method may be, home healthcare also comes along with many …challenges involving use and management of medical devices. Difficulties regarding device function, use, the environment, and human factors can all serve as factors to jeopardize patient safety. FDA recognizes that devices need to be safe and capable of meeting needs in an uncontrolled home environment. Participants: Major stakeholders such as manufacturers, distributors, human factor specialists, professional health organizations, healthcare professionals, patient/caregivers, and other government agencies. Result: FDA would assure that manufacturers are designing and testing devices for the home, that proper training and education to use the device are available and completed, and the public knows how to report problems with their devices. Methods: FDA launched the Medical Device Home Use Initiative in April 2010 which proposed different methods that can support safety and safe use of medical devices in the home environment. Conclusion: FDA faces many challenges in assuring safe usage of medical devices in the home. FDA hopes that stakeholders can also become actively involved in working with us to address a total life cycle approach on device safety. Show more

Keywords: Caregiver, care recipient, manufacturer, human factors, policy

DOI: 10.3233/WOR-2012-1305

Citation: Work, vol. 41, no. 3, pp. 361-365, 2012