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The effectiveness of a preclinical reflectional, actional and transformative Interprofessional Collaboration and Communication program prepared with interdisiciplinary collaboration: A pilot study

Yıl 2020, Cilt: 19 Sayı: 59, 123 - 139, 30.12.2020
https://doi.org/10.25282/ted.696831

Öz

Background: There has been an explosion of knowledge and information in all health professions, together with increased specialization. While an increased workload and interaction between disciplines and professions may be expected within this complex environment, fewer and more superficial relations have been established. The university system known as ‘multiversity’ promises interprofessional interaction as a competence for medical students. This article presents the preclinical program called interprofessional colloboration and communication designed and applied by us, together with its early outcomes. The basic and long-term goal of the program is to create cultural change in learning and practice in the university context.
Methods: The course was designed with a transformative approach. Qualitative data obtained from the Professional Identity Scale and the Readiness for Interprofessional Learning Scale and from portfolios were used within a pretest-postest experimental design to assess student and program success/satisfaction.
Results: This study was conducted among first-year medical students (n = 43) participating in a two-week “Interprofessional Colloboration and Communication” elective course. Educational methods involving active participation on the part of students, such as clinical observations, case studies, brainstorming, and self-assessment. Research shows a significant difference between total Professional Identity Scale pretest (27.02±3.09) and post-test (29.28±2.65) scores (t= -4.58, p= 0.00).and a significant different between pretest (70.88±10.1) and post-test (78.19±6.8) total RILS scores (p= 0.00). A change between pre- and post-program attitudes regarding internship and prejudices concerning health personnel and personal and professional experience was found.
Conclusions: At the end of the program, students’ professional identity perceptions increased, while we determined changes in pre-and post-program preconceptions regarding the internship period and health personnel, and in awareness concerning personal and professional life. Feedback concerning students’ clinical observations was shared with the hospital administration and represented a trigger for culture change. 

Kaynakça

  • Kurdak H, Altıntaş D, Doran F. Medical Education in Turkey: Past to Future. Medical Teacher. 2008; 30: 768-773.
  • Bainbridge L, Nasmith L, Orchard C, Wood V. Competencies for interprofessional colloboration. Journal of Physicical Therapy Education. 2010; 24(1): 6-11.
  • AAMC. The Core Competencies for Entering Medical Students, 2010. Retrieved from https://students-residents.aamc.org/applying-medical-school/article/core-competencies/ 04.02.2019
  • Frank JR, Snell L, Sherbino J. CanMEDS 2015 Physician Competency Framework. Royal College of Physicians and Surgeons of Canada, 2015 (ISBN: 978-1-926588-28-5).
  • Peng J, Clarkin C, Doja A. Uncovering cynicism in medical training: a qualitative analysis of medical online discussion forums. BMJ Open, 2018; 8.
  • Macilwraith P, Bennett D. Burnout and Physical Activity in Medical Students. 2018; 14;111(3):707.
  • Mata DA, Ramos MA, Kim MM, Guille C, Sen S. In Their Own Words: An Analysis of the Experiences of Medical Interns Participating in a Prospective Cohort Study of Depression. Acad Med. 2016; 91(9): 1244–1250.
  • Hammick M, Olckers L, Champion-Smith C. Learning in interprofessional teams: AMEE Guide no 38. Medical Teacher. 2009; 31 (1): 1-12.
  • Paige JT, Garbe DD, Kozmenko V, Yu Q, Kozmenko L, Yang T, Bonanno L ve ark. Getting a head start: high fidelity, simulation- based operating room team training of interprofessional students. Journal of the American College of Surgeons, 2014; 218(1): 140-9.
  • Reeves S, Perrier L, Goldman J, Freeth D, Zwarenstein M. Interprofessional education: effects on Professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews. 2013; 3.
  • Bridges DR, Richard A, Odegard PS, Maki IV, Tomkowiak J. Interprofessional colloboration: three best practice models of interprofessional education. Medical Education Online. 2011; 16: 6035
  • Barr H. Interprofessional education. Section 3: Educational strategies. Chapter: 24, 2002.
  • Yalçınoğlu N, Kayı İ, Işık Ş, Aydın T, Zengin Ş, Karabey S. The Vıews of Intern Doctors on Medıcal Educatıon In Istanbul Faculty of Medıcıne, Istanbul Unıversıty. İstanbul Tıp Fakültesi Dergisi, 2012; 75( 3) – 41-45.
  • Cihan FG, Kutlu R, Karademirci MM. Occupational Future Concerns and Stress Management Conditions of Intern Doctors. JAREM, 2017; 7: 122-7.
  • Köse C, Günegül Y, Erdem C, Uyurca G, Sandalcı BE, et all. The Self-Assessments by the Interns Studying at a Medical School on Certain Basic Professional Knowledge and Skills. STED. 2018; 27 (3): 176-189.
  • Mezirow J. Epistemology of Transformative Learning. Retrieved from http://learningtheories.synthasite.com/resources/Mezirow_EpistemologyTLC.pdf 02.02.2019
  • Karpiak, IE. Evolutionary Theory and The “New Sciences. Studies in Continuing Education. 2000; (22): 1-3.
  • Clark. PG. Reflecting on reflection in interprofessional education: Implications for theory and practice. Journal of Interprofessional Care. 2009; 23(3): 213–223.
  • D’amour D, Ferrada-Vıdela M, Rodrıguez LM, & Beaulieu MD. The Conceptual basis for interprofessonal colloboration: Core concepts and theoretical frameworks. Journal of Interprofessional Care. 2005; 1: 116 – 131.
  • Bainbridge L, Nasmith L, Orchard C, Wood V. Competencies for interprofessional colloboration. Journal of Physicical Therapy Education. 2010; 24(1): 6-11.
  • Adams, Hean, S, Sturgis, P, Macleod Clark, J. Investigating the factors influencing professional identity of first-year health and social care students. Learning in Health and Social Care. 2006; 5 (2), 55–68.
  • Thomson AM, Perry JL. Miller TK. Conceptualizing and Measuring Collaboration. Journal of Public Administration Research and Theory. 2009; 29 1 (1): 23-56.
  • Team Effectiveness Survey. Retrieved from web.augsburg.edu/global/intranet/TeamEffectivenessSurvey.doc 04.02.2019
  • Parsell, G, & Bligh, J. The development of a questionnaire to assess the readiness for health care students for interprofessional learning (RIPLS). Medical Education. 1999; 33, 95 – 100.
  • McFadyen AK, Webster V, Strachan K, Figgins E, Brown H & Mckechnie J. The Readiness for interprofessional learning scale: A possible more stable sub-scale model for the original version of RIPLS. Journal of Interprofessional Care. 2005; 19(6): 595 – 603.
  • Onan A, Turan S, Elcin M, Simsek N, Deniz KZ. A Test Adaptation of the Modified Readiness for Inter-professional Learning Scale in Turkish. Indian Journal of Pharmaceutical Education and Research. 2017; 51 (2): 207-215.
  • Huberman A.Miles M. Nitel Veri Analizi. Ed. Sadegül Akbaba Altun, Ali Ersoy. 3. Baskı, Pegem A Yayıncılık, 2016.
  • Bainbridge L, Nasmith L, Orchard C, Wood V. Competencies for interprofessional colloboration. Journal of Physicical Therapy Education. 2010; 24(1): 6-11.
  • Wagner JRN, Liston B, Miller J. Developing interprofessional communication skills. Teaching and Learning in Nursing. 2011; (6): 97-101.
  • Reyhan Özkaraca. Hekim ve Hemşirelerin işbirlğine ilişkin tutumları ve birbirlerini profesyonellik açısından değerlendirmeleri. Yüksek Lisans Tezi. Ankara, 2009

Disiplinlerarası İşbirliği ile Hazırlanmış Klinik öncesi Reflektif, Aksiyonel ve Transformatif Meslekler Arası İşbirliği ve İletişim Programının Etkililiği: Pilot çalışma

Yıl 2020, Cilt: 19 Sayı: 59, 123 - 139, 30.12.2020
https://doi.org/10.25282/ted.696831

Öz

Amaç: Karmaşık sağlık hizmeti ortamında iş yükü ile birlikte disiplinlerin ve mesleklerin birbirleri ile etkileşiminin artması beklenirken daha az ve yüzeysel ilişkiler kurulduğu görülmektedir. ‘Çok-çeşitlilik' gösteren üniversite sistemi tıp öğrencileri için mesleklerarası etkileşimi bir yetkinlik olarak tanımlamaktadır. Bu çalışma tasarladığımız klinik öncesi mesleklerarası iletişim ve işbirliği programının uygulanması ve erken sonuçlarını sunmayı amaçlamaktadır. Programın temel ve uzak hedefi üniversite bağlamında öğrenme ve uygulamada kültürel değişim yaratmaktır.


 Gereç ve Yöntem: Kurs, dönüştürücü bir yaklaşımla tasarlanmıştır. Öğrenci ve program başarı/memnuniyetini değerlendirmeye yönelik öntest- sontest deneysel tasarım içerisinde Mesleki Kimlik Ölçeği ve Mesleklerarası Öğrenmeye Yönelik Hazır Bulunuşluk ölçekleri ile portfolyodan elde edilen niteliksel veriler kullanılmıştır.


Bulgular: Bu çalışma 2017–2018 öğretim yılında Ondokuz Mayıs Üniversitesi Tıp Fakültesi programında iki haftalık ‘Mesleklerarası İletişim ve Etkileşim’ seçmeli kursuna katılan 43 birinci sınıf öğrencisi ile yürütülmüştür. Programda klinik gözlemler, vaka çalışmaları, beyin fırtınası, özdeğerlendirme gibi öğrencilerin aktif katılımını gerektiren yöntemlere yer verilmiştir. Çalışmada Mesleki Kimlik Ölçeği öntest (27.02 ± 3.09)-sontest (29.28 ± 2.65) puanları (t = -4.58, p = 0.00) ile; RILS ön test (70,88 ± 10,1) -sontest (78,19 ± 6,8) puanları arasında (p = 0,00) anlamlı fark saptanmıştır. Öğrencilerin sağlık personeline yönelik program öncesi ve sonrası tutumları ile kişisel ve mesleki deneyime ilişkin önyargılar arasında değişiklik bulunmuştur.


Sonuç: Mesleklerarası İletişim ve Etkileşim seçmeli programı sonunda öğrencilerin mesleki kimlik algısının yükseldiği, program öncesi ve sonrası intörnlük dönemi ve sağlık personeli ile ilgili önyargılarında, kişisel ve mesleki yaşantıya ilişkin farkındalıklarında değişim olduğu tespit edilmiştir. Öğrencilerin klinik gözlemlerine ilişkin geribildirimler eğitim ve hastane yönetim ile paylaşılmış, kültür değişimi için bir başlatıcı olmuştur.

Kaynakça

  • Kurdak H, Altıntaş D, Doran F. Medical Education in Turkey: Past to Future. Medical Teacher. 2008; 30: 768-773.
  • Bainbridge L, Nasmith L, Orchard C, Wood V. Competencies for interprofessional colloboration. Journal of Physicical Therapy Education. 2010; 24(1): 6-11.
  • AAMC. The Core Competencies for Entering Medical Students, 2010. Retrieved from https://students-residents.aamc.org/applying-medical-school/article/core-competencies/ 04.02.2019
  • Frank JR, Snell L, Sherbino J. CanMEDS 2015 Physician Competency Framework. Royal College of Physicians and Surgeons of Canada, 2015 (ISBN: 978-1-926588-28-5).
  • Peng J, Clarkin C, Doja A. Uncovering cynicism in medical training: a qualitative analysis of medical online discussion forums. BMJ Open, 2018; 8.
  • Macilwraith P, Bennett D. Burnout and Physical Activity in Medical Students. 2018; 14;111(3):707.
  • Mata DA, Ramos MA, Kim MM, Guille C, Sen S. In Their Own Words: An Analysis of the Experiences of Medical Interns Participating in a Prospective Cohort Study of Depression. Acad Med. 2016; 91(9): 1244–1250.
  • Hammick M, Olckers L, Champion-Smith C. Learning in interprofessional teams: AMEE Guide no 38. Medical Teacher. 2009; 31 (1): 1-12.
  • Paige JT, Garbe DD, Kozmenko V, Yu Q, Kozmenko L, Yang T, Bonanno L ve ark. Getting a head start: high fidelity, simulation- based operating room team training of interprofessional students. Journal of the American College of Surgeons, 2014; 218(1): 140-9.
  • Reeves S, Perrier L, Goldman J, Freeth D, Zwarenstein M. Interprofessional education: effects on Professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews. 2013; 3.
  • Bridges DR, Richard A, Odegard PS, Maki IV, Tomkowiak J. Interprofessional colloboration: three best practice models of interprofessional education. Medical Education Online. 2011; 16: 6035
  • Barr H. Interprofessional education. Section 3: Educational strategies. Chapter: 24, 2002.
  • Yalçınoğlu N, Kayı İ, Işık Ş, Aydın T, Zengin Ş, Karabey S. The Vıews of Intern Doctors on Medıcal Educatıon In Istanbul Faculty of Medıcıne, Istanbul Unıversıty. İstanbul Tıp Fakültesi Dergisi, 2012; 75( 3) – 41-45.
  • Cihan FG, Kutlu R, Karademirci MM. Occupational Future Concerns and Stress Management Conditions of Intern Doctors. JAREM, 2017; 7: 122-7.
  • Köse C, Günegül Y, Erdem C, Uyurca G, Sandalcı BE, et all. The Self-Assessments by the Interns Studying at a Medical School on Certain Basic Professional Knowledge and Skills. STED. 2018; 27 (3): 176-189.
  • Mezirow J. Epistemology of Transformative Learning. Retrieved from http://learningtheories.synthasite.com/resources/Mezirow_EpistemologyTLC.pdf 02.02.2019
  • Karpiak, IE. Evolutionary Theory and The “New Sciences. Studies in Continuing Education. 2000; (22): 1-3.
  • Clark. PG. Reflecting on reflection in interprofessional education: Implications for theory and practice. Journal of Interprofessional Care. 2009; 23(3): 213–223.
  • D’amour D, Ferrada-Vıdela M, Rodrıguez LM, & Beaulieu MD. The Conceptual basis for interprofessonal colloboration: Core concepts and theoretical frameworks. Journal of Interprofessional Care. 2005; 1: 116 – 131.
  • Bainbridge L, Nasmith L, Orchard C, Wood V. Competencies for interprofessional colloboration. Journal of Physicical Therapy Education. 2010; 24(1): 6-11.
  • Adams, Hean, S, Sturgis, P, Macleod Clark, J. Investigating the factors influencing professional identity of first-year health and social care students. Learning in Health and Social Care. 2006; 5 (2), 55–68.
  • Thomson AM, Perry JL. Miller TK. Conceptualizing and Measuring Collaboration. Journal of Public Administration Research and Theory. 2009; 29 1 (1): 23-56.
  • Team Effectiveness Survey. Retrieved from web.augsburg.edu/global/intranet/TeamEffectivenessSurvey.doc 04.02.2019
  • Parsell, G, & Bligh, J. The development of a questionnaire to assess the readiness for health care students for interprofessional learning (RIPLS). Medical Education. 1999; 33, 95 – 100.
  • McFadyen AK, Webster V, Strachan K, Figgins E, Brown H & Mckechnie J. The Readiness for interprofessional learning scale: A possible more stable sub-scale model for the original version of RIPLS. Journal of Interprofessional Care. 2005; 19(6): 595 – 603.
  • Onan A, Turan S, Elcin M, Simsek N, Deniz KZ. A Test Adaptation of the Modified Readiness for Inter-professional Learning Scale in Turkish. Indian Journal of Pharmaceutical Education and Research. 2017; 51 (2): 207-215.
  • Huberman A.Miles M. Nitel Veri Analizi. Ed. Sadegül Akbaba Altun, Ali Ersoy. 3. Baskı, Pegem A Yayıncılık, 2016.
  • Bainbridge L, Nasmith L, Orchard C, Wood V. Competencies for interprofessional colloboration. Journal of Physicical Therapy Education. 2010; 24(1): 6-11.
  • Wagner JRN, Liston B, Miller J. Developing interprofessional communication skills. Teaching and Learning in Nursing. 2011; (6): 97-101.
  • Reyhan Özkaraca. Hekim ve Hemşirelerin işbirlğine ilişkin tutumları ve birbirlerini profesyonellik açısından değerlendirmeleri. Yüksek Lisans Tezi. Ankara, 2009
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Orjinal Araştırma
Yazarlar

Özlem Mıdık 0000-0002-0151-7461

Hatice Kumcağız

Aynur Arslan

Yayımlanma Tarihi 30 Aralık 2020
Gönderilme Tarihi 2 Mart 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 19 Sayı: 59

Kaynak Göster

Vancouver Mıdık Ö, Kumcağız H, Arslan A. The effectiveness of a preclinical reflectional, actional and transformative Interprofessional Collaboration and Communication program prepared with interdisiciplinary collaboration: A pilot study. TED. 2020;19(59):123-39.