Hammick M, Freeth D, Koppel I, Reeves S, Barr H
University of Central England, UK.
Med Teach. 2007 Oct;29(8):735-51. doi: 10.1080/01421590701682576.
BACKGROUND AND REVIEW CONTEXT: Evidence to support the proposition that learning together will help practitioners and agencies work better together remains limited and thinly spread. This review identified, collated, analysed and synthesised the best available contemporary evidence from 21 of the strongest evaluations of IPE to inform the above proposition. In this way we sought to help shape future interprofessional education and maximize the potential for interprofessional learning to contribute to collaborative practice and better care.
To identify and review the strongest evaluations of IPE. To classify the outcomes of IPE and note the influence of context on particular outcomes. To develop a narrative about the mechanisms that underpin and inform positive and negative outcomes of IPE.
Bibliographic database searches as follows: Medline 1966-2003, CINAHL 1982-2001, BEI 1964-2001, ASSIA 1990-2003 which produced 10,495 abstracts. Subsequently, 884 full papers were obtained and scrutinized. In addition, hand searching (2003-5 issues) of 21 journals known to have published two or more higher quality studies from a previous review.
Peer-reviewed papers and reports included in the review had to be formal educational initiatives attended by at least two of the many professional groups from health and social care, with the objective of improving care; and learning with, from and about each other.
DATA COLLECTION, ANALYSIS AND SYNTHESIS: Standard systematic review procedures were applied for sifting abstracts, scrutinizing full papers and abstracting data. Two members of the team checked each abstract to decide whether the full paper should be read. A third member was consulted over any discrepancies. Similarly, each full paper was read by at least two members of the team and agreement sought before passing it to one member of the team (SR) for data abstraction. Other members of the team checked 10% of the abstraction records. Coding into a Statistical Package for Social Scientists (SPSS) data base led to collection of different outcome measures used in the primary studies via the common metric of an adapted Kirkpatrick's four-level model of educational outcomes. Additionally, a narrative synthesis was built after analysis of primary data with the 3-P model (presage-process-product) of education development and delivery.
Government calls for enhanced collaboration amongst practitioners frequently leads to IPE that is then developed and delivered by educators, practitioners or service managers. Staff development is a key influence on the effectiveness of IPE for learners who all have unique values about themselves and others. Authenticity and customization of IPE are important mechanisms for positive outcomes of IPE. Interprofessional education is generally well received, enabling knowledge and skills necessary for collaborative working to be learnt; it is less able to positively influence attitudes and perceptions towards others in the service delivery team. In the context of quality improvement initiatives interprofessional education is frequently used as a mechanism to enhance the development of practice and improvement of services.
背景与综述背景:支持共同学习有助于从业者和机构更好协作这一观点的证据仍然有限且分布零散。本综述识别、整理、分析并综合了来自21项关于跨专业教育(IPE)的最强有力评估的现有最佳当代证据,以为上述观点提供信息。通过这种方式,我们试图帮助塑造未来的跨专业教育,并最大限度地发挥跨专业学习对协作实践和改善护理的潜在作用。
识别并综述对IPE的最强有力评估。对IPE的结果进行分类,并注意背景对特定结果的影响。阐述支撑和解释IPE正负结果的机制。
进行如下书目数据库检索:1966 - 2003年的Medline、1982 - 2001年的CINAHL、1964 - 2001年的BEI、1990 - 2003年的ASSIA,共检索到10495篇摘要。随后获取并审查了884篇全文。此外,对21种已知在先前综述中发表过两篇或更多高质量研究的期刊进行了手工检索(2003 - 2005年各期)。
纳入综述的同行评审论文和报告必须是至少有来自健康和社会护理领域多个专业组中的两个专业组参与的正式教育活动,目的是改善护理;且是相互学习、向他人学习以及了解他人。
数据收集、分析与综合:应用标准的系统综述程序筛选摘要、审查全文并提取数据。团队的两名成员检查每篇摘要,以决定是否应阅读全文。如有分歧则咨询第三名成员。同样,每篇全文至少由团队的两名成员阅读,并在将其交给团队的一名成员(SR)进行数据提取之前寻求一致意见。团队的其他成员检查了10%的提取记录。编码到社会科学统计软件包(SPSS)数据库中,通过改编后的柯克帕特里克教育成果四级模型这一通用指标,收集了主要研究中使用的不同结果测量指标。此外,在使用教育发展与实施的3 - P模型(前提 - 过程 - 产品)对主要数据进行分析后,构建了叙述性综述。
政府呼吁从业者加强协作,这常常促成了由教育工作者、从业者或服务经理开展和实施的IPE。员工发展对IPE的有效性具有关键影响,因为学习者对自己和他人都有独特的价值观。IPE的真实性和针对性是其产生积极结果的重要机制。跨专业教育总体上受到好评,能让学习者学到协作工作所需的知识和技能;但它对服务提供团队中对他人的态度和看法的积极影响较小。在质量改进举措的背景下,跨专业教育经常被用作促进实践发展和改善服务的一种机制。