Walsh Allyn, Moore Ainsley, Barber Anne, Opsteen Joanne
Department of Family Medicine at McMaster University in Hamilton, Ont.
Clinical Director in the School of Nursing at York University in Toronto, Ont.
Can Fam Physician. 2014 Jun;60(6):e316, e318-21.
To examine the role of nurse practitioners (NPs) as educators of family medicine residents in order to better understand the interprofessional educational dynamics in a clinical teaching setting.
A qualitative descriptive approach, using purposive sampling.
A family practice centre that is associated with an academic department of family medicine and is based in an urban area in southern Ontario.
First-year (8 of 9) and second-year (9 of 10) family medicine residents whose training program was based at the family practice centre, and all NPs (4 of 4) who worked at the centre.
Semistructured interviews were conducted, which were audiotaped and transcribed. An iterative approach was used for coding and analysis. Data management software guided organization and analysis of the data.
Four interconnected themes were identified: role clarification, professional identity formation, factors that enhance the educational role of NPs, and factors that limit the educational role of NPs. Although residents recognized NPs' value in team functioning and areas of specialized knowledge, they were unclear about NPs' scope of practice. Depending on residents' level of training, residents tended to respond differently to teaching by NPs. More of the senior residents believed they needed to think like physicians and preferred clinical teaching from physician teachers. Junior residents valued the step-by-step instructional approach used by NPs, and they had a decreased sense of vulnerability when being taught by NPs. Training in teaching skills was helpful for NPs. Barriers to providing optimal education included opportunity, time, and physician attitudes.
The lack of an intentional orientation of family medicine residents to NPs' scope of practice and educational role can lead to difficulties in interprofessional education. More explicit recognition of the evolving professional identity of family medicine residents might decrease resistance to teaching by NPs and ensure that interprofessional teaching and learning strategies are effective. Faculty development opportunities for all educators are required to manage these issues, both to ensure teaching competencies and to reinforce positive interprofessional collaboration.
探讨执业护士（NPs）作为家庭医学住院医师教育者的角色，以便更好地理解临床教学环境中的跨专业教育动态。
采用目的抽样的定性描述性方法。
一个与家庭医学学术部门相关联、位于安大略省南部市区的家庭医疗中心。
培训项目以该家庭医疗中心为基地的一年级（9人中有8人）和二年级（10人中有9人）家庭医学住院医师，以及在该中心工作的所有执业护士（4人中有4人）。
进行半结构化访谈，录音并转录。采用迭代方法进行编码和分析。数据管理软件指导数据的组织和分析。
确定了四个相互关联的主题：角色澄清、职业身份形成、增强执业护士教育角色的因素以及限制执业护士教育角色的因素。尽管住院医师认识到执业护士在团队运作和专业知识领域的价值，但他们不清楚执业护士的执业范围。根据住院医师的培训水平，他们对执业护士教学的反应往往不同。更多的高年级住院医师认为他们需要像医生一样思考，更喜欢医生教师的临床教学。低年级住院医师重视执业护士采用的循序渐进的教学方法，并且在接受执业护士教学时他们的脆弱感降低。教学技能培训对执业护士有帮助。提供最佳教育的障碍包括机会、时间和医生的态度。
家庭医学住院医师对执业护士的执业范围和教育角色缺乏有意的认知可能导致跨专业教育出现困难。更明确地认识家庭医学住院医师不断演变的职业身份可能会减少对执业护士教学的抵触，并确保跨专业教学和学习策略有效。需要为所有教育者提供师资发展机会来处理这些问题，既要确保教学能力，又要加强积极的跨专业协作。
