Clausen Christina, Cummins Kelly, Dionne Kelley
a Center for Innovation in Nursing Education and Training , Université de Montréal , Montreal , QC , Canada.
b Montréal Children's Hospital , McGill University , Montreal , QC , Canada.
J Interprof Care. 2017 Nov;31(6):685-695. doi: 10.1080/13561820.2017.1347153. Epub 2017 Sep 1.
Collaborative leadership and management structures are critical to transforming care delivery. Both nurse and physician managers are uniquely positioned to co-lead. However, little is known on how to prepare and support individuals for these co-leader arrangements. The re-design of healthcare professional education focuses on interprofessional collaboration, mutual learning, and a competency-based approach. While competencies for interprofessional collaboration have been delineated, competencies for collaborative management practice have yet to be addressed. An integrative review of empirical studies on existing educational interventions was conducted to critically appraise and synthesise the results regarding collaborative competence among nurse and physician leaders. We reviewed how these interventions have been designed, implemented, and evaluated within workplace settings in order to inform our understanding of what components are effective or ineffective for the future development of an educational programme. This review reports on key characteristics of nine empirical studies and emphasises that: a uniprofessional approach to leadership development is predominant within educational programmes and that the assessment of shared learning experiences are not addressed; there are inconsistency in terms used to describe competencies by individual researchers and limitations within the competency frameworks used in the studies reviewed; and there is a lack of suitable instruments available to assess whether competencies have been achieved through the educational programmes. None of the studies discussed the process of how individuals learned specific competencies or whether learning outcome were achieved. Educational programmes were developed based on a perceived lack of leadership preparation and orientation programmes for leaders in formal management positions and used multiple interventions. Only two of the programmes involved organisational or systems level competencies. Interprofessional co-leading requires enhanced capabilities and capacity for managers. There is a need for developing an in-action education intervention that addresses the unique learning needs of co-leader arrangements particularly among nurses and physicians who are new to their role.
协作式领导和管理结构对于转变医疗服务提供方式至关重要。护士和医生管理者都具备独特的共同领导优势。然而，对于如何培养和支持个人参与这些共同领导安排，我们知之甚少。医疗专业教育的重新设计侧重于跨专业协作、相互学习以及基于能力的方法。虽然已经明确了跨专业协作的能力要求，但协作管理实践的能力要求尚未得到解决。我们对现有教育干预措施的实证研究进行了综合综述，以批判性地评估和综合有关护士和医生领导者协作能力的研究结果。我们审视了这些干预措施在工作场所环境中的设计、实施和评估方式，以便了解哪些要素对教育项目的未来发展有效或无效。本综述报告了九项实证研究的关键特征，并强调：领导力发展的单一专业方法在教育项目中占主导地位，且未涉及对共享学习经历的评估；个别研究人员用于描述能力的术语存在不一致，且在所审查研究中使用的能力框架存在局限性；缺乏合适的工具来评估通过教育项目是否实现了能力要求。没有一项研究讨论个人如何学习特定能力的过程或是否实现了学习成果。教育项目是基于正式管理职位的领导者缺乏领导力培养和定向项目这一认知而制定的，并采用了多种干预措施。只有两个项目涉及组织或系统层面的能力。跨专业共同领导要求管理者具备更强的能力和才能。有必要开发一种行动中的教育干预措施，以满足共同领导安排的独特学习需求，特别是针对新担任该角色的护士和医生。
