Olde Bekkink Marleen, Farrell Susan E, Takayesu James Kimo
Radboud University Medical Centre, Department of Internal Medicine, Nijmegen, Netherlands.
Massachusetts General Hospital, Institute of Health Professions, Center for Interprofessional Studies and Innovation, Boston, USA.
Int J Med Educ. 2018 Oct 25;9:262-270. doi: 10.5116/ijme.5bb5.c111.
Objectives of the current study were to: i) assess residents' perceptions of barriers and enablers of interprofessional (IP) communication based on experiences and observations in their clinical work environments, ii) investigate how residents were trained to work in IP collaborative practice, iii) collect residents' recommendations for training in IP communication to address current needs.
Focus group study including fourteen Emergency Medicine (EM) residents, who participated in four focus groups, facilitated by an independent moderator. Focus group interviews were audiotaped, transcribed verbatim, independently reviewed by the authors, and coded for emerging themes.
Four themes of barriers and enablers to IP communication were identified: i) the clinical environment (high acuity; rapidly changing health care teams, work overload, electronic communications), ii) interpersonal relationships (hierarchy, (un)familiarity, mutual respect, feeling part of the team), iii) personal factors (fear, self-confidence, uncontrolled personal emotions, conflict management skills), and iv) training (or lack thereof). Residents indicated that IP communication was learned primarily through trial and error and observing other professionals but expressed a preference for formal training in IP communication.
Based on this pilot study, barriers to effective IP communication in the ED were inherent in the system and could be exacerbated by relational dynamics and a lack of formal training. Opportunities for both curricular interventions and systems changes were identified and are presented.
本研究的目的是：i）根据住院医师在临床工作环境中的经验和观察，评估他们对跨专业（IP）沟通障碍和促进因素的看法；ii）调查住院医师如何接受IP协作实践培训；iii）收集住院医师对IP沟通培训的建议，以满足当前需求。
焦点小组研究，包括14名急诊医学（EM）住院医师，他们参加了由独立主持人主持的4个焦点小组。焦点小组访谈进行了录音，逐字转录，作者独立审查，并对出现的主题进行编码。
确定了IP沟通障碍和促进因素的四个主题：i）临床环境（高急症程度；快速变化的医疗团队、工作负荷过重、电子通信）；ii）人际关系（等级制度、（不）熟悉、相互尊重、团队归属感）；iii）个人因素（恐惧、自信、无法控制的个人情绪、冲突管理技能）；iv）培训（或缺乏培训）。住院医师表示，IP沟通主要是通过试错和观察其他专业人员学到的，但他们表示更喜欢IP沟通的正规培训。
基于这项试点研究，急诊室有效IP沟通的障碍是系统固有的，可能会因关系动态和缺乏正规培训而加剧。确定并提出了课程干预和系统变革的机会。
