Keshmiri Fatemeh, Rezai Mahdi, Tavakoli Nader
Medical Education Department, Educational Development Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Faculty of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
J Eval Clin Pract. 2020 Aug;26(4):1153-1161. doi: 10.1111/jep.13379. Epub 2020 Mar 1.
The present study aimed to investigate the effects of interprofessional education on healthcare providers' intentions to engage in an interprofessional shared decision-making (IP-SDM) process at emergency department and exploring the affecting factors on their intentions.
We conducted the study through a sequential explanatory mixed method (quantitative-qualitative) design. All ED residents and nurses from two university hospitals were invited and assigned to the intervention and control groups. The intervention group was exposed to case-based learning sessions conducted by applying interprofessional strategies. The intentions of the participants engaged in IP-SDM were assessed before and 2 weeks after the intervention by a questionnaire designed based on the theory of planned behaviour. The questionnaire scores were compared between the intervention and control groups using analysis of covariance (ANCOVA). Partial eta-squared (η ) was used for effect size calculations in ANCOVA. Subsequently, to explore the affecting factors in engagement in IP-SDM, qualitative data were collected through semi-structured individual interviews. The inductive content analysis approach by Elo and Kyngas was employed to analyze the qualitative data.
Out of 117 potentially eligible healthcare professionals, 113 completed the study in the intervention (n = 55) and control (n = 58) groups. The results showed that the difference between the mean scores of the learners in the intervention (1.41 ± 0.27) and control (0.80 ± 0.52) groups was statistically significant (P-value = .00001). The main effect of the intervention and a large educational effect size for the intervention were found to be statistically significant F (1, 11) = 180.54, P-value = .00001, η = 0.62. The qualitative data analysis showed two main categories of "team-based facilitators" and "contextual challenges" as the main affecting factors in the engagement of participant in IP-SDM.
Our findings suggested that applying interprofessional education strategies could improve the learners' intention to engage in IP-SDM. Moreover, the results showed that the interprofessional collaboration among team members, adherence to the team-based care principles, and administrative support at different levels could be the influential factors the intentions of the participants to engage in IP-SDM.
本研究旨在调查跨专业教育对医疗服务提供者在急诊科参与跨专业共同决策（IP-SDM）过程的意愿的影响，并探索影响其意愿的因素。
我们采用了顺序解释性混合方法（定量-定性）设计进行研究。邀请了两家大学医院的所有急诊科住院医师和护士，并将他们分配到干预组和对照组。干预组参加了应用跨专业策略开展的基于案例的学习课程。在干预前和干预后2周，通过基于计划行为理论设计的问卷对参与IP-SDM的参与者的意愿进行评估。使用协方差分析（ANCOVA）比较干预组和对照组的问卷得分。在ANCOVA中，部分 eta 平方（η ）用于效应量计算。随后，为了探索参与IP-SDM的影响因素，通过半结构化个人访谈收集定性数据。采用Elo和Kyngas的归纳性内容分析方法对定性数据进行分析。
在117名潜在符合条件的医疗专业人员中，113人完成了干预组（n = 55）和对照组（n = 58）的研究。结果表明，干预组（1.41±0.27）和对照组（0.80±0.52）学习者的平均得分差异具有统计学意义（P值 = .00001）。干预的主要效应和干预的较大教育效应量在统计学上具有显著意义，F（1, 11） = 180.54，P值 = .00001，η = 0.62。定性数据分析显示，“基于团队的促进因素”和“背景挑战”这两个主要类别是影响参与者参与IP-SDM的主要因素。
我们的研究结果表明，应用跨专业教育策略可以提高学习者参与IP-SDM的意愿。此外，结果表明团队成员之间的跨专业协作、坚持基于团队护理的原则以及不同层面上的行政支持可能是影响参与者参与IP-SDM意愿的因素。
