Visser Cora Lf, Wouters Anouk, Croiset Gerda, Kusurkar Rashmi A
Faculty of Medicine, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Amstel Academy, VU University Medical Center, Amsterdam, The Netherlands.
J Med Educ Curric Dev. 2020 Feb 24;7:2382120520907915. doi: 10.1177/2382120520907915. eCollection 2020 Jan-Dec.
Interprofessional education (IPE) on a ward supports students to generate interprofessional patient care plans as a means to learn about the roles, responsibilities, and clinical reasoning of other professions. We investigated how clinicians guide the clinical reasoning of students from their own and other professions and whether clinicians from nursing, midwifery, and medicine could scaffold students from all professions, that is, by providing just-in-time and tailored support.
Nine supervising clinicians from medicine, nursing, and midwifery were interviewed and a repeat interview held 3 to 15 weeks later; one nurse supervisor was interviewed only once. Using conventional content analysis, themes were identified inductively. Next, we applied an existing scaffolding framework to conceptualise how clinicians supported the clinical reasoning in an IPE setting.
Themes were clinicians' interventions and intentions, results of interventions and of IPE, characteristics of students and clinicians, interactions between clinicians and students, and logistics. Clinicians applied various interventions and expressed several intentions to guide the learning of students from all professions. Clinicians stimulated students' clinical reasoning by structuring meetings, asking students to explain their thoughts to each other and through giving group assignments. Thus, clinicians used peer-assisted learning for the students. By collaborating with other supervising clinicians regarding the form and amount of guidance to give to the students, clinicians applied peer-assisted learning for themselves as well.
Clinicians can learn to scaffold the clinical reasoning of students from different professions, when they are provided with training, good examples, and structures. An existing scaffolding framework can serve as an overview of aims and interventions to provide just-in-time guidance to students from all professions. The scaffolding framework is useful for training clinicians and for depicting the pedagogical approach for IPE wards.
病房中的跨专业教育（IPE）可帮助学生制定跨专业患者护理计划，以此了解其他专业的角色、职责和临床推理过程。我们调查了临床医生如何指导来自本专业和其他专业的学生进行临床推理，以及护理、助产和医学专业的临床医生是否能够为所有专业的学生提供支持，即提供及时且量身定制的支持。
对9名来自医学、护理和助产专业的督导临床医生进行了访谈，并在3至15周后进行了重复访谈；一名护士督导仅接受了一次访谈。采用常规内容分析法，归纳出主题。接下来，我们应用现有的支架式教学框架来概念化临床医生在IPE环境中如何支持临床推理。
主题包括临床医生的干预措施和意图、干预措施及IPE的结果、学生和临床医生的特征、临床医生与学生之间的互动以及后勤保障。临床医生采用了各种干预措施，并表达了多种指导所有专业学生学习的意图。临床医生通过组织会议、要求学生相互解释想法以及布置小组作业来激发学生的临床推理。因此，临床医生为学生采用了同伴辅助学习法。通过与其他督导临床医生就给予学生的指导形式和数量进行协作，临床医生也为自己采用了同伴辅助学习法。
当临床医生获得培训、良好范例和架构时，他们能够学会为不同专业的学生提供临床推理支架。现有的支架式教学框架可作为目标和干预措施的概述，为所有专业的学生提供及时指导。该支架式教学框架对培训临床医生以及描述IPE病房的教学方法很有用。
