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“不仅仅是为了相处融洽”:通过跨专业协作的话语和实践来探索学习。

"It's Not Just About Getting Along": Exploring Learning Through the Discourse and Practice of Interprofessional Collaboration.

机构信息

M.A. Martimianakis is associate professor, scientist, and associate director, collaboration and partnerships, Department of Paediatrics and The Wilson Centre, University of Toronto, Toronto, Ontario, Canada; ORCID: http://orcid.org/0000-0002-2531-3156.

O. Fernando is research associate, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; ORCID: http://orcid.org/0000-0002-4600-9399.

出版信息

Acad Med. 2020 Nov;95(11S Association of American Medical Colleges Learn Serve Lead: Proceedings of the 59th Annual Research in Medical Education Presentations):S73-S80. doi: 10.1097/ACM.0000000000003637.

Abstract

PURPOSE

Interprofessional collaboration (IPC) is a necessary competency for all professionals. However, IPC can be fraught with politics leading to variable uptake and execution. The authors set out to understand how trainees come to appreciate the value of the "team" in their learning and to describe the type of learning related to IPC afforded to trainees in a highly collaborative complex care context.

METHOD

The authors conducted 72 hours of observations of pediatric rheumatology settings at a large pediatric hospital across 18 months. They interviewed 10 health professionals and analyzed an archive of texts to ascertain how the field of pediatric rheumatology conceptualizes the role of IPC. They used the concept of governmentality and critical discourse analysis to describe how values of collaboration enabled learning and theories of expertise to understand how learning was enacted and perceived.

RESULTS

Collaboration was perceived to be a product of providing good rheumatological care, which in this case, aligned well with hospital model of IPC. This alignment afforded trainees learning opportunities beyond preparing them to get along with other health professionals. IPC, when role modeled during problem solving, created the conditions for learning "why" collaboration is important for clinical expertise.

CONCLUSIONS

By critically examining the relationship between discourse, practice, and learning, the authors have described how practices that underpin collaboration as a clinical competency are distinct from collaboration as cultural work contributing to civility within teams and across the organization.

摘要

目的

跨专业协作(IPC)是所有专业人员的必备能力。然而,IPC 可能充满政治因素,导致其采用和执行情况各不相同。作者旨在了解学员如何逐渐认识到“团队”在学习中的价值,并描述在高度协作的复杂护理环境中为学员提供的与 IPC 相关的学习类型。

方法

作者在 18 个月的时间里,对一家大型儿童医院的儿科风湿病学环境进行了 72 小时的观察。他们采访了 10 名卫生专业人员,并分析了一系列文本,以确定儿科风湿病学领域如何概念化 IPC 的作用。他们使用治理概念和批判性话语分析来描述协作价值观如何促进学习,以及专家理论如何理解学习的实施和感知。

结果

协作被认为是提供良好风湿病护理的产物,在这种情况下,与医院的 IPC 模式非常吻合。这种一致性为学员提供了超越与其他卫生专业人员相处的学习机会。当在解决问题时进行角色扮演时,IPC 为学习“为什么”协作对于临床专业知识很重要创造了条件。

结论

通过批判性地审视话语、实践和学习之间的关系,作者描述了支撑协作作为临床能力的实践与协作作为文化工作之间的区别,这种文化工作有助于团队内部和整个组织的文明。

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