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使用患者文档促进临床实践中的跨专业协作的跨专业学生小组——一项实地研究。

Interprofessional student groups using patient documentation to facilitate interprofessional collaboration in clinical practice - A field study.

作者信息

Gudmundsen Anita Carin, Norbye Bente, Dahlgren Madeleine Abrandt, Obstfelder Aud

机构信息

UiT The Arctic University of Norway, PO Box 6050 Langnes, N-9037 Tromsoe, Norway.

UiT The Arctic University of Norway, Norway.

出版信息

Nurse Educ Today. 2020 Dec;95:104606. doi: 10.1016/j.nedt.2020.104606. Epub 2020 Sep 28.

Abstract

BACKGROUND

This article explores and provides insights into how students learn interprofessional collaboration in a clinical placement. This topic is of interest for stakeholders in health services and education and for the research field of interprofessional education.

OBJECTIVES

How patient documentation facilitates collaboration in interprofessional student groups is explored.

DESIGN

This study uses qualitative research with an ethnographic design.

SETTINGS

This research studies interprofessional education at a Norwegian university.

PARTICIPANTS

Three student groups that participated in a two-week interprofessional clinical placement in a geriatric rehabilitation ward were studied, which comprised students of medicine, nursing, occupational therapy and physiotherapy.

METHODS

Data were generated through observational studies and informal conversations with the students in interprofessional placement and consists of written field notes and transcribed audio-recorded conversations. The analysis drew on concepts from practice theory related to the social practices of learning.

RESULTS

The students creatively and dynamically used a narrative note in the electronic patient record system in the ward to create an overview of care and ensure continuity of care for the patients for whom they were responsible. By using the narrative note in the record, the students aimed to develop a comprehensive understanding of their patients' clinical situations and care needs. When new information was entered in the note, information already written by individual students and student pairs was reviewed by all students, revised and mutually refined. As a result, multidimensional representations of the patients' health statuses and care needs emerged, including how the patients responded to the students' suggested interventions.

CONCLUSIONS

Patient documentation can be a tool for stimulating interprofessional collaboration when students are allowed to organize patient care independently. We suggest that students' natural meaning-seeking capability is a hidden resource that can be exploited in interprofessional education.

摘要

背景

本文探讨并深入分析了学生在临床实习中如何学习跨专业协作。这一主题对于卫生服务与教育领域的利益相关者以及跨专业教育的研究领域而言具有重要意义。

目的

探讨患者文档如何促进跨专业学生小组的协作。

设计

本研究采用民族志设计的定性研究方法。

地点

本研究针对挪威一所大学的跨专业教育展开。

参与者

对三个参与了为期两周老年康复病房跨专业临床实习的学生小组进行了研究,这些小组的学生来自医学、护理、职业治疗和物理治疗专业。

方法

通过观察研究以及与跨专业实习中的学生进行非正式交谈来收集数据,数据包括书面实地记录和转录的音频对话。分析借鉴了与学习社会实践相关的实践理论概念。

结果

学生们富有创造性且灵活地运用病房电子病历系统中的叙事性记录,以创建护理概况并确保他们所负责患者的护理连续性。通过在记录中使用叙事性记录,学生们旨在全面了解患者的临床状况和护理需求。当新信息录入记录时,所有学生都会查看个别学生及学生小组已写入的信息,并进行修订和相互完善。结果,呈现出了患者健康状况和护理需求的多维度表征,包括患者对学生建议干预措施的反应。

结论

当允许学生自主组织患者护理时,患者文档可成为促进跨专业协作的工具。我们认为学生天然的意义探寻能力是跨专业教育中可加以利用的潜在资源。

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