School of Medical Sciences, Örebro University, Örebro, Sweden.
Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
BMC Med Educ. 2020 Nov 25;20(1):467. doi: 10.1186/s12909-020-02379-9.
Interprofessional collaboration is increasingly important in healthcare, but interprofessional education (IPE) faces challenges, such as different study programmes with varied schedules and campuses. These challenges can be met, in part, by using web-based virtual patients (VPs) as a tool in IPE. However, demands for relevant patient presentations and clinical practice increase when VPs are used by students from different programmes. The aim of this study was to improve the presentation of professional perspectives regarding nurses and physicians and their collaboration in order to increase the clinical authenticity of existing VPs.
Clinical observations were conducted to gain familiarity with the context. Semi-structured interviews were performed with individual nurses and physicians with experience of patients with leg ulcers. The interviews were recorded, transcribed and analysed using thematic analysis.
The clinical observations exposed a lack of interprofessional collaboration in practice with regard to patients with leg ulcers. The interview analysis resulted in two themes: Clinical care and Organizational structure. The theme Clinical care included nursing with a holistic approach to the patient and awareness of the patient's well-being, including nutrition and home situation. The theme Organizational structure revealed a lack of teamwork in primary care. The interviewees stressed learning together and sharing responsibility, and they emphasised the importance of implementing interprofessional learning in the education of nurses and physicians in order to stimulate future teamwork. The VP should offer a broad medical history so that healthcare students are made aware of how a disease can affect the patient's social situation, and thereby illustrate the importance of interprofessional collaboration. The information should also be comprehensive and clear, leading to a diagnosis, so the student can gain clinical knowledge and build a foundation for discussion of treatment.
Interviews and observations in clinical practice can be used to enhance authenticity in VPs for interprofessional learning. A thorough look at authentic clinical environments can enrich and improve educational settings using VPs, and it can highlight the challenges students can encounter in clinical care of the patient and in an organisation with regard to interprofessional collaboration.
跨专业协作在医疗保健中变得越来越重要,但跨专业教育 (IPE) 面临着一些挑战,例如不同的学习计划有不同的时间表和校园。这些挑战可以部分通过使用基于网络的虚拟患者 (VP) 作为 IPE 工具来应对。然而,当来自不同计划的学生使用 VP 时,对相关患者呈现和临床实践的需求会增加。本研究的目的是改善护士和医生的专业观点以及他们的协作呈现,以增加现有 VP 的临床真实性。
进行临床观察以熟悉背景。对有腿部溃疡患者经验的个别护士和医生进行半结构化访谈。采访进行了录音、转录和主题分析。
临床观察暴露了在腿部溃疡患者的实践中缺乏跨专业协作。访谈分析产生了两个主题:临床护理和组织结构。主题临床护理包括护士对患者的整体护理方法和对患者福祉的认识,包括营养和家庭情况。主题组织结构揭示了初级保健中缺乏团队合作。受访者强调共同学习和分担责任,并强调在护士和医生的教育中实施跨专业学习的重要性,以激发未来的团队合作。VP 应该提供广泛的病史,以便医疗保健学生意识到疾病如何影响患者的社会状况,从而说明跨专业合作的重要性。信息还应该全面清晰,导致诊断,以便学生获得临床知识并为讨论治疗奠定基础。
临床实践中的访谈和观察可用于增强 VP 中跨专业学习的真实性。对真实临床环境的全面审视可以丰富和改进使用 VP 的教育环境,并突出学生在患者临床护理和跨专业协作方面可能遇到的挑战。