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注册前跨专业教育对卫生专业人员早期职业态度和技能的纵向影响:一项具有 4 年结果的非随机试验。

Longitudinal impact of preregistration interprofessional education on the attitudes and skills of health professionals during their early careers: a non-randomised trial with 4-year outcomes.

机构信息

Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand

Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand.

出版信息

BMJ Open. 2022 Jul 20;12(7):e060066. doi: 10.1136/bmjopen-2021-060066.

Abstract

OBJECTIVE

To assess whether a preregistration interprofessional education (IPE) programme changed attitudes towards teamwork and team skills during health professionals' final year of training and first 3 years of professional practice.

DESIGN

Prospective, longitudinal, non-randomised trial.

SETTING

Final year health professional training at three academic institutions in New Zealand.

PARTICIPANTS

Students from eight disciplines eligible to attend the IPE programme were recruited (617/730) prior to their final year of training. 130 participants attended the IPE programme; 115 intervention and 372 control participants were included in outcome analysis.

INTERVENTION

The 5-week Tairāwhiti IPE (TIPE) immersion programme during which students experience clinical placements in interdisciplinary teams, complete collaborative tasks and live together in shared accommodation.

MAIN OUTCOME MEASURES

Data were collected via five surveys at 12-month intervals, containing Attitudes Towards Healthcare Teams Scale (ATHCTS), Team Skills Scale (TSS) and free-text items. Mixed-model analysis of covariance, adjusting for baseline characteristics, compared scores between groups at each time point. Template analysis identified themes in free-text data.

RESULTS

Mean ATHCTS scores for TIPE participants were 1.4 (95% CI 0.6 to 2.3) points higher than non-TIPE participants (p=0.002); scores were 1.9 (95% CI 0.8 to 3.0) points higher at graduation and 1.1 (95% CI -0.1 to 2.4) points higher 3 years postgraduation. Mean TSS scores for TIPE participants were 1.7 (95% CI 0.0 to 3.3) points higher than non-TIPE participants (p=0.045); scores were 3.5 points (95% CI 1.5 to 5.5) higher at graduation and 1.3 (95%CI -0.8 to 3.5) points higher 3 years postgraduation. TIPE participants made substantially more free-text comments about benefits of interprofessional collaboration and perceived the TIPE programme had a meaningful influence on their readiness to work in teams and the way in which they performed their healthcare roles.

CONCLUSIONS

TIPE programme participation significantly improved attitudes towards healthcare teams and these changes were maintained over 4 years.

摘要

目的

评估在卫生专业人员最后一年的培训和最初 3 年的专业实践期间,预先注册的跨专业教育(IPE)计划是否改变了他们对团队合作和团队技能的态度。

设计

前瞻性、纵向、非随机试验。

地点

新西兰三所学术机构的最后一年卫生专业培训。

参与者

在最后一年的培训之前,从有资格参加 IPE 计划的八个学科中招募了学生(617/730)。130 名参与者参加了 IPE 计划;115 名干预组和 372 名对照组参与者纳入了结果分析。

干预措施

为期 5 周的 Tairāwhiti IPE(TIPE)沉浸式课程,在此期间,学生在跨学科团队中体验临床实习,完成协作任务,并在共享住宿中共同生活。

主要观察指标

在 12 个月的间隔时间内通过五次调查收集数据,包含医疗保健团队态度量表(ATHCTS)、团队技能量表(TSS)和自由文本项目。使用混合模型协方差分析,根据基线特征调整,比较每个时间点组间的得分。模板分析确定了自由文本数据中的主题。

结果

TIPE 参与者的平均 ATHCTS 评分比非 TIPE 参与者高 1.4(95%CI 0.6 至 2.3)分(p=0.002);在毕业时,TIPE 参与者的评分高 1.9(95%CI 0.8 至 3.0)分,毕业后 3 年高 1.1(95%CI -0.1 至 2.4)分。TIPE 参与者的平均 TSS 评分比非 TIPE 参与者高 1.7(95%CI 0.0 至 3.3)分(p=0.045);在毕业时,TIPE 参与者的评分高 3.5 分(95%CI 1.5 至 5.5),毕业后 3 年高 1.3(95%CI -0.8 至 3.5)分。TIPE 参与者在自由文本中对跨专业合作的益处发表了更多的评论,并认为 TIPE 计划对他们准备团队合作以及执行医疗保健角色的方式产生了有意义的影响。

结论

TIPE 计划的参与显著改善了对医疗保健团队的态度,并且这些变化在 4 年内得到了维持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/571b/9305815/a84904225bc6/bmjopen-2021-060066f01.jpg

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