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多站点定性研究:为改善多专业协作和实践而进行的纵向教师发展:五所美国学术健康中心。

Longitudinal faculty development to improve interprofessional collaboration and practice: a multisite qualitative study at five US academic health centres.

机构信息

Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA.

Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA.

出版信息

BMJ Open. 2023 Apr 18;13(4):e069466. doi: 10.1136/bmjopen-2022-069466.

Abstract

OBJECTIVES

Interprofessional (IP) collaboration and effective teamwork remain variable in healthcare organisations. IP bias, assumptions and conflicts limit the capacity of healthcare teams to leverage the expertise of their members to meet growing complexities of patient needs and optimise healthcare outcomes. We aimed to understand how a longitudinal faculty development programme, designed to optimise IP learning, influenced its participants in their IP roles.

DESIGN

In this qualitative study, using a constructivist grounded theory approach, we analysed participants' anonymous narrative responses to open-ended questions about specific knowledge, insights and skills acquired during our IP longitudinal faculty development programme and applications of this learning to teaching and practice.

SETTING

Five university-based academic health centres across the USA.

PARTICIPANTS

IP faculty/clinician leaders from at least three different professions completed small group-based faculty development programmes over 9 months (18 sessions). Site leaders selected participants from applicants forecast as future leaders of IP collaboration and education.

INTERVENTIONS

Completion of a longitudinal IP faculty development programme designed to enhance leadership, teamwork, self-knowledge and communication.

RESULTS

A total of 26 programme participants provided 52 narratives for analysis. Relationships and relational learning were the overarching themes. From the underlying themes, we developed a summary of relational competencies identified at each of three learning levels: (1) Intrapersonal (within oneself): reflective capacity/self-awareness, becoming aware of biases, empathy for self and mindfulness. (2) Interpersonal (interacting with others): listening, understanding others' perspectives, appreciation and respect for colleagues and empathy for others. (3) Systems level (interacting within organisation): resilience, conflict engagement, team dynamics and utilisation of colleagues as resources.

CONCLUSIONS

Our faculty development programme for IP faculty leaders at five US academic health centres achieved relational learning with attitudinal changes that can enhance collaboration with others. We observed meaningful changes in participants with decreased biases, increased self-reflection, empathy and understanding of others' perspectives and enhanced IP teamwork.

摘要

目的

在医疗保健组织中,专业间(IP)协作和有效的团队合作仍然存在差异。IP 偏见、假设和冲突限制了医疗团队利用成员专业知识的能力,无法满足患者需求日益复杂的情况,也无法优化医疗保健结果。我们旨在了解旨在优化 IP 学习的纵向教师发展计划如何影响其参与者在 IP 角色中的表现。

设计

在这项定性研究中,我们使用建构主义扎根理论方法,分析了参与者对我们的 IP 纵向教师发展计划中获得的特定知识、见解和技能的匿名叙事性回答,以及将这些学习应用于教学和实践的情况。

地点

美国五个基于大学的学术医疗中心。

参与者

来自至少三个不同专业的 IP 教师/临床领导者完成了为期 9 个月(18 次会议)的小组为基础的教师发展计划。现场负责人从申请人中挑选出他们预测为未来 IP 合作和教育领导者的参与者。

干预措施

完成一项旨在增强领导力、团队合作、自我认知和沟通的纵向 IP 教师发展计划。

结果

共有 26 名计划参与者提供了 52 份叙事分析。关系和关系学习是最重要的主题。从基础主题中,我们在三个学习层次上确定了关系能力的总结:(1)个人内部(自身内部):反思能力/自我意识、意识到偏见、对自己的同理心和正念。(2)人际间(与他人互动):倾听、理解他人的观点、欣赏和尊重同事以及对他人的同理心。(3)系统层次(在组织内互动):弹性、冲突参与、团队动态和利用同事作为资源。

结论

我们在美国五个学术医疗中心为 IP 教师领导者开设的教师发展计划实现了关系学习,并带来了可以增强与他人合作的态度变化。我们观察到参与者的变化具有重要意义,包括偏见减少、自我反思增加、同理心和对他人观点的理解增强以及 IP 团队合作增强。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f189/10124268/df3f8b1df4cd/bmjopen-2022-069466f01.jpg

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