Witti Matthias J, Zottmann Jan M, Wershofen Birgit, Thistlethwaite Jill E, Fischer Frank, Fischer Martin R
Institute of Medical Education, LMU University Hospital, LMU Munich, Munich, Germany.
Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
Front Med (Lausanne). 2023 Oct 2;10:1213300. doi: 10.3389/fmed.2023.1213300. eCollection 2023.
The health care system in Germany and in many other countries is facing fundamental challenges due to demographic change, which require new integrated care concepts and a revision of the collaboration between health care professions in everyday clinical practice. Internationally, several competency framework models have been proposed, but a framework that explicitly conceptualizes collaborative activities to improve interprofessional problem-solving competency in health care is still missing. Such a framework should define contextual, person-related, process-related, and outcome-related variables relevant to interprofessional problem solving in health care. Against this background, we present a conceptual framework to improve interprofessional collaboration in health education and care (FINCA) developed with scientific consideration of empirical data and various theoretical references. FINCA reflects an interprofessional learning and interaction process involving two persons from different health care professions and with different individual learning prerequisites. These two initially identify a problem that is likely to require interprofessional collaboration at some point. FINCA acknowledges the context of interprofessional learning, teaching, and working as well as its action-modifying context factors. We follow the reasoning that individual learning prerequisites interact with the teaching context during learning activities. At the heart of FINCA are observable collaborative activities (information sharing and grounding; negotiating; regulating; executing interprofessional activities; maintaining communication) that can be used to assess individuals' cognitive and social skills. Eventually, the framework envisages an assessment of the outcomes of interprofessional education and collaboration. The proposed conceptual framework provides the basis for analysis and empirical testing of the components and variables it describes and their interactions across studies, educational interventions, and action-modifying contexts. FINCA further provides the basis for fostering the teaching and learning of interprofessional problem-solving skills in various health care settings. It can support faculty and curriculum developers to systematize the implementation and improvement of interprofessional teaching and learning opportunities. From a practical perspective, FINCA can help to better align curricula for different health professions in the future. In principle, we also see potential for transferability of the framework to other areas where different professions collaborate.
由于人口结构变化,德国和许多其他国家的医疗保健系统正面临着根本性挑战,这需要新的综合护理理念,并需要修订日常临床实践中医护专业之间的协作方式。在国际上,已经提出了几种能力框架模型,但仍缺少一个明确将协作活动概念化以提高医疗保健中跨专业解决问题能力的框架。这样一个框架应定义与医疗保健中跨专业解决问题相关的情境、人员相关、过程相关和结果相关变量。在此背景下,我们提出了一个旨在改善健康教育与护理中跨专业协作的概念框架(FINCA),该框架是在对实证数据和各种理论参考进行科学考量的基础上制定的。FINCA反映了一个跨专业学习和互动过程,涉及来自不同医护专业且具有不同个人学习前提条件的两个人。这两个人首先要识别一个可能在某个时候需要跨专业协作的问题。FINCA承认跨专业学习、教学和工作的背景以及其行动修正背景因素。我们遵循这样的推理,即在学习活动中,个人学习前提条件与教学背景相互作用。FINCA的核心是可观察到的协作活动(信息共享与奠定基础;协商;调节;执行跨专业活动;保持沟通),这些活动可用于评估个人的认知和社交技能。最终,该框架设想对跨专业教育与协作的结果进行评估。所提出的概念框架为分析和实证检验其描述的组成部分、变量及其在不同研究、教育干预和行动修正背景下的相互作用提供了基础。FINCA还为在各种医疗保健环境中培养跨专业解决问题技能的教学和学习提供了基础。它可以支持教师和课程开发者将跨专业教学和学习机会的实施和改进系统化。从实际角度来看,FINCA有助于未来更好地协调不同健康专业的课程。原则上,我们也认为该框架有可能应用于不同专业进行协作的其他领域。