Against a backdrop of poor maternity and obstetric care, identified in the Morecambe Bay Inquiry, the UK government has recently called for improvements and heralded investment in training. Given the complex mix of professionals working closely together in maternity services addressing the lack of joined up continuing professional development (CPD) is necessary. This led us to ask whether there is evidence of IPE in maternity services. As part of a wider systematic review of IPE, we searched for studies related to CPD in maternity services between May 2005 and June 2014. A total of 206 articles were identified with 24 articles included after initial screening. Further review revealed only eight articles related to maternity care, none of which met the inclusion criteria for the main systematic review. The main reasons for non-inclusion included weak evaluation, a focus on undergraduate IPE, and articles referring to paediatric/neonatal care only. Fewer articles were found than anticipated given the number of different professions working together in maternity services. This gap suggests further investigation is warranted.
Despite the growing knowledge base on evidence-based practices in social work and medicine, there is a large gap between what is known and what is consistently done. Implementation research is the study of methods to promote the uptake of research findings into routine practice. In this article, we describe the rationale for implementation research and outline the concepts and effectiveness of its practices. Despite a large number of systematic reviews of implementation interventions, many of the fundamental questions regarding what approaches should be used in which settings for which problems remain unanswered. We go on to argue that future implementation studies should assess the context of practice and key features of interventions to better inform service quality improvement efforts.
Objective: The purpose of this research was to compare gesture-function mappings for experts and novices using a 3D, vision-based, gestural input system when exposed to the same context of anesthesia tasks in the operating room (OR). Background: 3D, vision-based, gestural input systems can serve as a natural way to interact with computers and are potentially useful in sterile environments (e.g., ORs) to limit the spread of bacteria. Anesthesia providers' hands have been linked to bacterial transfer in the OR, but a gestural input system for anesthetic tasks has not been investigated. Methods: A repeated-measures study was conducted with two cohorts: anesthesia providers (i.e., experts) ( N = 16) and students (i.e., novices) ( N = 30). Participants chose gestures for 10 anesthetic functions across three blocks to determine intuitive gesture-function mappings. Reaction time was collected as a complementary measure for understanding the mappings. Results: The two gesture-function mapping sets showed some similarities and differences. The gesture mappings of the anesthesia providers showed a relationship to physical components in the anesthesia environment that were not seen in the students' gestures. The students also exhibited evidence related to longer reaction times compared to the anesthesia providers. Conclusion: Domain expertise is influential when creating gesture-function mappings. However, both experts and novices should be able to use a gesture system intuitively, so development methods need to be refined for considering the needs of different user groups. Application: The development of a touchless interface for perioperative anesthesia may reduce bacterial contamination and eventually offer a reduced risk of infection to patients.
Examining effective collaboration in critical care settings -- Assessing and addressing collaborative practice issues -- Collaboration with patients and family members -- Collaboratively identifying and addressing critical care delivery issues -- Developing and undertaking effective evaluation -- Concluding comments
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AbstractBackground: Interest in interprofessional education (IPE) to promote effective interprofessional collaboration (IPC) has gained momentum across healthcare, professional education, and government sectors. In general, the IPE literature tends to report single-site studies. This article presents a rare study that reports a largescale multi-site IPE initiative. It draws upon a newly developed notion of mainstreaming—introduced to the literature by Barr and Ross—that helps illuminate the implementation issues related to an IPE initiative.Methods and Findings: A realistic evaluation framework was employed to explore the overarching impact of this large initiative (involving 6 IPE programs within 13 hospitals) on the teaching hospital network in which it was implemented. Qualitative methods were used to gather a total of 142 interviews with program leaders, facilitators, and learners. Findings provide insight into the mainstreaming of IPE in relation to educational, professional, and organizational outcomes. Educational outcomes detail how inter-organizational partnerships developed among hospitals with the sharing of ideas and resources for implementing IPE and IPC. Professional outcomes describe learners' experiences of increased awareness of the policy agenda and the meanings and value they attach to IPE and IPC. Organizational outcomes demonstrate that interprofessional champions with senior management support and protected time were core mainstreaming elements, and yet participants outlined a range of concerns and desires for the sustainability of this IPE initiative.Conclusions: This article provided empirical insight into the perceptions, ideas, and experiences of IPE from a wide range of program developers, facilitators, and attendees. Barr and Ross' concept of mainstreaming and the use of a realistic evaluation framework provide a useful way to illuminate the processes and outcomes of implementing a large multi-institutional IPE initiative.
The healthcare practices supported by interprofessional education (IPE) and the debate about those processes are in the early stages in Brazil. The SUS is the national public policy in health matters and is geared towards universal access, comprehensiveness, and social participation, articulated around Primary Health Care as the back-bone of the network. In this editorial, we outline social and political processes that have contributed to the development of interprofessional practice (IPP) in Brazil. This promising context and subsequently the need of strengthening the public policies for a reorientation of health professional training were the starting point for summoning a first International Colloquium of Interprofessional Educationand Practice, in Natal (Rio Grande do Norte state, in the Northeast region of Brazil). Several of the IPE experiences analysed were considered aswide-range innovations in the federal universities. As a result of the colloquium, a set of action sand priority areas demanding for investments in order to strengthen IPE in Brazil. The road ahead in Brazil looks extensive, and progress willrequire not only dialogues but an effective alliance amongall those with a stake in the improvement of healthcareand professional training
