The Training Setting as a Social and Liminal Space for Professional Hybridization

This article addresses the liminality concept as a way to explore a particular group context, relating to a training setting intended as a liminal space, and to highlight its potential to trigger evolutionary personal and organizational identity trajectories. Dealing with a contemporary uncertain, volatile, and ambiguous organizational scenario, people are asked for consistent and quick professional hybridization processes. This article refers to a case study related to an action research process aimed at a cultural transformation and nurturing organizational learning inside an extra-hospital Rehabilitation Center, challenged by a strong organizational reconfiguration and the creation of new functions and roles, among which the one coordinator, responsible for the operational activity to be managed within the units of the organizational context. This article also highlights both the main features that characterize a training setting as a liminal space and identifies the possible plots of professional hybridization paths that a training group as a liminal space can trigger and develop.

Adapting the patient and physician versions of the 9-item shared decision making questionnaire for other healthcare providers in Japan

Background In Japan, the number of older people with various health problems and difficulties in living is increasing. In order to practice patient-centered care for them, not only medical professionals but also multidisciplinary teams including care professionals and patients need to practice shared decision making (SDM) in the context of long-term care. For this reason, a measure of SDM in consultations with healthcare professionals (HCPs) other than physicians is needed. Therefore, this study aimed at adapting the patient and physician versions of the 9-item Shared Decision Making Questionnaire (SDM-Q-9, SDM-Q-Doc) for consultations with HCPs other than physicians in Japan. Methods A pair of SDM measures that can be used by HCPs other than physicians, “Care SDM-Questionnaire for care receivers (SDM-C-patient)” and “Care SDM-Questionnaire for care providers (SDM-C-provider)” were prepared based on the Japanese versions of the SDM-Q-9 and SDM-Q-Doc. The internal consistency and conceptual structure of these measures were tested by secondary analysis of data from 496 participants from a workshop on SDM for different HCPs. Measurement invariance were tested by multigroup confirmatory factor analysis (CFA) for the patient (SDM-C-patient and SDM-Q-9) and provider (SDM-C-provider vs. SDM-Q-Doc) versions. Results Both the Japanese SDM-C-patient and SDM-C-provider demonstrated high internal consistencies (Cronbach’s α coefficient was 0.90 and McDonald’s ω coefficient was 0.90 for both measures). CFA showed one-factor structures for both measures and original measures for physicians. Moreover, multigroup CFA showed configural and metric invariance between the novel care measures and original physician’s measures. Conclusions Thus, the novel SDM measures for care providers in Japan as well as the original physician’s measures could be used in training setting. As these measures were tested only in a training setting, their reliability and validity as new measures for care should be tested in a clinical setting in future.