What professional language do you speak?

The inter-disciplinary learning project invited undergraduate adult nursing and social work students from a London university to take part in a research activity focusing on communication between the two disciplines. The project aimed to provide a direct contribution to the students’ retention and progression, and to enhance students understanding of inter-disciplinary working at early stages of their professional careers. Students were observed during a table-top exercise in which they jointly worked on deciding priorities of care for a complex family situation. They reflected on the activity afterwards, sharing an interesting outlook on their interactions. The project confirmed the significance of inter-disciplinary learning and teaching. Most importantly however, it recognised that effective, collaborative inter-disciplinary working requires time to develop, maintain and grow. The study demonstrated that we do not all speak the same professional language. It emphasised the need for sustainable longitudinal approach with opportunities for inter-professional interactions and collaborative learning and teaching. The purpose of this paper is to reflect on the project findings with a brief consideration of its impact. While contemplating ‘professional language’ relevant to each discipline, we aim to revisit conversation on teaching and learning for inter-disciplinary communication in the Higher Education setting. Keywords: inter-disciplinary communication, interprofessionality, nursing and social work students, interprofessional working

Identifying and Responding to Delirium in Acute Stroke: Clinical Team Members’ Understandings

Delirium is associated with increased mortality, morbidity, and length of hospital stay. In the acute stroke setting, delirium identification is challenging due to the complexity of cognitive screening in this patient group. The aim of this study was to explore how members of interprofessional stroke-unit teams identified and responded to a potential delirium in a patient. Online focus groups and interviews utilizing case vignettes were conducted with 15 participants: nurses, occupational therapists, speech and language therapists, and physiotherapists working in acute stroke services. Participants’ understandings of delirium varied, most participants did not identify the symptoms of a possible hypoactive delirium, and nearly all participants discussed delirium symptoms in tentative terms. Aspects of interprofessional working were discussed through the expression of distinct roles around delirium identification. Although participants demonstrated an ethos of person-focused care, there are ongoing challenges involved in early identification and management of delirium in stroke survivors.

Enhancing interprofessional working

It is only through the determination and commitment of individual health visitors and midwives that a seamless, effective transition from one service to the other will occur for families, says Judy Brook

Promoting safe prescribing practice and interprofessional working: a workshop follow-up evaluation

Safe prescribing requires successful interprofessional working. One way to facilitate this is to develop interprofessional education across disciplines. This paper presents findings from a follow-up evaluation of an interprofessional workshop for prescribing safety to assess the perceptions and attitudes toward working interprofessionally in non-medical prescribers and MPharm students. The objectives were to further validate an internal workshop questionnaire and the use of the of a scale to assess the readiness for interprofessional learning. An interprofessional workshop, centered around the issue of prescriptions and determinants of competence and safety, was attended by 126 non-medical prescribers and MPharm students. The workshop was evaluated using the Readiness for Interprofessional Learning questionnaire and an internally-produced evaluation, The workshop was evaluated using the Readiness for Interprofessional Learning questionnaire and an internally-produced evaluation. As part of this process, internal consistency of the internally-produced evaluation was verified.. The workshop was rated highly by all participants with overall positivity toward working interprofessionally. There was no evidence that non-medical prescribers and students rated the workshop significantly differently, but MPharm students scored slightly higher than non-medical prescribers on one domain of the internally-produced instrument. All domains of this instrument demonstrated good internal consistency. The workshop overall was received well and appears to meet the standards set out by The Centre for the Advancement of Interprofessional Education. While reliability measures of the internally produced instrument are promising, further work is needed to develop internal validity; and to determine whether any adaptations to the Readiness for Interprofessional Learning Scale are needed for subsequent use with different groups of participants.

A J curve of interprofessional change: co-locating non-health partners in an oncology unit

Background: Internationally, clinicians face increased demand, pressure on resources and unmet patient needs. A community social support service was co-located within cancer clinics in Glasgow, Scotland to help address some of these needs. Aim: To analyse the impact of the service on clinical staff and to propose an explanatory theory of change. Method: Qualitative exploratory design, using thematic analysis of semistructured interviews with 8 nurse specialists and 2 medical oncologists from lung, breast, head and neck, and gastrointestinal oncology teams in Glasgow in 2018–2019. Findings: Four themes captured this process: ‘The conversation’, ‘A better experience’, ‘Freedom to focus’ and ‘Working hand in hand’. Conclusion: Together, these four themes explained the process of effective interprofessional working. This process would have been predicted by the J-curve literature on diffusion of innovations. Linking J-curve theory to this successful process provides new understanding that could prove essential for clinical teams who are implementing change within their practice.

The Overlap Between Geriatric Medicine and Palliative Care: A Scoping Literature Review

With an increasing aging population worldwide, there is a growing need for both palliative care and geriatric medicine. It is presumed in medical literature that both specialties share similar goals about patient care and could collaborate. To inform future service development, the objective of this review was to identify what is currently empirically known about overlapping working practices. This article provides a scoping literature review on the relationship between geriatric medicine and palliative care within the United Kingdom. The review encompassed literature written between 1997 and 2019 accessed via Scopus, Web of Science, PubMed, and Google Scholar. Three themes were identified: (a) unclear boundaries between specialties, (b) communication within and between specialisms, and (c) ambiguity of how older people fit in the current health care system. We suggest that more empirical research is conducted about the overlap between palliative care and geriatric medicine to understand how interprofessional working and patient care can be improved.

Using in situ simulation to improve care of the acutely ill patient by enhancing interprofessional working: a qualitative proof of concept study in primary care in England

ObjectiveAcutely unwell patients in the primary care setting are uncommon, but their successful management requires involvement from staff (clinical and non-clinical) working as a cohesive team. Despite the advantages of interprofessional education being well documented, there is little research evidence of this within primary care. Enhancing interprofessional working could ultimately improve care of the acutely ill patient. This proof of concept study aimed to develop an in situ simulation of a medical emergency to use within primary care, and assess its acceptability and utility through participants’ reported experiences.SettingThree research-active General Practices in south east England. Nine staff members per practice consented to participate, representing clinical and non-clinical professions.MethodsThe intervention of an in situ simulation scenario of a cardiac arrest was developed by the research team. For the evaluation, staff participated in individual qualitative semistructured interviews following the in situ simulation: these focused on their experiences of participating, with particular attention on interdisciplinary training and potential future developments of the in situ simulation.ResultsThe in situ simulation was appropriate for use within the participating General Practices. Qualitative thematic analysis of the interviews identified four themes: (1) apprehension and (un)willing participation, (2) reflection on the simulation design, (3) experiences of the scenario and (4) training.ConclusionsThis study suggests in situ simulation can be an acceptable approach for interdisciplinary team training within primary care, being well-received by practices and staff. This contributes to a fuller understanding of how in situ simulation can benefit both workforce and patients. Future research is needed to further refine the in situ simulation training session.