Katelyn Llewellyn posted 1, In your peer responses, offer suggestions and other thoughts for your colleagues to consider. Responds to this post in half a page use different reference to response please
Question 1: How should we prepare health professional students so that they are able to be an effective Interprofessional team member in the clinical environment?
According to the World Health Organization (WHO) (2010), Interprofessional Education is defined as students from two or more professions learning about, from and with each other to enable effective collaboration and improve health outcomes. The Health Professions Accreditors Collaborative (HPAC) has developed a set of guidelines to establish quality interprofessional education across health care professions (2019). The HPAC indicates that as health care becomes more complex, there is a greater need for interprofessional collaboration. Additionally, the health care model has evolved into one of prevention and community/social deterrents to health, increasing the desire for innovative ways to provide quality cost-effective care.
Fostering IPE in health professional students can be achieved by supporting the four competencies related to IPE listed by the Interprofessional Education Collaborative (IPEC). These four competencies are; Competency 1, Values/Ethics for Interprofessional Practice. This includes working with people in other professions to nurture an environment of mutual respect and shared values: Competency 2, Roles/Responsibilities. Using the knowledge of one’s own role and those of other professions to assess and address and advance the health care needs of patients and populations: Competency 3, Interprofessional Communication. Communicate with patients, families, communities, and professionals in health and other fields to foster a team approach to the promotion and maintenance of health and the prevention and treatment of illness: Competency 4, Teams and Teamwork. This relates to ideals of team dynamics for effective performance in different team roles to plan, deliver, and evaluate high-quality cost-effective patient centered care and population health programs and policies.
In support of these IPE competencies, The HPAC (2019) recommends the following examples of learning modalities for in-person learning; case discussions, simulations, service learning, clinical observations, and clinical rotations. For online learning, HPAC recommends collaborative online learning, video conferencing, mock electronic medical record collaborations, interprofessional gaming, simulations, and chat rooms.
As far as student evaluations of successful IPE, HPAC (2019) describes Learner Assessment, Supervision, and IPE Plan Evaluation as effective ways to evaluate mastery of interpersonal collaborative practice competencies. Learner assessment serves various purposes, including providing individualized feedback to a student, grading according to determined competency requirements, and providing data for IPE plan. Supervision/Precepting: A preceptor can help ensure and evaluate a student’s mastery of interprofessional collaborative practice knowledge, skills and behaviors. And finally, IPE Plan Evaluation can provide data to measure the impact on students and outcomes. These data could include percentage of students achieving desired levels of competency, percentage of teams hitting quality improvement benchmarks, and cost/benefits of IPE plan
Question 2: How can/does emotional intelligence influence interprofessional collaborative practices? Please share your quiz results only as you are comfortable.
Emotional intelligence refers to the ability to recognize, interpret, and process emotions in yourself and others. The five elements that make up emotional intelligence are self-awareness, self-regulation, motivation, empathy, and social skills (MindTools, 2019). Having emotional intelligence will allow you to work in teams more effectively.
My score on the How Emotionally Intelligent Are You? (2020) quiz was 56, indicating that I just squeaked by as emotionally intelligent. If anyone else has young children and are aware of the show Daniel Tiger’s Neighborhood (a modern spin on Mister Rogers), you will understand this. Whenever I am in a trying situation and can feel my emotions running high (whether it is with my kids or at work), I like to ask myself “What would Mom Tiger do”? On the show, Mom Tiger is the most patient, emotionally intelligent being in the universe. I always knew the show aimed to teach emotional intelligence, but I actually came across a research study on Daniel Tiger while looking for articles this week! Rasmussen et al., (2016) did find that watching Daniel Tiger’s Neighborhood was successful in improving the empathy scores of children, but the empathy scores were only significant in the cohort in which the parents participated. Without the parent being there to actively validate the show, it did not have as positive of a benefit.
Question 3: What strategies can be used to disable the hierarchies and allow a shared leadership approach? Have you seen the physician role changeover time in your clinical experiences? How should the care coordination responsibilities be shared effectively in a collaborative situation?
Hierarchies in health care leadership are going to be extremely difficult to change. This is partly due to the organizational structure in leadership. Usually the top-ranking administrators (CEOs, COOs) are physicians. I think the shift needs to come with IPE. Education is really the key to change. The hospital in which I work is an academic center that partners with a medical school. The medical school has a “SELECT” program which stands for Scholarly Excellence, Leadership Experiences, Collaborative Training. The SELECT program focuses on intellectual perspective, empathy, creativity and passion with the goal to change patient care, the health of communities and the medical profession. The founding principle of SELECT is the concept that students with high emotional intelligence are more likely to transform health care and improve the health of communities.
Question 4: Finally, reflect on your capstone project from this standpoint. In your work with other professionals, as you prepare for your capstone project how can you encourage a shared leadership approach?
My capstone project involves many health care disciplines. Providers (doctors and advanced practice clinicians), nurses, social workers, and Information Technology department will all be working collaboratively. Wow, just looking at what I did there- I subconsciously listed a traditional hierarchy. So maybe the change really has to start within ourselves and us being aware of how ingrained these health care hierarchies actually are. I am going to use the techniques of mutual respect and mutual purpose learned in Crucial Conversations (2012) to even the playing field in regard to my project.
References
Health Professions Accreditors Collaborative. (2019). Guidance on developing quality interprofessional education for the health professions. Chicago, IL: Health Professions Accreditors Collaborative.
Interprofessional Education Collaborative (2016). Core competencies for interprofessional collaborative practice: 2016 update. Retrieved May 31, 2022 from https://nebula.wsimg.com/2f68a39520b03336b41038c370497473?AccessKeyId=DC06780E69ED19E2B3A5&disposition=0&alloworigin=1.
Mind Tools (2020, September 27). How emotionally intelligent are you? Boosting your people skills. https://www.mindtools.com/pages/article/ei-quiz.htm
MindTools. (2019, September 3). Developing emotional intelligence [Video]. YouTube.
Patterson, K., Granny. J., McMillan, R., & Switzler, A. (2012). Crucial Conversations: Tools for talking when the stakes are high. McGraw Hill.
Rasmussen, E. E., Shafer, A., Colwell, M. J., White, S., Punyanunt-Carter, N., Densley, R. L., & Wright, H. (2016). Relation between active mediation, exposure toDaniel Tiger’s neighborhood, and US preschoolers’ social and emotional development. Journal of Children and Media, 10(4), 443–461. https://doi.org/10.1080/17482798.2016.1203806
World Health Organization (2010). Framework for action on interprofessional education & collaborative practice. Retrieved May 31, 2022, from https://whqlibdoc.who.int/hq/2010/WHO_HRH_HPN_10.3_eng.pdf.
Alex 2 , In your peer responses, offer suggestions and other thoughts for your colleagues to consider. Responds to this post in half a page use different reference to response please
Optimal outcomes in the clinical environment can result from the continuous engagement of an interprofessional team (Harris et al., 2020). One benefit of collaborating with interprofessional members is including representatives from a particular area with different roles, education, experiences, and views. This approach best guides practice change and allows for added value as well as the ability to manage and address conflicts throughout the process (Harris et al., 2020). One important way to prepare health professional students for this role is to demonstrate or teach the value of interprofessional teams and distinguish role expectations. A team has both mutual and individual accountability (Harris et al., 2020). Each team member has a shared purpose that they are working towards. When a health professional student understands the value of this role they become prepared to then take on this role.
The Health Professions Accreditors Collaborative (HPAC) gives detailed guidance on the importance of interprofessional education and how to incorporate this for healthcare professionals. The HPAC (2019) reports an unprecedented need for health professionals to work in interprofessional teams to provide quality and cost-effective care. They give several examples of how to implement this training including in-person or virtual learning incorporating case studies, simulations, clinical rotations, and chat room discussions. Fisher et al. (2017) also notes that a positive impact on clinical practice occurs when students receive education on interprofessional collaboration.
2.
Emotions can influence interprofessional collaborative practices in positive or negative ways. The idea of emotional intelligence refers to the ability to recognize, interpret and process emotions (MindTools, 2019). By engaging emotional intelligence, emotions can be identified in both yourself and others and be a valuable resource for rational decision making processes and practices (MindTools, 2019). When emotional intelligence is engaged, an individual is self aware and is able to recognize triggers or the source of emotions in themself. This allows the individual to take responsibility for their emotions and avoid impulsive decisions. An emotionally intelligent individual will also be beneficial to interprofessional collaboration as this individual will have the ability to empathize, have better interaction and have the ability to use verbal and nonverbal communication cues to engage with interprofessional colleagues (MindTools, 2019).
3.
As healthcare becomes more diverse, it is appropriate to encourage a shared leadership by increasing collaboration among different disciplines and levels of hierarchy (Bradley, 2020). By encouraging leadership from members of different hierarchies, individuals will feel able and willing to participate. This participation and shared leadership has been shown to lead to improved performances and decreased mortality rates (Bradley, 2020). Additionally, Bradley (2020) discussed managing conflict through role definitions, addressing viewpoints, and reviewing shared goals as methods to disable hierarchies and encouraged shared leadership.
There are unavoidable hierarchies in healthcare systems. It is a common hierarchical pattern that doctors have a higher rank over nurses and mid-level providers. Doctors even have a hierarchy among themselves with resident classes and attendings. Even among nurses on my own unit there is a hierarchy of junior and senior nurses; each respectively identified by a different badge. A hierarchy can be beneficial, giving a chain of command to ascend as needed. Unfortunately, hierarchies in a shared leadership approach can pose problems. As discussed in the editorial by Brown (2013), as a nurse she felt limited in her ability to speak up to a physician and needed to weigh the consequences of either being reprimanded by him or potentially putting the patient at risk.
In my clinical experience I have not seen much change in the physician role. I currently work at an academic center with physician residents. There is a clear hierarchy among each class. I believe that by ingraining a strict hierarchy among their training years, this translates to a continued expectation of hierarchy after residency.
4.
In my capstone project I will encourage a shared leadership approach with the nurse participants as well as with the stakeholders. Among the stakeholders, I have included staff from different hierarchies and have been working with attending physicians, a nurse manager, nurse educator, and data analyst. An additional method I have used among stakeholders is to encourage participation. I have asked for feedback of the ideas I have presented as well as welcomed ideas from them as well. By encouraging a shared leadership approach I will also continue to review our main goal of improved patient outcomes and utilize this as a foundation and starting point to resolve any conflicts.
References
Bradley, E. H. (2020). Diversity, inclusive leadership, and health outcomes. International Journal of Health Policy and Management, 9(7), 266-268. https://doi.org/10.15171/ijhpm.2020.12
Brown, T. (2013, March 16). Healing the hospital hierarchy. The New York Times. https://opinionator.blogs.nytimes.com/2013/03/16/healing-the-hospital-hierarchy/
Fisher, M., Weyant, D., Sterrett, S., Ambrose, H., & Apfel, A. (2017). Perceptions of interprofessional collaborative practice and patient/family satisfaction. Journal of Interprofessional Education & Practice, 8, 95-102. https://doi.org/10.1016/j.xjep.2017.07.004
Harris, J. L., Roussel, L., Dearman, C., & Thomas, P. L. (2020). Project planning
and management: A guide for nurses and interprofessional teams (3rd Ed.). Jones & Bartlett.
MindTools. (2019, September 3). Developing emotional intelligence [Video]. YouTube. https://www.youtube.com/watch?v=n9h8fG1DKhA