Abstracts

Abstract

The abstracts service introduces readers to recent articles from a wide range of refereed journals, which may be of interest in respect of interprofessional practice, education and research, from any where in the world. The abstracts highlight the interprofessional nature of the article, within the context of a brief overview. We invite all readers to send us articles, which fit the criteria, and will acknowledge those who send the selected articles in the Journal. (For address see end of the section.)

Smith, W.R., Betancourt, J.R., Wynia, M.K., Bussey-Jones, J., Stone, V.E., Phillips, C.O., Fernandez, A., Jacobs, E., & Bowles, J. (2007). Recommendations for teaching about racial and ethnic disparities in health and health care. Annals of Internal Medicine, 147, 654 – 665.

(Abstracted by David Adams)

Caucasian patients, despite careful controlling for socioeconomic and demographic factors, receive higher levels of health care than their non-Caucasian counterparts. Improvement of this situation, the authors suggest, may emerge through novel curricular efforts. Their rationale is to train health professionals to appreciate more proficiently the myriad of factors that skew levels of health care among Caucasians and non-Caucasians. Curricular guidelines to address this situation, whether as content or method, remain sparse.

The Health Disparities Task Force (HDTF) of the Society of General Internal Medicine has proposed a series of recommendations that target students, residents, and practitioners in primary care. These principles include enhanced understanding of one's own biases, deeper awareness of the multifactorial etiology of health disparities, and acquisition of improved communicative skills that may help the practitioner to transcend such barriers. Of greatest importance, however, are potential applications of these initiatives to health care fields other than general medicine.

Recommendations for “Teaching about racial and ethnic disparities in health and health care” offers the contemporary health care professional a trove of clinical-curricular pearls. The proposals are timely and, one hopes, will be potentially applicable to health care access issues. Of broadest interest to health professionals, however, are several resource lists that health educators can apply to their own clinical settings.

Andrulis, D.P., & Brach, C. (2007). Integrating literacy, culture, and language to improve health care quality for diverse populations. American Journal of Health Behavior, 31(Suppl. 1), S122 – S133.

(Abstracted by Anne Thompson)

We live in a global society in which immigration, intercontinental travel, commerce, and humanitarian initiatives have brought together multiple cultures. Service users in unfamiliar environments may lack health literacy, defined as the ability to “obtain, process, and understand basic health information and services needed to make appropriate health decisions” (US Department of Health and Human Services, 2000). Culture, which involves other issues of social custom, beliefs, and values, will affect an individual's views of illness and treatment, as well as choices of healthcare providers or treatments. Finally, limitations in language proficiency add another layer of difficulty which severely limits one's ability to navigate through health issues.

The authors frame these concepts within the United States, where health literacy has been identified as one of the national goals of the Health People 2010 initiative. Patient assessment strategies, workforce protocols, educational needs, and direct interventional practices are suggested for achieving health literacy, cultural competency, and language proficiency. Moreover, the authors advocate for increased communication and coordination within interprofessional teams. Some of the proposed tactics include assessments of health literature, culture, and language; the use of multilingual team members; and the formulation of community advisory boards. While the authors' experience is grounded in the United States, these are useful approaches that could be implemented in any community that serves a multicultural constituency.

Salvatori, P.S., Berry, S.C., & Eva, K.W. (2007). Implementation and evaluation of an interprofessional education initiative for students in the health professions. Learning in Health and Social Care, 6(2), 72 – 82.

(Abstracted by Bryony Lamb)

Chronic and complex health problems are prevalent in northern Ontario First Nations people and the aim of this interprofessional education (IPE) initiative was to provide shared learning experiences for students in the health professions while preparing them to work within this kind of environment. This two year pilot study, funded by the Ministry of Health, included a series of voluntary interprofessional tutorials and other shared learning experiences, offered to medical, nursing, occupational therapy, physiotherapy and midwifery students while on clinical placement from McMaster University. They were joined by students from other universities and community colleges representing nine different professions. Weekly IPE tutorials, each with two tutors from different professions, were offered on three sites three times a year, providing the opportunity for students to discuss their roles and explore the potential for collaboration in the management of patients/clients. Additional learning activities, which were again optional and the type of activity dependent on the tutorial group, included shadowing; visits to reserves and meeting reserve elders; participation in a pow-wow or a sweat lodge. Neither the tutorials nor the additional learning experiences were assessed.

The project evaluation, although limited due to small numbers participating, included comparing pre- and post-test experience using the Interprofessional Education Perception Scale (IEPS); weekly learning journals; project evaluation form; and feedback from tutors and preceptors/supervisors. Of the 136 students who participated in the 13 pilots, only 62 completed the IEPS pre-test, and 27 undertook both the pre and post test. The only significant difference was between professions: OT and PT students perceived IPE more positively than medical students. Project evaluation forms indicated 95% of the 46 respondents rated the overall learning experience as good or higher. Analysis of the reflective journals submitted by only 35 students found the learning experience enabled students to: gain new knowledge of the other professions; develop confidence in their own roles and what they could offer the healthcare team; and learn about the complexities of the First Nation culture and managing health care working as an interprofessional team. While preceptors found the learning experience to add value to the students' clinical learning, overall feedback emphasized the need for a more structured approach with elements being mandatory and assessed for programme sustainability and long term benefit to patients. In spite of these limitations, the authors provide examples of interprofessional learning within clinical practice, which can be applied within a variety of settings, preparing students to work in interprofessional teams to meet the complex health needs of different client groups.

Addresses for sending articles for abstracting:

Bryony Lamb

Faculty of Health & Social Care Sciences,

Kingston University & St George's,

University of London, UK

E-mail: [email protected]

Anne Thompson

Department of Physical Therapy,

Armstrong Atlantic State University,

Savannah, Georgia, USA

E-mail: [email protected]