“Mainstreaming” Interprofessional Education within Hospital Settings: Findings from a Multiple Case Study

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

Computer-assisted resilience training to prepare healthcare workers for pandemic influenza: a randomized trial of the optimal dose of training

<p>Abstract</p> <p>Background</p> <p>Working in a hospital during an extraordinary infectious disease outbreak can cause significant stress and contribute to healthcare workers choosing to reduce patient contact. Psychological training of healthcare workers prior to an influenza pandemic may reduce stress-related absenteeism, however, established training methods that change behavior and attitudes are too resource-intensive for widespread use. This study tests the feasibility and effectiveness of a less expensive alternative - an interactive, computer-assisted training course designed to build resilience to the stresses of working during a pandemic.</p> <p>Methods</p> <p>A "dose-finding" study compared pre-post changes in three different durations of training. We measured variables that are likely to mediate stress-responses in a pandemic before and after training: confidence in support and training, pandemic-related self-efficacy, coping style and interpersonal problems.</p> <p>Results</p> <p>158 hospital workers took the course and were randomly assigned to the short (7 sessions, median cumulative duration 111 minutes), medium (12 sessions, 158 minutes) or long (17 sessions, 223 minutes) version. Using an intention-to-treat analysis, the course was associated with significant improvements in confidence in support and training, pandemic self-efficacy and interpersonal problems. Participants who under-utilized coping via problem-solving or seeking support or over-utilized escape-avoidance experienced improved coping. Comparison of doses showed improved interpersonal problems in the medium and long course but not in the short course. There was a trend towards higher drop-out rates with longer duration of training.</p> <p>Conclusions</p> <p>Computer-assisted resilience training in healthcare workers appears to be of significant benefit and merits further study under pandemic conditions. Comparing three "doses" of the course suggested that the medium course was optimal.</p