Assessment of interprofessional competence in undergraduate health professions education: protocol for a systematic review of self-report instruments

Background Health practitioners from different professions, and with differing competencies, need to collaborate to provide quality care. Competencies in interprofessional working need developing in undergraduate educational preparation. This paper reports the protocol for a systematic review of self-report instruments to assess interprofessional learning in undergraduate health professionals’ education. Methods We will search PubMed, Web of Science, CINAHL and ERIC from January 2010 onwards. A combination of search terms for interprofessional learning, health professions, psychometric properties, assessment of learning and assessment tools will be used. Two reviewers will independently screen all titles, abstracts and full-texts. Potential conflicts will be resolved through discussion. Quantitative and mixed-methods studies evaluating interprofessional learning in undergraduate health professions education (e.g. medicine, nursing, occupational and physical therapy, pharmacy and psychology) will be included. Methodological quality of each reported instrument, underpinning theoretical frameworks, and the effects of reported interventions will be assessed. The overall outcome will be the effectiveness of instruments used to assess interprofessional competence. Primary outcomes will be the psychometric properties (e.g. reliability, discriminant and internal validity) of instruments used. Secondary outcomes will include time from intervention to assessment, how items relate to specific performance/competencies (or general abstract constructs) and how scores are used (e.g. to grade students, to improve courses or research purposes). Quantitative summaries in tabular format and a narrative synthesis will allow recommendations to be made on the use of self-report instruments in practice. Discussion Many studies use self-report questionnaires as tools for developing meaningful interprofessional education activities and assessing students’ interprofessional competence. This systematic review will evaluate both the benefits and limitations of reported instruments and help educators and researchers (i) choose the most appropriate existing self-report instruments to assess interprofessional competence and (ii) inform the design and conduct of interprofessional competency assessment using self-report instruments. Systematic review registration Open Science Framework [https://osf.io/vrfjn]

UK Greenhouse Gas Inventory 1990 to 2021: annual report for submission under the Framework Convention on Climate Change

This is the United Kingdom’s National Inventory Report (NIR) submitted in 2023 to the United Nations Framework Convention on Climate Change (UNFCCC). It contains national greenhouse gas emission estimates for the period 1990-2021, and descriptions of the methods used to produce the estimates. The greenhouse gas inventory (GHGI) is based on the same datasets used by the UK in the National Atmospheric Emissions Inventory (NAEI) for reporting atmospheric emissions under other international agreements. The GHGI is therefore consistent with these other air emissions inventories where they overlap. The greenhouse gas inventory is compiled on behalf of the UK Department for Energy Security and Net Zero (DESNZ) for the Science and Innovation for Climate and Energy (SICE) Directorate, by Ricardo Energy & Environment. We acknowledge the positive support and advice from DESNZ throughout the work, and we are grateful for the help of all those who have contributed to this NIR. A list of the contributors can be found in Chapter 18. The GHGI is compiled according to the Intergovernmental Panel on Climate Change (IPCC) 2006 Guidelines (IPCC, 2006). Each year the inventory is updated to include the latest data available. Improvements to the methodology are backdated as necessary to ensure a consistent time series. Methodological changes are made to take account of new data sources, or new guidance from IPCC, and new research, sponsored by DESNZ or otherwise

Professionalization of a nonstate actor

Can nonstate militants professionalize? That is the core question of this piece. Discussions of professionalism have spread to the state military from civilian professions such as education, medicine, and law. This piece examines whether nonstate actors exhibit the same fundamental processes found within these state-based organizations. These fundamentals are the creation of a recognized internal ethos, which acts as a collective standard for those involved. A commitment to expertise and the punishment of those who do not reach these collective expectations reinforce this ethos. To answer this question, this piece examines the development of the Provisional Irish Republican Army (PIRA) during the Troubles. It highlights consistencies and inconsistencies with traditional forces and argues that groups like the PIRA can professionalize and increase their effectiveness in doing so. This widens the field of professionalism studies and provides an additional lens through which to examine nonstate groups

'Umbrella' review of family-focused care interventions supporting families where a family member has a long-term condition

Aim: To summarise reviews of family-focused care interventions that support families with a family member with a long-term condition across the life course. Design: Umbrella review. Data sources: Medline (1946- 2019), Cochrane Data Base of Systematic Reviews (2019), Database of Abstracts of Reviews of Effect and EMBASE (1947- 2019), CINAHL (1981-2019), Health Technology Assessment Database (2019) and PsycInfo (1806-2019). Review Methods: All authors independently undertook title/abstract screening, data extraction and quality appraisal on a cluster of papers, working in groups of two or three to reach a consensus. The AMSTAR tool was used to appraise the quality of the studies and descriptive syntheses were undertaken. Results: Fifteen reviews met the selection criteria. Overall family-focussed care and associated terms were poorly defined. Typically interventions were educational or psychological therapy/counselling with the goal of empowering individuals to manage their condition. There is some evidence that family-focused care interventions can improve clinical/biological health measures and self-care outcomes such as treatment adherence. Multi-component psychosocial interventions that include cognitive-behavioral therapy, skills training, education and support and are focused on wider family members appear to improve family relationships and martial functioning. Conclusion: Long-term conditions have an impact on individual and family health and well-being, yet the impact of family-focused care interventions on family outcomes was overall inconclusive. A better understanding of how family-focused care interventions improve the health and well-being of individuals and their families is needed to promote the inclusion of family-focused care into practice. Impact: Supporting people with a long-term condition is a key health and social care priority. Family-focused care interventions have potential to improve the health and well-being of individuals and families but there is a need to evaluate their clinical and cost effectiveness. The findings from this review could be used by funding bodies when commissioning research for long-term conditions

Engineering T cells for cancer therapy

It is generally accepted that the immune system plays an important role in controlling tumour development. However, the interplay between tumour and immune system is complex, as demonstrated by the fact that tumours can successfully establish and develop despite the presence of T cells in tumour. An improved understanding of how tumours evade T-cell surveillance, coupled with technical developments allowing the culture and manipulation of T cells, has driven the exploration of therapeutic strategies based on the adoptive transfer of tumour-specific T cells. The isolation, expansion and re-infusion of large numbers of tumour-specific T cells generated from tumour biopsies has been shown to be feasible. Indeed, impressive clinical responses have been documented in melanoma patients treated with these T cells. These studies and others demonstrate the potential of T cells for the adoptive therapy of cancer. However, the significant technical issues relating to the production of natural tumour-specific T cells suggest that the application of this approach is likely to be limited at the moment. With the advent of retroviral gene transfer technology, it has become possible to efficiently endow T cells with antigen-specific receptors. Using this strategy, it is potentially possible to generate large numbers of tumour reactive T cells rapidly. This review summarises the current gene therapy approaches in relation to the development of adoptive T-cell-based cancer treatments, as these methods now head towards testing in the clinical trial setting

Working and learning across professional boundaries

This paper focuses on a context where interdisciplinarity intersects with interprofessionality: the work of children's services professionals who address the needs of children identified as vulnerable. It draws on evidence and perspectives from two disciplines - educational studies and health care - to consider the issues and challenges posed by learning and/or working across disciplinary boundaries and why these have proved so obdurate

Doctor–patient communication in a Southeast Asian setting: the conflict between ideal and reality

Doctor–patient communication has been extensively studied in non-Western contexts and in relation to patients’ cultural and education backgrounds. This study explores the perceived ideal communication style for doctor–patient consultations and the reality of actual practice in a Southeast Asian context. We conducted the study in a teaching hospital in Indonesia, using a qualitative and a quantitative design. In-depth interviews were conducted with ten internal medicine specialists, ten internal medicine residents, 16 patients in two groups based on education level and ten most senior medical students. The contributions of doctors and patients to the communication during consultations were observed and rated quantitatively by thirty internal medicine residents, 393 patients with different educational backgrounds and ten senior medical students. The ‘informed and shared decision making’ is the central observation in this quantitative study. The results of the interviews showed that Southeast Asian stakeholders are in favor of a partnership style of communication and revealed barriers to achieving this: doctors and patients are not prepared for a participatory style and high patient load due to an inefficient health care system does not allow sufficient time for this type of communication. The results of the quantitative study showed a sharp contrast between observed and ideal communication styles. A paternalistic style seems to prevail, irrespective of patients’ educational background. We found a sharp conflict between ideal and reality concerning doctor–patient communication in a Southeast Asian context. Further studies should examine ways to change the prevailing communication style in the desired direction