Interprofessional collaboration in sports medicine : findings from a scoping review

BACKGROUND Sports medicine has grown from a special interest area in healthcare to an established profession in its own right. Containing many specialties and a range of professional inputs there are complex dynamics at work which often dictate the provision of care. Whilst interprofessional interventions have been successfully applied in more mainstream healthcare contexts there has been no equivalent application in sports medicine. PURPOSE We seek to map the literature to explore interprofessional collaboration, interaction and tension in sports medicine. METHOD The study utilised a scoping review methodology followed by a thematic analysis. DISCUSSION & CONCLUSIONS The review located 13 studies which provided an insight into a number of key themes which affect interprofessional collaboration (IPC) in a variety of athletic contexts. All of these themes relate to IPC. The structured introduction of interprofessional education programmes for sports medicine professionals and others, will enable a response to the numerous challenges identified in the review

Health care as a team sport? - Studying athletics to improve interprofessional collaboration

Organizations value teamwork and collaboration as they strive to build culture and attain their goals and objectives. Sports provide a useful and easily accessible means to study teamwork. Interprofessional collaborative practice (IPCP) has been identified as a means of improving patient and population health outcomes. Principles of teamwork in sports can inform health professionals and organizations regarding possible improvement strategies and barriers in the optimization of IPCP. Twenty-eight delegates from the 2017 All Together Better Health Conference in Oxford, UK participated in a World Café to discuss the how teamwork in sports can inform IPCP in healthcare and sports medicine. These discussions were captured, transcribed and coded using the domains developed by the Interprofessional Education Collaborative (IPEC) along with extrapersonal or interpersonal loci. Extrapersonal factors regarding structure of leadership, roles and organizational commitment can be positive factors to promote teamwork. However, interpersonal factors affecting communication, values and lack of commitment to collaboration can serve as barriers. Athletic trainers and other sports medicine professionals can serve as valuable members of interprofessional teams and teamwork is essential in the field of sports medicine

Embedding Interprofessional Activities with Physical Therapy and Athletic Training Students in Shared Professional Course

Introduction and Background: Interprofessional education (IPE) is outlined in many health professions education standards creating an increased demand for its inclusion in already crowded curricula with limited faculty and financial resources. The Interprofessional Education Collaborative (IPEC) developed “Core Competencies for Interprofessional Collaborative Practice” that outline a framework for meaningful IPE experiences. Case-based learning activities have been used to foster improvements in interprofessional role clarity, communication, and rapport among student groups. The authors describe one trial of incorporating interprofessional and team work activities in a shared professional course and report on student learning outcomes in the context of IPEC competencies. Course Design: In an existing shared professional course, athletic training (AT) and physical therapy (PT) students were exposed to an interprofessional teaching team and engaged in team work activities during lab sessions. Students were also assigned to interprofessional (IP) and uniprofessional (UP) teams to complete four case-based learning activities regarding the application of therapeutic modalities in various patient cases. Students then wrote critical reflections of their experiences working in teams. Instructors evaluated these reflections in the context of eight relevant IPEC sub-competencies. Outcomes: Both IP and UP groups of students were able to articulate the demonstration of each of the eight IPEC sub-competencies, suggesting that incorporating a variety of interprofessional and team work activities in a shared professional course may offer a valuable IPE experience that promotes development of students’ collaboration skills. Discussion and Conclusion: Embedding IPE in existing curricula could be a viable way to overcome many of the challenges faced by health professions programs, meet IPE accreditation standards, and prepare students for interprofessional collaborative practice

Interprofessional Role Clarity, Case-Based Learning, and Perceptions of Group Effectiveness Among Athletic Training and Physical Therapy Students in a Shared Professional Course

Purpose: Health professions students experience professional socialization during their program of study. Institutions have turned to interprofessional education as a means of preparing students for their role as collaborative health care professionals. This study examines the effect of case-based learning experiences in a shared professional Therapeutic Modalities course on student’s interprofessional role clarity as well as the relationship between interprofessional role clarity and measure of group effectiveness. Methods: 112 students (22 Athletic Training and 90 Physical Therapy) were assigned to one of 18 interprofessional and 18 uniprofessional teams and asked to complete four case-based learning activities. All students completed pre-test, retrospective pre-test, and post-test role clarity/ambiguity scales. Measures of team viability, team member satisfaction, and self-rated output were collected post-intervention. Results: Results suggest the experience of interacting with one another in this course, including during case-based learning activities, may lead to increased knowledge of other’s roles and responsibilities as shown in the retrospective pre-test and post-test role clarity differences. Additionally, role clarity has meaningful relationships with measures of perceived group effectiveness, particularly team viability and self-rated output. Conclusion: We suggest that health professions educators consider incorporating case-based learning activities into existing curricula to introduce other professions’ roles and engage students in teamwork

Athletic Trainers\u27 Perceptions and Experiences with Interprofessional Practice

INTRODUCTION Understanding athletic trainers’ (ATs) perceptions of and experiences with interprofessional collaborative practice (IPCP) can help improve their interactions with other healthcare professionals. The purpose of this study was to explore ATs’ perceptions (beliefs, benefits, barriers), experiences and recommended strategies related to IPCP. METHODS 314 ATs (139 male, 175 female) completed an online survey that collected participant demographics in addition to sections about participants’ perceptions experiences related to ICPC and recommended strategies implementation of IPCP. RESULTS Participants reported the primary sports medicine team should include ATs, orthopedic physicians and physical therapists (PTs) with the AT serving as the point person. Athletic trainers reported interacting most frequently with other ATs, orthopedic physicians and primary care physicians using a combination of direct and indirect communication methods. The primary benefits of IPCP included providing comprehensive patient care, building understanding of each other’s professions and professional growth. Barriers to collaboration centered on limited knowledge of providers’ scopes of training, inadequate communication, work setting, work schedules and providers’ attitudes toward each other and collaboration. Strategies to facilitate IPCP focused on building relationships with providers, establishing regular communication and understanding each other’s scope of training. CONCLUSIONS Currently, ATs interact with other healthcare providers and have positive perceptions of IPCP. It is recommended that ATs build on the current relationships and aim to enhance them through purposeful communication

Perceived protein needs and measured protein intake in collegiate male athletes: an observational study

<p>Abstract</p> <p>Background</p> <p>Protein needs for athletes are likely higher than those for the general population. However, athletes may perceive their protein needs to be excessively high. The purpose of this research was to compare collegiate athletes' perceived protein needs and measured protein intake to the recommended protein intake (RDI) for healthy adults (i.e. 0.8 g/kg/d) and to the maximum beneficial level for strength-trained athletes (i.e. 2.0 g/kg/day).</p> <p>Methods</p> <p>Perceived protein needs were quantified in 42 strength-trained collegiate male athletes by using a survey that asked the athletes to provide their perception about protein needs in specific quantitative terms (i.e. g/kg/d). Perceived protein needs were also determined by having the athletes select a daylong menu that they perceived to have adequate protein content from a collection of 5 isoenergetic menus, which differed in terms of protein content. Actual protein intake was quantified using 3-day food records and nutrient analysis. Single sample t-tests were used to compare protein intake and perceived protein needs to 0.8 g/kg/day and 2.0 g/kg/day.</p> <p>Results</p> <p>When asked to provide, in quantitative terms, protein needs for athletes, 67% of the athletes indicated "do not know." Of the remaining 33% of athletes, all gave values greater than 2.0 g/kg/d (mean 21.5 ± 11.2 g/kg/d, p = 0.14 vs. 2.0 g/kg/d). Based on the menu selection method for determining perceived protein needs, the athletes indicated that their protein needs were 2.4 ± 0.2 g/kg/d, which was greater than the RDI for protein (p < 0.0001) and tended to be greater than the maximally beneficial protein intake of 2.0 g/kg/d (p = 0.13). Measured protein intake was 2.0 ± 0.1 g/kg/d, which was greater than the RDI (p < 0.0001) but not different from the maximally beneficial protein intake of 2.0 g/kg/d (p = 0.84).</p> <p>Conclusions</p> <p>Male collegiate athletes recognize that their protein needs are higher than that of the general population and consume significantly more protein than recommended in the RDI. However, it also appears that athletes are not aware of objective recommendations for protein intake and may perceive their needs to be excessively high. This study highlights the need for nutrition education in collegiate athletes, in particular nutrition education on macronutrient distribution and protein needs.</p

The Effectiveness of an Introductory Interprofessional Course in Building Readiness for Collaboration in the Health Professions

INTRODUCTION Interprofessional Education (IPE) prepares collaborative-ready health professionals although the actual process of learning “about, from and with” each other is widely debated in the literature (World Health Organization, 2010). The goal of the study was to examine the effectiveness of an introductory IPE course in improving students’ collaboration skills. METHODS Undergraduate, health professions students completed the 11-item Self-Assessed Collaboration Skills (SACS) survey before and after completing an introductory IPE course. RESULTS Results of paired samples t-tests suggest that there were significant improvements in students’ self-assessed collaboration skills and on the learning, information sharing, and team support dimensions. DISCUSSION This study highlights the role of an introductory IPE course in improving self-assessed collaboration and teamwork skills of entry-level learners. Features of the course design that contribute to its effectiveness include: interactive class sessions, a culminating team project, and using in-class time for team meetings. CONCLUSION An introductory IPE course can be effective in improving learners’ self-assessed collaboration skills and can prepare them for future IPE courses

Forward Thinking and Adaptability to Sustain and Advance IPECP in Healthcare Transformation Following the COVID-19 Pandemic

The proliferation of the novel SARS-CoV-2 (COVID-19) virus across the globe in 2020 produced a shared trauma internationally of unprecedented devastation, disruption, and death. At the same time, the pandemic has been a transformation catalyst accelerating the implementation and adoption of long overdue changes in healthcare education and practice, including telehealth and virtual learning. The COVID-19 pandemic has placed healthcare at a crossroads, either viewing it as a temporary situation that requires short-term solutions, or as a major disruption that presents opportunities for innovation for sustainable development and transformation. As COVID-19 transitions from pandemic to endemic, we have a unique opportunity to leverage lessons learned that can foster healthcare transformation through innovation, forward thinking, and interprofessional education and collaborative practice (IPECP). With the changing landscape of higher education and healthcare, IPECP leaders need to reflect on and implement ‘Forward Thinking and Adaptability’ and ‘Sustainability and Growth’ in their IPECP approaches and strategies to achieve the Quintuple Aim. To capitalize on this opportunity and based on a recent publication by InterprofessionalResearch Global, this paper explores and debates (from a global perspective) the impact and application of healthcare education and practice transformation on IPECP with the goal to identify best practices in integrating and sustaining IPECP and building a resilient workforce

Anastrozole versus tamoxifen for the prevention of locoregional and contralateral breast cancer in postmenopausal women with locally excised ductal carcinoma in situ (IBIS-II DCIS): a double-blind, randomised controlled trial

Background Third-generation aromatase inhibitors are more effective than tamoxifen for preventing recurrence in postmenopausal women with hormone-receptor-positive invasive breast cancer. However, it is not known whether anastrozole is more effective than tamoxifen for women with hormone-receptor-positive ductal carcinoma in situ (DCIS). Here, we compare the efficacy of anastrozole with that of tamoxifen in postmenopausal women with hormone-receptor-positive DCIS. Methods In a double-blind, multicentre, randomised placebo-controlled trial, we recruited women who had been diagnosed with locally excised, hormone-receptor-positive DCIS. Eligible women were randomly assigned in a 1:1 ratio by central computer allocation to receive 1 mg oral anastrozole or 20 mg oral tamoxifen every day for 5 years. Randomisation was stratified by major centre or hub and was done in blocks (six, eight, or ten). All trial personnel, participants, and clinicians were masked to treatment allocation and only the trial statistician had access to treatment allocation. The primary endpoint was all recurrence, including recurrent DCIS and new contralateral tumours. All analyses were done on a modified intention-to-treat basis (in all women who were randomised and did not revoke consent for their data to be included) and proportional hazard models were used to compute hazard ratios and corresponding confidence intervals. This trial is registered at the ISRCTN registry, number ISRCTN37546358. Results Between March 3, 2003, and Feb 8, 2012, we enrolled 2980 postmenopausal women from 236 centres in 14 countries and randomly assigned them to receive anastrozole (1449 analysed) or tamoxifen (1489 analysed). Median follow-up was 7·2 years (IQR 5·6–8·9), and 144 breast cancer recurrences were recorded. We noted no statistically significant difference in overall recurrence (67 recurrences for anastrozole vs 77 for tamoxifen; HR 0·89 [95% CI 0·64–1·23]). The non-inferiority of anastrozole was established (upper 95% CI <1·25), but its superiority to tamoxifen was not (p=0·49). A total of 69 deaths were recorded (33 for anastrozole vs 36 for tamoxifen; HR 0·93 [95% CI 0·58–1·50], p=0·78), and no specific cause was more common in one group than the other. The number of women reporting any adverse event was similar between anastrozole (1323 women, 91%) and tamoxifen (1379 women, 93%); the side-effect profiles of the two drugs differed, with more fractures, musculoskeletal events, hypercholesterolaemia, and strokes with anastrozole and more muscle spasm, gynaecological cancers and symptoms, vasomotor symptoms, and deep vein thromboses with tamoxifen. Conclusions No clear efficacy differences were seen between the two treatments. Anastrozole offers another treatment option for postmenopausal women with hormone-receptor-positive DCIS, which may be be more appropriate for some women with contraindications for tamoxifen. Longer follow-up will be necessary to fully evaluate treatment differences