Interprofessional primary care in academic family medicine clinics: implications for education and training
- PMID: 22893347
- PMCID: PMC3419002
Interprofessional primary care in academic family medicine clinics: implications for education and training
Abstract
Objective: To explore the status and processes of interprofessional work environments and the implications for interprofessional education in a sample of family medicine teaching clinics.
Design: Focus group interviews using a purposive sampling procedure.
Setting: Four academic family medicine clinics in Alberta.
Participants: Seven family physicians, 9 registered nurses, 5 licensed practical nurses, 2 residents, 1 psychologist, 1 informatics specialist, 1 pharmacist, 1 dietitian, 1 nurse practitioner, 1 receptionist, and 1 respiratory therapist.
Methods: Assessment of clinic status and performance in relation to established principles of interprofessional work and education was explored using semistructured focus group interviews.
Main findings: Our data supported the D'Amour and Oandasan model of successful interprofessional collaborative practice in terms of the model's main "factors" (ie, shared goals and vision, sense of belonging, governance, and the structuring of clinical care) and their constituent "elements." It is reasonable to conclude that the extent to which these factors and elements are both present and positively oriented in academic clinic settings is an important contributory factor to the establishment of interprofessional collaborative practice in primary care. Using this model, 2 of the 4 clinics were rated as expressing substantial progress in relation to interprofessional work, while the other 2 clinics were rated as less successful on that dimension. None of the clinics was identified as having a clear and explicit focus on providing interprofessional education.
Conclusion: The key factor in relation to the implementation of interprofessional work in primary care appears to be the existence of clear and explicit leadership in that direction. Substantial scope exists for improvement in the organization, conduct, and promotion of interprofessional education for Canadian primary care.
Objectif: Étudier l’état et le fonctionnement des milieux de travail interprofessionnels ainsi que leurs répercussions sur la formation interprofessionnelle dans un échantillon de cliniques d’enseignement de médecine familiale.
Type d’étude: Entrevues avec des groupes de discussion à partir d’un échantillonnage raisonné.
Contexte: Quatre cliniques de médecine familiale universitaires en Alberta.
Participants: Sept médecins de famille, 9 infirmières diplômées, 5 infirmières auxiliaires, 2 résidents, 1 psychologue, 1 informaticien, 1 pharmacien, 1 diététiste, 1 infirmière praticienne, 1 réceptionniste et 1 inhalothérapeute.
Méthodes: On a réalisé des entrevues semi-structurées avec des groupes de discussion pour évaluer l’état et le fonctionnement des cliniques par rapport aux principes reconnus du travail et de la formation interprofessionnels.
Principales observations: Nos données sont conformes au modèle de D’Amour et Oandasan pour une pratique interprofessionnelle en collaboration en ce qui concerne les principaux facteurs (c.-à-d. partage des visions et des buts, sentiment d’appartenance, gouvernance et organisation des soins cliniques) et les éléments constituants d’un tel modèle. On peut raisonnablement conclure que le degré auquel ces facteurs et ces éléments sont présents et positivement orientés dans un milieu clinique universitaire est un important facteur favorisant l’établissement d’une pratique interprofessionnelle en collaboration dans un contexte de soins primaires. En utilisant ce modèle, on a jugé que 2 des 4 cliniques avaient fait des progrès substantiels pour ce qui est du travail interprofessionnel tandis que les 2 autres avaient moins bien réussi sur ce point. Aucune des cliniques n’a démontré une intention claire et explicite de fournir une formation interprofessionnelle.
Conclusion: Le facteur clé en rapport avec l’instauration d’un travail interprofessionnel dans les soins primaires semble être la présence d’un leadership clair et explicite dans cette direction. Il reste beaucoup à faire pour améliorer l’organisation, la mise en place et la promotion de la formation interprofessionnelle dans les soins primaires au Canada.
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