The ability to work with professionals from other disciplines to deliver collaborative, patient-centred care is considered a critical element of professional practice requiring a specific set of competencies. However, a generally accepted framework for collaborative competencies is missing, which makes consistent preparation of students and staff challenging. Some authors have argued that there is a lack of conceptual clarity of the "active ingredients" of collaboration relating to quality of care and patient outcomes, which may be at the root of the competencies issue. As part of a large Health Canada funded study focused on interprofessional education and collaborative practice, our goal was to understand the competencies for collaborative practice that are considered most relevant by health professionals working at the front line. Interview participants comprised 60 health care providers from various disciplines. Understanding and appreciating professional roles and responsibilities and communicating effectively emerged as the two perceived core competencies for patient-centred collaborative practice. For both competencies there is evidence of a link to positive patient and provider outcomes. We suggest that these two competencies should be the primary focus of student and staff education aimed at increasing collaborative practice skills.
The results provide evidence to support our blended learning format without compromising pedagogy. They also suggest that this format enhances students' perceptions of their learning.
For many years, an overly "siloed" approach has hampered efforts to understand violence and minimize the societal burden of violence and victimization. This article discusses the limitations of an overly specialized approach to youth violence research, which has focused too much on violence in particular contexts, such as the family or the school. Instead, a child-centered approach is needed that comprehensively assesses all exposures to violence. This concept of the total cumulative burden of violence is known as poly-victimization. The poly-victimization framework reveals that many youth are entangled in a web of violence, experiencing victimization in multiple settings by multiple perpetrators. This more accurate view of children's exposure to violence has many advantages for advancing our scientific understanding of violence. Perhaps somewhat surprisingly, this more comprehensive view also points to new insights for resilience and prevention. This includes recognizing a parallel concept, "poly-strengths," which captures the number of resources and assets children and their families can use to help insulate youth from violence (prevention) or assist in coping and promoting well-being after victimization (intervention). Reconceptualizing how resilience is defined and understood among youth populations can help alleviate the true societal burden of youth victimization.
It is often said that intimate partner violence (IPV) happens "behind closed doors"; however, research on IPV and other crimes suggests that witnesses are sometimes present. This suggests that bystanders may be in a position to help victims or potential victims of violence. Bystander behavior has been studied primarily in school settings, and consequently, little is known about how often it occurs or what its effects may be in the broader community. This study examined IPV incidents in a rural sample to assess the presence and potential impact of bystanders on victim-reported outcomes. One thousand nine hundred seventy-seven adult participants completed a questionnaire that asked about five violent behaviors (my partner threatened to hurt me; pushed, grabbed, or shook me; hit me; beat me up; sexually assaulted me), bystander characteristics, and victim outcomes (fear; injury; disruption of daily routines; mental health). Adult or teen bystanders were present for each IPV approximately one third of the time, except in the case of sexual assault (14.3%). When a bystander was present, victims reported higher rates of injury, greater disruption in their routines, and poorer mental health. When a bystander's safety was threatened, victims reported more physical injury and more routine disruption. A considerable number of IPV incidents do not happen behind closed doors, and the presence of a bystander was associated with worse outcomes for victims. Prevention efforts for adult IPV may need to take a more cautious or nuanced approach to encouraging bystander action, especially when confronted with more severe incidents. Bystander safety should be a priority for violence prevention.
Many forms of victimization, including bullying and property crime, are increasingly moving online, but most studies of poly-victimization still primarily focus on in-person crime and violence. Few studies have examined the importance of incorporating technology-based victimizations for assessing the true burden of violence. The purpose of this study is to explore whether digital poly-victimization contributes to post-traumatic stress and anxiety/dysphoria symptoms after controlling for in-person poly-victimization. Given that technology use and technology-based victimization are changing rapidly, a mixed methods approach was adopted. In the first two phases, focus groups and cognitive interviews (89 total participants) were used to identify the range of digital victimization and develop the Digital Poly-Victimization Scale. In the third phase, the new measure was included in a community survey (n = 478, 57.5% female; 62.6% earning under $50,000 per year) in a rural Southern region, along with measures of in-person poly-victimization, posttraumatic stress and anxiety/dysphoria symptoms, and other outcomes and personal characteristics. A comprehensive measure of digital poly-victimization indicated that almost 3 in 4 participants (72.3%) had experienced at least one form of digital victimization. The results indicated that digital poly-victimization contributed unique variance to post-traumatic stress and anxiety/dysphoria symptoms (p < .001), health-related quality of life (p < .01), and subjective and family well-being (both p < .001), even after controlling for demographics and in-person poly-victimization. Digital victimization often presents fewer risks to perpetrators and can be expected to represent an increasing share of the societal burden of violence. Future research on poly-victimization should pay more attention to the role of digital victimization.
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