No abstract

The aim of this study was to evaluate the effectiveness of an innovative pediatric interprofessional education clinical experience using oral‐systemic health as the clinical population example for improving the self‐reported interprofessional competencies of family nurse practitioner, dental, and medical students. The objectives of the interprofessional experience were for students to apply pediatric oral health assessment, identify the pediatric oral‐systemic connection, and practice a team‐based approach to improve oral‐systemic outcomes. In spring 2015, fall 2015, and spring 2016, a total of 162 family nurse practitioner, dental, and medical students participated in this interprofessional experience at Bellevue Pediatric Outpatient Clinics together with a pediatric dental resident. Team members collaborated in reviewing the patient chart, taking the patient's medical and dental history, performing an oral assessment, applying fluoride varnish, and providing education and anticipatory guidance. The Interprofessional Collaborative Competency Attainment Survey (ICCAS) was used as a pretest and posttest to evaluate the degree to which students perceived changes in their attitudes about interprofessional competencies following the learning experience. In the results, all students had improved mean scores from pretest to posttest after the experience, and these changes were statistically significant for all students: nurse practitioner (p<0.01), dentistry (p<0.01), and medicine (p<0.001). The mean change from pretest to posttest was statistically significant for each of the six interprofessional competency domains (p<0.01). In both pediatric dental and primary care settings, the changes from pre‐ to posttest were significant (p<0.001). The experience was similarly effective for all groups of students in increasing their attitudes about interprofessional collaboration. These findings suggest that a clinical approach can be an effective strategy for helping health professions students develop interprofessional competence.

To examine relations between infant social withdrawal behavior and maternal major depression (MDD), 155 mother-infant dyads were evaluated at the 6-month primary care visit. Maternal depression was determined based on a psychiatric interview. Infant social withdrawal behavior was assessed with the Alarm Distress Baby Scale (ADBB; A. Guedeney & J. Fermanian, 2001) based on videotaped mother-infant interactions. Of the sample, 18.7% of mothers were diagnosed with MDD, and 39.4% of infants scored above the clinical ADBB cutoff. Infants of depressed mothers were more likely to score positive on the ADBB (75.8 vs. 31.0%, p < .001) and showed distinct patterns of withdrawal behavior. Within the group of withdrawn infants, however, no differential patterns of behavior could be identified for infants of depressed mothers as compared to infants of mothers with no depression. These findings confirm the validity of the ADBB for detection of infant social withdrawal in the context of MDD. At the same time, they support evidence that the ADBB identifies nonspecific infant distress behaviors. Future studies will need to determine if and how positive ADBB screening results in the absence of maternal MDD might be associated with other maternal psychiatric disorders such as anxiety or borderline personality disorder. These results have important implications for screening guidelines in primary care.