Are role perceptions of residents and nurses translated into action?

Abstract

BackgroundEffective interprofessional collaboration (IPC) has been shown to depend on clear role definitions, yet there are important gaps with regard to role clarity in the IPC literature. The goal of this study was to evaluate whether there was a relationship between internal medicine residents’ and nurses’ role perceptions and their actual actions in practice, and to identify areas that would benefit from more specific interprofessional education.MethodsFourteen residents and 14 nurses working in internal medicine were interviewed about their role perceptions, and then randomly paired to manage two simulated clinical cases. The authors adopted a general inductive approach to analyze the interviews. They identified 13 different role components that were then compared to data from simulations. Descriptive and kappa statistics were used to assess whether there was a relationship between role components identified in interviews and those performed in simulations. Results from these analyses guided a further qualitative evaluation of the relationship between role perceptions and actions.ResultsAcross all 13 role components, there was an overall statistically significant, although modest, relationship between role perceptions and actions. In spite of this relationship, discrepancies were observed between role components mentioned in interviews and actions performed in simulations. Some were more frequently performed than mentioned (e.g. “Having common goals”) while others were mentioned but performed only weakly (e.g. “Providing feedback”).ConclusionsRole components for which perceptions do not match actions point to role ambiguities that need to be addressed in interprofessional education. These results suggest that educators need to raise residents’ and nurses’ awareness of the flexibility required to work in the clinical setting with regard to role boundaries.

Use of profession-role exchange in an interprofessional student team-based community health service-learning experience

“…Along with the rapid advancement of modern health-care practices, an interprofessional care model has been well-accepted to be important for supporting a comprehensive patient-centred service provision through blending complementary knowledge and skills from multiple health professions, such as medicine, nursing and pharmacy [1][2][3][4]. Through working together in team to care for patients, clinical interprofessional practice makes possible the best use of resources, improves outcomes, and is able to meet increasingly complex health needs of patients [4].…”

“…Through working together in team to care for patients, clinical interprofessional practice makes possible the best use of resources, improves outcomes, and is able to meet increasingly complex health needs of patients [4]. As an essential element of interprofessional practice and collaboration, clear perceptions of interprofessional team members regarding their professional roles are crucial for the effectiveness of interprofessional care [2,3]. To successfully participate in a well-functioning interprofessional team, health-care professionals first need to understand the roles of their own and other team members.…”

“…The role is considered to represent "a set of expectations in the sense that it is what one should do" [2]. The role perceptions of health-care professionals would translated into actual actions in clinical practice, thus are essential for improving patient care and achieving interprofessional team success [2,3,5,6]. Compared to understanding of one's own professional role and function, it might be more difficult to clarify the roles and contributions of the other health-care team members because of the inter-professional barrier.…”

“…In order to provide a comprehensive and optimal team-based health care, each team member should revolve around specific role expectations and meet perceived professional responsibilities. Team members as a group must have an understanding of the competencies and skills which each team member could contribute, and can determine who is the best suitable one to implement the given clinical intervention that is required in a given situation [2]. Nevertheless, a lack of awareness, definition and recognition of one another's role was still believed as a main conceptual barrier to interprofessional collaboration as perceived by the involved actors [4,8,9], which need to be overcome in the future.…”

“…Interprofessional education (IPE), whereby students from different health-care professions learn and practise together, has shown to have a positive impact on team work in the students' future health-care practice, contribute to train effectual health-care teams and optimize future holistic patient care [9,10]. In order to prepare the students to interprofessional team practice, health-care education programs should provide adequate learning opportunities that enable students to interact with potential professional team members, gain insight into the roles, professional cultures, and contributions of collaborating team members [2,10]. In our previous study [11], we developed an IPE opportunity through integrating cooperative learning into an interprofessional student team-based community service event, and found a significant increase in positive attitudes among the involved students towards interprofessional collaboration after participation in this IPE activity.…”