Critical Care Interprofessional Education: Exploring Conflict and Power—Lessons Learned

Friend, Mary Louanne; Friend, Richard; Ford, Cassandra D.; Ewell, Patrick J.

doi:10.3928/01484834-20161114-06

Cited by 11 publications

(9 citation statements)

References 21 publications

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“…Accordingly, addressing perceived gaps in knowledge, dissemination, team roles, and inter-professional communication is essential [ 27 , 28 ]. In addition to simulation training mentioned previously, other solutions for improved communication include training programs on cultural humility, conflict resolution, reinforcing aligned objectives that attend to skills specific to each discipline, and post-intubation clinical or “hot” debriefs [ 26 , 27 , 29 – 31 ]. The lessons learned from this rapidly implemented and high-acuity collaboration will remain pertinent as external personnel continue to play active roles in ED care [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Experiences of healthcare providers with a novel emergency response intubation team during COVID-19

et al. 2022

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Objectives In the early stages of the COVID-19 pandemic, there were significant concerns about the infectious risks of intubation to healthcare providers. In response, a dedicated emergency response intubation team (ERIT) consisting of anesthesiologists and allied health providers was instituted for our emergency department (ED). Given the high-risk nature of intubations and the new interprofessional team dynamics, we sought to assess health-care provider experiences and potential areas of improvement. Methods Surveys were distributed to healthcare providers at the University Health Network, a quaternary healthcare centre in Toronto, Canada, which includes two urban EDs seeing over 128,000 patients per year. Participants included ED physicians and nurses, anesthesiologists, anesthesia assistants, and operating room nurses. The survey included free-text questions. Responses underwent thematic analysis using grounded theory and were independently coded by two authors to generate descriptive themes. Discrepancies were resolved with a third author. Descriptive themes were distilled through an inductive, iterative process until fewer main themes emerged. Results A total of 178 surveys were collected (68.2% response rate). Of these, 123 (69%) participated in one or more ERIT activations. Positive aspects included increased numbers of staff to assist, increased intubation expertise, improved safety, and good team dynamics within the ERIT team. Challenges included a loss of scope (primarily ED physicians and nurses) and unfamiliar workflows, perceived delays to ERIT team arrival or patient intubation, role confusion, handover concerns, and communication challenges between ED and ERIT teams. Perceived opportunities for improvement included interprofessional training, developing clear guidelines on activation, inter-team role clarification, and guidelines on handover processes post-intubation. Conclusions Healthcare providers perceived that a novel interprofessional collaboration for intubations of COVID-19 patients presented both benefits and challenges. Opportunities for improvement centred around interprofessional training, shared decision making between teams, and structured handoff processes.

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Section: Discussionmentioning

confidence: 99%

Experiences of healthcare providers with a novel emergency response intubation team during COVID-19

et al. 2022

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“…Based on Friend et al . study, medical and nursing students believed that to succeed in their career, they need to create effective communication in a team and cooperate with each other in clinical settings [ 37 ]. Also, Zweibel's study showed that students considered conflicts in healthcare teams to be essential for growth and beneficial, and in their opinion, how to manage conflicts was important.…”

Section: Discussionmentioning

confidence: 99%

“…The concepts of the five items of this subscale show that acquiring conflict management competency is a necessary qualification for students to play a professional role as a member of the healthcare team in future and to establish effective communication with other team members. Based on Friend et al study, medical and nursing students believed that to succeed in their career, they need to create effective communication in a team and cooperate with each other in clinical settings [37]. Also, Zweibel's study showed that students considered conflicts…”

Section: Discussionmentioning

confidence: 99%

Development and validation of conflict management attitude questionnaire for medical students

et al. 2022

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Background Medical students should effectively manage conflicts in teamwork and communication with other team members. This study aimed to develop and validate a tool to evaluate attitude of medical students and physicians toward conflict management. Method A multi-step process was employed to develop and validate a Conflict Management Attitude Questionnaire (CMAQ) based on the steps recommended in AMEE Guide No. 87. First, the initial items were obtained from the literature review and focus group. After cognitive interviews with the medical students and revision of the questionnaire, content validity was performed by experts. The construct validity and reliability of the questionnaire were assessed using exploratory Factor Analysis (EFA) and Cronbach’s alpha coefficient, respectively. Results This multi-step process resulted in a 12-item, five-point Likert-type questionnaire with satisfactory construct validity. Exploratory factor analysis revealed three factors, comprising the four items from the "perceived interactions in conflict management" subscale loading on the first factor, and five items from the "perceived value of learning conflict management" subscale loading on the second factor, along with three items from the "perceived application of conflict management" subscale loading on the third factor. All subscales described 56.48% of the variance. Validation results showed that Content Validity Index (CVI) and Content Validity Ratio (CVR) were greater than 0.75. Cronbach's alpha coefficient was 0.791. Conclusion This study showed that CMAQ has valid evidence for assessing the attitude of medical students toward conflict management with favorable psychometric properties and strong evidence of construct validity. However, due to the lack of evidence on any specific questionnaire to evaluate the attitude towards conflict management, future studies should conduct a confirmatory investigation regarding other aspects of medical students' attitudes toward conflict management.

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“…In our study, we found the categories from the data flow. In this approach, researchers immerse in the data to allow new insights tofind, also described as inductive category development [ 32 , 33 ].…”

Section: Methodsmentioning

confidence: 99%

Transparency in public pharmaceutical sector: the key informants’ perceptions from a developing country

Esfandiari

Yazdi‐Feyzabadi

Zarei

et al. 2021

BMC Health Serv Res

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Background Policymaking in the pharmaceutical sector plays a pivotal role in achieving the health systems’ goals. Transparency in the pharmaceutical policy could increase confidence in decision-making processes. This study aims to assess transparency in the public pharmaceutical sector of Iran. Methods This qualitative study with a content analysis approach was conducted in 2017 using the World Health Organization tool to explore pharmaceutical transparency. The perceptions of the various stakeholders of the health system through semi-structured interviews with a maximum variation of stakeholders were obtained in eight functions, including registration, licensing, inspection, promotion, clinical trials, selection, procurement, and distribution of medicines. Results There are some problems in two main categories: (1) General problems, including lack of transparency, conflict of interest, centralization, and monopoly. (2) Ethical problems include illegal payments, gifts, bribes, conflicts of interest, hidden power, hoarding, relationship-oriented behavior, medicine trafficking, and counterfeit medicine. Suggested solutions include evidence-based decision-making, the use of transparent and accountable processes, standardization, needs assessment, declaring a conflict of interest, skilled human resources, and tracking prescription. Conclusion Despite the development of effective pharmaceutical policy in the health care system and government interventions for the control of the market, in some functions, reviewing the pharmaceutical policy is essential. Additionally, declaring a conflict of interest statement must be at the core of policy development to provide greater transparency.

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Critical Care Interprofessional Education: Exploring Conflict and Power—Lessons Learned

Cited by 11 publications

References 21 publications

Experiences of healthcare providers with a novel emergency response intubation team during COVID-19

Experiences of healthcare providers with a novel emergency response intubation team during COVID-19

Development and validation of conflict management attitude questionnaire for medical students

Transparency in public pharmaceutical sector: the key informants’ perceptions from a developing country

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