Interprofessional education on complex patients in nursing homes: a focus group study

Abstract

Background An ageing population leads up to increasing multi-morbidity and polypharmacy. This demands a comprehensive and interprofessional approach in meeting patients’ complex needs. This study describes graduate students’ experiences of working practice based in interprofessional teams with complex patients’ care needs in nursing homes. Method Students from advanced geriatric nursing, clinical nutrition, dentistry, medicine and pharmacy at the University of Oslo in Norway were assigned to groups to examine and develop a care plan for a nursing home patient during a course. Focus groups were used, 21 graduate students participating in four groups. Data were collected during spring 2018, were inductively analysed according to a thematic analysis method (Systematic Text Condensation). An analytical framework of co-ordination practices was applied to get an in-depth understanding of the data. Results Three themes were identified: 1) Complex patients as learning opportunities- an eye-opener for future interprofessional collaboration 2) A cobweb of relations, and 3) Structural facilitators for new collective knowledge. Graduate university students experienced interprofessional education (IPE) on complex patients in nursing homes as a comprehensive learning arena. Overall, different co-ordination practices for work organization among the students were identified. Conclusions IPE in nursing homes facilitated the students’ scope from a fragmented approach of the patients towards a relational and collaborative practice that can improve patient care and strengthen understanding of IPE. The study also demonstrated the need for preparatory teamwork training to gain maximum benefit from the experience. Something that can be organized by the education institutions in the form of a stepwise learning module and as an online pre-training course in interprofessional teamwork. Further, focusing on the need for well thought through processes of the activity by the institutions and the timing the practice component in students’ curricula. This could ensure that IPE is experienced more efficient by the students.

Exploring factors associated with healthcare professionals’ subjective perceptions of complex issues in primary care in Japan: a self-administered survey study on confidence, satisfaction and burden levels

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“… 49 For instance, a study within a nursing home visited complex patients as opportunities for interprofessional learning, where participants managed complex issues through developed facilitation skills and the ability to structure new knowledge amidst professional conflicts. 50 Considering the inherent uncertainty in many complex issues, where health professionals often perceive challenges vaguely, we propose comparing these findings to the model of uncertainty in complexhealth care environments. 51 ( figure 1 ) This model illustrates how uncertainties in healthcare are interconnected across personal, scientific and practical categories, suggesting that ongoing engagement with complex issues may enhance interprofessional competency and frame such issues as learning opportunities.…”

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