Mandy Lowe

Conflicting messages: examining the dynamics of leadership on interprofessional teams.

Purpose Despite the importance of leadership in interprofessional health care teams, little is understood about how it is enacted. The literature emphasizes a collaborative approach of shared leadership, but this may be challenging for clinicians working within the traditionally hierarchical health care system. Method Using case study methodology, the authors collected observation and interview data from five interprofessional health care teams working at teaching hospitals in urban Ontario, Canada. They interviewed 46 health care providers and conducted 139 hours of observation from January 2008 through June 2009. Results Although the members of the interprofessional teams agreed about the importance of collaborative leadership and discussed ways in which their teams tried to achieve it, evidence indicated that the actual enactment of collaborative leadership was a challenge. The participating physicians indicated a belief that their teams functioned nonhierarchically, but reports from the nonphysician clinicians and the authors’ observation data revealed that hierarchical behaviors persisted, even from those who most vehemently denied the presence of hierarchies on their teams. Conclusions A collaborative approach to leadership may be challenging for interprofessional teams embedded in traditional health care, education, and medical-legal systems that reinforce the idea that physicians sit at the top of the hierarchy. By openly recognizing and discussing the tensions between traditional and interprofessional discourses of collaborative leadership, it may be possible to help interprofessional teams, physicians and clinicians alike, work together more effectively.

Flying blind: The experience of online interprofessional facilitation

The role of the facilitator is known to be important in fostering productive interprofessional education (IPE) in the face-to-face (F2F) environment. Online learning can help surmount some of the logistical challenges in IPE by bringing together diverse professionals in multiple geographical locations. Best practices in F2F IPE facilitation are beginning to emerge, but there is scant literature examining IPE facilitation online. What little research exists has focused on the asynchronous environment and suggests that the skill sets of online and F2F facilitators have considerable overlap, but there are further demands in the online setting. This qualitative study sought to examine online synchronous IPE facilitation through the self-reported experiences of seven trained facilitators during a 12-week online course. Data collected through focus groups and targeted interviews were analyzed by the research team using constant comparison techniques. Four major themes were revealed: technology as a dynamic force, reduction in non-verbal cues, evolution of the online IPE group process over time and the importance of co-facilitation. The foundations of IPE facilitation were seen to carry over to the online setting. This study has implications for the training of IPE facilitators and for the design of online IPE learning experiences.

Evaluating the effectiveness of an interprofessional education faculty development course: The transfer of interprofessional learning to the academic and clinical practice setting

Centre for Interprofessional Education, University of Toronto, Toronto, Canada, Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada, Sunnybrook Health Science Centre, Toronto, Canada, University Health Network, Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada, Faculty of Pharmacy, University of Toronto, Toronto, Canada, Centre for Faculty Development, Faculty of Medicine, University of Toronto, Toronto, Canada, Mount Sinai Hospital, Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada, Toronto Rehabilitation Institute, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada, Division of Physiatry, Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada, Office of Continuing Education and Professional Development, Faculty of Medicine, University of Toronto, Toronto, Canada, Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Canada, and Department of Speech-Language Pathology, Faculty of Medicine, Toronto, University of Toronto, Canada

Healthcare providers' perspectives on an interprofessional education intervention for promoting community re-engagement post stroke

Toronto Western Hospital, Toronto West Stroke Network, Toronto, Ontario M5T 2S8, Canada, St. Michaels Hospital, South East Toronto Stroke Network, Toronto, Ontario M5B 1W8, Canada, Toronto Rehabilitation Institute and Centre for IPE, University of Toronto, Toronto, Ontario, Canada, Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada, and Department of Physical Therapy, University of Toronto, Toronto, Canada

Catalyzing and sustaining communities of collaboration around interprofessional care: An evaluation of four educational programs

Given the complexity of patients’ needs and a shifting health care environment, effective interprofessional collaboration (IPC) is regarded by many as essential to the delivery of high quality patient care (e.g., Health Canada, 2003; Department of Health, 2002). Interprofessional relationships can, however, be undermined by boundary infringements, a lack of understanding of one another’s roles, limited communication and poorly coordinated teamwork (e.g., Reeves & Lewin, 2004). Interprofessional education (IPE) is increasingly being seen as a key approach to improving poor collaboration (e.g., Health Canada, 2003; Department of Health, 2002). It is argued that because professionals have been traditionally trained in isolation from one another they are often not equipped with the attitudes, skills or knowledge to work effectively in interprofessional teams. IPE for both students and professionals is advocated as a way to address this problem. A growing body of evidence, generated from systematic review work (e.g., Barr et al., 2005) has indicated that IPE can help foster a range of attributes required for effective collaboration. To encourage health care workers in Ontario, Canada to work collaboratively to improve job satisfaction, achieve efficiencies within the health care system and enhance the delivery

Community Re-engagement and Interprofessional Education: The Impact on Health Care Providers and Persons Living With Stroke

Abstract Purpose: This study evaluated the impact of an educational intervention that integrates concepts of a community re-engagement framework (CR) and interprofessional collaboration (IPC) on health care providers’ (HCP) practice with persons living with stroke (PLS). Method: A mixed-methods design was used in which HCPs (n = 67) and PLS (n = 29) participated from 9 organizations across the care continuum. Pre- and postintervention surveys and interviews were conducted with the HCPs. One-on-one interviews with stroke clients were also conducted pre and post intervention. Quantitative responses were analyzed in SPSS (Chicago, Illinois, USA) for descriptive frequencies and differences between pre- and postintervention groups. Qualitative open-ended responses were thematically coded using NVivo7. Results: Significant increases occurred in HCPs’ knowledge of CR, confidence levels in working with PLS, enhanced understanding of the complex needs of PLS, and positive self-reported impacts on practice. PLS reported positive perceptions of care pre and post intervention. Conclusions: The intervention provided HCPs with a common language and framework to work collaboratively and holistically in delivering care consistent with stroke best practices.