Phillip G. Clark

What would a theory of interprofessional education look like? Some suggestions for developing a theoretical framework for teamwork training 1.

Much of the literature on interprofessional education (IPE) is descriptive, anecdotal, and atheoretical. To advance both practice and research in this field, IPE needs to develop theoretical frameworks that: (i) identify major concepts to guide the development of course and program structures and processes, (ii) specify learning objectives and effective methods for their achievement, (iii) suggest appropriate roles for faculty and students in the educational process, and (iv) aid in research and assessment of program impacts and outcomes. Following an exploration of what theory should mean and the role it might play in advancing IPE, this discussion surveys five different theoretical approaches for guidance in developing an IPE framework: (i) cooperative, collaborative, or social learning; (ii) experiential learning; (iii) epistemology and ontology of interdisciplinary inquiry; (iv) cognitive and ethical student development; and (v) education of the reflective practitioner. Common themes are discussed and their implications for IPE are explored. These include: (i) social context of collaborative and experiential learning, (ii) epistemology and ontology, facts and values, (iii) importance of reflection, and (iv) implications for student and faculty roles. Overall, this discussion aims to foster continued dialogue, discussion, and debate on the need for, and the role of, theory in IPE.

Reflecting on reflection in interprofessional education: Implications for theory and practice

Interprofessional education (IPE) involves learning, and learning requires reflection. Educators need to “reflect more on reflection” if they are to be effective teachers in ensuring the learning outcomes essential for teamwork and interprofessional practice (IPP), including incorporating both theory and practice into the development of educational interventions. First, this discussion surveys the IPE-relevant literature on reflection, and then defines and refines the multidimensional concept of reflection as it relates to IPE in developing and implementing teamwork learning programs and experiences. Second, specific methods to promote reflection are presented and explored, including self-assessments, journaling, and written papers. Actual samples from student journals and assignments provide examples of the impacts of using these methods on participant reflection and learning. Finally, implications for an expanded understanding and application of reflection for IPE will be discussed, and recommendations made for educational practice and research in this area.

Physical and mental health-related correlates of physical function in community dwelling older adults: a cross sectional study

BackgroundPhysical function is the ability to perform both basic and instrumental activities of daily living, and the ability of older adults to reside in the community depends to a large extent on their level of physical function. Multiple physical and health-related variables may differentially affect physical function, but they have not been well characterized. The purpose of this investigation was to identify and examine physical and mental health-related correlates of physical function in a sample of community-dwelling older adults.MethodsNine hundred and four community dwelling older men (n = 263) and women (n = 641) with a mean (95% Confidence Interval) age of 76.6 (76.1, 77.1) years underwent tests of physical function (Timed Up and Go; TUG), Body Mass Index (BMI) was calculated from measured height and weight, and data were collected on self-reported health quality of life (SF-36), falls during the past 6 months, number of medications per day, depression (Geriatric Depression Scale; GDS), social support, and sociodemographic variables.ResultsSubjects completed the TUG in 8.7 (8.2, 9.2) seconds and expended 6,976 (6,669, 7,284) Kcal.wk-1 in physical activity. The older persons had a mean BMI of 27. 6 (27.2, 28.0), 62% took 3 or more medications per day, and14.4% had fallen one or more times over the last 6 months. Mean scores on the Mental Component Summary (MCS) was 50.6 (50.2, 51,0) and the Physical Component Summary (PCS) was 41.3 (40.8, 41.8).Multiple sequential regression analysis showed that, after adjustment for TUG floor surface correlates of physical function included age, sex, education, physical activity (weekly energy expenditure), general health, bodily pain, number of medications taken per day, depression and Body Mass Index. Further, there is a dose response relationship such that greater degree of physical function impairment is associated with poorer scores on physical health-related variables.ConclusionsPhysical function in community-dwelling older adults is associated with several physical and mental health-related factors. Further study examining the nature of the relationships between these variables is needed.

Social, Professional, and Educational Values on the Interdisciplinary Team: Implications for Gerontological and Geriatric Education.

Values define and guide the practice of health care professionals, and educational programs also reflect prevailing academic norms, assumptions, and principles. Initiatives to develop interdisciplinary instructional programs in gerontological and geriatric teamwork are heavily influenced by social and academic values that emphasize individualism, competition, and unidisciplinary thinking, I analyze the influence of these values on interprofessional education and develop a framework for conceptualizing the role of values on the interdisciplinary health care team. This structure encompasses dimensions or axes relating to professional‐client and professional‐professional relationships and to the emerging importance of shared team values. Implications for gerontological and geriatric programs and pedagogy are explored, particularly with regard to the development of instructional models and methods.

Intervening on exercise and nutrition in older adults: the Rhode Island SENIOR Project.

Presented are the basic design, methods, and baseline data analyses for the Study of Exercise and Nutrition in Older Rhode Islanders (SENIOR Project) an experimental study to investigate the relative effectiveness of a 12-month, stage of readiness to change-based multiple-behavior intervention (exercise and nutrition) compared to single-behavior interventions in a community-dwelling population of 1,277 older adults. Relationships between stage of readiness to change in the two target behaviors, as well as the relationship between stage of readiness and self-reported exercise levels and fruit and vegetable consumption, were examined using a combination of Pearson chi-squares, analyses of variance (ANOVA), and Spearman’s rank order correlations. Stage of change (SOC) for fruit and vegetable consumption was significantly associated with the dietary measure, and SOC for exercise was associated with both the three physical activity measures and servings of fruits and vegetables per day. Overall, individual older adults readiness to change seems largely to be behavior-specific.

Theory and practice in interprofessional ethics: a framework for understanding ethical issues in health care teams.

Interprofessional teamwork is an essential and expanding form of health care practice. While moral issues arising in teamwork relative to the patient have been explored, the analysis of ethical issues regarding the function of the team itself is limited. This paper develops a conceptual framework for organizing and analyzing the different types of ethical issues in interprofessional teamwork. This framework is a matrix that maps the elements of principles, structures, and processes against individual, team, and organizational levels. A case study is presented that illustrates different dimensions of these topics, based on the application of this framework. Finally, a set of conclusions and recommendations is presented to summarize the integration of theory and practice in interprofessional ethics, including: (i) importance of a framework, (ii) interprofessional ethics discourse, and (iii) interprofessional ethics as an emerging field. The goal of this paper is to begin a dialogue and discussion on the ethical issues confronting interprofessional teams and to lay the foundation for an expanding discourse on interprofessional ethics.

LEARNING ON INTERDISCIPLINARY GERONTOLOGICAL TEAMS: INSTRUCTIONAL CONCEPTS AND METHODS

The use of geriatric and gerontological health care teams has become increasingly widespread, and institutions of higher education need to provide more training opportunities for students from different health disciplines to work together as interdisciplinary teams. At the same time, new and innovative means of enhancing and monitoring the effectiveness of our instructional methods in team development must be developed. This paper reports on two methods used in a course on interdisciplinary teamwork in gerontology that have proven useful in fostering and gauging students’ progress in becoming team players. The first method is a structured journal in which students record observational, theoretical, and methodological notes in the process of experiential learning. The important conceptual underpinnings of this process and the use of writing as a way of encouraging collaborative learning are emphasized. The second method is a team development inventory that is completed each week by the students and uses a ...

The Philosophical Foundation of Empowerment Implications for Geriatric Health Care Programs and Practice

Empowerment of the elderly within the health care system is a concept increasingly discussed in clinical and policy-making contexts. An examination of its current expressions and underlying philosophical principles reveals four different interpretations: empowerment as political activism and social process, empowerment as effective deliberation and moral reflection, empowerment as personal process. and empowerment as balance and interdependence. How empowerment is defined and expressed has distinct implications for the practitioner. who must be sensitive to tile underlying value conflicts that are at the core of decision making in the clinical or the public policy setting.

Service-Learning Education in Community-Academic Partnerships: Implications for Interdisciplinary Geriatric Training in the Health Professions.

Major changes are taking place within the health care system that have important implications for health professions education in geriatrics. The forces driving these changes are also affecting academic settings, where trends supporting the development of community-academic partnerships, service-learning models, and interdisciplinary education are all evident. These trends have major implications for health professions educators working to develop academic programs to prepare students for future practice with older adults. This article explores the impacts of these changes, in particular, on the design of interdisciplinary or collaborative education programming, including the following dimensions: assessment and definition of the problem, emphasis on functioning and quality of life, professional identity, changing roles of faculty and students, and institutional-organizational implications. General recommendations on how to respond to the challenges represented in these trends are also explored.

Position statement on interdisciplinary team training in geriatrics: An essential component of quality health care for older adults

Interdisciplinary team training (IDT) is an important component of ensuring quality geriatric care delivery, which can be complex and time intensive, requiring coordination of many medical, psychosocial, and therapeutic interventions and professionals. The Partnership for Health in Aging (PHA), a loose coalition of more than 30 organizations representing healthcare professionals who care for older adults supported by the American Geriatrics Society, identified IDT training in geriatrics as a priority area in addressing the geriatrics workforce shortage described in the 2008 Institute of Medicine report, Retooling for An Aging America: Building the Health Care Workforce. A PHA Workgroup on Interdisciplinary Team Training in Geriatrics was convened to review the literature focused on geriatrics IDT training and to develop a position statement that would inform and influence groups involved in the development and expansion of academic and continuing education programs in IDT training, including professional associations, credentialing and licensing bodies, accreditation organizations, and university administrators. There are significant challenges to expanding the development and implementation of geriatrics IDT training for health professionals, and such training will be successful only with substantial and sustained advocacy from the above professional groups.