Mandy Lowe

Background: To optimize their use of a new Health Information System (HIS), supporting health care providers require effective HIS education. Failure to provide this education can significantly hinder an organization’s HIS implementation and sustainability efforts. Objective: The aim of this review is to understand the most effective educational strategies and approaches to enable health care providers to optimally use an HIS. Methods: Ovid MEDLINE, Ovid Embase, EBSCO Cumulative Index to Nursing and Allied Health Literature, and EBSCO Education Resources Information Center were searched to identify relevant papers. Relevant studies were systematically reviewed and analyzed using a qualitative thematic analysis approach. Results: Of the 3539 studies screened, 17 were included for data extraction. The literature on the most effective approaches to enable health care providers to optimally use an HIS emphasized the importance of investing in engaging and understanding learners in the clinical context, maximizing the transfer of learning to care, and designing continuous and agile evaluation to meet the emerging demands of the clinical environment. Conclusions: This review supports the advancement of a new HIS learning framework that organizational leaders and educators can use to guide HIS education design and development. Future research should examine how this framework can be translated into practice.

BACKGROUND To optimize their use of a new Health Information System (HIS), supporting health care providers require effective HIS education. Failure to provide this education can significantly hinder an organization’s HIS implementation and sustainability efforts. OBJECTIVE The aim of this review is to understand the most effective educational strategies and approaches to enable health care providers to optimally use an HIS. METHODS Ovid MEDLINE, Ovid Embase, EBSCO Cumulative Index to Nursing and Allied Health Literature, and EBSCO Education Resources Information Center were searched to identify relevant papers. Relevant studies were systematically reviewed and analyzed using a qualitative thematic analysis approach. RESULTS Of the 3539 studies screened, 17 were included for data extraction. The literature on the most effective approaches to enable health care providers to optimally use an HIS emphasized the importance of investing in engaging and understanding learners in the clinical context, maximizing the transfer of learning to care, and designing continuous and agile evaluation to meet the emerging demands of the clinical environment. CONCLUSIONS This review supports the advancement of a new HIS learning framework that organizational leaders and educators can use to guide HIS education design and development. Future research should examine how this framework can be translated into practice.

Background and Rationale: Numerous calls have been made for faculty development programming to better address faculty members’ ongoing needs, to situate training strategies within the workplace and to utilize social learning perspectives, communities of practice in particular. Reviews have pointed to a paucity of published qualitative research on faculty development communities of practice and, more generally, on the processes of change and the organizational contexts in which interventions are implemented. Intervention: An initiative was started to instigate education scholarship communities of practice in three highly distinct academic health care settings, to address faculty members’ ongoing needs for community and, ultimately, to serve as a source of support for the application of new knowledge to routine education activities. A research project was launched jointly to describe the process and progress of attempting to develop communities of practice at the three sites and to identify common and unique influences on sites’ progress. Data Collection: Phone interviews were conducted with group facilitators from each site following group meetings, for the duration of the initiative. Analysis: Multiple case study methodology was employed to describe and compare the processes and progress of attempting to initiate communities of practice at the three sites and to identify obstacles related to organizational context. Findings: All three sites made limited progress in developing a shared domain of interest and a shared history of regular interaction (i.e. regular meetings). Participants identified different professional backgrounds and different education practices as challenges to establishing shared interest. More prominently, they identified busy schedules, geographic barriers, and absence of protected time as obstacles to regular and consistent meetings. Discussion: Difficulty establishing shared interest and shared history are considered in light of the unclear meaning of “education scholarship”, cognitive and ethical boundaries between professions, and time constraints within modern, highly complex academic healthcare settings. Conclusions: While CoPs may appeal as self-sustaining, low-cost alternatives to formal programming, limited progress is possible without institutional investment and allowance commensurate with the implied scope and challenges. Keywords: faculty development, education scholarship, community of practice, qualitative research Keywords: faculty development, education scholarship, community of practice, qualitative research

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.

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.

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.

Healthcare leaders have long expressed the need to effectively engage all members of their organizations in the process of decision-making. The group priority sort is an innovation in healthcare leadership that supports both consensus building and effective consultation.

(2011). Healthcare providers' perspectives on an interprofessional education intervention for promoting community re-engagement post stroke. Journal of Interprofessional Care: Vol. 25, No. 5, pp. 380-382. doi: 10.3109/13561820.2011.583367