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J Pain Symptom Manage · Oct 2021
"We're performing improvisational jazz": Interprofessional pediatric palliative care fellowship prepares trainees for team-based collaborative practice.
- Shih-Ning Liaw, Amy Sullivan, Jennifer Snaman, Marsha Joselow, Janet Duncan, and Joanne Wolfe.
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts, USA; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA. Electronic address: Shih-Ning_Liaw@dfci.harvard.edu.
- J Pain Symptom Manage. 2021 Oct 1; 62 (4): 768-777.
ContextInterprofessional education (IPE) prepares clinicians for collaborative practice, yet little is known about the effectiveness of postgraduate IPE.ObjectivesThis is the first study to describe educational outcomes of an interprofessional fellowship in pediatric palliative care. Objectives were to understand the experiences of postgraduate trainees in an interprofessional, clinical environment and to evaluate program effect on interprofessional competencies.MethodsIn this mixed-methodology study, we surveyed former fellows from 2002 to 2018 about their fellowship experience and perceived change in interprofessional skills. We performed qualitative semantic content analysis of fellows' responses about learning in an interprofessional context. We compared fellows' self-rated ability (5-point Likert scale), before and after fellowship, in 10 interprofessional competencies selected from the Interprofessional Education Collaborative's core competencies.ResultsResponse rate was 87% (41/47). Fifty-one percent of respondents were physicians, 29% were social workers, and 20% were nurse practitioners. Respondents reported significant improvement in all 10 competencies, with summed mean scores of 2.8 ± 0.6 prefellowship ("not very well prepared") and 4.4 ± 0.4 postfellowship ("very well" to "extremely well prepared") (t = 15.6, P< 0.0001). Effect size for each competency was greater than 1.9 (strong positive impact). The fellowship experience was characterized by dynamic educational relationships: peer relationships with interprofessional co-fellows, mentoring relationships with faculty, clinical relationships with patients and families, and collaborative relationships with the healthcare system. Benefits and challenges of IPE were associated with interprofessional roles, teamwork, patient care, and educational needs.ConclusionThis study demonstrates the feasibility and effectiveness of an interprofessional postgraduate fellowship in preparing clinicians for collaborative practice.Copyright © 2021 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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