Class 2 Flashcards
1
Q
what key concepts are found in the Cahn article? (2)
A
- core competencies of IPC can be re-written to work towards correcting systemic racism
- the importance of structural competency
2
Q
according to Cahn, the core competencies of IPC can be re-written to…
A
- work towards correcting systemic racism
3
Q
according to Cahn, how can the core competency of IPC “values/ethics” be re-written to include correction of systemic racism?
A
- HCP should band together to advocate for repeal of policies that adversely affect the health of minority populations
4
Q
according to Cahn, how can the core competency of IPC “roles/responsibilities” be re-written to include correction of systemic racism?
A
- HCP should reflect critically on their own racial positions & how it establishes power imbalances between team members, pts, and families
5
Q
according to Cahn, how can the core competency of IPC “interprofessional communication” be re-written to include correction of systemic racism?
A
- HCP should enhance perspective taking & analysis of idenity-making thru small group discussion
6
Q
according to Cahn, how can the core competency of IPC “teams/teamwork” be re-written to include correction of systemic racism?
A
- HCP should form meaningful partnerships w local organizations which lead to sustained immersion in low-resource communities
7
Q
according to Cahn, in place of cultural competency, health profession educators interested in advancing anti-racism have offered the term…
A
- structual competency
8
Q
what is structural competency
A
- an approach to the relationships among race, class, and symptom expression
- bridges research on social determinants of health to clinical interventions, and prepares clinical trainees to act on systemic causes of health inequalities
9
Q
according to Cahn, structural competency considers… (3)
A
- governmental policies
- residential patterns
- environmental inputs
outside the clinical setting that impact health
10
Q
IPC often stops at the lvl of cultural awareness, which avoids…. (3) what risks does this have??
A
analysis of:
- historical insults
- societal norma
- privileges perpetrated by current structures
= risks reducing populations to stereotypes and ignores systemtc racism
11
Q
according to Cahn, IPC and anti-racism mvmts share the goal of???
A
- instilling structural competency –> collaboration requires an overarching view of the system in which everyone operates
12
Q
what key concepts are found in Drinka’s article? (2)
A
- 4 components of IPC development
- challenges to IPC
13
Q
what are the 5 components of IPC/team development?
A
- forming
- norming
- confronting/storming
- performing
- leaving
14
Q
according to Drinka, what are the symptoms of the Forming phase of IPC development? (6)
A
- superficially share name and background info
- members size up & test each other; categorize by professional roles & status
- members guarded, more impersonal than personal, some active, most passive
- uncertain about team membership
- conflict is neither discussed nor addressed
- focus on own professional role & perspective
15
Q
according to Drinka, what are the interventions of the Forming phase of IPC development? (6)
A
- create icebreaks (ex. potlucks, informal discussions)
- discuss formal and potential informal roles of members, verbalize stated team goals
- encourage informal time to get to know one another
- new team = discuss and agree on core & secondary team membership
- new team member = mentor should discuss and ensure understanding
- encourage conflict recognition as an opportunity for creative problem solving
16
Q
according to Drinka, forming can occur when?
A
- when a single person enters an already formed team
- or when there is a new team altogether
17
Q
according to Drinka, forming is often a ______ process
A
- rushed process –> involves members of a healthcare team coming together to engage in pt care
18
Q
according to Drinka, what are the rates in which individual members of the team go thru the forming stage
A
- at different rates depending on confidence, experience, etc.
19
Q
what is an example of the forming phase
A
- showing up as a new nurse on the first day –> narrower focus of learning, more shy, not confident enough to address issues in pt care
20
Q
according to Drinka, the Norming Phase of IPC development is the…
A
- conflict or storming phase
21
Q
according to Drinka, what are the symptoms of the Norming phase of IPC development? (14)
A
- difficult to understand goals and purpose of the team
- attempt to establish common team goals & purpose
- mistrust each other, exhibit caution and conformity
- begin to see role overlaps (other people helping w things you thought were only in ur scope)
- know conflicts are present, cover them up or whitewash them
- few members attempt to establish bonds w others w similar views
- team establishes ground rules, begin to clarify common roles
- team may want leader(s) to assume responsibility
- team tries strategies to increase equality of leadership (ex. rotating leadership)
- defensive communication & disruptive behavior increases
- team members frustrated
- some members project blame & responsibility towards perceived leaders
- team members compete
- some members come to meeting late or not at all
22
Q
according to Drinka, what are the interventions for the Norming phase of IPC development? (14)
A
- discuss goals as a team
- discuss & agree as a team
- structure opportunities for informal communication about training, values, experience, and duties of each member
- observe members from other disciplines, discuss overlaps
- encourage conflict recognition as an opportunity for creative problem solving
- form a subcommittee and include members from different coalition
- reinforce ground rules, negotiate common roles
- identify informal leadership roles that needs to be filled and who can fill them
- emphasize development of competence for different leadership roles
- at process team meeting, give open feedback & discuss patterns of disruption & solutions
- promote informal leadership for resolving provblems
- discuss different leadership roles, praise members for indiv contributions
- review rules for membership (ex. attendance, start & end meetings on time, ignore late arrivals)
23
Q
according to Drinka, why does storming or conflict in the group occur during the Norming phase?
A
- group is too rushed to deal w it, and issues are pushed under the table
24
Q
according to Drinka, what may occur between different disciplines of an IPC team in the Norming phase? (2)
A
- competition between disciplines
- discipline specific goals may form instead of team goals
25
According to Drinka, in the Norming phase the team may be placed into a ____ mentality
- groupthink
26
according to Drinka, describe the progression past the Norming Phase
- some teams dont move past this phase
27
according to Drinka, what occurs in the confronting/storming phase of IPC development?
- issues from the norming phase are addressed (may be constructive or not) --> ex. egos, hierarchies, not liking a co-worker
- problem solving behavior occurs
28
according to Drinka, what are the symptoms of the Confronting Phase of IPC development? (12)
- can no longer avoid conflicts, some members verbally attack other members
- conflicts of leadership, equality, and commitment increase
- members feel anxiety over expression of affect
- address some conflicts directly
- some members withdraw from the team
- search for leader who will resolve conflicts
- functional leaders emerge
- realize that power is not equal
- realize that everyone has power for leadership and decision making
- conflicts lead to constructive confrontation
- team re-clarifies goals and rules
- form coalition that change according to needs of the team
29
according to Drinka, what are the interventions of the Confronting Phase of IPC development? (12)
- bring team conflicts to team forum or proces leader, process leader mediates
- identify, clarify, and assign informal leadership roles
- encourage expressions of affect - positive & negative
- encourage practice of constructive confrontation --> focus on solutions to problems
- review reasons for leaving, may be symptom of team dysfnxn
- identify members w skills and willingness to assume role of process analyzer
- identify & encourage informal leaders
- identify all potential power sources
- encourage members to recognize and assume power sources that are capable of assuming
- help the team discuss & resolve conflicts, regard as an opportunity for creative problem solving
- as a team, update goals, discuss roles & agree
- praise this as a sign of team growth
30
according to Drinka, transition from the Confronting to the Performing phase of IPC development occurs as...
- members establish that every person has power to make decisions and engage in constructive confrontation
31
according to Drinka, what may occur r/t the initial team goals in the Confronting stage of IPC development
- may be re-examined
32
according to Drinka, the team is Performing when the conflicts are...
- directed more at program development than at individual members
33
according to Drinka, what are symptoms of the Performing stage of IPC development (9)
- appreciate differences of members
- members encourage and help each other
- increase reality testing, team grows stronger
- norm is self-initiated active participation
- members trust each other & develop strong relationships
- members meet regularly and come on time
- see conflicts as normal and use as impetus for program improvement
- emphasize productivity and problem solving
- members responsible for leadership in teaching, wherever skills warrant it
34
according to Drinka, what are interventions for the Performing stage of IPC development (9)
- encourage the appreciation of member differences
- reinforce helping behaviors as part of the team's culture
- schedule open feedback of members to team
- praise informal leadership
- enjoy the relationships, offer to mentor new members
- reinforce regular & on time meeting as part of team culture
- reinforce the view of conflicts as normal as part of team culture
- reinforce productivity and problem solving as part of team culture
- reinforce members responsible for leadership in teaching as part of team culture & ensure all informal leadership roles are filled
35
according to Drinka, describe the duration of the Performing stage of IPC development
- doesnt last long as members come and go
36
according to Drinka, the Leaving phase of IPC development occurs when..
- an individual leaves
- or the team terminantes
*IPC team rarely fully dissolves, often involves departure of 1 member*
37
according to Drinka, the symptoms of the Leaving phase when 1 individual leaves include (6)
- individual may feel anger or sadness toward members or team in general
- members deny impending departure bc of disbelief and regret
- team express wish for member to remain w team --> want team to remain the same
- team may regress to earlier phase
- individual may express happiness over leaving team
- see value/pride in the teamwork
38
according to Drinka, the interventions for the Leaving phase when 1 individual leaves include (6)
- praise the member for team accomplishments
- wish members well in new endeavor
- as a team, discuss interim situation, plan for replacement
- accept the team's expression of wish for member to stay as a sign of signif loss to team, regard as potential ghost for team to address in future
- determine team's developmental phase, proceed from there (if regresses)
- accept that member is happy & team has a shortage to address
39
according to Drinka, the Leaving phase of IPC development occurs when..
- an individual leaves
*IPC team rarely fully dissolves, often involves departure of 1 member*
40
according to Drinka, the symptoms for the Leaving phase when the team terminants include (4)
- some members withdraw, depression & sadness result
- members express team's superiority
- express feelings as testimonials
- affirm team membership as valuable
41
according to Drinka, the interventions for the Leaving phase when the team terminates include (4)
- develop team & personal plan of action
- celebrate and record the team's accomplishments
- listen & encourage team members to express their feelings and plan for their future
- celebrate w an eye to the future
42
according to Drinka, are all members in the same phases of IPC development?
- no, members can all be in different phases depending on if are new, full-time, like working in teams, etc.
43
according to Drinka, what determines which phase the overall team is in?
- the phase which the most members are currently in
44
according to Drinka, what are the challenges to IPE? (6)
- disciplinary dominance
- academic arrogance
- professional power
- IPE lite
- resource requirements
- continuous commitment
45
according to Drinka, what is included under the Disciplinary Dominance challenge to IPE? (2)
- healthcare disciplines have cultural, linguistic, and epistemological differences
- unless al disciplines prioritize IPE it may fail --> requires coordination and shared goal
46
according to Drinka, what is included under the Academic Arrogance challenge to IPE? (2)
- certain healthcare disciplines may feel superior to others (often medicine)
- IPC approach lvls the playing field and may threaten people who wish to dominate in a clinical setting
47
according to Drinka, what is included under the Professional Power challenge to IPE? (3)
- IPC seeks to distribute power equally
- disciplines in power (ie medicine) are statistically more likely to have poor IPE particiption
- physicians may believe they are able to overrule care plans created by the team
48
according to Drinka, what is included under the IPC Lite challenge to IPE? (3)
- professors may jump on the IPE bandwagon for personal or professional gain
- when IPE stops being a trending topic at their institution they lose interest and stop supporting the initiative
- grant funding may not support IPE initiatives longterm
49
according to Drinka, what is included under the Resource Requirements challenge to IPE?
- grant funding must be paired w genuine support from admin in order to be a longterm component of healthcare program
50
according to Drinka, what is included under the Continuous Commitment challenge to IPE? (2)
- programs must have longterm focus
- must be supported by more than 1 main person
51
what are the key concepts found in Lawlis (3)
- populations impacting IPE
- various factors cam serve as barriers or enables to IPE implementation
- 5 key fundamental elements that inhibit or enhance IPE success/sustainability (successful programs typically have 1 or more of these)
52
according to Lawlis, what populations impact IPE (3)
- government & professional
- institutional
- & individual stakeholders
53
according to Lawlis, the government and professional populations that impact IPE refer to...? what are examples of this population (2)?
- encompass the top-lvl stakeholders that influence the incorporation of IPE into higher education health professional degree programs
ex. government organizations and accreditation boards
54
according to Lawlis, the institution population that impacts IPE refers to... what is an example of this population?
- the areas within a higher education instituion that influence the embedding of IPE into the health professional education
ex. mngmt
55
according to Lawlis, the individual population that impacts IPE encompasses... (3)
- staff
- instructors/educators/professors
- and/or students
all of which can positively or negatively impact the embedding of IPE into the health professional curriculum 1
56
according to Lawlis, what are the categories of barriers to implementing IPE?
- gvmt and professional
- institutional
- individual
57
according to Lawlis, what are the gvmt and professional barriers to implementing IPE (2)
- lack/limited financial resources
- changes within the organizations and higher education institutions involved
58
according to Lawlis, what are the institutional barriers to implementing IPE? (6)
- lack/limited financial resources
- lack/limited support
- limited faculty development initiatives
- scheduling of IPE within current program (health professional degree calendars -- different lengths of degree year, different degree time-tables, rigid/condensed curriculum)
- extra-curricula versus required course/unit
- differences in assessment requirements
59
according to Lawlis, what are individual barriers to implementing IPE (10)
- faculty attitudes
- lack of reward for faculty
- high workload (including teaching & admin)
- lack/limited knowledge about other health professions
- not understanding IPE concept
- lack of perceived value
- diff student learning styles
- "turf" or professional battles
- bias towards own profession
- lack of respect towards other HCP
60
according to Lawlis, what are the categories of enables to IPE (3)
- gvnmt & professional
- institutional
- individual
61
according to Lawlis, what are the categories of enables to IPE (3)
- gvnmt & professional
- institutional
- individual
62
according to Lawlis, what are the gvnmt/professional enables to IPE (4)
- establishment of collaborative groups from diff higher education institutions and organizations
- stakeholder commitment
- shared ownership and unified goals
- gvmt funding
63
according to Lawlis, what are the institutional enablers to IPE (3)
- funding by organizations
- organizational structures within higher education institutions developed
- faculty development programs
64
according to Lawlis, what are the individual enablers to IPE (8)
- skill of the facilitator
- enthusian of facilitator/staff
- staff as role models
- champions for IPE within a student group or faculty
- commitment
- understand of IPE and CP
- shared interprofessional vision
- showing of equal status regardless of position or background
65
according to Lawlis, what are the 5 key fundamental elements that inhibit or enhance IPE success/sustainabiliy
- gvmt funding
- higher education institution fundings
- faculty development programs
- higher education institution organizational structures to support the embedding of IPE into health professional curricula
- staff ownership and commitment across all disciplines involved in IPE program s
66
what are the 9 Belbin Team Roles?
- resource investigator
- teamworker
- co-ordinator ( the social roles)
- monitor evaluator
- specialist (the thinking roles)
- shaper
- implementor
- completer finisher (the action or task roles)
67
what are the thinking roles of the 9 Belbin Team Roles (3)
- plant
- monitor evaluator
- specialist
68
what are the action roles of the 9 Belbin Team Roles (3)
- implementer
- shaper
- completer finisher
69
what are the People roles of the 9 Belbin Team Roles (3)
- resource investigator
- teamworker
- co-ordinator
70
describe the role of the resource investigator
- uses their inquisitive nature to find ideas to bring back to the team
71
describe the role of the Teamworker
- helps the team to gel, using their versatility to identify the work required to complete it on behalf of the team
72
describe the role of the coordinator
- needed to focus on the team's objective
- draw out team members and delegate work appropriately
73
describe the role of the Plant
- tends to be highly creative and good at solving problems in unconventional ways
74
describe the role of the monitor evaluator (3)
- provides a logical eye
- makes impartial judgements where required
- weighs up the team's options in a dispassionate way
75
describe the role of the Specialist
- brings in-depth knowledge of a key area to the team
76
describe the role of the Shaper
- provides the necessary drive to ensure that the team keeps moving and does not lose focus or motivation
77
describe the role of the implementer
- needed to plan a workable strategy & carry it out as efficiently as possible
78
define: team
- a small number of people with complementary skills who are committed to a common purpose, set of performance goals, and approach for which they hold themselves mutually accountable
- focus: mutual and individual accountability
79
define: group
- a number of people assembled together or having some unifying relationship
- focus: individual goals and accountabilities
*use team over group on exam*
80
define: interprofessional education
- occasions when members or students of 2 or more professions learn with, from, and about each other to improve collaboration and the quality or care & services
*key words = with, from, and about*
81
what are some of the benefits of IPC/IPE (7)
- reduced wait times
- increasing pt safety
- better access to primary care
- chronic disease mngmt
- better human resource planning
- improve the health outcomes of clients
- meet the competencies for collaboration (collaborator role)
82
review D'Amour framework
83
what are considerations for effective IPE (5)
- intro IPE/IPC early in professional curricula or later?
- teaching & practicing the IPC competencies, skills of the facilitators
- creating relevant learning experiences (formal & informal) with a structured de-briefing opportunity (learning experiences can occur in healthcare context)
- non-threatening learning enviro --> learners should feel psychologically safe to express themselves openly (feeling like people might think they're stupid can reduce quality of learning, familiar people & safe enviro = increase confidence)
- develop the skill of reflective practice
84
reflective practice can occur...
- in action
- on action
85
describe reflection in action
- reshape what you are doing while you are doing it
86
describe reflection on action
- look back on experiences to improve for future events and encounters
87
what are some barriers to IPE (13)
- lack of & limited financial resources
- rigid cirriculum = leads to scheduling difficulties
- different degree timetables, high workload
- limited faculty development
- disciplines may not see others as equal (subordinate) --> "lvl playing" field could be threatening for some
- IPE can be marginalized and considered as an "add on"
- faculty attitudes & not understanding IPE concepts
- many academic units are familiar w working only in their "professional silos"
- lack of resources (human, financial)
- IPE seeks to distribute power (collab leadership), may be opposed by some
- supported by admin in theory, but not providing resources to make IPE happen
- long-term commitment for continued IPE --> needs to be woven into the academic curricula
- scheduling of IPE into current program
88
what are gvmt & professional regulatory bodies enablers to IPE (3)
- stakeholder commitment
- adequate funding
- shared ownership
89
what are organizational/institutional enablers to IPE (3)
- funding support
- faculty development
- developed organizational structures within higher education institutions
90
what are individual enablers to IPE (7)
- skill of the facilitator
- "champions"
- staff as role models
- commitment
- enthusiasm of staff
- understanding of IPE
- shared IP vision
91
according to the WRHA, what are imp characteristics to successful team functioning (6)
- mindful (of the impact of their role & actions)
- reflective (on how to improve their roles and actions within the team)
- respectful (of one's expertise)
- encouraging (the pt they're caring for to participate)
- pt centered (adjusting healthcare plans as needed)
- participating (in decision-making process and being inclusive in it)
honoring (team ethics)
92
according to the CIHC, what is including in team functioning (5)
- understand the process/stages of team development
- be respectful of the participation of all members
- reflect on team's functioning regularly
- reflect on team ethics
- develop set of principles for working together
93
what is a tame problem
- problem that can be easily defined
94
what is a wicked problem
- problem that is difficult to formulate, has more than 1 explanation, and if often a symptom of other problem
- often does not resolve w simple interventions
95
what are key messages from Dr. Cahn's article
4 structural competencies:
- values and ethics
- role and responsibilities
- IP communication
- teamwork
96
describe the dominant focus of pt centered care practices in medicine
- a holistic approach to care & individualization of care
97
describe the dominant focus of pt centered care practices in rehab sciences
- autonomy and partnership w pts in planning and implementing care
98
describe the dominant focus of pt centered care practices in nursing
- pts experiences and on the development of the therapeutic relationship w the pt
99
describe the dominant focus of pt centered care practices in social work
- client self-determination
100
what are 4 important characteristics of pt centered care
- integral partners (support participation in planning & implementation of care)
- education & support (that's approp to the needs of the pt)
- info sharing (respectful engagement, encouraging dialogue, take active role in healthcare decisions)
- active listening (understand expressed needs, adapt care to meet the needs)
101
what are the benefits of pt/family centered care (5)
- less pt falls on unit
- less med errors
- less readmissions
- less admissions from community or continuing care to ER
- increased pt engagement and satisfaction scored
102
what are common myths r/t pt centered care (5)
- pts and families are interested or able to talk about their care
- doctor knows best
- pts should get everything they want
- providing pt centered care is only the job of nurses
- to provide pt centered care we need to increase our staffing ratios
