FINAL EXAM Flashcards
Interprofessional Collaboration:
Six competency domains highlight the knowledge, skills, attitudes and values that together shape the judgments that are essential for interprofessional collaborative practice. These domains are:
- Role clarification;
- Team functioning;
- Patient/Client/Family/Community-Centered care;
- Collaborative leadership;
- Interprofessional communication;
- Interprofessional conflict resolution.
Learning Styles:
Nurses progress through five stages gradually as they gain more experience in patient care and become more competent:
-Novice, advanced beginner, competent practitioner, proficient practitioner, expert practitioner.
Teaching is an interactive process that involves learning.
Effective communication is essential to the teaching-learning interchange: listen empathetically, observe astutely, speak clearly.
Interpersonal variables are important-attitudes, values, culture, emotions, knowledge, motivation to teach and learn, personal learning style.
Domains of learning:
-Cognitive:
Intellectual learning: mind based-requires thinking and understanding: knowledge, comprehension, application, synthesis, and evaluation.
-Affective:
Feelings and acceptance of attitudes, opinions, and values: receiving, responding, valuing, organizing, characterizing.
-Psychomotor:
Motor skills: perception, set, guided response, mechanism, complex overt response, adaptation, origination.
Appropriate teaching methods based on domains of learning:
Cognitive: Discussion (one-on-one or group), lecture, question-and-answer session, role play and discovery, independent projects and field experience.
Affective: Role play, discussion (one-on-one or group).
Psychomotor: Demonstration, practice, return demonstrations, independent projects and games.
A profession exists to?
meet the needs of society. It provides services that are essential and desired by society.
A profession enters into a contract with society:
The profession promises to meet a set of identified needs better than any other group
Society gives the profession monopoly over the services it promises to provide
Transparency is important
A profession results in:
A monopoly over the services provided
Public recognition
Prestige; power; authority
Characteristics of a Profession
Education:
That is prolonged and specialized:
-Provides exclusive knowledge pertinent to the role that will be performed
-Fosters expertise – having a high level of specialized skill and knowledge
Expertise:
Is gained through ongoing education and research, and by practicing skills
Accountability:
Members of a profession are accountable for proving to society that they are faithful to the promises their profession makes
Competency and accountability in nursing imply
responsibility for all conduct and actions –
even collaborative ones
Means being answerable to someone for your actions
Society trusts nurses and gives us the right to self-regulation (autonomy), thus we are responsible and accountable for our actions
High levels of accountability= high levels of public trust in a profession
What are two mechanisms of accountability:
1.Codes of ethics
Are one of the criteria of a profession
Support professional members’ autonomous decision making and responsibility
Nurses are always responsible for their actions
2.Standards of practice
Are written documents that outline the minimum expectations for safe practice
Standards are used to guide and evaluate practice
Internal standards: developed within the profession e.g. the College of Nurses of Ontario’s Compendium of Standards of Practice
External standards: developed outside of the profession e.g. the Regulated Health Professions Act (RHPA) of Ontario
Accountability
Codes of ethics and standards of practice are accessible to the public
The courts are guided by a profession’s standards of practice and its code of ethics when a member’s conduct is questioned
What is autonomy?
Means self-governing (self-regulating)
Individual autonomy in professional practice
Professional autonomy – e.g. self-regulating
Means the profession runs and governs its professional colleges
Self-regulation provides professional autonomy
One mechanism of regulation is title protection:
oImportant for the public because it implies that anyone who says they are a member of the profession has the basic level of competency to practice in the manner identified by the regulating body
What is Autonomy in nursing?
Nurses are both ethically and legally required to practice autonomously
This provides a safeguard for the public
The purpose of autonomy in any profession is to protect the public – in nursing’s case, to keep the patient safe from harm
Does not mean we have complete control over every aspect of our practice
Autonomous practice is professional practice and is an ethical imperative – doing something simply “because the doctor said so” is unsafe practice
What is Authority?
Refers to government granting power to a profession to have the autonomy to conduct its affairs:
E.g. determining educational requirements
E.g. granting a license to practice
E.g. disciplining a member
What is Unity?
Means a sense of belonging, of sharing the same professional values, beliefs and worldviews
Members come together to fulfill the profession’s promises to the public
Members form professional relationships / associations to promote, nurture and support professional goals
What is Interprofessional education (IPE):
Is when “two or more professionals learn with, from, and about each other across the spectrum of their life-long professional educational journey to improve collaboration, practice, and quality of client-centered care”.
What is intraprofessional education (IPE):
IPE is the most recent health human resources education reform initiative in Canada (Health Canada, n.d.; Oandasan & Reeves, 2005).
Demands on health care are increasing in Canada related to:
- Increases in chronic diseases e.g. diabetes, mental illness, heart disease, respiratory disease
- Improved chronic disease management
- An aging population
- Longer life expectancy
At the same time, health care organizations are
asked to provide:
- High quality, safe, and timely patient care
- Care that is decided upon in partnership with patients and families
- All of the above within finite human and financial resources
What is Interprofessional collaboration (IPC)
Is the provision of comprehensive health services to patients by multiple health caregivers who work collaboratively to deliver quality care within and across settings
IPC is a care model offering a team based approach to care:
-Members include everyone who has contact with the patient:
-Regulated and unregulated care providers
Housekeeping and dietary staff, porters
The patient’s family
-The patient is central and is the most important team member
IPE sows the seeds for effective IPC:
- Provides opportunities to learn about one another’s roles and scopes of practice
- Provides you with an understanding of one another’s similarities and differences
- It exposes myths and misunderstandings about one another
- Lays the groundwork for development of mutual respect and trust among team members
- Fosters effective communication and working partnerships
- Very importantly, encourages you to acknowledge, honour and respect the client as the expert knower of self
What are the four stages of group development?
1.Forming
2.Storming
3.Norming
4.Performing
No set time for the stages. May seem that some
group members move back and forth between two or
more stages.
What is forming?
1.Forming: coming together for the first time
New introductions: polite but impersonal – getting to know each other – cautious
Learning more about the work – needs and deadlines
Forming group goals
Organizing the work and getting to know one another’s strengths/skills
Forming group relationships - “figuring out where I fit”
What is storming?
2.Storming: conflict
Resistance to teamwork and collaboration
May be overt - e.g. open verbal hostility; negative body language; bullying; power struggles, impatience
May be covert – e.g. not sharing information, not including all members in decision making, re-doing another member’s work, frustration
Some members may be absent, others may be apathetic
What is Norming?
3.Norming: cohesion, collaboration, commitment
Confront issues and problems constructively
The work is the primary focus - the group organizes itself around the work
Develop rules for effective group work and clarify goals
Firm up/ establish member roles and responsibilities
Increased feeling of comfort within/with the group
What is Preforming?
4.Performing: getting the work done
Group members are productive
Members are flexible in their roles, and support one another in getting the work done
Members are collaborative – respect one another
Group pride in what is being achieved together
Group pride in quality work
Effective group development requires three conditions. All group members must?
- Trust one another
- Have a sense of group efficacy:
A “yes we can - yes we will” attitude about the group’s ability to work well together
3.Believe the group as a whole performs better on the project/assignment than individuals working on their own
What is not helpful to group process?
- The agressor/dominator – destroys others self-esteem
- Miss/Mr. Negative – finds fault with everything
- The blocker – could fill a book with reasons against
- The recognition seeker – “focus on me”
- The self-confessor – seeking group therapy
- The silent one – non contributor
- The know it all – “I’m right as usual”
- The playboy/playgirl - group work as a means of developing flirting skills
- The latecomer – no respect for the group
- The gossip – undermines group cohesion
- The scapegoater – “I thought you were doing it”
Establish rules from the outset:
–To demonstrate common manners and show consideration toward one another
–For decision making
–For member roles and responsibilities
–For a timeframe to re-visit all of the above
Recognize who group members are:
–The extrovert
–The introvert
What are extroverts?
Extroverts are the talkers
•They think out loud – form thoughts as they talk
•May share partially formed ideas
•Often move quickly from one thought to the next
•Gain energy from past paced conversations
•May share an idea just to get a reaction – doesn’t necessarily mean they believe what they say
•Extroverts usually do their best work when they can think and talk and work all at the same time.
What are introverts?
Introverts are the quiet ones
•They think before talking
•Want to give their best answer so take their time answering
•Prefer to share only fully formed ideas
•Use fewer words and choose their words
•Introverts usually do their best work in a quieter environment that allows them to think “in their heads”.
What are strategies for getting along:
Introvert?
Allow extroverts time to process thoughts out loud – recognize what the extroverts are doing. They aren’t just “yammering”
•Ask for a minute to think
•Take the initiative to make sure you are heard
What are strategies for getting along:
Extrovert:
- Allow introverts time to process thoughts in their heads. Recognize silence does not mean consensus
- Practice listening skills – take time to hear what’s said
- Be conscious of the need to slow down - ask one question at a time, and wait for a response
What are thinking styles?
–Intuitive
–Sensory
What does the Intuitive style thinker include?
Intuitive style thinker:
•Focuses on the big picture (i.e. end result/product)
•Is OK if a few steps get skipped in the process
•May jump to conclusions – may not weigh all the evidence
•Trusts intuition and often uses it to help solve problems
What does the Sensing style thinker include?
Sensing style thinker:
•Focuses on the details
•Believes every step of the process is important
•Categorizes and organizes data and summarizes key points
•Wants to explore and weigh all options
•Solves problems by collecting facts - can never have too much information – may lead to “analysis paralysis”
What are Strategies for getting along with
Intuitive style thinkers?
Strategies for getting along:
Intuitive style thinkers
•Be more patient with attention to detail
•Slow down – address each step
•Take time to learn the key facts
•Focus on the task at hand and be thorough with it
What are Strategies for getting along with
Sensing style thinkers?
Strategies for getting along:
Sensing style thinkers
•Take time to hear the ideas posed by intuitive thinkers
•Be open to listening to your own “gut”
•Set boundaries around data collection – be cognizant of how your work affects the timelines of others
Tools for effective group meetings As an individual are?
- Take responsibility for your share of the work - come prepared
- Take responsibility for making sure that what you mean to say is what is heard
- Practice your manners – please and thank you and common courtesy are appreciated by everyone
- Be open to different opinions and viewpoints
- Be an active participant
- Be committed to the group’s goals
- Be open to constructive criticism and be willing to give the same to others
- Never use feedback as a means to “settle a score” or make a point
- Respect other people’s work
- Never re-do or take over someone’s work
- Be patient during the storming stage – recognize it as part of a natural group process
- Demand respect
- Give respect
- Own your mistakes
- Know when laugh at yourself
- Walk your talk
Tools for effective group meetings As an group are?
As a group:
•Create ground rules at the outset
Write them down
Pull them out at every meeting
Use them!! Revise them periodically
Hold everyone to them
•Identify three top priorities at the start of each meeting
Write them down
Use the list to stay on topic
Treat the meeting as business – leave socializing for another time
Strive to hear what each group member has to say:
Ask each member in turn if they have anything to add
Summarize and confirm discussions
Clarify until everyone has the same understanding
Benner’s 5 Stages of Nursing Proficiency are?
Novice Advanced Beginner Competent Practitioner Proficient Practitioner Expert Practitioner
Interpersonal variables are important how?
Interpersonal variables are important – attitudes, values, culture, emotions, knowledge, motivation to teach and to learn, personal learning style
What are the Domains of Learning?
Cognitive
Intellectual learning: mind based - requires thinking & understanding
Affective
Expressions of feelings, acceptance of attitudes, opinions, values
Psychomotor
Motor skills based - involves acquiring skills that require the integration of mental & muscular activity
Learning may involve one or more (or all) domains
Cognitive learning: Includes all intellectual behaviours and requires thinking: the simplest behaviour is acquiring knowledge, whereas the most complex is evaluation. Cognitive learning includes the following:
- Knowledge: the learning of new facts or information and the ability to recall them.
- Comprehension: the ability to understand the meaning of learned material.
- Application: the use of abstract, newly learned ideas in a practical situation.
- Analysis: the breaking down of information into organized parts.
- Synthesis: the ability to apply knowledge and skills to produce a new whole.
- Evaluation: a judgement of the worth of information given for a specific purpose.
