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      Does PBL deliver constructive collaboration for students in interprofessional tutorial groups?

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          Abstract

          Background

          Training health professional students in teamwork is recognized as an important step to create interprofessional collaboration in the clinical workplace. Interprofessional problem-based learning (PBL) is one learning approach that has been proposed to provide students with the opportunity to develop the necessary skills to work collaboratively with various health professionals. This study aimed to explore the extent to which students in interprofessional tutorial groups demonstrate constructive collaboration during group discussions.

          Methods

          Students ( N = 52) from the Medical, Midwifery and Nursing programmes took part in the study. Video-recordings were made of interprofessional PBL discussions ( N = 40) in five groups, eight videos per group. Over a period of 4 weeks, participants discussed four scenarios concerned with the reproductive system. The resulting 67 h of video data were analysed qualitatively. To ensure inter-rater reliability, two tutors assessed the students’ constructive, collaborative activities using the Maastricht Peer-Activity Rating Scale (MPARS). Finally, to gain an understanding of students’ perceptions of their performance and participation in the interprofessional PBL tutorial, we organized three uni-professional focus groups (FGs) at the end of pilot project.

          Results

          The translated MPARS was reliable (Kappa coefficient 0.01–0.20 and p < 0.05). Students were actively involved in the discussion and contributed to a better understanding regardless of their professional background. Group members from different professions complemented one another in solving learning issues. They were open, feeling free to question and argue from the viewpoint of their own profession, and also understood their strengths and limitations. The statistical test of the scores for constructive and collaborative activities indicated a significant difference between students and the various healthcare professionals, p = 0.000, with medical students scoring highest on both activities. Focus groups further clarified some of the observed dynamics.

          Conclusion

          Implementing interprofessional PBL could motivate students to engage collaboratively in co-constructing knowledge to solve the patients’ problem. Medical students scored highest on constructive and collaborative activities.

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          Most cited references56

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          What fosters or prevents interprofessional teamworking in primary and community care? A literature review.

          The increase in prevalence of long-term conditions in Western societies, with the subsequent need for non-acute quality patient healthcare, has brought the issue of collaboration between health professionals to the fore. Within primary care, it has been suggested that multidisciplinary teamworking is essential to develop an integrated approach to promoting and maintaining the health of the population whilst improving service effectiveness. Although it is becoming widely accepted that no single discipline can provide complete care for patients with a long-term condition, in practice, interprofessional working is not always achieved. This review aimed to explore the factors that inhibit or facilitate interprofessional teamworking in primary and community care settings, in order to inform development of multidisciplinary working at the turn of the century. A comprehensive search of the literature was undertaken using a variety of approaches to identify appropriate literature for inclusion in the study. The selected articles used both qualitative and quantitative research methods. Following a thematic analysis of the literature, two main themes emerged that had an impact on interprofessional teamworking: team structure and team processes. Within these two themes, six categories were identified: team premises; team size and composition; organisational support; team meetings; clear goals and objectives; and audit. The complex nature of interprofessional teamworking in primary care meant that despite teamwork being an efficient and productive way of achieving goals and results, several barriers exist that hinder its potential from becoming fully exploited; implications and recommendations for practice are discussed. These findings can inform development of current best practice, although further research needs to be conducted into multidisciplinary teamworking at both the team and organisation level, to ensure that enhancement and maintenance of teamwork leads to an improved quality of healthcare provision.
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            The determinants of successful collaboration: a review of theoretical and empirical studies.

            Successful collaboration in health care teams can be attributed to numerous elements, including processes at work in interpersonal relationships within the team (the interactional determinants), conditions within the organization (the organizational determinants), and the organization's environment (the systemic determinants). Through a review of the literature, this article presents a tabulated compilation of each of these determinant types as identified by empirical research and identifies the main characteristics of these determinants according to the conceptual work. We then present a "showcase" of recent Canadian policy initiatives--The Canadian Health Transition Fund (HTF)--to illustrate how the various categories of determinants can be mobilized. The literature review reveals that very little of the empirical work has dealt with determinants of interprofessional collaboration in health, particularly its organizational and systemic determinants. Furthermore, our overview of experience at the Canadian HTF suggests that a systemic approach should be adopted in evaluative research on the determinants of effective collaborative practice.
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              The effects of problem-based learning during medical school on physician competency: a systematic review.

              Systematic reviews on the effects of problem-based learning have been limited to knowledge competency either during medical school or postgraduate training. We conducted a systematic review of evidence of the effects that problem-based learning during medical school had on physician competencies after graduation. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Databases, and the tables of contents of 5 major medical education journals from earliest available date through Oct. 31, 2006. We included studies in our review if they met the following criteria: problem-based learning was a teaching method in medical school, physician competencies were assessed after graduation and a control group of graduates of traditional curricula was used. We developed a scoring system to assess the quality of the studies, categorized competencies into 8 thematic dimensions and used a second system to determine the level of evidence for each competency assessed. Our search yielded 102 articles, of which 15 met inclusion criteria after full text review. Only 13 studies entered final systematic analysis because 2 studies reported their findings in 2 articles. According to self-assessments, 8 of 37 competencies had strong evidence in support of problem-based learning. Observed assessments had 7 competencies with strong evidence. In both groups, most of these competencies were in the social and cognitive dimensions. Only 4 competencies had moderate to strong levels of evidence in support of problem-based learning for both self-and observed assessments: coping with uncertainty (strong), appreciation of legal and ethical aspects of health care (strong), communication skills (moderate and strong respectively) and self-directed continuing learning (moderate). Problem-based learning during medical school has positive effects on physician competency after graduation, mainly in social and cognitive dimensions.
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                Author and article information

                Contributors
                endanglestari@unissula.ac.id
                r.stalmeijer@maastrichtuniversity.nl
                widyandana@yahoo.com
                a.scherpbier@maastrichtuniversity.nl
                Journal
                BMC Med Educ
                BMC Med Educ
                BMC Medical Education
                BioMed Central (London )
                1472-6920
                18 September 2019
                18 September 2019
                2019
                : 19
                : 360
                Affiliations
                [1 ]GRID grid.444258.b, Medical Education Unit, Faculty of Medicine, , Universitas Islam Sultan Agung, ; Semarang, Indonesia
                [2 ]ISNI 0000 0001 0481 6099, GRID grid.5012.6, School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, , Maastricht University, ; Maastricht, The Netherlands
                [3 ]GRID grid.8570.a, Department of Medical Education, Faculty of Medicine, , Gadjah Mada University, ; Yogyakarta, Indonesia
                Author information
                http://orcid.org/0000-0001-7275-2701
                Article
                1802
                10.1186/s12909-019-1802-9
                6751883
                31533721
                cd353a5f-6f4d-418d-9c1c-4b5e82fa10fe
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 10 May 2019
                : 9 September 2019
                Funding
                Funded by: Ministry of Research Technology and Higher Education of The Republic of Indonesia
                Award ID: 0100/E5.1/PE/2015
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Education
                interprofessional problem-based learning,maastricht peer-activity rating scale (mpars)

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