Research Tag

Introduction

Interprofessional learning (IPL) and Quality Improvement Education (QIE) are increasingly recognized as important tools to improve performance of U.S. healthcare teams and address the changes the U.S. healthcare system and the Continuing Professional Development (CPD) system are undergoing (Hager, Russell, Fletcher, & Macy Jr, 2008; IoM, 2010; Macy, 2013; WHO, 2010). The need for change is clear: Healthcare is increasingly delivered by teams, yet healthcare teams are not trained as teams or familiar with team-based quality improvement (QI) methodology – and therefore their ability to address the need for quality improvement is limited.

Figure 1. Rising interest in IPL. Source: CIHC (2008)

To address that gap, the Institute of Medicine concluded that professional development of the healthcare workforce and healthcare system should be analyzed together. To improve our healthcare outcomes, it is important to better align the transformation of healthcare workforce CPD with the massive reform of the U.S. healthcare system, and ensure widespread adoption of IPL (IoM, 2015).

This research aims to contribute to that goal by finding how QIE and IPL are perceived by four professions participating in the perioperative team (physician anesthesiologists, surgeons, nurse anesthetists and anesthesiologist assistants), and which QIE- and IPL-related technologies and practices each profession involved in the research have available or plan to implement soon. Results of this research will help healthcare leaders better plan implementation of technology-enhanced QIE and IPL in the context of the perioperative team. In addition, although the perioperative context is specific, a significant part of the findings will be applicable to other interprofessional healthcare teams.
I believe that the research will show that technology-enhanced QIE and IPL are in many ways related to networked learning, and that their successful implementation will require creation of networked learning communities.

Interviews

Sample size

Literature states that there is “no prescriptive sample size for a phenomenographic study” (Yates, Partridge, & Bruce, 2012, p. 103). Bowden (2005) suggested that the sample should be large enough to find sufficient variation in perceptions, but small enough that the amount of data is manageable. A concept close to sufficient variation in perceptions is the saturation point. Research will achieve the saturation point when additional perceptions cannot be detected (Kaapu & Tiainen, 2012).

Following that recommendation, I plan to interview 5-8 members of each of the four groups: physician anesthesiologists, nurse anesthetists (NA), anesthesiologist assistants (AA) and surgeons.. Optimally, the majority of participants (~60%) will be members and leaders who are clinically active. The rest will be CPD professionals and staff leaders (for example, a CEO).

Interview questions

The questions below were selected to provide the critical variation among participants. Those variations will be categorized and organized in an outcome space (Cope, 2004).

1. Can you please reflect on your previous experience of working in multi-professional teams?
2. How would you describe IPL and QIE? For example, what is the purpose of each? Is it the same purpose?
3. What are the differences or similarities?
4. How about benefits and challenges?
5. Can technology help us address those challenges, or enhance the benefits? If yes, how?
6. What, in your opinion, are the most important benefits and challenges associated with perioperative surgical home (PSH)?

Reference

Bowden, J. A. (2005). Reflections on the phenomenographic research process. In J. A. Bowden & P. Green (Eds.), Doing Developmental Phenomenography. Melbourne, Victoria: RMIT University Press.

Cope, C. (2004). Ensuring validity and reliability in phenomenographic research using the analytical framework of a structure of awareness. Qualitative Research Journal, 4(2), 5-18.

Kaapu, T., & Tiainen, T. (2012). Phenomenography: Alternative Research Approach for Studying the Diversity of Users’ Understandings. Paper presented at the European Conference on Information Systems, http://aisel.aisnet.org/ecis2012/29.

Yates, C., Partridge, H., & Bruce, C. (2012). Exploring information experiences through phenomenography. Library and Information Research, 36(112), 96-119.

Research questions

As the literature review shows, education focused on quality improvement of clinical practice and IPL has been grabbing our attention for more than half a century, and there is a wealth of publications on that topic. However, very few changes were accepted. It is fair to say that QIE/IPL are still in the early stages. On the other hand, recent strong political-economic forces and technology-enhanced learning solutions have created an environment that can enable implementation of QIE and IPL on a scale that was never possible before. Therefore, the research questions are:

1. How are QIE/IPL and technologies and policies that shape QIE/IPL perceived by four groups involved in perioperative teams: anesthesiologists, surgeons, anesthesiologist assistants and nurse anesthetists?
2. How is technology-enhanced collaborative learning used and perceived in the context of QIE/IPL and perioperative teams?
3. How are professional cultures and contextual factors related to collaborative learning influencing implementation of technology-enhanced QIE/IPL?

Answers to those questions will help us better utilize technology to support QIE/IPL, to the benefit of all healthcare professions involved, and their patients; it will help us understand cultural and contextual factors so we can navigate more quickly and safely to successful QIE/IPL programs.