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Interprofessional Learning to Improve Communication in Challenging Healthcare Conversations

What Clinicians Learn From Each Other

Bell, Sigall K. MD; Langer, Thorsten MD; Luff, Donna PhD; Rider, Elizabeth A. MSW, MD; Brandano, Jessica MS; Meyer, Elaine C. PhD, RN

Journal of Continuing Education in the Health Professions: Summer 2019 - Volume 39 - Issue 3 - p 201–209
doi: 10.1097/CEH.0000000000000259
Original Research
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Introduction: Although contemporary health care involves complex interactions among clinicians of varying professions, opportunities to learn together are relatively few. The authors assessed participants' views about the educational value of learning with colleagues of mixed health care professions in communication and relational skills training focused on challenging conversations.

Methods: Between 2010 and 2013, 783 participants enrolled in 46 workshops hosted by the Institute for Professionalism and Ethical Practice at Boston Children's Hospital, Boston, USA. Participants received pre–, post–, and 3-month follow-up questionnaires with quantitative and qualitative questions about their experiences learning with clinicians of varying professions (“interprofessional learning”). Descriptive statistics and chi-square tests were used to compare participant groups. Responses to open-ended questions were coded according to standard principles of content analysis.

Results: Seven hundred twenty-two (92%) participants completed surveys. Previous interprofessional learning was reported by 60% of respondents, but generally comprised <30% of their education. Clinicians with <3 years of work experience were least likely to have previous interprofessional learning. Nearly all (96%) participants reported interprofessional colleagues contributed valuably to their learning. Asked specifically what they learned, participants described five themes: Stronger Teamwork, Patient-Centered Focus, Specific Communication Skills, Content-Specific Knowledge, and Shared Global Values. After 3 months, 64% of respondents reported that workshop participation helped make their interactions with interprofessional colleagues more collaborative.

Discussion: Communication skills training for challenging health care conversations is a valuable opportunity for interprofessional learning and generates sustained positive attitudes about collaboration. Clinicians learn from their colleagues a deeper understanding of each other's professional roles, challenges, and unique contributions; specific communication approaches; and a sense of belonging to a collaborative community reinforcing the patient at the center of care.

Dr. Bell: Associate Professor, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, and Associate Professor, Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Harvard Medical School, Boston, MA. Dr. Langer: Research Associate, Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Harvard Medical School, Boston, MA, and Attending in Pediatric Neurology, Department of Neuropediatrics and Muscle Disorders, Center for Pediatrics, Faculty of Medicine, University of Freiburg, Freiburg, Germany. Dr. Luff: Associate Director, Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Harvard Medical School, Boston, MA. Dr. Rider: Director of Academic Programs, Assistant Professor, Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Harvard Medical School, Boston, MA, Director of Academic Programs, Assistant Professor, Department of Pediatrics, Harvard Medical School, Boston, MA, and Director of Academic Programs, Assistant Professor, Division of General Pediatrics, Department of Medicine, Boston Children's Hospital, Boston, MA. Dr. Brandano: Senior Clinical Coordinator, Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Harvard Medical School, Boston, MA, and Senior Clinical Coordinator, Department of Psychology, Simmons College, Boston, MA. Dr. Meyer: Senior Attending Psychologist, Associate Professor, Institute for Professionalism and Ethical Practice, Boston Children's Hospital, Harvard Medical School, Boston, MA, and Senior Attending Psychologist, Associate Professor, Department of Psychiatry, Boston Children's Hospital, Harvard Medical School, Boston MA.

Correspondence: Thorsten Langer, MD, Department of Neuropediatrics and Muscle Disorders, Center for Pediatrics, Faculty of Medicine, University of Freiburg, Mathildenstr. 2, 79106 Freiburg, Germany; e-mail: thorsten.langer@uniklinik-freiburg.de.

T. Langer received a grant by the Deutsche Forschungsgemeinschaft/German Research Foundation (LA-2344/2-1). The remaining authors declare no conflict of interest.

S. K. Bell and T. Langer are co-first authors.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jcehp.org).

Received June 23, 2018

Accepted May 28, 2019

© 2019 Lippincott Williams & Wilkins, Inc.
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