ارزيابي همكاري بين حرفه‌اي اعضاي تيم درمان: روانسنجي روبريك سنجش همكاري بين حرفه‌اي و پايلوت آن

Assessment of the interprofessional collaboration of healthcare team members: validation of Interprofessional Collaborator Assessment Rubric (ICAR) and pilot study

زمينه و هدف: توسعه آموزش و ارزيابي همكاري بين حرفه‌اي در سيستم‌هاي آموزش علوم پزشكي در جهت ارائه بهتر خدمات سلامت اهميت دارد. مطالعه حاضر با هدف ارزيابي همكاري بين حرفه‌اي اعضاي تيم درمان در اورژانس با استفاده از روبريك سنجش همكاري بين حرفه‌اي انجام شده است. در اين مطالعه روانسنجي روبريك سنجش همكاري بين حرفه‌اي (روايي، پايايي و تحليل عاملي تاييدي) نيز انجام شده است. روش ­ها: مطالعه توصيفي- مقطعي حاضر در دو فاز انجام شد. در فاز اول، روايي محتوايي، صوري و سازه‌اي روبريك سنجش همكاري بين حرفه‌اي تاييد شد. اين ابزار شامل 17 گويه در شش بعد اساسي همكاري بين حرفه‌اي شامل ارتباطات، همكاري، نقش و مسئوليت، كارتيمي، همكاري با بيمار و خانواده وي و مديريت تعارض است. پايايي روبريك با استفاده از انسجام دروني و تكرارپذيري (با استفاده از رويكرد آزمون- بازآزمون در دو هفته متوالي) بررسي شد. تحليل عاملي تاييدي از روش برآورديابي ML از نرم افزار EQS استفاده شده است. در فاز دوم ارزيابي همكاري بين حرفه‌اي از طريق مشاهده مستقيم اعضاي تيم درمان بخش اورژانس (شامل 70 نفر از دستياران، كارورزان و پرستاران) انجام شد. همچنين همكاري بين حرفه‌اي اعضاي تيم درمان با استفاده از آزمون‌هاي توصيفي (ميانگين و انحراف معيار) آناليز و از آزمون تحليل واريانس يكطرفه براي مقايسه بين گروه‌ها استفاده شده است. يافته‌ها: با توافقِ كليه شركت كنندگان (18 نفر از اعضاي هيئت علمي آموزش پزشكي، آموزش پرستاري و متخصصين باليني) روايي محتوايي و صوري ابزار تاييد شد (CVR> 0/49، 0/70

Background and Aim: Developing Interprofessional education and collaboration is important in systems of medical sciences to deliver better health care. The present study aimed to assess the validation of the Interprofessional Collaborator Assessment Rubric (ICAR) (validity, reliability and confirmatory factor analysis). Also, the interprofessional collaboration of the healthcare team members in emergency departments was evaluated by ICAR. Methods: This descriptive and cross-sectional study conducted in two phases. In the first phase, the face and content validity of ICAR was assessed. The Rubric includes 17 items in six domains including communication skills, collaboration, role and responsibility, teamwork, collaborative patient-centered approach, and conflict management). Also, a confirmatory factor analysis of Rubric was assessed. The reliability of the Rubric was evaluated by internal consistency and reproducibility (test-retest approach). The CFA assessed using Maximum Likelihood by EQS. In the second phase, the interprofessional collaboration of Emergency care team members (including 70 residents, interns, and nurses) were assessed by direct observations. Also, an inter-professional collaboration of healthcare team members was analyzed using descriptive tests (mean and standard deviation) and one-way analysis of variance was used to compare between groups. Results: The face and content validity of ICAR approved by consensus of 18 faculty members in medical education, nursing education and clinical specialties (CVI>0.70 and CVR>0.49). The reliability of Rubric approved by Cronbach's alpha =0.89 and ICC=0.80. The construct of Rubric confirmed in six domains through GFI=0.9, AGFI=0.9, CFI=0.976, RMSEA=0.06, χ2/df=1.88, χ2=195.78, df=104, P<0.001. The mean score of participants (including interns, emergency medical assistants, and nursing personnel) in the emergency department was 63.35 (17.53). There was a significant difference between the performance of three groups (nurses, interns and assistants) (p-value=0.03). Conclusion: The results of the present study showed that the scores of inter-professional cooperation of participants in the present study were lower than expected. It is recommended to plan and implement interprofessional training courses to improve inter-professional collaboration between healthcare providers in the study environment. Regarding, the confirmation of ICAR validation, it can be used to assess the interprofessional collaboration of participants.