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3. The Implementation of Interprofessional Education: A Scoping Review

Author

Bogossian, Fiona, New, Karen, George, Kendall, Barr, Nigel, Dodd, Natalie, Hamilton, Anita L., Nash, Gregory, Masters, Nicole, Pelly, Fiona, Reid, Carol, Shakhovskoy, Rebekah, and Taylor, Jane

Abstract

Introduction: Implementation of interprofessional education (IPE) is recognised as challenging, and well-designed programs can have differing levels of success depending on implementation quality. The aim of this review was to summarise the evidence for implementation of IPE, and identify challenges and key lessons to guide faculty in IPE implementation. Methods: Five stage scoping review of methodological characteristics, implementation components, challenges and key lessons in primary studies in IPE. Thematic analysis using a framework of micro (teaching), meso (institutional), and macro (systemic) level education factors was used to synthesise challenges and key lessons. Results: Twenty-seven primary studies were included in this review. Studies were predominantly descriptive in design and implementation components inconsistently reported. IPE was mostly integrated into curricula, optional, involved group learning, and used combinations of interactive and didactic approaches. Micro level implementation factors (socialisation issues, learning context, and faculty development), meso level implementation factors (leadership and resources, administrative processes), and macro level implementation factors (education system, government policies, social and cultural values) were extrapolated. Sustainability was identified as an additional factor in IPE implementation. Conclusion: Lack of complete detailed reporting limits evidence of IPE implementation, however, this review highlighted challenges and yielded key lessons to guide faculty in the implementation of IPE.

Published
2023
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12. Central Australian Aboriginal women's placental and neonatal outcomes following maternal smokeless tobacco, cigarette or no tobacco use

Author

Ratsch, Angela, Bogossian, Fiona, Burmeister, Elizabeth A., and Steadman, Kathryn

Subjects
Patient outcomes, Health aspects, Placenta -- Health aspects, Minority women -- Health aspects, Aboriginal Australians -- Health aspects, Pregnancy -- Patient outcomes, Tobacco products -- Health aspects, Australian aborigines -- Health aspects
Abstract

Maternal tobacco smoking and maternal exposure to combusted tobacco vapour are associated with adverse maternal, placental, foetal and neonatal outcomes, with sequelae through childhood and adolescence[sup.1?10] and into adulthood.[sup.11?16] Reducing [...], : Objective: To describe the placental characteristics and neonatal outcomes of Central Australian Aboriginal women based on maternal self?report of tobacco use. Methods: Placental and neonatal variables were collected from a prospective maternal cohort of 19 smokeless tobacco chewers, 23 smokers and 31 no?tobacco users. Results: Chewers had the lowest placental weight (460 g) while the no?tobacco group had the heaviest placental weight (565 g). Chewers and the no?tobacco group had placental areas of similar size (285 cm[sup.2] and 288 cm[sup.2] , respectively) while the placentas of smokers were at least 13 cm[sup.2] smaller (272 cm[sup.2] ). There were two stillbirths in the study and more than one?third (36%) of neonates (newborns) were admitted to the Special Care Nursery, with the chewers? neonates having a higher admission rate compared with smokers? neonates (44% vs. 23%). The cohort mean birthweight (3348 g) was not significantly different between the groups. When stratified for elevated maternal glucose, the chewers? neonates had the lowest mean birthweight (2906 g) compared to the neonates of the no?tobacco group (3242 g) and smokers (3398 g). Conclusions: This research is the first to demonstrate that the maternal use of Australian Nicotiana spp. (pituri) as smokeless tobacco may negatively impact placental and neonatal outcomes. Implications for public health: Maternal smokeless tobacco use is a potential source of placental and foetal nicotine exposure. Maternal antenatal screening should be expanded to capture a broader range of tobacco and nicotine products, and appropriate cessation support is required.

Published
2022
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