Established Evidence Results

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education, Patient-Centered Medical Home, Quality Improvement/Practice-Wide Intervention,

Intervention Description: pre-test, training intervention and tool guide, post test

Intervention Results: After completing the educational intervention to promote family and sibling adaptation in the NICU, the nurses' knowledge and perceptions were more favorable, and they implemented more nursing practices.

Conclusion: Based on the findings of our quality improvement project, the educational intervention could be offered to all NICU nurses working with families, as the positive attitudes of nurses are central to the implementation of FCC (Maree & Downes, 2016). FCC should be encouraged in NICUs as parental presence, educational sessions and participating actively in the care of preterm infants have been recently reported to improve both infant and parental outcomes (O'Brien et al., 2018), as well as the infants' medical outcomes (Lv et al., 2019). Visitors' programs in hospital centers to support FCC have reported significant results for parents (Lee et al., 2014). Policies in the NICU should encourage the parents' presence and participation in care and also include siblings and extended families, such as grandparents (Craig et al., 2015; Lee et al., 2014). If necessary, the visitation policy could be modified to promote parental presence, participation and partnership in FCC (Griffin, 2013). The design of the NICU can also support FCC (Maree & Downes, 2016). With the goal of expanding the reach of our training intervention, this quality improvement project is currently being turned into an online training program in order to be offered to all NICU nurses across the province. This project should be replicated with a larger sample of NICU nurses. Future research could also evaluate the parents' satisfaction with the FCC in the NICU using an instrument that includes all FCC principles (Dall'Oglio et al., 2018). Using FCC guidelines, the effect of training or educational programs on the family members' psychological and wellness outcomes should be evaluated (Davidson et al., 2017). Comparing the effect of FCC on the adaptation of different sibling age groups (i.e., 3 to 8 years old vs. 12 to 16 years old), as well as grandparents or even others deemed to be significant others by families during NICU hospitalization, would also contribute to the body of knowledge about FCC. Finally, nurses' perceptions of the benefits of implementing FCC in their practice could be further explored through a qualitative study. The findings of our project reinforce the importance of offering NICU nurses educational training programs to support them in their practice, as part of quality improvement processes. Our results support the main objective of the educational intervention, which was to develop the nurses' competencies in intervening with siblings and families in the NICU. This FCC educational intervention can significantly contribute to the quality of care offered to family members, including siblings, who have a preterm infant hospitalized at the NICU

Study Design: quality improvement project

Setting: NICU: a level III NICU in Montreal, Canada, with a capacity of 40 beds designed in pods - a level III NICU in Montreal, Canada, with a capacity of 40 beds designed in pods (intermediate and intensive care) and single-family rooms, where approximately 110 nurses work

Population of Focus: NICU Nurses - the nurses working in the NICU. A convenience sample of 20 nurses initially participated in the project, and 13 completed the post-intervention evaluation .

Sample Size: 20 nurses

Age Range: 23-44

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education, Patient-Centered Medical Home, Quality Improvement/Practice-Wide Intervention,

Intervention Description: common reading program in their first year. 12-16 months later, participate in focus groups discussions

Intervention Results: 5 primary themes - seeing family members as stakeholders, establishing common ground with peers and affirming the larger reason for graduate school, applying lessons from clinical practice that see the parient as a person, experiencing an emotional connections with a story and its characters, taking alternative perspectives/stepping into the shoes of the patient

Conclusion: Story can be a global way to construct meaning. In health care, health professionals must piece together the illness narrative to fully appreciate their client’s illness experience (Clark, 2014; Kleinman, 1988). A common reading program provides a means for helping interprofessional learners construct this narrative. Through shared reading and reflection on a fictional account, health professions students better understand the dimensions of illness, what it means to give and receive care, and the uncertainty of the human condition. This narrative, experiential approach for socializing entering graduate students to the health professions can serve to impart the values of patient-centered care from day one. When implemented in an integrative and comprehensive inter-professional education curriculum, it has the potential to encourage students to embrace the dual identity entailed by interprofessional professionalism. Facilitation of a common reading follows best practices in interprofessional learning by creating and sustaining group culture and role modeling reflection, values, and challenges to stereotypes (Barr, 2013; Bridges, Davidson, Odegard, Maki, & Tomkowiak, 2011; Carpenter & Dickerson, 2016; Interprofessional Education Collaborative, 2016; Institute of Medicine, 2015; Oandasan & Reeves, 2005). Although no known studies to date have evaluated the staying power of common reading programs, our findings mirror research in liberal arts education that suggest first-year seminars are best practice in the development of a holistic student, citizen, and lifelong learner (Association of American Colleges and Universities, 2007; Padgett, Keup, & Pascarella, 2013). A common reading appears to be a relatively low-cost, high-yield interprofessional educational activity that serves to develop health professions students’ knowledge, attitudes, and behaviors in patient-centered care. It is easily introduced into educational programs and bridges both uniprofessional and interprofessional learning. A common reading program can curtail typical alignment challenges between programs, timetables, and faculty (Barr, Helme, & D’Avray, 2014) since students complete the reading pre-matriculation and reflect on the reading during program orientation. It facilitates meaningful conversations across a variety of backgrounds and experiences, and translates contexts from academic to clinical education settings along the continuum of learning. A common reading may be an effective and lasting way for educators to establish a patient-centered, perspective-taking approach to care in pre-licensure health professions students. Assigning and facilitating discussion on a common reading imparts the message to students that the institution values the human aspects of care. It is an effective way to foster interprofessionalism and make patient-centered care explicit for novice health professionals. Themes elicited from this research suggest the staying power of this pedagogy in regard to perspective-taking, understanding family as stakeholders, and the importance of seeing the patient as a person. A common reading program allows the learner to engage with an illness narrative, connecting learner to patient and preparing students for collaborative practice.

Study Design: An exploratory case study approach using focus groups and thematic analysis was used to evaluate whether students’ attitudes about a literary account of illness endured a year after clinical and professional education

Setting: MGH Institute of Health Professions, an independent graduate school in Boston, Massachusetts, - second-year students in nursing, physical therapy, occupational therapy, and communication sciences and disorders (i.e., speech-language pathology) entry-level programs .

Population of Focus: second-year students in nursing, occupational therapy, physical therapy, and speech-language pathology - second-year students in nursing, physical therapy, occupational therapy, and communication sciences and disorders (i.e., speech-language pathology) entry-level programs .

Sample Size: 316 students from the four participating health professions programs, with representation from nursing, physical therapy, occupational therapy, and speech-language pathology . Additionally, 24 students agreed to participate in the focus group discussions, with the four professions represented as follows: nursing (n = 4), occupational therapy (n = 5), physical therapy (n = 8), and speech-language pathology (n = 7) .

Age Range: college students

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education, Patient-Centered Medical Home, Quality Improvement/Practice-Wide Intervention,

Intervention Description: We developed BBetter Together on the basis of adult learning theory to prepare providers to implement best practices in FCC. The training was delivered as six consecutive in-person workshops (30-hr total over 10 wk).

Intervention Results: Observed changes included improved reports of FCC implementation and increased self-efficacy in all MPOC domains, with medium effect sizes. These outcomes were positively interrelated.

Conclusion: BT training can enhance health care providers’ perceptions of FCC implementation and self-efficacy and minimize differences in FCC implementation by providers across expertise levels and practice settings. This study can inform the development of future FCC training interventions for providers, managers, educators, and researchers

Setting: Continuing education centers in Israel - The research was conducted in northern Israel

Population of Focus: medical professionals - occupational therapists, speech-language pathologists, physical therapists, and art therapists working in outpatient or school-based pediatric practices in Israel

Sample Size: 82 providers - 82 participants, including 68 occupational therapists, 9 speech-language pathologists, 2 physical therapists, and 3 art therapists .

Age Range: adults who provided care to children - The participants had a mean age of 37.3 years, with a range from 24 to 55 years .

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education, Patient-Centered Medical Home, Quality Improvement/Practice-Wide Intervention,

Intervention Description: attended ‘Me first’ training (‘Me first’ is a 1-day masterclass focused on understanding and promoting effective communication through a six-step model as well as tackling barriers to effective communication) and completed questionnaires across three time points: (1) prior to attending the training; (2) at the end of the training; and (3) 4–6 weeks later.

Intervention Results: A total of 28 training sessions of ‘Me first’ took place between March 2015 and May 2017. The Friedman test showed a statistically significant improvement in participants’ attitudes towards partnership working with PPs across the three time points. There were statistically significant increases in all four communication domains when comparing scores at time point 1 (prior to the masterclass) with scores at time point 3 (4–6 weeks later)

Conclusion: Future research should focus on whether ‘Me first’ training results in changes to shared decision making and satisfaction with care. Longer term follow-up should also be considered to examine whether improvements in attitude and behaviour are maintained for certain groups. Finally, intervention developers may wish to examine which behaviour-change techniques may be contributing to change.

Study Design: Attitude was measured using the Leeds Attitudes to Concordance II (LATCon II) scale, and communication skills were measured using the Effective Listening and Interactive Communication Scale (ELICS).

Setting: London clinic

Population of Focus: medical staff - 69 clinicians who participated in the 'Me first' training programme

Sample Size: 69 clinicians

Age Range: Adult medical staff providing care in pediatrics - The study focused on paediatric patients, defined as individuals up to the age of 18 years .

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education, Patient-Centered Medical Home, Quality Improvement/Practice-Wide Intervention,

Intervention Description: The educational intervention was a 3-part curriculum delivered over a 6-month period. The curriculum included: 1) monthly interactive in-person workshops 2) monthly emails outlining communication skills, tips for success and reminders about inperson training, 3) individualized family feedback from CAT data including average composite scores related to their peers scores suitable for self-reflection. In-person workshops were scheduled with attention to resident work hours

Intervention Results: In this pilot study, we found that an educational intervention using family feedback and deliberate practice over a 6-month period improved advanced communication skills in pediatric residents. CAT assessments demonstrated improvement in performance for all residents, but those who received our unique multimodal communications intervention demonstrated statistically significant change from pre to post assessment testing.

Conclusion: There are patient and self-identified performance gaps in communication skills for pediatric residents, underscoring the need for formalized curricula dedicated to these skills. Practice implications: Our study highlights the value of deliberate practice and the integration of family feedback as an educational tool in communication skills development.

Study Design: Pediatric residents at a large academic center were randomized into 2 groups. The intervention group received 6 educational sessions from 2019 to 2020, parent feedback of performance via the Communication Assessment Tool (CAT), and monthly communication tips. Communication skills of both groups were assessed at the end of the intervention

Setting: pediatric residents at a large academic center - pediatric residency program

Population of Focus: pediatric residents - first-year pediatric residents, with 38 residents participating in the research .

Sample Size: 38 students

Age Range: first year residents

Intervention Components (click on component to see a list of all articles that use that intervention): Provider Training/Education, Patient-Centered Medical Home, Quality Improvement/Practice-Wide Intervention,

Intervention Description: Pre-test for families and providers, provide Close Collaboaration with Parents training program to staff, post test by famliles and providers

Intervention Results: An educational intervention, Close Collaboration with Parents, succeeded in improving all elements of FCC in eight NICUs as reported by both staff and parents. This intervention was able to define and apply elements of FCC, such as decision making and mutual partnership, which have been challenging to capture and implement in earlier studies.

Conclusion: The educational intervention, which developed the receptive listening capacity and negotiation skills of the multi-professional NICU staff, increased the quality of all elements of FCC and enabled mutual partnership between parents and staff. In the future, more attention should be paid to involving all doctors in the FCC intervention. Based on our findings, systematic training is an effective way to facilitate implementation of FCC in entire NICU care. Importantly, this makes the benefits of the FCC available for all infants and families cared in a unit

Study Design: mixed-method pre–post intervention study in eight NICUs in Finland.

Setting: NICU: eight neonatal intensive care units (NICUs) in Finland

Population of Focus: NICU famlies and providers - medical staff in neonatal units, including managers (doctors and head nurses) and nurses, who participated in the Close Collaboration with Parents training program. In addition, parents who were available during the days of research visits were also invited to participate in the study .

Sample Size: 300+ - The number of staff members and patients in each unit varied, and the proportion of trained staff ranged from 46% to 100%. The total number of admissions per year across all eight units was 4,181 .

Age Range: NICU age - newborn infants