Interprofessional Healthcare Teams in the Military: A Scoping Literature Review.

Interprofessional Healthcare Teams in the Military: A Scoping Literature Review.

Mil Med. 2018 May 08;:

Authors: Varpio L, Bader KS, Meyer HS, Durning SJ, Artino AR, Hamwey MK

Abstract
Introduction: Research into healthcare delivered via interprofessional healthcare teams (IHTs) has uncovered that IHT can improve patient satisfaction, enhance collaborative behaviors, reduce clinical error rates, and streamline management of care delivery. Importantly, these achievements are attained by IHTs that have been trained via interprofessional education (IPE). Research indicates that interprofessional healthcare team training must be contextualized to suit the demands of each care context. However, research into the unique demands required of military IHTs has yet to be explored. For any form of IPE to be successfully implemented in the military, we need a clear understanding of how interprofessional healthcare team competencies must be tailored to suit military care contexts. Specifically, we must know: (1) What evidence is currently available regarding IHTs in the military?; and (2) What gaps in the evidence need to be addressed for IPE to be customized to meet the needs of military healthcare delivery?
Method: We conducted a scoping review of the literature was conducted to identify the breadth of knowledge currently available regarding MIHTs. A search of PubMed, EMBASE, PsycInfo, ERIC, DTIC.mil, and NYAM Gray Literature databases was conducted without date restrictions. The search terms were: (interprofessional* OR interprofessional*) AND (military OR Army OR Navy OR Navy OR Marines OR "Air Force" OR "Public Health Service") AND (health OR medicine). Of the 675 articles identified via the initial search, only 21 articles met inclusion criteria (i.e., involved military personnel, teams were medically focused, comprised at least two professional disciplines, and at least two people).
Results: The manuscripts included: seven original research studies, six commentaries, five reviews, one letter, one annual report, and one innovation report. Analyses identified three themes (i.e., effective communication, supportive team environments, members) related to successful MIHT collaborations and five related to unsuccessful MIHT collaborations (i.e., inability to develop team cohesion, lack of trust, ineffective communication and communication breakdowns, unaddressed or unresolved conflicts, rank conflicts). These manuscripts highlighted contextual factors that shape MIHTs. For example, MIHTs often work and live together for extended periods of time when deployed. Also, military rank can facilitate collaboration by establishing clear lines of reporting, but can problematize collaboration when inexperienced care providers (e.g., early career physicians) outrank other team members (e.g., medics) who have more experience providing care in deployment contexts.
Discussion: Given the experiences of military personnel can be perilous and unpredictable, the military has an obligation to study the unique contexts of care where interprofessional healthcare teams are employed. In doing so, better interprofessional education interventions can be tailored to better aid our service men, women, and their families.

PMID: 29741728 [PubMed - as supplied by publisher]

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