Understanding Interprofessional Perceptions and Experiences: An Investigation of Professional Counselors and Allied Health Professionals
INTRODUCTION Interprofessional collaboration is essential to improve coordination, communication, quality, and safety of patient care. Interprofessional perception is an important variable in interprofessional collaboration as it can impact attitudes, ability to successfully engage in interprofessionalism, and willingness to engage. The study focuses on understanding perceptions and experiences of interprofessional collaboration of professional counselors and other allied health professionals. METHODS Participants were recruited online and through snowball sampling. The survey was taken by a diverse sample of healthcare professionals. The survey items consisted of demographic information, the 18 item Interprofessional Education Perception Scale (IEPS) and the 16 item individual construct subscale for the Perception of Interprofessional Collaboration Model Questionnaire (PINCOM Q) Chi Square and one way analysis of variance (ANOVA) was used to compare the groups on the IEPS and the PINCOM Q. RESULTS Results suggested that 31% of professional counselors had previous interprofessional education (IPE) and 41.4% reported that they had engaged in interprofessional clinical experience, and the majority of counselors have positive perceptions of interprofessional collaboration. Results from the ANOVA indicated that counselors have similar professional perceptions as other behavioral health professionals, however their professional beliefs are different from that of other allied health professionals. CONCLUSION Professional counselors are gaining experiences with interprofessionalism and seem to have positive perceptions of interprofessional collaboration. It is thought that the inclusion of professional counselors on interprofessional teams will not only affect the teams positively but also the clients that are served. Received: 11/24/2015 Accepted: 07/14/2016 (c) 2016 Johnson. This open access article is distributed under a Creative Commons Attribution License, which allows unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. H IP Understanding Interprofessional Perceptions and Experiences ORIGINAL THEORY RESEARCH 3(1):eP1095 2 Introduction Interprofessionalism, a paradigm for integrated social service and healthcare practice, is defined as "two or more professions working together as a team with a common purpose, commitment and mutual respect" (Dunston et al. 2009, p.6) Advances in health care practice and policy encourage practitioners to avoid operating in disciplinespecific silos in favor of regular communication and collaboration with other professionals involved in the provision of care to a shared client population (Pecukonis, 2014) Shifts in the way that mental health issues, chronic diseases, and provisions of culturally competent services to diverse populations are viewed have led to increased emphasis on service coordination across settings, disciplines, and communities of practice (Grumbach Bodenhelmer, 2004) These healthcare trends have led to the development and expansion of the interprofessional movement in the areas of research, education, training, and direct care (IECEP, 2011) However, complicating these new developments are practitioners who are either: a) not professionally ready to operate from an interprofessional perspective, b) have limited experience operating interprofessionally, and/or c) have negative attitudes towards interprofessional collaboration (Freshwater, Cahill, Essen, 2013) These negative attitudes have sometimes been linked back to siloed educational experiences in graduate school, misperceptions of other professions, or limited access to interprofessional collaboration in clinical settings (Johnson, Fowler, Kott, Lemaster, 2014) Strides have been made toward improving education experiences (e.g. IOM report on health professions education; Knebel Greiner, 2003) and incentivizing interprofessional collaboration in practice settings, such as the use of bundled payments and penalties for hospital re admittance. In addition to the practice changes mentioned above, research has highlighted perceptions of interprofessional providers, such as social workers and psychologists, in an attempt to understand perceptions from different behavioral health professions. Unfortunately, professional counselors who hold graduate degrees in counseling have been absent from the research literature in terms of their perceptions and experiences (Hawk et al, 2002; Sargeant, Loney, Murphy, 2008) Perception is an important variable in the discussion of interprofessionalism because positive or negative perceptions can influence attitudes, ability to successfully engage in interprofessionalism, and willingness to engage (Johnson, Fowler, Kott, Lemaster, 2014; Johnson, Haney, Rutledge, 2015; Leaviss, 2000) Interprofessionalism Interprofessional collaboration is an approach that was introduced to health care in the 1970s to improve coordination, communication, quality, and safety of patient Implications for Interprofessional Practice Counseling programs lack a focus on interprofessional education and practice. The findings from the study can be used to promote interprofessional education and practice in counseling programs. In addition, these findings suggest counselors hold a favorable view towards interprofessional collaboration. This can encourage further placements of counselors in training in such settings to increase their interprofessional experience. Furthermore, for other professional groups to include professional counselors on these interprofessional collaboration teams, awareness of the skills, knowledge, training, licensure, and scope of practice for professional counselors must be brought to the awareness of other professional groups in healthcare through education and clinical experiences. Lastly, continued efforts towards and need for interprofessional education and practice, can lead to changes in the accrediting standards set by CACREP, to incorporate interprofessionalism in all counseling programs. Describe implementation of an IPE activity in a challenging setting due to the rural location and lack of access to traditional health care facilities and disciplines H IP ISSN 2159 1253 Health Interprofessional Practice commons.pacificu.edu/hip 2(4):eP1095 3 care (Bridges et al. 2011; Conn et al. 2012) According to Reeves et al. (2010) interprofessional collaboration is a process for communication and decision making that enables the separate and shared knowledge and skills of care providers to synergistically influence the patient care provided. This process involves different professional groups working together and negotiating expertise in order to make positive contributions to health care (Zwarenstein, Goldman, Reeves, 2009) In addition, Arredondo et al. (2004) provided a comprehensive definition of interprofessional collaboration: Interprofessional collaboration refers to education, training, scholarship, practice, and other professional activities that prepare and call for professionals to work: (a) in a respectful, collaborative, integrative, and informed manner with members of other disciplines and professions; and (b) with individuals, groups, systems, and organizations that may have diverse values, ethical perspectives, or worldviews, and accountability to different constituencies (p. 789) The counseling profession is increasingly emphasizing collaboration as a best practice strategy for addressing social issues across school, family, and community levels (Lopez Baez Paylo, 2009) However, lack of clarity of professional roles and responsibilities from related disciplines and conflict over power and identity have led interprofessional collaborations to rarely involve professional counselors (King Ross, 2003) Additionally, stereotypes and misperceptions about professional roles and professional identity can impede collaborative efforts between counselors and other related professionals (Johnson, Fowler, Kott, Lemaster, 2014; Mellin, Hunt, Nichols, 2011) Despite the challenges, professional counselor involvement in interprofessional collaboration can increase advocacy for the profession and clients (Myers, Sweeney, White, 2002) Interprofessional Perceptions and Experience Interprofessional perceptions can be defined as social categorical judgments and are similar to stereotyping (Turner, 1999) Perceptions that health care providers have about one another are not all harmful and are considered a natural human process (Lidskog, Lofmark, Ahlstrom, 2008) However, negative perceptions and positive perceptions can either inhibit or enhance the group process. Understanding held perceptions allows organizations to work within the scope of the provider and also assist in garnering appropriate training for providers. As an example, Pollard and Miers (2008) reported on a longitudinal study of ten different professions after an interprofessional education intervention and found that perceptions of interprofessionalism changed for students who went through the intervention. Specifically, students' negative perceptions (or stereotypical views) shifted after the interprofessional intervention, and students reported more positive perceptions of interprofessionalism 9 12 months out of school. In addition, Pollard et al. (2006) found that as students many held negative perceptions about interprofessional interaction, but as qualified practitioners views shifted and individuals reported more positive perceptions. An interpretation of the results provided by the authors indicated that the opportunities for students to engage in interprofessional interaction is limited because they are not qualified practitioners and are usually in a supportive role and not in the role of independent provider (Pollard et al. 2006) This study and a later study highlight the importance of