Electronic Thesis and Dissertation Repository

Thesis Format

Integrated Article

Degree

Doctor of Philosophy

Program

Nursing

Supervisor

Orchard, Carole

Abstract

Enhancement of healthcare systems has increased the demand for healthcare practitioners (HCPs) to share client care by functioning in a variety of roles within interprofessional teams. When these roles are integrated into team practice, the outcome can be collaborative sharing of client care responsibilities but without sharing, team members can experience uncertainty as to what their contributions should be. Understanding this shift in practice begins with role clarification, whereby HCPs have self-awareness about their own roles, and then gain an understanding of the roles of others in their collaborative practitioner groupings. Interprofessional role clarification (IPRC) is thought to be necessary for collaborative practice, but a paucity of literature and measurement instruments address its nature and processes, resulting in gaps that limit our knowledge. This study examined factors that potentially influence HCPs’ capacity to achieve IPRC when engaging with IP team members. Structural equation modelling was used to examine the relationships between contributing antecedents (general self-efficacy, conscientiousness, work engagement) and HCPs’ IPRC and furthermore whether these relationships were mediated by their work engagement and/or moderated by members’ reciprocity with team members. The competency of IPRC require further development; this study began with a concept analysis of role clarification as a means to identify its attributes to generate instrument items, followed by psychometric testing of an instrument designed to measure its effectiveness in licensed HCPs. The model was tested using a convenience sample of 238 HCPs from 15 licensed professions who provided client care. The preliminary model demonstrated a reasonably good fit [X2 (df) = (111.65/48) = 2.33, p

Summary for Lay Audience

When providing healthcare, those providing the care work must work well together to ensure that the care is safe, effective and takes clients’ needs and wishes into account. When care providers (HCPs) from two or more healthcare professions work together to share the care for a patient, this is referred to as interprofessional collaborative care. Research suggests HCPs working within a healthcare team must fully understand their own professional roles and the roles of other professions because without this understanding, problems can develop between team members and can negatively affect patient care. Clarifying roles within the IP team has been recommended as a necessary competency for HCPs, however, there is limited research to back this claim. The intent of this research study was to explore factors that could contribute to interprofessional role clarification (IPRC). No instrument to measure IPRC was found, therefore, the Interprofessional Role Clarification Scale was developed for this study. In total, 238 HCPs from 15 licensed healthcare professions participated in this study. A concept analysis of IPRC was completed to help define IPRC and outline its antecedents, attributes and consequences. A literature review explored IPRC with possible links to conscientiousness, general self-efficacy (GSE), work engagement, and reciprocity with coworkers within a proposed framework. The results indicated that HCPs overall reported only a midrange level of IPRC, with room to improve it. Of all the concepts mentioned above, only GSE had a significant impact on IPRC; this meant that as HCPs level of GSE went up, their level of IPRC also went up. If we can guide HCPs in building their self-efficacy, this could raise their levels of IPRC and provide further insight into role clarification. These contributions could help to facilitate development of IPRC as a key component in team building as well as a professional competency.This in turn, could be valuable for HCPs, healthcare organizations, post-secondary healthcare education, and future research.

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License

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