http://informahealthcare.com/jic ISSN: 1356-1820 (print), 1469-9567 (electronic) J Interprof Care, 2014; 28(5): 471–472 ! 2014 Informa UK Ltd. DOI: 10.3109/13561820.2014.900480
SHORT REPORT
A proposed interprofessional oath Sara Simpson Brown1,2, Jeannie Scruggs Garber1,2, Judy Lash1,2 and Abrina Schnurman-Crook3 1
Department of Nursing, Jefferson College of Health Sciences, Roanoke, VA, USA, 2Department of Interprofessionalism, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA, and 3Batten Leadership Institute, Hollins University, Roanoke, VA, USA
Abstract
Keywords
Identifying and capitalizing on shared professional values, health-care professionals have the potential to promote collaboration and facilitate enhanced patient outcomes. This paper describes a qualitative study that sought to identify values shared among health-care professionals through the development of an interprofessional health-care provider oath. Core competencies for collaborative practice of all health-care workers were delineated by the recent report from the Interprofessional Education Collaborative Expert Panel and these include values and ethics of collaboration as well as an understanding of team roles. This proposed interprofessional oath was developed from a qualitative analysis of oaths developed by interprofessional teams of health-care students. Using Colaizzi’s method, 18 oaths were evaluated to identify significant statements, formulated meanings, and themes. A proposed interprofessional oath was developed based on these elements and is offered for consideration along with discussion of the potential benefits and challenges of an interprofessional oath.
Collaboration, interprofessional ethics, interprofessional practice, qualitative research, shared models History Received 29 August 2013 Revised 9 January 2014 Accepted 28 February 2014 Published online 28 March 2014
Introduction
Methods
Collaboration among health-care professionals has never been more important than at this time. Identifying and capitalizing on shared professional values among health-care professionals have the potential to enhance collaboration and to facilitate enhanced patient outcomes (World Health Organization, 2010). This paper describes a qualitative study that sought to identify values shared among health-care professionals in the development of an interprofessional health-care provider oath. Core competencies for collaborative practice of health-care workers in the United States were delineated by the 2011 report of the Interprofessional Education Collaborative (IPEC) Expert Panel and include values/ethics for collaboration, understanding of the roles and responsibilities of team members, interprofessional communication, and teams and teamwork. The first competency is in the area of values and ethics for interprofessional practice suggesting collaborative competency includes an understanding of shared values and ethics among interprofessional team members (IPEC, 2011). Shared professional values for health-care providers include ‘‘altruism, accountability, excellence, duty advocacy, service, honor, integrity, respect for others and ethical and moral standards’’ (McNair, 2005, p. 458). It would be difficult to achieve adoption of a single code of ethics acceptable to each professional organization but an interprofessional oath that identifies shared values may be more readily accepted (Davis, 2003). Therefore, the purpose of this study was to describe the shared professional values of health-care professionals through the development of an interprofessional oath.
A qualitative approach was employed to examine oaths developed by interprofessional student teams. The study occurred during an interprofessional leadership course that is a joint endeavor between a college of health sciences and a medical school. The students were first-year medical students, first-year master’s physician assistant students, and senior baccalaureate nursing students who were assigned to interprofessional learning teams that completed team building activities, discussed roles and values, and set personal leadership goals. Each group had seven to eight members with two to three of each profession represented. After institutional review board approval, the students were given an assignment to create an interprofessional health-care professional oath. They were asked to analyze the values of various health-care professions, discuss which values were shared, and then compose an interprofessional health-care provider oath referencing the shared values. Oaths were submitted without identifiers. The oaths were analyzed following Colaizzi’s (1978) phenomenological method that included determination of significant statements, identifying corresponding formulated meanings, organizing theme clusters from the formulated meanings, and describing the investigated problem and structure of the phenomenon. The research team consisted of varied interprofessional faculty including two nursing professors, one leadership professor, and one physician assistant professor, three of which have backgrounds in psychology or social work.
Correspondence: Sara Simpson Brown, DNP, Jefferson College of Health Sciences, Nursing, 101 Elm Avenue, SE, Roanoke 24013, VA, USA. E-mail: [email protected]
Results Eighteen oaths were reviewed, from which 52 significant statements were extracted. The statements included concepts such as honesty, promoting health, research, respect for team members, faithfulness, compassion, equality, patient autonomy, privacy, confidentiality, beneficence, safety, and justice.
472
S. S. Brown et al. Proposed Interprofessional Oath
We make this oath in due faith and we recognize the unique role of being a healthcare professional and the associated responsibilities which include honesty, faithfulness, compassion and collaboration. We pledge to promote health in individuals and the community rather than just treating the sick. We will protect privacy and confidentiality. The patient is the ultimate priority and focus of our care. Our role is to empower, teach and promote health in the patient, treating all persons equally and appropriately. The patient is more than a body and we will benefit the patient rather than harm. Our care will be of the highest quality, safe, and based on evidence. We will seek to provide care within our scope of practice with ever-growing knowledge and skills. We will work with others to provide care, recognizing the unique skills of each and we will seek to collaborate effectively on the healthcare team.
Figure 1. Proposed interprofessional provider oath.
Sixteen formulated meanings were created from significant statements and were reviewed by the researchers for thoroughness and accuracy. Formulated meanings included making the oath in due faith, the patient as the ultimate priority and focus of care, working effectively with team members, and practicing in an evidence-based manner. Theme clusters The formulated meanings were organized into five identified themes. The first theme focused on teamwork and included collaborating with other professionals and expressing the commitment to work effectively on a team. The next theme included characteristics of the professional and their motivations for assuming the oath such as making the oath in due faith, recognizing the unique role and responsibilities associated with being a health-care professional. The third theme described the role of health-care professionals as promoters of health in individuals and communities. The fourth theme focused on the patient as having worth and ultimate priority and focus of care. The final theme focused on practice excellence and included mention of research, evidence-based practice, and practicing within one’s professional scope. The creation of an interprofessional oath Core shared values of interprofessional teams were identified and a framework was created for an interprofessional oath. A composite interprofessional oath was developed from the derived themes of each of the submitted oaths (Figure 1). The emergence of teamwork as a theme is a meaningful finding differing from previously published oaths. Due to the nature of the project, the composite oath was not returned to the participants for validation but was found to be consistent with the literature (IPEC, 2011; McNair, 2005).
Discussion There would be great difficulty in creating a universal code of ethics for health-care professions due to the associated political
J Interprof Care, 2014; 28(5): 471–472
factors and the differences in scopes of practice. An interprofessional oath could serve as a means of promoting collaboration which has the potential to improve patient outcomes and safety (WHO, 2010). The literature reveals that there is no interprofessional oath for all health-care providers but demonstrates the importance of the identification of shared professional values and its potential to enhance collaboration (Buetow & Adams, 2010). It appears the students are aware of shared values and are beginning to develop values that are precursors to collaborative practice. Limitations of this research include the use of students with limited health-care experience. Additional research could seek to explore acceptance of an interprofessional oath in health-care professionals. In summary, the creation of an interprofessional health-care professional oath could serve as a valuable exercise in aiding the development of values for competency in collaboration. Although much work is being done on the knowledge, attitude, and skills necessary for collaborative practice, continued work is needed to determine the themes and the strength of shared values of healthcare professionals. An interprofessional oath could offer a means of articulating shared values and promoting collaboration among health-care professionals.
Acknowledgements The authors would like to acknowledge Dr. Elizabeth Madigan, Associate Dean for Academic Affairs and Independence Foundation Professor at the Frances Payne Bolton School of Nursing, Case Western Reserve University, for her inspiration to conduct this project and to look at education and health care with new paradigms. This project was presented as a poster at Collaboration Across Borders IV, Vancouver, British Columbia, Canada.
Declaration of interest The authors report no conflicts of interest. The authors alone were responsible for the writing and content of this paper.
References Buetow, S.A., & Adams, P. (2010). Oath-taking: A divine prescription for health-related behaviour change? Medical Hypothesis Hypotheses, 74, 422–427. Colaizzi, P. (1978). Psychological research as the phenomenologist views it. In R.S. Valle & M. King (Eds.), Existential phenomenological alternatives for psychology. New York: Oxford University Press. Davis, M. (2003). What can we learn by looking at the first code of professional ethics? Theoretical Medicine, 24, 433–454. Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, DC: Interprofessional Education Collaborative. McNair, R.P. (2005). The case for educating health care students in professionalism as the core content of interprofessional education. Medical Education, 39, 456–464. World Health Organization. (2010). Framework for action on interprofessional education & collaborative practice. Geneva: World Health Organization.
Copyright of Journal of Interprofessional Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
SHORT REPORT
A proposed interprofessional oath Sara Simpson Brown1,2, Jeannie Scruggs Garber1,2, Judy Lash1,2 and Abrina Schnurman-Crook3 1
Department of Nursing, Jefferson College of Health Sciences, Roanoke, VA, USA, 2Department of Interprofessionalism, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA, and 3Batten Leadership Institute, Hollins University, Roanoke, VA, USA
Abstract
Keywords
Identifying and capitalizing on shared professional values, health-care professionals have the potential to promote collaboration and facilitate enhanced patient outcomes. This paper describes a qualitative study that sought to identify values shared among health-care professionals through the development of an interprofessional health-care provider oath. Core competencies for collaborative practice of all health-care workers were delineated by the recent report from the Interprofessional Education Collaborative Expert Panel and these include values and ethics of collaboration as well as an understanding of team roles. This proposed interprofessional oath was developed from a qualitative analysis of oaths developed by interprofessional teams of health-care students. Using Colaizzi’s method, 18 oaths were evaluated to identify significant statements, formulated meanings, and themes. A proposed interprofessional oath was developed based on these elements and is offered for consideration along with discussion of the potential benefits and challenges of an interprofessional oath.
Collaboration, interprofessional ethics, interprofessional practice, qualitative research, shared models History Received 29 August 2013 Revised 9 January 2014 Accepted 28 February 2014 Published online 28 March 2014
Introduction
Methods
Collaboration among health-care professionals has never been more important than at this time. Identifying and capitalizing on shared professional values among health-care professionals have the potential to enhance collaboration and to facilitate enhanced patient outcomes (World Health Organization, 2010). This paper describes a qualitative study that sought to identify values shared among health-care professionals in the development of an interprofessional health-care provider oath. Core competencies for collaborative practice of health-care workers in the United States were delineated by the 2011 report of the Interprofessional Education Collaborative (IPEC) Expert Panel and include values/ethics for collaboration, understanding of the roles and responsibilities of team members, interprofessional communication, and teams and teamwork. The first competency is in the area of values and ethics for interprofessional practice suggesting collaborative competency includes an understanding of shared values and ethics among interprofessional team members (IPEC, 2011). Shared professional values for health-care providers include ‘‘altruism, accountability, excellence, duty advocacy, service, honor, integrity, respect for others and ethical and moral standards’’ (McNair, 2005, p. 458). It would be difficult to achieve adoption of a single code of ethics acceptable to each professional organization but an interprofessional oath that identifies shared values may be more readily accepted (Davis, 2003). Therefore, the purpose of this study was to describe the shared professional values of health-care professionals through the development of an interprofessional oath.
A qualitative approach was employed to examine oaths developed by interprofessional student teams. The study occurred during an interprofessional leadership course that is a joint endeavor between a college of health sciences and a medical school. The students were first-year medical students, first-year master’s physician assistant students, and senior baccalaureate nursing students who were assigned to interprofessional learning teams that completed team building activities, discussed roles and values, and set personal leadership goals. Each group had seven to eight members with two to three of each profession represented. After institutional review board approval, the students were given an assignment to create an interprofessional health-care professional oath. They were asked to analyze the values of various health-care professions, discuss which values were shared, and then compose an interprofessional health-care provider oath referencing the shared values. Oaths were submitted without identifiers. The oaths were analyzed following Colaizzi’s (1978) phenomenological method that included determination of significant statements, identifying corresponding formulated meanings, organizing theme clusters from the formulated meanings, and describing the investigated problem and structure of the phenomenon. The research team consisted of varied interprofessional faculty including two nursing professors, one leadership professor, and one physician assistant professor, three of which have backgrounds in psychology or social work.
Correspondence: Sara Simpson Brown, DNP, Jefferson College of Health Sciences, Nursing, 101 Elm Avenue, SE, Roanoke 24013, VA, USA. E-mail: [email protected]
Results Eighteen oaths were reviewed, from which 52 significant statements were extracted. The statements included concepts such as honesty, promoting health, research, respect for team members, faithfulness, compassion, equality, patient autonomy, privacy, confidentiality, beneficence, safety, and justice.
472
S. S. Brown et al. Proposed Interprofessional Oath
We make this oath in due faith and we recognize the unique role of being a healthcare professional and the associated responsibilities which include honesty, faithfulness, compassion and collaboration. We pledge to promote health in individuals and the community rather than just treating the sick. We will protect privacy and confidentiality. The patient is the ultimate priority and focus of our care. Our role is to empower, teach and promote health in the patient, treating all persons equally and appropriately. The patient is more than a body and we will benefit the patient rather than harm. Our care will be of the highest quality, safe, and based on evidence. We will seek to provide care within our scope of practice with ever-growing knowledge and skills. We will work with others to provide care, recognizing the unique skills of each and we will seek to collaborate effectively on the healthcare team.
Figure 1. Proposed interprofessional provider oath.
Sixteen formulated meanings were created from significant statements and were reviewed by the researchers for thoroughness and accuracy. Formulated meanings included making the oath in due faith, the patient as the ultimate priority and focus of care, working effectively with team members, and practicing in an evidence-based manner. Theme clusters The formulated meanings were organized into five identified themes. The first theme focused on teamwork and included collaborating with other professionals and expressing the commitment to work effectively on a team. The next theme included characteristics of the professional and their motivations for assuming the oath such as making the oath in due faith, recognizing the unique role and responsibilities associated with being a health-care professional. The third theme described the role of health-care professionals as promoters of health in individuals and communities. The fourth theme focused on the patient as having worth and ultimate priority and focus of care. The final theme focused on practice excellence and included mention of research, evidence-based practice, and practicing within one’s professional scope. The creation of an interprofessional oath Core shared values of interprofessional teams were identified and a framework was created for an interprofessional oath. A composite interprofessional oath was developed from the derived themes of each of the submitted oaths (Figure 1). The emergence of teamwork as a theme is a meaningful finding differing from previously published oaths. Due to the nature of the project, the composite oath was not returned to the participants for validation but was found to be consistent with the literature (IPEC, 2011; McNair, 2005).
Discussion There would be great difficulty in creating a universal code of ethics for health-care professions due to the associated political
J Interprof Care, 2014; 28(5): 471–472
factors and the differences in scopes of practice. An interprofessional oath could serve as a means of promoting collaboration which has the potential to improve patient outcomes and safety (WHO, 2010). The literature reveals that there is no interprofessional oath for all health-care providers but demonstrates the importance of the identification of shared professional values and its potential to enhance collaboration (Buetow & Adams, 2010). It appears the students are aware of shared values and are beginning to develop values that are precursors to collaborative practice. Limitations of this research include the use of students with limited health-care experience. Additional research could seek to explore acceptance of an interprofessional oath in health-care professionals. In summary, the creation of an interprofessional health-care professional oath could serve as a valuable exercise in aiding the development of values for competency in collaboration. Although much work is being done on the knowledge, attitude, and skills necessary for collaborative practice, continued work is needed to determine the themes and the strength of shared values of healthcare professionals. An interprofessional oath could offer a means of articulating shared values and promoting collaboration among health-care professionals.
Acknowledgements The authors would like to acknowledge Dr. Elizabeth Madigan, Associate Dean for Academic Affairs and Independence Foundation Professor at the Frances Payne Bolton School of Nursing, Case Western Reserve University, for her inspiration to conduct this project and to look at education and health care with new paradigms. This project was presented as a poster at Collaboration Across Borders IV, Vancouver, British Columbia, Canada.
Declaration of interest The authors report no conflicts of interest. The authors alone were responsible for the writing and content of this paper.
References Buetow, S.A., & Adams, P. (2010). Oath-taking: A divine prescription for health-related behaviour change? Medical Hypothesis Hypotheses, 74, 422–427. Colaizzi, P. (1978). Psychological research as the phenomenologist views it. In R.S. Valle & M. King (Eds.), Existential phenomenological alternatives for psychology. New York: Oxford University Press. Davis, M. (2003). What can we learn by looking at the first code of professional ethics? Theoretical Medicine, 24, 433–454. Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, DC: Interprofessional Education Collaborative. McNair, R.P. (2005). The case for educating health care students in professionalism as the core content of interprofessional education. Medical Education, 39, 456–464. World Health Organization. (2010). Framework for action on interprofessional education & collaborative practice. Geneva: World Health Organization.
Copyright of Journal of Interprofessional Care is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.
