Interdisciplinary Communication in the Context of FamilyCentered Care Rachel Esch Emily Graybill PhD Stephen Truscott PsyD Anna Torres Kirnel Daniel Mark Crenshaw MTS Erin Vinoski ID: 733107
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A LEND Program’s Case-Based Simulation Approach to Measuring
Interdisciplinary Communication in the Context of Family-Centered Care
Rachel Esch, Emily Graybill, PhD, Stephen Truscott, PsyD, Anna Torres, Kirnel Daniel, Mark Crenshaw, MTS, Erin Vinoski, MPH, & Daniel Crimmins, PhD
Overview Our GaLEND Program is committed to better understanding the development and use of MCH interdisciplinary competencies as a result of training experiences. The current study examined family member involvement in simulated interdisciplinary team discussions at two times during the training year. Guiding Questions How does family member and LEND trainee involvement change from Time 1 to Time 2? What information can be provided by each of the three communication coding schemes on family member and trainee communication patterns?
Participants
Two case-based simulation (CBS) activities were scheduled for the 2013-2014 GaLEND year: one in the Fall semester (Time 1 [T1]) and one in the Spring semester (Time 2 [T2]).At Time 1, GaLEND trainees were divided into two groups.
Group 1
T1
Group 2
T1
At Time 2, GaLEND trainees were divided into three groups.
Group 1
T2
Group 2
T2
Group 3
T2
Case-Based Simulation Activity Development
The CBS activities consisted of two cases in which the family of a child with a disability was seeking services and supports.
At each time point, trainees received a case file intended to mirror a file that an interdisciplinary team might work from during service planning and provision.
The case files were developed in collaboration with a local community-based organization and were derived from an existing case.
The “family member” was played by a former GaLEND trainee.
Case-Based Simulation Procedures
The group facilitator gave each trainee a case summary, written instructions for the activity, and a facilitation form to guide the activity. One case file was provided to the group.
The groups were given 30 minutes to complete the simulation and to answer the questions outlined on the facilitation form.
The groups debriefed with the group facilitator and afterward, the groups joined together to participate in a discussion about the experience led by a GaLEND research team member.
Table 1. Coding Process
Coding Scheme
Author
Utility
Family Relational Communication Control Coding System
(F-RCCCS)
Heatherington & Friedlander, 1987
Analyzes the power dynamics of teams:
Domineeringness: an individual’s attempts to control a team conversation;
Dominance: an individual’s successful attempts to control the conversation.
Language Style
Matching
(LSM)
Niederhoffer & Pennebaker, 2002
Measures verbal mimicry of dyads through the relative use of function word categories
(e.g., personal pronouns, articles, conjunctions, prepositions, auxiliary verbs, quantifiers, etc.).Maternal Child Health Leadership Applied Competencies Coding Scheme (MCH-LACCS)Internally developed by the GaLEND research team, 2013Identifies a team’s use of problem-solving steps (i.e., identifying a problem, devising a plan, carrying out a plan, and evaluating) while demonstrating MCH leadership competencies (e.g., Interdisciplinary Team Building, Family Balance of Power, and Individual and Family-Centered Care).
Key Findings F-RCCCSFrom T1 to T2, trainees increased in dominance. From T1 to T2, family decreased in dominance. In other words, trainees became more and families became less effective at controlling the conversation. LSM LSM was high in all groups at T1 and T2, across family members and trainees, suggesting that language mimicry was high throughout the activity.MCH-LACCSTrainee Individual and Family-Centered Care increased from T1 to T2 due to increased questioning.Family Balance of Power (average # of responses made to their initiating statements) decreased from T1 to T2SummaryTrainees increased in dominance, not necessarily a bad thing as it involves being more focused on furthering the conversation; they may, however, have dominated by asking lots of questions.
Figure 1.
GaLEND trainees discuss the CBS materials.
Figure 2.
A GaLEND trainee engages with the “family member.”
Future Directions
Develop more specific instructional activity
occurring between Time 1 and Time 2 to
develop
skills related to interdisciplinary team communication and family-centered care.
Drop LSM as scheme and continue with the other two.
Assess the quality of communication through participant interviews; the present study did not measure quality, only nature, of communication.
Standardize activity:
Improve training for “family members.”
Use equivalent groups at Time 1 and Time 2.