Interprofessional Healthcare Teams in the Military: A Scoping Literature Review

• Published in: Military medicine 2018-11, Vol.183 (11-12), p.e448-e454
• Main Authors: Varpio, Lara, Bader, Karlen S, Meyer, Holly S, Durning, Steven J, Artino, Anthony R, Hamwey, Meghan K
• Format: Article
• Language: English
• Subjects: Armed forces; Collaboration; Communication; Interprofessional cooperation; Interprofessional education; Literature reviews; Military personnel; Patient safety; Patient satisfaction; Systematic review; Teams
• ISSN: 0026-4075; 1930-613X
• DOI: 10.1093/milmed/usy087

Research into healthcare delivered via interprofessional healthcare teams (IHTs) has uncovered that IHTs 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 IHT 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 IHT 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? A scoping review of the literature was conducted to identify the breadth of knowledge currently available regarding military interprofessional healthcare teams (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 inter-professional*) AND (military OR Army OR Navy OR Naval 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, included teams that were medically focused, comprised at least two professional disciplines, and had at least two people). 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, shared role understanding, and equity among team 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, and 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 line