Crossing boundaries: Implementing an interprofessional module into uniprofessional Bachelor programmes

In accordance with the curriculum reforms within health education in Norway, the Faculty of Health Sciences at Oslo University College introduced in 1998 an interprofessional module, entitled “VEKS”, for eight different professional programmes. A shared module of 30 credits (15 for technically oriented programmes) was introduced into the three-year programmes. A problem-based and project-oriented format was chosen as the teaching and learning model to enhance the interactive, experiential and collaborative learning. This paper describes experience gained during the five-year implementation period. Empirical data were collected through participatory observations, students' and tutors' evaluations and group interviews with tutors and faculty leaders. The innovative project described challenged traditional educational boundaries and structures, frames of thought and habits. It broadened perspectives within the particular professional programmes as well as preparing students for their future professional careers. Lessons learned can be summed up as: Time, resources and a certain staff consensus are needed to deal with and overcome traditions and attitudes, the students' learning is a socialization process which needs to be developed over time; intermittent interprofessional interventions during the three-year period was found to be inadequate, and the tutor role is essential in order to support the students' learning process.     

Second year scepticism: pre-qualifying health and social care students' midpoint self-assessment, attitudes and perceptions concerning interprofessional learning and working

A study in an English Faculty of Health and Social Care explores the effects of a pre-qualifying interprofessional curriculum incorporating interprofessional modules in each year of study. The study design involves collecting data on entry to the Faculty, after completion of the second interprofessional module, on qualification and after 9 months qualified practice. At each point, students complete questionnaires concerning communication and teamwork skills and interprofessional learning and working. This paper presents results from 723 students at the second data collection point. Although most students were positive about their communication and teamwork skills, they were less positive than on entry to the Faculty. Similarly there was a negative shift in students' attitudes to interprofessional learning and interprofessional interaction. Nevertheless, most students were positive about their own interprofessional relationships. Mature students' responses were more positive than those of younger students. The emergence of differences in responses based on a professional programme suggests that interprofessional education may not necessarily influence professional socialization. Demographic and professional variables affecting students' responses in their second year of study demonstrate the complexity of student learning. The planned follow-up of the students will show whether variables affecting interim data have a long-term effect on attitudes.     

Interprofessional perceptions of health care students

Effective interprofessional working, which is widely considered as essential to high-quality health care, is influenced by the attitudes of health care professionals towards their own and other professional groups. Relatively little is known, however, about interprofessional attitudes, particularly of students in health care professions. This study aimed to increase our understanding of students' attitudes towards their own and other professional groups on entry to a programme of professional education. Hypothesised relationships between stereotypes, professional identity and readiness for professional learning were tested by means of a questionnaire survey of 933 undergraduate health care students drawn from five health care groups (medicine, nursing, dietetics, pharmacy and physiotherapy) within a multi-faculty UK university. Positive statistically significant correlations were found between stereotypes, professional identity and readiness for interprofessional learning. As predicted, students identified strongly with their own professional group at the start of pre-registration education. They were also willing to engage in interprofessional learning. More unexpected was the positive association found between heterostereotype and professional identity scores. There are potential benefits of introducing active interprofessional education activities at an early stage of professional preparation to capitalise on students' positive attitudes towards their own and other professional groups.     

Changing student attitudes through interaction: Findings from an interprofessional workshop

Healthcare professionals are increasingly expected to work in interprofessional teams. Students therefore need opportunities to learn and practise skills that will allow them to be effective team members when they enter the workforce. This article summarises an interprofessional learning experience for 289 undergraduate and graduate students representing 13 programmes in a College of Health Professions (CHP) at a US public university. The half-day workshop provided an opportunity for participants with no prior interprofessional education to collaborate in a problem-solving case study and to inform students of other professions about their professions. Faculty members from all CHP programmes collaborated in writing the case study and facilitating student discussions during the event. Attitudes related to interprofessional collaboration and professional roles were assessed prior to and after workshop participation. A paired t test showed a statistically significant difference in four attitude questions. Participants reported a significant increase in understanding the roles of other professionals in healthcare and community situations. They also reported an increased understanding of the benefits and challenges of working in interprofessional teams. This event successfully introduced participants to interprofessional collaboration and provided them the opportunity to share their professional expertise and understand the expertise of others.     

Developing interprofessional communication skills for pharmacists to improve their ability to collaborate with other professions

Successful communication between health professionals is a prerequisite for collaborative practice. Clinical pharmacists completed a learning and practice module introducing them to a framework for successful interprofessional communication (IPC) in the course of their postgraduate studies. A face-to-face discussion of a contemporary clinical topic with a health professional was then scheduled, mainly with junior doctors, in their practice setting. An exploratory case study methodology was employed to investigate pharmacists’ written reflections on their experience applying their newly acquired IPC skills. Thematic analysis of reflections developed five categories relating to interprofessional collaboration, learning, and education. Themes describing pharmacists’ preconceptions about the health professional and scheduled interprofessional encounter, how it allowed them to learn about doctors’ and other health professionals’ practice and build collaborative relationships were identified. Reflections also elaborated that applying the communication framework and strengthening of collaboration created opportunities for IPE, with added observations about these increasing potential impact on patient care and change of practice. Analysis of anonymous feedback provided by the health professionals yielded similar themes and was integrated for triangulation. Applying successful IPC skills in healthcare settings may increase interprofessional collaboration and create practice models which facilitate interprofessional learning in health profession programmes.     

Initial experiences of interprofessional problem-based learning: a comparison of male and female students' views

Few studies have considered the contribution of problem-based learning (PBL) to interprofessional education, and even fewer have examined whether women and men evaluate PBL differently. This paper examines first year occupational therapy and physiotherapy students' evaluations of their initial participation in PBL, during an interprofessional module focusing on communication skills and patient-focused approaches to care. Questionnaire data included attitude ratings and qualitative evaluations of PBL. A total of 133 females and 24 males responded (comprising 83% of the total cohort). Most students were positive that PBL contributed to both personal learning and team-working skills. Both female and male students felt able to express their opinions within the seminar groups and were positive that their understanding of therapists' roles within the multidisciplinary team had increased. However, women expressed rather more trust in the information provided by other students, confirmed greater enjoyment in taking responsibility for their own learning and had more positive views about working with students from another course. In their qualitative comments, more women made reference to enjoying the social aspects of PBL (such as group work, support and collaboration). The gender differences were not substantial but those that were observed support previous researchers' arguments that women are more inclined to be 'connected learners' who value the social aspects of learning contexts. The findings overall suggested that PBL made a positive, well-received contribution to learning during an interprofessional module.     

Empathy,emotional intelligence and interprofessional skills in healthcare education

According to the World Health Organization (WHO), health professionals maintain the health of citizens through evidence-based medicine and caring. Students enroled in health professional programmes are required to have successfully attained all core learning outcomes by reaching key milestones throughout the course of their studies, demonstrating they have developed the required graduate skills and attributes upon completion of the programme. While some of the knowledge, skills and competencies that make up these learning outcomes are very discipline specific, there are more general professional skills across all disciplines which are difficult to define, such as empathy, emotional intelligence and interprofessional skills. These are at the heart of all health professional programmes that once defined, can be mapped through curricula and further evaluated.Literature will be presented on these three professional skills: empathy, emotional intelligence, and interprofessional skills, based on studies that focussed primarily in health professional programmes and highlight some of the key findings and issues at undergraduate and postgraduate levels. The paper will present the need for these skills to be defined and then mapped through curricula so that students are better supported in their professional development. Empathy, emotional intelligence and interprofessional skills transcend the discipline specific skills and as such it is important that all educators consider how best these may be fostered. Efforts should also be made to further the integration of these professional skills within curricula to produce health professionals with an enhanced focus on person-centred care.     

Students' perceptions of the interprofessional team in practice through the application of servant leadership principles

This study examined students' perceptions of interprofessional practice within a framework of servant leadership principles, applied in the care of rural older adults utilizing a service learning model. Mobile wellness services were provided through the Idaho State University Senior Health Mobile project in a collaborative team approach in the community-based setting. Students from varied health professional programs were placed in teams for the provision of wellness care, with communication among team members facilitated by a health professions faculty member serving as field coordinator. The Interdisciplinary Education Perception Scale (IEPS) was used to measure students' perceptions of interprofessional practice using a pretest post-test research design. Multivariate analysis was performed revealing a significant pretest to post-test effect on students' perceptions as measured by factors inherent in the IEPS and deemed essential to effective interprofessional practice. Univariate analysis revealed a significant change in students' perception of professional competence and autonomy, actual cooperation and resource sharing within and across professions, and an understanding of the value and contributions of other professionals from pretest to post-test.     

Launching first-year health sciences students into collaborative practice: Highlighting institutional enablers and barriers to success

Developing and sustaining a comprehensive interprofessional education (IPE) curriculum infused throughout health science programmes at large post-secondary institutions requires not only champions within each program but also collaboration across professional programmes and strong support at an institutional level. The purpose of this article is twofold. First, it reports on the development of an interprofessional learning pathway, an institutional curricular model, and the pathway launch, an introductory learning experience within the context of a large post-secondary institution. The interprofessional curricular model provides a framework to connect the IPE that was previously fragmented across faculties and professional programmes into a scaffolded coherent pathway. The launch exposes students to the principles and competencies of collaborative practice. Second, it explores the dual role of enablers and barriers to IPE within the context of one institution’s 20-year experience of developing and delivering. In examining the elements that have sustained the institution’s IPE programming, it is highlighted how the seemingly positive elements (e.g., IPE champions and strong university support from central administration) have also served as hindrances within the academy potentially threatening the sustainability and institutionalisation of IPE. We anticipate that this curricular model and learning experiences will provide mechanisms to sustain and foster IPE.     

Experiences of encouraging student-centred learning within a wellness-oriented curriculum

This paper describes the use of learninglogs as a tool for self-assessment and reflection during a ‘well people’ module within a Bachelor of Nursing programme. A qualitative analysis of the students' learning goals and reflective accounts from the learning logs are presented, together with extracts from the written evaluation of the module. Recommendations are made for enhancing the potential of the learning log as a flexible learning tool which can help students to draw upon professional knowledge in order to make sense of their experiences.     

What did first-year students experience during their interprofessional education? A qualitative analysis of e-portfolios

Interprofessional collaboration is an essential approach to comprehensive patient care. As previous studies have argued, interprofessional education (IPE) must be integrated in a stepwise, systematic manner in undergraduate health profession education programmes. Given this perspective, first-year IPE is a critical opportunity for building the foundation of interprofessional collaborative practice. This study aims to explore the first-year students’ learning processes and the longitudinal changes in their perceptions of learning in a year-long IPE programme. Data were collected at a Japanese medical university, in which different pedagogical approaches are adopted in the IPE programme. Some of these approaches include interprofessional problem-based learning, early exposure, and interactive lecture-based teaching. The students are required to submit written reflections as a formative assessment. This study conducted an inductive thematic analysis of 104 written reflections from a series of e-portfolios of 26 first-year students. The themes related to learning outcomes from student perspectives included communication (e.g., active listening and intelligible explanation), teams and teamwork (e.g., mutual engagement and leadership), roles/responsibilities as a group member (e.g., self-directed learning and information literacy), and roles/responsibilities as a health professional (e.g., understanding of the student’s own professional and mutual respect in an interprofessional team). The study also indicated three perspectives of students’ learning process at different stages of the IPE, i.e., processes by which students became active and responsible learners, emphasised the enhancement of teamwork, and developed their own interprofessional identities. This study revealed the first-year students’ learning processes in the year-long IPE programme and clarified the role of the first-year IPE programme within the overall curriculum. The findings suggest that the students’ active participation in the IPE programme facilitated their fundamental understanding of communication/teamwork and identity formation as a health professional in interprofessional collaborative practice.     

Using an online case conference to facilitate interprofessional learning

Interprofessional learning is seen as increasingly important for all health and social care workers. How this is integrated into the education of these workers is less clear and more of a challenge. This article describes an online learning activity used to facilitate interprofessional learning in a Faculty of Health and Social Care in the UK. An online conference was used to bring students together, utilising a real life case scenario based around a family within a virtual town. Students from a variety of programmes and professional groups participated in an asynchronous discussion forum. The student evaluation of this event was, on the whole, positive and suggests further development of such an approach would address some of the challenges of interprofessional learning.     

Learning orthopaedics: assessing medical students' experiences of interprofessional training in an orthopaedic clinical education ward

Interprofessional training is becoming commonplace in undergraduate medical education. Orthopaedics is considered to be a setting that offers good opportunities for interprofessional training. Curriculum overload is a common problem, which has to be addressed with respect to content. The aim of this study was to assess medical students' experiences of interprofessional care during their orthopaedic training. Over a two-week period, medical, nursing, physiotherapy and occupational therapy students trained together in teams in an orthopaedic ward (Clinical Education Ward, CEW). A questionnaire was distributed to assess the impact of this new curriculum on medical students. A patient-satisfaction questionnaire was also administered to assess patients' satisfaction with the treatment provided by students at the CEW. In general, the medical students were satisfied with the interprofessional course in the CEW. Of the 178 medical students who took the course, 134 (75%) responded to the questionnaire. Total time devoted to orthopaedics was reported to be between 7 - 44% (mean). The total time regarding medical tasks was reported to be between 57 - 71% (mean). Results from the patient-satisfaction questionnaire showed that patients perceived CEW as highly satisfactory. The medical students reported generally satisfactory experiences of interprofessional orthopaedic training in general. In an interprofessional training context, professional supervision and role modeling takes on added importance, and may be regarded as essential ingredients in helping students to learn effectively within an authentic clinical setting.     

Preparing placement supervisors for primary care: an interprofessional perspective from the UK

All the professions working in primary care provide placements for students. How common, or how profession-specific, are the competency requirements of the different professions for their members who supervise students on placements? If there is a significant degree of commonality in these competency requirements, how feasible would it be to develop an integrated interprofessional development and support programme for placement educators? These were the main questions addressed in this research project. The requirements for placement educators of four professions in the UK - nursing, medicine, occupational therapy and social work - were analysed and classified. Categories identified included the skills of enabling learning, knowledge of the theory and principles of learning, the ability to manage the learning environment and the ability to impart a sense of professional responsibility, as well as up-to-date knowledge on professional practice and on the relevant curricula. We concluded that only the last of these was profession-specific. The potential to use this classification for the development of an interprofessional placement educator training and support programme was explored, and the potential benefits of using this area to promote interprofessional learning were discussed. Issues that need to be considered include gaining cross professional involvement, whether service providers or universities should run programmes, whether there should be one or several programmes, and accreditation. In order to explore and take action on these issues a working group with representatives of the four professions was set up in the Primary Care Trust.     

Integrating interprofessional education into 10 health and social care programmes

The current policy agenda purports the need for education establishments and practice agencies to join together to promote interprofessional working. It was within this policy context that in September 2000 the Faculty of Health and Social Care, University of the West of England (Bristol) introduced an interprofessional strand within 10 professional programmes. This article outlines a number of challenges associated with the incorporation of interprofessional education into the pre-qualifying curriculum and details the approaches used to meet these challenges. Logistical barriers associated with organising more than 700 students into interprofessional groups in a format that does not result in an over representation of any group, developing and selecting appropriate scenarios, resourcing the interprofessional modules, integrating interprofessional education throughout the whole student experience and facilitating the delivery of the interprofessional modules are all considered, together with adjustments made in the light of evaluations to date.     

An interprofessional initiative aimed at creating a common learning resource for the operating room ward

Every semester, the operating room (OR) ward receives students from different educational programmes. Although interprofessional knowledge is essential for OR teamwork, students have traditionally been prepared in an uniprofessional manner, with no focus on interprofessional learning outcomes. This report describes the work process of an interprofessional initiative undertaken to create a common learning resource aimed at preparing students for OR practice. With a focus on interprofessional learning, shared and profession-specific learning outcomes, which are needed to prepare for practice, were identified by an interprofessional faculty. To avoid timetabling and geographic barriers, learning outcomes and constructed learning activities were packaged into an e-module and delivered on-line as an adjunct to existing lectures and workshops. A survey was administered to 4th year medical (n = 42) and 1st year OR nurse students (n = 4) to evaluate their perceptions of the e-module. We found that most learning outcomes from the different syllabuses were common for all professions. The overall response rate of the survey was 59% (27 of 46 students). Eighteen of the 27 responding students had used the learning resource, of which 15 students considered it to be of ‘high’ or ‘very high’ value. In summary, this interprofessional initiative resulted in a new common learning resource for the OR, which was used and perceived valuable by a majority of the students. The learning outcomes needed to prepare students from different educational programmes for OR practice are, to a great extent, generic and interprofessional and we thus argue that the interprofessional nature of the faculty was essential for the success of the initiative.     

Family,Ties, and Care Family Transformation in a Plural Modernity

Abstract

A holistic, collaborative interprofessional team approach, which includes patients and families as significant decision-making members, has been proposed to address the increasing burden being placed on the health-care system. This project hypothesized that learning activities related to the humanities during clinical placements could enhance interprofessional teamwork. Through an interprofessional team of faculty, clinical staff, students, and patient representatives, we developed and piloted the self-learning module, “interprofessional education for collaborative person-centred practice through the humanities”. The module was designed to provide learners from different professions and educational levels with a clinical placement/residency experience that would enable them, through a lens of the humanities, to better understand interprofessional collaborative person-centred care without structured interprofessional placement activities. Learners reported the self-paced and self-directed module to be a satisfactory learning experience in all four areas of care at our institution, and certain attitudes and knowledge were significantly and positively affected. The module’s evaluation resulted in a revised edition providing improved structure and instruction for students with no experience in self-directed learning. The module was recently adapted into an interactive bilingual (French and English) online e-learning module to facilitate its integration into the pre-licensure curriculum at colleges and universities.     

Healthcare students as innovative partners in the development of future healthcare services: An action research approach

BackgroundHealth care systems in Norway and the western world have experienced extensive changes due to patients living longer with complex conditions that require coordinated care. A Norwegian healthcare reform has led to significant restructuring in service delivery as a devolution of services to municipalities.Action Research DesignPartners from three rural healthcare services, students from four professional programmes, and one lecturer from each of the professional programmes used a collaborative approach to obtain new knowledge through interprofessional practice. Using an action research design, the research group facilitated democratic processes through dialogues with healthcare services and students. The design is visualised as a cyclical process in which each cycle contributes to improvements, innovations, and increased understanding. A total of 32 students and 3 supervisors were interviewed before and after the clinical practice experiences. Fieldwork was conducted during three clinical periods.FindingsInterprofessional student groups formed small healthcare teams and assessed patients with chronic and long-term conditions. Students prepared and negotiated patient follow-up. The teams' responsibilities led to reflective practices that enhanced their professional knowledge. The teams achieved a new understanding of patient situations, which influenced “second opinions” for patients with complex conditions and led to innovative practices. The change in perception of patient needs led to a changed professional approach. The students' perceptions changed as they learned from and about each other and in collaboration with the health service; this led to more coordinated care of patients with complex conditions. Interprofessional learning in community settings provided a platform to improve both healthcare education and rural healthcare services.ConclusionThis research contributes to knowledge of how students' placement in interprofessional teams can enhance students learning from, with and about each other. The student teams promoted new ways of approaching and delivering complex patient treatment and care in community healthcare service. Collaborative partnerships in interprofessional learning have potential in the wider international arena as a means for practice improvement.     

Integrating interprofessional education into 10 health and social care programmes

The current policy agenda purports the need for education establishments and practice agencies to join together to promote interprofessional working. It was within this policy context that in September 2000 the Faculty of Health and Social Care, University of the West of England (Bristol) introduced an interprofessional strand within 10 professional programmes. This article outlines a number of challenges associated with the incorporation of interprofessional education into the pre-qualifying curriculum and details the approaches used to meet these challenges. Logistical barriers associated with organising more than 700 students into interprofessional groups in a format that does not result in an over representation of any group, developing and selecting appropriate scenarios, resourcing the interprofessional modules, integrating interprofessional education throughout the whole student experience and facilitating the delivery of the interprofessional modules are all considered, together with adjustments made in the light of evaluations to date.     

Educational interventions to enhance competencies for interprofessional collaboration among nurse and physician managers: An integrative review

Collaborative leadership and management structures are critical to transforming care delivery. Both nurse and physician managers are uniquely positioned to co-lead. However, little is known on how to prepare and support individuals for these co-leader arrangements. The re-design of healthcare professional education focuses on interprofessional collaboration, mutual learning, and a competency-based approach. While competencies for interprofessional collaboration have been delineated, competencies for collaborative management practice have yet to be addressed. An integrative review of empirical studies on existing educational interventions was conducted to critically appraise and synthesise the results regarding collaborative competence among nurse and physician leaders. We reviewed how these interventions have been designed, implemented, and evaluated within workplace settings in order to inform our understanding of what components are effective or ineffective for the future development of an educational programme. This review reports on key characteristics of nine empirical studies and emphasises that: a uniprofessional approach to leadership development is predominant within educational programmes and that the assessment of shared learning experiences are not addressed; there are inconsistency in terms used to describe competencies by individual researchers and limitations within the competency frameworks used in the studies reviewed; and there is a lack of suitable instruments available to assess whether competencies have been achieved through the educational programmes. None of the studies discussed the process of how individuals learned specific competencies or whether learning outcome were achieved. Educational programmes were developed based on a perceived lack of leadership preparation and orientation programmes for leaders in formal management positions and used multiple interventions. Only two of the programmes involved organisational or systems level competencies. Interprofessional co-leading requires enhanced capabilities and capacity for managers. There is a need for developing an in-action education intervention that addresses the unique learning needs of co-leader arrangements particularly among nurses and physicians who are new to their role.