Design and evaluation of interprofessional cross-cultural communication sessions

Abstract

The 2013 National Standards for Culturally and Linguistically Appropriate Services (CLAS) call for healthcare professionals to provide quality care and services that are responsive to diverse cultural health beliefs and practices. Accreditation organizations for health professional programs require their curriculum to adequately prepare future practitioners for serving culturally and linguistically diverse populations. Another common curricular need of health professional programs is interprofessional education (IPE). This study presents data that evaluates two IPE culturally competent communication sessions designed for pharmacy and nursing students. Teams of nursing and pharmacy students (n?=?160) engaged in case studies focused on developing cross-cultural communication skills, using the LEARN model. Quantitative survey data collected pre-test and post-test measured cultural competency (including subscales of perceived skills, perceived knowledge, confidence in encounter, and attitude) and knowledge related to culturally competent communication. Univariate ANOVA results indicate that actual knowledge as measured by the test and all four Clinical Cultural Competency Questionnaire (CCCQ) subscales significantly increased after the IPE sessions. Pharmacy students scored higher than nursing students on the knowledge pre-test, and nursing students had a more positive attitude at pre-test. The IPE sessions effectively addressed all learning outcomes and will continue in future course offerings. Using cross-cultural communication as a thematic area for IPE program development resulted in educational benefits for the students. To further strengthen nursing and pharmacy students’ interprofessional practice, additional IPE opportunities are to be explored.     

Junior doctors’ experience of interprofessional shadowing in a palliative care setting

ABSTRACT

Interprofessional shadowing, whereby medical students take on the role of another profession, is an effective interprofessional education (IPE) method to promote interprofessional teamwork. Palliative care is an ideal setting for IPE as multidisciplinary teams work together to deliver holistic patient care. This brief report explores junior doctors’ experiences in shadowing nurses to provide care to patients in a hospice setting in New Zealand. We conducted semi-structured interviews with six participants to find out the impact that this shadowing experience had on their professional development and feasibility of incorporating this activity into the undergraduate medical curriculum. Inductive thematic analysis revealed that shadowing a nurse for two days increased participants’ awareness of the nursing role and gave them the opportunity to develop a personal relationship with their patients, both of which made participants actively reflect on the value of IPE and the way they practice medicine. Participants considered the palliative care setting as conducive to IPE and saw the value of incorporating interprofessional shadowing into the undergraduate medical curriculum.     

Survey of Australian Schools of Nursing Use of Human Patient (Mannequin) Simulation

Rapid adoption of high-fidelity human patient (mannequin) simulation has occurred in Australian Schools of Nursing in recent years, as it has internationally. This paper reports findings from a 2012 online survey of Australian Schools of Nursing and builds on findings of earlier studies. The survey design allowed direct comparison with a previous study from the USA but limited its scope to the pre-registration (pre-service Bachelor of Nursing) curriculum. It also included extra mental health specific questions. Australian patterns of adoption and application of high-fidelity human patient (mannequin) simulation in the pre-registration nursing curriculum share features with experiences reported in previous US and Australian surveys. A finding of interest in this survey was a small number of Schools of Nursing that reported no current use of high-fidelity human patient (mannequin) simulation and no plans to adopt it, in spite of a governmental capital funding support programme. In-line with prior surveys, mental health applications were meagre. There is an absence of clearly articulated learning theory underpinnings in the use of high-fidelity human patient (mannequin) simulation generally. It appears the first stage of implementation of high-fidelity human patient (mannequin) simulation into the pre-registration nursing curriculum has occurred and the adoption of this pedagogy is entering a new phase.     

Disaster education for Australian nursing students: An integrative review of published literature to inform curricula

BackgroundGlobally, families and communities are impacted by disasters every day. Nurses are integral to assisting in disasters, in the support and enablement of individuals and communities. However, some studies indicate that nurses feel ill-equipped to assist, partially because disaster content is not thoroughly addressed in the undergraduate curriculum. Therefore, nursing schools need to equip undergraduate nursing students with the knowledge and preparation required to assist effectively during and/or following a disaster.AimTo explore priority disaster topic areas aimed at preparing Australian undergraduate nursing students to assist in caring for survivors in the aftermath of disasters.MethodThis study used an integrative review methodology. Various databases and platforms were searched for literature published between 2000 and 2018 using Medical Subject Heading terms and keywords relating to the undergraduate nursing curriculum. A thematic analysis of the included papers was conducted.ResultsA total of 10 articles were identified that meet the inclusion criteria. The reviewed studies highlighted that the areas of disaster knowledge, assessment and triage, critical thinking, teamwork, technical skills, mental wellbeing, legal and ethical consideration, and socio-cultural contexts, are relevant for the undergraduate curriculum.DiscussionThis review highlights disaster education and training topic areas that could be considered for inclusion in Australian undergraduate nursing curricula. The content relating to disaster assistance must be incorporated into nursing schools’ curriculum.ConclusionThe incorporation of disaster-related content in the undergraduate nursing curriculum may enhance the disaster preparedness of nursing students and the nursing workforce more broadly.     

“Oh,older people,it's boring”: Nurse academics’ reflections on the challenges in teaching older person's care in Australian undergraduate nursing curricula

BackgroundNursing students encounter older people in all health care sectors; however, few choose a career primarily focused on older person's care.AimTo explore the challenges to teaching older person's care to Bachelor of Nursing students and how pre-registration nursing students are prepared to care for older people, part of a large study investigating content on care of older people in Australian nursing curricula.MethodsA purposive sample of Australian nurse academics involved in Bachelor of Nursing curriculum development or delivery completed a telephone-assisted survey. Qualitative content analysis of two open-ended questions was undertaken.ResultsAll Australian schools of nursing participated, and 45 nurse academics were interviewed. Reflecting on the challenges of teaching older person's care to nursing students, most participants felt the curriculum was too crowded and some called for a 4 year degree. In addition, students’ ageist attitudes, fuelled by unrealistic portrayals of nursing in popular culture, were reinforced by curricula being acute care focused and the ageist attitudes of some nurse academics.ConclusionsTeaching older person's care in Australian nursing curricula is challenged by insufficient time and ageism among students and academics. Regulatory bodies need to urgently provide direction so that nursing curricula content aligns with emerging Australian health care priorities, in particular the health care needs of older people.     

Interprofessional Pain Curriculum for an Academic Health Science Center

AIMThe aim of this project is to develop a comprehensive pain curriculum to educate a diverse group of students across health care disciplines who care for those in pain. The outcome goals for participants of this educational program are to have increased knowledge and skills associated with the management of pain. This poster will describe the process of team development, development of the grant proposal, conducting a gap analysis, designing and developing the content of the program, and finally the integration of technology as we prepare for program delivery.METHODSThe team developing the program include representatives from the disciplines of nursing, physical therapy, social work, and psychology. The curriculum is based on the Interprofessional Pain Curriculum developed by the International Association for the Study of Pain. Holographic technology will be used to optimize participant engagement and interest. Additional modes of content delivery include synchronous video meetings, asynchronous discussions, and the use of case studies in both modes, all completed in multidisciplinary teams.RESULTSContent has been developed and loaded into a Canvas course shell. Delivering parts of the program via hologram technology will be recorded within the next 3 months.CONCLUSIONSThis content will be delivered to student groups in the Spring 2023 semester during an Interprofessional Education (IPE) event focused on the management of pain. Health disciplines represented at the IPE event will include Medicine, Nursing, Physical Therapy, Psychology, Social Work, and Pharmacy. Outcome assessments related to knowledge, beliefs and attitudes about pain from IPE participants will be collected. Based on that data, further tweaking of the education program will be considered.ACKNOWLEDGEMENTThis project was made possible through funding from the Elizabeth Morse Genius Foundation, Grant number: AWD00001443     

A critical review of social and health inequalities in the nursing curriculum

ContextSocial and health inequalities are a reality around the world and one of the most important challenges in the current age. Nurse educators can respond to these challenges by incorporating curricular components to identify and intervene in social and health inequalities.ObjectiveTo examine how social and health inequalities have been addressed in the nursing curriculum.DesignInformed by the work of Paulo Freire, a critical literature review was performed to examine how social and health inequalities have been addressed in the nursing curriculum.Data Sources and Review MethodsIn July 2015, we searched for articles published from 2000 to 2015 in ERIC, CINAHL, Web of Science, Scielo, MEDLINE and LILACS databases. Main search terms included “disparity” or “inequality” and “curriculum” and “nursing.” We included studies published in academic journals in English, Portuguese and Spanish.ResultsA total of 20 articles were included in this review. Most of the articles (15) were from the United States and described educational experiences in implementing courses in nursing undergraduate curricula. Limited experiences with graduate nursing education were identified. Social and health inequalities were approached in these articles through elements such as social justice, cultural competence, cultural safety, and advocacy. A concern to reduce social and health disparities was noted. We identified three major themes in the articles included in this review: 1) elements in the curricula that can contribute to reducing social and health inequalities; 2) educational and research strategies used to address the theme of inequalities; 3) a focus on socially vulnerable populations to increase awareness on social and health inequalities.ConclusionFindings suggest that nursing education initiatives align with the recommendations from the World Health Organization to address disparities. There is also a need to identify existing conceptual and practical content on inequalities in the nursing curriculum through future research.     

Developing asynchronous online interprofessional education

For many health programmes, developing interprofessional education (IPE) has been a challenge. Evidence on the best method for design and implementation of IPE has been slow to emerge, with little research on how to best incorporate IPE in the asynchronous online learning environment. This leaves online programmes with no clear guidance when embarking upon an initiative to integrate IPE into the curriculum. One tool that can be effective at guiding the incorporation of IPE across all learning platforms is the Interprofessional Education Collaborative (IPEC) competencies. A project was designed to integrate the nationally defined IPEC competencies throughout an asynchronous, online baccalaureate nursing completion programme. A programme-wide review led to targeted revision of course and unit-level objectives, learning experiences, and assessments based on the IPEC framework. As a result of this effort, the programme curriculum now provides interprofessional learning activities across all courses. This report provides a method for using the IPEC competencies to incorporate IPE within various asynchronous learning assessments, assuring students learn about, with, and from other professions.     

Intellectual disability health content within nursing curriculum: An audit of what our future nurses are taught

BackgroundIndividuals with intellectual disability experience chronic and complex health issues, but face considerable barriers to healthcare. One such barrier is inadequate education of healthcare professionals.ObjectiveTo establish the quantity and nature of intellectual disability content offered within Australian nursing degree curricula.DesignA two-phase national audit of nursing curriculum content was conducted using an interview and online survey.SettingAustralian nursing schools offering pre-registration courses.ParticipantsPre-registration course coordinators from 31 universities completed the Phase 1 interview on course structure. Unit coordinators and teaching staff from 15 universities in which intellectual disability content was identified completed the Phase 2 online survey.MethodsQuantity of compulsory and elective intellectual disability content offered (units and teaching time) and the nature of the content (broad categories, specific topics, and inclusive teaching) were audited using an online survey.ResultsOver half (52%) of the schools offered no intellectual disability content. For units of study that contained some auditable intellectual disability content, the area was taught on average for 3.6 h per unit of study. Units were evenly distributed across the three years of study. Just three participating schools offered 50% of all units audited. Clinical assessment skills, and ethics and legal issues were most frequently taught, while human rights issues and preventative health were poorly represented. Only one nursing school involved a person with intellectual disability in content development or delivery.ConclusionDespite significant unmet health needs of people with intellectual disability, there is considerable variability in the teaching of key intellectual disability content, with many gaps evident. Equipping nursing students with skills in this area is vital to building workforce capacity.     

Interprofessional education for first year psychology students: career plans,perceived relevance and attitudes

Abstract

Undergraduate psychology students have been largely excluded from interprofessional education (IPE) initiatives. In contrast to many health professions, undergraduate psychology students do not engage in work placements as part of their degree, and many enter careers outside the health care context. However, the collaborative skills gained through an IPE experience may well be beneficial to students who work in this wider context. This research examines whether undergraduate psychology students’ views of IPE vary according to their planned career directions, and if so, whether the perceived relevance of IPE mediates the relationships. A sample of 188 Australian university undergraduate psychology students completed an online questionnaire following completion of a first-year IPE health sciences program. Path analysis indicated that psychology students’ attitudes towards IPE are associated with both professional identification and practitioner orientation, fully mediated through the perceived relevance of IPE to future career and study plans. Stronger professional identification and practitioner orientation were associated with greater perceived relevance and more positive and less negative attitudes towards IPE. Placing a stronger emphasis on the generalizability of IP skills taught may increase students’ awareness of the relevance outside of the health context, reducing disengagement of students planning alternative careers.     

Interprofessional socialization as a way to introduce collaborative competencies to first-year health science students

Abstract

Interprofessional education (IPE) is the cornerstone of preparing future health care providers but remains to be a challenge for many health science programs. We aimed to develop and evaluate an interprofessional conference for first-year health science students with goals to provide students with interprofessional socialization opportunity and introduce IPE principles. A half-day conference was based upon core competencies for health professionals and involved 277 first-year health sciences, nursing, pharmacy, physical therapy, and speech language pathology and audiology students. Alcohol and substance misuse was chosen as a topic for its relevance to college students and health professionals. Results from program evaluation revealed that the conference was successful in exposing students to core interprofessional competencies and provided useful information about alcohol and substance misuse. This study advocates for early inclusion of IPE in the health professions curricula in the form of interprofessional socialization.     

A systematic review and meta-analysis of outcomes of interprofessional education for healthcare students from seven countries

AimThis study aimed to analyze the effectiveness of the learning outcomes of the interprofessional education (IPE) model for healthcare students.BackgroundInterprofessional education (IPE) is an important teaching and learning model that involves two or more professions engaging or working together to improve the knowledge of healthcare students. However, the specific outcomes of IPE for healthcare students are unclear as only a few studies have reported them.DesignA meta-analysis was conducted to draw broad conclusions on the impact of IPE on healthcare students’ learning outcomes.MethodsThe CINAHL, Cochrane Library, EMBASE, MEDLINE, PubMed, Web of Science, and Google Scholar databases were searched for relevant articles in the English language. To investigate the effectiveness of IPE, a pooled estimate of knowledge, readiness for and attitude toward interprofessional learning, and interprofessional competence were analyzed using a random effects model. The methodologies of the studies evaluated were assessed using the Cochrane risk-of-bias tool for randomized trials, version 2. Sensitivity analysis was performed to ensure the rigor of the findings. STATA 17 was used to perform the meta-analysis.ResultsEight studies were reviewed. IPE had a significant positive impact on healthcare students’ knowledge (Standardized Mean Difference [SMD]: 0.43; 95% Confidence Interval [CI]: 0.21–0.66). However, its impact on readiness for and attitude toward interprofessional learning and interprofessional competence was nonsignificant and needs further investigation.ConclusionIPE enables students to develop their knowledge of healthcare. This study provides evidence that IPE is a better strategy for enhancing healthcare students’ knowledge than traditional/discipline-specific teaching techniques.     

Economic models for sustainable interprofessional education

ABSTRACT

Limited information exists on funding models for interprofessional education (IPE) course delivery, even though potential savings from IPE could be gained in healthcare delivery efficiencies and patient safety. Unanticipated economic barriers to implementing an IPE curriculum across programs and schools in University settings can stymie or even end movement toward collaboration and sustainable culture change. Clarity among stakeholders, including institutional leadership, faculty, and students, is necessary to avoid confusion about IPE tuition costs and funds flow, given that IPE involves multiple schools and programs sharing space, time, faculty, and tuition dollars. In this paper, we consider three funding models for IPE: (a) Centralized (b) Blended, and (c) Decentralized. The strengths and challenges associated with each of these models are discussed. Beginning such a discussion will move us toward understanding the return on investment of IPE.     

An integrative systematic review of interprofessional education on diabetes

ABSTRACT

Interprofessional education (IPE) aims at enhancing the ability of healthcare professionals from different disciplines to work together effectively, improving the quality of patient care. An interprofessional approach is essential in diabetes management, but there is only limited evidence of the effects of diabetes-specific IPE. The aim of this integrative review is to gather all relevant recent data on the outcomes of IPE on diabetes management. The search in the CINAHL, Medline and PsycINFO databases resulted in 1136 potential studies. An inductive content analysis was used to synthesize the key findings of the 14 studies found to fulfill the inclusion criteria of the systematic review. Two main categories and four subcategories of findings were identified. Firstly, the achieved outcomes included individual gain (e.g., learner´s confidence and motivation to treat patients with diabetes) and external benefits (e.g., benefits for the patient). Secondly, the experiences of IPE included both challenges (e.g., competing interests of different professions) and strengths (e.g., practical approach to diabetes management). In conclusion, the findings indicate that both learners and patients with diabetes benefit from IPE on diabetes management. Educators are encouraged to adopt practical IP approaches in diabetes education. However, it is necessary to estimate the resources available. More research is needed on the cost-effectiveness, long-term effects, and patient perspective of IPE on diabetes management.     

The disconnections between space,place and learning in interprofessional education: an overview of key issues

Abstract

This article explores and discusses current conceptual and empirical dimensions of the study of space, place, education and interprofessional education (IPE) within a health professions context. This article addresses defining elements of the concepts, their use in nursing and medical literature and their positioning within educational theories. It outlines a series of ideas and approaches for future research aimed at investigating the intersections and relationships amongst these concepts. Importantly, this article argues that the conceptualization of space and place in IPE can potentially impact how educational space, places and curricular are (re)conducted and utilized.     

Nursing informatics in undergraduate nursing education in Australia before COVID-19: A scoping review

BackgroundTechnology can support transformational outcomes of high quality and evidenced-based care and education. Embedding nursing informatics into the undergraduate nursing curriculum enhances nursing students’ digital health literacy, whilst preparing them to use health information systems and technological innovations to support their learning both at university and in the clinical environment.AimThis scoping review aimed to provide an overview of the published literature on how nursing informatics was embedded and integrated into the undergraduate nursing curriculum in Australia before coronavirus disease (COVID-19).MethodologyA scoping review approach guided this study using the Levac, Colquhoun, and O'Brien framework, and the following databases were searched: CINAHL Plus, EMCARE, MEDLINE Ovid, Scopus, ERIC ProQuest, and Web of Science. A total of 26 articles were included: Five quantitative studies, eight qualitative studies and 13 mixed-methods studies.FindingsFew studies focused on the concept of nursing informatics itself, and only two studies described the process of developing curricula that contain nursing informatics competencies and their implementation: the educational scaffolding and modular development approach and a Community of Inquiry Framework (COI). Most studies centred on nursing informatics tools to facilitate teaching and learning in classrooms and skills laboratories. The reported pedagogical strategies were online learning, blended learning, and technology-enabled simulations. Hindrances to nursing informatics being integrated into undergraduate curricula were disparities of the informatics content, a lack of guidelines and/or frameworks, and poor digital literacy.ConclusionThis study provided a baseline perspective of how nursing informatics was embedded and integrated into nursing education in Australia before COVID-19. Overwhelmingly, the focus of research to date was found to be mainly on the utilisation of technological tools to support learning and teaching.     

An interprofessional education Russian cultural competence course: Implementation and follow-up perspectives

Abstract

Health sciences educators are faced with creating meaningful, effective and satisfying experiences in interprofessional education (IPE) and cultural competence (CC) required of both students and professionals in practice. This study evaluated the experience and attitudes of the participants in a course combining IPE and CC. A novel, interprofessional course in the Russian language and culture was developed and delivered to a group of medical, nursing, and pharmacy students. One year after the completion of the course, an anonymous, online survey was sent to the participants. Attitudes, comfort, self-efficacy in working with other cultures/healthcare professionals, and comparison of the course to other IPE activities were assessed. The survey suggested that the course was a satisfying and effective combination of IPE and CC in a pre-professional health educational setting. Further work could be undertaken to evaluate the experiences of similar activities in the professional and continuing education arenas.     

Team decision making: design,implementation and evaluation of an interprofessional education activity for undergraduate health science students

Abstract

An undergraduate health science student curriculum activity in interprofessional education (IPE) focused on team decision making was piloted. The IPE activity included a lecture, small group learning activity and an onsite observation of an interprofessional health care team (IPHCT) meeting. Measures included the Readiness for Interprofessional Learning scale, Interdisciplinary Education Perception scale and the Role Perception Questionnaires. The students completed a workbook to assess decision making capacity in IPHCTs. The results indicated that students (n?=?61) were willing to share their knowledge and skills as a way of understanding clinical problems in the workplace and had professionally oriented perceptions and related affective domains. They also showed a positive role perception of their own role and that of other professions. Analysis of the workbooks revealed that students were able to identify positive and negative impacts on effective team decision making and its effects on a patient centred approach to health care.