Health care partnerships: a literature review of interdisciplinary education

Interdisciplinary education is an excellent teaching model for nursing and other health care professions students. When one considers that nurses, physicians, and other health care professionals must work together in the same environment, it seems feasible that learning together through allocated learning activities as an interdisciplinary group might enhance educational outcomes. According to the literature, interdisciplinary education fosters collaboration and teamwork among the health care team. In addition, anecdotal comments from nursing students indicate that they feel unprepared to communicate with other health care disciplines. Although there is an abundance of articles related to interdisciplinary education, few studies of student outcomes have been conducted. This article provides an overview of interdisciplinary education studies with nursing and other health professions students.     

Educating CAM practitioners about integrative medicine: an approach to overcoming the communication gap with conventional health care practitioners

OBJECTIVE: To assess an educational initiative that teaches complementary and alternative medicine (CAM) students how to communicate more effectively with conventional physicians about CAM. DESIGN: We introduced an educational initiative in integrative medicine to CAM students in their final year of study, emphasizing evidence-based learning, patient-centered care, and communication skills with conventional health care providers. A precourse semistructured questionnaire and an anonymous open essay about the students' experiences at the end of the course were used as tools for assessment. The precourse questionnaires and the postcourse essays were evaluated, using content analysis for parallel responses to determine whether students' views changed during the course. RESULTS: We evaluated the experience in 62 students exposed to the initiative during 4 academic years, 2001-2005. We found that CAM students perceive that they need practical communication tools in order to communicate effectively with conventional practitioners. After the educational experience, the students confirmed that critical thinking training is important, and reported feeling more empowered and more confident in their work as well as in communicating with physicians. CONCLUSIONS: The results of this study suggest that CAM practitioners feel better equipped to communicate with conventional health care practitioners after exposure to a structured educational initiative that emphasizes critical thinking, patient-centered care, and communication skills with conventional practitioners.     

现代教育技术与健康评估课程整合的探索

目的探讨现代教育技术与健康评估课程整合的方法及教学效果。方法将72名护理中专生随机分为试验组和对照组,试验组采用现代教育技术与课程教学整合的方法进行教学,对照组采用传统的教学方法,比较两组的期末理论考试和护理评估实践考核成绩。结果试验组期末理论成绩（33.1±5.8）和实践考核成绩（31.8±5.9）均分别高于对照组理论成绩（28.0±6.4）和实践考核成绩（24.3±6.4）（P〈0.01）。结论将现代教育技术与健康评估课程整合教学能够帮助学生学习健康评估的知识和技能,提高其护理评估能力。     

Care of homeless men in the community

The author describes health care provided to homeless men by community health nursing students who conduct a service learning project at an inner city mission. Service learning is an educational method that combines the academic learning objectives of community nursing students and the health care educational and service needs of a vulnerable population of homeless men. Holistic and interdisciplinary nursing skills are practiced. Clients learn healthier life-style choices and to determine more appropriately the need and source for professional health care when problems are identified.     

Development of an international comorbidity education framework

ContextThe increasing number of people living with multiple chronic conditions in addition to an index condition has become an international healthcare priority. Health education curricula have been developed alongside single condition frameworks in health service policy and practice and need redesigning to incorporate optimal management of multiple conditions.AimOur aims were to evaluate current teaching and learning about comorbidity care amongst the global population of healthcare students from different disciplines and to develop an International Comorbidity Education Framework (ICEF) for incorporating comorbidity concepts into health education.MethodsWe surveyed nursing, medical and pharmacy students from England, India, Italy and Sweden to evaluate their understanding of comorbidity care. A list of core comorbidity content was constructed by an international group of higher education academics and clinicians from the same disciplines, by searching current curricula and analysing clinical frameworks and the student survey data. This list was used to develop the International Comorbidity Education Framework.ResultsThe survey sample consisted of 917 students from England (42%), India (48%), Italy (8%) and Sweden (2%). The majority of students across all disciplines said that they lacked knowledge, training and confidence in comorbidity care and were unable to identify specific teaching on comorbidities. All student groups wanted further comorbidity training. The health education institution representatives found no specific references to comorbidity in current health education curricula. Current clinical frameworks were used to develop an agreed list of core comorbidity content and hence an International Comorbidity Education Framework.ConclusionsBased on consultation with academics and clinicians and on student feedback we developed an International Comorbidity Education Framework to promote the integration of comorbidity concepts into current healthcare curricula.     

An interdisciplinary team model for substance abuse prevention in communities.

Recognizing the continuing threat of alcohol, tobacco, and other drug abuse and the mandate for health care reform with emphasis on community-based care and prevention, the University of Texas-Houston Health Science Center School of Nursing developed a model to link faculty to communities to provide culturally competent, scientifically based, preventive interventions. Faculty and community associates engaged in individual and group training activities such as seminars, courses, and off-site meetings. The Preventive Intervention Research Cycle was used to structure prevention activities and assure scientific rigor. In addition to the specific outcomes of five preventive interventions, the project resulted in increased faculty scholarship in the field, increased community awareness and sustained interventions related to substance abuse, enhanced curriculum for students, and expanded collaborations with other community-based organizations. Collaborative interdisciplinary partnerships between academic institutions and community organizations are critical to the development of the science of substance abuse prevention.     

Academic health leadership: looking to the future. Proceedings of a workshop held at the Canadian Institute of Academic Medicine meeting Québec, Que., Canada, Apr. 25 and 26, 2003

The academic health sector will face major changes in governance, health care delivery, educational requirements and research programs over the next decade. Increased emphasis on disease prevention and health outcomes, the need for evidence to support both clinical and policy decisions, educational changes both in content and delivery, and the importance of working in teams will challenge the academic health care community. Large research teams may require new ways of training and nurturing young investigators, including improved grant writing and knowledge translation, human resource management skills and the ability to interact with disciplines that have different research methodologies. MD/PhD and Clinician Investigator Programs may help to fill these gaps in medicine, but nursing is faced with a serious shortage of doctoral-trained educators and researchers and may need targeted programs to achieve a critical mass of academics able to accept leadership roles. The success of the Quebec model of support for health research networks and researchers is encouraging. There is a leadership gap within health care institutions that spans jurisdictions and affects both institutional performance and individual careers. Young investigators need good mentors and adequate protected time to acquire the skills necessary for leadership roles. Policy changes within health care institutions and academic organizations will be necessary to adapt to the coming decade. The Canadian Institute of Academic Medicine is committed to developing better mentoring strategies for the next generation of academic leaders and to creating formal assessments of major Canadian health issues that can be used by health care advocacy groups when talking with policy-makers.     

Strategies used by interdisciplinary rural health training programs to assure community responsiveness and recruit practitioners

In this article, the strategies used by five US rural interdisciplinary training grant programs to respond to local needs and to promote recruitment in rural communities are described. The programs provide training to 17 health care disciplines and serve disadvantaged Hispanic, African-American, Amish, Native American, and Anglo populations. Four programs are based in academic institutions; one is based in a community health center. The programs provide services to the rural communities through individual clinical or case management services, population-level interventions, and collaborative research. All programs use specific mechanisms (e.g. case conferences or participation in local coalitions) to facilitate collaboration with residents and to link student activities with community or individual needs. Unique strategies include the use of problem-based learning and community health workers on the interdisciplinary team to increase responsiveness. The programs also provide educational support to students while they work in the rural communities. Finally, the primary strategy used to promote recruitment is the training experience in rural communities. The programs also appear to indirectly improve the environment of rural practice.     

Strategies used by interdisciplinary rural health training programs to assure community responsiveness and recruit practitioners

In this article, the strategies used by five US rural interdisciplinary training grant programs to respond to local needs and to promote recruitment in rural communities are described. The programs provide training to 17 health care disciplines and serve disadvantaged Hispanic, African-American, Amish, Native American, and Anglo populations. Four programs are based in academic institutions; one is based in a community health center. The programs provide services to the rural communities through individual clinical or case management services, population-level interventions, and collaborative research. All programs use specific mechanisms (e.g. case conferences or participation in local coalitions) to facilitate collaboration with residents and to link student activities with community or individual needs. Unique strategies include the use of problem-based learning and community health workers on the interdisciplinary team to increase responsiveness. The programs also provide educational support to students while they work in the rural communities. Finally, the primary strategy used to promote recruitment is the training experience in rural communities. The programs also appear to indirectly improve the environment of rural practice.     

Perceptions of digital storytelling in the classroom

Digital storytelling is used as an educational tool that enhances learning in many disciplines, although little is known about how prelicensure nursing students perceive the use of digital stories in the classroom. Digital stories were featured in the class sessions followed by a group care planning activity with objectives based on The Quality and Safety Education for Nurses (QSEN) Initiative Patient-Centered Care Competency. Focus group discussions and classroom evaluations by prelicensure students indicated positive results.     

A nontraditional curriculum for the preparation of nurse educators.

The purpose of this article is to describe a bold and innovative program for the preparation of nurse educators in a developing country. This program was designed to anticipate the competing demands for radical change in both the health care system and the nursing educational system. Consideration was given to the need for a curriculum model that was flexible and broad enough to accommodate the educational and professional needs of a very diverse group of students regarding academic ability, culture, and language. The aim of the curriculum was to achieve the desire for meaningful, lifelong learning and personal growth, while maintaining academic excellence within a transformative and democratizing context.     

Graduate education in nursing leadership through distance technologies: the Canada-Norway Nursing Connection

The Canada-Norway Nursing Connection was a collaborative project designed to provide an international educational experience for graduate students in nursing via distance technology. Computer-conferencing and video-teleconferencing were used to address nursing leadership content through case studies. The same technologies were employed to develop the project. The processes of planning and implementing the international linkage are described. Agreement about goals, content, context for online discussion, delivery methods, academic expectations, language support, and logistics was essential. The media proved to be effective for students to gain understandings about nursing leadership, health care, and the forces influencing the nursing profession globally. Insights from the project provided a basis for the development of a model for interactive, international graduate education that will be of value to educators dedicated to helping students gain a global understanding of nursing and health care issues.     

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.     

Introducing the ICF: the development of an online resource to support learning, teaching and curriculum design

The International Classification of Functioning, Disability and Health (ICF) was adopted as one of the key models to support early health professional learning across a suite of new preregistration health science courses. It was decided that an online resource should be developed to enable students, course designers and teaching staff, across all disciplines, to have access to the same definitions, government policies and other supporting information on disability. As part of the comprehensive curriculum review, enquiry-based learning was adopted as the educational approach. Enquiry-based learning promotes deeper learning by encouraging students to engage in authentic challenges. As such, it was important that the online resource was not merely a site for accessing content, but enabled students to make decisions about where else to explore for credible information about the ICF. The selection of a host location that all students and staff could access meant that the resource could not be located in the existing online learning management system. Construction using software being trialled by the library at La Trobe University allowed for the required access, as well as alignment with an enquiry-based learning approach. Consultation for the content of the online resource included formal and informal working groups on curriculum review. The published version included resources from the World Health Organization, examples of research completed within different disciplines, a test of knowledge and a preformatted search page. The format of the online resource allows for updating of information, and feedback on the utilisation of the software has been used to enhance the student experience. The key issues for the development of this online resource were accessibility for students and staff, alignment with the adopted educational approach, consultation with all disciplines, and ease of modification of information and format once published.     

Metacognition: implications for instruction in nursing education

Published research efforts devoted to metacognition in post-secondary learners are accumulating and provide a stimulating array of instructional implications and fuel for further inquiry. Faculty in disciplines such as nursing where there is concern about the decline in a number of applicants and the academic ability of entering students may find that the literature on metacognition offers guidance on assisting students to perform at a more optimal level. Like preventative health care, providing instruction on metacognitive skills is a preventative educational practice: the goal being prevention of learning deficits and failure. The purpose of this article is to provide an analysis of the construct of metacognition and describe a specific dimension of metacognition, strategic reading, useful to student nurses.     

Shared teaching in health care ethics: a report on the beginning of an idea

In the majority of academic institutions nursing and medical students receive a traditional education, the content of which tends to be specific to their future roles as health care professionals. In essence, each curriculum design is independent of each course. Over the last decade, however, interest has been accumulating in relation to interprofessional and multi-professional learning at student level. With the view that learning together during their student training would not only encourage and strengthen future collaboration in practice settings but also enhance patient care, the University of Dundee decided to run a pilot study to explore shared teaching in ethics between medical and nursing students. This article presents a report on the reasons for selecting health care ethics as a precursor for shared teaching, the educational tool used for the sessions, and the results of student and facilitator evaluation of the short course. Overall, despite problems such as poor attendance by some students, and facilitation and timetable difficulties, most of the feedback from students and facilitators has been positive. In essence the 'idea' has gone from strength to strength and there are now three levels of shared teaching in ethics between nursing and medical students, with plans to include further sessions with students from other disciplines. Within the text, 'health care ethics' will be referred to as 'ethics'; nursing students/nurses encompasses midwifery students/midwives.     

Building academic and practical knowledge in nursing through TB skin testing certification in a BSN curriculum

Tuberculosis (TB) is a communicable disease with worldwide health care consequences. After decades of declining incidence there was a 14% increase in the United States from 1985 to 1992, although rates are now declining due to focused programs. The State of Indiana mandates continuous TB monitoring by health care workers who have completed an educational course. The Indiana State Department of Health (ISDH) and the American Lung Association designed an educational program called a Basic TB Skin Test Course, which is used by the Community Health Nursing faculty at Indiana University School of Nursing (IUSON) in the baccalaureate curriculum to assist students in meeting state requirements. All students receive the didactic TB content of the course in the epidemiological concepts unit. Students can elect to receive certification by attending an additional 2-hour clinical session. Over 500 community health nursing students have completed the Basic TB Skin Test course in the past 5 years. The outcomes are positive for students, community, and public health.     

Using a problem-based learning format to teach CLS students interdisciplinary health care practice.

OBJECTIVE: To simulate interdisciplinary collaborative practice using a problem-based format so students can increase their knowledge and understanding of health care disciplines other than their own. The basic premise of this approach is that learners are more likely to master necessary subject matter if it is presented in a manner that is realistic. SETTING: University of Kentucky Center for Rural Health. PARTICIPANTS: Eight student participants-three undergraduate clinical laboratory science students, three students in the masters degree nursing program, one family practice resident, and one visiting student from a physician's assistant program. MAIN OUTCOME MEASURES: Group discussion, peer review, and student questionaires. CONCLUSION: The interdisciplinary, case-study approach to learning offers the clinical laboratory science student an opportunity to work with other health care providers in an informal setting as an introduction to group interaction, interdisciplinary health care, and evaluation of health care access in any community.     

Integrating Poverty and Gender into Health Programs: A Sourcebook for Health Professionals

Evidence increasingly shows that poverty and gender inequalities are important determinants of health and influence the opportunity for timely and appropriate health care. These findings suggest that health professionals need to have a sound understanding of health inequalities and their causes, as well as of how they can be addressed. However, through surveys to health ministries and educational institutions in 2001, the World Health Organization Regional Office for the Western Pacific found that awareness of, and capacity to respond to, poverty and gender concerns in health was weak. In response, the Regional Office initiated a project to develop materials to support the integration of poverty and gender concerns into health professional education curricula. The multimodule publication, Integrating Poverty and Gender into Health Programmes: A Sourcebook for Health Professionals, supports evidence-based and participatory learning. The experience to date suggests that the publication might be meeting a long-felt need for such a response.