Examining the influence of professional identity formation on the attitudes of students towards interprofessional collaboration

An expectation of introductory interprofessional education (IPE) is improvement in attitudes towards other professions. However, the theory surrounding professional identity formation suggests this expectation may be premature. The objective of this study was to quantify first-year health professional students’ attitudes towards their own and other professions and to investigate the relationship between strength of professional identity and attitudes towards other professions and interprofessional learning. Using a pre/post-test design, researchers administered the Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS) to 864 first-year healthcare students in the Academic Health Center (AHC) at the University of Minnesota. The findings showed a decline in student attitudes towards their own and other professions. Additionally, a positive correlation between a weakened professional identity and readiness for interprofessional learning was demonstrated. This study found that an introductory IPE course did not positively affect student attitudes towards other professions, or strengthen professional identity or readiness for interprofessional learning. Analysis of the findings support the successive stages of professional identity formation.     

The team builder: the role of nurses facilitating interprofessional student teams at a Swedish clinical training ward

Interprofessional education (IPE) is an educational strategy attracting increased interest as a method to train future health care professionals. One example of IPE is the clinical training ward, where students from different health care professions practice together. At these wards the students work in teams with the support of facilitators. The professional composition of the team of facilitators usually corresponds to that of the students. However, previous studies have revealed that nurse facilitators are often in the majority, responsible for student nurses' profession specific facilitation as well as interprofessional team orientated facilitation. The objective of this study was to describe how nurses act when facilitating interprofessional student teams at a clinical training ward. The research design was ethnography and data were collected through participant observations and interviews. The analysis revealed the four strategies used when facilitating teams of interprofessional students to enhance collaborative work and professional understanding. The nurse facilitator as a team builder is a new and exciting role for nurses taking on the responsibility of facilitating interprofessional student teams. Future research needs to explore how facilitating nurses balance profession specific and team oriented facilitating within the environment of an interprofessional learning context.     

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.     

Perceptions of interprofessionalism in health professional students participating in a novel community service initiative

Interprofessional collaboration is integral to effective patient care in today’s healthcare system. Early exposure to other professions in a hands-on manner during education can be helpful for future practice. However, opportunities for interprofessional education are typically faculty driven and remain limited. Thirty-eight students from different health professions at the University of British Columbia worked collaboratively to promote cardiovascular risk reduction in Vancouver’s Downtown Eastside. Student attitudes toward interprofessionalism were assessed using the Interdisciplinary Education Perception Scale (IEPS). While 38 participants (55%) completed the survey prior to participation in this initiative, only 21 individuals completed the follow-up survey After participation, there were significant improvements in the competency and autonomy (p = 0.02) and perception of actual cooperation (p = 0.04). Students did not report any difference in their perceived need for cooperation after participation in the initiative. These results suggest that student-led community service initiatives can be an effective method for interprofessional education amongst health professional students.     

Prospective health students’ perceptions of the pharmacist role in the interprofessional team

Negative perceptions or underdeveloped understanding of healthcare team member roles can impact the functionality of the team and stunt innovations in interprofessional practice and education. Therefore, the intent of this study was to explore the perception of pharmacists’ role on the healthcare team by future team members: prospective health professional students. The study utilised a survey to examine these perceptions in prospective health professional students (n = 34) nearing the application process to health professional school. A coding process was used to explore open-ended text responses through a line-by-line analysis and identify emerging themes regarding perception of pharmacists’ roles, responsibilities, and practice settings. Quantitative data examined perception of pharmacists by intended prospective profession, healthcare experience, and pharmacy experience. Results indicate that while prospective health professional students find pharmacists to be an important part of the healthcare team, they lack a developed understanding of pharmacists’ roles, responsibilities, and practice settings. Identifying and addressing prospective health professional students’ misperceptions surrounding pharmacists’ roles and responsibilities may encourage them to make informed career decisions and shape them into more knowledgeable future professionals with the ability to better impact patient care on interprofessional teams.     

Revealing tacit knowledge used by experienced health professionals for interprofessional collaboration

ABSTRACT

With the current interest in interprofessional collaboration in health care as a response to ever-increasing complexity of health issues and scarcity of resources, many higher education institutions are developing interprofessional education (IPE) programs. However, there has been little empirical work on what. With the current interest for interprofessional collaboration in health care ever-increasing knowledge and skills are required to work collaboratively between health professions. We have undertaken to describe interprofessional collaboration as a practice largely underpinned by tacit knowledge acquired by experienced clinicians. Clinicians from all health professions in a large francophone university in Eastern Canada were invited to participate in explicitation interviews. Explicitation interviews require participants to freely recall an interprofessional collaboration event (e.g., team meeting or joint care delivery) and describe specific actions they personally enacted. An experienced health professional encounters many interprofessional situations over time; the actions they describe reflect their personal theories about the practice. Hence, it is highly probable that they use them frequently when working with colleagues in clinical settings. Unveiled tacit knowledge was divided into four themes: the importance of a sense of belonging to a team, the imperative to meet face-to-face, the practice of soliciting the working hypotheses of colleagues, and the art of summarizing meeting discussions.     

How can student experience enhance the development of a model of interprofessional clinical skills education in the practice placement setting?

The practice placement setting offers opportunities and challenges for engaging students in high-quality interprofessional learning. The Fife Interprofessional Clinical Skills Model for Education was established to develop structured interprofessional learning opportunities for students during their clinical attachments in NHS Fife. This short report describes the delivery and evaluation of the model, which was piloted with students from the nursing, medicine and allied health professions. Scheduled workshops were delivered within primary and secondary care locations. The learning activities involved exploring and comparing their professional identities, discussing roles and responsibilities within the healthcare team and practicing nontechnical clinical skills. Students who participated in the workshops reported that they developed a better understanding of each other's roles and responsibilities and also identified that this would be transferable knowledge to their future practice. Exploring the student experience has assisted in developing relevant and accessible interprofessional learning opportunities within the practice placement setting.     

Evaluation of a student-led interprofessional innovative health promotion model for an underserved population with diabetes: A pilot project

Interprofessional education seeks to encourage different health professions to interact and learn together during their training process which will eventually lead to collaborative healthcare practices and improved care for patients. This study determined whether student understanding of diabetes management and the role of health professionals in diabetes care improved after the implementation of an interprofessional health promotion program. Sixty-three students from five health professions led six educational sessions concentrating on critical components of diabetes management. The longitudinal program covered topics within the Alphabet Strategy (A-G). Students were surveyed to determine their understanding of diabetes management. Data were gathered at the beginning of the study and its conclusion. Forty-seven students completed the program and the pre- and post-survey. There were significant improvements in students' knowledge of diabetes care, understanding of the roles of healthcare professionals and ability to work with other healthcare professionals. Nineteen patients completed the study. There were no significant differences in patients' diabetes knowledge, understanding of diabetes care and clinical outcomes. This study acknowledged the potential value of an interprofessional team approach to care. This innovative model could be applied to other practice settings and used for the management of other chronic diseases.     

Interprofessional training in clinical practice on a training ward for healthcare students: a two-year follow-up

This follow-up study describes the former students' lasting impressions of a two-week interprofessional course on a training ward aimed at enhancing the understanding of the roles of other professions and the importance of communication for teamwork and for patient care as well as providing an opportunity for profession-specific training. A questionnaire with both closed and open-ended questions was sent to 633 former students two years after the course and 348 (55%) responded. The course was rated as very good and most of the former students had lasting and positive impressions. Ninety-two percent of respondents encouraged teamwork in their present work and 90% wanted to retain the course. The qualitative analysis of the open-ended questions resulted in five categories describing students' perceptions: professional role development, working in teams, tutoring, patient care and future aspects of the course and real world practice. Our results suggest that interprofessional training during undergraduate education provides lasting impressions that may promote teamwork in students' future occupational life.     

OPIOIDS: cultivating interprofessional collaboration to find solutions to public health problems

This study evaluated perceived effectiveness of an interprofessional case-based activity that allowed medical and pharmacy students to engage in problem-solving around the role of social determinants of health (SDOH) in opioid misuse. Students participated in a case-based activity, and then completed a post-activity survey that included five open-ended questions and the Interprofessional Collaborative Competency Attainment Survey. Twelve pharmacy students (100%) and 47 medical students (75%) completed the post-activity survey. Results indicate the activity resulted in a statistically significant increase in student ability to: 1) recognize interprofessional team members’ knowledge, skills, and contributions to the interprofessional team; 2) communicate effectively across professions; and 3) learn with, from, and about interprofessional team members to develop a patient care plan. Students also reported enhanced understanding of treatment considerations with opioid misuse, the role of SDOH, and recognition of the value of interprofessional collaboration in their future practice. This interprofessional case-based activity appeared to promote collaboration among students from different professional programs as they engaged in problem-solving around a contemporary public health issue that intersects their future practices. This activity may serve as a model for health professional programs, practitioners, healthcare systems, and communities that seek interprofessional solutions to combat opioid misuse.     

Measuring the impact of an online IPE course on team perceptions

ABSTRACT

Interprofessional education (IPE) needs to begin with foundational learning experiences for health professions learners at an institution. There is a recognized need for IPE to be embedded into health profession curriculums; however, several barriers prevent the implementation. The purpose of this project was to determine if an introductory online IPE course can overcome some of the existing barriers to implementing IPE while influencing team perceptions among health professional students. The modified Team Skills Scale was used to assess perceptions of students from six health professions programs pre-posttest to the introductory course. The researchers grounded the development of the course in the Institute of Medicine’s Interprofessional Learning Continuum. Results show that an introductory online course in IPE can affect team perceptions of students and can be offered on a large scale with minimal impact on faculty workload. The pedagogical approach implies institutions with large numbers of health professions programs, large numbers of students and distance learners may benefit from a similar approach to introducing interprofessional collaboration.     

Determining frameworks for interprofessional education and core competencies through collaborative consultancy: the CARE experience

It is claimed that an interprofessional approach to health care aims to provide optimal client care, reduce duplication of services, address gaps in service delivery and prevent adverse consequences to patients. Hence there is widespread international interest in interprofessional education in undergraduate programs. However, after employment in the Australian health care workforce, there is limited opportunity for this. The continued education and training of health professionals and other care workers frequently occurs in a climate where professional development is dominated by the existence of professional demarcations. In order to enhance interprofessional collaboration in health care practice and education, mechanisms to guide individual performance within a multi-professional health team are required. This paper presents both the process and outcomes of a consultancy undertaken in order to determine core competencies for collaborative interprofessional practice in a community and aged care service.     

A network model of communication in an interprofessional team of healthcare professionals: A cross-sectional study of a burn unit

Healthcare teams consist of individuals communicating with one another during patient care delivery. Coordination of multiple specialties is critical for patients with complex health conditions, and requires interprofessional and intraprofessional communication. We examined a communication network of 71 health professionals in four professional roles: physician, nurse, health management, and support personnel (dietitian, pharmacist, or social worker), or other health professionals (including physical, respiratory, and occupational therapists, and medical students) working in a burn unit. Data for this cross-sectional study were collected by surveying members of a healthcare team. Ties were defined by asking team members whom they discussed patient care matters with on the shift. We built an exponential random graph model to determine: (1) does professional role influence the likelihood of a tie; (2) are ties more likely between team members from different professions compared to between team members from the same profession; and (3) which professions are more likely to form interprofessional ties. Health management and support personnel ties were 94% interprofessional while ties among nurses were 60% interprofessional. Nurses and other health professionals were significantly less likely than physicians to form ties. Nurses were 1.64 times more likely to communicate with nurses than non-nurses (OR = 1.64, 95% CI: 1.01–2.66); there was no significant role homophily for physicians, other health professionals, or health management and support personnel. Understanding communication networks in healthcare teams is an early step in understanding how teams work together to provide care; future work should evaluate the types and quality of interactions between members of interprofessional healthcare teams.     

Europe,the professions and interprofessional education: An exploration in inter-culture relativity

This paper seeks to understand the inter-cultural relationships between the notions of Europe, the professions and interprofessional education (IPE) in developing an argument for the necessity of interprofessional education for meeting the complex challenges for the professions and society in the 21st century. The concept of “strange loops” is used to explore the paradoxes and recursions in understanding what Europe, the professions and interprofessional education really are. After questioning perceptions of the professions in a changing Europe, I challenge interprofessional education to greater heights. IPE has to accompany all professional exchanges across borders as a critical, constructive process that focuses on differences in theory and practice within the different professional fields to overcome their problems of adjustment to changing user needs and cultural requirements.     

Which of the four models? Examining the measurement properties of the Interdisciplinary Education Perception Scale (IEPS) in healthcare and socialcare prelicensure curriculum in Hong Kong

Interdisciplinary Education Perception Scale (IEPS) is one of the popular measures of perceptions of collaboration. In its original inception, a four-factor model was proposed but subsequent study offered alternative measurement models: three-factor model, two-factor model, and further revision of the three-factor model. Despite the changes in the model structures, none of these has been examined in the Asian context which could have paved the way for local researchers to start representing Asian perspectives in the discussion of interprofessional practice and cooperation in medical education. This study therefore aimed to examine the measurement properties of the IEPS by testing the four a priori models using the data from 335 Chinese students from eight prelicensure health and social care programs from two universities in Hong Kong. Through item analysis, confirmatory factor analysis, and regression, the results suggest that the 12-item, three-factor model best represented the sample and was invariant across genders and year levels. Theoretical and practical implications to interdisciplinary education literature are discussed.     

Two heads are better than one: the future of patient safety and quality care

IPE summits can be used as a mechanism to have students from multiple disciplines explore ethical issues, define professional roles and responsibilities, and encourage interdisciplinary discussion. Students can be facilitated in this process through questions related to each member's role and scope of practice. The goals for students participating in these types of activities are to expand the students' knowledge of other health professions and to promote interprofessional understanding of other health professionals' roles and responsibilities to patient care. It is hopeful that students will reflect upon the identification of healthcare professional roles and responsibilities and use such opportunities to collaborate in ways to improve patient outcomes.     

Understanding interprofessional relationships by the use of contact theory

The importance and necessity of interprofessional collaboration (IPC) present challenges for educators as they determine how best to achieve IPC through interprofessional education (IPE). Simulation-based teaching has been shown to enhance students' understanding of professional roles and promote positive attitudes toward team members; yet, empirical evidence providing direction on the conditions necessary to promote these positive outcomes is lacking. This study used a quasi-experimental design with a pre-/post-test to examine changes in undergraduate healthcare students' perceptions and attitudes toward IPC following their participation in an interprofessional simulation program. Allport's (1954) intergroup contact theory was used to help understand the nature of this IPE workshop and its reported outcomes. Participants included students in the final year of their respective programs (n?=?84) such as pharmacy technician, paramedic, nursing and occupational therapy assistant/physical therapy assistant programs. These students were engaged in simulation exercises with interactive contact opportunities. Using the interdisciplinary education perceptions scale, statistically significant increases in positive attitudes in three of four sub-scales were found. An analysis of the structure and format of the workshop suggests that this IPE initiative fulfilled the key conditions suggested by intergroup contact theory. Attention to the key conditions provided by Allport's theory in the context of successful intergroup relationships may help provide direction for educators interested in planning IPE initiatives with student groups enrolled in various health programs.     

Interprofessional learning for pre-qualification health care students: an outcomes-based evaluation

Within health, it is widely acknowledged that a collaborative, team-oriented approach to care is required to ensure patient safety and quality of service delivery. A pre-qualification interprofessional learning experience should provide an ideal opportunity for students to gain the necessary knowledge, skills and attitudes to enable them to work as part of a patient-centred interprofessional team. In this article we report a multidimensional evaluation of a pre-qualification interprofessional learning (IPL) program. The program brings together senior year students from various health care professions on clinical placement in the same service area of a hospital to take part in shared, structured learning experiences centred on interprofessional teamwork. We used a combination of qualitative and quantitative methods to evaluate the IPL program. Results indicate that students' understanding of the roles of other team members was enhanced, and students and supervisors perceived the program to be of value for student learning. Measured changes in attitude were limited. Unexpected findings emerged in relation to role responsibilities within teams and attitudes towards doctors. We conclude that such programs have the potential to expand students' understanding of the contributions made by other professionals/colleagues to effective patient care, although challenges persist in overcoming pre-existing role stereotypes.     

The evaluation of a national interprofessional palliative care workshop

Abstract

The purpose of this study was to evaluate the impact of a palliative/end-of-life care workshop on students’ perceptions of professional identity, team understanding, and their readiness for interprofessional education (IPE). A before-and-after design was used combining both qualitative and quantitative methods. A survey was completed by 25 undergraduate students from a variety of health care professional schools across Canada, both before and after they attended the five-day workshop. There was a significant increase in students’ readiness for IPE, perceptions of professional identity, and team understanding after they attended the palliative care workshop. Students stated that learning about other professionals’ backgrounds and becoming more sensitive to other team members and their scopes of practice helped change the way they would practice. The findings from this study will contribute to our understanding of student attitudes around IPE and palliative care.     

Simulated interprofessional education: an analysis of teaching and learning processes

Simulated learning activities are increasingly being used in health professions and interprofessional education (IPE). Specifically, IPE programs are frequently adopting role-play simulations as a key learning approach. Despite this widespread adoption, there is little empirical evidence exploring the teaching and learning processes embedded within this type of simulation. This exploratory study provides insight into the nature of these processes through the use of qualitative methods. A total of 152 clinicians, 101 students and 9 facilitators representing a range of health professions, participated in video-recorded role-plays and debrief sessions. Videotapes were analyzed to explore emerging issues and themes related to teaching and learning processes related to this type of interprofessional simulated learning experience. In addition, three focus groups were conducted with a subset of participants to explore perceptions of their educational experiences. Five key themes emerged from the data analysis: enthusiasm and motivation, professional role assignment, scenario realism, facilitator style and background and team facilitation. Our findings suggest that program developers need to be mindful of these five themes when using role-plays in an interprofessional context and point to the importance of deliberate and skilled facilitation in meeting desired learning outcomes.