Online interprofessional education facilitation: A scoping review

Introduction: The use of online media to deliver interprofessional education (IPE) is becoming more prevalent across health professions education settings. Facilitation of IPE activities is known to be critical to the effective delivery of IPE, however, specifics about the nature of online IPE facilitation remains unclear.

Aim: To explore the health professions education literature to understand the extent, range and nature of research on online IPE facilitation.

Methods: Scoping review methodology was used to guide a search of four electronic databases for relevant papers. Of the 2095 abstracts initially identified, after screening of both abstracts and full-text papers, 10 studies were selected for inclusion in this review. Following abstraction of key information from each study, a thematic analysis was undertaken.

Results: Three key themes emerged to describe the nature of the IPE facilitation literature: (1) types of online IPE facilitation contributions, (2) the experience of online IPE facilitation and (3) personal outcomes of online IPE facilitation. These IPE facilitation themes were particularly focused on facilitation of interprofessional student teams on an asynchronous basis.

Discussion: While the included studies provide some insight into the nature of online IPE facilitation, future research is needed to better understand facilitator contributions, and the facilitation experience and associated outcomes, both relating to synchronous and asynchronous online environments.     

Using a meta-ethnographic approach to explore the nature of facilitation and teaching approaches employed in interprofessional education

Background: Interprofessional facilitators and teachers are regarded as central to the effective delivery of interprofessional education (IPE). As the IPE literature continues to expand, most studies have focused on reporting learner outcomes, with little attention paid to IPE facilitation. However, a number of studies have recently emerged reporting on this phenomenon.

Aim: To present a synthesis of qualitative evidence on the facilitation of IPE, using a meta-ethnographic approach.

Methods: Electronic databases and journals were searched for the past 10 years. Of the 2164 abstracts initially found, 94 full papers were reviewed and subsequently 12 papers were included. Teams of two reviewers independently completed each step in the review process. The quality of these papers was assessed using a modified critical appraisal checklist.

Results: Seven key concepts embedded in the included studies were synthesized into three main factors which provided an insight into the nature of IPE facilitation. Specifically, the synthesis found that IPE facilitation is influenced by “contextual characteristics”; “facilitator experiences”; and the “use of different facilitation strategies”.

Conclusions: IPE facilitation is a complex activity affected by contextual, experiential and pedagogical factors. Further research is needed to explore the effects of these factors on the delivery of IPE.     

Evaluation of an online postgraduate education programme

Information technology supporting training in medicine is unstructured and critical evaluation of its use is lacking. The objective of the paper was the evaluation of an Internet-delivered postgraduate training course in medicine. The work took place in the Division of Obstetrics and Gynaecology and Institute for Learning and Research Technology, University of Bristol. Postgraduate trainees were invited to participate in an Internet delivered training programme over 5 months. Tutors and the participants were interviewed, inter-participant emails were collected and post-course evaluation of all trainees was undertaken at 2 and 6 months. Of 18 enrolled participants, 11 actively participated (mean: five each month). Participants were more likely to view other participants' responses or tutor feedback than respond themselves. The Internet is a suitable medium for courses of this nature. Satisfaction levels with the content of the course and with the medium used were high. Constructive criticism was incorporated into future courses.     

An interprofessional problem-based learning course on rehabilitation issues in HIV

This study examined students' perceptions of their learning through participation in an interprofessional problem-based course on rehabilitation and HIV. Students representing five health professions participated in an eight-week tutorial course. Qualitative analysis of journals that the students completed throughout the course, and of interviews of the students at completion of the course, revealed that they valued their learning experience. Students gained an appreciation of the roles of others and developed a sense of confidence through justifying their professional role. Through the interprofessional discussions, students were able to increase the breadth and depth of their learning and also gained a rehabilitation perspective. Learning related to HIV and rehabilitation is ideally suited to an interprofessional, problem-based environment.     

Twelve tips for effective online discussions in continuing medical education

Online discussions for continuing medical education are increasing but many are ineffective. Close attention needs to be paid to the requirements of the learner and the wider healthcare organizational context within which continuing medical education takes place. There is a preference for structured and facilitated online discussions by this group of doctors. The essential skills for effective online facilitation are outlined.     

A best evidence systematic review of interprofessional education: BEME Guide no. 9

BACKGROUND AND REVIEW CONTEXT: Evidence to support the proposition that learning together will help practitioners and agencies work better together remains limited and thinly spread. This review identified, collated, analysed and synthesised the best available contemporary evidence from 21 of the strongest evaluations of IPE to inform the above proposition. In this way we sought to help shape future interprofessional education and maximize the potential for interprofessional learning to contribute to collaborative practice and better care. OBJECTIVES OF THE REVIEW: To identify and review the strongest evaluations of IPE. To classify the outcomes of IPE and note the influence of context on particular outcomes. To develop a narrative about the mechanisms that underpin and inform positive and negative outcomes of IPE. SEARCH STRATEGY: Bibliographic database searches as follows: Medline 1966-2003, CINAHL 1982-2001, BEI 1964-2001, ASSIA 1990-2003 which produced 10,495 abstracts. Subsequently, 884 full papers were obtained and scrutinized. In addition, hand searching (2003-5 issues) of 21 journals known to have published two or more higher quality studies from a previous review. TOPIC DEFINITION AND INCLUSION CRITERIA: Peer-reviewed papers and reports included in the review had to be formal educational initiatives attended by at least two of the many professional groups from health and social care, with the objective of improving care; and learning with, from and about each other. DATA COLLECTION, ANALYSIS AND SYNTHESIS: Standard systematic review procedures were applied for sifting abstracts, scrutinizing full papers and abstracting data. Two members of the team checked each abstract to decide whether the full paper should be read. A third member was consulted over any discrepancies. Similarly, each full paper was read by at least two members of the team and agreement sought before passing it to one member of the team (SR) for data abstraction. Other members of the team checked 10% of the abstraction records. Coding into a Statistical Package for Social Scientists (SPSS) data base led to collection of different outcome measures used in the primary studies via the common metric of an adapted Kirkpatrick's four-level model of educational outcomes. Additionally, a narrative synthesis was built after analysis of primary data with the 3-P model (presage-process-product) of education development and delivery. HEADLINE RESULTS: Government calls for enhanced collaboration amongst practitioners frequently leads to IPE that is then developed and delivered by educators, practitioners or service managers. Staff development is a key influence on the effectiveness of IPE for learners who all have unique values about themselves and others. Authenticity and customization of IPE are important mechanisms for positive outcomes of IPE. Interprofessional education is generally well received, enabling knowledge and skills necessary for collaborative working to be learnt; it is less able to positively influence attitudes and perceptions towards others in the service delivery team. In the context of quality improvement initiatives interprofessional education is frequently used as a mechanism to enhance the development of practice and improvement of services.     

A case study of teaching presence in virtual problem-based learning groups

Interest in conducting problem-based learning (PBL) on-line has increased to meet student and physician schedules. Little research describes skills needed to facilitate PBL on-line. In this paper we studied teaching presence in asynchronous PBL groups. Two raters, with average inter-rater agreements of 0.80, used an existing code to measure teaching presence in 62 PBL case discussions facilitated by one instructor over five years. This instructor was selected because of consistently high teaching evaluations. Messages sent by the instructor in the on-line PBL discussion were coded into three categories: instructional design and organization, facilitating discourse and direct instruction. Instructional design indicators were most frequent averaging 22.5 (SD = 5.6)/discussion. Facilitating discourse and direct instruction were comparable, 19.5(SD = 7.4) and 19.5 (SD = 6.7), respectively. Messages and indicators of teacher presence rose across time with a decline during subsequent PBL cases with the same group.     

A BEME systematic review of the effects of interprofessional education: BEME Guide No. 39

Background: Interprofessional education (IPE) aims to bring together different professionals to learn with, from, and about one another in order to collaborate more effectively in the delivery of safe, high-quality care for patients/clients. Given its potential for improving collaboration and care delivery, there have been repeated calls for the wider-scale implementation of IPE across education and clinical settings. Increasingly, a range of IPE initiatives are being implemented and evaluated which are adding to the growth of evidence for this form of education.

Aim: The overall aim of this review is to update a previous BEME review published in 2007. In doing so, this update sought to synthesize the evolving nature of the IPE evidence.

Methods: Medline, CINAHL, BEI, and ASSIA were searched from May 2005 to June 2014. Also, journal hand searches were undertaken. All potential abstracts and papers were screened by pairs of reviewers to determine inclusion. All included papers were assessed for methodological quality and those deemed as “high quality” were included. The presage–process–product (3P) model and a modified Kirkpatrick model were employed to analyze and synthesize the included studies.

Results: Twenty-five new IPE studies were included in this update. These studies were added to the 21 studies from the previous review to form a complete data set of 46 high-quality IPE studies. In relation to the 3P model, overall the updated review found that most of the presage and process factors identified from the previous review were further supported in the newer studies. In regard to the products (outcomes) reported, the results from this review continue to show far more positive than neutral or mixed outcomes reported in the included studies. Based on the modified Kirkpatrick model, the included studies suggest that learners respond well to IPE, their attitudes and perceptions of one another improve, and they report increases in collaborative knowledge and skills. There is more limited, but growing, evidence related to changes in behavior, organizational practice, and benefits to patients/clients.

Conclusions: This updated review found that key context (presage) and process factors reported in the previous review continue to have resonance on the delivery of IPE. In addition, the newer studies have provided further evidence for the effects on IPE related to a number of different outcomes. Based on these conclusions, a series of key implications for the development of IPE are offered.     

Scholarship in teaching and best evidence medical education: synergy for teaching and learning

Medical education has lagged behind research and clinical care in developing a value system and social construct that promotes and stimulates the open discussion of the state of the art in teaching among teachers. The recent development of best evidence medical education (BEME) in Europe and the renewed attention to the concept of scholarship in North America provide a conceptual and strategic approach for enhancing the educational enterprise in the health professions. The similarities and differences between BEME and an approach to Scholarship in Teaching developed by a subcommittee of the Group on Educational Affairs of the Association of American Medical Colleges is examined. Combining these two approaches to medical teaching can maximize the potential for advancing the science and art of medical education.     

Student participation in the development of interprofessional education courses: Perceptions and experiences of faculty members and the students

Abstract

Introduction: Student participation has shown positive effects on the curriculum development process for a single health profession. This qualitative study explores faculty members’ and students’ perceptions and experiences regarding student participation in interprofessional course development.

Methods: Interprofessional courses were developed and implemented by interprofessional teams of faculty members and students. Two focus group discussions were carried out: one with faculty members and one with students.

Results: Students contributed to both the process and the results of interprofessional course development in a complementary manner. Student participation was facilitated via motivation for and through work on interprofessional education, a balance between clarity on tasks and students’ autonomy, and a low-hierarchy team atmosphere. Students developed professionally, and faculty members saw them as future ambassadors for interprofessional collaboration.

Conclusions: This study provides multiple qualitative evidence for a positive, complementary role of student participation in interprofessional course development. A number of factors were identified that should be nurtured to facilitate this effect. Our findings may stimulate and guide other schools to actively involve students in the development of interprofessional education.