Innovations in interprofessional learning and teaching: providing opportunities to embed patient safety within the pre-registration physiotherapy curriculum. A Pilot Study

Abstract

Background: Despite recognition of the need to embed patient safety within undergraduate healthcare education, there are limited examples of how this has been achieved within physiotherapy. The purpose of this regional initiative was to develop a course and teaching resources to support Higher Education Institutions in the United Kingdom (UK) when embedding the World Health Organization (WHO) multiprofessional patient safety curriculum into undergraduate healthcare education.

Objectives: In this pilot study, researchers assessed the impact of the interprofessional simulation-based education (IPSE) course on students’ perceptions of interprofessional learning and patient safety post-course, and explored the participants’ perceived application of knowledge and skills 3 months later.

Methods: A sequential mixed-methods evaluation was conducted, including pre- and post-course Readiness for Interprofessional Learning Scale (RIPLS) questionnaires and two course evaluation questionnaires featuring open and closed items (administered immediately post-course and 3 months later). Participants included undergraduate physiotherapy, medical, nursing, and pharmacy students.

Results: The IPSE course enabled students to develop an appreciation of each other’s professional roles and particularly their individual and collaborative practices that may positively impact upon patient safety. Post-course students reported being able to influence patient safety through an increased application of their ability to identify errors and influence their colleagues’ practices, thus impacting directly upon patient safety.

Conclusion: This paper provides an evaluation of an innovative method of providing interprofessional patient safety learning and teaching opportunities within undergraduate healthcare curricula.     

Inter-professional nursing education and the roles of swift trust,interaction behaviors,and creativity: A cross-sectional questionnaire survey

BackgroundTechnological advances in medicine have generated an increase in the complexity of delivering quality medical care, which is a challenge to the healthcare system. Improving interdisciplinary teamwork among all healthcare staff is one approach to meeting these new challenges. Interdisciplinary teamwork can be improved through inter-professional teaching in nursing education, which provides instruction from at least two professions to teams of students from different specialties. Behaviors that foster collaboration and creativity in temporary organizations, such as teams, include swift trust, interactive behaviors, and team creativity. A better understanding of the relationships between these behaviors could help educators improve inter-professional education courses for nursing students.MethodA cross-sectional study was conducted with 210 nursing students enrolled in inter-professional education courses with interdisciplinary teams that included design students. Three self-report questionnaires assessed nursing students' perceptions about swift trust, interactive behaviors, and creativity: 1) swift trust measured cognitive-based and affective-based domains; 2) interactive behaviors measured domains of constructive controversy, helping behaviors, and spontaneous communication; and 3) team creativity measured collaborative abilities. Scale scores range from 1 to 5; higher scores indicate more swift trust, better interactive behaviors, and greater team creativity. Analysis with Pearson's correlation coefficient and SPSS PROCESS macro was employed to test the mediating effects.FindingsCognitive-based swift trust was positively correlated with all three domains of interactive behaviors (p < .01); all domains of interactive behaviors were positively associated with team creativity (p < .01). Mediation models indicated that interactive behaviors mediated the relationship between cognitive-based swift trust and team creativity.DiscussionEnhancing cognitive-based swift trust and interactive behaviors in interdisciplinary education for nursing students could promote team creativity. Faculty involved in interdisciplinary education courses for nurses should encourage interactive behaviors, which could increase cognitive-based swift trust among nursing students and improve collaboration and creativity.     

Can student-peers teach using simulated-based learning as well as faculty: A non-equivalent posttest-only study

BackgroundPeer-assisted learning has an important place in the delivery of health care education with benefits for both the learners and the peer teachers. Simulation-based learning (SBL) is evolving in healthcare professions training and academic programs as a modality that conveys realism and fidelity through immersion.ObjectivesThe primary aim was to compare physiotherapy student's motivation to learn between a conventional faculty-led SBL activity and the same SBL activity delivered by trained final year physiotherapy peer tutors.MethodsPhysiotherapy students from two Universities (n = 226) undertook a SBL learning activity (either faculty led or peer led) and completed the Instructional Materials Motivation Scale questionnaire to assess motivation to learn.ResultsThere was a high level of learner motivation in all learning groups, with significantly higher learner satisfaction (p < 0.001) and lower attention (p < 0.001) in student-led SBL than faculty-led SBL.ConclusionsThis study has highlighted the potential to incorporate peer-assisted and simulation-based learning together in the development of future educational activities in health care training.     

Student perceptions about interprofessional education after an elective course

Abstract

A growing body of evidence indicates interprofessional collaborative practice improves patient care. With this in mind, Louisiana State University Health Sciences Center formally committed to expanding interprofessional education (IPE) initiatives. Thirty-eight self-selected students enrolled in an IPE elective course during the fall of 2012. Students completed the Readiness for Interprofessional Learning Scale (RIPLS) pre- and post-course and also completed a post-course survey. Results indicated a significant change in the roles and responsibilities scale of the RIPLS. Analysis of the data from the post-course survey demonstrated students were able to identify key terms of an IPE definition, as related to their learning experience. In addition, themes of communication, learning/increased knowledge, and collaboration/contribution of other health care professionals were noted across all questions in the post-course survey. Based on the results of this study, an elective course is a promising educational opportunity to increase awareness and knowledge of IPE within academic medical centers.     

Interprofessional education using simulation of an overnight inpatient ward shift

Abstract

In healthcare it is rare for professionals to practice together before they practice together. Nightmare Night Care is an annual interprofessional voluntary event for health sciences students in nursing, medicine and pharmacy to come together for a simulated hospital overnight ward shift. The purpose of this study was to investigate the interprofessional knowledge, skills and attitudes the students learn from this experience. Students responded to surveys before (n?=?45) and after the event (n?=?11) regarding their understanding of the goals of interprofessional education (IPE), roles and responsibilities of other professions, and what they learned from this event. Responses demonstrated that students are eager to learn in interprofessional settings and that IPE events may aid in building understanding and communication between professions. IPE events are an opportunity to allow students to learn about each other; however, they must occur frequently, and must include an orientation on role clarification if they are to have an effect on changing preconceived stereotypes of the other professions.     

Effectiveness of simulation-based education on nursing students’ professional knowledge,attitude and self-confidence in handling child abuse cases

AimThis study aimed to enhance nursing students’ professional knowledge, attitudes and self-confidence in handling child abuse cases through a Child Abuse Simulation-Based Education (CASE).BackgroundGiven that nursing students seldom learn about child abuse case management in textbooks, simulation-based education could assist them in appropriately handling child abuse cases when they become nurses.DesignUsing a quasi-experimental design.Methods190 nurses enrolled in a night school in-service program at a Taiwanese university were recruited for this study. Ninety-four nurses in the experimental group took a simulation-based education on child abuse while 96 nurses in the contrast group took a general nursing course. The pretest and posttest professional knowledge, attitudes and self-confidence of both groups were analyzed using generalized estimating equations in SPSS V22 software.ResultsFollowing the introduction of the CASE course, the experimental group’s posttest professional knowledge, attitudes and self-confidence in handling child abuse cases were higher than those of the contrast group (p < .001). Further analysis showed that professional knowledge increased with tenure, positivity in attitude increased with clinical ladder rating and male nurses were more confident than female nurses when handling child abuse cases.ConclusionsBased on the results, this study proposes recommendations for implementing child abuse simulation-based education for new nurses and those undergoing continuing education.     

Partnering to provide simulated learning to address Interprofessional Education Collaborative core competencies

Abstract

Learning to effectively communicate and work with other professionals requires skill, yet interprofessional education is often not included in the undergraduate healthcare provider curriculum. Simulation is an effective pedagogy to bring students from multiple professions together for learning. This article describes a pilot study where nursing and social work students learned together in a simulated learning activity, which was evaluated to by the Readiness for Interprofessional Learning Scale (RIPLS). The RIPLS was used before and after the simulated activity to determine if this form of education impacted students’ perceptions of readiness to learn together. Students from both professions improved in their RIPLS scores. Students were also asked to identify their interprofessional strengths and challenges before and after the simulation. Changes were identified in qualitative data where reports of strengths and challenges indicated learning and growth had occurred. In conclusion, this pilot study suggests that interprofessional simulation can be an effective method to integrate Interprofessional Education Collaborative core competencies into the curriculum.     

DVD-based stories of people with developmental disabilities as resources for inter-professional education

Purpose.?The use of DVD stories about people with developmental disabilities within inter-professional education (IPE) across healthcare disciplines was evaluated.

Methods.?First year healthcare students (n?==?241) from an IPE unit responded to an attitude scale before and after viewing and discussing a DVD portraying the life and healthcare needs of an adult with cerebral palsy; a third round of data collection occurred later. Qualitative data were obtained from four first year and six second year tutors who discussed student reactions to the DVD. Six first year and four second year students participated in focus groups following viewing of a second DVD, about a young girl with developmental disabilities and complex health needs.

Results.?ANOVA of the attitude scores did not show significant differences from pre- to post-viewing and discussion of the DVD, nor at a third round of data collection. Qualitative analysis revealed that the DVDs did cause students to shift assumptions, perceptions and understanding of the disabilities depicted, and to learn about their own and other professions.

Conclusions.?DVD scenarios of real people with developmental disabilities in real settings offer a means of providing IPE opportunities. The data also point to the need and directions for the development of a new attitudinal measure.     

Making it easy to do the right thing in healthcare: Advancing improvement science education through accredited pan European higher education modules

BackgroundNumerous international policy drivers espouse the need to improve healthcare. The application of Improvement Science has the potential to restore the balance of healthcare and transform it to a more person-centred and quality improvement focussed system. However there is currently no accredited Improvement Science education offered routinely to healthcare students. This means that there are a huge number of healthcare professionals who do not have the conceptual or experiential skills to apply Improvement Science in everyday practise.MethodsThis article describes how seven European Higher Education Institutions (HEIs) worked together to develop four evidence informed accredited inter-professional Improvement Science modules for under and postgraduate healthcare students. It outlines the way in which a Policy Delphi, a narrative literature review, a review of the competency and capability requirements for healthcare professionals to practise Improvement Science, and a mapping of current Improvement Science education informed the content of the modules.ResultsA contemporary consensus definition of Healthcare Improvement Science was developed. The four Improvement Science modules that have been designed are outlined. A framework to evaluate the impact modules have in practise has been developed and piloted.ConclusionThe authors argue that there is a clear need to advance healthcare Improvement Science education through incorporating evidence based accredited modules into healthcare professional education. They suggest that if Improvement Science education, that incorporates work based learning, becomes a staple part of the curricula in inter-professional education then it has real promise to improve the delivery, quality and design of healthcare.     

The impact of covid-19 on psychosocial well-being and learning for australian nursing and midwifery undergraduate students: a cross-sectional survey

AimTo explore the impact of COVID-19 on psychosocial well-being and learning for nursing and midwifery undergraduate students in an Australian university.BackgroundThe World Health Organization has reported a substantial psychological impact of COVID-19 on healthcare professionals to date. Evidence is lacking, however, regarding university nursing and midwifery students of the pandemic and its impact on their educational preparation and/or clinical placement during the COVID-19 pandemic.DesignCross-sectional survey of nursing and midwifery undergraduate students enrolled in the Bachelor of Nursing suite of courses from the study institution in August- September 2020.MethodsA cross-sectional self-administered anonymous online survey was distributed to current nursing and midwifery undergraduate students. The survey included three open-ended questions; responses were thematically analysed.ResultsOf 2907 students invited, 637 (22%) responded with 288 of the respondents (45%) providing a response to at least one of the three open-ended questions. Three major themes associated with the impact of the pandemic on psychosocial well-being and learning were identified: psychosocial impact of the pandemic, adjustment to new modes of teaching and learning, and concerns about course progression and career. These themes were underpinned by lack of motivation to study, feeling isolated, and experiencing stress and anxiety that impacted on students’ well-being and their ability to learn and study.ConclusionsStudents were appreciative of different and flexible teaching modes that allowed them to balance their study, family, and employment responsibilities. Support from academic staff and clinical facilitators/mentors combined with clear and timely communication of risk management related to personal protective equipment (PPE) in a healthcare facility, were reported to reduce students’ stress and anxiety. Ways to support and maintain motivation among undergraduate nursing and midwifery students are needed.     

Interprofessional simulation-based training in gynecologic oncology palliative care for students in the healthcare profession: A comparative randomized controlled trial

BackgroundPreprofessional palliative care education may be inadequate, leaving a gap in health professional students' knowledge and understanding of managing patients with gynecologic cancer and their families. Interprofessional simulation-based training may be useful in helping health professional students gain the necessary skills required for palliative care.ObjectiveThis study aimed to determine the effectiveness of different simulation methods used for interprofessional training on gynecologic oncology palliative care knowledge, interdisciplinary education perceptions, and teamwork attitudes of health professional students and to compare these methods.DesignA comparative randomized controlled trial was conducted with a pre-test and two post-tests.SettingsThis study was conducted at a university in Ankara, Turkey, in 2016–2017.ParticipantsA convenience sample of 84 interprofessional students (nursing, medical, nutrition-dietician, and social work) was used in the study.MethodsStudents were stratified by their profession and randomized by four blocks into high-fidelity simulation, hybrid simulation, and a control group. Data were collected using a semi-structured questionnaire form, palliative care knowledge test, interdisciplinary education perception scale, and teamwork attitudes questionnaire.ResultsThe high-fidelity simulation and hybrid simulation groups improved their palliative care knowledge, interdisciplinary education perception, and teamwork attitudes from pre-test to first and second post-tests compared to the control group.ConclusionThe introduction of high-fidelity simulation and hybrid simulation or hybrid simulation-based interprofessional training in undergraduate education can increase students' palliative care knowledge, interdisciplinary education perception, and teamwork attitudes. Training programs that are used together with high-fidelity simulation and hybrid simulation applications in interdisciplinary training should be integrated into the undergraduate curricula of future cooperating health professions.     

Fostering interprofessional teamwork through an immersive study abroad experience

ABSTRACT

In 2017, American university students representing seven healthcare professions traveled to Australia (AU) for a 17-day study abroad course focused on expanding students’ knowledge of interprofessional education (IPE) and global communities. This innovative course allowed for an immersive IPE learning experience through an examination of healthcare and culture. Based upon pilot study survey data from the 12 participating students (i.e., students from athletic training, nursing, occupational therapy, physical therapy, physician assistant studies, pre-medical, and speech-language pathology), positive perceptions of the experience related to teamwork, learning, and healthcare differences were achieved. However, survey data from the Readiness for Interprofessional Learning Scale (RIPLS) showed no significant change in attitudes or perceptions of collaboration, professional identity, or roles and responsibilities. These results suggest the potential that students who elect to participate in optional IPE study abroad programs already have positive attitudes toward IPE. Study abroad may be an appropriate setting to expand healthcare students’ appreciation of IPE, teamwork, and global awareness. The results of this study may assist other professionals in developing future IPE activities in the international setting.     

The feasibility and acceptability of using virtual world technology for interprofessional education in palliative care: a mixed methods study

ABSTRACT

The objective of this mixed methods study was to evaluate the feasibility and acceptability of using a virtual world educational environment for interprofessional health professions students learning about palliative care. Graduate students (n = 35) from five different health professions programs (medicine, nursing, nutrition, physical therapy, and social work) across two educational institutions participated in a small-group immersive educational experience focused on palliative care in the virtual world of Second Life. Collected data included pre and post surveys of interprofessional attitudes using previously-published questionnaires as well as student reflective writing and photographs about their experience. We found it was feasible to create and deliver an interprofessional educational experience in palliative care in a virtual world environment. The educational experience was acceptable to participants, with an improvement in attitudes toward interprofessional education and interprofessional teamwork after a single virtual world educational session, based on both quantitative and qualitative results. Students found the virtual world environment acceptable for interprofessional education focused on palliative care, based on qualitative results. As health professions schools develop interprofessional education curricula, the use of virtual world technology may be an important modality to consider, to effectively and conveniently bring interprofessional learners together.     

Use of a simulation intervention to examine differences in nursing students' hand hygiene knowledge,beliefs, and behaviors

BackgroundAlthough hand hygiene remains an essential aspect of quality care, adherence to best patient safety practices continues to pose major challenges.ObjectivesThe objectives of this study are to examine hand hygiene knowledge, beliefs, practices, perceived importance and behaviors using Social Cognitive Theory and simulation-based intervention.DesignParticipants were taken from a convenience sample of 131 undergraduate nursing students enrolled in a nursing fundamentals course at an urban university in the midwestern United States, and then randomly assigned to their respective groups. Using an experimental pretest-posttest design, control and intervention groups received the same lecture pertaining to hand hygiene and 3 data collection points where van de Mortel's Hand Hygiene Questionnaire (HHQ) was administered. In addition, the intervention group viewed a 6.5 min video related to healthcare acquired infection and participated in 4 simulated situations requiring hand hygiene, based on World Health Organization guidelines. For all students, the hand hygiene technique was assessed through the use of Glo Germ, followed by handwashing and photography under ultraviolet light (posttest only). Image illumination was analyzed using image processing software. Microbiological sampling plates (pretest-posttest) were assessed quantitatively by colony counting.ResultsStudy findings did not support differences in the intervention group for the 5 hypothesized relationships. Social desirability responding and negative item confusion were found to occur with the HHQ in the student population. There was a significant difference in the UV hand photographs, with students in the afternoon having lower values than students in the morning.ConclusionsGiven the study results, there were no definitive educational recommendations to teach hand hygiene to nursing students. Future research should continue to further examine multi-focal modalities to enhance adherence to hand hygiene practices, as well as control for extraneous mediating or moderating variables found in educational settings.     

Mock ECHO: A Simulation-Based Medical Education Method

Problem: This study was designed to develop a deeper understanding of the learning and social processes that take place during the simulation-based medical education for practicing providers as part of the Project ECHO® model, known as Mock ECHO training. The ECHO model is utilized to expand access to care of common and complex diseases by supporting the education of primary care providers with an interprofessional team of specialists via videoconferencing networks. Intervention: Mock ECHO trainings are conducted through a train the trainer model targeted at leaders replicating the ECHO model at their organizations. Trainers conduct simulated teleECHO clinics while participants gain skills to improve communication and self-efficacy. Context: Three focus groups, conducted between May 2015 and January 2016 with a total of 26 participants, were deductively analyzed to identify common themes related to simulation-based medical education and interdisciplinary education. Principal themes generated from the analysis included (a) the role of empathy in community development, (b) the value of training tools as guides for learning, (c) Mock ECHO design components to optimize learning, (d) the role of interdisciplinary education to build community and improve care delivery, (e) improving care integration through collaboration, and (f) development of soft skills to facilitate learning. Outcome: Mock ECHO trainings offer clinicians the freedom to learn in a noncritical environment while emphasizing real-time multidirectional feedback and encouraging knowledge and skill transfer. Lessons Learned: The success of the ECHO model depends on training interprofessional healthcare providers in behaviors needed to lead a teleECHO clinic and to collaborate in the educational process. While building a community of practice, Mock ECHO provides a safe opportunity for a diverse group of clinician experts to practice learned skills and receive feedback from coparticipants and facilitators.