Indonesian students’ participation in an interprofessional learning workshop

Abstract

Interprofessional learning activities, such as workshops allow students to learn from, with and about each other. This study assessed the impact on Indonesian health students’ attitudes towards interprofessional education (IPE) from participating in a workshop on medication safety. The students attended a two-day IPE workshop on medication safety. Thirty-five (48.6%) students completed pre-/post-workshop surveys using a modified Readiness for Interprofessional Learning Scale (RIPLS) survey. The post-workshop survey also had a series of open-ended questions. Students’ responses to each RIPLS statement pre-/post-workshop were compared, whilst their responses to open-ended questions in post-workshop survey were thematically analysed. Students reported positive attitudinal changes on statements of shared learning and teamwork sub-scale (Wilcoxon p value <0.05). Analysis of the open-ended questions indicated that students perceived the workshop as having improved their understanding on the importance of teamwork and communication skills. This study found that learning with other health students through an IPE workshop improved medical, nursing and pharmacy students’ attitudes towards the importance of shared learning, teamwork and communication in healthcare service.     

Interprofessional ethics learning between schools of pharmacy and dental medicine

Abstract

A case-based interprofessional education (IPE) ethics activity between pharmacy and dental students was developed and evaluated. Eighty-two third-year pharmacy and 51 first-year dental students were divided into teams for two sessions. The IPE activity involved the student teams analyzing two cases at each session utilizing an ethical decision-making process followed by debriefing of each case. Assessments included pre-/post-Readiness for Interprofessional Learning Scale (RIPLS), pre-/post-individual ethics knowledge quiz, pre-team ethics knowledge quiz and post-student perception survey. The results indicated no significant differences in RIPLS scores although scores indicated a high readiness for interprofessional learning including teamwork and collaboration among pharmacy and dental students. When comparing pre-/post-ethics knowledge quiz scores a significant difference was found between individual and team scores as well as between professions. Perception survey results were highly favorable toward the value of interprofessional learning activities. The sessions resulted in enhanced knowledge about ethical decision-making.     

Examining the perceived impact of an ethics workshop on interprofessional values and teamwork

Interprofessional education (IPE) is a vital component of healthcare education yet challenges to implementation persist. This study aimed to evaluate the perceived impact of an ethics-based IPE workshop designed for professional phase healthcare students enrolled in athletic training, health management systems, occupational therapy, physical therapy, physician assistant studies, and speech-language pathology programmes at one university. A pre/post-test cohort study was conducted to evaluate the impact of the workshop on interprofessional values and teamwork. Findings from the 61 students who completed both pre- and post-programme evaluation surveys suggest that the ethics-based workshop was successful in improving perceived confidence as related to the workshop objectives and strengthened positive perceptions of IPE as evaluated by the Student Perceptions of Interprofessional Clinical Education-Revised (SPICE-R). Analysis of responses to open-ended reflection questions after the workshop suggest that student participants perceived changes in understanding related to multiple areas of IPE. These results suggest that an ethics-based workshop using case-based collaborative pedagogy may be an effective mechanism for delivery of IPE-oriented information resulting in greater student confidence and understanding of IPE competencies.     

A comparison of student attitudes and perceptions before and after an introductory interprofessional education experience

Abstract

There is increasing acknowledgement that interprofessional education (IPE) holds promise for preparing health professionals as collaborative-ready practitioners. The effects of IPE on learning outcomes are critical in determining the value of such programs. Attitudes are recognized as a significant element in developing behaviors. This study was designed to determine attitudes and perceptions of students toward collaborative learning in an interprofessional context. Three hundred and five students completed a questionnaire regarding attitudes and perceptions toward interprofessional collaboration before and after an introductory IPE course. Also 202 graduating health professional students without IPE completed the same questionnaire. The questionnaire included questions from the University of West England Interprofessional Questionnaire (UWE IQ) and Readiness for Interprofessional Learning Scale (RIPLS). Independent samples t-tests revealed significant positive changes before and after the IPE course for UWEIQ IP-Learning subscale (p?=?0.012) and RIPLS (p?=?0.05). This study provides some evidence that students who participate in an introductory IPE course early in their professional preparation not only keep positive attitudes toward interprofessional learning, but improve them. As a result, they are expected to be more engaged in learning this important knowledge that should help them to become interprofessional collaborative-ready practitioners.     

Test/Re-Test reliability of the readiness for interprofessional education learning scale and interdisciplinary education perception scale in health science students

ABSTRACT

This study aimed to establish the test/re-test reliability of two common interprofessional education (IPE) instruments, the Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS), and to compare results based on previous IPE experience. The RIPLS and the IEPS were distributed to 251 students within five academic health science programs at one university. Both instruments were distributed at a second session 10–14 days later. Weighted Kappa, intraclass correlation coefficients (ICC), standard error of measurement, and minimal detectable change were calculated for each instrument’s composite scores and subscales. Assessments occurred for all subjects and between students with and without previous IPE experience. Overall and between-group composite score reliability for the RIPLS and IEPS were excellent (ICC≥0.81). RIPLS subscale ICCs were variable per previous IPE experience, ranging from fair-excellent (ICC = 0.56–0.86). IEPS subscale ICCs were excellent for students with previous IPE experience (ICC≥0.76), and fair-excellent for students without previous experience (ICC = 0.64–0.84). Students with previous IPE experience had significantly higher scores within and between sessions for the RIPLS (p ≤ 0.031) but not the IEPS. Both instruments have acceptable measurement consistency; however, the RIPLS varied in repeatability compared to the IEPS. Previous IPE experience should be accounted for when distributing/interpreting the results.     

Changes in attitudes toward interprofessional health care teams and education in the first- and third-year undergraduate students

The interprofessional education (IPE) program at Gunma University, Maebashi, Japan, implements a lecture style for the first-year students and a training style for the third-year students. Changes in the scores of modified Attitudes Toward Health Care Teams Scale (ATHCTS) and those of modified Readiness of health care students for Interprofessional Learning Scale (RIPLS) at the beginning and the end of the term were evaluated in the 2008 academic year. Two hundred and eighty-five respondents of a possible 364 completed the survey. In both the scales, the overall mean scores declined significantly after the lecture-style learning in the first-year students, while the scores improved significantly after the training-style learning in the third-year students. Exploratory factor analysis revealed that the modified ATHCTS was composed of three subscales, and the modified RIPLS two subscales. Analyses using regression factor scores revealed that the scores of “quality of care delivery” subscale in the modified ATHCTS and those of “expertise” subscale in the modified RIPLS declined significantly in the first-year students. Consequently, IPE programs may be introduced early in the undergraduate curriculum to prevent stereotyped perceptions for IPE, and comprehensive IPE curricula may result in profound changes in attitudes among participating students.     

The impact of interprofessional simulation on readiness for interprofessional learning in health professions students

Healthcare does not occur in a silo and yet healthcare education remains fractured into individual disciplines. This isolated curricular methodology does not represent the intricate interprofessional environment that healthcare providers are required to thrive in post-graduation. Interprofessional Education (IPE) has been identified as a crucial stratagem for creating effective collaborative healthcare teams. The purpose of this research project was to create an interprofessional education (IPE) simulation that represents the current collaborative healthcare practice environment. Medical students, Physicians Assistant's students and Nursing students from different educational institutes participated in a patient simulation using the Situation Background Assessment and Recommendation communication framework (SBAR).The design of this study was a one-group comparative, quasi-experimental, quantitative pilot study. The study employed the Readiness for Interprofessional Learning Scale (RIPLS) in a pre-and-post questionnaire to measure readiness for IPE simulation and student attitudes. Attitude toward collaboration has been found to positively influence care team collaboration, which can positively affect patient outcomes. The sample population (n=45) included the second-year associate degree nursing students, first-year medical students, and first-year physician assistant students. The results of this study indicated that the implementation and participation in an interprofessional communication simulation had a positive effect on readiness and attitudes.     

Honors students in the health professions: An academic-practice partnership for developing interprofessional competencies through simulation

Abundant literature supports the value of interprofessional education (IPE) in health profession programs, but few studies focus on undergraduate honors students. The goals of this academic-practice partnership quality improvement project were to increase awareness of IPE, provide experiential opportunities to learn the principles of interprofessional practice, assess perceptions of readiness for practice, and to explore motivations and learning expectations of undergraduate nursing and pre-medical honors students. Average scores on the Readiness for Interprofessional Learning Scale (RIPLS) increased in several areas after the IPE simulation experiences, with small to medium effect sizes (Cohen's d) on individual items and two subscales (Teamwork & Collaboration and Positive Professional Identity). Themes identified in the narrative data were opportunity, fun, self-awareness, situational awareness, and the value of teamwork. These findings add to literature on honor students' expectations and motivations for learning and can be used in designing interprofessional collaborative learning activities for undergraduate health profession students.     

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.     

Changes in attitudes toward interprofessional health care teams and education in the first- and third-year undergraduate students

The interprofessional education (IPE) program at Gunma University, Maebashi, Japan, implements a lecture style for the first-year students and a training style for the third-year students. Changes in the scores of modified Attitudes Toward Health Care Teams Scale (ATHCTS) and those of modified Readiness of health care students for Interprofessional Learning Scale (RIPLS) at the beginning and the end of the term were evaluated in the 2008 academic year. Two hundred and eighty-five respondents of a possible 364 completed the survey. In both the scales, the overall mean scores declined significantly after the lecture-style learning in the first-year students, while the scores improved significantly after the training-style learning in the third-year students. Exploratory factor analysis revealed that the modified ATHCTS was composed of three subscales, and the modified RIPLS two subscales. Analyses using regression factor scores revealed that the scores of "quality of care delivery" subscale in the modified ATHCTS and those of "expertise" subscale in the modified RIPLS declined significantly in the first-year students. Consequently, IPE programs may be introduced early in the undergraduate curriculum to prevent stereotyped perceptions for IPE, and comprehensive IPE curricula may result in profound changes in attitudes among participating students.     

An examination of students’ perceptions of their interprofessional placements in residential aged care

ABSTRACT

It is essential that health professionals are trained to provide optimal care for our ageing population. Key to this is a positive attitude to older adults along with the ability to work in teams and provide interprofessional care. There is limited evidence on the impact an interprofessional education (IPE) placement in a residential aged care facility (RACF) has on students. In 2015 in Western Australia, 51 students (30% male, median age 23 years), from seven professions, undertook a placement between 2 and 13 weeks in length at 1 RACF. Pre- and post-placement measurements of attitudes to the elderly were collected using the Ageing Semantic Differential (ASD) questionnaire and level of readiness for interprofessional learning with the Readiness for Interprofessional Learning Scale (RIPLS). A total of 47 students completed matched ASD and RIPLS surveys. The mean total score on the ASD survey decreased significantly from pre- to post-placement from 116.0 to 108.9 (p = 0.033), indicating attitudes became increasingly positive towards older adults. Significant differences post-placement were seen indicating better readiness for interprofessional learning, for two out of four subscales on the RIPLS, namely “teamwork & collaboration” (42.1–44.0; (p = 0.000)) and “positive professional identity” (18.2–19.3 (p = 0.001)). The degree of change is similar to findings from other settings. The results support IPE-focussed student placements within RACF positively influence student’s attitudes towards the older adult as well as increase student’s readiness for interprofessional learning, confirming RACF are valuable places for training health professionals.     

Student perceptions towards interprofessional education: Findings from a longitudinal study based in a Middle Eastern university

The Lebanese American University Interprofessional Education (LAU IPE) Steps Framework consists of a five-step workshop-based series that is offered throughout the curriculum of health and social care students at an American university in Lebanon. The aim of the present study was to report students’ perceptions of their readiness for interprofessional learning before and after completing the IPE steps, their evaluations of interprofessional learning outcomes, as well as their satisfaction with the learning experience as a whole. A longitudinal survey design was used: questionnaires were completed by students before IPE exposure and after each step. The results showed that before IPE exposure, students’ perceptions of their readiness for interprofessional learning were generally favourable, with differences across genders (stronger professional identity in females compared to males) and across professions (higher teamwork and collaboration in pharmacy and nutrition students compared to other professions and lower patient centredness in nursing students compared to others). After participation in the IPE steps, students showed enhanced readiness for interprofessional learning and differences between genders and professions decreased. Participants were satisfied with the learning experience and assessment scores showed that all IPE learning outcomes were met. The LAU IPE Steps Framework may be of value to other interprofessional education course developers.     

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.     

Attitudes of nursing school deans toward interprofessional education in Western Pacific Region countries

Abstract

A previous survey distributed to medical school deans in the Western Pacific Region (WPR) showed positive attitudes toward collaborative practice and interprofessional education (IPE). This study aimed to clarify the present state of IPE and the attitudes of nursing school deans in the WPR. The modified Attitudes Toward Health Care Teams Scale (ATHCTS) and the modified Readiness of healthcare students for Interprofessional Learning Scale (RIPLS) were used. Unexpectedly, the response rate was less than 20%. Deans of nursing schools with IPE courses showed significantly more positive attitudes than those of schools without IPE courses. The mean score of the modified ATHCTS and RIPLS of deans of nursing schools in rural areas were significantly higher than those in urban areas. Compared with medical schools, nursing schools in the WPR pay less attention to IPE and this may be one of the present characteristics of the region.     

Evaluation of a modified 16-item Readiness for Interprofessional Learning Scale (RIPLS): Exploratory and confirmatory factor analyses

The Readiness for Interprofessional Learning Scale (RIPLS) was developed to assess undergraduate readiness for engaging in interprofessional education (IPE). It has become an accepted and commonly used instrument. To determine utility of a modified 16-item RIPLS instrument, exploratory and confirmatory factor analyses were performed. Data used were collected from a pre- and post-intervention study involving 360 New Zealand undergraduate students from one university. Just over half of the participants were enrolled in medicine (51%) while the remainder were in pharmacy (27%) and nursing (22%). The intervention was a two-day simulation-based IPE course focused on managing unplanned acute medical problems in hospital wards (“ward calls”). Immediately prior to the course, 288 RIPLS were collected and immediately afterwards, 322 (response rates 80% and 89%, respectively). Exploratory factor analysis involving principal axis factoring with an oblique rotation method was conducted using pre-course data. The scree plot suggested a three-factor solution over two- and four-factor solutions. Subsequent confirmatory factor analysis performed using post-course data demonstrated partial goodness-of-fit for this suggested three-factor model. Based on these findings, further robust psychometric testing of the RIPLS or modified versions of it is recommended before embarking on its use in evaluative research in various healthcare education settings.     

Working together: Using a unique approach to evaluate an interactive and clinic-based longitudinal interprofessional education experience with 13 professions

Interprofessional education (IPE) involving an interactive and longitudinal clinic experience at an inner-city charitable clinic from September to May 2013/2014 was evaluated. Pre-, mid-, and post-intervention data were collected from students in 13 different professions including medicine (medical and physician assistant), dentistry (dental and dental hygiene), nursing (undergraduate and clinical nurse specialist), public health, pharmacy, physical therapy, occupational therapy, nutritional sciences, speech and language pathology, and social work. To evaluate their interprofessional attitudes, students completed the TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ) and Readiness for Interprofessional Learning Scale (RIPLS). They also completed a unique measure, healthcare professionals circles diagrams (HPCDs), that indicated student conceptualisation of a healthcare team caring for a complex patient, along with perception of their team’s progress towards meeting patient goals. Results from the T-TAQ and RIPLS scores indicated small but significant increases from pre- to post-intervention (p = 0.005 and 0.012, respectively). Analysis of the HPCDs revealed significant increases in students’ perceptions of the types of interprofessional team members, relationships, and communication between professions to provide medical care to patients (p < 0.01). Most HPCDs included pharmacists, nurses, and physicians as part of the care team at all time points. Students significantly increased their inclusion of dentistry, public health, social work, and physician assistants as members of the healthcare team from pre- to post-intervention. Implications of our data indicated the importance of IPE interventions that include not only classroom-based sessions, but actual patient care experiences within interprofessional teams. It also reinforced the importance of new and unique methods to assess IPE.     

Cross-cultural adaptation of the professional version of the Readiness for Interprofessional Learning Scale (RIPLS) in Japanese

Interprofessional education (IPE) for healthcare professionals is important in Japan because of its rapidly aging population and increasingly complex healthcare needs. However, no tools have been validated in the Japanese context to evaluate healthcare professionals’ attitudes towards, or readiness for, IPE. The professional version of the Readiness for Interprofessional Learning Scale (RIPLS) with 23 items was selected for cross-cultural adaptation because it has been widely used internationally and a Japanese edition of the student version has already been developed. We followed a guideline for cross-cultural adaptation and subsequently conducted factor analysis with 368 responses from over 16 professions. Face and content validity was confirmed through the translation process. We obtained four factors with good internal consistency (Cronbach’s alpha > 0.7). These results were similar to those of the original UK study, apart from one factor being divided into two different factors in this study. Studies are required to further confirm the rigor and generalisability of the results; however, the Japanese RIPLS can be used to evaluate healthcare professionals’ attitudes towards IPE, which can eventually lead to a better IPE development for healthcare professionals in Japan.     

Patient narratives: The potential for “patient-centred” interprofessional learning?

The success of interprofessional education initiatives depends substantially on attitudes and readiness of health care students to this type of learning. To our knowledge, nothing is known about this subject in a non-western educational context. Using a self-administered extended 29 item version of the Readiness for Interprofessional Learning Scale (RIPLS), this study examined attitudes and readiness for interprofessional education of senior medical (n = 90) and nursing (n = 88) students' from the United Arab Emirates University and Institute of Nursing. The researchers also tested the validity of the RIPLS in this Middle Eastern context. Three main factors, comprising 20 statements emerged from statistical analysis of the data. Sub-scales were labelled “teamwork and collaboration”, “professional identity” and “patient-centredness” and each had a strong internal consistency (0.86, 0.80, 0.80 respectively). Both groups of students believed that there are potential academic and clinical benefits of interprofessional learning. Nevertheless, analysis of variance indicated significant differences between the two groups of students in respect of key statements on each factor. The extended RIPLS was validated for use in an undergraduate Middle Eastern community and thus provides programme developers and evaluators with a useful tool to assess medical and nursing students' readiness for interprofessional learning in this context.     

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.     

Respiratory therapy faculty perspectives on interprofessional education: Findings from a cross-sectional online survey

Interprofessional education (IPE) improves collaboration and patient care through joint education between health professions. Respiratory therapy (RT) has not been previously evaluated as participants in IPE. A cross-sectional online survey was distributed to evaluate the opportunities and barriers towards IPE of 874 respiratory therapy faculty with both quantitative measures and open-ended questions. Responses (n = 187) to open-ended questions about the opportunities and barriers to IPE inclusion included only one significant difference between Associate’s (n = 121, 64.7%) and Bachelor’s faculty (n = 66, 35.3%). Open-ended questions were analyzed using directed content analysis. Two trained independent reviewers examined responses for common categories. Reviewers then collated initial categories into broader categories. Faculty responses indicate the importance of IPE, barriers related to schedule and faculty attitudes, and perceived opportunities for IPE with nursing programs and through increasing simulation training opportunities. The most common barriers identified were faculty attitudes, scheduling and logistics, curriculum requirements, administration, and time. All faculty seemed to perceive similar opportunities and barriers regardless of programme type and are supportive of IPE inclusion within their curriculums.