Implementation of interprofessional learning activities in a professional practicum: The emerging role of technology

Abstract

To prepare future healthcare professionals to collaborate effectively, many universities have developed interprofessional education programs (IPE). Till date, these programs have been mostly courses or clinical simulation experiences. Few attempts have been made to pursue IPE in healthcare clinical settings. This article presents the results of a pilot project in which interprofessional learning activities (ILAs) were implemented during students' professional practicum and discusses the actual and potential use of informatics in the ILA implementation. We conducted a pilot study in four healthcare settings. Our analysis is based on focus group interviews with trainees, clinical supervisors, ILA coordinators, and education managers. Overall, ILAs led to better clarification of roles and understanding of each professional's specific expertise. Informatics was helpful for developing a common language about IPE between trainees and healthcare professionals; opportunities for future application of informatics were noted. Our results support the relevance of ILAs and the value of promoting professional exchanges between students of different professions, both in academia and in the clinical setting. Informatics appears to offer opportunities for networking among students from different professions and for team members' professional development. The use of technology facilitated communication among the participants.     

Implementing and evaluating a community-based,inter-institutional,interprofessional education pilot programme

Many health professions programmes have begun integrating interprofessional learning into their curricula; however, community-based interprofessional education (IPE) initiatives are relatively scarce. The Meharry-Vanderbilt Alliance IPE Faculty Collaborative, comprised of faculty from five institutions, developed a community-based IPE programme that allowed students to engage in meaningful interprofessional activities while exposing them to social determinants of health. Thirty students from ten professions were divided into six teams and paired with three community organisations. Each team engaged community organisation staff and clients to develop practical solutions to their priorities. Teams participated in debriefings and team-building exercises to further support interprofessional learning. Students’ comfort working with others (CWO), value in working with others (VWO), and self-perceived ability (SPA) to work with others were assessed using the Interprofessional Socialisation and Valuing Scale (ISVS). Mean rank scores in all three subcategories increased significantly from baseline (CWO: z = ?4.11, p < 0.0001; VWO: z = ?3.41. p = 0.001; SPA: z = ?2.79, p = 0.005). In addition, programme evaluations suggest the programme improved students’ understanding of social determinants of health. Our findings align with those of two other community-based IPE initiatives and support the expansion of IPE efforts beyond traditional settings.     

Studio-based learning in interprofessional education

Abstract

The recent growth of interprofessional education (IPE) in healthcare has been accompanied by exploration of teaching strategies to improve its effectiveness. Experts in IPE advise faculty to explore teaching models from other disciplines outside of healthcare. Studio-based learning (SBL) in design education embodies many of the features that are integral to effective IPE. Students work in teams to design new processes and products to solve complex and real-life problems. The purpose of this paper is to describe features of SBL that enhance IPE and examine student experiences of interprofessional learning from three healthcare design studios. Findings from an exploratory case study of these design studios involving students from a range of professions suggest that the students transition through learning stages in SBL that may enhance IPE. The paper goes on to discuss the unique features of SBL and how they offer new and complementary strategies for building interprofessional curricula.     

An evaluation of an interprofessional practice-based learning environment using student reflections

The 12th Street Health and Wellness Center is an interprofessional, student-led, community-based clinic. Students from all University of Arkansas for Medical Sciences colleges work together to provide healthcare services for residents of an underserved community. Interprofessional student teams assess patients and present to an interprofessional preceptor team. At the conclusion of clinic, teams reflect on their experience. The objective of this study is to generate key themes from the end of clinic reflections to describe learning outcomes in an interprofessional practice environment. Student teams were asked to reflect on what they learned about patient care and interprofessional practice while volunteering at the clinic. Three hundred eighty reflection statements were assessed using the constant comparative approach with open coding by three researchers who identified and categorised themes by selecting key phrases from reflections. Eight themes emerged from this process which illuminated students’ self-perceived development during practice-based learning and interprofessional collaboration. Key phrases were also coded to the four core Interprofessional Education Collaborative competency domains. These results suggest learners’ perception that the Center is a practice-based environment that provides an opportunity to learn, integrate, and apply interprofessional curricular content.     

A cross-institutional examination of readiness for interprofessional learning

This paper examines the readiness for and attitudes toward interprofessional (IP) education in students across four diverse educational institutions with different educational mandates. The four educational institutions (research-intensive university, baccalaureate, polytechnical institute and community college) partnered to develop, deliver and evaluate IP modules in simulation learning environments. As one of the first steps in planning, the Readiness for Interprofessional Learning Scale was delivered to 1530 students from across the institutions. A confirmatory factor analysis was used to expand upon previous work to examine psychometric properties of the instrument. An analysis of variance revealed significant differences among the institutions; however, a closer examination of the means demonstrated little variability. In an environment where collaboration and development of learning experiences across educational institutions is an expectation of the provincial government, an understanding of differences among a cohort of students is critical. This study reveals nonmeaningful significant differences, indicating different institutional educational mandates are unlikely to be an obstacle in the development of cross-institutional IP curricula.     

Organizational evaluation of an interprofessional study unit – Results from a Danish case study

This article presents results from an organizational evaluation of an interprofessional clinical study unit (ICS) in Denmark. The aim of this study was to test whether the ICS was based on a durable organizational concept and to identify the prerequisites for the unit to be successful. The evaluation framework was “theory-based evaluation”. A program theory was developed based on the concepts and expectations of the steering committee which initiated and designed the ICS. The program theory was tested for conflicts of interest among the stakeholders related to the ICS regarding prerequisites for the study unit to function organizationally. Further analysis examined whether these conditions had been present during the project period and whether all elements had been correctly implemented. The results suggested that although the ICS had taken into account stakeholders' requests, it was not possible to fully implement all the necessary conditions identified as essential for the unit to function successfully. The results generate a set of recommendations for future ICS units to function successfully.     

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.     

Assessing students’ and health professionals’ competency learning from interprofessional education collaborative workshops

Interprofessional education (IPE) is a key element in preparing current and future health professionals to function in a collaborative practice-ready workforce. California State University, Fresno’s College of Health and Human Services and Valley Children’s Healthcare have partnered together to create an IPE collaborative that organizes and provides interagency-sponsored workshops that align learning objectives of relevant healthcare topics with 2016 IPEC core competencies for university students and health professionals. Using a pre/post design with the IPEC Competency Self-Assessment Tool, two cross-sectional studies were conducted to measure whether interprofessional learning of core competencies improved after participation in IPE workshops, and if such improvements were different between students and health professionals. In Study 1, 67 participants attended a Pediatric Head Injury IPE workshop. Of these, 19 students and 22 health professionals consented to participate and complete the IPEC survey. In Study 2, 99 participants attended an Error Disclosure IPE workshop. Of these, 26 students and 29 health professionals consented to participate and complete the IPEC survey. This investigation showed that the IPEC Competency Self-Assessment Tool discriminated competency ratings between students and health professionals in both studies and demonstrated a positive impact of IPE workshops on students’ and health professionals’ self-assessment of interprofessional competencies.     

Changing stress while stressing change: The role of interprofessional education in mediating stress in the introduction of a transformative technology

The introduction of a transformative technology into practice settings can affect the functioning of interprofessional teams, placing stress on interprofessional relationships, thus slowing adoption and change. This study explored the potential of an interprofessional education (IPE) approach to mediate this stress and facilitate the adoption of a transformative technology- Image Guided Radiation Therapy (IGRT). Oncologists, physicists, and therapists in radiation medicine who attended an interprofessional IGRT Education Course were interviewed about perceived benefits and stressors to IPE and to interprofessional practice (IPP) in the IGRT context. A modified grounded theory approach was used to conduct 14 interviews, with 200 minutes of interview time recorded. In introducing IGRT, participants noted interprofessional stress in understanding and adopting new technology. IPE offered common terminology, appreciation for others' knowledge, and a holistic framework for practice. Outcomes were thought to foster collaboration, efficiency, and improved professional role definition. Time constraints and power relations were noted to be residual stressors exacerbated by IPE, but were thought to be transient. IPE can thus be of benefit in the implementation of transformative technologies such as IGRT, through mediation of interprofessional stress inherent in change. Interprofessional knowledge, collaboration, and efficiency in practice facilitate the development and adoption of a new practice model.     

Using learning theory,interprofessional facilitation competencies,and behavioral indicators to evaluate facilitator training

Abstract

Despite the increasing need for faculty and preceptors skilled in interprofessional facilitation (IPF), the relative novelty of the field poses a challenge to the development and evaluation of IPF programs. We use learning theory and IPF competencies with associated behavioral indicators to develop and evaluate six key messages in IPF training and experience. Our mixed methods approach included two phases: quantitative data collection with embedded qualitative data, followed by qualitative data collection in explanatory sequential fashion. This enabled triangulated analyses of both data types and of facilitation behaviors from facilitator and student perspectives. Results indicate the competency-based training was effective. Facilitators felt comfortable performing behaviors associated with IPF competencies; student observations of those behaviors supported facilitator self-reported performance. Overall, students perceived more facilitation opportunities than facilitators. Findings corroborate the importance of recruiting seasoned facilitators and establishing IPF guidelines that acknowledge variable team dynamics and help facilitators recognize teachable moments.     

Examining student perceptions of an inter-institutional interprofessional stroke simulation activity

Integration of interprofessional educational (IPE) activities into health professions’ curricula aims to promote collaborative practice with a goal of improving patient care. An interprofessional stroke simulation involving standardised patients was organised for IPE student learners from a number of different health professions programmes based across several different institutions. In this article, we describe the development of an inter-institutional IPE activity and examine the outcomes of this activity on student interprofessional growth. Using a pre-post-study design, all participants were invited to anonymously respond to the 16-question IPEC Competency Self-Assessment tool to examine self-assessed interprofessional interactions and values as a result of the simulation. The questionnaire was available to the students using an online platform, and paired t-tests were used to analyse the responses. Quantitative data revealed significant positive changes in both the values and interaction domains of the assessment from pre- to post-simulation experience (p < 0.0001 and p = 0.0003, respectively). Student reflections identified new realisations around the concepts of leadership and team member roles in the context of patient care. Results of this endeavour support the effectiveness of this activity for developing interprofessional competencies among students, suggest that the self-assessment tool may be used as a means to detect these changes, and lend support to our methods for establishing inter-institutional IPE partnerships.     

Case-based interprofessional learning for undergraduate healthcare professionals in the clinical setting

Interprofessional learning (IPL) within the healthcare setting has well documented positive outcomes for patients, yet it is not widely offered at the undergraduate level, particularly in a clinical setting. We set up case-based teaching scenarios involving a real patient, aimed at small groups of four students representing two or more healthcare professions. The aim of the sessions was to give students a greater awareness of the roles of all the different healthcare professions involved in patient care in a hospital setting. Weekly sessions were offered on six wards covering different clinical specialties. Three hundred and twenty-nine undergraduate students from different healthcare professions (nursing, medicine, pharmacy, midwifery, physician associate, physiotherapy, occupational therapy, speech, and language therapy) each attended one IPL session during the current academic year. Students were given an evaluation sheet at the end of each session to be filled out anonymously. Forty per cent of the students reported experiencing interprofessional case-based learning for the first time. Over 90% of students agreed or strongly agreed with a list of statements promoting the advantages and benefits of case-based IPL for undergraduate students and many of them requested more sessions. Seventy per cent of all respondents stated they would alter their future professional behaviour as a result of this session. We propose to introduce the sessions into the undergraduate curriculum across all healthcare related professions.     

Design and evaluation of interprofessional cross-cultural communication sessions

Abstract

The 2013 National Standards for Culturally and Linguistically Appropriate Services (CLAS) call for healthcare professionals to provide quality care and services that are responsive to diverse cultural health beliefs and practices. Accreditation organizations for health professional programs require their curriculum to adequately prepare future practitioners for serving culturally and linguistically diverse populations. Another common curricular need of health professional programs is interprofessional education (IPE). This study presents data that evaluates two IPE culturally competent communication sessions designed for pharmacy and nursing students. Teams of nursing and pharmacy students (n?=?160) engaged in case studies focused on developing cross-cultural communication skills, using the LEARN model. Quantitative survey data collected pre-test and post-test measured cultural competency (including subscales of perceived skills, perceived knowledge, confidence in encounter, and attitude) and knowledge related to culturally competent communication. Univariate ANOVA results indicate that actual knowledge as measured by the test and all four Clinical Cultural Competency Questionnaire (CCCQ) subscales significantly increased after the IPE sessions. Pharmacy students scored higher than nursing students on the knowledge pre-test, and nursing students had a more positive attitude at pre-test. The IPE sessions effectively addressed all learning outcomes and will continue in future course offerings. Using cross-cultural communication as a thematic area for IPE program development resulted in educational benefits for the students. To further strengthen nursing and pharmacy students’ interprofessional practice, additional IPE opportunities are to be explored.     

Aligning interprofessional education collaborative sub-competencies to a progression of learning

In the United States, the Interprofessional Education Collaborative (IPEC) developed four core competencies for interprofessional collaborative practice. Even though the IPEC competencies and respective sub-competencies were not created in a hierarchal manner, one might reflect upon a logical progression of learning as well as learners accruing skills allowing them to master one level of learning and building on the aggregate of skills before advancing to the next level. The Louisiana State University Health-New Orleans Center for Interprofessional Education and Collaborative Practice (CIPECP) determined the need to align the sub-competencies with the level of behavioural expectations in order to simplify the process of developing an interprofessional education experience targeted to specific learning levels. In order to determine the most effective alignment, CIPECP discussions revolved around current programmatic expectations across the institution. Faculty recognised the need to align sub-competencies with student learning objectives. Simultaneously, a progression of learning existing within each of the four IPEC domains was noted. Ultimately, the faculty and staff team agreed upon categorising the sub-competencies in a hierarchical manner for the four domains into either a “basic, intermediate, or advanced” level of competency.     

Interprofessional Education and Practice Guide No. 7: Development,implementation, and evaluation of a large-scale required interprofessional education foundational programme

Health profession educators and administrators are interested in how to develop an effective and sustainable interprofessional education (IPE) programme. We describe the approach used at the University of Kansas Medical Centre, Kansas City, United States. This approach is a foundational programme with multiple large-scale, half-day events each year. The programme is threaded with common curricular components that build in complexity over time and assures that each learner is exposed to IPE. In this guide, lessons learned and general principles related to the development of IPE programming are discussed. Important areas that educators should consider include curriculum development, engaging leadership, overcoming scheduling barriers, providing faculty development, piloting the programming, planning for logistical coordination, intentionally pairing IP facilitators, anticipating IP conflict, setting clear expectations for learners, publicising the programme, debriefing with faculty, planning for programme evaluation, and developing a scholarship and dissemination plan.     

International service learning in the Dominican Republic: An asynchronous pilot in interprofessional education

Despite the logistical barriers of asynchronous academic calendars, university students in nursing and physical therapy in one academic health centre piloted an international, interprofessional, service learning project in the Dominican Republic. Although the nursing students and physical therapy students were not able to be in-country at the same time, they provided care to a common caseload of traumatic injury patients and those with chronic, debilitating conditions. Interprofessional communication occurred with the development of SBAR (Situation, Background, Assessment, Recommendation) reports from the Team Training curriculum of the Agency for Healthcare Research and Quality. Students learned the depth of physical therapy and the breadth of nursing. The pilot led to a more refined design to pair nursing and PT students, requiring them to communicate via mobile phone regarding results of examinations, and suggestions for follow-up by the nursing students, to ensure continuity of care and a more comprehensive approach to services.     

An interprofessional train-the-trainer evidence-based practice workshop: Design and evaluation

Abstract

Evidence-based practice (EBP) is a core skill of health professionals and one that is regularly taught in health sciences programs. This report covers the design and results of an interprofessional EBP workshop at a large university aimed at improving faculty’s confidence in practicing and teaching EBP. The two-day workshop was designed by the University’s Health Sciences Libraries and emphasized small-group work, with the first day focused on critical appraisal and searching and the second on effective teaching strategies. Twenty-five faculty from the schools and colleges of Medicine, Nursing, Pharmacy, Dentistry, and Veterinary Medicine and the Center for Allied Health Programs attended this study. Nine faculty and librarians served as instructors. Attendees rated the workshop and individual lectures highly and reported that it improved their ability to both practice and teach EBP. In addition, they reported a preference for learning in an interprofessional environment. This report suggests that a short EBP workshop can improve faculty members’ self-reported confidence and ability to practice and teach core EBP skills.     

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.     

Innovations in interprofessional education and collaboration in a West Australian community health organisation

This article is a short report that describes an initiative in interprofessional education (IPE) and collaboration in health practices in a community health organisation. Staff and students from nursing and allied health professions collaborate to implement a video feedback parenting programme. The results include an increased awareness of the benefits of both IPE and infant mental health principles, in particular the establishment of a common language across professions. Further systematic evaluations are required.