Australian evidence for interprofessional education contributing to effective teamwork preparation and interest in rural practice

A pilot interprofessional education (IPE) placement for undergraduate health care professional students was undertaken in rural Victoria, Australia from 2001 to 2003. Medical, nursing, physiotherapy and pharmacy students were involved, and the project is ongoing. This paper briefly outlines the educational model, then focuses on the evaluation methods and results obtained from student evaluations. The placement experience improved self-reported teamwork skills and knowledge, and supported participating students' belief in the value of interprofessional practice. Placements strengthened nursing and allied health students' intention to work in rural health settings after graduation. The rural interprofessional educational experience improved interprofessional abilities in a group of students who have the potential to influence change towards collaborative practices in their future workplaces. The results obtained provide sufficiently strong evidence to justify the continuation and expansion of this educational model in the Australian setting. Pedagogical and evaluation modifications are discussed that may benefit future IPE programs.     

Interprofessional education: The student perspective

The Toronto Rehabilitation Institute (Toronto Rehab) is a current leader in the movement of interprofessional education (IPE) initiatives in Ontario, Canada. Nine students from seven different health care disciplines, including medicine, nursing, occupational therapy, pharmacy, physiotherapy, social work, and speech language pathology participated in the second IPE clinical placement in the winter of 2005 on Toronto Rehab's Stroke inpatient unit. In an effort to increase interprofessional collaboration, improve communication skills, foster respect and enhance knowledge of the different roles each discipline plays on the health care team, these students met together over a five week period and participated in interprofessional group sessions led by different health care professional leaders from the unit. This paper discusses the students' perspectives on this IPE experience and the corresponding benefits and challenges. All participants in the study recognized the importance of interprofessional teamwork in patient care and agreed that all health care education should include opportunities enabling them to develop the skills, behaviours and attitudes needed for interprofessional collaboration.     

Interprofessional socialization as a way to introduce collaborative competencies to first-year health science students

Abstract

Interprofessional education (IPE) is the cornerstone of preparing future health care providers but remains to be a challenge for many health science programs. We aimed to develop and evaluate an interprofessional conference for first-year health science students with goals to provide students with interprofessional socialization opportunity and introduce IPE principles. A half-day conference was based upon core competencies for health professionals and involved 277 first-year health sciences, nursing, pharmacy, physical therapy, and speech language pathology and audiology students. Alcohol and substance misuse was chosen as a topic for its relevance to college students and health professionals. Results from program evaluation revealed that the conference was successful in exposing students to core interprofessional competencies and provided useful information about alcohol and substance misuse. This study advocates for early inclusion of IPE in the health professions curricula in the form of interprofessional socialization.     

Knowing your allies: Medical education and interprofessional exposure

Collaborative, team-based, interprofessional approaches to patient management are becoming increasingly recognized as beneficial to health outcomes. This project aimed to develop interprofessional skills among 134 third year medical students that were of clinical educational value to the students, and through activities that directly benefited the rural health professionals in their daily work. Placements were undertaken during a six week rural clinical attachment, mainly throughout South-West Queensland. Pre- and post-placement self-report questionnaires completed by both students and health professionals were used to evaluate the project. Results showed that over 80% of the health professional group reported the medical student placements were useful. Similarly, almost 80% of medical students reported positive changes in their attitude to other health professionals from the placement, and 91% indicated they had derived clinical educational benefit from their interprofessional activity. Despite difficulties due to poor communication between the various parties involved, the project proved successful in improving medical students' skills, knowledge and perceptions concerning interprofessional practice, through a placement and educational project which delivered practical benefits to rural health professionals and rural communities.     

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.     

Health science center faculty attitudes towards interprofessional education and teamwork

The attitudes of faculty towards interprofessional education (IPE) and teamwork impact the education of health professions education (HPE) students. This paper reports on a study evaluating attitudes from health professions educators towards IPE and teamwork at one academic health science center (HSC) where modest IPE initiatives have commenced. Drawing from the results of a previous investigation, this study was conducted to examine current attitudes of the faculty responsible for the training of future healthcare professionals. Survey data were collected to evaluate attitudes from HSC faculty, dentistry, nursing, medicine, pharmacy and public health. In general, positive HSC faculty attitudes towards interprofessional learning, education, and teamwork were significantly predicted by those affiliated with the component of nursing. Faculty development aimed at changing attitudes and increasing understanding of IPE and teamwork are critical. Results of this study serve as an underpinning to leverage strengths and evaluate weakness in initiating IPE.     

Interprofessional curriculum development achieves results: Initial evidence from a dementia-care protocol

This report describes the outcomes of a five-day, protocol-based interprofessional education (IPE) initiative to prepare undergraduate medical, nursing, and paramedic students for collaborative work with adults with dementia. Clinical placements provided a structured and supervised IPE experience for 127 students in two Residential Aged Care Facilities (RACFs) in Hobart, Australia, during 2013 and 2014. The IPE activity was based on a seven-step protocol formulated by an interprofessional team of educators and aged care practitioners that revolved around collaborative assessments of adults with complex health needs. This article describes the IPE protocol and presents the results of a pre- and post-placement attitude questionnaire and knowledge quiz administered to evaluate student attitudes towards IPE and knowledge of dementia. Data suggest that a five-day, supervised, and protocol-based IPE experience in a dementia-care setting can inculcate positive changes in student attitudes about collaborative practice and may encourage dementia-related learning outcomes.     

Interprofessional education: the student perspective

The Toronto Rehabilitation Institute (Toronto Rehab) is a current leader in the movement of interprofessional education (IPE) initiatives in Ontario, Canada. Nine students from seven different health care disciplines, including medicine, nursing, occupational therapy, pharmacy, physiotherapy, social work, and speech language pathology participated in the second IPE clinical placement in the winter of 2005 on Toronto Rehab's Stroke inpatient unit. In an effort to increase interprofessional collaboration, improve communication skills, foster respect and enhance knowledge of the different roles each discipline plays on the health care team, these students met together over a five week period and participated in interprofessional group sessions led by different health care professional leaders from the unit. This paper discusses the students' perspectives on this IPE experience and the corresponding benefits and challenges. All participants in the study recognized the importance of interprofessional teamwork in patient care and agreed that all health care education should include opportunities enabling them to develop the skills, behaviours and attitudes needed for interprofessional collaboration.     

Impact of a collaborative interprofessional learning experience upon medical and social work students in geriatric health care

Abstract

Interprofessional collaborative practice is increasingly recognized as an essential model in health care. This study lends preliminary support to the notion that medical students (including residents) and social work students develop a broader understanding of one another’s roles and contributions to enhancing community-dwelling geriatric patients’ health, and develop a more thorough understanding of the inherent complexities and unique aspects of geriatric health care. Wilcoxon Signed Rank Tests of participants’ scores on the Index of Interdisciplinary Collaboration (IIC) indicated the training made significant changes to the students’ perception of interprofessional collaboration. Qualitative analysis of participants’ statements illustrated (1) benefits of the IPE experience, including complementary roles in holistic interventions; and (2) challenges to collaboration. The findings suggest that interprofessional educational experiences have a positive impact upon students’ learning and strategies for enhanced care of geriatric patients.     

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

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

From students to professionals: Results of a longitudinal study of attitudes to pre-qualifying collaborative learning and working in health and social care in the United Kingdom

During a longitudinal evaluation of a pre-qualifying interprofessional curriculum, health and social care students completed questionnaires concerning communication and teamwork skills and interprofessional learning and working. Data were collected on entry to their educational programme, during the second year of study, at qualification and after 9–12 months' qualified practice. This paper presents results from practice data from 414 professionals; 275 were educated on the interprofessional curriculum, 139 on previous uniprofessional curricula. The former were more confident at qualification about their communicative skills, their interprofessional relationships and other professionals' interaction, and showed positive correlations between perceptions of their relevant skills and their interprofessional relationships. They were also more positive about their interprofessional relationships than practitioners educated on uniprofessional curricula. Age and previous experience of higher education influenced professionals' attitudes negatively: mature individuals may require more support when entering the workforce. Between qualification and practice, respondents from the interprofessional cohorts grew more critical of interprofessional education. However, experience of interprofessional education appears to produce and sustain positive attitudes towards collaborative working, suggesting that individuals' perceptions of their own educational experience are inadequate as an evaluative measure of interprofessional learning initiatives. This study reinforces the argument for including IPE in pre-qualifying curricula.     

Case-based learning in cross-professional groups – the development of a pre-registration interprofessional learning programme

This paper describes the development and evaluation of an interprofessional learning (IPL) programme at the pre-registration level. The principal aim of the study was to investigate whether case-based learning in cross-professional groups is a feasible and an effective way to conduct interprofessional education (IPE). Student volunteers from five different health professional training programmes were allocated to two groups: an intervention group and a control group. Interprofessional attitudes of all students were measured at the beginning and at the end of the study. Group members fed back their views about their learning experience after the 9-week long intervention. The study reports significant effects of the intervention on students' attitudes to different health professions. For example, students in the intervention group tended to view each profession as more ‘caring’ when compared to the control group. Student feedback was positive, with the main message to integrate the programme in the timetable and to introduce an opportunity for IPE in future years. The initial findings reported in this paper show that this is a feasible and an effective way to deliver IPE across the wide range of professions in the study and that the learning programme was viewed positively by the students who took part.     

Medical student perceptions of an initial collaborative immersion experience

Recent reviews of interprofessional education (IPE) highlight the need for innovative curricula focused on longitudinal clinical learning. We describe the development and early outcomes of the initial clinical experience (ICE), a longitudinal practice-based course for first-year medical students. While IPE courses focus on student-to-student interaction, ICE focuses on introducing students to interprofessional collaboration. Students attend 14 sessions at one of 18 different clinical sites. They work directly with different health professionals from among 17 possible professions, including nurses, pharmacists, social workers, and respiratory, occupational, and physical therapists. Between 2015 and 2016, 167 students completed the course, and 81 completed the end-of-course evaluation. Students agreed or strongly agreed that ICE meaningfully contributed to their understanding of healthcare teams and different professional roles (86%), improved their understanding of healthcare systems (84%), improved their ability to communicate with healthcare professionals (61%), and improved their ability to work on interprofessional teams (65%). Select themes from narrative comments suggest that clinical immersion improves understanding of professional roles, helps students understand their own future roles in healthcare teams, and increases awareness of and respect for other professionals, with the potential to change future practice. ICE may be a template for other schools wishing to expand their current educational offerings, by engaging learners in more authentic, longitudinal clinical experiences with practicing healthcare professionals.     

Interprofessional education at Laval University: Building an integrated curriculum for patient-centred practice

The Laval University Faculty of Medicine, Faculty of Nursing, and School of Social Work, in partnership with the Vieille-Capitale Health and Social Services Centre in Quebec City, obtained funding from Health Canada to design, implement, and evaluate an integrated interprofessional education (IPE) program for family medicine, nursing, and social work students and for professionals from those professions working in primary care. The program was developed around four components and produced the following outcomes: a 45-hour undergraduate curriculum; IPE practical training for professionals, supervisors, residents and trainees in primary care teaching settings; a continuing education model for professionals based on a coaching approach, and; information and communication technology resources. After briefly describing the implementation process, educational content, and evaluation highlights of each component, the integrated program is discussed with respect to the inter-area complementarities and coherence with the conceptual dimensions that have guided the development of the program: IPE, collaboration, and collaborative patient-centered practice. The positive evaluation outcomes, the sustainability of the educational activities, and the enthusiasm of the different partners led to the creation of the Collaborative Network on Interprofessional Practices at Laval University and its affiliated health and social services clinical network.     

Interprofessional ethics education seminar for undergraduate health science students: A pilot study

To prepare for the modern collaborative healthcare system, health science academia is charged with educating future professionals to be competent members of the interprofessional team. The purpose of this pilot study was to assess self-efficacy for interprofessional education (IPE) in medical laboratory technology, dental hygiene, and nursing students before and after an IPE session. The specific topic of ethics was the focus of the session. The interprofessional seminar was designed to compare the codes of ethics from each programme through discussion and a case-based approach. The Self-Efficacy for Interprofessional Experiential Learning scale was used to collect quantitative data. A total of 75 participants rated self-efficacy for IPE before and after the educational offering. A paired sample t-test was used to analyse data. Significant results were found in students’ pre- and post-test scores that indicated increased levels of self-efficacy related to working as a collaborative team for the benefit of the patient. Overall, there was an increase in participants’ self-efficacy after collaborating with students from different health professions programmes. Healthcare students that learn together are more confident in their abilities to implement a team-structured approach, and understand that doing so will foster optimal patient wellbeing.     

Bridging understanding in nursing and radiography students: An interprofessional experience

Health professionals must improve interprofessional communication and collaboration to ensure quality patient care. Through socialization, simulation, and case‐based learning, improved collaboration among health professions is possible. Students from two programs, nursing and radiography, were involved in interprofessional activities, including case studies, simulation, and debriefing. The students completed a pre‐ and postsurvey to assess attitudes and knowledge of each profession. Data were analyzed in SPSS using paired t tests. Nursing and radiography students were assessed separately. A 4‐point Likert scale ranging from 1 (strongly disagree) to 4 (strongly agree) was used to quantify student selections. The nursing students showed increased confidence and knowledge in preparing patients, and deeper understanding of the role and knowledge base of the radiographer. While significant changes in student nurse attitudes and perceptions were noted, no significance was shown pre‐ to postsurvey in the radiography students’ attitudes and perceptions. This may be attributed to an increased level of clinical exposure and experience in the radiography students. The perceptions of the students during debriefing, as well as from the survey data, indicate a heightened awareness of the collaborative nature of health care. Student comments support interprofessional education (IPE) as a method to reach beyond a single professional boundary and increase communication and understanding among healthcare providers. Through this activity, attitudes changed and knowledge of health profession roles increased in novice nursing students. Health professions educators must embrace IPE to encourage interprofessional collaboration for patients navigating the complex healthcare system today and in the future.     

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.     

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.     

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.