Integrating interprofessional education into 10 health and social care programmes

The current policy agenda purports the need for education establishments and practice agencies to join together to promote interprofessional working. It was within this policy context that in September 2000 the Faculty of Health and Social Care, University of the West of England (Bristol) introduced an interprofessional strand within 10 professional programmes. This article outlines a number of challenges associated with the incorporation of interprofessional education into the pre-qualifying curriculum and details the approaches used to meet these challenges. Logistical barriers associated with organising more than 700 students into interprofessional groups in a format that does not result in an over representation of any group, developing and selecting appropriate scenarios, resourcing the interprofessional modules, integrating interprofessional education throughout the whole student experience and facilitating the delivery of the interprofessional modules are all considered, together with adjustments made in the light of evaluations to date.     

Building interprofessional frameworks through educational reform

The North American health care sector is being reformed to enhance collaboration among health care professionals to render patient care and improve outcomes. Changing educational frameworks will play a key role in achieving this goal. It is therefore important to gain an understanding of the application of interprofessional health care education and collaborative models of education. Chiropractic and other health care faculties would need to have an effective understanding and clarification of the characteristics of interprofessional care and its foundation in education from which appropriate educational and curricular models could be developed.     

Perceptions of chiropractic students regarding interprofessional health care teams

ObjectiveTo describe perceptions of knowledge of interprofessional teams and value of interprofessional education (IPE) among 3 distinct years of chiropractic students at 1 chiropractic college.MethodsA 24-item cross-sectional survey was administered to 247 chiropractic students in years 1–3 within a single institution. Surveys included 5 demographic questions and the 19-item Readiness for Interprofessional Learning Scale (RIPLS). The RIPLS collected information on perceptions and value of interprofessional health care in a health care training program. Each question is scored on a 1–5 scale, with 5 indicating a stronger agreement. Multivariable analysis was used for comparison.ResultsOut of a total 321 eligible students, 247 (148 male) students completed the survey from year 1 (n = 66), year 2 (n = 102), and year 3 (n = 79), respectively. Most students (68%) were 18–25 years old. The mean compiled score of all 3 years (n = 231) was 77.2 (SD = 9.1). Each individual''s year scores were as follows: year 1 (n = 60, mean = 79.7, SD=7.4), year 2 (n = 95, mean = 76.9, SD = 9.1), and year 3 (n = 76, mean = 75.4, SD = 9.9). Of the 247 students who responded, 87% of participantsagreed with “shared learning with other health care students will increase my ability to understand clinical problems.”ConclusionMost participants demonstrated a positive response to IPE and collaborating with health care teams. Participants in earlier years demonstrated a more positive response compared to later years. While positive perceptions to IPE were demonstrated, chiropractic students lacked knowledge and understanding of their role within an interprofessional health care team.     

Using co-teaching as a means of facilitating interprofessional collaboration in health and social care

In this paper we report the findings of a collaborative enquiry on our experience as tutors co-teaching interprofessional collaboration to a multidisciplinary group of undergraduates. We have different professional/academic backgrounds and the student group included health and social work professionals alongside a number of non-professionals. Our data included our perceptions of the co-teaching experience collected by means of our reflective diaries and reflective conversations during planning and after teaching sessions. We also collected data on student perceptions elicited by means of student evaluations and a student focus group discussion. The data illuminate the process of using co-teaching to role model shared learning and collaborative working within the classroom and highlight the importance of carefully planning co-teaching interaction, including the use of humour, tension, different knowledge bases and styles of debate. The deliberate use of the interactions made possible by co-teaching enabled us to create an active learning environment that facilitated the teaching of collaboration. Drawing on our experience, we discuss the considerable potential of using co-teaching to role model collaborative working for multidisciplinary student groups.     

Development of a scale to measure health professions students' self-efficacy beliefs in interprofessional learning

A need exists for measures to evaluate the impact of interprofessional education (IPE) interventions. We undertook development and evaluation of a scale to measure self-efficacy perceptions of pre-licensure students in medicine, dentistry and health professions. The scale was developed in the context of a project entitled, “Seamless Care: An Experiential Model of Interprofessional Education for Collaborative Patient-Centered Practice”. As self-efficacy perceptions are associated with the likelihood of taking on certain tasks, the difficulty of those tasks, and perseverance in the face of barriers, we reasoned that understanding changes in students' perceptions and their relation to other outcomes was important. A 16-item scale was developed from a conceptual analysis of relevant tasks and the existing literature. Content validity was assessed by six Canadian IPE experts. Pre-licensure students (n = 209) participated in a pilot test of the instrument. Content validity was rated highly by the six judges; internal consistency of the scale (Cronbach's α = 96) and subscales 1 (α = .94) and 2 (α = .93) were high. Principal components analysis resulted in identification of two factors, each accounting for 34% of the variance: interprofessional interaction, and interprofessional team evaluation and feedback. We conclude that this scale can be useful in evaluating IPE interventions.     

A survey of interprofessional education in communication skills in health care programmes in the UK

There is considerable evidence to indicate that patient satisfaction is directly related to the communication skills of health care providers. However, communication is an area in which health care practitioners often fail to meet patients' needs. Interprofessional education (IPE) is advocated as one way of improving health care communication for the consequent development of interprofessional care. However, poorly planned and delivered IPE can reinforce professional differences, so it is imperative that its introduction is based upon sound evidence of local need, opportunity and resources. A multidisciplinary and cross university project was designed to identify opportunities for, and best practice in, IPE in communication skills amongst undergraduate health care practitioners within one Workforce Development Directorate (WDD) in England. Methods included a comprehensive literature review of relevant educational initiatives, together with telephone and e-mail interviews with key informants in higher education institutions (HEIs) across the UK. This paper reports the findings from the interviews. Based upon these findings, a series of recommendations are made for the planning, implementation, and evaluation of IPE in communication skills, which should be taken into account by local curriculum planning groups.     

Integrating public health students into interprofessional education

ABSTRACT

Recognizing the public health professional are critical members of interprofessional teams, the Council on Education for Public Health (CEPH) recently added a required Masters of Public Health (MPH) student competency focused on interprofessional education (IPE). A student-centered approach to the design and evaluation of an emergency preparedness-focused curricular program to meet the interprofessional needs of MPH students was used to meet this expectation at the University of Washington. Curriculum design was informed by two 80-minute listening sessions with MPH students to better understand their current interprofessional educational experiences and needs, and how an emergency preparedness-focused two-hour Interprofessional Active Learning Series (iPALS) session could help them develop interprofessional competency. The resultant iPALS session was assessed with a short, paper-based questionnaire. We found MPH students have an interest in participating in IPE, and that all students who participated in the emergency preparedness-focused iPALS session reported significant increases in their interprofessional and disaster response abilities based on their pre- and post-session evaluations. Student-centered IPE curriculum focused on emergency preparedness can enhance the self-reported ability of students across the health sciences to perform on interprofessional teams while engaging in a topic that has relevance to MPH students.     

The impact of recent primary care reforms in the UK on interprofessional working in primary care centres

This study comprises the perspectives of professionals in primary care regarding the impact of the changes in its organisation and interprofessional collaboration in the UK. General practitioners (GPs), nurses and practice managers were interviewed in three primary cares located within a 20-mile radius and in the same health authority. Interviews were analysed using the grounded theory approach of Glaser & Strauss (1967) as developed by Strauss & Corbin (1998). The separate ideologies and subcultures of GPs, nurses and managers influenced their perceptions of reforms in primary care. Professional identities and the traditional power structure generated some conflict between the three groups which affected collaboration in implementing the reforms. Based on the findings of the study, it seems probable that it will take a new generation of health professionals to bring about an interprofessional culture in the NHS.     

Changing systems in health and social care for older people in Japan: observations and implications for interprofessional working

The impact of a rapidly ageing population on the development of insurance policies and health and social care services of older people is a major concern in Japan. The discussion in this paper draws on information gained from recent visits to leaders of these services in Japan. The paper briefly reviews the policy and demographic background to recent legislative changes in the long-term care insurance system, models of care management and assessment and outstanding challenges for health and social care professionals. Some key issues have emerged with implications for interprofessional working, such as the lack of integrated care systems, contradictions within the scope and responsibilities of care management, and the absence of quality and ethical frameworks to safeguard the interests of the service user and carer.     

Interprofessional perceptions of health care students

Effective interprofessional working, which is widely considered as essential to high-quality health care, is influenced by the attitudes of health care professionals towards their own and other professional groups. Relatively little is known, however, about interprofessional attitudes, particularly of students in health care professions. This study aimed to increase our understanding of students' attitudes towards their own and other professional groups on entry to a programme of professional education. Hypothesised relationships between stereotypes, professional identity and readiness for professional learning were tested by means of a questionnaire survey of 933 undergraduate health care students drawn from five health care groups (medicine, nursing, dietetics, pharmacy and physiotherapy) within a multi-faculty UK university. Positive statistically significant correlations were found between stereotypes, professional identity and readiness for interprofessional learning. As predicted, students identified strongly with their own professional group at the start of pre-registration education. They were also willing to engage in interprofessional learning. More unexpected was the positive association found between heterostereotype and professional identity scores. There are potential benefits of introducing active interprofessional education activities at an early stage of professional preparation to capitalise on students′ positive attitudes towards their own and other professional groups.     

Values-based interprofessional education: how interprofessional education and values- based practice interrelate and are vehicles for the benefit of patients and health and social care professionals

ABSTRACT

The 2016 All Together Better Health VIII Oxford conference brought together interprofessional education (IPE) and values-based practice (VBP) communities. As there is a paucity of research and publications in the area, following the event a working party consisting of representatives from both communities continued to meet and has developed a joint community of practice. This report describes the work achieved by the group so far and is intended for those involved in the planning and implementation of IPE and collaborative working. The authors consider that incorporating principles of VBP within a framework of IPE can provide a different perspective and understanding of the complexities involved in delivering realistic, student centered learning for collaborative practice, relevant in the 21st century workplace. In particular the authors suggest that using the principles of values and VBP in this way can inform the transition between IPE and collaborative practice facilitating effective person centered collaborative care. This process will require not only the incorporation of these principles within IPE sessions, but also incorporation within the training and support of new and established teachers involved in IPE.     

Crossing boundaries: Implementing an interprofessional module into uniprofessional Bachelor programmes

In accordance with the curriculum reforms within health education in Norway, the Faculty of Health Sciences at Oslo University College introduced in 1998 an interprofessional module, entitled “VEKS”, for eight different professional programmes. A shared module of 30 credits (15 for technically oriented programmes) was introduced into the three-year programmes. A problem-based and project-oriented format was chosen as the teaching and learning model to enhance the interactive, experiential and collaborative learning. This paper describes experience gained during the five-year implementation period. Empirical data were collected through participatory observations, students' and tutors' evaluations and group interviews with tutors and faculty leaders. The innovative project described challenged traditional educational boundaries and structures, frames of thought and habits. It broadened perspectives within the particular professional programmes as well as preparing students for their future professional careers. Lessons learned can be summed up as: Time, resources and a certain staff consensus are needed to deal with and overcome traditions and attitudes, the students' learning is a socialization process which needs to be developed over time; intermittent interprofessional interventions during the three-year period was found to be inadequate, and the tutor role is essential in order to support the students' learning process.     

Learning for interprofessional and inter-agency practice in the new social work curriculum: evidence from an earlier research study

The UK Government's consultation document, A Quality Strategy for Social Care (2000) seeks consistency and excellence in care services and enhanced service partnerships. It states that this requires improved training for social workers and raises the prospect of a new social work curriculum in which learning for interprofessional and inter-agency practice will be strengthened. The document stresses the importance of evidence in decision-making in social care and this principle applies equally to training but there are few recent research findings on interprofessional and inter-agency learning in the social work curriculum. There are, however, findings from an earlier study which contributed to the mid-1990s review of the Diploma in Social Work but which have not previously been published in the mainstream media. These findings are reported and show: the kinds of organisations and professions with whom social work practitioners were in close contact in their jobs; the importance attached by social workers to defined skills in working with them; the perceived usefulness of training in developing relevant knowledge and skills; perceptions of shared training; and marked differences of learning experience reported by practitioners who had taken different training courses. Each set of findings is described and used as the basis of questions for the new social work curriculum.     

Making space: Integrating meaningful interprofessional experiences into an existing curriculum

Many health professional education programs have instituted, or are in the process of developing, structures for implementing interprofessional education (IPE). Professional organizations are also adopting IP competencies for their respective memberships and accreditations. Our IPE design and educational framework was informed by evidence gathered from professional organizations; the students' lived experience with traditional approaches and evolving IPE designs and data from our school's longitudinal curriculum evaluation study. This paper briefly describes the evolution and design of an embedded IPE program within an existing master's level curriculum – which meets not only curriculum competencies but also nationally recognizes IPE competencies. In addition, the embedded program articulates with a mandatory faculty-wide IPE initiative. The creation of embedded IPE within existing courses allowed for enriched learning opportunities for both discipline-specific and IPE knowledge without changing the overall curriculum structure.     

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.     

Making organizational change to achieve improvement and interprofessional learning: perspectives from health professions educators

Health professionals must learn to work in the context of an interdisciplinary team in order to meet the needs of the evolving health care delivery system. These teams must work successfully with community systems to achieve common goals, while understanding and respecting diverse perspectives, experiences and skills. Strategies for changing health professions education to prepare new health professionals for such work have been tested by the Interdisciplinary Professional Education Collaborative. Illustrations of making educational change, and creating situations to sustain the change, are offered from the Collaborative's experience. Teams participating in the Collaborative engaged in interprofessional education, working on community-based health improvement issues. The illustrations are offered in the context of higher education, and the many barriers to making change that must be overcome. The work of the Collaborative provides valuable illustrations of successful activities to promote and create change, and ultimately to achieve improvement and interprofessional learning, better preparing new health professionals for the health systems in which they will work.     

Innovations in oral health: A toolkit for interprofessional education

The integration of oral health competencies into non-dental health professions curricula can serve as an effective driver for interprofessional education (IPE). The purpose of this report is to describe a replicable oral-health-driven IPE model and corresponding online toolkit, both of which were developed as part of the Innovations in Oral Health (IOH): Technology, Instruction, Practice, and Service programme at Bouvé College of Health Sciences, Northeastern University, USA. Tooth decay is a largely preventable disease that is connected to overall health and wellness, and it affects the majority of adults and a fifth of children in the United States. To prepare all health professionals to address this problem, the IOH model couples programming from the online resource Smiles for Life: A National Oral Health Curriculum with experiential learning opportunities designed for undergraduate and graduate students that include simulation-learning (technology), hands-on workshops and didactic sessions (instruction), and opportunities for both cooperative education (practice) and community-based learning (service). The IOH Toolkit provides the means for others to replicate portions of the IOH model or to establish a large-scale IPE initiative that will support the creation of an interprofessional workforce—one equipped with oral health competencies and ready for collaborative practice.     

The practitioner as policy analyst: a study of student reflections of an interprofessional course in higher education

Health and welfare practitioners in the United Kingdom have experienced and continue to experience considerable turbulence as services and occupational boundaries undergo restructuring. To a significant extent such turbulence is driven by policies that promote interprofessional agendas. This paper reports on an evaluation of a higher education programme that adopted a social policy approach to the analysis of interprofessional working. The retrospective views were sought of nursing, midwifery, social work and community and youth work post-qualifying students with use of semi-structured questionnaires and focus groups. Although difficulties were encountered with the political science focus to the programme, overall the participants very positively evaluated the opportunity to engage in policy analysis in a shared learning environment. Given the highly politicised, complex and shifting environment of interprofessional working, it is suggested that the study lends support to the argument that 'policy acumen' is a central skill for contemporary health and welfare practitioners. The paper, therefore, starts to explore issues of particular relevance for educationalists involved in developing frameworks for interprofessional programmes particularly in higher education.