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.     

E-Learning with virtual teammates: A novel approach to interprofessional education

Abstract

The Institute of Medicine identified interprofessional education (IPE) as a key innovation for achieving the triple aim of better care, better outcomes, and reduced healthcare costs. Yet, a shortage of qualified faculty and difficulty with aligning learners’ schedules often prevent sustainable and scalable IPE. A virtual IPE intervention was developed to circumvent these barriers and compared to a blended-learning IPE intervention. We used a pre-test and post-test design with two comparison interventions to test the effects of these IPE interventions on changes in teamwork knowledge, skills, and attitudes. The interventions were delivered to pre-licensure learners at a large, metropolitan medical and a nursing school. We used one-sample and independent-sample t-tests to analyze data from 220 learners who received the blended-learning intervention in 2011 and 540 learners who received the virtual learning intervention in 2012. The students in the blended-learning intervention did not significantly (p?<?0.05) outperform the students in the virtual learning intervention for any of the measured outcomes, except for medical students’ attitudes around team value. Virtual IPE learning is an effective, scalable, and sustainable solution for imparting foundational teamwork knowledge in health profession students.     

Current trends in interprofessional education of health sciences students: A literature review

There is a pressing need to redesign health professions education and integrate an interprofessional and systems approach into training. At the core of interprofessional education (IPE) are creating training synergies across healthcare professions and equipping learners with the collaborative skills required for today's complex healthcare environment. Educators are increasingly experimenting with new IPE models, but best practices for translating IPE into interprofessional practice and team-based care are not well defined. Our study explores current IPE models to identify emerging trends in strategies reported in published studies. We report key characteristics of 83 studies that report IPE activities between 2005 and 2010, including those utilizing qualitative, quantitative and mixed method research approaches. We found a wide array of IPE models and educational components. Although most studies reported outcomes in student learning about professional roles, team communication and general satisfaction with IPE activities, our review identified inconsistencies and shortcomings in how IPE activities are conceptualized, implemented, assessed and reported. Clearer specifications of minimal reporting requirements are useful for developing and testing IPE models that can inform and facilitate successful translation of IPE best practices into academic and clinical practice arenas.     

Faculty perceptions of interprofessional education

Nurses and other health professionals are required to demonstrate broad levels of expertise and service to ensure quality patient-centred health care. Interprofessional practice aligned with interprofessional education (IPE) has been promoted as a vehicle to promote broad levels of expertise. However, challenges remain for universities and other higher education institutions to successfully provide IPE opportunities for students. This paper presents perceptions of academic staff towards IPE from one Australian multi-campus health faculty. Perceptions were collected using interviews and two workshops. Findings are themed under the categories of faculty barriers, industry challenges and future opportunities. The perceptions of one health faculty regarding the fundamental factors required for IPE success were executive leadership of IPE, a supportive funding framework and an IPE based curricula. Nursing education can play a key role in embracing and leading future IPE approaches given that nurses are the numerically dominant health professional group and work collaboratively with other professionals to deliver patient-centred care.     

Student attitudes to undergraduate interprofessional education

Interprofessional education in health care has been the focus of increasing attention in recent years. However, there is still great debate about when and how to introduce it in undergraduate studies. St George’s Hospital Medical School with the Joint Faculty of Health Care Sciences of Kingston University was ideally placed to introduce, as part of its 1996 new curriculum, a Common Foundation Programme (CFP). This incorporated degree students in medicine, radiography, physiotherapy, and nursing learning together for the first term of their courses. As part of the evaluation of the CFP, students’ attitudes to the course and each other were surveyed at the beginning and the end of the term, for the 1998 and 1999 intakes. The results showed that students arrive at university with stereotyped views of each other, and that these views appeared to become more exaggerated during the CFP. Students felt that the CFP would enhance interprofessional working, but there were concerns that it forced them to learn irrelevant skills. Students whose parents worked as health care professionals, held stronger stereotyped views. Our findings challenge any notion that students arrive without preconceived ideas about the other professions. Further work is needed to appropriate models for interprofessional education, to enable graduates to work effectively in today’s environment.     

Evaluating interprofessional education: The tautological need for interdisciplinary approaches

This paper explores some issues associated with evaluating interprofessional education (IPE) programs. It proposes options that harness the synergy made possible through interdisciplinary and multi-method approaches. Both qualitative and quantitative research approaches are suggested. It is argued that traditional, control group experimental designs may not be adequate, appropriate or reasonable as the sole means of evaluating interprofessional education. The example of the four-year Rural IPE (RIPE) project, from southeastern Australia, is provided to suggest ways to identify indicators and implement features of successful IPE programs. It offers an interdisciplinary approach to measuring the effectiveness of IP programs. A particular focus is the use of self-assessment to both monitor and promote structured reflective learning and practice. Sample triangulatory data are presented from a range of evaluation methods collected from the RIPE project. The results suggest evidence of some significant educational gains as a result of this intervention. The data, the methods and the analyses may be useful for others interested in implementing or strengthening interprofessional education. The paper suggests a judicious, customized and balanced blend of methods and methodologies may offer more useful ways forward than relying on single method controlled studies which are, in any case, rarely feasible.     

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.     

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.     

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.     

Teaching interprofessional teamwork in medical and nursing education in Norway: A content analysis

The notions of interprofessional education and interprofessional teamwork have attained widespread acceptance, partly because lack of teamwork has been tentatively linked to adverse incidents in healthcare. By analyzing data from 32 educational institutions, this study identifies the status of interprofessional teamwork in all nursing and medical education in Norway. The study programs issued by the 32 educational institutions were subject to content analysis, distilling the ambitions and goals for teaching interprofessional teamwork. Study program coordinators were approached and asked to what degree interprofessional teamwork was actually introduced in lecturing and clinical training. Results indicate that the medical and nursing schools clearly aspire to teach interprofessional teamwork and that this has largely been achieved when it comes to theoretical teaching. Although three of the four medical programs have integrated interprofessional teamwork into their clinical training, there is a gap in the nursing programs where introduction of interprofessional teamwork in clinical training has been limited. Current challenges are related to organizational issues (e.g. lack of institutional collaboration), practical difficulties (e.g. finding time to bring students of various professions together) and possibly managerial issues (e.g. lack of strategic perspective and change management).     

Student-run clinics in Canada: an innovative method of delivering interprofessional education

Abstract

The age of siloed healthcare delivery is coming to an end. Research demonstrates that interprofessional collaboration (IPC), the provision of comprehensive services to patients by multiple health providers who collaborate within and across settings, improves the efficiency of the healthcare system, work environments, and patient outcomes. However, developing IPC skills requires training, often referred to as interprofessional education (IPE). This report aims to describe an innovation in IPE: student-run clinics (SRCs). SRCs are organizations composed of students from various disciplines who collaboratively plan and deliver healthcare and health promotion. Recent trends in Canadian SRCs are contrasted with those in the United States. The literature supporting SRCs as a method of delivering IPE, as well as the benefits conferred to patients, students, and communities at large is explored. It is clear that SRCs in Canada are an evolving approach to IPE and are filling a previously undiscovered healthcare niche.     

Teaching interprofessional teamwork skills to health professional students: A scoping review

An expanding body of literature is examining interprofessional teamwork and its effect in healthcare. To produce capable healthcare professionals prepared to participate in interprofessional roles, teamwork training must begin early in health professional students’ training. The focus of this scoping review was to explore interprofessional education (IPE) studies designed to teach and/or assess interprofessional teamwork skills to students from two or more different health professions, to find and describe effective pedagogy and assessment strategies. Using a scoping review methodology, 1,106 abstracts were reviewed by three teams of investigators. Eligibility criteria were inclusion of students in interprofessional teams, an intervention to improve interprofessional teamwork skills and assessment of outcomes related to teamwork. Thirty-three studies met the criteria for inclusion. The literature was varied in terms of study design, teaching methods and assessment measures for interprofessional teamwork. The lack of rigorous, comparable studies in this area makes recommending one teaching method or assessment measure over another difficult. Regardless of teaching method, it appears that most learning activities where interprofessional teams interact result in positive changes in student perceptions and attitudes towards IPE and practice. As health education programs seek to incorporate more interprofessional activities into their respective programs, it is important to review methods and measures that would best fit their individual program. This review highlights the importance of standardising the reporting of methods and outcomes for those who wish to incorporate the studied methods into their curricula.     

A systematic review and meta-analysis of outcomes of interprofessional education for healthcare students from seven countries

AimThis study aimed to analyze the effectiveness of the learning outcomes of the interprofessional education (IPE) model for healthcare students.BackgroundInterprofessional education (IPE) is an important teaching and learning model that involves two or more professions engaging or working together to improve the knowledge of healthcare students. However, the specific outcomes of IPE for healthcare students are unclear as only a few studies have reported them.DesignA meta-analysis was conducted to draw broad conclusions on the impact of IPE on healthcare students’ learning outcomes.MethodsThe CINAHL, Cochrane Library, EMBASE, MEDLINE, PubMed, Web of Science, and Google Scholar databases were searched for relevant articles in the English language. To investigate the effectiveness of IPE, a pooled estimate of knowledge, readiness for and attitude toward interprofessional learning, and interprofessional competence were analyzed using a random effects model. The methodologies of the studies evaluated were assessed using the Cochrane risk-of-bias tool for randomized trials, version 2. Sensitivity analysis was performed to ensure the rigor of the findings. STATA 17 was used to perform the meta-analysis.ResultsEight studies were reviewed. IPE had a significant positive impact on healthcare students’ knowledge (Standardized Mean Difference [SMD]: 0.43; 95% Confidence Interval [CI]: 0.21–0.66). However, its impact on readiness for and attitude toward interprofessional learning and interprofessional competence was nonsignificant and needs further investigation.ConclusionIPE enables students to develop their knowledge of healthcare. This study provides evidence that IPE is a better strategy for enhancing healthcare students’ knowledge than traditional/discipline-specific teaching techniques.     

Effects of a graduate-level interprofessional education program on adult nurse practitioner student and internal medicine resident physician attitudes towards interprofessional care

Abstract

This article describes the development, implementation and evaluation of a longitudinal interprofessional education (IPE) experience for adult nurse practitioner students and internal medicine residents. This experience focused on providing care for complex community based patients during clinic and home visits, preceded by didactic learning that emphasized understanding one another’s professional roles and education, teamwork and conflict management. Evaluation demonstrated significant improvements in attitudes and beliefs associated with professional role, respect among health professions’ disciplines and conflict management. Results with regards to attitudes towards IPE and interprofessional practice, and valuing teamwork training were mixed. In particular, the curricular intervention did not change participants’self-reported skill in communication and did not affect attitudes and beliefs towards effects of interprofessional education on patient outcomes.     

Enigma variations: Unraveling interprofessional education in time and place

Abstract

Designing the learning environment for the health care professionals of tomorrow is less than complete unless and until it includes interprofessional education (IPE). Progress depends on establishing a shared understanding of IPE between architects and teachers as the dialogue between them during the forum confirmed. My brief presentation provided no more than the catalyst. This paper goes further. It locates IPE within a coherent, consistent and pervasive rationale distilled over time from its roots in different countries and fields of practice, including the formulation of objectives, the adaptation of a repertoire of learning methods, the adoption of a definition and values and the framing of principle and competency-based outcomes, before alerting readers to some of the many complexities during the planning process.     

Escaping the professional silo: an escape room implemented in an interprofessional education curriculum

ABSTRACT

Communication skills among healthcare professionals are a necessary component in ensuring quality outcomes for patients. This report describes the design and curricular implementation of an interprofessional escape room, an innovative way to promote communication and positive team dynamics among students. In this interactive, serious game, teams of approximately eight interprofessional participants were provided with a fictitious patient case in a simulated hospital environment. Within a 45-minute time limit, students needed to use objects in the room to solve a series of puzzles to successfully complete the room by addressing all the patient’s needs. A facilitated debrief following the activity allowed participants to reflect on their communication skills and teamwork during the experience. A total of thirty students across seven professions piloted the activity, and 181 students across five professions participated in the activity as part of an academic course. Feedback from students was collected on a seven-point Likert scale and revealed the value of an interprofessional escape room in academia. This report, which describes what appears to be the first interprofessional health care escape room within an IPE curriculum, demonstrates the value of the escape room in encouraging teamwork, facilitating communication, and promoting interprofessionalism.     

Taking the long view: Exploring the development of interprofessional education

Interprofessional education (IPE) in health and social care has been well documented regarding student outcomes. Less has been written from the perspective of those who actually developed IPE. This study explores IPE within the context of a university partnership working with service providers in Southwest London (UK). We focused on the experiences and perspectives of 19 key players who were interviewed about the inception, implementation and development of IPE over 15 years. Our aim was to understand their views of IPE and its evolution over time. Interviewees provided different understandings of IPE, as well as contrasting views regarding its purpose and optimum delivery. Problems such as lack of central planning and the logistics of implementation were also discussed. Paradoxically, however, the participants highlighted positive outcomes and conveyed optimistic messages for the future. Despite various challenges and setbacks, a strong belief in the importance of IPE and a commitment to carrying it through were strong motivators contributing to finding solutions, as were building trust and positive relationships across professional and disciplinary boundaries.     

Attitudes of pharmacy and nutrition students towards team-based care after first exposure to interprofessional education in Qatar

Abstract

Little is known regarding attitudes of healthcare professional students towards team-based care in the Middle East. As modernization of health systems is rapidly occurring across the Gulf Cooperation Council countries, it is important for students to engage in interprofessional education (IPE) activities. The objective of this study was to assess pre-clinical students’ attitudes towards interprofessional healthcare teams after completion of their first IPE activity. A previously validated questionnaire was distributed to 25 pharmacy and 17 nutrition students at Qatar University after participation in an IPE event. Questions related to quality of team-based care and physician centricity. Results showed high agreement regarding high quality care provided by teams yet students were unsure of the value of team-based care when considering required time for implementation. Results provide baseline data for future studies to assess student attitudes throughout the professional programs and give valuable insight for future IPE program design in the Middle East.     

Bridging the gap: Enhancing interprofessional education using simulation

Simulated learning and interprofessional education (IPE) are increasingly becoming more prevalent in health care curriculum. As the focus shifts to patient-centred care, health professionals will need to learn with, from and about one another in real-life settings in order to facilitate teamwork and collaboration. The provision of simulated learning in an interprofessional environment helps replicate these settings thereby providing the traditional medical education model with opportunities for growth and innovation. Learning in context is an essential psychological and cognitive aspect of education. This paper offers a conceptual analysis of the salient issues related to IPE and medical simulation. In addition, the paper argues for the integration of simulation into IPE in order to develop innovative approaches for the delivery of education and improved clinical practice that may benefit students and all members of the health care team.     

Relationships of power: implications for interprofessional education

Interprofessional education (IPE) is considered a key mechanism in enhancing communication and practice among health care providers, optimizing participation in clinical decision making and improving the delivery of care. An important, though under-explored, factor connected to this form of education is the unequal power relations that exist between the health and the social care professions. Drawing on data from the evaluation of a large multi-site IPE initiative, we use Witz's model of professional closure (1992) to explore the perspectives and the experiences of participants and the power relations between them. A subset of interviews with a range of different professionals (n?=?25) were inductively analyzed to generate emerging themes related to perceptions of professional closure and power. Findings from this work highlight how professionals' views of interprofessional interactions, behaviours and attitudes tend to either reinforce or attempt to restructure traditional power relationships within the context of an IPE initiative.