Interprofessional education day – an evaluation of an introductory experience for first-year students

Interprofessional health care teams have been shown to improve patient safety and reduce medical errors, among other benefits. Introducing interprofessional concepts to students in full day events is an established model that allows students to learn together. Our group developed an academic day for first-year students devoted to an introductory interprofessional education (IPE) experience, ‘IPE Day’. In total, 438 students representing medicine, dentistry, pharmacy and optometry gathered together, along with 25 facilitators, for IPE Day. Following the day’s program, students completed the evaluation consisting of the Interprofessional Collaborative Competencies Attainment Survey and open-ended questions. Narrative responses were analyzed for content and coded using the Canadian Interprofessional Health Collaborative competency domains. Three hundred and eight evaluations were completed. Students reported increased self-ratings of competency across all 20 items (p < 0.05). Their comments were organized into the six domains: interprofessional communication, collaborative leadership, role clarification, patient-centred care, conflict resolution, and team functioning. Based on these findings, we suggest that this IPE activity may be useful for improving learner perceptions about their interprofessional collaborative practice competence.     

Examining the effects of an experiential interprofessional education activity with older adults

The need for experienced healthcare professionals to work with older adults is great, yet educational training is limited. In this interprofessional education (IPE) study, 861 students from five professions made 293 visits in the homes or preferred community settings of 208 older adults. Surveys with quantitative and open-text feedback assessed attitudes towards older adults, IPE team functioning, and the value of home visits. Survey results showed strongly positive attitudes towards ageing and older adults. Students from all professions expressed surprise and admiration for the active lives led by these healthier older adults, lives clearly in contrast to stereotypes of ageing. They further acknowledged the value of collaborative team functioning in meeting older adult needs, learned more about the roles and responsibilities of other professions, and identified strengths of the home as a site for care. Students positively valued the experience as part of their professional training, with 82% of all students stating they would welcome additional IPE opportunities. Results suggest that an experiential IPE activity can positively shape student attitudes towards older adults, IPE, and interprofessional collaboration.     

Development of an interprofessional and interdisciplinary collaborative research practice for clinical faculty

This article describes an interprofessional collaborative research practice fellowship designed to foster the research skills of clinical faculty. The year-long fellowship was grounded in big data analysis and the triangle of informatics—knowledge, information, and data. Fellows were selected to include diverse perspectives, training, and knowledge but had limited experience in team science or being a member of an interprofessional research team. The underlying philosophy of the fellowship was experiential learning. Protected time and formal mentorship were necessary factors for developing the interprofessional research practice and the skills to participate in an interprofessional research team. We believe that this innovative interprofessional faculty research fellowship is a viable option for supporting scholarly activity and research collaboration. The findings could inform interprofessional clinical practice and be implemented for patient care. Engagement in interprofessional collaborative research and incorporation of the perspectives, knowledge and expertise of multiple professions, is a model to de silo knowledge creation.     

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.     

Reply to Manthorpe & Iliffe

Effective interprofessional collaboration is considered essential for optimum healthcare delivery. Studies have investigated interprofessional education (IPE) as a means for improving collaborative practice, and evidence suggests that the clinical setting offers opportunities for interprofessional learning (IPL). Little is known, however, about the aspects of clinical practice that students perceive as meaningful to their IPL. This study explores physiotherapy students' experiences of collaborative working, and identifies their perceptions of the skills used and factors affecting interprofessional interactions in the clinical setting. Twenty second-year physiotherapy students studying in London provided written critical incident reports describing good and poor interprofessional collaborative encounters in the clinical setting. The data were subjected to thematic content analysis. Students identified communication and interprofessional relationships as the main factors affecting collaboration and perceived teamwork in formal contexts (e.g., team meetings) as generally effective with positive outcomes for professionals and patients. Informal collaboration was perceived to be poor and attributed primarily to insufficient direct contact and communication. The wide range of described experiences and learning outcomes indicate that clinical placements provide potentially valuable IPL opportunities. Facilitating the development of informal (ad hoc) collaborative teamwork skills is proposed as an important consideration when planning and implementing IPE in this setting.     

An interprofessional patient assessment involving medical and nursing students: a qualitative study

Interprofessional collaboration is fundamental to providing optimal patient care. The readiness of the team entering a framework of interprofessional collaborative practice is critical to its success. In this study, we conducted an interprofessional education (IPE) activity for medical and nursing students in an acute care setting. Over nine occasions, 21 student pairs (one nursing and one medical student per pair) jointly assessed a patient and created a list of problems and interventions to achieve the patient’s goals. Immediately after the activity, students were debriefed to gain insight into their experiences. Debriefing sessions were audiotaped and analysed using a phenomenological approach and four major themes were identified. Overall, students felt responsible for representing their profession and were initially apprehensive about the interprofessional task. Nevertheless, they identified their own shortcomings and recognized the value in their partner’s approach. These realizations promoted convergence on a shared vision to provide optimal care for patients as a team. Acknowledging and understanding these perceptions may help design better ways to improve patient care. This educational model may be utilized by others who are seeking IPE activities in acute care.     

Professional status and interprofessional collaboration: A view of massage therapy

Abstract

Interprofessional education (IPE) can be hindered by the lack of infrastructure required to support it. We developed a clinical IPE experience for medical and pharmacy students built upon an existing infrastructure. We created tools to orient students to IPE and had students participate in pharmacist-led and physician-led IPE clinics. Results from the surveys indicated that after participating in the IPE experience, there were no significant changes in attitudes toward interprofessional teamwork or attitudes toward different members of the healthcare team. Students found less value in tools outlining roles and responsibilities of team members, on-line modules about the other profession, and IPE group discussion. They placed more value on the actual clinical experience. Themes derived from analysis of open-ended survey questions reflected the value that students placed on interprofessional interaction in the setting of direct patient care.     

Interprofessional education and practice guide: interprofessional team writing to promote dissemination of interprofessional education scholarship and products

ABSTRACT

Collaborations to develop, implement, evaluate, replicate, and write about interprofessional education (IPE) activities within and across institutions are wonderful opportunities to experience teamwork, team communication, ethics and values, and the roles and responsibilities of interprofessional team writing. Just as effective communication in interprofessional team-based care is essential for providing safe, high-quality health care, similar communication strategies are necessary to produce high-quality scholarship of IPE curricula and activities. Relationship and communication issues that affect health care teams’ abilities to work together effectively (e.g., hierarchy, exclusion, assumptions, non-responsiveness, biases, stereotypes and poor hand-offs of information) can also occur in interprofessional team writing. Between 1970 and 2010, interprofessional practice research publications increased by 2293%. Although there has been tremendous growth in the IPE literature, especially of articles that require collaborative writing, there have not been any papers addressing the challenges of interprofessional team writing. As more teams collaborate to develop IPE, there is a need to establish principles and strategies for effective interprofessional team writing. In this education and practice guide, a cross-institutional team of faculty, staff, and graduate students who have collaborated on externally funded IPE grants, conferences, products, and workshops will share lessons learned for successfully collaborating in interprofessional team writing.     

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

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

Student perceptions about interprofessional education after an elective course

Abstract

A growing body of evidence indicates interprofessional collaborative practice improves patient care. With this in mind, Louisiana State University Health Sciences Center formally committed to expanding interprofessional education (IPE) initiatives. Thirty-eight self-selected students enrolled in an IPE elective course during the fall of 2012. Students completed the Readiness for Interprofessional Learning Scale (RIPLS) pre- and post-course and also completed a post-course survey. Results indicated a significant change in the roles and responsibilities scale of the RIPLS. Analysis of the data from the post-course survey demonstrated students were able to identify key terms of an IPE definition, as related to their learning experience. In addition, themes of communication, learning/increased knowledge, and collaboration/contribution of other health care professionals were noted across all questions in the post-course survey. Based on the results of this study, an elective course is a promising educational opportunity to increase awareness and knowledge of IPE within academic medical centers.     

Using a real-life case scenario to integrate additional health professions students into an existing interprofessional team seminar

The World Health Organization stated that the goal of interprofessional education (IPE) is to prepare students as collaboration-ready members of interprofessional care teams. Educators try to create meaningful and relevant learning experiences for multiple health professions students. A longitudinal Interprofessional Team Seminar (IPTS) course includes over 650 students from seven health professions at the professional training level. Recommendations from the National Athletic Trainers’ Association (NATA) promote the inclusion of athletic training (AT) students in IPE initiatives. A new IPTS module included AT students focusing on the attributes of rapidly forming and different care teams as the patient transitions from an on-field injury, to acute care, inpatient care, and rehabilitative care, and back to activities of daily living. Qualitative review of reflections from the students assessed the impact of these IPTS modules. The intentional design of this course, focusing on behaviours of collaborative practice and supporting students to be collaboration ready, effectively introduced and highlighted profession-specific strengths and unique contributions to team-based care.     

A scoping review to improve conceptual clarity of interprofessional interventions

Interprofessional education (IPE) and interprofessional collaboration (IPC) have been identified in health education and health care as playing an important role in improving health care services and patient outcomes. Despite a growth in the amount of research in these areas, poor conceptualizations of these interprofessional activities have persisted. Given the conceptual challenges, a scoping review of the interprofessional field was undertaken to map the literature available in order to identify key concepts, theories and sources of evidence. The objective of this review was to develop a theoretically based and empirically tested understanding of IPE and IPC. A total of 104 studies met the criteria and were included for analysis. Studies were examined for their approach to conceptualization, implementation, and assessment of their interprofessional interventions. Half of the studies were used for interprofessional framework development and half for framework testing and refinement. The final framework contains three main types of interprofessional interventions: IPE; interprofessional practice; and interprofessional organization; and describes the nature of each type of intervention by stage, participants, intervention type, interprofessional objectives, and outcomes. The outcomes are delineated as intermediate, patient, and system outcomes. There was very limited use of theory in the studies, and thus theoretical aspects could not be incorporated into the framework. This study offers an initial step in mapping out the interprofessional field and outlines possible ways forward for future research and practice.     

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.     

“Refreshed…reinforced…reflective”: A qualitative exploration of interprofessional education facilitators’ own interprofessional learning and collaborative practice

While there is extensive research examining the outcomes of interprofessional education (IPE) for students, minimal research has investigated how facilitating student learning influences the facilitators themselves. This exploratory case study aimed to explore whether and how facilitating IPE influences facilitators’ own collaborative practice attitudes, knowledge, and workplace behaviours. Sixteen facilitators of an online pre-licensure IPE unit for an Australian university participated in semi-structured telephone interviews. Inductive thematic analysis revealed three emergent themes and associated subthemes characterising participants’ reflexivity as IPE facilitators: interprofessional learning; professional behaviour change; and collaborative practice expertise. Participants experienced interprofessional learning in their role as facilitators, improving their understanding of other professionals’ roles, theoretical and empirical knowledge underlying collaborative practice, and the use and value of online communication. Participants also reported having changed several professional behaviours, including improved interprofessional collaboration with colleagues, a change in care plan focus, a less didactic approach to supervising students and staff, and greater enthusiasm impressing the value of collaborative practice on placement students. Participants reported having acquired their prior interprofessional collaboration expertise via professional experience rather than formal learning opportunities and believed access to formal IPE as learners would aid their continuing professional development. Overall, the outcomes of the IPE experience extended past the intended audience of the student learners and positively impacted on the facilitators as well.     

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.     

What did first-year students experience during their interprofessional education? A qualitative analysis of e-portfolios

Interprofessional collaboration is an essential approach to comprehensive patient care. As previous studies have argued, interprofessional education (IPE) must be integrated in a stepwise, systematic manner in undergraduate health profession education programmes. Given this perspective, first-year IPE is a critical opportunity for building the foundation of interprofessional collaborative practice. This study aims to explore the first-year students’ learning processes and the longitudinal changes in their perceptions of learning in a year-long IPE programme. Data were collected at a Japanese medical university, in which different pedagogical approaches are adopted in the IPE programme. Some of these approaches include interprofessional problem-based learning, early exposure, and interactive lecture-based teaching. The students are required to submit written reflections as a formative assessment. This study conducted an inductive thematic analysis of 104 written reflections from a series of e-portfolios of 26 first-year students. The themes related to learning outcomes from student perspectives included communication (e.g., active listening and intelligible explanation), teams and teamwork (e.g., mutual engagement and leadership), roles/responsibilities as a group member (e.g., self-directed learning and information literacy), and roles/responsibilities as a health professional (e.g., understanding of the student’s own professional and mutual respect in an interprofessional team). The study also indicated three perspectives of students’ learning process at different stages of the IPE, i.e., processes by which students became active and responsible learners, emphasised the enhancement of teamwork, and developed their own interprofessional identities. This study revealed the first-year students’ learning processes in the year-long IPE programme and clarified the role of the first-year IPE programme within the overall curriculum. The findings suggest that the students’ active participation in the IPE programme facilitated their fundamental understanding of communication/teamwork and identity formation as a health professional in interprofessional collaborative practice.     

Exploring physiotherapy students' experiences of interprofessional collaboration in the clinical setting: a critical incident study

Effective interprofessional collaboration is considered essential for optimum healthcare delivery. Studies have investigated interprofessional education (IPE) as a means for improving collaborative practice, and evidence suggests that the clinical setting offers opportunities for interprofessional learning (IPL). Little is known, however, about the aspects of clinical practice that students perceive as meaningful to their IPL. This study explores physiotherapy students' experiences of collaborative working, and identifies their perceptions of the skills used and factors affecting interprofessional interactions in the clinical setting. Twenty second-year physiotherapy students studying in London provided written critical incident reports describing good and poor interprofessional collaborative encounters in the clinical setting. The data were subjected to thematic content analysis. Students identified communication and interprofessional relationships as the main factors affecting collaboration and perceived teamwork in formal contexts (e.g., team meetings) as generally effective with positive outcomes for professionals and patients. Informal collaboration was perceived to be poor and attributed primarily to insufficient direct contact and communication. The wide range of described experiences and learning outcomes indicate that clinical placements provide potentially valuable IPL opportunities. Facilitating the development of informal (ad hoc) collaborative teamwork skills is proposed as an important consideration when planning and implementing IPE in this setting.     

Becoming an interprofessional practitioner: factors promoting the application of pre-qualification learning to professional practice in maternity care

Abstract

Teamwork and collaboration have been recognized as essential competencies for health care providers in the field of maternity care. Health care policy and regulatory bodies have stressed the importance of Interprofessional Education (IPE) for learners in this field; however, there is little evidence of sustained application of pre-qualifying IPE to the realm of interprofessional collaboration (IPC) in practice following qualification. The aim of this research was to understand how newly qualified midwives applied their IPE training to professional practice. A purposive sample of midwifery students, educators, new midwives and Heads of Midwifery from four universities in the United Kingdom participated in semi-structured interviews, questionnaires and focus groups. Qualitative, grounded theory methodology was used to develop the emerging theory. Newly qualified midwives appeared better able to integrate their IPE training into practice when IPE occurred in a favourable learning environment that facilitated acquisition and application of IPE skills and that recognized the importance of shared partnership between the university and the clinical workplace.     

The development of an instrument to evaluate interprofessional student team competency

Healthcare institutions, accreditation agencies for higher learning, and organizations such as the National Academy of Medicine in the United States, support interprofessional education (IPE) opportunities. However, incorporating IPE opportunities into academic settings remains difficult. One challenge is assessing IPE learning and practice outcomes, especially at the level of student performance to ensure graduates are “collaboration-ready”. The Creighton-Interprofessional Collaborative Evaluation (C-ICE) instrument was developed to address the need for a measurement tool for interprofessional student team performance. Four interprofessional competency domains provide the framework for the C-ICE instrument. Twenty-six items were identified as essential to include in the C-ICE instrument. This instrument was found to be both a reliable and a valid instrument to measure interprofessional interactions of student teams. Inter-rater reliability as measured by Krippendorff’s nominal alpha (nKALPHA) ranged from .558 to .887; with four of the five independent assessments achieving nKALPHA greater than or equal to 0.796. The findings indicated that the instrument is understandable (Gwet’s alpha coefficient (gAC) 0.63), comprehensive (gAC = 0.62), useful and applicable (gAC = 0.54) in a variety of educational settings. The C-ICE instrument provides educators a comprehensive evaluation tool for assessing student team behaviors, skills, and performance.