The effectiveness of interprofessional education in healthcare: A systematic review and meta-analysis

Documentation of neurovascular assessment in fracture patients in a tertiary care hospital: A retrospective review

Introduction

Materials and methods

Results

Conclusion

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Neurovascular problems are common in people who have suffered an acute fracture.

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When these injuries appear to the emergency room, the patient should be reviewed when examined by an orthopedic specialist.

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The objective of the study•

identify if the current documentation of upper limb and lower limb trauma patient is compliant with (British Orthopaedic Association Standards for Trauma guidelines).

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improve current documentation of orthopaedic and emergency department at major trauma centre(MTC).

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improve quality of documentation and adherence to guidelines by introducing a predesigned performa

Improvement Strategies for the Challenging Collaboration of General Practitioners and Specialists for Patients with Complex Chronic Conditions: A Scoping Review

Introduction

Coordination of healthcare professionals seems to be particularly important for patients with complex chronic disease, as they present a challenging interplay of conditions and symptoms. As one solution, to counteract or prevent this, improving collaboration between general practitioners (GPs) and specialists has been the aim of studies by linking or coordinating their services along the continuum of care. This scoping review summarises role distributions and components of this collaboration that have potential for improvement for the care of patients with complex chronic conditions.

Methods

Scoping review as a knowledge synthesis for components of collaboration and role distributions between medical specialists and GPs in intervention studies. The PubMed database was searched for literature from 2010-2020.

Results

Literature search and reference screening generated 2,174 articles. 30 articles originating from 22 unique projects were included in our synthesis. In the interventions to improve collaboration, the GP is most commonly in charge of patient management and extends the scope of practice. The specialist provides support when needed. Clear definition of roles, resources for knowledge transfer and education from specialists are commonly utilised interventions. Typically, combinations of process and system changes addressing communication and coordination issues are applied. Most interventions improve provider and patient satisfaction, health outcomes, and reduce care fragmentation.

Conclusion

This review showed that interventions to improve collaboration between GPs and medical specialists seem promising. Further efforts should be made to test and apply the findings systematically in broad clinical practice.

An Undergraduate Interprofessional Experience with Self-Learning Methodology in Simulation Environment (MAES©): A Qualitative Study

This article describes the impact that a Self-learning Methodology in Simulated Environments can have on Interprofessional Education within a Crisis Resource Management simulated scenario. We used a qualitative approach. It is divided into three phases: study and design, plan of action, and analysis and evaluation. During the first phase of the study, there emerged a poor use of Interprofessional Education in the nursing and medical degrees, and it became apparent that there was a need for an implementation. Due to the possibility for better training for both technical and non-technical skills within Crisis Resource Management, a simulation scenario within this setting has been established as a learning baseline objective. The technique used to develop the scenario in the second phase of the study was the Self-learning Methodology in Simulated Environments. Its structure, comprising six items, was previously demonstrated in the literature as appropriate for healthcare degree students. The main result of the third phase shows an overall acceptance of an Interprofessional Education within Self-learning Methodology in Simulated Environments during the practice of a Crisis Resource Management scenario. The integrated application of a Self-learning Methodology in Simulated Environments, Interprofessional Education, and Crisis Resource Management result in a synergistic combination that allows students to share knowledge, technical, and non-technical skills using an innovative learning method.

Creating Patient Safety Team Members Through a Simulation-Based Interprofessional Root Cause Analysis Course

BACKGROUND

The Accreditation Council for Graduate Medical Education Common Program Requirements require residents to participate in real or simulated interprofessional patient safety activities. Root cause analysis (RCA) is widely used to respond to patient safety events; however, residents may lack knowledge about the process.

OBJECTIVE

To improve clinicians' knowledge of the tools used to conduct an RCA and the science behind them, and to describe this course and discuss outcomes and feasibility.

METHODS

A flipped classroom approach was used. Participants completed 5 hours of pre-course work then attended an 8.5-hour program including didactic sessions and small group, facilitator-led RCA simulations. Pre- and post-surveys, as well as a 10-month follow-up on knowledge of and comfort with the RCA process were compared. Statistical significance was evaluated for matched pairs using a repeated measures analysis of variance.

RESULTS

Of 162 participants trained, 59 were residents/fellows from 23 graduate medical education programs. Response rates were 96.9% (157 of 162) for pre-course, 92.6% (150 of 162) for post-course, and 81.5% (132 of 162) for 10-month follow-up survey. Most participants had never participated in an RCA (57%, 89 of 157) and had no prior training (87%, 136 of 157). Following the course, participants reported improved confidence in their ability to interview and participate in an RCA (P<.001, 95% CI 4.4-4.6). This persisted 10 months later (P<.001, 95% CI 4.2-4.4), most prominently among residents/fellows who had the highest rate (38.9%, 23 of 59) of participation in real-world RCAs following the training.

CONCLUSIONS

The course led to a sustained improvement in confidence participating in RCAs, especially among residents and fellows.

The Mediating Effect of Self-Regulated Learning on the Relationships Among Emotional Intelligence, Collaboration, and Clinical Performance in Korean Nursing Students

BACKGROUND

Clinical performance is an important competence for nursing students to achieve. However, little is known about the degree to which self-regulated learning mediates the relationships among emotional intelligence, collaboration, and clinical performance in nursing students.

PURPOSE

This study was designed to investigate the mediating effect of self-regulated learning on clinical performance.

METHODS

A cross-sectional, descriptive, correlational design was used, and a convenience sample of 302 nursing students in Years 3 and 4 of a bachelor's degree program were recruited as participants from five universities in South Korea. Information on participant characteristics, emotional intelligence, collaboration, self-regulated learning, and clinical performance was collected from the participants using self-reported questionnaires from September to October 2019. Partial least squares structural equation modeling was used to evaluate the research model.

RESULTS

Emotional intelligence, collaboration, and self-regulated learning were found to be statistically significantly related to clinical performance. Moreover, self-regulated learning was identified as a full mediator of the relationship between emotional intelligence and clinical performance (accounting for 62.0% of the variance) and a partial mediator of the influence of collaboration on clinical performance (accounting for 25.4% of the variance).

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

Nursing educators should encourage self-regulated learning among their students and provide a collaborative learning environment to enhance their students' clinical performance.

Effectiveness of Interdisciplinary Teaching on Creativity: A Quasi-Experimental Study

Little is known about the effectiveness of Interdisciplinary teaching (IDT) in higher education, particularly for healthcare education in Taiwan. It is vital to determine if IDT could enhance divergent creative thinking and team creativity among nursing students. A quasi-experimental study with a pretest-posttest design. Students enrolled in a capstone nursing course for the development of healthcare-related products were divided into two groups. The intervention group (n = 61) was taught creative thinking skills with IDT by faculty. The control group (n = 84) was taught by nursing faculty with traditional teaching. This study found that students who received the IDT intervention scored significantly higher on measures of creative thinking and team creativity compared with students in the control group. These findings suggest integrating IDT from nursing and design faculty into the teaching curriculum to foster students’ creative thinking abilities when formulating interdisciplinary student teams to develop innovative, creative healthcare products.

How does interprofessional education influence students' perceptions of collaboration in the clinical setting? A qualitative study

BACKGROUND

Interprofessional education (IPE) aims to improve students' collaborative competencies and behaviour. The effect of classroom IPE on students' perceptions of collaboration in clinical practice, and how knowledge is possibly transferred, has yet to be investigated. The research question of this study was: How does IPE in a classroom setting influence students' perceptions of collaboration in clinical practice? Social capital theory is used as the theoretical lens. Social capital theory describes how social relationships generate benefits for the individuals involved. Social capital can be divided into three forms of social cohesion: bonding, bridging and linking social capital. Bonding refers to connections that are close and strong, such as family. Bridging social capital occurs in more distant relationships. Linking social capital refers to relationships between individuals with different power or social status.

METHODS

A qualitative study with semi-structured face-to-face interviews was conducted to explore students' perceptions and experiences. Nursing and medical students who had participated in four classroom IPE-sessions were asked about the perceived influence of the IPE-sessions they had attended on their interprofessional collaboration. Thematic analysis was conducted, with sensitising concepts of 'bonding', 'bridging' and 'linking social capital' from the social capital theory.

RESULTS

Twenty-two interviews were conducted. Students experienced: 1) exchange of discipline specific knowledge, 2) general knowledge about each other's responsibilities, 3) reduction of hierarchy, and 4) improvement in patient care. The first two themes reflect bridging social capital, since students experience that the other student is from a different group. The third theme reflects linking social capital, since students experience a difference in (social) status. The fourth theme most explicitly reflects 'getting ahead' or doing better, what is referred to as an effect of increased social capital.

CONCLUSION

This study reveals new insights regarding how increased social capital of undergraduate students after IPE-sessions in a classroom setting influences the way they conceptualise and experience interprofessional collaboration in clinical practice. These insights contribute to the understanding of the effectiveness of IPE in undergraduate curricula. Further research on long-term effects is underway.

A Weight and Meta-Analysis on the Academic Achievement of High School Students

Understanding the determinants of academic achievement (AA) is crucial for virtually every stakeholder interested in personal development and individual and societal wellbeing. Extensive research in several areas, such as education, economics, or psychology, has addressed this topic, identifying a vast number of determinants that impact high school students’ AA. In this work, we perform a meta-analysis, including a weight analysis of 49 quantitative studies that investigate this topic, exploring the best predictors of high school students’ academic success. We also explore moderation effects. Our results show that academic self-efficacy and socioeconomic status are the best predictors of AA, and they are statistically significant. Other statistically significant predictors, albeit less common in the analyses, are mastery avoidance, motivation, sleep habits, and work avoidance. Implications for theory and practice and directions for future research are discussed.

Joint learning for improvement - interprofessional competence development within the framework of a co-operative project between the University of Applied Sciences for Health Professions Upper Austria and the Medical Faculty of Johannes Kepler University Linz

Objectives

This project carried out in cooperation between the University of Applied Sciences for Health Professions Upper Austria (UASHPUA) and the Medical Faculty of Johannes Kepler University Linz (MFJKUL), describes the feasibility, i.e., the planning and implementation, and presents selected results of an inter-university lecture on interprofessional cooperation.

Methodology

The lecture "Grundlagen zu interprofessioneller Zusammenarbeit im Gesundheitswesen (IPZ3I)"/"Introduction to interprofessional cooperation in health care (IPZ3I)" as well as an interprofessional job shadowing were designed. The pilot lecture started in the winter semester (WS) 2019/20. An evaluation of IPZ3I was undertaken by means of a questionnaire.

Results

IPZ3I was held in the WS 2019/20 for 296 students from nine different health care professions and included a specialist lecture, the presentation of the professions, and interprofessional case processing. In the evaluation approx. 80% of the students described a better understanding of the interprofessional collaboration. More than 70% regard interprofessional courses in education as important or very important. The majority of respondents indicate that after completing the lecture they can make recommendations for action for interprofessional cooperation.

Conclusions

The joint lecture IPZ3I will be maintained at both universities. The process of evaluation and adaptation of curricula at UASHPUA is currently underway. This includes, for instance, consultations with the curriculum officers at MFJKUL, and the exploration of further possibilities to identify and to implement joint interprofessional teaching aspects in the curricula. This shall be achieved by considering the existing resources, increasing student numbers at MFJKUL as of 2023, planned curricula revisions as well as using possible synergies aiming at an extension of the existing cooperation.

Position paper of the GMA Committee Interprofessional Education in the Health Professions - current status and outlook

In the wake of local initiatives and developmental funding programs, interprofessionality is now included in national curricula in the German-speaking countries. Based on the 3P model (presage, process, product), this position paper presents the development of interprofessional education in recent years in Germany, Austria and Switzerland and places it in an international context. Core aspects as legal frameworks, including amendments to occupational regulations as well as the formation of networks and faculty development are basic requirements for interprofessional education. New topics and educational settings take shape in the process of interprofessional education: patient perspectives and teaching formats, such as online courses, become more important or are newly established. The influence of the COVID-19 pandemic on interprofessional education is explored as well. Among many new interprofessional courses, particularly the implementation of interprofessional training wards in Germany and Switzerland are positive examples of successful interprofessional education. The objective of interprofessional education continues to be the acquisition of interprofessional competencies. The main focus is now centered on evaluating this educational format and testing for the corresponding competencies. In the future, more capacities will be required for interprofessional continuing education and post-graduate education. Structured research programs are essential to ascertain the effects of interprofessional education in the German-speaking countries. In this position paper the GMA committee on interprofessional education encourages further advancement of this topic and expresses the aim to continue cooperating with other networks to strengthen and intensify interprofessional education and collaboration in healthcare.

The Need for and Perceptions of Interprofessional Education and Collaboration Among Undergraduate Students in Nursing and Medicine in South Korea

Purpose

Interprofessional education (IPE) for undergraduate students in the healthcare disciplines facilitates the acquisition of skills required for interprofessional collaboration, which is critical for patient care. This study assesses the need for and perceptions of IPE and interprofessional collaboration among undergraduate students in nursing and medicine in South Korea.

Participants and Methods

This was a cross-sectional survey of undergraduate students in nursing (n = 130) and medicine (n = 68), who had never been exposed to IPE, using a convenience sampling method. The Readiness for Interprofessional Learning Scale (RIPLS) (19 items), Interdisciplinary Education Perception Scale (IEPS) (12 items), and Interprofessional Education and Collaborative (IPEC) Competency Self-Assessment Scale (16 items) were used. Data were analyzed using descriptive statistics, χ² test, and independent sample t-test.

Results

Students in both schools almost equally indicated the need for IPE and practice-based IPE in their clinical rotations, focusing on patients in general wards, and wanted to learn teamwork. The mean RIPLS scores were 68.5 ± 5.62 in nursing students and 67.5 ± 6.53 in medical students, and those of the IEPS were 57.0 ± 7.03 in nursing students and 58.7 ± 7.08 in medical students, without significant differences. Nursing students scored significantly higher on the positive professional identity subscale of the RIPLS, whereas medical students scored higher on the competency and autonomy and perceived need for cooperation subscales of the IEPS. The total scale scores on the IPEC Competency Self-Assessment Scale were 65.2 ± 3.35 for nursing students and 67.4 ± 2.96 for medical students, the latter having a significantly higher score.

Conclusion

This study revealed differences in needs and perceptions regarding IPE and interprofessional collaboration between schools. These findings warrant further research to design IPE program goals and strategies that are reflective of students’ needs.

"Getting Started": A Pilot Introductory Narrative Writing Session for Interprofessional Faculty in Academic Health Sciences

PURPOSE

We designed and implemented a pilot introductory narrative writing session with the two-fold goal of fostering the dissemination of faculty writing for submission to peer-reviewed journals and other publication venues while simultaneously creating a framework for establishing collaborative and empathic interprofessional teams by enhancing narrative-related competencies.

METHODS

The session was open to interprofessional faculty at our academic health sciences center. Participants were accepted via a competitive application process, with group size limited to 18 individuals due to the workshop-style format. Learners were reflective of our diverse campus regarding sex, race/ethnicity, department, rank, and professional role. The session began with an experiential seminar providing instruction on writing theory and practice, discussion questions, and reflective writing prompts. The seminar was followed by a writing workshop. We conducted a mixed-methods evaluation to gauge participant satisfaction and educational efficacy.

RESULTS

The mixed-methods evaluation revealed that faculty reported high satisfaction with the session as a designated space to contemplate, discuss, practice, share, and critique narrative writing. All learners (18, 100%) rated it "very good" or "excellent" in overall quality and value as well as in relevance to personal growth. Participants reported growth in communication (13, 72%), self-reflection (12, 67%), active listening (12, 67%), writing confidence (11, 61%), perspective-taking (11, 61%), writing skills (10, 56%), and empathy (8, 44%).

DISCUSSION

Faculty valued the session as a venue for improving their writing skills and sharing with a diverse group of colleagues about the significance of narrative in relation to their professional lives.

CONCLUSION

Seminar outcomes suggest that narrative-based education for interprofessional health sciences faculty can be effective in achieving the two-fold goal of enhancing writing competencies while simultaneously fostering essential skills for building collaborative and empathic teams to promote high-quality education, research, and whole person clinical care.

[Training in Multi-Professional Primary Health Care Residency Programs: a systematic review of the literature]

The scope of this study is to investigate how the training of health professionals has been provided in Multi-professional Primary Health Care Residency Programs in Brazil. A systematic review was conducted on Scielo, BVS and PubMed databases in 2019, under registration number CRD42019134350. The search was carried out using key words related to Multi-Professional Residency Programs and Primary Health Care, including empirical research on the theme with a low-level risk of bias. Of the 700 studies identified, 13 articles were included in this review. All the studies adopted a qualitative approach predominantly performed in São Paulo with a low risk of bias (69%). The main results were categorized as: Contribution of measures for occupational training; Definition of professional training strategies; Potential of Multi-Professional Primary Health Care Residency Programs for health professional training and difficulties experienced during the training process. Professional training on programs studied has provided a new profile of health providers, despite limitations in the training process. Investments in the qualification of the personnel involved in training were perceived as being necessary, since it was one of the main weaknesses reported.

Translation and validation of the Swedish version of the IPECC-SET 9 item version

Interprofessional Education (IPE) is essential to prepare future health-care professionals for collaborative practice, but IPE requires evaluation. One psychometrically sound instrument is the Interprofessional Education Collaborative Competence Self-Efficacy Tool consisting of nine items (IPECC-SET 9). This tool does not, to date, exist in a Swedish version. Therefore, the aim of this study was to translate and validate the Swedish version of the IPECC-SET 9. The English version was translated into Swedish and tested among 159 students in the 3-year Bachelor Programs in Nursing and in Biomedical Laboratory Science. The psychometric analysis was guided by a Rasch model, which showed that the items functioned well together, confirming unidimensionality, and that the person misfit was also lower than the set criterion. The separation index was 2.98, and the Rasch-equivalent Cronbach-alpha measure was estimated to .92, supporting internal consistency. No systematic differences on item level in IPECC-SET 9 further supported fairness in testing. The Swedish IPECC-SET 9 demonstrates sound psychometric properties and has the potential to be used as a measure of self-efficacy for competence in interprofessional collaborative practice among health profession students. However, the IPECC-SET 9 is recommended to be further tested in larger samples representing the entirety of health-care teams.

The effect of ISBARR on knowledge of and attitudes about interprofessional communication skills among Chinese undergraduate nursing students

BACKGROUND

Interprofessional communication is essential for the coordination and collaboration of healthcare team members during patient care, especially in critical situations. Therefore, nursing students must learn and practice interprofessional communication skills throughout their education and clinical training. Previous studies evaluating standardized communication frameworks in the United States (e.g., ISBARR [identify, situation, background, assessment, recommendation, and repeat]) suggest that nursing students feel more confident about interprofessional communication and collaboration through familiarity with these frameworks.

OBJECTIVE

To evaluate the effect of an ISBARR workshop on knowledge of and attitude about effective communication among Chinese undergraduate students.

DESIGN

A pre- and posttest quasi-experimental study.

PARTICIPANTS

A convenience sample of 90 undergraduate nursing students at a vocational health college in China.

METHOD

The two-part ISBARR workshop featured a lecture and a video-simulation exercise. Differences in students' knowledge of and attitudes about interprofessional communication skills using ISBARR were compared pre- and post-workshop.

RESULTS

We observed a statistically significant (p < 0.001) improvement in overall mean scores of students' knowledge of and attitudes about utilizing ISBARR post-workshop. We also observed a statistically significant (p < 0.001) improvement in the overall mean scores of students' knowledge of and attitudes about ISBARR after the video-simulation exercise.

CONCLUSION

The ISBARR workshop improved Chinese nursing students' knowledge and attitudes about interprofessional communication. Incorporating ISBARR into the nursing healthcare team eventually can lead to improved patient safety. Subsequent studies should target nursing faculty and clinical instructors to evaluate their knowledge and attitudes about teaching ISBARR and interprofessional education. Improving these attitudes can help establish a positive interprofessional communication learning environment for nursing students in China and other cultural contexts worldwide.

Undergraduate-level teaching and learning approaches for interprofessional education in the health professions: a systematic review

BACKGROUND

Although most systematic reviews of interprofessional education (IPE) evaluated the impact of IPE on the students' acquisition of knowledge in relation to other professions, the development of teamwork skills, and the changes in collaborative behaviour, the processes involved in IPE (i.e., approaches to teaching and learning) are under-researched. The purpose of the study was to conduct a systematic review to establish how IPE has been implemented in university-based undergraduate curricula, focusing on the teaching and learning approaches.

METHODS

The systematic review was performed in 2020 with three databases: PubMed, Science Direct, and the Cochrane Library. Titles and abstracts were included based on pre-identified eligibility criteria. We used the article entitled 'Systematic reviews in medical education: a practical approach: AMEE guide 94' as the basis to establish the aim and methods of the current systematic review from 2010 to 2019.

RESULTS

We found 16 articles that met the inclusion criteria and reported the implementation process of IPE in universities from Western, Asian, and African countries. A combination of at least two teaching and learning approaches was used to deliver IPE. The findings indicated that of all the teaching and learning approaches, simulation-based education, e-learning, and problem-based learning were the most prevalent approaches used to deliver IPE. This systematic review also revealed a lack of IPE programmes in the Middle East region.

CONCLUSIONS

The evidence synthesised in the current systematic review could support IPE curriculum planners and educators when planning an IPE programme. More global IPE initiatives are required to meet the global health workforce needs. Further studies are required to identify the effectiveness of the different teaching and learning approaches in the development of IPE competencies.

Psychometric appraisal of the Readiness for Interprofessional Learning Scale (RIPLS) Arabic-version

Interprofessional education within healthcare has been shown to have many benefits, however, it is a relatively new educational concept within the Arabic setting. Although the Readiness for Interprofessional Learning Scale is a commonly utilised tool to examine student attitudes, there is a lack of evidence for use of an Arabic translated version. The aim of this study was to develop and psychometrically evaluate an Arabic language version of the Readiness for Interprofessional Learning Scale with Saudi nurses. Two independent translators, proficient in both English and Arabic languages, completed a forward-backward translation of the original English version of the Readiness for Interprofessional Learning Scale. Subsequently, this Readiness for Interprofessional Learning Scale-Arabic version was used to collect data from undergraduate nursing students enrolled at a number of Saudi Arabian universities. Exploratory and Confirmatory Factor Analyses were then performed on the scale. Six hundred and fifty-two participants were recruited. Exploratory Factor Analysis of the Readiness for Interprofessional Learning Scale-Arabic version resulted in a 15-item, three-factor model. Subsequent analysis with Confirmatory Factor Analysis and the resultant final 13-item model demonstrated a poor fit between the hypothesized model and the data. Although our three-factor model is supported by previous studies, the proposed model did not perform well on Confirmatory Factor Analysis assessment. This suggests that there may be issues of applicability of the Readiness for Interprofessional Learning Scale-Arabic version within the current cohort. The present study of the Readiness for Interprofessional Learning Scale-Arabic version has demonstrated some psychometric inadequacies and thus it is possible that this scale may not be appropriate for use with Saudi nurses. However further research with different professional groups is suggested to fully explore its utility within the Saudi setting.

Moral Distress Among Operating Room Personnel During the COVID-19 Pandemic: A Qualitative Study

Introduction

The ongoing COVID-19 pandemic has necessitated the reallocation of healthcare resources, and a minimization of elective activities. Healthcare personnel involved in COVID-19 care have been negatively affected by the associated excess stress. The existing COVID-19 research has focused on the experiences among healthcare personnel in general, and not particularly on the operating room team members, who have often been relocated to overburdened workplaces. Therefore, we aimed to explore the experiences in this particular group.

Methods

This study has a qualitative inductive design based on interviews with a strategic sample of 12 operating room team members: surgeons, anesthesiologist, specialist nurses, and nurse assistants. The interviews were analyzed using content analysis.

Results

Three themes were identified: “Feeling safe in the familiar and anxiety in the unknown”, “To be the ones left behind”, and “The possibility for recuperation in a seemingly everlasting situation”. The participants described working hard, although their efforts were experienced as not enough according to their moral ideals. We interpreted this as feelings and signs of moral distress, a commonly described concept in previous studies during the COVID-19 pandemic, and a risk for burn out.

Conclusions

The operating room team members emphasized the negative stress of being in the unknown, performing work tasks in an unfamiliar place and situation, and experiencing conflicting feelings of relief and guilt. Organizational strategies toward a functional leadership and support should be emphasized. Such strategies might reduce the risk of psychological consequences such as burn out.

The Value of Interprofessional Learning Through Patient Simulation in Developing Interprofessional Relationships: Medical Students' Perspectives

OBJECTIVE

This study aimed to explore the value of interprofessional learning in developing interprofessional relationships, as perceived by medical students participating as simulated patients for chiropractic students.

METHODS

A cross-sectional study of university medical students, using an online survey and interview sessions, was conducted at the International Medical University, Malaysia, from July 2020 to October 2020. Only students who had previously participated as a simulated patient within a chiropractic examination setting were included; this involved interacting with chiropractic students in observed structured clinical examinations, including history taking, physical examination or motion palpation, and adjustment setups for end-of-semester examinations. Survey responses focused on themes of interprofessional learning, with values of reduction of prejudice, increase in understanding, and improved collaborative attitude. These responses were grouped as positive, neutral, or negative based on Likert scores. Interview responses were analyzed and categorized according to the survey themes.

RESULTS

Fifteen male medical students aged 23 to 26 years completed the questionnaire and interview. Respondents perceived that their experience helped clarify doubts on the scope of chiropractic (66.7%), the role of a chiropractor (80%), and chiropractic professional practices (80%). A majority of respondents (80%) felt that being a simulated patient increased their willingness to learn collaboratively with chiropractic students. Most (93.3%) responded positively to being more willing to work with other health care professionals.

CONCLUSION

This study showed an overall positive perception among medical students of developing interprofessional relationships with chiropractors and other health care professionals. The results suggest that opportunities for interprofessional learning between chiropractic and other health care programs may assist with the long-term goal of promoting patient-centered care.

Perspectives of Inter-professional Education Under a Global Infectious Menace

Health systems worldwide are facing unprecedented challenges, as a result of a convergence of major threats to our social and population health systems. For an epidemic of any magnitude, prevention and preparation by healthcare personnel in clinical settings are essential, both locally and globally. The need for the development of domestic and international training programs in the expanding field of emerging and reemerging infectious diseases is well recognized but particularly urgent at this time. Interprofessional education plays key roles in infectious diseases (ID) and in training the new generation of ID-related specialists.

Impact of COVID-19 Pandemic on Undergraduate Psychiatry Teaching, Educational Environment, and Learning Processes

PURPOSE

The COVID-19 pandemic has brought about significant changes in the way undergraduate medical education is conducted including psychiatry teaching. In view of sparse data on how the perception of the undergraduate educational environment (EE) is affected by the pandemic, we sought to compare the ratings of EE and learning processes (motivation, engagement, equipping, appreciation of psychiatry) between the 2020 (during pandemic) and 2019 (before pandemic) cohorts of students, and examined how the perception of the EE would influence overall experience within the psychiatry rotation.

PATIENTS AND METHODS

The DREEM (Dundee Ready Education Environment Measure) was administered to fourth-year medical undergraduate students undergoing a psychiatry rotation in 2020 during the pandemic and these ratings were compared with those of the preceding cohort in 2019. Students also completed five additional items evaluating various learning processes and overall rating of the posting. Relationships between the DREEM scores, learning processes, and overall effectiveness of rotation were assessed using correlation and mediational analyses.

RESULTS

Altogether, 84 (response rate 93.3%) and 269 (response rate 89.7%) medical undergraduates participated in the study from 2020 and 2019 cohorts, respectively. The 2020 cohort had higher scores on the total DREEM (p = 0.032), academic self-perception DREEM subscale (p = 0.002), felt more engaged (p = 0.043) and better equipped (p = 0.003) compared with the 2019 cohort. Overall, DREEM and subdomain scores correlated significantly with specific learning processes. The direct effect of total DREEM and overall rating of psychiatry posting was significant in mediational analyses.

CONCLUSION

Our results highlighted that students' perception of the EE remained positive during the pandemic and impacts overall experience of the psychiatry posting. Undergraduate psychiatry training should continually seek to enhance the EE so as to optimize learning through better engagement and equipping of the learners even during the pandemic.

A Systematic Review of Educational Interventions and Their Impact on Empathy and Compassion of Undergraduate Medical Students

Introduction: A compassionate and patient-centered care leads to improved clinical outcomes. Promoting empathy and compassion of medical students is a forerunner of their well-being, emotional stability, and a patient-centered care. However, there is slender evidence about best educational interventions that can inculcate empathy and compassion skills. Our objective was to conduct a systematic review of research evaluating the associations between spectrum, effectiveness, frequency of teaching modalities and their outcomes on compassion and empathy to highlight best practices.

Methods: We searched the Web of Science, PubMed, Scopus, and EBSCO Host on 22nd July 2020. We adapted our search strategy from a previously published systematic review on education for compassion and empathy. Selected studies were required to have used unique educational interventions for promoting empathy and compassion of medical students. The research questions were based on Participants (medical students), Intervention (empathy and/or compassion related teaching), Comparison, and Outcome.

Results: We analyzed 24 articles from the initial yield of 2,861. Twenty-two were quantitative studies with a mean of 12.8 on MERSQI. Twelve were randomized controlled trials while 5 measured outcomes with single group pre- and post-tests. There was no association found between duration, frequency and complexity of an educational intervention and its effectiveness. Twenty used multimodality curricula, and of those 18 reported statistically significant positive improvement in empathy, while 3 of 4 single modality were effective. Only three studies looked for long-term effects of educational interventions. Fourteen studies evaluated Kirkpatrick's level one (self-reported knowledge), 2 level three (behavior), and 6 level four (patient outcomes). We identified six major educational constructs of teaching empathy and compassion; communication, mindfulness, early clinical exposure, technology-enhanced learning, comics and arts and culture.

Discussion: Our review couldn't identify a standard teaching construct in place and highlighted that different teaching tools carry similar impact in promoting compassion and empathy and a sustainable program rather than a single training activity is essential.

Program Profile: The Expansion of Associated Health Training in the VA

Purpose

Approximately 21,000 US Department of Veterans Affairs (VA) health professions trainees per year are in associated health (AH) occupations. We describe the VA Office of Academic Affiliation's expansion of AH education in recent years and highlight the importance of increasing AH education broadly in the United States. Our focus is on the growing role of AH education in the VA over the past decade by describing the demand for AH professionals in all clinical settings; scope of funded AH training in the VA; and targeted AH education expansion efforts.

Observations

The VA provides clinical training for more than 40 AH professions and provides funding for 17 of these professions. Expansion efforts in AH over the past 10 years have yielded a 33% increase in stipend-funded positions and targeted interprofessional training, VA strategic initiatives, rural populations, and conversion of pregraduate-degree positions to postgraduate-degree positions.

Conclusions

In order to meet the complex health care needs of our nation, continued attention to interprofessional care and health professions education is of paramount importance. The VA has worked to address these broad needs and to meet the needs of veterans through increasing stipend-funded AH training positions by 33% and directly targeting high-need clinical areas. Ongoing expansion is anticipated in the areas of postgraduate-degree training and rural training.

Effectiveness of an Educational Intervention With High-Fidelity Clinical Simulation to Improve Attitudes Toward Teamwork Among Health Professionals

BACKGROUND

Failures in teamwork are a common reason for adverse medical events. The goals of this study are to evaluate attitudes toward teamwork among an interprofessional group of health professionals and to analyze the effectiveness of an educational intervention with high-fidelity clinical simulation to improve these attitudes.

METHOD

An educational intervention was developed that used a 6-hour session that included three simulated clinical cases. The Attitudes Toward Health Care Teams Scale was used for assessment. Mean difference before and after the intervention was calculated with the Wilcoxon test.

RESULTS

Positive attitude toward teamwork after completion of the training activities was measured. The health care professionals who showed the most positive attitude toward teamwork were physicians (93.92, SD = 6.58) and resident physicians (95.01, SD = 6.33). The greatest increase was observed among orderlies (p < .001) and nursing assistants (p < .001).

CONCLUSION

The use of clinical simulation for interprofessional training of health care professionals showed a positive effect on attitudes toward teamwork. [J Contin Educ Nurs. 2021;52(10):457-467.].

Developing intersubjectivity and teamwork skills through learning circles on clinical placement: A mixed methods study

AIM

To determine the efficacy of learning circles on developing intersubjectivity and teamwork skills and determine barriers to and facilitators of, learning circles as a learning tool.

BACKGROUND

Teamwork skills are vital for safe, effective nursing care and are dependent on individual team members' shared understandings or intersubjectivity. Work-based learning circles offer a potential pedagogic strategy to promote teamwork.

METHODS

In work-based learning circles conducted in 2018, students drew a concept map based on a clinical case and discussed an element of it with the group. Using a convergent parallel mixed methods design, a cross-sectional survey of students using a student clinical experience questionnaire and a qualitative descriptive approach for interviews with clinical facilitators was conducted.

RESULTS

Overall, 128 Bachelor of Nursing students (88.9% response) completed the survey and five facilitators (50%) attended group interviews. Students agreed that core teamwork skills were developed during their placement and clinical facilitators reported (1) student engagement in the learning circle processes; (2) learning much about students' abilities; and (3) developing subtle teaching skills to enhance discussion. Sharing experiences from different wards and clinical experiences was a platform for developing intersubjectivity.

CONCLUSIONS

To promote intra-professional teamwork skills, conducting learning circles with students from different disciplines may further enhance intersubjectivity and is an area for further research.

Implementation of Interdisciplinary Province-Wide Webinar Series During the COVID-19 Pandemic by the Federation of Medical Specialists of Quebec (FMSQ): A Survey Study

Objectives: COVID-19 has forced a transformation in continuing professional development (CPD), shifting to virtual platforms. We report the results of a rapidly-implemented COVID-19 online interdisciplinary CPD webinar series. We aimed to determine if this virtual approach for large-scale CPD was relevant, appreciated, and effective for specialist physicians in Quebec.

Methods and Analysis: This was a retrospective descriptive online survey-based study. The weekly virtual educational webinars took place between March 3, 2020 to June 15, 2020, resulting in a total of 26 webinars over 16 weeks. The study included all individuals who attended any of the webinar sessions, namely specialist physicians and department chiefs. Number of participants and overall appreciation of webinar sessions were data points collected.

Results: Across all webinars, there were 8,500 unique specialist physicians which comprises 80.7% of the entire specialist practicing population in Quebec. Of note, every medical and surgical specialty was represented by attendance in at least one session. In total, 27,504 evaluation forms were completed out of all the sessions, meaning a 78.4% response rate. In post-webinar surveys, 97.6% of respondents agreed or strongly agreed that the webinars were pertinent to their practice and 94.6% agreed or strongly agreed that the presentation met their continuing professional needs.

Conclusions: This novel interdisciplinary COVID-19 webinar series is a successful and appreciated strategy to maintain CPD amidst a global pandemic. One year later, it has become a mainstay in our toolbox and we trust this unique model of large-scale interdisciplinary CPD via webinar sessions is useful in normal times as well as in times of crisis.

Exploring transformative learning for trainee pharmacists through interprofessional simulation: a constructivist interview study

BACKGROUND

The expanding roles of UK pharmacists have prompted substantial changes to the initial pharmacy education and training, including increasing recognition of the value of learning alongside other professional groups in acute settings. Interprofessional immersive simulation training appears to represent a useful educational tool to meet the evolving needs of the profession, but the impact of such training on workplace behaviour and relationships has not been explored. This study aimed to explore how interprofessional simulation training facilitates transformative learning in pre-registration pharmacists.

METHODS

Across three different locations in Scotland, pre-registration pharmacists were paired with medical students to participate in immersive simulation scenarios with post-scenario debriefs. Pre-registration pharmacists were individually interviewed shortly after their simulation session, using a semi-structured interview schedule based on the transformative learning framework. Transcripts were analysed using template analysis, with Mezirow's phases of perspective transformation forming the initial coding template.

RESULTS

Fifteen interviews following five simulation sessions at three different sites were undertaken. Phases 1-6 of the transformative learning framework all resonated with the pre-registration pharmacists to varying degrees. Two prominent threads became evident in the data: a change in participants' perceptions of risk, and deepened understanding of their role within an acute context. These themes were woven throughout phases 2-6 of the transformative learning framework.

CONCLUSIONS

Interprofessional immersive simulation training involving acute clinical scenarios has been found to be helpful for pre-registration pharmacists and can foster transformative learning. Through this powerful process, they developed new ways to see the world, themselves and their professional relationships. Positive future actions and roles were planned. As the patient-facing roles of pharmacists expand, educational practices that translate into meaningful change to workplace behaviour and relationships become increasingly important. Carefully constructed interprofessional immersive simulation training should be utilised within pharmacy education more widely.

Training in Interprofessional Learning and Collaboration: An Evaluation of the Interprofessional Education Program in the Scale-up Phase in Antwerp (Belgium)

BACKGROUND

Curricula are reviewed and adapted in response to a perceived need to improve interprofessional collaboration for the benefit of patient care. In 2005, the module Interprofessional Collaboration in Healthcare (IPCIHC) was developed by the Antwerp University Association (AUHA). The program was based upon a concept of five steps to IPCIHC. This educational module aims to help graduates obtain the competence of interprofessional collaborators in health care.

METHODS

Over a span of 15 years, the IPCIHC module is evaluated annually by students and provided with feedback by the tutors and steering committee. Data up to 2014 were supplemented with data up to 2019. For the students the same evaluative one-group, post-test design was used to gather data using a structured questionnaire. The tutors' and students' feedback was thematically analyzed.

RESULTS

Based upon the results and the contextual changing needs, the program was adjusted. Between 2005 and 2019, a total of 8616 evaluations were received (response rate: 78%). Eighty percent of the respondents indicated through the evaluations that they were convinced of the positive effect of the IPCIHC module on their interprofessional development. Over the years, two more disciplines enrolled into this program and also education programs form the Netherlands.

CONCLUSIONS

After 15 years, positive outcomes are showed, and future health professionals have a better understanding of interprofessional learning. Gathering feedback and annually evaluation helped to provide a targeted interprofessional program addressing contextual changes. The challenge remains to keep on educating future healthcare providers in interprofessional collaboration in order to achieve an increase in observable interprofessional behaviour towards other professional groups.

The impact of an online intervention on the medical, dental and health sciences students about interprofessional education; a quasi-experimental study

BACKGROUND

Interprofessional education (IPE) encompasses integration, communication, mutual trust and shared decision-making with a common goal of improved patient care and safety. Despite its crucial role, IPE has not gained its anticipated popularity. This study aims to determine the impact of an online educational intervention about IPE on medical, dental and health sciences students in the University of Sharjah (UoS).

METHODS

This quasi-experimental research was conducted in three phases; a pre-intervention phase where the Readiness for Interprofessional Learning Scale (RIPLS) inventory was administered online to the medical, dental and health sciences students of UoS; an intervention phase where an online workshop was organized via Microsoft Teams®; and a post-intervention phase where RIPLS was used to gather the students' attitudes towards IPE. The independent t test was used to compare the responses between genders and junior and senior students. A paired sample t test was used to determine the impact of the intervention on the students' understandings and attitudes about IPE.

RESULTS

Out of 800 invited students, 530 students responded to the pre-intervention RIPLS survey. A comparison of the pre-post intervention for the RIPLS subscales of teamwork and collaboration, professional identification, and professional roles showed a significant improvement of students' attitudes with p-values 0.03, 0.00 and 0.00, respectively. All workshop moderators scored a median of 4 or 5 to the essential elements of IPE during intervention except for a median of 3 for group dynamics.

CONCLUSION

The present data, derived from the application of a brief online educational intervention, underpins the readiness and positive attitudes of undergraduate medical students towards IPE. The positive impact of online intervention necessitates the development of a structured and unified IPE curriculum to enhance the receptiveness and application of IPE in the medical field.

Mental performance and mental health services in sport: a call for interprofessional competence and collaboration

The provision of holistic care for athletes often involves interprofessional teams with specialists to support athletic performance and overall wellness. Yet, regarding psychological support, some have advocated for a single professional to attain both a certified mental performance consultant (CMPC) credential and any type of mental health license (e.g., Licensed Psychologist [LP], Licensed Social Worker [LSW], or Licensed Professional Counselor [LPC]) to address the mental performance and mental health needs of athletes. Unfortunately, this approach may hinder interprofessional collaboration and ignore distinctions between CMPCS and other types of mental health professionals. Alternatively, CMPCs and various types of mental health professionals may work together on interprofessional psychological support teams. The purpose of this paper is to clarify the distinct historical and theoretical foundations of mental performance consulting, clinical psychology, social work, and professional counseling in sport contexts to serve as a resource for enhancing interprofessional competence within such teams. The distinct training pathways of CMPCs, LPs, LSWs, and LPCs are outlined with attention to how each can serve a valuable role on an interprofessional support team for athletes. Applications of the World Health Organization's framework for interprofessional education and collaborative practice (IPECP) to psychological support teams in sport contexts is discussed.

Development of interprofessional healthcare teamwork skills: mapping students' process of learning

Higher education institutions commonly prepare future healthcare workers to engage in increasingly complex, interprofessional healthcare environments through interprofessional education. Development of appropriate teamwork skills is complex and takes time. However, much of the research on student engagement with teamwork in higher education has been focused on the end goal of teamwork. This obscures the process of how students learn to work in interprofessional healthcare teams and in what ways, over time. The current study used an exploratory interpretive approach to obtaining students' experiences, perceptions and developing understanding of teamwork from the start of their undergraduate studies, through to completion of five semesters of group or teamwork projects. Through qualitative methodology, educators explored student experiences of teamwork, their focus at designated points of their undergraduate teamwork, and the meaning they attributed to being a member of a team. Student perceptions of successful teamwork developed over time to a positive and purposeful orientation toward teamwork, learner attributes that enhanced team function, and a growing awareness of how the assessment context affected team function. By mapping these processes of learning over time, educators can gain a clearer understanding of influences and experiences that impact on student learning in teamwork.

The International Pharmacy Game: A Comparison of Implementation in Seven Universities World-Wide

The utilization of serious games and simulations in health professional education has increased. The Pharmacy Game is one such concept that intersects gamification and simulation, in which pharmacy student teams competitively manage simulated pharmacies; a concept included in the pharmacy curricula of seven international universities. This study aimed to compare the implementation and conduct of the Pharmacy Game of participant universities and their students’ performance in the same educational task. Data were collected via a questionnaire completed by academic staff in April 2020, and the collation of results of the same patient case was conducted at each university (April 2020 to March 2021). The main results reflected differences in the game frequencies and the curricular approach (standalone or integrated course) and in the learning outcomes for the Pharmacy Game. Other differences were identified in the extent to which students of other professions were part of the game such as medical students or pharmacy assistants. Student case outcomes revealed similar strengths across the universities in patient communication and focus on safety, with variations identified as areas for improvement. Collation of the international utilization of the Pharmacy Game identified a broad spectrum of similar learning outcomes, inspiring a model of international core and aspirational learning outcomes. While the Pharmacy Game has been implemented with flexibility regarding the numbers of teams (4–10) and the duration of activity (12–36 days), all universities reported positive experiences and student outcomes, suggesting that the intervention represents a potential tool to deliver capstone learning experiences, promote interprofessional education, reinforce patient safety, and prepare pharmacy graduates for future practice.

Designing a Short-Term Healthcare Service-Learning Mission Trip for Impact and Sustainability

ABSTRACT

Educators creating healthcare service-learning mission trips for students recognize that success is measured in benefit to students, the community served, and in sustainability. Partnering in Guatemala with a nonprofit ministry, Belmont University faculty describe their experience with service-learning trips and how impact was measured, particularly on students' faith and service. Useful steps for overcoming barriers to sustainability for the university and local community served are provided.

A mixed methods approach to determine the climate of interprofessional education among medical and health sciences students

BACKGROUND

High-quality patient care is a complex phenomenon that requires collaboration among healthcare professionals. Research has shown that Interprofessional Education (IPE) carries promise to improve collaborative work and patient care. So far, collaboration among various health professionals remains a challenge. Very few focus group discussions to determine the medical students' readiness and positive attitudes towards IPE have been reported from the Arabian context.

METHODS

A two-staged sequential mixed methods study was conducted among medical, dental, pharmacy, and health sciences students of the University of Sharjah United Arab Emirates. The perspectives of students toward IPE and collaborative practice were first gathered by administering a validated instrument, Readiness for Interprofessional Learning Scale (RIPLS). This was followed by focused group discussions. A quantitative as well as a qualitative data analysis was performed.

RESULTS

This study cohort included 282 students. All respondents showed readiness to adopt IPE as all statements of the RIPLS inventory scored high median scores. All participants showed positive attitudes and readiness towards IPE. Three main domains of themes were generated from focus group discussions; prior knowledge, need for IPE framework and its implementation. Information workload, lack of clarity and less focused teaching pedagogies of IPE were considered as perceived barriers.

CONCLUSION

This study demonstrated a substantial agreement of medical and health sciences students towards readiness and perceived effectiveness of IPE. Educators are urged to embed new IPE programs into existing curricular frameworks, which can potentially enhance collaborative learning and improve quality of patient care.

Challenges to Interprofessional Education: will e-Learning be the Magical Stick?

PURPOSE

In Egypt, the main challenges to interprofessional education (IPE) implementation are complexity of the required curricular design, the attitudinal barriers between professions, and the needed resources. Action research work was planned and implemented to identify alternative solutions to overcome barriers to IPE in the local Egyptian context.

METHODS

-An 8-week e-learning elective course was developed, implemented, and evaluated. A mixed group of 30 nursing and medical students was enrolled voluntarily in the course. Female to male ratio was 3:2. Four faculty members were assigned to manage the course. Based on the EMRO-WHO guidelines, ethics content was selected and organized. A closed Facebook group was created and utilized as the e-learning platform. Facilitated large-group and case-based discussions were the main instructional methods. Scoring of mixed small group assignments was the main assessment tool. Course evaluation was conducted using the Interprofessional Socialization and Valuing Scale (ISVS) and an Online-Course Evaluation Questionnaire (OCEQ).

RESULTS

ISVS results revealed that students' perception of ability, comfort and value in working with others, were all positive. The OCEQ provided additional evidence regarding the satisfaction of students with the Facebook group as a learning platform. Assignment submission rate was 90%. Success rate of small group assignments (scores ≥ 60%) was 100%. Response rate to the open online discussions was 63%. Through peer evaluation as well as direct observation of online discussions, there was evidence of distinct contributions by females and by medical students compared to nursing students.

CONCLUSION

As evidenced by the students' perception and performance, our IPE distance learning experience was valuable. Motivation of medical students as well as females was evident. IPE is a challenging process. The elective approach and using DL can offer solutions. Conducting relevant practical sessions as well as sustainability of this IPE e-learning experience remain key challenges.

Training in communication skills for self-efficacy of health professionals: a systematic review

BACKGROUND

Communication skills are essential for health professionals to establish a positive relationship with their patients, improving their health and quality of life. In this perspective, communication skills training can be effective strategies to improve the care provided by professionals in patient care and the quality of health services.

OBJECTIVE

To identify the best available evidence on training programs in communication skills to promote changes in attitude and behavior or self-efficacy of health professionals.

METHODS

Systematic searches were performed in eight databases, evaluating Randomized Controlled Trials and quasi-experimental studies with a control group, focusing on training communication skills for health professionals, who assessed self-efficacy or behaviors related to these skills. The phases of study selection and data extraction were carried out by two independent researchers, and the conflicts were resolved by a third. The risk of bias was assessed using the Cochrane method.

RESULTS

Eight studies were included in the review. Most programs lasted between 4½ h and 2 days, involved information about communication skills and the content was applied to the health professionals' context. Several teaching strategies were used, such as lectures, videos and dramatizations and the evaluation was carried out using different instruments. Improvements in the performance and in the self-efficacy of communication skills were observed in the trained groups. The RCT had a low risk of bias and the quasi-experimental studies had a moderate risk.

CONCLUSION

Training in communication skills can improve the performance and self-efficacy of health professionals. Programs that approach the conceptual issues and promote the space for experiential learning could be effective in communication skills training for professionals.

PROSPERO

CRD42019129384.

Nutrition education in core medical curricula: a call to action from tomorrow's doctors

In recent years lifestyle interventions have gained traction as increasingly useful ways to promote health among the population. Within these changes, nutrition remains paramount. We aimed to present an overview of the current status of nutrition education in UK undergraduate medical curricula, highlighting pockets of innovative teaching, alongside areas for improvement. Nutrition competency is outlined in General Medical Council Outcomes for Graduates, increasingly featured in mainstream headlines and relevant to each medical speciality. Drawing on our personal experiences we offer insights and suggestions on how the delivery and assessment of nutrition education could be improved. We believe that integrating nutrition into core curricula is urgently needed in order to increase students' and doctors' confidence in discussing the topic of nutrition with patients, with the aim to empower patients to make health promoting dietary changes.

Interprofessional Education and the Diagnostic Radiography curriculum: Students' perceived value of a case-based, whole day activity

INTRODUCTION

This study aimed to examine Diagnostic Radiography (DR) students' perceptions and attitudes towards the Health Collaboration Challenge (HCC), as an interprofessional learning opportunity.

METHODS

DR students participated in the HCC, an annual intensive interprofessional collaboration and assessment activity involving case-based learning. Students' attitudes towards Interprofessional Education (IPE) were measured using a modified version of the Interprofessional Socialisation and Valuing Scale (ISVS-21) and a bespoke questionnaire with items relating to the HCC. Subsequent focus groups explored students' experience of IPE within the HCC context.

RESULTS

Survey results (n = 30) suggested a mostly positive attitude towards IPE alongside other health care students, acknowledging the value of interprofessional teams in patient health care. Qualitative themes from focus group participants (n = 8) revealed that DR students, while appreciating the value of shared-decision making, found the HCC assessment distracting. Challenges included the intensive nature of the HCC, roles that DR students undertook in addressing assessment criteria, case complexity and opportunities for DR students to showcase their knowledge.

CONCLUSION

Results suggest that the intensive and assessable nature of the HCC can overshadow the value of IPE for DR students, and immersive or staggered approaches to IPE could better align with DR professionals' unique role within the patient care spectrum.

IMPLICATIONS FOR PRACTICE

Revised IPE models for DR students could include a more immersive environment, conducted over a longer period of time, with meetings at semi-regular intervals to promote an interprofessional-focus over a task-focus approach.

Open and Distance Learning Programs for Nursing and Midwifery Education in East Africa: Protocol for a Scoping Review

BACKGROUND

In the face of growing modernity and the coronavirus disease 2019 (COVID-19) pandemic, open and distance learning (ODL) is considered to play an important role in increasing access to education worldwide. There is a robust evidence base demonstrating its cost effectiveness in comparison with conventional class-based teaching; however, the transition to this new paradigm of learning for nursing and midwifery courses has been difficult in low-income countries. While there are notable efforts to increase internet and education access to health care professionals, not much is known about ODL for nurses and midwives in East African countries.

OBJECTIVE

The objective of this scoping review is to understand whether ODL programs for nursing and midwifery education exist, the drivers of their adoption, their implementation, the topics/courses covered, their acceptability, and their impacts in East African countries.

METHODS

The scoping review methodology employs the framework developed by Arksey and O'Malley. Using an exploratory approach, a two-stage screening process consisting of a title and abstract scan and a full-text review will be used to determine the eligibility of articles. To be included, articles must report on an existing ODL initiative for nurses and midwives in Uganda, Tanzania, and Kenya. All articles will be independently assessed for eligibility by pairs of reviewers, and all eligible articles will be abstracted and charted in duplicate using a standardized form.

RESULTS

Details of ODL for nursing and midwifery education initiatives and study outcomes will be summarized in a table. The extracted data will undergo exploratory descriptive analysis, and the results will be classified into learner and clinical outcomes.

CONCLUSIONS

Evidence on ODL for nursing and midwifery education will inform the ongoing development and restructuring of health care professional education in East Africa amidst the COVID-19 pandemic.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/17765.

Leveraging the age friendly healthcare system initiative to achieve comprehensive, hearing healthcare across the spectrum of healthcare settings: an interprofessional perspective

OBJECTIVE

Hearing loss is associated with multiple physical, cognitive, and psychosocial co-morbidities. Achievement of safe healthcare in the context of these complex co-morbidities necessitates accurate hearing and coordination across specialties. This paper discusses the potentials for and barriers to an interprofessional approach to integrating hearing screening and treatment across all healthcare settings.

DESIGN

The paper reviews the relationship between hearing loss and other health care concerns to emphasise the need for an inclusive, coordinated, interprofessional approach; discusses interprofessional and patient/family centred coordinated care as essential to achieving quality care; and introduces the Age Friendly Health System initiative as a framework that could be leveraged to move towards comprehensive hearing healthcare.

RESULTS

The literature highlights prior work identifying gaps in quality care and the need for new and innovative approaches to evolve interdisciplinary and interprofessional collaborations to achieve comprehensive healthcare. The literature also provides support for using the Age-Friendly initiative as a point of leverage.

CONCLUSION

Bringing together thought leaders from the health care provider community, World Health Organisation, age-friendly cities movement, and field of architecture to coordinate the integration of hearing healthcare into Age Friendly Health Systems initiatives has potential to achieve comprehensive hearing healthcare across healthcare settings. (198).

Preferred teaching styles of medical faculty: an international multi-center study

BACKGROUND

In the current wave of educational reforms, understanding teaching styles of medical faculty can help modify instructional strategies for effective teaching. Few studies have probed distinctive teaching styles of medical faculty. We compared preferred teaching styles of faculty from seven medical schools in United Arab Emirates, the Netherlands, Saudi Arabia, Malaysia, Pakistan, and Sudan.

METHODS

The validated Grasha-Riechmann teaching style inventory was administered online for data collection and used SPSS version 20.0 for statistical analysis.

RESULTS

Of the 460 invitees, 248 responded (response rate; 54%). Delegator teaching style was most common with a highest median and mean of 2.38 and 2.45, respectively. There was a significant correlation between expert and authority teaching styles, correlation coefficient 0.62. Similarly, we found a significant correlation between authority teaching style and nature of curriculum, correlation coefficient 0.30. Multiple regression analysis showed that only authority teaching style and male gender had significant correlation. Interestingly, 117 (47%) teachers disagreed with the teaching philosophy of delivering course contents by strictly following learning outcomes. Female teachers (114/248) were more willing to negotiate with their students regarding how and what to teach in their course, while male teachers tended to allow more autonomy by allowing students to set their learning agenda.

CONCLUSIONS

This study showed that the medical teachers preferred delegator teacher style that promotes students' collaboration and peer-to-peer learning. Most teachers are conscious of their teaching styles to motivate students for scientific curiosity. These findings can help medical educators to modify their teaching styles for effective learning.

Interprofessional education clinical placement program: a qualitative case study approach

The goal of health professional education programs is to produce competent graduates, with an ability to work collaboratively as effective healthcare team members. We explored the reflections of students and clinical facilitators, in response to participation in a structured interprofessional education (IPE) clinical placement program. In our qualitative study we used an exploratory case study design. In our analysis, we highlight the benefits of interprofessional practice. Key themes identified by students included: limited opportunities to engage in IPE across their course; lack of clarity around IPE; value of IPE for students, practitioners, and patient outcomes; and need for IPE opportunities to be integrated into placements. Key themes identified by the clinical facilitators included: being reminded of the value of IPE for students and patients; preparation for IPE placements need to be embedded in curricula; coordination and communication of IPE learning activities need to be clear for staff and students; and IPE should continue as part of the broader clinical education agenda. Our findings reinforce the notion that students and clinical facilitators value the importance of IPE for student learning within the clinical placement setting. The outcomes offer valuable insights for universities and hospital and health care contexts for setting up and implementing IPE activities, and we provide recommendations for improving ongoing IPE efforts within clinical placement setting.

Interprofessional collaboration associated with frequency of life-saving links to HIV continuum of care services in the urban environment of Newark, New Jersey

BACKGROUND

HIV continuum of care has been used as a strategy to reduce HIV transmission rates, with timely engagement in HIV testing being the first and most critical step. This study examines interprofessional-collaboration (IPC) after controlling for agency/ provider demographics, provider training and self-efficacy as a significant predictor of how frequently HIV service providers link their clients to HIV testing.

METHODS

Multilevel binary logistic regression analysis was conducted to examine the effects of IPC on links to HIV testing while controlling for demographic and agency information, provider training, and standardized measures of providers' feelings, attitudes, and opinions about IPC. Cross-sectional data from 142 providers in 13 agencies offering treatment and prevention services for HIV and substance-use disorders were collected via a survey.

RESULTS

Those who scored higher on the IPC scale reported significantly higher rates of linkages to HIV testing. Compared to the null model (i.e., no predictor model), the final multilevel binary logistic regression model showed a significantly improved likelihood of linkage to HIV testing by 11.4%, p. < .05. The final model correctly classified 90.2% of links to HIV testing. Providers in agencies with smaller budgets and in agencies offering substance use disorder services were more likely to link clients to HIV testing. Younger providers who received HIV training were also more likely to link clients to HIV testing.

CONCLUSIONS

Findings suggest IPC training as a potential strategy to improve linkages to HIV testing for clients at risk for HIV infection. Future research is recommended to identify specific areas of IPC that might have differential effects on links to HIV testing.

Students' readiness for and perception of Interprofessional learning: a cross-sectional study

BACKGROUND

Several studies reported that Inter-professional Education (IPE) plays a major role in creating an effective collaborating environment in healthcare settings to achieve high-quality patient care. This study measured the College of Applied Medical Sciences (CAMS) students' readiness for and perceptions of IPE.

METHODS

A cross-sectional study was conducted with 232 undergraduate students in Riyadh, using a stratified random sampling method. All the undergraduate students of CAMS were included. Two previously validated questionnaires, the Interdisciplinary Education Perception Scale (IEPS) and the Readiness for Interprofessional Learning Scale (RIPLS) were used in the study.

RESULTS

The mean score for the RIPLS was 86.8. The Tukey post-hoc test score was significantly higher comparing the Occupational Therapy and the Respiratory Therapy programs. There was no difference between the overall RIPLS and subscales between male and female students as well as senior and junior students. For the IEPS, the mean score was 77.7. The Tukey post-hoc test score was significantly higher in the Occupational Therapy and Respiratory Therapy programs.

CONCLUSION

The current study indicated that the Applied Medical Sciences' students demonstrated readiness for IPE as an important element in creating collaborative teamwork in their programs. The early incorporation of IPE in the pre-professional years will enhance collaboration in management and patient care.

A virtual patient model for students' interprofessional learning in primary healthcare

Objectives

Interprofessional education is important for increasing the quality of patient care, but organising it in primary healthcare is still challenging. The aim of this study was to develop and assess a virtual patient model for primary healthcare and to investigate students' perceptions of learning with this interprofessional virtual patient model.

Methods

The virtual patient case described a patient with several medical conditions who had returned home after surgery. The virtual patient included text files, short videos, and links to illustrate different health professions' roles in home care. Ten interprofessional groups with 39 students assessed the virtual patient from four different study programmes: nursing, physiotherapy, medicine, and occupational therapy. The students answered a questionnaire about how they perceived the usability of the virtual patient and participated in group interviews. Qualitative content analysis was used to analyse the data from the semi-structured group interviews.

Results

The analysis of the interviews resulted in four main categories: The virtual patient model facilitated the learning process; It was beneficial to have students from different programmes in the group when working with the virtual patient; Working with the virtual patient helped the students to understand the roles and competencies of their own and other professions and All professions are needed in clinical work in order to help the patient. The students perceived that the mixture of text and multimedia made the virtual patient seem authentic and stimulated their group discussions, which they valued most. The students gave generally high points for usability in the questionnaire, but they also gave input for improvement of the program in their comments.

Conclusions

The interprofessional virtual patient model facilitated interactions and discussions between students and may be a useful complement for interprofessional education in clinical contexts and might be a suitable tool in preparing students for future teamwork.

Bone health assessments by student pharmacists during interprofessional education

INTRODUCTION

Bone-healthy lifestyle is a cornerstone of osteoporosis prevention and treatment. Student pharmacists are ideally suited to perform bone health assessments during interprofessional education (IPE) programs. In this article, we describe the outcomes of bone health assessments performed by second-year student pharmacists (P2s) as part of a novel IPE activity.

METHODS

Bone health assessments provided by P2s to older adults during an interprofessional team home visit were evaluated. Three health profession students (pharmacy, medicine, physician assistant, nursing, physical therapy, occupational therapy, and/or social work) worked as collaborative teams, with each student completing discipline-specific patient assessments. Data collected included bone density scan status, Fracture Risk Assessment Tool (FRAX) score, and calcium and vitamin D intakes. P2s' recommendations for bone density testing and adjustments to dietary intakes based on patient-specific factors were also evaluated.

RESULTS

All P2s (n = 98) completed a bone health assessment with their older adult. Almost all older adults (85.6%) met risk criteria for bone density scanning. In addition, 51.5% and 27.8% reported taking less than their age and sex-specific recommended dietary allowance of calcium and vitamin D, respectively. P2s recommended changes in calcium and vitamin D dietary intake, supplement use, or both for 64.3% of the older adults.

CONCLUSIONS

In a novel IPE home-visit program, P2s were successfully utilized to assess bone health and provide recommendations for bone density scanning and calcium and vitamin D intakes to volunteer older adult patients.

Attitudes towards Interprofessional education in the medical curriculum: a systematic review of the literature

BACKGROUND

There is agreement among educators and professional bodies that interprofessional education needs to be implemented at the pre-registration level. We performed a systematic review assessing interprofessional learning interventions, measuring attitudes towards interprofessional education and involving pre-registration medical students across all years of medical education.

METHODS

A systematic literature review was performed using PubMed, PsycINFO, EThOS, EMBASE, PEDro and SCOPUS. Search terms were composed of interprofession*, interprofessional education, inter professional, inter professionally, IPE, and medical student. Inclusion criteria were 1) the use of a validated scale for assessment of attitudes towards IPE, and results for more than 35 medical students; 2) peer-reviewed articles in English and German, including medical students; and 3) results for IPE interventions published after the 2011 Interprofessional Education Collaborative (IPEC) report. We identified and screened 3995 articles. After elimination of duplicates or non-relevant topics, 278 articles remained as potentially relevant for full text assessment. We used a data extraction form including study designs, training methods, participant data, assessment measures, results, and medical year of participants for each study. A planned comprehensive meta-analysis was not possible.

RESULTS

This systematic review included 23 articles with a pre-test-post-test design. Interventions varied in their type and topic. Duration of interventions varied from 25 min to 6 months, and interprofessional groups ranged from 2 to 25 students. Nine studies (39%) reported data from first-year medical students, five (22%) from second-year students, six (26%) from third-year students, two (9%) from fourth-year students and one (4%) from sixth-year students. There were no studies including fifth-year students. The most frequently used assessment method was the Readiness for Interprofessional Learning Scale (RIPLS) (n = 6, 26%). About half of study outcomes showed a significant increase in positive attitudes towards interprofessional education after interventions across all medical years.

CONCLUSIONS

This systematic review showed some evidence of a post-intervention change of attitudes towards IPE across different medical years studied. IPE was successfully introduced both in pre-clinical and clinical years of the medical curriculum. With respect to changes in attitudes to IPE, we could not demonstrate a difference between interventions delivered in early and later years of the curriculum.

TRIAL REGISTRATION

PROSPERO registration number:  CRD42020160964 .

An evaluation of educational interventions aimed at preparing medical students for discharge summary writing: a rapid review of the literature

Whilst discharge summaries are important for ensuring patient continuity of care, they often lack important information. Medical students and newly qualified doctors have attributed this to insufficient teaching, thereby indicating a need to improve discharge summary education within the undergraduate medical curriculum. The aim was to review educational approaches used to prepare undergraduate medical students for discharge summary writing, and their effectiveness Medline and Scopus were systematically searched using keywords, for studies published between 2009 and 2019. Narrative synthesis was used to integrate the findings of the included studies. Study quality was appraised using the Medical Education Research Study Quality Instrument. Six studies were included in this review. Allowing students to write a discharge summary following a real patient encounter and receive written feedback was the most common educational approach used (n = 4). Three of these studies improved student attitudes towards discharge summary writing. One study described the use of a mobile application, which improved discharge summary quality. Another study utilized interprofessional learning but the effect was statistically insignificant. Medical Education Research Study Quality Instrument scores were satisfactory (mean = 12, range = 8.4-15). The literature concerning this topic is limited. The results indicate that providing written feedback to students can positively influence attitudes towards discharge summary writing. Optimisation of the quality of discharge summaries written by medical students using feedback and checklists requires further investigation, as does the use of interprofessional learning. Future studies would additionally benefit from including participant baseline data and control groups, being multicentred and measuring behavioural or patient/healthcare outcomes.