Attitudes towards Interprofessional Education among Medical and Nursing Students: the Role of Professional Identification and Intergroup Contact

The association between proactive personality and interprofessional learning readiness in nursing students: The chain medication effects of perceived social support and professional identity

BACKGROUND

Interprofessional education (IPE) has been advocated for all healthcare students, and readiness for interprofessional learning significantly influences its effectiveness. It is essential to explore the antecedent factors of readiness for interprofessional learning among nursing students to promote IPE. While a proactive personality might impact readiness for interprofessional learning, its specific role has remained unspecified.

OBJECTIVE

To examine the mediation effects of perceived social support and professional identity on the association between proactive personality and readiness for interprofessional learning among nursing students.

DESIGN

The study utilised a cross-sectional design.

SETTINGS

Research was conducted at two universities and two vocational schools in Hainan Province, China.

PARTICIPANTS

On-campus nursing students were invited to participate between March and May 2023.

METHODS

A flyer was distributed to the participants with a QR code to scan to voluntarily complete the online survey, including the Readiness for Interprofessional Learning Scale (RIPLS), Proactive Personality Scale, Perceived Social Support Scale and Professional Identity Status Questionnaire Scale 5d. Descriptive analysis, Pearson associations and mediation analysis were conducted using SPSS software version 26.0 and PROCESS version 4.2 for SPSS.

RESULTS

The participants' average RIPLS score was 66.93 ± 9.28. Proactive personality (r = 0.633, p < 0.01), perceived social support (r = 0.605, p < 0.01) and professional identity (r = 0.549, p < 0.01) were all positively related to readiness for interprofessional learning. Meanwhile, the relationship between proactive personality and readiness for interprofessional learning was partly mediated by perceived social support (25.15 %), professional identity (13.35 %) and the chain effects (9.48 %) of perceived social support and professional identity.

CONCLUSIONS

The nursing students in Hainan, China demonstrated a medium level of readiness for interprofessional learning. Compound strategies that foster proactive personality, provide social support and boost positive professional identity are warranted to improve nursing students' readiness for interprofessional learning.

Variations in measurement of interprofessional core competencies: a systematic review of self-report instruments in undergraduate health professions education

Educating health care professionals for working in interprofessional teams is a key preparation for roles in modern healthcare. Interprofessional teams require members who are competent in their roles. Self-assessment instruments measuring interprofessional competence (IPC) are widely used in educational preparation, but their ability to accurately and reliably measure competence is unknown. We conducted a systematic review to identify variations in the characteristics and use of self-report instruments measuring IPC. Following a systematic search of electronic databases and after applying eligibility criteria, 38 articles were included that describe 8 IPC self-report instruments. A large variation was found in the extent of coverage of IPC core competencies as articulated by the Interprofessional Education Collaborative. Each instrument's strength of evidence, psychometric performance and uses varied. Rather than measuring competency as "behaviours", they measured indirect proxies for competence, such as attitudes towards core interprofessional competencies. Educators and researchers should identify the most appropriate and highest-performing IPC instruments according to the context in which they will be used.Systematic review registration: Open Science Framework (https://archive.org/details/osf-registrations-vrfjn-v1).

Measuring Veterinarian Professions' Readiness for Interprofessional Learning in a Pre- and Post-Intervention Study

The integration of interprofessional collaboration is becoming increasingly crucial in veterinary care settings, emphasising the need for interprofessional education (IPE) in veterinary programmes. This study explores the readiness for interprofessional learning among German veterinary students, apprentices and related occupations before and after an interprofessional communication course. It assesses the impact of this course on the participants' attitudes using the Readiness for Interprofessional Learning Scale (RIPLS). The course, offered in two iterations, combined asynchronous online modules, live seminars and practical training elements. The RIPLS was administered before and after the course to gauge attitude shifts towards interprofessional learning. Statistical analyses, including McNemar, Cohen's Kappa and exact Fisher tests, were employed to compare pre- and post-test responses. Despite challenges in participant linking, significant findings emerged between the student and apprentice groups in specific areas of the RIPLS, notably in the "Professional Identity" subscale post-course. However, correlations between face-to-face contact and RIPLS ratings were not observed, suggesting a need for more integrated interprofessional learning experiences. While some limitations in sample size and profession distribution hinder generalisability, this study indicates a high receptiveness to interprofessional learning in veterinary education, emphasising the potential for attitude changes with more interactive participation and programme adjustments.

An Exploration of Student Perception Toward Interprofessional High-Fidelity Clinical Simulation

OBJECTIVES

Interprofessional education is recognized for its potential for collaboration and teamwork, reflecting clinical practice; however, existing literature for simulation-based interprofessional education does not include Physician Associate (PA) students. This initiative aimed to explore the students' perception of interprofessional clinical simulation for PA students and allied health professional (AHP) students as part of our program development.

METHODS

A high-fidelity simulation session was designed and conducted for volunteering students from the PA, paramedic science, and physiotherapy courses. We used a mixed-method electronic questionnaire consisting of 15 statements rated on a numerical rating scale (0-5) and four open-ended questions with unlimited free-text responses to explore student perceptions. Inductive thematic analysis was used for qualitative analysis. The session design was underpinned by Allport's (intergroup) contact hypothesis with an emphasis on mutual intergroup differentiation.

RESULTS

Forty-six students participated in the simulation teaching, with 48% (n = 22) providing feedback. Overall student perception was mainly positive toward the interprofessional simulation; however, some barriers to learning were recognized. Based on the evaluation of our initiative and existing literature, we propose 5 top tips to promote an effective learning experience for students. (1) Understand the importance of interprofessional collaboration. (2) Establish clear roles. (3) Plan the scenarios in advance. (4) Maintain equal status between groups. (5) Provide clear instructions and expectations.

CONCLUSION

To our knowledge, this is the first study of high-fidelity interprofessional simulation involving PA and AHP students. We successfully explored student perception which highlighted aspects that can impact learning. This pilot study demonstrated that interprofessional simulation is a feasible and acceptable form of learning for our students and highlighted how to improve future interprofessional simulation teaching sessions.

Interprofessional Identity in Health and Social Care: Analysis and Synthesis of the Assumptions and Conceptions in the Literature

Interprofessional identity (IPI) development is considered essential in reducing incongruency and improving interprofessional collaboration. However, noticeable differences in conceptualizations are being put forward in the literature, hindering interpretation of research findings and translation into practice. Therefore, a Concept Analysis and Critical Interpretative Synthesis of empirical research articles were conducted to explore the assumptions and conceptions of IPI. Independent literature screening by two researchers led to the inclusion and extraction of 39 out of 1334 articles. Through critical analysis, higher order themes were constructed and translated to a synthesizing argument and a conceptual framework depicting what constitutes IPI (attributes), the boundary conditions (antecedents) and the outcomes (consequences) of its development. The attributes refer to both IPI's structural properties and the core beliefs indicative of an interprofessional orientation. The antecedents inform us on the importance of IPI-fitting constructivist learning environments and intergroup leadership in enabling its development. This development may lead to several consequences with regard to professional wellbeing, team effectiveness and the quintuple aim. Given the educational orientation of this study, ways for facilitating and assessing the development of IPI among learners across the professional continuum have been proposed, although empirical research is needed to further validate links and mediating and moderating variables.

Adaptation and validation of the Interprofessional Socialization and Valuing Scale (ISVS) in Spanish university health sciences students

Many interprofessional education programs are being designed to help students improve their collaborative practice. Traditionally, the evaluation of these programs is focused on attitudes, knowledge and skills, but according to some authors, the evaluation of these activities should be expanded to include the evaluation of the development of an interprofessional identity. The Interprofessional Socialization and Valuing Scale (ISVS) is a self-report tool used to measure interprofessional socialization, but it has not been validated with Spanish students. In this study, the tool was translated into Spanish and administered to a sample of 645 undergraduate students. The data were analyzed to estimate structural validity, internal consistency and convergent validity. Regarding the structural validity, our data supported the unidimensional model found in the English version of the ISVS-21 (normed chi-square = 2.3, RMSEA = 0.045, SRMR = 0.087, CFI = 0.963 and TLI = 0.969). The internal consistency reliability of the scale was adequate, Cronbach α = 0.913 [95% CI 0.903, 0.923]. The Spanish version of the ISVS-21 shows adequate psychometric properties in terms of the construct validity (structural validity and convergent validity) and internal consistency of its scores. This study provides the Spanish-speaking population with an adaptation of the only instrument that has been specifically developed to assess interprofessional socialization.

The effect of group-dynamics, collaboration and tutor style on the perception of profession-based stereotypes: a quasi-experimental pre- post-design on interdisciplinary tutorial groups

BACKGROUND

Group processes in inter-professional Problem-Based Learning (iPBL) groups have not yet been studied in the health-care educational context. In this paper we present findings on how group-dynamics, collaboration, and tutor style influence the perception of profession-based stereotypes of students collaborating in iPBL groups. Health-care students are trained in iPBL groups to increase their ability to collaborate with other healthcare professionals. Previous research focusing iPBL in healthcare implies that more systematic studies are desired, especially concerning the interaction between group processes and internalized professional stereotypes. The aim of this study is to investigate whether changes in group processes, collaboration, and tutor style, influence the perception of profession-based stereotypes of physician- and nursing-students.

METHODS

The study is a quasi-experimental pre- post-design. The participants included 30 students from five different healthcare professions, mainly medicine and nursing. Other professions were physiotherapy, occupational therapy and speech therapy. The students were divided into four iPBL groups, each consisting of six to nine students and a tutor. Data were collected through systematic observation using four video-recorded tutorials. SPGR (Systematizing the Person Group Relation), a computer-supported method for direct and structured observation of behavior, was used to collect and analyze the data.

RESULTS

Traditional stereotypical profession-based behaviors were identified in the first observed group meeting. Although the groups followed different paths of development, the group-dynamics changed in all groups over the 6 weeks of collaboration. Two of the groups became more cohesive, one became more fragmented and one became more polarized. Stereotypical behaviors became less frequent in all groups. Our findings indicate that tutor behavior has a strong influence on the development of the group's dynamics.

CONCLUSION

Our findings strongly suggest iPBL is a means of reducing stereotypical behaviors, and may positively increase members' ability to engage in inter-professional collaboration. Although the pattern of dynamics took different forms in different groups, we argue that iPBL forces students to see the colleague behind his or her profession, thus breaking professional boundaries. The tutor style significantly influenced the iPBL groups' development. This study contributes to our field by emphasizing the effect of group-processes in increasing mutual understanding across professions.

Attitudes towards interprofessionalism among midwife students after hybrid-simulation: A prospective cohort study

BACKGROUND

Team performance, communication and leadership enhance the quality and effectiveness of interprofessional collaborations between midwifery students and anaesthetists in obstetric emergencies. The realistic setting of hybrid simulation provides practice for interprofessional competencies in a stressful environment without putting women at risk during childbirth.

OBJECTIVES

We investigated how full-scale interprofessional hybrid simulation affects the attitudes towards interprofessionalism of final year midwife students.

DESIGN

Two-centre prospective cohort study.

SETTINGS

Bern Simulation and CPR Centre of the Department of Anaesthesiology and Pain Medicine at the Bern University Hospital (Bern, Switzerland) and Zürich University of Applied Sciences.

PARTICIPANTS

Final year midwife students from Bern University of Applied Sciences and Zürich University of Applied Sciences, both from the German-speaking Switzerland.

METHODS

One cohort was exposed to hybrid simulation and the other served as control. The simulation group filled in the German Interprofessional Attitude Scale (G-IPAS) before and after simulation, and then again three months later. The control group filled in two sets of G-IPAS questionnaires three months apart.

RESULTS

The total G-IPAS score increased significantly towards a more positive interprofessional attitude directly after the hybrid simulation. This increase was not sustained over the observation period of three months, although the score remained significantly higher than the score of the cohort without simulation.

CONCLUSIONS

A novel interprofessional hybrid simulation for obstetric emergencies for midwifery students promoted improved attitudes towards interprofessionalism immediately after simulation. These attitudes were improved compared to a control cohort without simulation, and the difference between the two cohorts remained three months after simulation. Future studies might focus on whether improved interprofessional attitudes lead to better healthcare and safety for women and children during childbirth.

Validity of Chinese Version of Attitudes Toward Interprofessional Health Care Teams Scale

Objective

Effective teamwork can provide safe and effective care in various medical systems. Thus, there is increasing recognition of the value of interprofessional collaborative practice. The Attitudes Toward Interprofessional Health Care Teams Scale (ATIHCTS) has been applied to a wide variety of health professions for evaluating attitudes toward health care teams. The ATIHCTS has been widely used internationally, but no Chinese version has been developed. The aim of this study was to adapt a Chinese version of the ATIHCTS among Chinese health care professionals and to test its validity.

Methods

The English version of the ATIHCTS was translated into Chinese, back-translated, and modified for cultural adaptation according to Brislin’s guideline. A total of 306 health professionals in a Shanghai tertiary hospital were investigated using the Chinese version of the ATIHCTS to test its validity.

Results

The Chinese version of the ATIHCTS was adjusted based on expert review and pilot testing. According to expert opinions, the text that did not conform to the Chinese language habits and the Chinese medical environment was adjusted. A total of five adjustments were made. After the pilot testing, minor corrections were made to improve the sentence structure of the scale instructions to make it easier to understand. Factor analysis was subsequently conducted with 306 respondents. The Chinese version of the ATIHCTS had 14 items. Exploratory factor analysis extracted two common factors, quality of care and time constraints, with the cumulative variance contribution rate reaching 70.011% and the load value of each entry on its common factor > 0.4. In addition, for scale confirmatory factor analysis (CFA), the chi-square/degrees of freedom ratio (X²/df) was 1.46, the normed fit index (NFI) was 0.97, the Tucker-Lewis index (TLI) was 0.99, the incremental fit index (IFI) was 0.99, the comparative fit index (CFI) was 0.99, and the root mean square error of approximation (RMSEA) was 0.04. The fitting values all met the judgment criteria, and the scale had good structural validity. Cronbach’s α of the Chinese version of the ATIHCTS was 0.861, and the Cronbach’s α values of each factor were 0.949 and 0.838, respectively. The split-half reliability was 0.644, and the Guttman split-half coefficients of each factor were 0.904 and 0.779, respectively.

Conclusion

The Chinese version of the ATIHCTS has good validity. It is a valuable tool for evaluating attitudes toward interprofessional health care teams among the health care professionals in China.

A Delphi survey of health education system and interprofessional nurse' role

BACKGROUND

Interprofessional education in healthcare academic and professional training is renowned to improve collaborative culture. International studies showed the existence of obstacles to establishing interprofessional collaboration and the relevance of Nurses' role in the implementation process.

AIM

This study was conducted to explore interprofessional collaboration practice and education perceptions, opinions and awareness of healthcare professionals, such as academics, professional bodies representatives and multidisciplinary team managers.

METHODS

A multi-method two-stage approach using: 1) explorative survey and 2) Delphi group technique. A survey questionnaire focusing on interprofessionality in practice and education was administered to a convenience group of students and academics from health degree courses of three universities. Delphi group panellists were selected from a list of experts from three areas (n = 169). The iterative Delphi technique implied three-rounds to reach panel consensus (or not) about the main research topics, starting from expert panel opinions about survey results.

RESULTS

The study witnessed nurses' overall large participation (60-75%). Survey results (n = 198) showed participants' willingness to implement interprofessional education programs but controversial visions of how to implement interprofessional culture in healthcare settings. The Delphi survey showed experts' (n = 25) convergent opinions about introducing elements of communication skills and interprofessional culture into academic curricula and improving the presence of non-medical professions among the academic body. Nurses showed ambiguous positions towards concepts of autonomy and shared responsibility.

CONCLUSIONS

Our study highlighted interprofessional education implementation obstacles and possible enablers. Nurses' controversial positions may reflect the struggle of the nursing profession to reach permanent academic positions and to support the shift from a medical-centric to a person-centred model of care.

Professional Attitudes in Health Professions' Education: The Effects of an Anatomy Near-Peer Learning Activity

Interprofessional attitudes existing between healthcare disciplines can negatively impact communication and collaboration in the clinical setting. While human anatomy is a topic central to healthcare trainees, the potential of the anatomy laboratory to minimize negative interprofessional attitudes has yet to be characterized. This study aimed to assess the effects of an anatomy interprofessional near-peer learning activity (AIP-NPLA) on medical and nursing students' interprofessional attitudes at McGill University. The authors employed a convergent parallel mixed methods study to explore participants' AIP-NPLA experiences. The Attitudes to Health Professionals Questionnaire (AHPQ) was used pre- and post-AIP-NPLA to assess participants' attitudes toward their own and their counterpart profession. In addition, a focus group was held immediately following the AIP-NPLA to explore participants' experiences and interprofessional perceptions. Quantitative results using a principal components analysis demonstrated significant changes in nursing students' responses between pre- and post-AIP-NPLA scoring, rating the medical profession as being more caring overall. Medical students' responses pre- and post-AIP-NPLA demonstrated no significant differences. Qualitative results also suggested a breakdown of negative attitudes, an increased understanding of inter- and intra-professional roles, and the importance of interprofessional collaboration and mutual learning for their careers. These findings revealed that attitudes among healthcare trainees may be positively restructured in the anatomy laboratory, allowing for collaborative care to predominate in current and future clinical practices.

Quality Olympics: Experiential Interprofessional Learning to Improve Quality and Safety

BACKGROUND

Effective communication and teamwork is essential to improve the safety, quality, and cost-effectiveness of patient care. Quality Olympics, a competitive, educational intervention, was designed to offer nursing and medical students the opportunity to apply new knowledge on safety quality and cost in an interprofessional environment.

METHOD

Nursing (N = 220) and medical students (N = 163) participated in Quality Olympics. Student perceptions of teamwork were analyzed using the Student Perceptions of Interprofessional Clinical Education-Revised (SPICE-R).

RESULTS

In years one and two, significance was found for nursing students on all survey items. Medical student responses reached significance on four items in year two.

CONCLUSION

The contrast in findings between these professions suggests that students would benefit from early, additional opportunities to link patient safety and outcomes to interprofessional collaboration. In doing so, educators may ensure that future providers have the attitudes, knowledge, and skills to impact individualized care and transform health care systems.[J Nurs Educ. 2020;59(10):589-593.].

Wirksamkeit von interprofessionellem Lernen: Stereotype und Wissen über die andere Berufsgruppe

Abstract. Angehende Fachkräfte in den Gesundheitsberufen sollen durch interprofessionelles Lernen (IPL) besser auf die berufsgruppenübergreifende Zusammenarbeit in der Patientenversorgung vorbereitet werden. Dazu wurde eine interprofessionelle Übungseinheit entwickelt, in der Medizinstudentinnen und -studenten und Schülerinnen und Schüler der Physiotherapieausbildung im reziproken Peer-Tutoring mit-, von- und übereinander lernen. In dieser Studie wurde die Wirksamkeit der Lehrveranstaltung im Hinblick auf die Veränderung von Stereotypen und das Wissen über die andere Berufsgruppe überprüft. Unter Anwendung des Solomon-Vier-Gruppen-Designs zeigte sich, dass die Wirksamkeit der Übungseinheit in Form einer positiveren Ausprägung der Stereotype sowie eines höheren Wissensstandes über die jeweils andere Berufsgruppe im Vergleich zu den rein monoprofessionell ausgebildeten Kontrollgruppen bedingt nachgewiesen werden konnte. Teilweise war sie nur in der Bedingung mit Pretest nachweisbar.

Applying the Readiness for Interprofessional Learning Scale (RIPLS) to medical, veterinary and dual degree Master of Public Health (MPH) students at a private medical institution

PURPOSE

With the emergence of zoonoses such as Ebola, many medical educators, have recommended the need for providing Interprofessional Education (IPE) as a pedagogical tool for familiarizing medical (MD) students with the framework of One Health (OH). This is important as students need to understand, the wider impacts of animal and environmental health factors on human health. IPE initiatives which typically incorporate the principles of OH, can provide MD and veterinary (DVM) students with a greater awareness of the role that animal diseases and climate change have on global health. However, negative attitudes to IPE have been reported as a key limitation to IPE implementation. The purpose of this paper is to examine the differences in readiness for interprofessional learning of medical and other allied human health professional students, including veterinarians and students undertaking dual degrees in combination with a Master of Public Health (MPH). Reflecting on Role Theory (RT) and Social Identity Theory (SIT), the paper aims to contribute to the understanding of differences in perceptions that exist between different types of health professionals.

METHODS

Students at a medical University enrolled in MD, DVM, DVM MPH and MD MPH programs, were invited to complete the standardized Readiness for Interprofessional Learning Scale (RIPLS), which consists of 19 Likert scale items measuring concepts relating to teamwork, professional identity and roles and responsibilities. A total of 364 students across the four programs took part. Descriptive and inferential statistical analyses were performed to assess differences between the programmes.

RESULTS

Results indicate that MD students score lower on the different RIPLS items compared to DVM, MD MPH and DVM MPH students. DVM and DVM MPH students are generally more positive about the need for teamwork, while MD MPH and DVM MPH students have a stronger positive identity about the need for IPE.

CONCLUSIONS

The findings drawn from this study suggests that the MD students keep on seeing themselves as a separate group of health professionals in their own right. In order to guarantee an increased level of understanding on issues relating to the human-animal-environmental spectrum, medical curricula might benefit from the incorporation of shared learning and teamwork, as occurs within the MPH, enabling students to appreciate the value of interprofessional collaboration to their future practice. This is especially important during a time at which human-animal-environmental issues are affecting social and economic life worldwide.

Does contact at work extend its influence beyond prejudice? Evidence from healthcare settings

This article reports on two studies investigating the role of intergroup contact on the reduction of prejudice against migrants and on organizational and health outcomes. Study 1 enrolled 624 native healthcare professionals and showed that frequent and positive contact with non-native co-workers was associated with a decrease in the professionals' prejudice and an increase in the professionals' perception of team functioning. These effects were mediated by reduced in-group threat perception. Study 2 enrolled 201 native patients and showed that frequent and positive contact with non-native healthcare providers was associated with a decrease in patients' prejudice and an increase in patients' satisfaction for the care received. These effects were mediated by reduced in-group threat perception. These novel findings showed that frequent and positive contact with non-native individuals can improve health and organizational outcomes along with facilitating positive intergroup relations.