Interprofessional education in a midwifery curriculum: the learning through the exploration of the professional task project (LEAPT)

The effect of electronic fetal monitoring (EFM) education program on EFM interpretation skills

Purpose: The aim of this study is to train midwifery students on electronic fetal monitoring (EFM) within the scope of the course and then to evaluate their pre- and post-course EFM knowledge and EFM interpreting skills.Methods: This interventional study was carried out at the Department of Midwifery, Faculty of Health Sciences. The study population comprised of the senior (last-year, 4th-year) students who attended the Midwifery Department of the Faculty of Health Sciences during the academic years 2015-2016 and 2016-2017. Of the 4th year students in the midwifery department, 42 who attended the school during the academic year 2015-16 and 61 who attended the school during the academic year 2016-2017 and accepted to participate in the study comprised the study sample.Results: The difference between the pre- and post-EFM course scores was statistically significant (p<.05). While the mean score obtained by the students before the EFM course was 55.29 ± 11.17, it was 76.15 ± 6.72 after the EFM course. Analysis of the success rates of the midwifery students in the EFM/NST course demonstrated that 80.6% of the students were successful.Conclusions: The findings of the study demonstrated that the participants' postcourse EFM knowledge and trace interpretation skills were better than their precourse EFM knowledge and trace interpretation skills.

Concept analysis of collaboration in implementing problem-based learning in nursing education

Objectives

The purpose of this concept analysis was to better understand and define collaboration as it relates to the implementation of problem-based learning (PBL).

Methods

The process of concept analysis was conducted in three phases; namely, theoretical or literature review, empirical or fieldwork; and analysis phases. Rodgers’ evolutionary approach was used to clarify the attributes, antecedents, surrogate, related terms and consequences of collaboration in implementing PBL. The search key terms were ‘collaboration’, ‘problem-based learning’, ‘nursing’ and ‘nursing education’. The search was performed in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline and PsycINFO databases. The articles were reviewed for trends that would reflect the current knowledge for collaboration as a concept. Descriptive qualitative study was used to collect data purposively from participants of three universities offering PBL in Republic of South Africa and three hospitals where PBL students are placed

Results

Collaboration in implementing PBL is described as using the following terms: interpersonal, interactive and personal process, shared goal and governance. The antecedents of collaboration include commitment and support; common goal; formal agreement; training and development; and monitoring and evaluation of tools and mechanisms. Consequences of collaboration in implementing PBL are as follows: information, resource and expertise sharing; personal development and mentoring; creation of supportive and nurturing environment; professional socialisation; improved students’ outcomes; and effective utilisation of resources.

Conclusion

Effective collaboration within nursing education and with other healthcare professionals to achieve quality outcomes in an increasingly interdependent higher education system continues to grow in importance.

Learning to create new solutions together: A focus group study exploring interprofessional innovation in midwifery education

Undergraduate students can learn how to be innovative in partnerships with health care institutions and private enterprises. This study portrays how a three phase innovation model was applied in an interprofessional health education context at a Danish university college. The aim of the study was to explore midwifery, nutrition and health as well physiotherapy students' perceptions of participating in a real-life innovation project situated in antenatal care. A total of eighteen students participated in five focus group interviews. Thematic analysis was used to interpret data findings. Data analysis revealed three themes: 'Navigating in uncertainty', 'Being part of a team' and 'Impact of project learning'. Students found project learning to be the most relevant with regards to their clinical practice. Furthermore, study findings suggest that innovation is promoted by teamwork, interprofessional participation, mentor support and external partnerships.

Interprofessional education for whom? --challenges and lessons learned from its implementation in developed countries and their application to developing countries: a systematic review

BACKGROUND

Evidence is available on the potential efficacy of interprofessional education (IPE) to foster interprofessional cooperation, improve professional satisfaction, and improve patient care. While the intention of the World Health Organization (WHO) is to implement IPE in all countries, evidence comes from developed countries about its efficiency, challenges, and barriers to planning and implementing IPE. We therefore conducted this review to examine challenges of implementing IPE to suggest possible pathways to overcome the anticipated challenges in developing countries.

METHODS

We searched for literatures on IPE in PubMed/MEDLINE, CINAHL, PsycINFO, and ERIC databases. We examined challenges or barriers and initiatives to overcome them so as to suggest methods to solve the anticipated challenges in developing countries. We could not conduct a meta-analysis because of the qualitative nature of the research question and the data; instead we conducted a meta-narrative of evidence.

RESULTS

A total of 40 out of 2,146 articles were eligible for analyses in the current review. Only two articles were available from developing countries. Despite the known benefits of IPE, a total of ten challenges or barriers were common based on the retrieved evidence. They included curriculum, leadership, resources, stereotypes and attitudes, variety of students, IPE concept, teaching, enthusiasm, professional jargons, and accreditation. Out of ten, three had already been reported in developing countries: IPE curriculum, resource limitations, and stereotypes.

CONCLUSION

This study found ten important challenges on implementing IPE. They are curriculum, leadership, resources, stereotypes, students' diversity, IPE concept, teaching, enthusiasm, professional jargons, and accreditation. Although only three of them are already experienced in developing countries, the remaining seven are potentially important for developing countries, too. By knowing these challenges and barriers in advance, those who implement IPE programs in developing countries will be much more prepared, and can enhance the program's potential success.

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

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

An interprofessional education pilot program in maternity care: findings from an exploratory case study of undergraduate students

An interprofessional team of maternity care providers and academics developed a pilot interprofessional education (IPE) program in maternity care for undergraduate students in nursing, midwifery and medicine. There are few published studies examining IPE programs in maternity care, particularly at the undergraduate level, that examine long-term outcomes. This paper outlines findings from a case study that explored how participation in an IPE program in maternity care may enhance student knowledge, skills/attitudes, and may promote their collaborative behavior in the practice setting. The program was launched at a Canadian urban teaching hospital and consisted of six workshops and two clinical shadowing experiences. Twenty-five semi-structured, in-depth interviews were completed with nine participants at various time points up to 20 months post-program. Qualitative analysis of transcripts revealed the emergence of four themes: relationship-building, confident communication, willingness to collaborate and woman/family-centered care. Participant statements about their intentions to continue practicing interprofessional collaboration more than a year post-program lend support to its sustained effectiveness. The provision of a safe learning environment, the use of small group learning techniques with mixed teaching strategies, augmented by exposure to an interprofessional faculty, contributed to the program's perceived success.

'New to Forensic'; implementing a problem-based introductory educational programme for forensic practitioners in Scotland

The New to Forensic educational programme has been developed for use across all forensic services in Scotland. It is designed to meet the needs of all staff who are both new to and already working within forensic mental health services. Its objectives are targeted to both clinical and non-clinical staff. The programme follows the patient's journey through the mental health and criminal justice systems. It covers mental disorder, legislation, psychiatric defences, assessment and treatment, risk of harm to others, services, attitudes and boundaries, multidisciplinary working, users and carers, community, learning disability, and prison services. It is self-directed and practice based, and uses a problem-based approach. Over a 3-year period, trainers and mentors have been trained to deliver the programme by members of the School of Forensic Mental Health http://www.forensicnetwork.scot.nhs.uk/ and all services have adopted the programme as a core educational initiative. Initial findings from the programme evaluation indicate a significant improvement in learning following engagement in the initiative.

Faculty perceptions of interprofessional education

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

Interventions to improve team effectiveness: a systematic review

OBJECTIVES

To review the literature on interventions to improve team effectiveness and identify their 'evidence based'-level.

METHODS

Major data bases (PubMed, Web of Science, PsycInfo and Cochrane Library) were systematically searched for all relevant papers. Inclusion criteria were: peer-reviewed papers, published in English between January 1990 and April 2008, which present empirically based studies focussing on interventions to improve team effectiveness in health care. A data abstraction form was developed to summarize each paper. The Grading of Recommendations, Assessment, Development, and Evaluation Scale was used to assess the level of empirical evidence.

RESULTS

Forty-eight papers were included in this review. Three categories of interventions were identified: training, tools, and organisational interventions. Target groups were mostly multidisciplinary teams in acute care. The majority of the studies found a positive association between the intervention and non-technical team skills. Most articles presented research with a low level of evidence. Positive results in combination with a moderate or high level of evidence were found for some specific interventions: Simulation training, Crew Resource Management training, Team-based training and projects on Continuous quality improvement.

CONCLUSIONS

There are only some studies available with high quality evidence on interventions to improve team effectiveness. These studies show that team training can improve the effectiveness of multidisciplinary teams in acute (hospital) care.

Interactive genetic counseling role-play: a novel educational strategy for family physicians

BACKGROUND

Family physicians (FPs) are increasingly involved in delivering genetic services. Familiarization with aspects of genetic counseling may enable FPs to help patients make informed choices.

PURPOSE

Exploration of interactive role-play as a means to raise FPs' awareness of the process and content of genetic counseling.

METHODS

FPs attending two large Canadian family medicine conferences in 2005 were eligible -- 93 participated. FPs discussed a case during a one-on-one session with a genetic counselor. Evaluation involved pre and post intervention questionnaires

RESULTS

FPs' baseline genetic knowledge was self-rated as uniformly poor. Baseline confidence was highest in eliciting family history and providing psychosocial support and lowest in discussing risks/benefits of genetic testing and counseling process. Post-intervention, 80% of FPs had better appreciation of family history and 97% indicated this was an effective learning experience.

CONCLUSIONS

Role-play with FPs is effective in raising awareness of the process and content of genetic counseling and may be applied to other health disciplines.

Child disability case studies: an interprofessional learning opportunity for medical students and paediatric nursing students

CONTEXT

We describe an interprofessional learning (IPL) opportunity for pre-qualification medical and paediatric nursing students using community-based case studies of disabled children and their families.

METHODS

A total of 160 students were randomly allocated into interprofessional and uniprofessional pairs. Each pair visited a disabled child at home and school and presented their experience to the rest of the group. Quantitative and qualitative evaluation methods were used to explore the learning experience. Data collection tools included a scale measuring attitudes towards IPL, which was completed by all students before and after their visits and focus groups.

RESULTS

The value of the community setting and independent working of the case study was appreciated by the students. The intimacy involved in working in IP pairs demonstrated both positive and negative features. Nursing students showed more open and positive attitudes towards IPL than medical students. Nursing students in IP pairs appear to have benefited most from the exercise, notably in terms of confidence and self-esteem. Professional differences in communication skills and approach were identified as particular learning points for all students.

CONCLUSIONS

The added value of combining quantitative and qualitative research methods is well demonstrated by this study. Learning opportunities from the case study were greater as a result of working interprofessionally. Student attitudes towards IPL and professional stereotyping changed as a result of this IPL exercise. The importance of the social context of learning and the contact hypothesis are supported by our findings.

A comparison of interprofessional perceptions and working relationships among health and social care students: the results of a 3-year intervention

A longitudinal quantitative study in an English faculty of health and social care explored the effects of a pre-qualifying interprofessional curriculum for students from 10 professional programmes. Students on the interprofessional curriculum completed questionnaires containing four attitude scales on entry to the faculty, during their second year and at the end of their final year. At qualification, 581 students (76.9% of those qualifying) completed scales concerning their communication and teamwork skills, their attitudes towards interprofessional learning, their perceptions of interaction between health and social care professionals, and their opinions about their own (inter)professional relationships. Questionnaires were completed at both entry and qualification by 526 students (69.8% of those qualifying), and at all three points by 468 students (61.9% of those qualifying). A comparison group of 250 students (67.6% of those qualifying) on the previous uniprofessional curricula also completed questionnaires at qualification. Students on the interprofessional curriculum showed no significant change in their self-assessment of their communication and teamwork skills between entering the faculty and qualification. However, there was a negative shift in their attitudes to interprofessional learning and interprofessional interaction. Nevertheless, most students were positive about their own professional relationships at qualification. Students with previous experience of higher education were comparatively positive about their communication and teamwork skills, as were female students about interprofessional learning. However, the strongest influence on students' attitudes at qualification appeared to be professional programme. This suggests that interprofessional education does not inhibit the development of profession-specific attitudes. Students who qualified on the interprofessional curriculum were more positive about their own professional relationships than those who qualified on the previous uniprofessional curricula. These data suggest that experiencing an interprofessional curriculum has an effect on students' attitudes at qualification, particularly with regard to their positive perception of their own professional relationships.