Evaluating a large-scale introductory interprofessional education workshop for developing interprofessional socialisation in medical, nursing and pharmacy students: A quasi-experimental pre-test post-test study

How does interprofessional education affect attitudes towards interprofessional collaboration? A rapid realist synthesis

Interprofessional collaboration (IPC) in healthcare is regarded as important by professionals, as it increases the quality of care while decreasing costs. Interprofessional education (IPE) is a prerequisite for IPC and influences learners' attitudes, knowledge, and collaboration skills. Since attitudes shape behavior, understanding how they are formed is crucial for influencing IPC in learners' professional practice. We investigated what kind of IPE works, for which students, how, and in what circumstances to develop positive attitudes towards IPC. Using realist synthesis, we extracted causal mechanisms that produce positive attitude outcomes and the conducive contexts that trigger them. Our analysis resulted in six plausible context-mechanism-outcome configurations that explain positive attitude development. Positive IPC attitudes are more likely to arise in contexts where IPE provides time and facilities for formal and informal interactions, as this allows learners to get to know each other both professionally and personally, fostering trust, respect, and mutual liking. Additionally, positive attitudes are more likely in contexts where the IPE curriculum is perceived as career-relevant and boosts confidence. Key mechanisms of positive attitude development include getting to know the other learners professionally and personally, experiencing positive affect during IPE, and learners experiencing mutual dependence. Sustained positive attitudes are more likely to develop when there is organizational support for IPC and professionals attend IPE on an ongoing basis, allowing the attitudes and values expected in IPC to be positively reinforced and eventually integrated into the learners' personal value system.

Psychometric evaluation of the Australian interprofessional socialisation and valuing scale: An invariant measure for health practitioners and students

OBJECTIVES

This study aimed to evaluate the psychometric properties of the Australian Interprofessional Socialisation and Valuing Scale (ISVS)-21 and provide an invariant measure for health practitioners and students to assess interprofessional socialisation.

METHODS

The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) were used as guidelines. This research began with a key step: conducting a pilot study to assess content validity, a requirement of COSMIN for item development. The ISVS-21 has not yet been validated in Australia. Content validity checks ensure the developed items accurately represent the measured construct in the intended cultural context. In addition to conducting more comprehensive tests of psychometric properties compared to previous studies on ISVS-21, this paper introduces something new by evaluating the internal structure of the instrument involving measurement invariance and hypothesis testing for construct validity based on several assumptions related to interprofessional socialisation and values. An invariant measure validates the use of the Australian ISVS-21 on practitioner and student equivalently, allowing the comparison of outcomes at both levels.

RESULTS

The evaluation of content validity indicated that the items were relevant, comprehensible (practitioners and students had an agreement score of >70% for all 21 items), and comprehensive to the concepts intended to be measured. Structural validity confirms ISVS-21 Australia as unidimensional, with good internal consistency reliabilities, Cronbach's α scores = 0.96 (practitioner) and 0.96 (student). Measurement invariance tests confirm ISVS-21 Australia is configural, metric and scalar invariance (ΔCFI ≤ 0.01) across the tested groups of practitioner and student, and therefore suitable for use by both cohorts in Australia. Age and length of work/study were discriminant factors for interprofessional socialisation in both cohorts; the professional background was a differentiating factor for practitioners but not for students. Hypotheses testing results support the COSMIN construct validity requirement for the measure, with 83.3% of assumptions tested accepted.

CONCLUSION

The Australian ISVS has good psychometric properties based on evaluating the content validity, internal structure, and hypotheses testing for construct validity. In addition, Australian ISVS is an invariant measure for use by health practitioners and students and, therefore, confirmed as a quality measure to assess interprofessional socialisation for both cohorts in Australia.

Promoting Safer Opioid Practices and Professional Collaboration Through Interprofessional Simulation

ABSTRACT

Simulation-enhanced interprofessional education is widely viewed as an effective teaching pedagogy to foster effective communication and teamwork for healthcare students. Pharmacists and registered nurses must learn to work collaboratively during their educational programs in order to be prepared for the complexities of modern healthcare. This study evaluated prelicensure pharmacy and prelicensure nursing students' perceptions of professional collaboration before and after caring for a standardized patient exhibiting opioid dependence secondary to inappropriate use of an opioid analgesic. Statistically significant gains in communication, collaboration, roles and responsibilities, patient-centered care, conflict management, and team functioning were measured for both pharmacy and nursing students after the interprofessional simulation. This study adds to the existing evidence that suggests simulation-enhanced interprofessional education is an effective teaching strategy; however, this study demonstrates its usefulness for students learning about safer opioid analgesic practices.

Graduate entry nursing students' development of professional nursing self: A scoping review

BACKGROUND

Accelerated graduate entry nursing programmes require students to rapidly socialise to the profession. Professional identity is an important element of becoming a nurse.

OBJECTIVE

This scoping review aimed to synthesise published literature reporting the development of professional identity, belongingness and self-concept as a nurse in students enrolled in a pre-registration graduate entry nursing programme.

DESIGN

Scoping review.

SETTING

Graduate entry nursing programmes.

PARTICIPANTS

Graduate entry nursing students.

METHOD

Following a pre-registered protocol, we searched electronic databases for publications investigating graduate entry nursing students' development of professional identity, belongingness and self-concept. Screening, data extraction and analysis were initially in duplicate and independent, and then by consensus.

RESULTS

Of the 871 records identified, twenty met the inclusion criteria. Publications were from the USA, Australia, New Zealand, Canada, and the UK. We identified one overarching theme of 'professional nursing self', with four sub-themes: 1) professional socialisation, 2) professional self-concept, 3) developing nursing agency, and 4) identity formation. Socialisation into nursing and belongingness to the profession occurred concurrently as students moved through their programme of learning. Due to the accelerated nature of the programmes, rapid professional socialisation was required, supported by positive relationships in the clinical setting. Strategies that enhanced belongingness and wellbeing enabled students to feel connected to the profession.

CONCLUSIONS

The development of professional identity in graduate entry nursing students is impacted by their rapid professional transition through an accelerated programme. Students' growing sense of nursing agency is embodied in their experiences of thinking and acting as a nurse. Their previous professional identity is then reconstituted in their new graduate selves; educational programmes support this transition.

TWEETABLE ABSTRACT

Scoping review finds professional identity development in graduate entry nursing students is rapid in accelerated preregistration degrees #belonging #connection.

Comparing quantitative outcomes of synchronous online versus in-person interprofessional symposium

Healthcare and educational practices changed due to COVID-19. Interprofessional education (IPE) events during the pandemic were canceled or presented through online platforms. Fortunately, IPE using online platforms had been growing during the decade prior to the pandemic. However, few publications document quantitative outcomes of online IPE, and most report qualitative outcomes of student reactions. The purpose of this study was to determine if student outcomes from an online IPE symposium were similar to the positive outcomes from prior in-person IPE symposia. A Community of Inquiry (CoI) model within a synchronous Zoom platform was developed with intentional design supporting cognitive, instructional, and social presence; interprofessional socialisation; and collaboration. Utilising a standardised instrument, student attitudes about healthcare teams were assessed comparing pretest and posttest. Students who participated in the online IPE displayed similar improvements in attitudes towards interprofessional teams at posttest. Hence, this study supports the use of a brief, synchronous, online IPE symposium.

A Qualitative Exploration of ACPE Standard 4 Key Elements From the Perspective of Student Pharmacists

OBJECTIVE

Attitudes and skills reflecting the Accreditation Council for Pharmacy Education Standard 4 (ACPE-S4) remain an important component of pharmacy education. The objectives of this study were (1) explore student perspectives on the importance of ACPE-S4 key elements, and (2) identify experiences that students described as supporting ACPE-S4 attitude and skill development.

METHODS

This was a qualitative study using focus groups and dyadic interviews with student pharmacists to collect data on ACPE-S4 key element importance and skill acquisition. A general inductive qualitative approach was used to analyze data, with 2 study authors independently reviewing all transcripts and assigning codes to text segments. Authors then met to discuss coding, iteratively organize coded segments into categories and subcategories, and select representative quotes.

RESULTS

Overall, 3 focus groups and 3 dyadic interviews were conducted with a total of 20 students. Students ranked professionalism and self-awareness as the 2 most important key elements. From qualitative analysis, 4 categories and 10 subcategories of educational activities, programs, and experiences were identified as follows: Mentorship (Identifying a Mentor, Formal Mentorship Programs), Curriculum (Practice Lab, Professional Development Course, Interprofessional Education, Experiential Education), Cocurriculum (Organizational Involvement, Volunteer Hours), and Opportunities Outside Academic Setting (Work, Conferences, and Innovative Pharmacy Practices).

CONCLUSION

Participants articulated several opportunities for developing the skills and attitudes reflecting ACPE-S4 key elements. Incorporating student input into ACPE-S4 attitude and skill development may help pharmacy programs consider how to design, refine, and implement initiatives and experiences to help students develop skills across ACPE-S4 focus areas.

Exploring the awareness, attitude, and inclination of healthcare students towards interprofessional education: A cross-sectional study in Saudi Arabia

Background

Interprofessional education (IPE) is acknowledged to enhance understanding between professionals and to facilitate learning. Healthcare professionals may be better equipped to accept and esteem other healthcare professionals, if interprofessional education is incorporated into undergraduate curricula. The management of challenging patient issues may also significantly benefit from this. As a result, the current study examined interprofessional education in their institutions and students' knowledge of and attitudes toward it.

Methodology

We conducted a cross-sectional questionnaire-based study among students from a university in the southwest of Saudi Arabia, who were enrolled in courses in medical, pharmacy, nursing, dentistry, allied health, and public health. Following validation, the questionnaire included six questions to probe their knowledge, ten questions to gauge their attitude, and eleven questions to inquire about the growth and use of IPE in their institutions. Multiple regression and the Kruskal-Wallis test were used to examine the data.

Results

The survey involved 600 students, and 66.8% of the respondents were male. Less than one-third of students studying medicine replied to the survey, while students in the public health department had the lowest response rate. Compared to students in other programs, pharmacy students achieved a higher mean attitude score toward IPE (P < 0.001). Additionally, nursing and pharmacy students' mean IPE awareness scores were higher than those of medical students (P < 0.001). However, all program participants firmly agreed that integrating IPE into the curriculum was a good idea.

Conclusions

The study found that students of a few programs had awareness and a positive attitude toward interprofessional education. Nonetheless, all of them favored its inclusion in their curriculum. They also stressed the need to educate teaching faculty on interprofessional education, to develop skilled facilitators within their institutions.

Nursing students' interprofessional socialisation and readiness for interprofessional learning: A cross-sectional research study

BACKGROUND

Interprofessional education programs in university settings have facilitated the development of student attributes needed to become a team-player, understand roles and responsibilities of other health disciplines, and acquire knowledge to deliver patient-centred care. Although the benefits of interprofessional education are widely acknowledged, there is limited research on interprofessional socialisation within university contexts.

OBJECTIVES

To examine readiness of undergraduate nursing students for interprofessional learning and interprofessional socialisation.

DESIGN

A cross-sectional design was used to examine the correlation between interprofessional learning and socialisation, and group differences between mode of study, year level, and prior healthcare experience.

SETTING

A large Australian regional university, across two campuses.

PARTICIPANTS

A total of 103 undergraduate nursing students across year levels, including 58 enrolled on-campus, and 45 studying externally.

METHOD

Students completed an online survey using the Readiness for Interprofessional Learning Scale and the Interprofessional Socialisation and Valuing Scale. Data analyses included independent t-tests, and a one-way between subjects ANOVA.

RESULTS

No significant differences in student readiness for interprofessional learning or interprofessional socialisation were found between on-campus and external modes of study and between healthcare experience and no prior healthcare experience. Participants with previous healthcare experience had significantly higher scores for interprofessional socialisation than those with no previous healthcare experience.

CONCLUSIONS

Readiness for interprofessional learning and interprofessional socialisation and were not impacted by the students' mode of study; however, previous experience in the healthcare industry and duration of study significantly improved interprofessional socialisation skills. As nursing students advance through their study, they may experience interprofessional education opportunities that influence their perceived socialisation skills.

Trauma Team High-Fidelity Simulation Training in a Rural Level III Trauma Center: An Interprofessional Experience

BACKGROUND

Emergency department trauma resuscitation requires teamwork and high-stakes clinical decision-making. Rural trauma centers with low trauma activation volumes must ensure that resuscitations are efficient and safe.

OBJECTIVE

The purpose of this article is to describe the implementation of high-fidelity, interprofessional simulation training to foster trauma teamwork and role identification for trauma team members responding to trauma activations in the emergency department.

METHODS

High-fidelity, interprofessional simulation training was developed for members of a rural Level III trauma center. Subject matter experts created trauma scenarios. An embedded participant led the simulations using a guidebook that outlined the scenario and learner objectives. The simulations were implemented from May 2021 through September 2021.

RESULTS

Postsimulation survey results identified that participants found training with other professions valuable and that knowledge was gained.

CONCLUSION

Interprofessional simulations enhance team communication and skills. Combining interprofessional education with high-fidelity simulation creates a learning environment that optimizes trauma team function.

Situated learning in community environments (SLICE): Systems design of an immersive and integrated curriculum for community-based learning

PURPOSE

We sought to design a micro-curriculum to structure supervised clinical placements for junior medical students within a variety of community-based settings of differing clinical disciplines. Given the gaps in the literature, this paper reflects on the opportunities and challenges of our design, implementation, and evaluation strategies in constructing an integrated task-based micro-curriculum for interprofessional community-based learning in year 2 of a four-year graduate entry program.

METHODS

The design was informed by a systems thinking framework and guided by contemporary curricular theories on self-directed and interprofessional learning. Extensive consultations with stakeholders were undertaken. Alignment with relevant national level documents and curricular frameworks was ensured.

RESULTS

The systems thinking approach provided first, an experience of applying thinking tools for a deeper understanding of how various parts of this micro-curriculum and subsystems should be integrated. Second, applying the toolkit uncovered tension points on which leverage could optimise future enhancements. Eighteen types of health professions were recruited including 105 general practitioners and 253 healthcare practitioners from a range of disciplines.

CONCLUSION

Systems thinking allows for the identification of various interacting elements within the curriculum to be considered as part of an integrated whole. Insights from this model could inform the design of similar innovative curricula.

Current views of community and hospital pharmacists on pharmaceutical care services in the United Arab Emirates: A mixed methodological study

Background: The profession of pharmacy has evolved significantly in recent years in terms of professional service delivery. The aim of this study was to explore the current views of pharmacists in the United Arab Emirates (UAE) on pharmaceutical care services and the nature of barriers encountered in practice using qualitative and quantitative assessment methods. Methods: A cross-sectional study was conducted among hospital and community pharmacists (n = 305) between March and May 2021, using qualitative and quantitative assessment methods. In the qualitative phase, 15 interviews were conducted to explore five main criteria: patient information, inadequate patient counseling, prescribing errors prevention and identifying drug-related problems, lack of participation in health awareness programs, and barriers to pharmaceutical care implementation. In the quantitative phase, 305 consenting pharmacists completed a questionnaire on seven criteria: demographic profile, pharmacist-physician interaction, patient counseling assessment, patient reports of adverse drug events, pharmacist participation in health awareness programs, perceptions of reducing prescribing errors and identifying drug-related problems, and barriers to appropriate pharmaceutical care implementation. Results: The results of both the qualitative and quantitative phases of the study revealed that pharmacists' influence on practice in the UAE is limited due to many factors, mainly lack of time and patients' ignorance of the pharmacist's role in the medical field. The mean responses regarding pharmacists' approach to patient counseling and patients' knowledge of pharmacists' role in managing adverse drug reactions were 77.1% and 59.7%, respectively. Active participation in health awareness programs was 64.8%. The mean positive response of participants in reducing prescribing errors and recognizing drug-related problems was 9.2%. Pharmacists' age and number of years in practice were the most important factors influencing the pharmaceutical care services implementation. Conclusion: The study has shown the need to shed light on the proper implementation of pharmaceutical care while maintaining a trusting relationship with physicians.

Current views of community and hospital pharmacists on pharmaceutical care services in the United Arab Emirates: A mixed methodological study

Background: The profession of pharmacy has evolved significantly in recent years in terms of professional service delivery. The aim of this study was to explore the current views of pharmacists in the United Arab Emirates (UAE) on pharmaceutical care services and the nature of barriers encountered in practice using qualitative and quantitative assessment methods. Methods: A cross-sectional study was conducted among hospital and community pharmacists (n = 305) between March and May 2021, using qualitative and quantitative assessment methods. In the qualitative phase, 15 interviews were conducted to explore five main criteria: patient information, inadequate patient counseling, prescribing errors prevention and identifying drug-related problems, lack of participation in health awareness programs, and barriers to pharmaceutical care implementation. In the quantitative phase, 305 consenting pharmacists completed a questionnaire on seven criteria: demographic profile, pharmacist-physician interaction, patient counseling assessment, patient reports of adverse drug events, pharmacist participation in health awareness programs, perceptions of reducing prescribing errors and identifying drug-related problems, and barriers to appropriate pharmaceutical care implementation. Results: The results of both the qualitative and quantitative phases of the study revealed that pharmacists' influence on practice in the UAE is limited due to many factors, mainly lack of time and patients' ignorance of the pharmacist's role in the medical field. The mean responses regarding pharmacists' approach to patient counseling and patients' knowledge of pharmacists' role in managing adverse drug reactions were 77.1% and 59.7%, respectively. Active participation in health awareness programs was 64.8%. The mean positive response of participants in reducing prescribing errors and recognizing drug-related problems was 9.2%. Pharmacists' age and number of years in practice were the most important factors influencing the pharmaceutical care services implementation. Conclusion: The study has shown the need to shed light on the proper implementation of pharmaceutical care while maintaining a trusting relationship with physicians.

[Interprofessional health education in the Region of the Americas from a nursing perspectiveEducação interprofissional em saúde na Região das Américas na perspectiva da enfermagem]

This study presents a reflective analysis of the implementation of interprofessional education in undergraduate nursing courses, considering as an example the curricula of undergraduate nursing careers in Brazil. Despite investments to advance interprofessional education, its practice is not institutionalized in the curricula of undergraduate courses. These findings represent a limitation for the implementation of interprofessional education in nursing courses, and the case of Brazil allows to learn lessons for the education of nursing professionals in other countries of the Region of the Americas. Recommendations are provided for training, management and intersectoral articulation of health and education services, with emphasis on primary health care and the Sustainable Development Goals, aimed at educational institutions wishing to implement interprofessional education.

Interprofessional Team-Based Learning: A Qualitative Study on the Experiences of Nursing and Physiotherapy Students

Traditional discipline-specific training has limitations in facilitating inter-professional communication and collaboration. To address this issue, two local universities in Hong Kong launched an interprofessional team-based learning program to allow the undergraduate healthcare students to form teams and experience collaborative problem-solving. This study aimed to evaluate the experiences of nursing and physiotherapy undergraduates following interprofessional learning activities. Twenty-seven 3rd-year nursing and physiotherapy undergraduates were recruited through purposive sampling. Semi-structured interviews were conducted, and written feedback was solicited until data saturation was achieved. An inductive thematic analysis was used for the data, and each theme was mutually exclusive. The findings revealed the positive experiences of the students with this interprofessional learning activity. Three main themes emerged: (1) the process of interprofessional learning; (2) profession-related outcomes of interprofessional learning; and (3) patient-related outcomes of interprofessional learning. The study indicated that interprofessional team-based learning activities enhanced learning experiences of the students through interactive learning with other healthcare students. Experiences of relationships that are trustful and complementary allow students to develop confidence in knowledge transfer and in interprofessional collaboration, as well as in providing a holistic patient-centered care. These findings substantiate the importance and value of interprofessional learning in healthcare education.

Early-learners' expectations of and experience with IPE: A multi-institutional qualitative study

BACKGROUND

Multi-institutional qualitative studies are scarce within the interprofessional education (IPE) literature; such a report would provide comprehensive evidence for the application of interprofessional instruction among earlier learners.

OBJECTIVE

This investigation explored students' expectations of and barriers to introductory IPE across four institutions.

DESIGN

Qualitative inductive content analysis was utilized to interpret students' narrative responses to assigned pre- and post-survey questions.

SETTING

Health science schools of four U.S. institutions at Institution A, Institution B, Institution C, and Institution D.

PARTICIPANTS

Twenty-two percent (n = 385) of eligible participants completed both pre- and post-surveys. Nursing student participation was greatest (n = 113, 33%), followed by occupational therapy (n = 44, 13%), and physical therapy (n = 36, 10%). All other program participation was <10%. In total, students' narrative comments from 19 degree programs were a part of the data set.

METHODS

Responses from one pre-survey question on expectations of introductory IPE and two post-survey questions on IPE benefits and barriers were studied using qualitative inductive thematic analysis.

RESULTS

Four themes emerged as IPE learning expectations and benefits: my own professional role, professional role of others, teamwork, and communication. The theme of interacting with peers surfaced as an additional IPE benefit. There were four themes noted as IPE barriers: course logistics, lack of context, course content, and social dynamics.

CONCLUSION

This multi-institutional qualitative study adds to the literature by providing empirical evidence regarding early learner perceptions of IPE experiences. Student expectations and benefits of their introductory IPE course/curriculum aligned. Perceived barriers are useful in informing future IPE implementation and research.

Use of Visual Dashboards to Enhance Pharmacy Teaching

Teaching large cohorts of pharmacy students with a team of multiple tutors in a feedback intensive course poses challenges in relation the amount of data generated, data integrity, interpretation of the data and importantly application of the insights gained from the data. The dispensing and counselling course in the third year BPharm at the University of Sydney has implemented the USyd Pharmacy Dashboard, developed to address these challenges following the Technological Pedagogical Content Knowledge Framework (TPACK) to integrate technology into teaching. The dashboard was designed to improve the student experience through more consistent feedback, gain insights to improve teaching delivery and provide efficiencies in maintaining data integrity. The tool has been developed using an action-based research approach whereby ideas are put into practice as the means to further develop the idea and improve practice. Refinement of the USyd Pharmacy Dashboard over three years has shown improvements in teaching delivery as teachers can respond to emerging trends. Student performance and satisfaction scores have increased, mainly due to improved consistency between tutors and improved delivery of feedback. Time involved with administrative tasks such as data maintenance is reduced. Opportunities for further refinements such as real time benchmarking and developing an open learner model have become apparent.