Creating interprofessional clinical learning units: developing an acute-care model

A review of interprofessional training wards: Enhancing student learning and patient outcomes

Background: In an interprofessional training ward (ITW), students from different health professions collaboratively perform patient care with the goal of improving patient care. In the past two decades, ITWs have been established world-wide and studies have investigated their benefits. We aimed to compare ITWs with respect to their logistics, interprofessional learning outcomes and patient outcomes. Methods: We explored PubMed, CINAHL, Web of Science and EMBASE (1990-June 2017) and included articles focusing on interprofessional, in-patient training wards with student teams of medical and other health professions students. Two independent reviewers screened studies for eligibility and extracted data. Results: Thirty-seven articles from twelve different institutions with ITWs were included. ITWs world-wide are organized similarly with groups of 2-12 students (i.e. medical, nursing, physiotherapy, occupational therapy, and pharmacy) being involved in patient care, usually for a period of two weeks. However, the type of clinical ward and the way supervisors are trained differ. Conclusions: ITWs show promising results in short-term student learning outcomes and patient satisfaction rates. Future ITW studies should measure students' long-term interprofessional competencies using standardized tools. Furthermore, a research focus on the impact of ITWs on patient satisfaction and relevant patient care outcomes is important.

The contribution of theory to the design, delivery, and evaluation of interprofessional curricula: BEME Guide No. 49

BACKGROUND

Interprofessional curricula have often lacked explicit reference to theory despite calls for a more theoretically informed field that illuminates curricular assumptions and justifies curricular practices.

AIM

To review the contributions of theory to the design, delivery, and evaluation of interprofessional curricula.

METHODS

Four databases were searched (1988-2015). Studies demonstrating explicit and a high-quality contribution of theory to the design, delivery or evaluation of interprofessional curricula were included. Data were extracted against a comprehensive framework of curricular activities and a narrative synthesis undertaken.

RESULTS

Ninety-one studies met the inclusion criteria. The majority of studies (86%) originated from the UK, USA, and Canada. Theories most commonly underpinned "learning activities" (47%) and "evaluation" (54%). Theories of reflective learning, identity formation, and contact hypothesis dominated the field though there are many examples of innovative theoretical contributions.

CONCLUSIONS

Theories contribute considerably to the interprofessional field, though many curricular elements remain under-theorized. The literature offers no "gold standard" theory for interprofessional curricula; rather theoretical selection is contingent upon the curricular component to which theory is to be applied. Theories contributed to interprofessional curricula by explaining, predicting, organizing or illuminating social processes embedded in interprofessional curricular assumptions. This review provides guidance how theory might be robustly and appropriately deployed in the design, delivery, and evaluation of interprofessional curricula.

The clinical learning environment in nursing education: a concept analysis

AIM

The aim of this study was to report an analysis of the clinical learning environment concept.

BACKGROUND

Nursing students are evaluated in clinical learning environments where skills and knowledge are applied to patient care. These environments affect achievement of learning outcomes, and have an impact on preparation for practice and student satisfaction with the nursing profession. Providing clarity of this concept for nursing education will assist in identifying antecedents, attributes and consequences affecting student transition to practice.

DESIGN

The clinical learning environment was investigated using Walker and Avant's concept analysis method.

DATA SOURCES

A literature search was conducted using WorldCat, MEDLINE and CINAHL databases using the keywords clinical learning environment, clinical environment and clinical education. Articles reviewed were written in English and published in peer-reviewed journals between 1995-2014.

METHODS

All data were analysed for recurring themes and terms to determine possible antecedents, attributes and consequences of this concept.

RESULTS

The clinical learning environment contains four attribute characteristics affecting student learning experiences. These include: (1) the physical space; (2) psychosocial and interaction factors; (3) the organizational culture and (4) teaching and learning components. These attributes often determine achievement of learning outcomes and student self-confidence.

CONCLUSION

With better understanding of attributes comprising the clinical learning environment, nursing education programmes and healthcare agencies can collaborate to create meaningful clinical experiences and enhance student preparation for the professional nurse role.

Student learning in interprofessional practice-based environments: what does theory say?

Student learning in interprofessional practice-based environments has garnered significant attention in the last decade, and is reflected in a corresponding increase in published literature on the topic. We review the current empirical literature with specific attention to the theoretical frameworks that have been used to illustrate how and why student learning occurs in interprofessional practice-based environments. Our findings show there are relatively few theoretical-based studies available to guide educators and researchers alike. We recommend a more considered and consistent use of theory and suggest that professional identity and socio-cultural frameworks offer promising avenues for advancing understandings of student learning and professional identity development within interprofessional practice-based environments.