Teaching and learning activities to educate nursing students for interprofessional collaboration: A scoping review

Nurse-to-Nurse Collaboration: A Scoping Review

OBJECTIVE

To map predictors and outcome of collaboration between nurses, outcomes of a good collaboration, and the tools developed to evaluate nurse-nurse collaboration.

BACKGROUND

Collaboration between nurses is an intraprofessional relationship between coworkers that is expressed through shared objectives, authority, and a decisional process. Studies on collaboration between nurses are very limited.

METHODS

A scoping review was conducted through 4 databases.

RESULTS

Eighteen studies were included. Nurses with higher levels of collaboration are more satisfied with their work and report less of an intention to leave their job. Greater collaboration among nurses resulted in a decrease of patient falling, hospital-acquired pressure ulcers, and a better care. Three tools have been developed to evaluate nurse-nurse collaboration: the Nurse-Nurse Collaboration Scale, the Nurse-Nurse Collaboration Behavior Scale, and the Nurse-Nurse Collaboration Between Sector.

CONCLUSIONS

Further studies should be conducted to fully understand the issue of collaboration between nurses and the factors connected to it.

Evaluation of a newly developed flipped-classroom course on interprofessional practice in health care for medical students

Interprofessional education is expected to promote collaborative practice and should therefore be included in health professionals' curricula. Reports on interprofessional curricular development and its evaluation are rare. We therefore undertook a comprehensive quantitative and qualitative evaluation of a new, mandatory course on interprofessional collaboration for medical students during their third year of the Bachelor of Medicine study programme. The newly developed and implemented course spans over six weeks and was designed in a hybrid, flipped-classroom format. It incorporates experience- and case-based learning as well as interactions with other health professionals. Each student completes an eLearning and a clinical workshadowing individually before attending the - due to the pandemic - virtual live lectures. To assess quality and usefulness of teaching-learning formats and course structure to learn about interprofessional collaboration and to develop interprofessional competencies and identity, a quantitative and qualitative evaluation was performed with more than 280 medical students and 26 nurse educators from teaching hospitals using online surveys (open & closed-ended format). Data were analyzed descriptively and using content analysis processes. Students appreciated the flipped-classroom concept, the real-world case-based learning scenarios with interprofessional lecturer teams, and the possibility of an experience-based learning opportunity in the clinical setting including interaction with students and professionals from other health professions. Interprofessional identity did not change during the course. Evaluation data showed that the course is a promising approach for teaching-learning interprofessional competencies to medical students. The evaluation revealed three factors that determined the success of this course, namely, a flipped-classroom concept, the individual workshadowing of medical students with another health professional, mainly nurses, and live sessions with interprofessional teaching-learning teams. The course structure and teaching-learning methods showed potential and could serve as a template for interprofessional course development in other institutions and on other course topics.

Australian statewide virtual care competency-based education framework for the healthcare workforce: a Delphi study

This study aimed to establish shared interprofessional competencies across health professions that promote education, communication, and teamwork, preparing the virtual care workforce to work collaboratively with the patient and their carers, family members, and communities to improve health outcomes. A modified, two-round Delphi process was undertaken with an interprofessional panel selected from the public health sector workforce across one Australian state. Sixty-nine panelists participated in Round 1 and 40 panelists participated in Round 2. Fifty-eight competencies across seven domains were established to support an interprofessional approach to virtual care provision: compliance, professional practice, patient safety, communication, interprofessional collaboration, patient assessment and care planning/delivery/coordination. This virtual care education framework may assist different health disciplines to develop, revise or map new or existing undergraduate or postgraduate education programs or design professional development activities. Drawing upon the expertise of a broad range of health professionals in its development, this education framework focuses on improving interprofessional collaboration in virtual care settings.

Patient safety interprofessional education program using medical error scenarios for undergraduate nursing and medical students in Korea

Interprofessional education (IPE) for patient safety is becoming increasingly important worldwide. However, Korea lacks a systematic approach toward patient safety, despite the high demand for teamwork and patient communication education. This study aims to determine the effectiveness of a patient safety IPE program using medical error scenarios. The program was developed to enhance patient safety motivation and interprofessional learning attitudes among medical and nursing students, and evaluate the design of the program and students' satisfaction levels. The program comprises two modules, each consisting of lectures, team-based case analysis, role-play, and high-fidelity simulation activities. This study followed a quasi-experimental pre-post test design to determine program outcomes. An online survey for the Readiness for Interprofessional Learning Scale (RIPLS), patient safety motivation, program design evaluation, and program satisfaction was conducted before and after the program. Data were analyzed using descriptive statistics, paired sample t-tests, and Pearson's correlation. The pre-post RIPLS and patient safety results were significant (t = -5.21, p < .001;t = -3.20, p = .002). The results of the medical scenario examination of the patient safety IPE program showed improved motivation for patient safety among students, and contributed to the improvement of IPE learning attitudes by improving team work and collaboration.

Nursing students' attitudes towards sexuality before training in sexual and reproductive health

AIM

To know the attitudes towards sexuality of nursing students and those sociodemographic and cultural factors that can influence it.

DESIGN

An observational study was carried out on Nursing degree students. One hundred and eighteen nursing degree students who were going to take the sexual and reproductive health nursing course.

METHODS

A self-administered online questionnaire. This questionnaire had several parts specifically designed to collect sociodemographic variables. In order to determine the attitudes towards sexuality, the questionnaire based on the ATSS (Attitudes Towards Sexuality Scale). The Double Standard Scale (DSS) was also used. This scale evaluates double standards within the area of sexuality. The Rape Supportive Attitude Scale (RSAS), was included to determine beliefs about rape, rapists and their victims.

RESULTS

The ATSS shows a statistically significant association with religious beliefs (p = 0.005), with mean scores of 113.84 (SD = 9.81) for non-believers (no religion), 108.36 (SD = 15.68) for non-practicing believers and 102.32 (SD = 17.87) for believers (those who practice their faith). The mean score in the DSS shows a statistically significant association with alcohol consumption (p = 0.001). The mean score on the RSAS is statistically significantly associated with the place of residence (p = 0.050), the means were 44.32 (SD = 9.26) for those who lived in the city, 34.94 (SD = 19.21) if the place of residence was between 10,000 and 5000 inhabitants and 32.54 (SD = 15.01) if the family home was in a town with less than 5000 inhabitants.

CONCLUSION

Religious beliefs reduce liberalism and positive attitudes towards sexuality, whereas sporadic alcohol consumption increases them.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

A Cross-Sectional Study on Attitude and Barriers to Interprofessional Collaboration in Hospitals Among Health Care Professionals

The need for an effective health personnel team is important due to the increasing complexity of patient care and increasing co-morbidities. Interprofessional collaboration (IPC) among healthcare professionals offers appropriate collaborative management for humans. This study aimed to assess the attitude and barriers to IPC in hospitals among healthcare professionals in Lahore, Pakistan. A cross-sectional study was conducted using a convenience sampling technique. Healthcare professionals (speech-language pathologists, audiologists, physiotherapists, occupational therapists, psychologists, psychiatrists, neurologists, ENT specialists, pediatricians, dentists, and nursing staff) working at Children Hospital, Shaikh Zayed Hospital, Pakistan Society for the Rehabilitation of the Disabled (PSRD), Lahore, Pakistan were included. The paper and online survey questionnaire composed in the google form and attitudes toward healthcare teams scale (ATHCT) and barriers scale toward interprofessional collaboration were used. Statistical package for the social sciences (SPSS) version 21 was used to analyze the survey data through frequency analyses and percentage distributions. Most of the respondents (response rate = 88.1%) had positive attitudes toward IPC and strongly agreed on 9 positive statements in ATHCT. Statistically, Major barriers were role and leadership ambiguity 68.6%, different goals of individual team members 68.1%, and 53.3% strongly agreed on the difference in levels of authority, power, expertise, and income. Although healthcare professionals have an optimistic attitude toward IPC, several healthcare professionals come across challenges during the practice of IPC. To overcome the analyzed barriers, the higher healthcare authorities must encourage interprofessional collaborative strategies and models.

Using an interprofessional competency framework to enhance collaborative pediatric nursing education and practice

Background

Interprofessional education (IPE) provides healthcare students with the knowledge and skills necessary to provide safe and effective collaborative care in a variety of clinical settings. Inclusion of IPE in nursing curricula is required for program accreditation in Canada; a variety of learning strategies at varied levels are used to meet this requirement. As this formal requirement only occurred over the last decade, development, facilitation, and evaluation of IPE interventions are ongoing.

Purpose

The purpose of this study was to examine if exposure to an introductory IPE activity influenced third-year undergraduate nursing students’ perceived ability to practice competent interprofessional collaboration (IPC).

Methods

The introductory IPE activity included ten-hours of interactive lectures and related case studies, grounded in the National Interprofessional Competency Framework, delivered by various healthcare professionals in a third-year nursing theory and clinical course. Following completion of the courses, quantitative data were collected via the Interprofessional Collaborative Competencies Attainment Survey (ICCAS) which was used to evaluate nursing students’ change in competencies for IPC. Frequencies, percentages, and means were used to analyze the demographic data, the Cronbach’s alpha coefficient was used to evaluate the internal reliability of the ICCAS, and paired t-tests were conducted to measure the difference from pre- to post-participation for all 20 items and 6 subscales of the ICCAS.

Results

Study participants (n = 111) completed the ICCAS at the end of the courses to measure change in six competencies. The survey results indicated improvements in all competencies following the IPE activity.

Conclusions

The significant findings demonstrate that exposure to introductory IPE activities, involving nursing students and other healthcare professionals, hold promise for enhancing IPC in pediatric clinical settings. These findings can be used to inform the development of formal IPE interventions.

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.

[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.

Envisioning Nursing Education for a Post-COVID-19 World: Qualitative Findings From the Frontline

BACKGROUND

This study sought to qualitatively describe the implications of coronavirus disease 2019 (COVID-19) on nursing education and provide recommendations for curricular changes expressed by frontline nurses practicing during the first wave of the pandemic.

METHOD

Nurses throughout the United States (N = 100) completed the study protocol. The study sample was diverse and included White (37%), Black (20%), Latinx (20%), Asian (14%), multiracial (7%), and Native American (2%) participants; the sample also included transgender and nonbinary nurses (2%). Thematic network analysis was used to determine the implications of COVID-19 for nursing education.

RESULTS

Findings included four distinct themes: teamwork and communication, flexibility and critical thinking, leadership and using your voice, and advocacy and policy.

CONCLUSION

Shifting nursing education curriculum to focus on these key attributes will help better prepare new nurses to be adaptable in practice settings, thereby improving nursing care, clinical outcomes, and the well-being of the communities that nurses serve. [J Nurs Educ. 2021;60(12):668-673.].

Nursing and medical students' experiences of interprofessional education during clinical training in psychiatry

The aim of the study was to describe nursing and medical students' experiences of participation in an interprofessional education (IPE) activity, "round school," during their clinical rotations in psychiatric care. Data were collected in six focus groups with 32 students from nursing and medical programs, focusing on their experiences of the IPE activity and their reflections on interprofessional collaboration. The students considered the round school to be meaningful and true-to-life. Important conditions for learning were well-informed staff, sufficient time for preparation and feedback, clear routines, instructions, and an open climate. Non-explicit instructions and limited preunderstanding of psychiatric care left the students feeling uncertain. Students' reflections regarding interprofessional competences encompassed both similarities and differences in roles, responsibilities, and collaboration. Evidence of hierarchical and stereotypical images of the nurse-physician relationship was identified. Round school is an example of how IPE can be integrated into the units' regular ward rounds. However, if the clinical everyday work is not based on collaboration between different professions, it can be arduous to implement IPE. Well-planned preparations are necessary, both in the clinic and at the faculty.

Improving Health Professions Students' Understanding of Interprofessional Roles Through Participation in a Patient Stabilization Simulation

Objective. To teach interprofessional communication and teamwork skills to health professions students through a standardized patient simulation on acute patient stabilization and measure the impact on learners' perceptions of interprofessional collaboration.Methods. Medical and pharmacy students in their final year and post-licensure nurses in their initial six-month probationary period worked together to stabilize a simulated acutely ill standardized patient. Perceptions of IPE were assessed pre- and post-simulation using the Student Perceptions of Interprofessional Clinical Education-Revised Instrument, version 2 (SPICE-R2). Medical student participants' scores were compared to those of a concurrently enrolled cohort of medical students who did not participate in the simulation.Results. Eighty learners participated in the simulation and all completed pre and post SPICE-R2 assessments. Learners' perceptions increased significantly in all domains, including understanding of roles in collaborative practice, interprofessional teamwork and team-based practice, and patient outcomes from collaborative practice. Compared to the control cohort, participants' perceptions of team-based practice and the impact on patient outcomes improved significantly, while a statistically similar improvement in scores for understanding of roles and responsibilities was seen. The SPICE-R2 scores increased similarly among students in each profession. Repeat exposure to the simulation continued to improve perceptions but not as robustly as the initial simulation.Conclusion. This simulation changed learners' perceptions of how interprofessional collaboration affects patient care, which supports the incorporation of standardized patient-based interprofessional education even in the late-stage education of health professionals.

Measuring the effect of simulation experience on perceived self-efficacy for interprofessional collaboration among undergraduate nursing and social work students

Barriers to effective interprofessional collaboration may include insufficient knowledge of other professional roles and inexperience using effective communication skills. Improving self-efficacy for interprofessional collaboration may enhance the ability to practice expertly within the interprofessional environment of healthcare. This article examines the results of a multiple methods pretest/posttest study that used the Self-Efficacy for Interprofessional Experiential Learning (SEIEL) scale to determine self-reported perceptions of self-efficacy development following participation in a trauma simulation. Participants included 74 undergraduate nursing students and nine undergraduate social work students. Findings included a significant increase in perceived self-efficacy from pretest to posttest for both groups. Nursing majors and participants who reported previous interaction with a member of another profession scored significantly higher on the posttest. Qualitative data were analyzed through thematic content analysis which produced three themes: an improved understanding of the importance of communication and the interconnection of interprofessional roles; a realistic simulation which challenged the students; and an increased appreciation for teamwork. These findings suggest that challenging simulations with pre-licensure students can increase undergraduate students' perceived self-efficacy for interprofessional collaboration and contribute to an improved understanding of interprofessional team roles and communication.

"Tutor and student dyadic interactions in relation to Interprofessional education and clinical care: A constructivist grounded theory study"

AIM

The aim of this study was to explore and understand the interprofessional collaboration preparation processes implemented by clinical tutors and students, in various professions, involved in interprofessional education experiences.

DESIGN

A constructivist grounded theory approach. The study was carried out between 2015-#2017.

METHOD

Semi-structured interviews were conducted with a total of ten undergraduate students and the seven clinical tutors who supervised them from three undergraduate courses in a university of applied sciences and arts in Switzerland. Students were sampled during their clinical placement. Data were analysed and coded using constant comparative analysis with the support of Nvivo 10 software.

RESULTS

A substantive theory "Practicing contextual models of interprofessional care" was generated. It explains how the whole process takes place, the tutor-student interactions, and how together they gradually build models of interprofessional care, linked to their clinical context and to the patients/families who are part of it.

CONCLUSION

The process describes a journey to comprehensively explain the roles played by the two main actors (student and tutor) who build a relationship of interaction.

IMPACT

This theory provides an understanding of the complex process set up by students and how they are prepared for collaboration with other professionals. Its importance is mainly expressed in the educational field because it reveals a different vision from the one present so far and enables a thorough reflection from the pedagogical point of view. Teachers will be able to observe and approach the students' training curricula from a different point of view by evaluating any changes to favour it and rethink the organizational and training models of current programs.

WHIRL Study: Workplace Health Interprofessional Learning in the Construction Industry

Interprofessional learning (IPL) is essential to prepare healthcare trainees as the future public health workforce. WHIRL (Workplace Health InteRprofessional Learning) was an innovative IPL intervention that engaged volunteer healthcare trainees (n = 20) in multi-professional teams to deliver health checks (n = 464), including tailored advice and signposting, to employees in the UK construction industry (across 21 events, 16 sites, 10 organisations) as part of an ongoing research programme called Test@Work. Volunteers undertook a four-part training and support package of trainer-led education, observations of practice, self-directed learning and clinical supervision, together with peer mentoring. In a one-group post-test only design, IPL outcomes were measured using the Inventory of Reflective Vignette-Interprofessional Learning (IRV-IPL), and the psychometric properties of the IRV-IPL tool were tested. WHIRL demonstrably improved healthcare trainees' interprofessional skills in all five areas of collaboration, coordination, cooperation, communication, and commendation. The IRV-IPL tool was found to be a valid and reliable measure of interprofessional competencies across three scenarios; before and after health promotion activities, and as a predictor of future health promotion competence. This industry-based workplace IPL programme resulted in the attainment of health check competencies and bridged the gap between research, education and clinical practice.

Simulations using telehealth to collaborate with other health-care professionals: effect on pre-licensure nursing students' competencies and amount of collaboration in the clinical setting

Nursing students must gain experience collaborating with other members of the health-care team. Simulation can provide intra- and interprofessional collaboration experience; however, there can be barriers such as scheduling difficulties. We evaluated multi-patient, standardized patient simulations using telehealth as a strategy to provide baccalaureate nursing students with opportunities to learn and practice intra- and interprofessional collaboration. Forty-four final-semester nursing students participated. Student groups rotated to the simulation laboratory over 12 weeks to participate in two simulations that used telehealth to enable them to communicate patient concerns to other clinicians: a nurse practitioner, respiratory therapists, and social workers. Self-reported collaborative competencies and amount of collaboration in the clinical setting were measured at the start and end of the semester. Satisfaction and self-confidence were measured immediately after each simulation. For collaborative competencies, there was a statistically significant improvement in all item, subscale, and overall scale mean scores. Amount of clinical collaboration significantly improved, with the amount who indicated they never reported a patient concern to another professional decreasing from 39.5% to 6.8%. Findings also revealed a high level of student satisfaction and self-confidence following the simulations. Using telehealth to collaborate during simulations is a promising strategy to prepare nursing students for practice by improving collaborative competencies and encouraging more collaboration in the clinical setting.

Nursing staff's and physicians' acquisition of competences and attitudes to interprofessional education and interprofessional collaboration in pediatrics

BACKGROUND

Interprofessional education (IPE) is deemed essential for interprofessional collaboration (IPC) in healthcare systems. IPC has positive effects for both patients and healthcare professionals. Especially in pediatrics, IPC is paramount for adequate care of patients and their families though there is a lack of data on the attitudes towards IPE and IPC and acquisition of respective competences in pediatric nursing and medical staff.

METHODS

Frequencies of interactions and attitudes towards IPE and IPC, with a focus on acquisition of competences for IPE and IPC, of nurses (N = 79) and physicians (N = 70) in a large pediatric university hospital were evaluated with an online questionnaire.

RESULTS

All participants worked as part of interprofessional teams, mostly consisting of nurses and physicians. The majority (94.9% (n = 75) of nurses and 100% (n = 70) of physicians) highly valued IPC. Medical doctors acquired most competences important for IPC during day-to-day work and reported a substantial lack of IPE. Nursing staff on the other hand did report significant interprofessional education during their training as well as ongoing interprofessional learning during day-to-day work. Nurses also appreciated IPE more.

CONCLUSIONS

Even though IPC is commonly reported in nurses and physicians working at a large pediatric university hospital there is a lack of structured IPE. A focus should be on IPE for nurses and physicians to enable them to effectively collaborate together. Political and local initiatives for IPE are gaining momentum but still need to be established nationally and internationally.

Learning and Teaching Together to Advance Evidence-Based Clinical Education: A Faculty Learning Community

Clinical teaching is a cornerstone of health sciences education; it is also the most challenging aspect. The University of Pittsburgh Schools of Dental Medicine, Nursing, and Pharmacy developed a new evidence-based interprofessional course framed as a faculty learning community (FLC) around the principles of learning in a clinical environment. The aim of this study was to assess the overall effectiveness of this two-semester FLC at four health professions schools in academic year 2014-15. The assessment included anonymous participant surveys in each session and an anonymous end-of-course survey. Thirty-five faculty members from dental, health and rehabilitation sciences, nursing, and pharmacy enrolled in the FLC, with six to 32 enrollees attending each session. All attendees at each session completed the session evaluation surveys, but the attendance rate at each session ranged from 17.1% to 91.4%. Sixteen participants (46%) completed the end-of-course survey. The results showed overall positive responses to the FLC and changes in the participants' self-reported knowledge. Session surveys showed that the participants found the FLC topics helpful and appreciated the opportunity to learn from each other and the interprofessional nature of the FLC. Responses to the end-of-course survey were in alignment with the individual session surveys and cited specific benefits as being the content, teaching materials, and structured discussions. In additional feedback, participants reported interest to continue as a cohort and to extend the peer-support system beyond the FLC. This outcomes assessment of the first round of the FLC confirmed that this cohort-based faculty development in an interprofessional setting was well received by its participants. Their feedback provided valuable insights for changes to future offerings.

Interprofessional simulation in undergraduate nursing program: An integrative review

OBJECTIVES

Interprofessional (IP) competencies are critical for successful collaborative practice. Nurse education, through interprofessional simulation, plays a critical role in preparing nursing students achieve these competencies. Although considerable research has been conducted on this topic, a broader perspective is lacking. This review systematically appraised and synthesized evidence examining the effects of interprofessional simulation on nursing students' outcomes.

DESIGN

An integrative review method guided this review.

DATA SOURCES

Five databases (Cumulative Index to Nursing and Allied Health Literature, SCOPUS, PubMed, PsychINFO, and MEDLINE) were searched to locate articles published from 2010 onwards. Search and MeSH terms included: interprofessional, interdisciplinary, simulation, nurse education, nursing, and student. Thirty (30) articles were included in this review.

RESULTS

Findings of content analysis revealed five essential themes: interprofessional communication, appreciation of interprofessional team roles, interprofessional teamwork or collaboration, self-confidence or self-efficacy, and positive attitudes or readiness toward interprofessional learning.

CONCLUSIONS

This review provides a current state of knowledge on the efficacy of interprofessional simulation in enhancing interprofessional learning and competencies in nursing students. However, more research should be done utilizing a more robust method of research and reliable assessment methods. Through interprofessional simulation experiences, nurse academe can adequately prepare nursing students for future collaborative practice. Inclusions of interprofessional simulation activities in all clinical nursing courses can help prepare nursing students achieve inter-professional learning.