Student attitudes to undergraduate interprofessional education

Interprofessional education (IPE) in medical radiation science: A scoping review

INTRODUCTION

Interprofessional education (IPE) in medical radiation education is designed to enhance both student and longer-term patient outcomes. This scoping review aims to provide an overview of the available evidence and examine the effectiveness of IPE strategies used to enhance the development of medical radiation science (MRS) students.

METHODS

Medline, CINAHL, Cochrane Library and Emcare were searched for articles which employed an experimental study design to quantitatively assess the effectiveness of IPE for MRS students. Two reviewers screened and extracted relevant data independently. Critical appraisal was conducted using the JBI critical appraisal tool.

RESULTS

Eighteen studies were included in this review. Diverse approaches to IPE were discovered, particularly in terms of the method of delivery, setting and duration of interventions. MRS students interact with many professions, particularly medical doctors and nurses. All studies which employed a control arm demonstrated statistically positive findings favoring IPE intervention(s). In pre-post studies, most IPE interventions reported significant positive differences after IPE was implemented. This entailed an enhanced perceived knowledge and understanding of other professions, and ability to undertake their role in the team.

CONCLUSION

IPE was shown to be effective in enhancing students' perceptions and attitudes and to a limited extent, improve knowledge acquisition. Future research should assess long-term effects and patient-related outcomes.

IMPLICATIONS FOR PRACTICE

IPE in a variety of formats demonstrates positive results for MRS students; however, interventions which are longer-term, conducted in small groups, and performed earlier in the educational pathway, may demonstrate greater effectiveness.

The Significance of Cooperation in Interdisciplinary Health Care Teams as Perceived by Polish Medical Students

Teamwork, as the preferred method of cooperation in healthcare, became prevalent in the 1960s, and since then has been universally recognized as a measure to improve the quality of healthcare. Research indicates that medical care based on interdisciplinary cooperation is associated with increased patient safety, lower hospitalization rates, and reduced rates of complications and medical errors. Furthermore, it enhances the coordination of care and improves patient access to medical services. This model of providing medical care also results in considerable benefits for medical professionals. These include greater job satisfaction and a reduced risk of professional burnout syndrome.

AIM

The aim of the study was to explore the opinions of medical students with regard to cooperation in the interdisciplinary team, as well as the factors affecting the formation of opinions.

MATERIAL AND METHODS

The study was conducted using the Polish version of the questionnaire Attitudes Towards Interprofessional Health Care Teams. The study involved 1266 participants, including students of medicine (n = 308), midwifery (n = 348), nursing (n = 316) and physiotherapy (n = 294).

RESULTS

According to the opinions of the students participating in the study, the therapeutic process based on the interdisciplinary model improves the quality of medical care provided, increases patient safety, and improves communication between members of the therapeutic team. The factors affecting the assessment of cooperation in interdisciplinary medical care teams included the faculty and the year of studies, gender, as well as participation in the multidisciplinary courses.

CONCLUSIONS

Students recognize the need for interdisciplinary medical teams. The training of future medical professionals should incorporate the elements of interprofessional education. This form of education allows students to develop both a professional identity and identification with their own profession, as well as encourages teamwork skills and shapes the attitude of openness towards representatives of other medical professions. However, in order to provide the students with the relevant knowledge, skills and competencies, it is essential to respect their diversity in terms of the faculty, as well as to account for the impact of gender and the year of studies which may affect their readiness to engage in teamwork.

Exploring possibilities of harmonising social justice with medical education through the use of CanMeds and AfriMeds when engaging in discipline integration

Medical curricula are largely content heavy and grossly overloaded but focus primarily on medical and biomedical sciences. It has been argued by authors such as Gukas and Filies that well-balanced professionals are seldom produced by such content heavy curricula. The incorporation of social justice principles in medical curricula is vital in promoting the production of well-balanced and competent healthcare professionals, as called for in the CanMeds/AfriMeds frameworks. However, the World Federation for Medical Education issued a consensus statement asserting that medical students in the USA and Canada receive little to no formal training and teachings as far as social justice is concerned. In this paper it is asserted that medical students in South Africa are no exception to such consensus.  It is further asserted in this paper that if one begins to examine principles of CanMeds/AfriMeds, entry points for the insertion of social justice principles becomes a possibility without having to further overload an overloaded curriculum. In essence, adopting and promoting roles of CanMeds/AfriMeds such as professional, collaborator and scholar enhance a non-hierarchical style and environment of teaching medical students. This new style and environment of learning are shown in this paper to enable an insertion of social justice principles in a medical curriculum in instances where such insertion may otherwise have been impossible.

Impact of interprofessional education on the teaching and learning of higher education students: A systematic review

AIM

This systematic review was to explore the potentialities and limitations of Interprofessional Education (IPE), from the perspective of undergraduate students.

BACKGROUND

The increasing complexity in health increasingly demand professionals with the capacity to act in the face of new global challenges. Thus, this pedagogical approach presents itself as one of the most promising choices in facing these new obstacles.

DESIGN

A synthesis of quantitative studies and mixed methods.

METHODS

Studies involving quantitative analyzes were included, with no restriction on the date of publication and language. The search strategy was carried out in the electronic databases: PubMed, Latin American and Caribbean Literature in Health Sciences (LILACS), Cochrane Library and Scientific Electronic Library Online (SciELO). In addition, searches were carried out in gray literature on the ERIC platforms (ProQuest), ProQuest Disserts and Theses Full text and Academic Google. The assessment of the quality of the studies was carried out using the instrument by Downs and Black. The risks of bias in the studies were examined with the aid of the adapted version of the Cochrane Collaboration tool, with the domains of the Downs and Black instrument.

RESULTS

After standardized filter procedures, critical summaries and assessment of relevance to the eligibility criteria, 11 articles were included. The results showed that most students have a positive perception of IPE, with different factors influencing this research finding. The need to develop more robust assessment instruments is highlighted, in view of the insufficiency of tools with sufficient methodological rigor to measure real changes in attitudes among different groups of students.

CONCLUSION

More consistent research is needed, which assesses, in a longitudinal way, the effects that the IPE has on the teaching and learning of undergraduate students and its impact after professional training.

Student readiness for interprofessional learning at a local university in South Africa

Working effectively with other disciplines has become an important competency as a graduate attribute in higher education institutions. Educational experiences should begin to foster the prerequisite competencies needed to collaborate successfully with other healthcare professionals. The purpose of this study was to determine how ready first year students are for interprofessional learning, and whether this readiness improves along the continuum of learning into their final year of undergraduate studies. First year undergraduate students from ten disciplines completed the Readiness for Interprofessional Learning Scale prior to participating in a compulsory interprofessional module, and the results were compared with that of senior students who completed the same questionnaire. Results for the study show that there were significant differences between first and senior-year level students on the subscales of negative professional identity (0.02 < 0.05); positive professional identity (0.00 < 0.05); and teamwork and collaboration (0.00 < 0.05). There was no significant difference found on the subscale roles and responsibilities (0.54 > 0.05). The results clearly show that senior students are more ready for learning interprofessionally compared to first year students. It is recommended that a scaffolded approach to learning be adopted, to ensure that students attain competence in all Interprofessional Education (IPE) core competencies when reaching their final year of study. This type of curriculum, with its specific activities and assessment methods, should be packaged in the form of an IPE model to create a clear understanding of the type of health profession graduate that will be produced.

Assessment of teamwork in interprofessional education

The aim of this study was to offer new insight into assessments of interprofessional education (IPE) by evaluating the association between students' self-assessment for teamwork and expert assessment of simulation and team-based writing examination. We also evaluated the relationship between students' demographic factors and their teamwork skill. A total 112 of medical and pharmacology students were divided into 36 interprofessional groups and participated interprofessional patient safety session. During the session, all students answered self-assessment for teamwork (SAT) individually. Teamwork skill of the student groups were rated by simulation assessment (SA) and team-based writing examination (WX). As a result, there was a weak correlation between the score of SAT and SA and no correlation between the score of SAT and WX. Also, as a demographic analysis, medical students assessed their teamwork higher than pharmacology students, and male students assessed their teamwork higher than female students. The duration of club activities including sports and arts correlated negatively with the score of WX. From this result, student's high self-assessment for teamwork could be an indication of good team performance in simulation assessment, but not in team-based writing examination.

Stereotypes of experienced health professionals in an interprofessional context: results from a cross-sectional survey in Germany

Interprofessional teamwork often suffers from the existence of negative stereotypes. To combat their prevalence, interprofessional education (IPE) activities are being implemented worldwide. The aim of this study is to inform IPE developers of the prevalence and content of interprofessional stereotypes in the workplace in Germany and similarly structured healthcare systems. We surveyed health professionals with several years of work experience as nurse, midwife, or therapist concerning their attitudes toward their own professions and those of doctors using an established trait rating measure and a qualitative approach. Stereotypes of respondents (N = 129) were mostly related to (1) academic, medical competence (being perceived as lower than that of doctors) and (2) the traditional role relationship (strict hierarchy, dependence on doctors) that guides a lot of behavior, such as the little participation of nurses, midwives and therapists. Despite profound structural differences in the education and healthcare systems, our analyses further revealed similar topics for further IPE activities as in international research, such as the general demand to convey knowledge about the roles, skills and responsibilities of the other professions. The demand to improve the teamwork skills of all health professionals and empower them to be full and equal members of the healthcare team was also evident. Thus, a more reflective approach to stereotypes and their impact on interprofessional teamwork is indicated, particularly in workplace-based interprofessional learning activities. More generally, to counteract stereotypes a more widespread adoption of IPE in pre and post licensure health professions education and continuing professional development in Germany is needed.

Development of a questionnaire to assess student behavioral confidence to undertake interprofessional education activities

Measurement of the impact of interprofessional education (IPE) is the golden chalice educationalists chase. We undertook the development of a scale to measure IPE Academic Behavioral Confidence (IPE-ABC) in allied health, nursing, and social work pre-registration students. This work formed part of the evaluation of a large IPE framework embedded across two Scottish universities. General ABC has been shown to influence student perceptions of study experiences and it is thus reasonable to postulate that ABC could influence student perceptions of IPE. This research developed a questionnaire to ascertain health and social care students' confidence to engage in IPE, utilizing a mixed method approach. Fifteen different professional groups of pre-registration students (n = 565) participated in the assessment of the 38 item questionnaire. Exploratory factor analysis identified three factors: 1/interprofessional teamwork, 2/behaviors underpinning collaboration, and 3/interprofessional communication collectively accounting for 38.2% of the variance. Internal consistency of the overall scale (Cronbach's α = .93) was very good with subscales demonstrating very good internal consistency, 1 (α = .89), or respectable consistency 2 (α = .78) and 3 (α = .79). We conclude the IPE-ABC questionnaire could be utilized to enhance and assess the success of IPE related activities.

An exploratory, cross-sectional and multi-institutional study using three instruments to examine student perceptions of interprofessional education

Interprofessional education (IPE) research needs to expand beyond single site, single event inquiry. Multi-institutional studies increase methodologic rigor and generalizability, advancing the pedagogical science of IPE. Four U.S. institutions used three different validated measures to examine early learner interprofessional outcomes. The three assessment tools included the Communication and Teamwork subscale of the University of West England Entry Level Interprofessional Questionnaire (UWE-ELIQ), the Self-Assessed Collaboration Skills (SACS), and the Interprofessional Teamwork and Team-based Practice factor of the Student Perceptions of Interprofessional Clinical Education-Revised, version 2 (SPICE-R2). Across the four institutions, 659 eligible participants, representing 19 programs completed the pre-survey, and 385 completed the post-survey. The UWE-ELIQ showed a statistically significant difference between the pre- and post-survey overall, but the effect size was small. One institution demonstrated a positive change in scores on the UWE-ELIQ with a small effect size, while the other institutions saw no significant change. Two institutions observed lower post-survey scores on the SPICE-R2. Cumulative results from the study indicated no statistically significant change from pre- to post- in total SACS or SPICE-R2 scores. Additional multi-site longitudinal research is needed to investigate use of validated instruments, as well as the impact of curricula and learning environment on educational outcomes.

Auto- and hetero-stereotypes in radiography students: perspectives and comparisons

Introduction:

How groups view themselves and each other is very important in order to promote effective work practices. These views can be tribal in nature and lead to stereotyping which may affect how we communicate and act with other groups. This study primarily aims to identify how student radiographers view their own and other radiographic profession.

Method:

A survey was undertaken using the Student Stereotypes Rating Questionnaire with all radiographic training sites in England. The questionnaire was given to radiography students training as either diagnostic radiographers or therapeutic radiographers. It asked students to rate four professions: doctors, diagnostic radiographers, therapeutic radiographers and nurses on nine characteristics.

Results:

The online survey was open between February and July 2019 and elicited 233 responses. Overall, the radiography students’ perceptions of their own profession and the other non-radiography professions were generally positive; however, each radiographic profession’s view on the other radiographic professions was less favourable, the scores being significantly lower than for other professions. The professions each identified unique attributes (interpersonal skills, being a team player and independent working) that separated the professions from each other. Differences and similarities in stereotypes appeared not to change with time, although gender differences for certain attributes did exist.

Conclusion:

Students appear to have preconceived positive stereotype of their own profession and a more negative stereotype of the other radiography profession that appears relatively stable during their training period and was unaffected by interprofessional education.

To IPAS or not to IPAS? Examining the construct validity of the Interprofessional Attitudes Scale in Hong Kong

Students' attitudes toward interprofessional teamwork can be linked to successful interprofessional education. This points to the importance of identifying a scale that may be useful in keeping track of the change in students' attitudes over time. In response to this, using a combination of within- and between-network approaches to construct validity, we examined the psychometric acceptability of the Interprofessional Attitude Scale (IPAS) involving 274 Chinese healthcare and social care pre-licensure students in Hong Kong. Overall results indicated that IPAS had good internal consistency. Results of the confirmatory factor analysis provided support to the overall five-factor solution although one negatively worded item obtained non-significant factor loading. Results of the between-network analysis suggest that various subscales of IPAS correlated systematically with other theoretically relevant variables: teamwork attitudes, communication, and team effectiveness. The IPAS is a valid measure to examine predominantly Chinese healthcare and social care students' interprofessional attitudes in online interprofessional education.

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.

Home visits as an interprofessional learning activity for students in primary healthcare

Aim:

To evaluate person-centred home visits as an interprofessional learning (IPL) activity for undergraduate students during clinical placements in primary healthcare.

Background:

Interprofessional collaboration is known to improve patient safety, increase job satisfaction, and reduce stress among healthcare professionals. Students should already during their basic training experience interprofessional collaboration.

Methods:

Students from six different educational programmes and supervisors and adjunct clinical lecturers from different professions participated in the learning activity. The students read a description of the patient history before the visit together with a supervisor. During the home visit, the students were responsible for history-taking and for performing relevant examinations. Afterwards, the students made a joint care plan for the patient. Students, supervisors, and adjunct clinical lecturers discussed the outcomes in a seminar and reflected on each other’s professional roles. The students and the patients answered a questionnaire about the activity, and the supervisors and the adjunct clinical lecturers were interviewed in focus groups.

Findings:

Thirty interprofessional home visits were conducted, involving 109 students from six different healthcare professions. The students reported that they had gained insights into how different professions could collaborate and an increased understanding of teamwork. All patients were satisfied with the visits and felt that they had been listened to. The interview analysis showed one overarching theme: ‘Interprofessional home visits in primary healthcare were an appreciated and effective pedagogical learning activity with a sustainability dependent on organisational factors’.

Conclusions:

The students felt that participation in the activity increased their understanding of collaboration and of other professions’ skills. The supervisors found the home visits to be an appreciated and effective learning activity. The results indicate that this learning activity can be used in primary healthcare settings to promote students’ IPL, but organisational factors need to be considered in order to support sustainability.

The linkage between medical student readiness for interprofessional learning and interest in community medicine

OBJECTIVES

The purpose of this study is to investigate the relationship between medical student readiness for interprofessional learning and interest in community medicine prior to incorporating community-oriented interprofessional education into the curriculum.

METHODS

A questionnaire was administered to students at Nagasaki University School of Medicine in Japan during each of three consecutive years (N=2244). The Readiness for Interprofessional Learning Scale (RIPLS) was administered in addition to a questionnaire to evaluate interest in community medicine. The Kruskal-Wallis and Steel-Dwass tests were used to determine differences between school years. Correlation between the RIPLS score and interest in community medicine was evaluated with Spearman's rank correlation coefficient. Relationships between RIPLS score and demographic parameters, and interest in community medicine were evaluated with multiple linear regression analysis.

RESULTS

Eighty-four percent (1891/2244) of students responded. The RIPLS score was highest in school year 1, followed by year 6, year 5, year 3, and years 4 and 2. Interest in community medicine correlated with the RIPLS score (rs = 0.332, p < 0.001), but less in year 1 (rs = 0.125, p = 0.002) than in other years. RIPLS score was significantly associated with gender, age, school year, interest in community medicine, but not the year that the survey was conducted.

CONCLUSIONS

Community-oriented interprofessional education has the potential to improve attitudes towards interprofessional learning. When introducing this promising education into the curriculum from year 1, attracting students' interest in community medicine should be considered.

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.

Improving stereotypes: The impact of interprofessional education in pre-health students

Research within interprofessional education (IPE) indicates health professional students hold stereotypes of other health professions at all stages within their academic journey. IPE can minimize negative stereotypes and influence a student's willingness and readiness to collaborate with others. This article explores undergraduate pre-health student stereotypes of various health professionals at the beginning and end of a six-week summer academic enrichment program, which included IPE. Convenience sampling was used to request participation in a survey, which included the Student Stereotypes Ratings Questionnaire (SSRQ). The SSRQ asks students to rate their perception of health professions on multiple traits. One hundred pre-health students across three institutions completed the SSRQ. The mean scores across all professions and all traits increased post-survey. Lowest pre-mean scores were for nursing (the ability to work independently and the ability to lead a team) and registered dietitian (the ability to lead a team). The highest pre-mean score was for the physician profession for academic ability. Results from this study indicate varying levels of stereotypes have already developed in pre-health students. After the six-week program, pre-health students' perceptions of health professions were positively affected. Data from this study indicates there are benefits to exposing pre-health students to IPE.

The Effect of High-Fidelity, Interprofessional Simulation on Teamwork Skills and Attitudes Toward Interprofessional Education

ABSTRACT

High-fidelity simulation is increasingly popular in interprofessional education (IPE). This study aimed to determine the effectiveness of high-fidelity simulation in teaching IPE content to prelicensure trainees. A quasi-experimental study took place at a simulation center in Southern California. It assessed medical and nursing students' teamwork skills and attitudes toward IPE before and after high-fidelity simulation. Multivariate analysis of variance results revealed a decline in positive attitudes toward IPE postintervention in both medical and nursing students. No changes in teamwork skills and no differences between nursing and medical trainees were found. The implications of the study's findings are discussed.

Professionalism dilemmas experienced by health professions students: a cross-sectional study

Health professions students will invariably confront professionalism dilemmas. These early encounters significantly influence future professional attitudes and behaviours. Heretofore, studies concerning professionalism dilemmas experienced by health professions students across disciplines have been limited. To address this issue, we recruited 56 students with clinical experience from the National Taiwan University College of Medicine in the nursing, dentistry, pharmacy, medical technology, occupational therapy, and physiotherapy programs to participate in this research to compare health professions students' understandings of professionalism and their experiences of professionalism dilemmas. We used group interviews to uncover students' experiences of professionalism dilemmas. We identified the six most commonly reported professionalism dilemmas and found that interprofessional dilemmas were the dominant workplace professionalism dilemma for health professions students. We also identified significant disciplinary differences regarding dilemma types and frequencies. We employed the framework of dual identity development to better understand the role of professional and interprofessional identities in interprofessional dilemmas. The professionalism dilemmas that individual students encountered were shaped by disciplinary differences. Our findings suggest that the development of a sense of belonging to both their own profession and a broader interprofessional care team in health professions students can increase the effectiveness of interprofessional healthcare teams.

Transforming Preprofessional Health Education Through Relationship-Centered Care and Narrative Medicine

ISSUE

The Institute of Medicine identified health care education reform as a key to improving the error prone, costly, and unsatisfying U.S. health care system. It called for health care education that no longer focuses exclusively on the mastery of technical skills but teaches students the human dimensions of care and develops their ability to collaborate with patients and colleagues to alleviate suffering and improve health. When should this educational reform begin, by what frameworks should it be guided, and which methods should it employ are important questions to explore.

EVIDENCE

There is increasing evidence that practitioners' relational skills, such as empathy and reflection, improve patients' health outcomes. Efforts to shift education toward patient-centered care in interprofessional teams have been made at the professional level, most notably in medical schools. However, reform must begin at the preprofessional level, to start cultivation of the habits that support humane care as early as possible and protect against empathic decline and the development of counterproductive attitudes to collaboration. The conceptual basis for reform is offered by relationship-centered care (RCC), a framework that goes beyond patient-centered care and interprofessional teamwork to focus on the reciprocal human interactions at the micro, mezzo, and macro levels of care. RCC identifies practitioners' relationships with patients, colleagues, community, and self as the critical interpersonal dimensions of healthcare and describes a foundation of values, knowledge, and skills required for teaching each dimension. The teaching of these foundations can be facilitated with techniques from narrative medicine, a compatible care model that conceptualizes health care as a context in which humans exchange stories and thus require narrative competence.

IMPLICATIONS

We suggest beginning the educational reform at the preprofessional level with the implementation of a formal curriculum based on the 4 RCC dimensions with students expected to gain beginner levels of competency on these dimensions in addition to evidence-based principles of health sciences. This requires interprofessional collaboration among health professions, social science, and liberal arts faculty and training of health professions faculty in narrative medicine. Next, we suggest engaging in incremental change in the organizational culture with professional development and team-building activities. Although we need systematic research on the efficacy of the components of the transformation, their impact on students' learning, and their costs, it is important to engage in efforts to prepare professionals who are able to respond to the complex health needs of individuals and society in the 21st century.

Evaluation of a pilot interprofessional education programme for eating disorder training in mental health services

OBJECTIVE

To evaluate the effectiveness of an Interprofessional Education (IPE) programme in eating disorders for mental health practitioners using a case-based learning approach.

METHODS

A total of 25 mental health clinicians were asked to evaluate their IPE programme as part of training for the National Clinical Programme in Eating Disorders. They completed a Readiness for Interprofessional Learning Scale (RIPLS), a learner reaction questionnaire after each session and a final open evaluation at 4 months. Non-parametric statistical analysis was employed to analyse learner attitudes and reactions, and qualitative information was coded.

RESULTS

A total of 23 (92%) clinicians from five disciplines participated. Baseline attitudes towards IPE were positive on all RIPLS subscales, and those with prior IPE experience had most positive views as to its benefits for teamwork and patient care (p=0.036). Learner reactions on content, delivery, outcome and structure indicated that individual learning experience was strongly positively endorsed. Change in clinical practice behaviour was reported in terms of communication, clinical activity, outcome evaluation and confidence. Barriers included other demands on time, organisational support, not having enough patients or co-workers to practice skills, and knowledge differentials between learners.

CONCLUSIONS

IPE using a case based learning approach is an effective and acceptable means of developing specialist training across existing service, team and professional boundaries. It has potential for positive impact on knowledge, clinical behaviour and service delivery. Recommendations include the introduction of IPE group guidelines, wider circulation of learning points and content, and the use of self-competency ratings and reflective logs.

Implementing an interprofessional information literacy course: impact on student abilities and attitudes

OBJECTIVES

The authors investigated the impact of an interprofessional, freshman-level, information literacy course on nursing, pharmacy, and allied health professions students by examining whether students successfully met learning objectives in the course related to interprofessional attitudes, identification of research study types, and ability to relate evidence-based practice questions to their disciplines.

METHODS

Student posters (n=20) completed in a team project were evaluated to determine whether students were able to accurately identify the type of evidence, population, intervention, and primary outcome of studies (n=192). Additionally, posters (n=78) were evaluated to assess whether students could identify a relevant foreground question and link it to their disciplines. Students also completed the Readiness for Interprofessional Learning Scale (RIPLS) before (n=413) and after (n=352) the course to determine whether their attitudes toward interprofessional learning changed.

RESULTS

Students performed well on learning outcomes in the course, with most teams identifying relevant evidence-based practice questions (83.8%) and effectively connecting questions with their disciplines (65.4%). Students correctly identified the type of evidence, population, intervention, and primary outcome for 70.0%, 81.8%, 76.0%, and 74.0% of cited studies, respectively. Student attitudes after the course did not significantly change.

CONCLUSION

Interprofessional information literacy education can generate positive learning experiences for freshman health care professions students to increase their beginning-level understanding of research in the health care professions and to prepare them for participation in future interprofessional courses and health care teams.

Integrating an interprofessional education initiative: Evidence from King Abdulaziz University

PURPOSE

This paper examines current issues with interprofessional education (IPE) at King Abdulaziz University (KAU) and discusses initiatives for integrating IPE into the medical curricula at KAU.

METHODS

We reviewed the current body of literature, studied reports from IPE conferences and workshops organized at KAU, and synthesized participants' feedback from the IPE programs, including an online survey.

RESULTS

A total of 506 participants responded to the online survey. Respondents rated Interprofessional Collaborative Learning as the highest category of IPE, followed by Interprofessional Self-Improvement and Interprofessional Relationship. A hybrid conceptual framework is proposed, to tackle the issue of role clarification across all healthcare colleges at KAU. This proposition was found to be necessary due to the current state of the undergraduate curriculum which does not prepare students properly for professional collaboration.

CONCLUSIONS

The hybrid model may narrow the gap in IPE by emphasizing professional identity while reducing autonomy. Recommendations toward IPE are presented. Challenges toward IPE reform are discussed in the context of implementation at KAU and at other medical schools in the region.

The Association of Readiness for Interprofessional Learning with empathy, motivation and professional identity development in medical students

BACKGROUND

The Readiness for Interprofessional Learning Scale is among the first scales developed for measurement of attitude towards interprofessional learning (IPL). However, the conceptual framework of the RIPLS still lacks clarity. We investigated the association of the RIPLS with professional identity, empathy and motivation, with the intention of relating RIPLS to other well-known concepts in healthcare education, in an attempt to clarify the concept of readiness.

METHODS

Readiness for interprofessional learning, professional identity development, empathy and motivation of students for medical school, were measured in all 6 years of the medical curriculum. The association of professional identity development, empathy and motivation with readiness was analyzed using linear regression.

RESULTS

Empathy and motivation significantly explained the variance in RIPLS subscale Teamwork & Collaboration. Gender and belonging to the first study year had a unique positive contribution in explaining the variance of the RIPLS subscales Positive and Negative Professional Identity, whereas motivation had no contribution. More compassionate care, as an affective component of empathy, seemed to diminish readiness for IPL. Professional Identity, measured as affirmation or denial of the identification with a professional group, had no contribution in the explanation of the variance in readiness.

CONCLUSIONS

The RIPLS is a suboptimal instrument, which does not clarify the 'what' and 'how' of IPL in a curriculum. This study suggests that students' readiness for IPE may benefit from a combination with the cognitive component of empathy ('Perspective taking') and elements in the curriculum that promote autonomous motivation.

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.

Comparison of the Readiness for Interprofessional Learning and the rate of contact among students from nine different healthcare courses

BACKGROUND

Despite the growth in the interprofessional literature, there are still few studies that have evaluated the differences among courses and periods in relation to Readiness for Interprofessional Learning. Likewise, the relationship between the influences of contact among students from different professions is still controversial.

OBJECTIVES

To evaluate whether greater contact among students from diverse health courses could be associated with improved Readiness for Interprofessional Learning (RIPLS) at the undergraduate level and to compare the RIPLS among healthcare courses, analyzing differences among courses and periods of their academic training.

DESIGN

Cross-sectional study.

SETTING

A Brazilian public university.

PARTICIPANTS

Students enrolled in the first and final periods of nine healthcare courses.

METHODS

The rates of contact between students and the Readiness for Interprofessional Learning were assessed. A comparison between students from these nine healthcare courses was carried out.

RESULTS

A total of 545 (73.45%) students answered the questionnaire. The highest RIPLS scores were from Nursing (42.39), Dentistry (41.33) and Pharmacy students (40.72) and the lowest scores were from Physical Education (38.02), Medicine (38.17) and Psychology (38.66) students. The highest rates of contact between students (RC) were from Physical Education, Nutrition and Psychology students and the lowest RC were from Pharmacy, Social service and Dentistry. There was a significant effect of "healthcare course" on RIPLS. Comparing RIPLS and RC between the first and final years we found that, considering all courses, there was an increase in the RC, whereas a decrease in RIPLS scores. No correlation was found between RIPLS and RC in general.

CONCLUSION

The current study found that RIPLS scores are very different between healthcare students. Although we found a significant increase in the RC, there was a decrease in the RIPLS scores. These findings lead to a greater understanding of the difficulties facing and potential for interprofessional education.

Medicine as It Should Be: Teaching Team and Teamwork during a Palliative Care Clerkship

BACKGROUND

Interprofessional Education (IPE) is an important component of medical education. Rotations with palliative care interdisciplinary teams (IDTs) provide an optimal environment for IPE and teaching teamwork skills.

OBJECTIVE

Our objective was to assess the learning of senior medical students during a palliative care rotation.

DESIGN

A constant comparison method based on grounded theory was used in this qualitative study.

SETTING/SUBJECTS

Senior medical students completed a semi-structured reflective writing exercise after a required one-week palliative care clerkship. Sixty randomly selected reflective writings were analyzed.

MEASUREMENTS

The reflective writings were analyzed to evaluate the student's experiences.

RESULTS

Dominant themes identified were related to teams and teamwork. Eight specific themes were identified: value of IDT for team members; value of IDT for patient/family; importance of each team member; reliance on other team members; roles of team members; how teams work; team communication; and interdisciplinary assessment and care planning. Students described exposure to novel experiences and planned to incorporate newly learned behaviors in their future practice.

CONCLUSION

By participating in palliative care IDTs, medical students consistently learned about teamwork within healthcare. Additionally, they learned the importance of such teamwork to patients and the team itself. Rotations with palliative care IDTs have a significant role to play in IPE and preparing medical students to practice on teams.

Stereotypes in health professional students – perspectives for research about interprofessional learning, teaching and working / Stereotype von Lernenden in den Gesundheitsprofessionen – Perspektiven für die Forschung zum interprofessionellen Lernen, Lehren und Arbeiten

Background

As the scientific discourse about interprofessional learning, teaching, and practice has been gaining momentum in recent years, German-speaking countries still have a considerable amount of catching up to do compared with other countries. The discourse about stereotypes and their effects may serve as an example in this respect.

Objective

We set out to establish which theoretical and methodological approaches have been used in research on stereotypes endorsed by health professions students and which empirical findings are currently available on the effects of such stereotypes on interprofessional learning, teaching and practice. The main goal was to summarize the current research, to point out research desiderata and identify starting points for further research about this topic.

Methods

A broad narrative review of English and German literature was performed. Results were prepared, reflected and descriptive and analytical summarized.

Results

International research on stereotypes of health professions students in the interprofessional discourse is characterized by social-psychological theoretical and quantitative-empirical methodological approaches. Heterogeneous study designs limit the comparability and generalizability of current study findings. Answers to questions of whether and how stereotypes can be influenced through interprofessional learning, teaching, and practice were inconsistent in the literature.

Conclusion

Research findings on stereotypes endorsed by health professions students provided interesting theoretical and empirical perspectives for the debate surrounding interprofessional learning, teaching, and practice. These perspectives should be used to guide and stimulate further research on this topic in German-speaking countries.

Health science students' attitudes towards healthcare teams: A comparison between two universities

There have been few studies comparing the attitudes towards healthcare teams between different universities. This study analysed the differences in attitudes towards healthcare teams between health science students at Gunma University, Japan, which implements a comprehensive interprofessional education (IPE) programme, and Kanazawa University, a similar national university. Study populations were first- and third-year students at the Gunma University School of Health Sciences and the Kanazawa University School of Health Sciences. The present study was performed just after the IPE and multi-professional education subjects at Gunma University in the first term of the 2012 academic year. The first-year students were different cohort from the third-year students. The modified Attitudes Toward Health Care Teams Scale (ATHCTS) was used to measure attitudes towards healthcare teams. The overall mean score on the modified ATHCTS of students at Gunma University was significantly higher than that of those at Kanazawa University. In both first- and third-year students, the regression factor score of "patient-centred care" was significantly higher at Gunma University than at Kanazawa University. Based on the present study, it can be stated that IPE may foster the value of collaborative practice (CP) among health science students.

What makes medical students receptive to interprofessional education? Findings from an exploratory case study

Interprofessional education (IPE) continues to grow as a field internationally, and therefore has become a key activity which numerous institutions have implemented around the world. A number of learner characteristics have been suggested as being important for the success of interprofessional interventions, including prior experiences, expectations, and motivations. This study sought to explore medical student engagement with IPE and the factors that affect this. Twelve final and penultimate year students took part in two focus groups to discuss previous IPE and the factors which they felt led to successful interprofessional experiences. Thematic analysis was used to interpret the data. Students were found to be receptive to the idea of IPE, but had some reservations about its current form. Students were enthusiastic about clinically relevant IPE experiences, but were put off by generic teambuilding exercises, especially those with a poor mix of professional groups. They also reported being aware of interprofessional tensions and communication issues, which they felt might be alleviated through frequent interprofessional contact at the undergraduate level. This study suggests that medical students desire realistic, clinically relevant, interprofessional experiences, with a good mix of professionals, through which they can gain more awareness of their own role and that of other professionals.

Professional Stereotypes of Interprofessional Education Naive Pharmacy and Nursing Students

Objective. To assess and compare interprofessional education (IPE) naive pharmacy and nursing student stereotypes prior to completion of an IPE activity. Methods. Three hundred and twenty-three pharmacy students and 275 nursing students at Mercer University completed the Student Stereotypes Rating Questionnaire. Responses from pharmacy and nursing students were compared, and responses from different level learners within the same profession also were compared. Results. Three hundred and fifty-six (59.5%) students completed the survey. Pharmacy students viewed pharmacists more favorably than nursing students viewed pharmacists for all attributes except the ability to work independently. Additionally, nursing students viewed nurses less favorably than pharmacy students viewed nurses for academic ability and practical skills. There was some variability in stereotypes between professional years. Conclusion. This study confirms the existence of professional stereotypes, although overall student perceptions of their own profession and the other were generally positive.

Perceptions of residents, medical and nursing students about Interprofessional education: a systematic review of the quantitative and qualitative literature

BACKGROUND

To identify facilitators and barriers that residents, medical and nursing students perceive in their Interprofessional Education (IPE) in a clinical setting with other healthcare students.

METHODS

A systematic review was carried out to identify the perceptions of medical students, residents and nursing students regarding IPE in a clinical setting. PubMed, CINAHL, ERIC and PsycInfo were searched, using keywords and MeSH terms from each database's inception published prior to June 2014. Interprofessional education involving nursing and medical students and/or residents in IPE were selected by the first author. Two authors independently assessed studies for inclusion or exclusion and extracted the data.

RESULTS

Sixty-five eligible papers (27 quantitative, 16 qualitative and 22 mixed methods) were identified and synthesized using narrative synthesis. Perceptions and attitudes of residents and students could be categorized into 'Readiness for IPE', 'Barriers to IPE' and 'Facilitators of IPE'. Within each category they work at three levels: individual, process/curricular and cultural/organizational. Readiness for IPE at individual level is higher in females, irrespective of prior healthcare experience. At process level readiness for IPE fluctuates during medical school, at cultural level collaboration is jeopardized when groups interact poorly. Examples of IPE-barriers are at individual level feeling intimidated by doctors, at process level lack of formal assessment and at cultural level exclusion of medical students from interaction by nurses. Examples of IPE-facilitators are at individual level affective crises and patient care crises situations that create feelings of urgency, at process level small group learning activities in an authentic context and at cultural level getting acquainted informally. These results are related to a model for learning and teaching, to illustrate the implications for the design of IPE.

CONCLUSIONS

Most of the uncovered barriers are at the cultural level and most of the facilitators are at the process level. Factors at the individual level need more research.

Teaching Health Care Ethics: why we should teach nursing and medical students together

This article argues that teaching medical and nursing students health care ethics in an interdisciplinary setting is beneficial for them. Doing so produces an education that is theoretically more consistent with the goals of health care ethics, can help to reduce moral stress and burnout, and can improve patient care. Based on a literature review, theoretical arguments and individual observation, this article will show that the benefits of interdisciplinary education, specifically in ethics, outweigh the difficulties many schools may have in developing such courses.

Understanding students' readiness for interprofessional learning in an Asian context: a mixed-methods study

BACKGROUND

Healthcare is generally provided by various health professionals acting together. Unfortunately, poor communication and collaboration within such healthcare teams often prevent its members from actively engaging in collaborative decision-making. Interprofessional education (IPE) which prepares health professionals for their collaborative role in the healthcare system may partially address this problem. This study aimed to investigate: 1) students' readiness for IPE in an Asian context, 2) the most important factors influencing students' perceptions of IPE, 3) the reasons underlying such perceptions, and 4) the factors mitigating or promoting their sense of readiness.

METHODS

To identify students' perceptions of IPE, we administered the Readiness for Interprofessional Learning Scale (RIPLS) to 398 in approximately 470 students from a range of health professions (medicine, nursing, midwifery and dentistry). The questionnaire included factors that could potentially influence readiness for IPE as found in the literature (GPA, etc.). To enhance our understanding of the responses to the RIPLS and to explore the reasons underlying them, we conducted 4 mono-professional focus group discussions (FGDs). We ran a statistical analysis on the quantitative data, while performing a thematic content analysis of the qualitative data using ATLAS.ti (version 7).

RESULTS

Medical students seemed to be the most prepared for IPE. Students' perceptions of IPE were conditioned by the study programme they took, their GPA, intrinsic motivation and engagement in the student council connoting experience of working with students from different programmes. Focus groups further revealed that: 1) early exposure to clinical practice triggered both positive and negative perceptions of IPE and of its importance to learning communication and leadership skills, 2) medical students caused insecurity and disengagement in other students, 3) medical students felt pressured to be leaders, and 4) there was a need to clarify and understand each other's profession and the boundaries of one's own profession.

CONCLUSION

Students were generally favourable to IPE, appreciating the opportunity it offered them to hone their interprofessional leadership, collaboration and communication skills and to learn to address the problem of role blurring. Hence, we judge the Asian context ready to implement IPE, allowing health professions students in Asian countries to reap its benefits. The present study revealed several important reasons underlying students' positive and negative perceptions of IPE implementation which may be addressed during the interprofessional learning process.

A BEME systematic review of the effects of interprofessional education: BEME Guide No. 39

BACKGROUND

Interprofessional education (IPE) aims to bring together different professionals to learn with, from, and about one another in order to collaborate more effectively in the delivery of safe, high-quality care for patients/clients. Given its potential for improving collaboration and care delivery, there have been repeated calls for the wider-scale implementation of IPE across education and clinical settings. Increasingly, a range of IPE initiatives are being implemented and evaluated which are adding to the growth of evidence for this form of education.

AIM

The overall aim of this review is to update a previous BEME review published in 2007. In doing so, this update sought to synthesize the evolving nature of the IPE evidence.

METHODS

Medline, CINAHL, BEI, and ASSIA were searched from May 2005 to June 2014. Also, journal hand searches were undertaken. All potential abstracts and papers were screened by pairs of reviewers to determine inclusion. All included papers were assessed for methodological quality and those deemed as "high quality" were included. The presage-process-product (3P) model and a modified Kirkpatrick model were employed to analyze and synthesize the included studies.

RESULTS

Twenty-five new IPE studies were included in this update. These studies were added to the 21 studies from the previous review to form a complete data set of 46 high-quality IPE studies. In relation to the 3P model, overall the updated review found that most of the presage and process factors identified from the previous review were further supported in the newer studies. In regard to the products (outcomes) reported, the results from this review continue to show far more positive than neutral or mixed outcomes reported in the included studies. Based on the modified Kirkpatrick model, the included studies suggest that learners respond well to IPE, their attitudes and perceptions of one another improve, and they report increases in collaborative knowledge and skills. There is more limited, but growing, evidence related to changes in behavior, organizational practice, and benefits to patients/clients.

CONCLUSIONS

This updated review found that key context (presage) and process factors reported in the previous review continue to have resonance on the delivery of IPE. In addition, the newer studies have provided further evidence for the effects on IPE related to a number of different outcomes. Based on these conclusions, a series of key implications for the development of IPE are offered.

Perceptions of Peer-to-Peer Interprofessional Feedback Among Students in the Health Professions

PURPOSE

Interprofessional teamwork should include interprofessional feedback to optimize performance and collaboration. Social identity theory predicts that hierarchy and stereotypes may limit receptiveness to interprofessional feedback, but literature on this is sparse. This study explores perceptions among health professions students regarding interprofessional peer feedback received after a team exercise.

METHOD

In 2012-2013, students from seven health professions schools (medicine, pharmacy, nursing, dentistry, physical therapy, dietetics, and social work) participated in a team-based interprofessional exercise early in clinical training. Afterward, they wrote anonymous feedback comments for each other. Each student subsequently completed an online survey to rate the usefulness and positivity (on five-point scales) of feedback received and guessed each comment's source. Data analysis included analysis of variance to examine interactions (on usefulness and positivity ratings) between profession of feedback recipients and providers.

RESULTS

Of 353 study participants, 242 (68.6%) accessed the feedback and 221 (62.6%) completed the survey. Overall, students perceived the feedback as useful (means across professions = 3.84-4.27) and positive (means = 4.17-4.86). There was no main effect of profession of the feedback provider, and no interactions between profession of recipient and profession of provider regardless of whether the actual or guessed provider profession was entered into the analysis.

CONCLUSIONS

These findings suggest that students have positive perceptions of interprofessional feedback without systematic bias against any specific group. Whether students actually use interprofessional feedback for performance improvement and remain receptive toward such feedback as they progress in their professional education deserves further study.

Dual Benefits of a Student-Assisted Interprofessional Men's Healthy Lifestyle Pilot Program

Men are less willing to seek health professional advice than women and die more often than women from preventable causes. Therefore, it is important to increase male engagement with health initiatives. This study reports the outcomes of a student-assisted, interprofessional, 12-week health program for overweight adult males. The program included weekly health education and structured, supervised group exercise sessions. Thirteen males (participants) and 18 university students (session facilitators) completed the program. Participants were assessed for a range of health and physical activity measures and health and health profession knowledge. Participants demonstrated significant improvement in activity, knowledge, and perceptions of physical and mental function, and appreciated the guided, group sessions. Students completed an interprofessional readiness questionnaire and reported significant improvement in the understanding of the benefits of interprofessional education and of their role in health care. This program provides evidence of the dual benefit that occurs from the delivery of a student-assisted, interprofessional men's health program to at-risk community members.

Effectiveness of interprofessional education by on-field training for medical students, with a pre-post design

BACKGROUND

Interprofessional Education (IPE) implies how to achieve successful teamwork, and is based on collaborative practice which enhance occasions for relationships between two or more healthcare professions. This study evaluates the effectiveness of IPE in changing attitudes after a training recently introduced to medical education for second-year students at the University of Padova, Italy.

METHODS

All medical students following a new program for IPE were enrolled in this study. The Interdisciplinary Education Perception Scale (IEPS) was administered before and after training, according to observation-based and practice-based learning. Data were analysed with Student's paired t-test and Wilcoxon's signed rank test.

RESULTS

277 medical students completed both questionnaires. Statistically significant improvements were found in students' overall attitudes as measured by the IEPS and four subscale scores. Gender-stratified analyses showed that improvements were observed only in female students in subscale 4 ("Understanding Others' Values"). Students who had a physician and/or health worker in their family did not show any improvement in subscales 2 ("Perceived need for cooperation") or 4 ("Understanding Others' Values").

CONCLUSIONS

Our results indicate that IPE training has a positive influence on students' understanding of collaboration and better attitudes in interprofessional teamwork. More research is needed to explore other factors which may influence specific perceptions among medical students.

Frank Netter's legacy: Interprofessional anatomy instruction

Several medical schools have recently described new innovations in interprofessional interactions in gross anatomy courses. The Frank H. Netter MD School of Medicine at Quinnipiac University in Hamden, CT has developed and implemented two contrasting interprofessional experiences in first-year medical student gross anatomy dissection laboratories: long-term, informal visits by pathologists' assistant students who work with the medical students to identify potential donor pathologies, and a short-term, formal visit by fourth-year dental students who teach craniofacial anatomy during the oral cavity dissection laboratory. A survey of attitudes of participants was analyzed and suggest the interprofessional experiences were mutually beneficial for all involved, and indicate that implementing multiple, contrasting interprofessional interactions with different goals within a single course is feasible. Two multiple regression analyses were conducted to analyze the data. The first analysis examined attitudes of medical students towards a pathologists' assistant role in a health care team. The question addressing a pathologists' assistant involvement in the anatomy laboratory was most significant. The second analysis examined attitudes of medical students towards the importance of a good foundation in craniofacial anatomy for clinical practice. This perceived importance is influenced by the presence of dental students in the anatomy laboratory. In both instances, the peer interprofessional interactions in the anatomy laboratory resulted in an overall positive attitude of medical students towards pathologists' assistant and dental students. The consequences of these interactions led to better understanding, appreciation and respect of the different professionals that contribute to a health care team.