Interprofessional learning for pre-qualification health care students: an outcomes-based evaluation

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSION

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

Exploring the implementation of a novel community pharmacist-led support service for people living with severe and persistent mental illness

BACKGROUND

Community pharmacists are well-placed to promote and provide mental health medication management services. However, literature evaluating the impact of pharmacy services in supporting people living with severe and persistent mental illness (SPMI) is currently limited. An individualised, goal-oriented pharmacist-led support service that focused on improving the physical and mental health of consumers living with SPMI, namely the PharMIbridge intervention, was provided to consumer participants as part of the PharMIbridge Randomised Controlled Trial (RCT).

OBJECTIVE(S)

To explore the experiences of the participants who delivered and supported the implementation of the PharMIbridge intervention and propose ideas and supports needed for broader implementation and sustainability of pharmacist-led support services for people living with SPMI.

METHODS

Interviews and focus group discussions were undertaken with PharMIbridge pharmacists and mentors, respectively. Audio-recordings were de-identified and transcribed verbatim. Data analysis was conducted using an iterative, inductive approach. The key themes identified were furthered divided into subthemes. Subthemes were then mapped to the EPIS (Exploration, Preparation, Implementation and Sustainment) framework.

RESULTS

Data were collected from one focus group involving six RCT mentors and 16 semi-structured interviews with community pharmacists. Five overarching themes emerged: "Training needs", "Pharmacist integration within the healthcare system", "Environmental factors", "Attitudes and behaviour" and "Pharmacy operations". Twelve subthemes were mapped to EPIS phases "Preparation", "Implementation" and "Sustainment" and EPIS constructs "Outer" context, "Inner" context and "Bridging" factors.

CONCLUSION

Adequate remuneration and supports to encourage healthcare professional collaboration are necessary to establish and sustain functioning, integrated pharmacy mental health services. A shift in pharmacy business and workflow models is necessary to support community pharmacies to implement mental health services. In addition, there is a need to promote psychological support services to ensure that pharmacists are well supported while delivering pharmacy mental health services.

An evaluation of the psychometric properties of the Australian Collaborative Practice Assessment Tool

OBJECTIVES

This study aimed to validate the Collaborative Practice Assessment Tool (CPAT) in the Australian setting and provide a quality instrument in terms of psychometric properties that can be used to measure interprofessional outcomes for both healthcare practitioners and students. The outcomes evaluated include the capacity to work in an interprofessional team, good interprofessional communication skills, leadership skills, ensuring clear division of tasks and roles in a team, effective conflict management, and being actively involved with patients and their families/communities in care.

METHODS

The COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) taxonomy and standards were used as guides for evaluating the psychometric properties of the Australian CPAT, which include evaluations regarding instrument development requirements of sample target and size, content validity, internal structure (structural validity, internal consistency reliability and measurement invariance), and hypotheses testing. CPAT Australia was developed through two stages involving pilot studies and a validation study, both of which included healthcare practitioners and students as participants. A pilot study examined content validity regarding item relevance, item comprehensibility, and instrument comprehensiveness. The validation study was carried out to assess the internal structure of CPAT Australia for aspects of structural validity, internal consistency reliabilities, and configural, metric and scalar measurement invariance. The structural validity was explored using the following three steps: exploratory, confirmatory, and multi-group factor analysis. Construct validity was evaluated to confirm direct and indirect paths of assumptions based on a previously validated model. Data collected between August 2021 and May 2022.

RESULTS

The content validity evaluation confirmed that all items were relevant, understandable and comprehensive for measuring interprofessional collaborative care in Australia. Three hundred ninety-nine participants contributed to the validation study (n=152 practitioners; n=247 students). The original instrument model of 8-Factor 56-Item was improved in the Australian CPAT. Two items, Item 27 (Physicians assume the ultimate responsibility) and Item 49 (Final decision rest with the physician), were consistently rejected and therefore discarded. The internal structure of the 7-Factor 54-Item solution was confirmed as a suitable model with fit indices meeting COSMIN standards for a good model in practitioner and student cohorts. Configural, metric and scalar invariances were confirmed, indicating the invariance of the instruments when used for the practitioner and student cohorts. The construct validity evaluation indicated that 81.3% of direct and indirect assumptions were accepted, fulfilling the COSMIN requirement of >75% of proposed assumptions being accepted.

CONCLUSION

The Australian CPAT with a 7-factor 54-item solution was confirmed as a quality measure for assessing interprofessional education and collaborative practice for both healthcare practitioners and students in Australia with robust psychometric properties.

Social and healthcare students' competence in patient-oriented care enhanced during interprofessional practice: A scoping review

AIM

This scoping review aimed to synthesise the findings of previous literature related to social and healthcare students' competence in patient-oriented care in interprofessional practice by attending multidisciplinary student teams.

BACKGROUND

Learning about patient-oriented care requires the comprehensive consideration of patients' physical, emotional, social and economic aspects to offer the best need-based care. Multidisciplinary student teams in the clinical practice may support learning patient-oriented care; however, the current knowledge is fragmented.

DESIGN

Scoping review METHODS: Data (N = 1548) were gathered from four databases, PubMed, MEDLINE, SocIndex and CINAHL, without start-date limitation until the end of December 2022. One article was found on the publisher's webpage recommendations. The selected studies (N = 15) answered the research questions and met the inclusion criteria. Quality assessment of the studies was conducted using the Joanna Briggs Institute (JBI) Quality Assessment Checklist. A thematic analysis process was used for data extraction and synthesis of results.

RESULTS

Perspectives on patient-oriented care competencies were analysed for both students and patients cared for by a multidisciplinary student team. The themes described students' profound understanding of professional roles and responsibilities in patient-oriented care, collaborative patient-oriented care skills, improved interprofessional communication and reported patient experiences.

CONCLUSIONS

Interprofessional practice versatility develops students' competence in patient-oriented care. Guaranteeing patient-oriented care requires a broad understanding of patients' comprehensive care needs, which can be addressed through multidisciplinary collaboration. Patients' experiences toward interprofessional student practice are mainly positive. Further research is needed to assess the impact of different interprofessional education methods on students' patient-oriented care competence using valid instruments and the long-term effects of students' competence in patient-oriented care.

Empathy, emotional intelligence and interprofessional skills in healthcare education

According to the World Health Organization (WHO), health professionals maintain the health of citizens through evidence-based medicine and caring. Students enroled in health professional programmes are required to have successfully attained all core learning outcomes by reaching key milestones throughout the course of their studies, demonstrating they have developed the required graduate skills and attributes upon completion of the programme. While some of the knowledge, skills and competencies that make up these learning outcomes are very discipline specific, there are more general professional skills across all disciplines which are difficult to define, such as empathy, emotional intelligence and interprofessional skills. These are at the heart of all health professional programmes that once defined, can be mapped through curricula and further evaluated. Literature will be presented on these three professional skills: empathy, emotional intelligence, and interprofessional skills, based on studies that focussed primarily in health professional programmes and highlight some of the key findings and issues at undergraduate and postgraduate levels. The paper will present the need for these skills to be defined and then mapped through curricula so that students are better supported in their professional development. Empathy, emotional intelligence and interprofessional skills transcend the discipline specific skills and as such it is important that all educators consider how best these may be fostered. Efforts should also be made to further the integration of these professional skills within curricula to produce health professionals with an enhanced focus on person-centred care.

Comparing outcomes of an innovative interprofessional student placement model to standard placement models in rural healthcare settings

This unique study investigated the educational and service delivery impacts of a team-based, innovative model of interprofessional education (IPE) namely the Rural Interprofessional Education and Supervision (RIPES) model on participating students, clinical educators, and their workplaces, in rural Australian healthcare settings. Participating professions included dietetics, occupational therapy, physiotherapy, and speech pathology. Outcomes from the RIPES model were compared with regular uni-professional placement models. A multi-site, pre-post, comparative design was used. The main data collection measures included were the Students Perceptions of Interprofessional Clinical Education - Revised scale, the Interprofessional Socialization and Valuing Scale, and time-usage data. The RIPES model resulted in significant improvement in students' beliefs, behaviors, and attitudes that underpin interprofessional socialization and collaborative practice in healthcare settings. Importantly, students were able to benefit from the RIPES learning activities without compromising their contact time with patients. Clinical educators spent significantly more time in non-patient contact activities than the uni-professional group. This important work was undertaken in response to previous calls to address a gap in IPE models in rural areas. It involved students from multiple professions and universities, measured impacts on multiple stakeholders, and followed international best practice interprofessional education research recommendations.

Long-term clinical clerkship improves medical students' attitudes toward team collaboration

OBJECTIVES

To examine the related factors associated with medical students' attitudes toward team collaboration.

METHODS

This cross-sectional study targeted medical students, residents, and doctors. A survey was conducted from 2016 to 2017 using the Japanese version of the Jefferson Scale of Attitudes Toward Interprofessional Collaboration (JeffSATIC-J), which evaluated "working relationship" and "accountability." We analyzed 2409 questionnaire responses with JeffSATIC-J items and the gender item. Analysis of variance was used for factors associated with the JeffSATIC-J score and Spearman's rank correlation coefficient for the relationship between educational intervention and the JeffSATIC-J score.

RESULTS

First-year students' scores were the highest (F_{(2, 2045)} = 13.42 to 18.87, p < .001), and female students' scores were significantly higher than those of male students (F_{(1, 2045)} = 21.16 to 31.10, p < .001). For residents' scores, the institution was not a significant variable. Female "accountability" scores were significantly higher than those of males (F _(1,108) = 4.95, p = .03). Gender was not a significant variable for doctors' scores. Sixth-year students' scores were significantly correlated with the length of clinical clerkship (r₍₅₎=.78 to .96, p<.05), with the exception of females' "working relationship" scores. The medical school with the highest JeffSATIC-J scores had the longest clinical clerkship in the community.

CONCLUSIONS

These results indicate that long-term clinical clerkship in the community at higher grades is important in improving medical students' attitudes toward team collaboration. A qualitative study is required to confirm our findings.

Design and Evaluation of Interprofessional Training Program for Healthcare Students from Collectivistic Culture

Background

Healthcare is team-based, and with increased mobility of healthcare workers, most of them will work with team members from all over the globe. Interprofessional education (IPE) research has mostly focused on specially designed programs in academic health institutions to prepare students for multidisciplinary work. Few IPE programs aim to integrate students with mixed disciplines from collectivist cultures.

Methods

This mixed-methods study was conducted between June and August 2019. Surveys and an e-portfolio were recorded of 33 final-year and graduated health professional students' participation in an 8-week IPE summer program at a medical school in Ireland. Survey results are described, and the content of portfolios was analyzed based on the deductive analysis of qualitative data derived from questions.

Results

Students reported the greatest improvement in presentation skills (63.6%), followed by communication (54.5%), team working skills (93.9%), and interprofessional learning (42.4%), respectively. Qualitative findings highlighted challenges for students from a collectivist culture adapting to an IPE: uncomfortable verbally expressing themselves in problem-based learning (PBL) and how to work with other sex. Positive themes about IPE that emerged were enjoyment in sharing ideas and building trust with PBL groups. We learned that the program had to be flexible enough to meet the educational requirements of a target community with mixed English language ability and adaptability to IPE.

Conclusion

The authors propose that an international PBL-based summer program is effective in improving healthcare students' attitudes towards IPE. This study provides valuable insights to facilitate the development of further IPE programs to increased collaboration between students across various healthcare disciplines.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40670-022-01536-7.

SIESTA: a quick interprofessional learning activity fostering collaboration and communication between paediatric nursing trainees and medical students

BACKGROUND

Interprofessional education has emerged as a key concept in education of health professionals over the last 20 years. Positive effects of interprofessional education have been shown, but it has proved to be more time-consuming than traditional teaching methods. We therefore developed a 30-minute interprofessional learning activity, using peer-teaching methods. We were interested in effects on and ways of interprofessional learning, including conditions and resources that make it successful despite limited time.

METHODS

Speed InterprofESsional Peer Teaching PaediAtric (SIESTA) was developed in the context of an interprofessional training ward. 20 paediatric nursing trainees and 20 medical students were enrolled in the study. Two students from each profession participated in a total of four SIESTA sessions each, supervised by registered paediatric nurses and paediatricians. We used a mixed-methods approach of quantitative and qualitative data (questionnaires, semi-guided focus group interviews) to evaluate self-perceived interprofessional competencies, interprofessional learning gains and ways of interprofessional learning.

RESULTS

Questionnaires were obtained from all participants (n = 40) and n = 26 took part in the group interviews. Participants from both professions reported an increase in self-perceived understanding of interprofessional roles and tasks. Communication and cooperation emerged as important aspects. The workplace-based nature of SIESTA promoted interprofessional learning, while peer teaching fostered a safe learning environment. Regarding time constraints participants suggested thorough preparation and structuring by facilitators as a solution.

CONCLUSIONS

Our short interprofessional peer teaching activity showed promising results. Participants reported enhanced interprofessional competencies and provided suggestions for successful learning in limited time. Further studies should include an objective assessment of the interprofessional learning progress. The SIESTA concept can be easily adapted to other medical fields, providing interprofessional learning opportunities for many more health care professionals to come.

Development of interprofessional healthcare teamwork skills: mapping students' process of learning

Higher education institutions commonly prepare future healthcare workers to engage in increasingly complex, interprofessional healthcare environments through interprofessional education. Development of appropriate teamwork skills is complex and takes time. However, much of the research on student engagement with teamwork in higher education has been focused on the end goal of teamwork. This obscures the process of how students learn to work in interprofessional healthcare teams and in what ways, over time. The current study used an exploratory interpretive approach to obtaining students' experiences, perceptions and developing understanding of teamwork from the start of their undergraduate studies, through to completion of five semesters of group or teamwork projects. Through qualitative methodology, educators explored student experiences of teamwork, their focus at designated points of their undergraduate teamwork, and the meaning they attributed to being a member of a team. Student perceptions of successful teamwork developed over time to a positive and purposeful orientation toward teamwork, learner attributes that enhanced team function, and a growing awareness of how the assessment context affected team function. By mapping these processes of learning over time, educators can gain a clearer understanding of influences and experiences that impact on student learning in teamwork.

Dental hygiene and public health students' perception of an online interprofessional education applied learning activity

PURPOSE/OBJECTIVES

To pilot an online interprofessional education (IPE) applied learning activity (ALA), to understand students' socialization and values towards IPE teams, and evaluate the IPE learning activity for future implementation.

METHODS

A pre-and post-test design was used to assess interprofessional socialization and values utilizing the (ISVS-9A/9B) surveys before and after the IPE ALA among dental hygiene (DH) and Master of Public Health (MPH) students (n = 86). Three statements from the ISVS-9A/9B surveys were not included due to the nature of the activity. The IPE ALA was a case study related to a federally funded community health center seeking funding for a dental van within 14 local targeted communities (i.e., children, senior citizens, special needs). Student groups were randomly assigned to one targeted community and completed questions that required application of prevention, systems thinking and management and solutions of oral health issues. Students collaboratively developed an executive summary and presentation through an online learning platform.

RESULTS

A total of 73 DH (n = 38) and MPH (n = 35) students (84.8% response rate) completed the ISVS 9-A (modified), and 57 students DH (n = 33) and MPH (n = 24) students (66.3% response rate) completed the ISVS-9B (modified) and IPE activity evaluation. A positive change (pre-post) was observed based on the students' responses (p < 0.05) and 64% agreed that the skills obtained from the IPE ALA would help them in their careers.

CONCLUSIONS

Overall, student learners' ISVS toward IPE improved after engaging in the online ALA. The use of online platforms is one low resource strategy to integrate IPE experiences into allied health and dental education.

Fostering Inter-Professional Education through Service Learning: The Belize Experience

Service-learning and interprofessional education are forms of experiential learning that instill confidence in students. This pilot study used a post-service learning survey to explore the benefits of interprofessional education in a service-learning experience with students. Findings indicated that this service-learning experience contributed to the development of cultural awareness, and professional skills, as well as increased team attitudes and perceptions related to the respective roles of occupational and physical therapy students. The following report describes students' perspectives and satisfaction concerning professional development, interprofessional education, and cultural awareness utilizing quantitative and qualitative descriptors.

Interprofessional education: tips for design and implementation

Interprofessional education (IPE) is a critical approach for preparing students to enter the health workforce, where teamwork and collaboration are important competencies. IPE has been promoted by a number of international health organisations, as part of a redesign of healthcare systems to promote interprofessional teamwork, to enhance the quality of patient care, and improve health outcomes. In response, universities are beginning to create and sustain authentic and inclusive IPE activities, with which students can engage. A growing number of health professionals are expected to support and facilitate interprofessional student groups. Designing interprofessional learning activities, and facilitating interprofessional groups of students requires an additional layer of skills compared with uniprofessional student groups. This article outlines the key points for planning and practicing interprofessional facilitation within the classroom and clinical setting.

Designing and evaluating an interprofessional education conference approach to antimicrobial education

BACKGROUND

Arguably, Medical School curricula are deficient in learning opportunities related to the safe and effective use of medicines, in particular antimicrobials. Infection management is complex and multidisciplinary, and learning opportunities should reflect these principles. Aligned to the complexity of the subject matter, simulation and interprofessional based teaching are methods that can foster the collaborative skills required of future healthcare professionals. There have been calls to develop these methods in the teaching of safe prescribing and the management of infections; however, reports of such studies are limited.

METHODS

We developed an interprofessional education (IPE) conference for second year undergraduate medical and pharmacy students based in the North East of England. We considered contact theory in the design of three small group interprofessional workshops, on the broad themes of antimicrobial stewardship, infection management and patient safety. A mixed methods approach assessed students' attitudes towards IPE, barriers and facilitators of learning, and perceived learning gains. Qualitative data from workshop evaluation forms were analysed thematically, while quantitative data were analysed descriptively and differences between medical and pharmacy cohorts analysed using unpaired two-tailed t-tests.

RESULTS

226/352 students returned the workshop evaluation forms (66% of pharmacy students, 62% of medical students). 281/352 students responded to a series of Likert scale questions on the value of interprofessional education (88% of pharmacy students, 70% of medical students). Students reported acquisition of knowledge and skills, including concepts and procedures related to infection management and antimicrobial prescribing, and the development of problem-solving and critical evaluation skills. Students reflected on their attitude towards interprofessional collaboration. They reported a greater understanding of the roles of other healthcare professionals, reflected on the importance of effective communication in ensuring patient safety, and were more confident to work in interprofessional teams after the conference.

CONCLUSIONS

A robust IPE event, theoretically underpinned by contact theory and developed collaboratively, achieved interprofessional learning at scale and helped develop healthcare professionals willing to collaborate across disciplines. The resources, and evaluation insights based on the 3P (presage, process, and product) model of learning and teaching, will be of value to other educators who seek to develop theoretically-sound IPE interventions.

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.

An objective structured teaching exercise for faculty training and assessment of teaching ability in interprofessional collaborative practice and education

OBJECTIVE

Improving clinical teachers' ability to teach interprofessional collaborative practice warrants development in current faculty training programs; in particular, current education training emphasizes experiential learning and multiple teaching strategies. The purpose of this study was to establish a teaching model to apply interdisciplinary collaborative care and to improve clinical teachers' execution of interprofessional practices.

MATERIALS AND METHODS

Health-care faculty members were studied; this study assessed a teacher education curriculum for interprofessional education (IPE) and applied an objective structured teaching exercise (OSTE) to evaluate IPE execution by clinical teachers.

RESULTS

The OSTE improved clinical teachers' IPE execution, verifying the necessity for multistrategy teaching in faculty training programs.

CONCLUSIONS

This study provides different types of interprofessional faculty training and assessments. Development of an OSTE requires long-term planning, and IPE should also be incorporated into formal programs.

Learning from interprofessional education: A cautionary tale

BACKGROUND

Interprofessional education (IPE) is time consuming to develop and sustain and presents many logistical and practical challenges to curriculum developers. Drawing on findings from an evaluation study of an IPE pilot, this paper brings new insights into both positive implications and potentially negative consequences of delivering large scale IPE.

OBJECTIVE

The aim of the study was to evaluate a large scale IPE pilot delivered to students in the first year of their training.

DESIGN AND SETTING

The IPE pilot took place on campus and was focused on patient safety (human factors).

PARTICIPANTS

The study involved 630 first year undergraduates across 10 programmes at a UK university.

METHODS

A mixed methods evaluation was conducted comprising a paper-based survey circulated at the end of the taught session followed by uni-professional focus groups (n = 4). Questionnaire data was subject to descriptive statistical analysis and key themes were generated from the focus group data.

RESULTS

Three overarching themes emerged from analysis of the qualitative data: Understanding differences in roles, Learning about stereotypes and Unintended perpetuation of stereotypes.

CONCLUSIONS

IPE is an important part of the training of all health and social care professionals and the study revealed many benefits of this approach. However, we should be sensitive to the possibility of inadvertently perpetuating negative stereotypes as a consequence of IPE activities. Our work highlights the need for caution when considering the planning and executing IPE activities.

Compounding medications in a rural setting: an interprofessional perspective

Background

Interprofessional learning (IPL) which focuses on the pharmacist's role in specialty practices as part of a multidisciplinary health care team has not been explored. This study aimed to determine health care students' understanding of the role of the pharmacist in compounding medications to optimize health outcomes for patients in rural and remote health care services.

Methods

Four workshops followed by focus group interviews were conducted with undergraduate pharmacy, medical, nursing, physiotherapy, dentistry, Aboriginal public health, and speech pathology students (n=15). After an introductory lecture, students working in multidisciplinary teams undertook to compound three products. Focus groups were held at the end of the compounding workshops to explore students' understanding and perceptions of these compounding activities. Thematic analysis was undertaken on the qualitative data obtained from the focus groups.

Results

Student participants responded positively both to the opportunity to undertake a compounding exercise and being part of an interprofessional team, perceiving benefit for their future rural and remote health practice. Four major themes emerged from the qualitative analysis: improved knowledge and understanding; application to practice; interprofessional collaboration; and rural, remote, and Indigenous context. Students acknowledged that the workshops improved their understanding of the role of the pharmacist in compounding and how they, as part of a multidisciplinary team, could deliver better health outcomes for patients with special needs, especially in a rural and remote context.

Conclusion

This study highlights that workshops of this nature have a role to play in developing collaborative interprofessional practice and increasing awareness of pharmaceutical services among undergraduate health students. However, further evidence is needed to assess whether positive perceptions of specialty practice IPL workshops will translate into improved patient outcomes in practice.

Understanding students' and clinicians' experiences of informal interprofessional workplace learning: an Australian qualitative study

OBJECTIVES

While postgraduate studies have begun to shed light on informal interprofessional workplace learning, studies with preregistration learners have typically focused on formal and structured work-based learning. The current study investigated preregistration students' informal interprofessional workplace learning by exploring students' and clinicians' experiences of interprofessional student-clinician (IPSC) interactions.

DESIGN

A qualitative interview study using narrative techniques was conducted.

SETTING

Student placements across multiple clinical sites in Victoria, Australia.

PARTICIPANTS

Through maximum variation sampling, 61 participants (38 students and 23 clinicians) were recruited from six professions (medicine, midwifery, nursing, occupational therapy, paramedicine and physiotherapy).

METHODS

We conducted 12 group and 10 individual semistructured interviews. Themes were identified through framework analysis, and the similarities and differences in subthemes by participant group were interrogated.

RESULTS

Six themes relating to four research questions were identified: (1) conceptualisations of IPSC interactions; (2) context for interaction experiences; (3) the nature of interaction experiences; (4) factors contributing to positive or negative interactions; (5) positive or negative consequences of interactions and (6) suggested improvements for IPSC interactions. Seven noteworthy differences in subthemes between students and clinicians and across the professions were identified.

CONCLUSIONS

Despite the results largely supporting previous postgraduate research, the findings illustrate greater breadth and depth of understandings, experiences and suggestions for preregistration education. Educators and students are encouraged to seek opportunities for informal interprofessional learning afforded by the workplace.

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.

Peer teacher training (PTT) program for health professional students: interprofessional and flipped learning

BACKGROUND

The need for developing healthcare professional students' peer teaching skills is widely acknowledged, and a number of discipline-based peer teacher training programs have been previously reported. However, a consensus on what a student peer teaching skills program across the health professions should entail, and the associated benefits and challenges, has not been previously described. The purpose of this study was to demonstrate the design and implementation of an interprofessional Peer Teacher Training (PTT) program, and explore outcomes and participant perceptions, using Experience-Based Learning (ExBL) theory.

METHODS

In 2016, an interprofessional team of academics from across three healthcare faculties: Medicine, Pharmacy and Health Sciences, developed and implemented a six module, flipped learning, interprofessional PTT program. Pre- and post questionnaires, using a Likert scale of 1-5, as well as open ended questions, were distributed to students. Descriptive statistics were used to analyse quantitative data, and thematic analysis was used to analyse qualitative data.

RESULTS

Ninety senior students from across the three faculties participated. Eighty nine percent of participants completed a pre- and post-course questionnaire. Students felt the required pre-class preparation, including online pre-reading, discussion board, videos, and teaching activities enhanced their face-to-face learning experience. In class, students valued the small-group activities, and the opportunities to practice their teaching skills with provision of feedback. Students reported increased confidence to plan and deliver peer teaching activities, and an increased awareness of the roles and responsibilities of health professionals outside of their own discipline, and use of different terminology and communication methods. Students' suggestions for improving the PTT, included; less large group teaching; more online delivery of theory; and inclusion of a wider range of health professional disciplines.

CONCLUSION

The PTT program provided a theoretically informed framework where students could develop and practice their teaching skills, helping to shape students' professional values as they assume peer teaching responsibilities and move towards healthcare practice. The flipped learning, interprofessional format was successful in developing students' skills, competence and confidence in teaching, assessment, communication and feedback. Importantly, participation increased students' awareness and understanding of the various roles of health professionals.

Pre-registration interprofessional clinical education in the workplace: a realist review

CONTEXT

The inclusion of interprofessional education opportunities in clinical placements for pre-registration learners has recently been proposed as a strategy to enhance graduates' skills in collaborative practice.

OBJECTIVES

A realist review was undertaken to ascertain the contexts, mechanisms and outcomes of formal interprofessional clinical workplace learning.

METHODS

Initial scoping was carried out, after which Ovid MEDLINE, CINAHL and EMBASE were searched from 2005 to April 2016 to identify formal interprofessional workplace educational interventions involving pre-registration learners. Papers reporting studies conducted in dedicated training wards were excluded, leaving a total of 30 papers to be included in the review.

RESULTS

Several educational formats that combined students from medicine, nursing, pharmacy and allied health professions were identified. These included: the use of engagement by student teams with a real patient through interview as the basis for discussion and reflection; the use of case studies through which student teams work to promote discussion; structured workshops; ward rounds, and shadowing. Meaningful interprofessional student discussion and reflection comprised the mechanism by which the outcome of learners acquiring knowledge of the roles of other professions and teamwork skills was achieved. The mechanism of dialogue during an interaction with a real patient allowed the patient to provide his or her perspective and contributed to an awareness of the patient's perspective in health care practice. Medication- or safety-focused interprofessional tasks contributed to improved safety awareness. In the absence of trained facilitators or in the context of negative role-modelling, programmes were less successful.

CONCLUSIONS

In the design of workplace education initiatives, curriculum decisions should take into consideration the contexts of the initiatives and the mechanisms for achieving the education-related outcomes of interest.

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.

Advancing medical education: connecting interprofessional collaboration and education opportunities with integrative medicine initiatives to build shared learning

BackgroundImproved teamwork between conventional and complementary medicine (CM) practitioners is indicated to achieve effective healthcare. However, little is known about interprofessional collaboration and education in the context of integrative medicine (IM). MethodsThis paper reports the findings from a constructivist-grounded theory method study that explored and highlighted Australian medical students' experiences and opportunities for linking interprofessional collaboration and learning in the context of IM. Following ethical approval, in-depth semi-structured interviews were conducted with 30 medical students from 10 medical education faculties across Australian universities. Results Medical students recognised the importance of interprofessional teamwork between general medical practitioners and CM professionals in patient care and described perspectives of shared responsibilities, profession-specific responsibilities, and collaborative approaches within IM. While students identified that limited interprofessional collaboration currently occurred in the medical curriculum, interprofessional education was considered a means of increasing communication and collaboration between healthcare professionals, helping coordinate effective patient care, and understanding each healthcare team members' professional role and value. Conclusions The findings suggest that medical curricula should include opportunities for medical students to develop required skills, behaviours, and attitudes for interprofessional collaboration and interprofessional education within the context of IM. While this is a qualitative study that reflects theoretical saturation from a selected cohort of medical students, the results also point to the importance of including CM professionals within interprofessional collaboration, thus contributing to more person-centred care.

Crucial Conversations: An interprofessional learning opportunity for senior healthcare students

Clinical errors due to human mistakes are estimated to result in 400,000 preventable deaths per year. Strategies to improve patient safety often rely on healthcare workers' ability to speak up with concerns. This becomes difficult during critical decision-making as a result of conflicting opinions and power differentials, themes underrepresented in many interprofessional initiatives. These elements are prominent in our interprofessional initiative, namely Crucial Conversations. We sought to evaluate this initiative as an interprofessional learning (IPL) opportunity for pre-licensure senior healthcare students, as a way to foster interprofessional collaboration, and as a method of empowering students to vocalise their concerns. The attributes of this IPL opportunity were evaluated using the Points for Interprofessional Education Score (PIPES). The University of the West of England Interprofessional Questionnaire was administered before and after the course to assess changes in attitudes towards IPL, relationships, interactions, and teamwork. Crucial Conversations strongly attained the principles of interprofessional education on the PIPES instrument. A total of 38 volunteers completed the 16 hours of training: 15 (39%) medical rehabilitation, 10 (26%) medicine, 7 (18%) pharmacy, 5 (13%) nursing, and 1 (2%) dentistry. Baseline attitude scores were positive for three of the four subscales, all of which improved post-intervention. Interprofessional interactions remained negative possibly due to the lack of IPL opportunities along the learning continuum, the hidden curriculum, as well as the stereotyping and hierarchical structures in today's healthcare environment preventing students from maximising the techniques learned by use of this interprofessional initiative.

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.

Student midwives and paramedic students' experiences of shared learning in pre-hospital childbirth

AIM

To explore the experiences of midwifery and paramedic students undertaking interprofessional learning.

METHOD

A one day interprofessional learning workshop incorporating peer assisted learning for undergraduate pre-registration midwifery and paramedic students was developed based on collaborative practice theory and simulation based learning. Twenty-five student midwives and thirty-one paramedic students participated in one of two identical workshops conducted over separate days. Videoed focus group sessions were held following the workshop sessions in order to obtain qualitative data around student experience. Qualitative data analysis software (ATLAS.ti) was used to collate the transcriptions from the focus group sessions and the video recordings were scrutinised. Thematic analysis was adopted.

RESULTS

Four main themes were identified around the understanding of each other's roles and responsibilities, the value of interprofessional learning, organisation and future learning. Students appeared to benefit from a variety of learning opportunities including interprofessional learning and peer assisted learning through the adoption of both formal and informal teaching methods, including simulation based learning. A positive regard for each other's profession including professional practice, professional governing bodies, professional codes and scope of practice was apparent. Students expressed a desire to undertake similar workshops with other professional students.

CONCLUSION

Interprofessional learning workshops were found to be a positive experience for the students involved. Consideration needs to be given to developing interprofessional learning with other student groups aligned with midwifery at appropriate times in relation to stage of education.

An education intervention to improve nursing students' understanding of medication safety

Medication safety is a significant issue. Whilst medication administration is a routine task, it is a complex nursing activity. It is recognised in the literature that medication related adverse events are most often related to systems failures associated with the complex process of medication administration. This paper examines student's perceived effectiveness of an educational intervention, designed to demonstrate the complex and multidisciplinary factors of systems related failures in medication administration. The intervention was underpinned by adult and experiential learning concepts and used a problem-based learning approach. A series of short digital recordings were developed along with discussion points to illustrate multidisciplinary interactions involved in medication administration. A small sample of second and third year undergraduate nursing students (n = 28) evaluated the effectiveness of the educational resource. Our findings suggest that such resources are effective in demonstrating the complexity of medication related error and were authentic to practice. An educational intervention using problem based learning afforded nursing students the opportunity to engage with the systems factors that contribute to medication errors. Interventions that highlight these factors may play an important role in raising awareness of these issues and encourage students to carry this knowledge into clinical practice.

Enhancing interprofessional student practice through a case-based model

Healthcare workers are increasingly being called upon to work collaboratively in practice to improve patient care and it seems imperative that interprofessional working should be mirrored in student education, especially during placements. This short report describes a qualitative evaluation of a client-centered, case-based model of interprofessional education (IPE) which aimed to improve interprofessional communication and team working skills for the students and therapists involved in practice placements. The IPE project implemented the meet, assess, goal set, plan, implement, evaluate (MAGPIE) framework for interprofessional case-based teaching (Queensland-Health (2008)) alongside the International Classification of Function, Disability and Health (ICF) (WHO, 2001). Three separate focus groups explored the experiences of the students, therapists and placement facilitators from the disciplines of occupational therapy, physiotherapy and speech and language therapy. Three themes emerged: IPE as a motivating experience, IPE enhancing the depth of learning and clarity of expectations. This report concluded that IPE in the clinical setting, using the client-centered MAGPIE model, provided a strong foundation for enhanced learning in practice education contexts.

The H-PEPSS: an instrument to measure health professionals' perceptions of patient safety competence at entry into practice

BACKGROUND

Enhancing competency in patient safety at entry to practice requires introduction and integration of patient safety into health professional education. As efforts to include patient safety in health professional education increase, it is important to capture new health professionals' perspectives of their own patient safety competence at entry to practice. Existing instruments to measure patient safety knowledge, skills and attitudes have been developed largely to examine the impact of specific patient safety curricular initiatives and the psychometric analyses of the instruments used thus far have been exploratory in nature.

METHODS

Confirmatory factor analytic approaches are used to extensively test the Health Professional Education in Patient Safety Survey (H-PEPSS), a newly designed survey rooted in a patient safety competency framework and designed to measure health professionals' self-reported patient safety competence around the time of entry to practice. The H-PEPSS focuses primarily on the socio-cultural aspects of patient safety including culture, teamwork, communication, managing risk and understanding human factors.

RESULTS

Results support a parsimonious six-factor measurement model of health professionals' perceptions of patient safety competency. These results support the validity of a reduced version of the H-PEPSS and suggest it can be appropriately used at or near training completion with a variety of health professional groups.

CONCLUSIONS

Given increased demands for patient safety competency among health professionals at entry to practice and slow, but emerging changes in health professional education, ongoing research to understand the extent of patient safety competency among health professionals around the time of entry to practice will be important.

Interprofessional education: a review of context, learning and the research agenda

CONTEXT

Interprofessional education (IPE) is not a recent phenomenon and has been the subject of several World Health Organization reports. Its focus is on health professionals and students learning with, from and about one another to improve collaboration and the quality of patient care. The drivers for IPE include new models of health care delivery in the context of an ageing population and the increasing prevalence of long-term chronic disease, in addition to the patient safety agenda. The delivery of complex health care requires a team-based and collaborative approach, although teamwork and collaborative practice are not necessarily synonymous. The rationale for IPE is that learning together enhances future working together.

DISCUSSION

Systematic reviews of IPE have shown some evidence that IPE fosters positive interaction among different professions and variable evidence that it improves attitudes towards other professionals. Generalisation across published papers is difficult because IPE initiatives are diverse and good evaluation methodology and data are lacking. In terms of constructive alignment from an education viewpoint, there is a need for educators to define learning outcomes and match these with learning activities to ensure that IPE demonstrates added value over uniprofessional learning. Assessment is difficult as pre-qualification professional education focuses on the individual and professional accreditation organisations mandate only for their own professions.

CONCLUSIONS

Interprofessional education draws from a number of education, sociology and psychology theories, and these are briefly discussed. The most pressing research questions for the IPE community are defined and the challenges for IPE explored.

An interprofessional learning module on asthma health promotion

OBJECTIVE

To develop, implement, and evaluate a new interprofessional learning module that focused on asthma health promotion called Taking Action Together for Asthma.

DESIGN

Faculty members in medicine, nursing, and pharmacy courses recruited 10 students each to participate in a 3-day interprofessional learning module. Students received extensive materials including a workbook to document their expectations and experience; completed a 1-day interprofessional workshop; received training in the Triple A (Adolescent Asthma Action) program; and went into high schools and taught the Triple A program to students in interprofessional teams.

ASSESSMENT

Before and after participating in the module, students completed a questionnaire consisting of 3 previously validated instruments: the Asthma Knowledge for Health Professionals Scale, Attitudes Toward Health Care Teams Scale, and Readiness for Interprofessional Learning Scale (RIPLS). Seventeen students completed both the pre- and post-module scales and significant changes were seen only in means scores for the Attitude Toward Healthcare Teams (81.0 ± 4.7 to 85.2 ± 5.9) and the Teamwork and Collaboration subscale of the RIPLS (41.4 ± 2.7 to 43.2 ± 2.7).

CONCLUSION

Health promotion activities offer a viable mechanism for fostering interprofessional learning among health professions students.

An interprofessional education session for first-year health science students

OBJECTIVE

To implement and evaluate the effectiveness and short-term impact of an interprofessional education (IPE) session in the first year for health sciences students representing 9 health professions.

DESIGN

An interprofessional faculty committee created a 2(1/2) hour introductory interprofessional education session focusing on a single patient case and 2 possible discharge scenarios. A mixed method pretest/posttest research design was used to examine changes in students' perceptions of and attitudes toward IPE. Six follow-up focus groups also were held with students from the participating professions.

ASSESSMENT

Of 1197 health professions students enrolled, 914 students (76%) attended the IPE session. Two hundred thirty-two of 240 pharmacy students (97%) attended. Forty-three (18.5%) pharmacy students responded to the open-ended questions on the survey instrument. The most frequently reported gains from attending the session were recognition of teamwork importance to benefit the patient (30%) and understanding of other professionals' roles (29%). Shortfalls reported by students related to the content/style of presentation (26%) and technical/organizational (23%) aspects of the session. Pharmacy students who participated in one of the focus groups stated the session demonstrated the benefits as well as facilitators and barriers to collaborative care.

CONCLUSION

The session served as an effective introduction to IPE; debriefing and integration with uniprofessional curricula should occur. Students need additional small group interaction with other health professional students, and can contribute as members of the planning committee.

Developing inter-professional learning: tactics, teamwork and talk

Teamwork and collaboration between all health professionals results in high quality clinical care, and increased job satisfaction for staff. Encouraging inter-professional learning (IPL) may be advantageous in developing more effective teams. There is little rigorous research in this area, but many small uncontrolled studies do demonstrate positive results. IPL involves structured learning opportunities that enhance problem-solving abilities and conflict resolution. It should be clearly differentiated from shared teaching (or multidisciplinary/multiprofessional learning), where common content is taught to many professions without any intention to develop interaction. To counteract the sometimes negative attitudes in both students and staff, educators need to commence IPL early in the programme, base it in both theoretical and clinical placements and ensure that it is valued and assessed. Difficulties with timetabling and accommodation need to be solved prior to commencement. A facilitator should be employed, and a team of committed lecturers developed, with an emphasis on teamwork and the discouragement of individualism. Opportunities for student interaction and ways of improving group dynamics within non-threatening learning environments should to be sought, and instances of conflict embraced and resolved. Future IPL programmes should be rigorously evaluated and may demonstrate enhanced inter-professional relationships and improved quality of patient/client care.