Perceptions versus reality: a qualitative study of students' expectations and experiences of interprofessional education

Impact of a game-based interprofessional education program on medical students' perceptions: a text network analysis using essays

BACKGROUND

The increasing complexity of the healthcare environment and the necessity of multidisciplinary teamwork have highlighted the importance of interprofessional education (IPE). IPE aims to enhance the quality of patient care through collaborative education involving various healthcare professionals, such as doctors, nurses, and pharmacists. This study sought to analyze how game-based IPE activities influence students' perceptions and reflective thinking. It also aimed to identify the shifts in perception and effectiveness caused by this educational approach.

METHODS

The study is based on a game-based IPE program conducted at University A, involving medical and nursing students in structured learning and team-based activities. Data were collected using essays written by the students after they had participated in IPE activities. Text network analysis was conducted by extracting key terms, performing centrality analysis, and visualizing topic modeling to identify changes in students' perceptions and reflective thinking.

RESULTS

Keywords such as "patient," "thought," "group," "doctor," "nurse," and "communication" played a crucial role in the network, indicating that students prioritized enhancing their communication and problem-solving skills within the educational environment. The topic modeling results identified three main topics, each demonstrating the positive influence of game-based collaborative activities, interprofessional perspectives, and interdisciplinary educational experiences on students. Topic 3 (interdisciplinary educational experience) acted as a significant mediator connecting Topic 1 (game-based collaborative activity experience) and Topic 2 (interprofessional perspectives).

CONCLUSION

This study demonstrates that game-based IPE activities are an effective educational approach for enhancing students' team building skills, particularly communication and interprofessional perspectives. Based on these findings, future IPE programs should focus on creating collaborative learning environments, strengthening communication skills, and promoting interdisciplinary education. The findings provide essential insights for educational designers and medical educators to enhance the effectiveness of IPE programs. Future research should assess the long-term impacts of game-based IPE on clinical practice, patient outcomes, and participants' professional development.

Merging the Worlds of Pets and Pills: Development and Evaluation of an Interprofessional Activity Linking Pharmacy and Veterinary Medicine

Interprofessional education (IPE) is noticeably lacking between pharmacy and veterinary medicine students despite the two health professions overlapping in practice. To address this, an asynchronous IPE activity was developed together with practicing pharmacists and veterinarians. Students worked in groups across two campuses to discuss clinical cases, specifically requiring input from both professions. Students reported they learned more about the two professions' interconnection, felt prepared to interact with the other professionals in the future, and found value in learning from each other. Overall, the results of this study outline a successful pilot IPE activity between veterinary medicine and pharmacy students.

The Interprofessional Standardized Patient Experience: An Effective Interprofessional Education Activity for Prelicensure Health Professional Students

Introduction

For future success in the modern health care environment, health professions students require effective interprofessional education experiences to develop their perceptions of other professionals on the health care team. The Interprofessional Standardized Patient Experience (ISPE) is an interprofessional education activity for prelicensure health professional students in nursing, pharmacy, physical therapy, medicine, social work, and occupational therapy.

Methods

The ISPE involved collaboration among students to conduct a subjective interview. Students from six health care professions individually interviewed a simulated patient while being observed by students from other professions. A structured faculty-guided debriefing session followed the comprehensive interview process. Students completed a voluntary pre- and post-ISPE survey with interprofessional questions and feedback on the activity. Descriptive statistics were used to analyze individual responses. Differences in student opinions by student profession and by the number of professions present were examined using chi-square tests.

Results

Over 4 consecutive academic years, 1,265 students completed the ISPE, and 1,028 completed the pre- and post-ISPE surveys. Analysis of the survey responses indicated that the ISPE enhanced student awareness of the functions of an interprofessional team and increased student knowledge of the roles of different health care professions. Students rated the ISPE as a valuable experience. Differences were noted in some of the measures by profession and group size.

Discussion

A single ISPE had a significant impact on prelicensure students' perceptions. The ISPE is a novel and effective approach to interprofessional education that students appreciate.

Interprofessional education in undergraduate dental curricula: A systematic review

INTRODUCTION

Health professionals who effectively communicate and coordinate their work increase patient safety and quality of care. Therefore, an interprofessional education (IPE) program may be a valuable addition to the curriculum of health science courses. This study aims to verify how IPE has been implemented in undergraduate dental program curricula.

METHODS

This is a qualitative systematic review performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with qualitative and qualitative-quantitative studies selected in the period between 2011 and 2021. The guiding question was as follows: how has IPE been implemented in undergraduate dentistry curricula around the world? The quality of the included articles was assessed using the CASP Qualitative Checklist (2018).

RESULTS

After the review, 22 studies were selected and data were extracted following the acronym PICo (Population, phenomenon of Interest, and COntext). The majority of studies in which IPE is included in Dentistry come from North American universities. Regarding the IPE teaching methodology, the use of active methodologies was observed and the interprofessional skills most common were role clarity, teamwork, and communication.

CONCLUSION

This systematic review indicated that Dentistry is included in interprofessional activities in many studies around the world, and primarily with colleagues in medicine, nursing, and pharmacy programs. IPE teaching takes place through the use of active methodologies and develops important skills for interprofessional work.

Social work involvement on student interprofessional teams: a qualitative investigation

Social workers on interprofessional teams help highlight the mental health aspects of wellness and alert teams to potential social barriers to care. Social work students have been valued in new interprofessional education (IPE) initiatives across the United States; however, researchers have shown that social work practitioners often feel outside of and not valued by interprofessional teams. Social work student reflections were analyzed as research data to explore experiences on student IPE teams. This was an inductive, qualitative study informed by literary analysis methods, reading for power dynamics and implicit bias. This analysis uncovered social work students holding on to stereotypes of other professions as well as detrimental stereotypes of their own profession. Displays of respect for social work and early opportunities for successful advocacy allowed social work students to feel confident in their role and encouraged participation. This study considers how social work participation can be encouraged on interprofessional student teams.

Student Pharmacists' Attitude Changes Toward Interprofessional Education Following an Introductory Interprofessional Course

Objective. Interprofessional education (IPE) has the potential to enhance collaboration among health care professionals in providing best patient care. Several IPE studies reported findings about multiple disciplines, but there is scant information focusing on IPE in student pharmacists. The objectives of this study were to, first, measure changes in student pharmacists' attitudes toward introductory interprofessional education using the survey Students Perceptions of Interprofessional Clinical Education Revised 2 (SPICE-R2) and, second, obtain a comprehensive understanding of attitude changes by integrating quantitative and qualitative results.Methods. A convergent mixed-methods design was used and involved quantitative data about the attitudes measured by the SPICE-R2 survey and qualitative open-ended questions about students' opinions. Participants completed the survey three times, namely before and after completing an online course and after participating in an in-person event.Results. Of 89 student pharmacists that participated in this study, 55 and 27 students provided complete responses for the online course and the event, respectively. Paired t tests showed significant improvements in students' attitudes after completing the online course for the three SPICE-R2 subdomains, and the qualitative data was confirmatory. After participating in the event, students' attitudes were not significantly changed. The meta-inferences were expansive in four areas, including team building, professional communication, learning from the group case study, and health care challenges.Conclusion. The online course was an effective learning activity for improving student pharmacists' attitudes toward IPE. The event was a viable learning activity to maintain or increase the students' attitudes toward interprofessional roles and teamwork. The mixed-methods findings provided "value added" with a more comprehensive understanding of attitude change.

Interprofessional education for shared decision making in drug therapy: a scoping review

The current complex scenario of medication use calls for the implementation of interprofessional education (IPE) initiatives focused on shared decision making (SDM) in drug therapy. A scoping review was conducted to collate, summarize, and report the evidence available on IPE teaching and learning approaches in this context, involving pre-licensure healthcare students. Searches were conducted in seven electronic databases, with 21 articles meeting the inclusion criteria. This review examines educational strategies employed for interprofessional SDM as well as characteristics of students, teachers, and tutors involved in IPE interventions. The reviewed studies lack detailed description of the students' decision-making process, and none addresses aspects related to patient preferences as a part of learning outcomes. We identified shortcomings in how IPE interventions are assessed and reported. Only a few of the studies explicitly describe the use of competency-based frameworks proposed by national and international organizations, and less than 60% describe learning outcomes. The absence of experiences focused on interprofessional SDM in drug therapy suggests a gap that needs to be addressed with future studies evaluated in a robust way. We argue that such experiences enable students, as a team, to learn to share decisions with the patient as an effective team member.

Evaluating the impact of interprofessional forums on dental medicine students' collaborative practice skill perception

PURPOSE

This study evaluates third-year dental medicine students' perceived competencies related to interprofessional collaborative practice (IPCP) after completing two exposure level experiences with students from other professions across a large academic health center.

METHODS

Two cohorts of D3 dental medicine students (2018-2019 and 2019-2020) completed the Interprofessional Collaborative Competencies Attainment Survey (ICCAS) after participating in in-person 2.5-h Interprofessional (IP) Forums in the Fall and Spring semesters. Self-reported competencies were compared between pre-and post-IP Forum ratings and between Fall and Spring.

RESULTS

Prior to the IP Forums, dental medicine students (n = 185) reported perceived skill in the interprofessional competencies to be from Good to Very Good using the ICCAS. After participation in the Fall IP Forum, students' ICCAS scores increased in all ICCAS subscales with large effect sizes. Students reported a perceived decline in these skills in the four months between Fall and Spring IP Forums and restoration of IP skill levels after participating in a second IP Forum (Spring).

CONCLUSIONS

Participation in IP Forums has a positive impact on students' IPCP skill perception. Our data suggest that perceived skill level requires repeated IP learning experiences. If dental medicine students are expected to embrace collaborative practice to enhance patient outcomes, then dental school educators must provide opportunities for students to engage in collaborative practice experiences at all levels of their training.

Interprofessional Education Week: the impact of active and passive learning activities on students' perceptions of interprofessional education

Healthcare professions faculty at a private Midwestern university designed an Interprofessional Education (IPE) Week, consisting of 12 different interprofessional learning activities over the span of one week. The purpose of the study was to determine students' perceptions toward interprofessional healthcare, as measured by the Student Perceptions of Interprofessional Clinical Education-Revised (SPICE-R), one week before and one week after the events to determine if the type of learning activity - more passive, didactic-type events or active learning events - impacted outcomes. Of the over 400 students representing predominantly athletic training, nursing, occupational therapy, and physical therapy programs who attended IPE Week, a total of 190 health professions students completed the pre- and post-IPE Week SPICE-R. Students who attended an active learning activity had a statistically significant increase in all three factors of the tool (interprofessional teamwork and team-based practice, roles/responsibilities for collaborative practice, and patient outcomes from collaborative practice) while students who attended more passive didactic type events only showed a statistically significant increase in roles/responsibilities and patient outcomes. This study demonstrates the utility of an IPE Week on student perceptions and highlights the potential importance of active interprofessional learning offerings.

Longitudinal outcomes of a brief interprofessional educational experience with or without an interprofessional education course

Best practices for delivering interprofessional education (IPE) continue to be debated. The objective of this study was to compare the longitudinal effects of two different methods of delivering IPE: a one-day IPE symposium (Symposium Only) vs. a one-day symposium plus a semester-long IPE course (Symposium + IPE). 40 Health Services Administration (HSA) and 57 Occupational Therapy (OT) students participated in this study. Participant attitudes in the Symposium Only group were compared to participant attitudes in the Symposium + IPE group using the Attitudes toward Health Care Teams Scale (ATHCTS). Participants completed the survey prior to the symposium (Time 1), immediately after the symposium (Time 2), and at least 18 months after the symposium (Time 3). A series of one-way repeated measures ANOVAs indicated that students in either the Symposium Only or Symposium +IPE group showed significantly better attitudes toward interprofessional teamwork at Time 2, and that these attitudes were maintained at Time 3. This was true for total ATHCTS, the Physician Centrality subscale, and Quality of Care/Process subscale. While the addition of the semester-long IPE course negatively impacted attitudes toward interprofessional teamwork in the short-term (at Time 2), it had no negative long-term impact at Time 3. Long-term, it appears that adding a semester-long course to a one-day symposium had no impact on attitude toward interprofessional teamwork.

IPE-COM: a pilot study on interprofessional learning design for medical and midwifery students

Background

The skills of interprofessional teamwork, such as collaboration, team management, and interprofessional communication skills, should be embedded in the early stages of health profession education. In Indonesia, medical doctors and midwives have important roles and often work closely to partnership within the primary health care settings. Therefore, both medical students and midwifery students should have an interprofessional education training together during their professional education, using a community-based learning approach.

Purpose

This study aimed to investigate the effect of a community-based interprofessional educational learning on collaborative competencies (communication, collaboration, roles and responsibilities, collaborative patient-centered approach, the team functioning, and conflict management).

Method

Pre-experimental study with one group pre- and post-test design in 15 medical students and 19 midwifery students were involved in the community-based IPE (IPE-COM) course, later divided into nine groups. Data were collected by direct observations of supervisors using Interprofessional Collaborator Assessment Rubric (ICAR) instrument.

Results

The finding showed significant increase in IPE competencies before and after the 4-week course. IPE community-based learning had the strongest effect on the team’s functioning competence, while collaborative patient-centered approach competence had a moderate effect.

Conclusion

IPE community-based learning had positive impact with increasing collaborative competencies for both medical and midwifery students.

Care Across Campus: Athletic Training, Nursing, and Occupational Therapy Student Experiences in an Interprofessional Simulation

Context:

This study explored health care students' experiences after participation in an interprofessional simulation. Interprofessional education incorporates students from several health care professions in a controlled, collaborative learning environment. Athletic training students are not well represented in interprofessional education literature.

Objective:

This study sought to explore the attitudes of athletic training, nursing, and occupational therapy students toward other professions after their participation in an interprofessional simulation.

Design:

This article describes the results of the qualitative portion of a mixed-methods study. Focus group discussions related to elements of the Interprofessional Attitude Scale to explore participants' attitudes toward other professions. Researchers analyzed transcribed focus group discussions for themes.

Setting:

This study occurred in a private midsized Midwestern university.

Patients or Other Participants:

Seventy-nine students, representing athletic training, nursing, and occupational therapy, participated in the simulation; a sample of 13 of these participated in the focus groups.

Intervention(s):

Students in all professions cared for or observed the care of a standardized patient from the time of a spinal cord injury on the football field through an ambulance ride and subsequent emergency and inpatient care. Students collaborated and communicated with one another. Faculty conducted debriefing after the simulation and before the focus groups.

Main Outcome Measure(s):

Focus groups included relevant questions from the Interprofessional Attitudes Scale, and themes were identified from participants' responses.

Results:

Researchers identified 4 themes from the focus group discussions: collaboration, respect, knowledge of other professions, and communication. These themes also mirror elements of the Interprofessional Education Collaborative's core competencies of interprofessional collaborative practice.

Conclusions:

After the simulation, students expressed positive attitudes toward other professions. This study suggests that athletic training, nursing, and occupational therapy students have positive attitudes toward each other's professions after an interprofessional simulation activity.

Interprofessional education among Nigerian clinical students: implications for interprofessional care

Interprofessional education (IPE) is effective for teaching health profession students about the roles of different healthcare professionals for collaborative practice. This study was designed to investigate clinical students' awareness, knowledge, and perception of IPE. A mixed method convergent parallel design of Cross-Sectional Survey (CSS) and Focus Group Discussion (FGD) was used. Data on awareness, perception and knowledge about IPE were collected using a self-developed, content-validated questionnaire and Readiness for Interprofessional Learning Scale, respectively, and was analysed using Chi-Square, and Mann-Whitney U test at α = 0.05. For the FGD, data were collected from 13 purposively selected students in a Nigerian university and analysed through content thematic analysis. Participants in the CSS were aged 21.9 ± 2.0 years. Over half of the participants (57.4%) reported being unaware of IPE. More than half (73.0%) of the participants that were aware had good knowledge. Majority (93.3%) had a positive perception of IPE. There was a significant association between participants' knowledge and perception (p = 0.008) of IPE; however, there was no significant association (p = 0.051) between their awareness and perception. Also, there were no significant sex variations in the knowledge of IPE (0.371). However, there was a significant sex difference in their perception (p = 0.008). Some of the discussants in the FGD reported being aware of the term IPE. Discussants had at least fair knowledge of IPE and reported that IPE is important; and supports its formal implementation and inclusion in the curricula of study; emphasizing that it should be started early enough in their training. Awareness of interprofessional education is sub-optimal among these clinical students, however more than half of those who were aware had good knowledge. Most of them had a positive perception. There is a need to improve clinical students' awareness and knowledge about IPE by using integrated seminars and implementing IPE into the curricula of their training.

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.

Perspectives of pharmacy students in Qatar toward interprofessional education and collaborative practice: a mixed methods study

In an IPE environment, students are expected to have better understanding of the roles, responsibilities, and contribution of other health care professions to enhance interprofessional working and collaboration with an end result of improving patient-centred and team-based care. Although many studies have investigated students' attitudes, very few employ a mixed methods design and hardly are from Middle Eastern countries. A two-staged sequential explanatory mixed method design was used to comprehensively capture the perspectives of pharmacy students toward IPE and collaborative practice. A quantitative survey was conducted as the first stage of the study, followed by an in-depth discussion of these perspectives through a qualitative phase by conducting two focus groups. For the quantitative surveys, the overall response rate was 102/132 (77%) for pharmacy students in Qatar. This was followed by two focus groups with a total of 27 participants from senior and junior students. In exploring the qualitative data, three main themes were identified in relation to the pharmacy students' perspectives. These were on the pharmacy students' perception on the enablers (professional related benefits, patient-related benefits and current positive influences), barriers (previous IPE experiences, educational related issues and current working practices and processes), and recommendations to implementing IPE and collaborative practice (future IPE and pharmacy profession).Overall, the results demonstrate a strong readiness and positive perception by pharmacy students toward IPE and collaborative practice. This study has highlighted different dimensions in pharmacy students' perceptions. It also provided a useful insight into the readiness of pharmacy students in a Middle Eastern university. Students are seeking more IPE experiences formally incorporated into their curriculum and hence educators should capitalise on these positive and enthusiastic attitudes to identify the most effective means for delivering IPE and inform curricula planning. Collaborative practice-ready graduates will produce better-educated professionals delivering higher quality care.

A Pilot Study on an Interprofessional Course Involving Pharmacy and Dental Students in a Dental Clinic

Objective. To assess the effect of a dental clinical rotation program involving pharmacy students and dental students. Methods. An interprofessional education (IPE) course was offered as an elective to second-year pharmacy students and required for third-year dental students. The course included two in-class sessions, one online lecture, and five clinic sessions. Program evaluation analyses included a comparison of participating versus nonparticipating students on a knowledge survey of pharmacotherapy and IPE, and a descriptive analysis of IPE course evaluation results. Results. Among pharmacy students, mean scores were significantly higher for participants than nonparticipants on the 31-item pharmacy knowledge component of the survey. On the eight-item IPE component of the survey, scores were significantly higher for participants than for nonparticipants, both among pharmacy students and among dental students. Awareness and attitudes about IPE were generally high among course participants. Conclusion. An IPE course that integrates second-year pharmacy students with third-year dental students in the dental clinic to provide medication history, education, and identification of potential drug-related problems improved pharmacy students' knowledge of pharmacotherapy related to or associated with dental conditions and improved pharmacy and dental students' knowledge and attitudes about IPE.

Defining and understanding the relationship between professional identity and interprofessional responsibility: implications for educating health and social care students

This paper is concerned with exploring the relationship between perceptions of professional identities, interprofessional education (IPE) and collaborative practice. It seeks to introduce the concept of interprofessional responsibility as both a shift in the way in which to conceptualise the professional identity of Health and Social Care (H&SC) staff and as a new set of practices that help to inform the way in which students are prepared for collaborative working. The presented research, undertaken as part of a Ph.D. study, is based upon semi-structured interviews (n = 33) with H&SC staff who were recruited from both the United Kingdom (UK) Health Service and UK universities. Drawing upon thematic analysis of the data, the results of the research identified that previous conceptualisations of professional identity aligned to a whole profession do not relate to the way in which professionals perceive their identities. Senior professionals claimed to be more comfortable with their own professional identity, and with working across professional boundaries, than junior colleagues. Academic staff also identified that much IPE currently taught in universities serves the purpose of box-ticking rather than being delivered in meaningful way. It is proposed that the findings have implications for the way in which IPE is currently taught, and that adoption of the proposed concept of 'interprofessional responsibility' may help address some of the concerns these findings raise.

Interprofessional education in dental education: An international perspective

Interprofessional collaborative care (IPC) is defined as working within and across healthcare disciplines and is considered essential to achieve a more inclusive, patient-centred care, provide a means to support patient safety and address global healthcare provider shortages. Interprofessional education (IPE) provides the knowledge and experience students need to achieve these goals. ADEE/ADEA held a joint international meeting 8-9 May 2017, with IPE being one of four topic areas discussed. The highly interactive workshop format, where "everyone was an expert," supported discussion, sharing and creative problem-solving of over seventy-one participants from twenty-nine countries. IPE participants broke out into five groups over a two-day period discussing three main areas: challenges and barriers to implementing IPE within their institution or country; discussion of successful models of introducing and assessing IPE initiatives, and exploring best practices and next steps for implementation for each group member. A mind-mapping model was used to graphically display participants' thoughts and suggestions. Key themes, revealed through the visual mind maps and discussion, included the following: IPE should lead to and enhance patient-centred care; student involvement is key to IPE success; faculty development and incentives can facilitate adoption and implementation of IPE; the role of a "champion" and leadership structure and commitment is important to move IPE forward; and IPE must be tailored to the unique issues found in each country. Overall, there was a high level of interest to continue both collaboration and discussion to learn from others beyond the London meeting.

What did first-year students experience during their interprofessional education? A qualitative analysis of e-portfolios

Interprofessional collaboration is an essential approach to comprehensive patient care. As previous studies have argued, interprofessional education (IPE) must be integrated in a stepwise, systematic manner in undergraduate health profession education programmes. Given this perspective, first-year IPE is a critical opportunity for building the foundation of interprofessional collaborative practice. This study aims to explore the first-year students' learning processes and the longitudinal changes in their perceptions of learning in a year-long IPE programme. Data were collected at a Japanese medical university, in which different pedagogical approaches are adopted in the IPE programme. Some of these approaches include interprofessional problem-based learning, early exposure, and interactive lecture-based teaching. The students are required to submit written reflections as a formative assessment. This study conducted an inductive thematic analysis of 104 written reflections from a series of e-portfolios of 26 first-year students. The themes related to learning outcomes from student perspectives included communication (e.g., active listening and intelligible explanation), teams and teamwork (e.g., mutual engagement and leadership), roles/responsibilities as a group member (e.g., self-directed learning and information literacy), and roles/responsibilities as a health professional (e.g., understanding of the student's own professional and mutual respect in an interprofessional team). The study also indicated three perspectives of students' learning process at different stages of the IPE, i.e., processes by which students became active and responsible learners, emphasised the enhancement of teamwork, and developed their own interprofessional identities. This study revealed the first-year students' learning processes in the year-long IPE programme and clarified the role of the first-year IPE programme within the overall curriculum. The findings suggest that the students' active participation in the IPE programme facilitated their fundamental understanding of communication/teamwork and identity formation as a health professional in interprofessional collaborative practice.

[Overlapping, interdependence or complementarity, interprofessional collaboration between nurse practitioners and other health professionals in Ontario]

OBJECTIVE

The Naylor Report (2015) states that nurse practitioners (NP) are still underutilized in Canada despite positive evidence of their work and the benefits they provide to health systems and, more generally, the health of the population.

METHODS

Why are nurse practitioners not more actively involved in the Canadian health care system? A socio-historical literature review showed that there is overlap, interdependence or complementarity between the role of NPs and that of other health professionals and that this concerns their status, training as well as the scope of their practice. The development of an interprofessional collaborative approach, although supported by most professional nursing associations in Canada, is difficult to establish in NP practice and training.

RESULTS

This article describes the emergence of the role of NPs in Canada and provides an update on the current status of their integration in the health system with reference to the Ontario example. It provides insight into the overlap and zones of complementarity or interdependence between NPs and other health professionals.

CONCLUSION

In conclusion, the authors call for improved governance by the contribution of a new collaborative contract with other health professionals. This contract should be based on the interdependence of practices and the complementarity of roles between all health professionals including NPs.

Development and delivery of an interdisciplinary course in mobile health (mHealth)

BACKGROUND

Interdisciplinary practice is a primary focus within the United States health care system. Despite the existence of interdisciplinary educational efforts in pharmacy for many years, the practice only recently entered mainstream health care education. Informatics offers interdisciplinary educational opportunities. Mobile health (mHealth), an informatics sub-discipline, is the use of mobile devices for health and wellness activities. We used the mHealth domain as the context for an interdisciplinary learning experience for pharmacy and computer science and software engineering (CSSE) students.

EDUCATIONAL ACTIVITY

Educational activities focused on creating an mHealth course sequence and an mHealth application (app). Students worked in teams to complete various assignments, including developing and presenting a course proposal, building a purchase plan for mHealth equipment, developing an mHealth app prototype, delivering a disease state presentation (pharmacy students only), developing use case scenarios (CSSE students only), and completing peer evaluations.

CRITICAL ANALYSIS OF THE EDUCATIONAL ACTIVITY

Course evaluations were only available from pharmacy students. They indicated an overall favorable rating (mean 3.27-3.55; 4=strongly agree). Survey data collected after students entered the workforce indicated that students felt better prepared than their colleagues to work with individuals from other disciplines (mean 4.82; 5=strongly agree). Students also indicated using the knowledge from course proposal development in their careers (mean 4.27; 5=strongly agree). Through team interactions, students learned from each other while overcoming challenges related to terminology and content areas. Skills learned through team interactions reflect real-world processes and are expected to support students' future professional responsibilities.

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.

Simulation in Occupational Therapy Curricula: A literature review

BACKGROUND/AIM

Simulated learning experiences are increasingly being used in health-care education to enhance student engagement and provide experiences that reflect clinical practice; however, simulation has not been widely investigated in occupational therapy curricula. The aim of this paper was to: (i) describe the existing research about the use and evaluation of simulation over the last three decades in occupational therapy curricula and (ii) consider how simulation has been used to develop competence in students.

METHODS

A literature review was undertaken with searches of MEDLINE, CINAHL and ERIC to locate articles that described or evaluated the use of simulation in occupational therapy curricula.

RESULTS/FINDINGS

Fifty-seven papers were identified. Occupational therapy educators have used the full scope of simulation modalities, including written case studies (22), standardised patients (13), video case studies (15), computer-based and virtual reality cases (7), role-play (8) and mannequins and part-task trainers (4). Ten studies used combinations of these modalities and two papers compared modalities. Most papers described the use of simulation for foundational courses, as for preparation for fieldwork, and to address competencies necessary for newly graduating therapists. The majority of studies were descriptive, used pre-post design, or were student's perceptions of the value of simulation.

CONCLUSION

Simulation-based education has been used for a wide range of purposes in occupational therapy curricula and appears to be well received. Randomised controlled trials are needed to more accurately understand the effects of simulation not just for occupational therapy students but for longer term outcomes in clinical practice.

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.

How We Engage Graduating Professional Students in Interprofessional Patient Safety

PROBLEM

Interprofessional curricula on patient safety do not acknowledge the culture and vulnerabilities of the student experience and often do not engage students.

METHODS

We describe a patient safety collaboration between graduating nursing and medical students during their Capstone courses that fostered conversations about the similarities and differences in professional school experiences around patient safety. Students wrote reflections about an unanticipated patient outcome. Qualitative content analysis was used to characterize themes within student reflections, and to create audience response system questions to highlight differences in each profession's reflections and to facilitate discussion about those differences during the collaboration.

FINDINGS

Medical students identified events in which perceived patient outcomes were worse than events identified by nursing students. Nursing students identified more near-miss events. Nursing students positively impacted the event and attributed action to the presence of a clinical instructor and personal responsibility for patient care. Medical students described themselves as "only a witness" and attributed inaction to hierarchy and concern about grades.

CONCLUSIONS

Students felt the session would change their future attitudes and behaviors. Stevenson Chudgar Molloy Phillips Engle Clay.

Design and evaluation of an IPE module at the beginning of professional training in medicine, nursing, and physiotherapy

AIM

Interprofessional education (IPE) is a central feature of modern education in the health care professions. Despite this, empirically founded and systematically structured IPE courses are absent from many curricula. To answer the WHO's call for improved interprofessional collaboration in the health care system, a seminar was designed, implemented and evaluated. The target group consisted of students beginning nursing and medical studies (first and second semesters) and physiotherapy students (first year of training). The aim was to develop a basic IPE module focusing not only on the demands placed by academia and politics, but also the interests of the target group. This module was evaluated on the basis of the modified four-level Kirkpatrick approach.

METHOD

Based on focus group interviews analyzed qualitatively using Mayring's content analysis, it was possible to define five learning objectives and develop four practice-oriented modules. The seminar was then implemented and evaluated using written pre- and post-seminar evaluations and group discussions.

RESULTS

Analysis confirmed the success of the IPE concept in that the seminar was positively rated by attendees not only in terms of their immediate reactions, but also attitude, knowledge and skills according to Kirkpatrick.

CONCLUSION

In the future, it is intended to offer the IPE module on a permanent basis and assess the competencies acquired in the seminar using observation. Courses to ensure sustained learning outcomes would also be desirable.

Perceptions of interprofessional clinical simulation among medical and nursing students: A pilot study

Interprofessional education (IPE) is a well-supported concept in medical education and a priority for leadership. How students experience IPE is unclear. This pilot study evaluated how medical and nursing students perceived and experienced IPE. Ten medical and 10 nursing students participated in a clinical simulation-based IPE exercise with 2 medical and 2 nursing students per group. Participants completed the KidSIM ATTITUDES questionnaire before and after the exercise. Students gave verbal feedback during the post-exercise debrief. Statistical analyses showed perceptions of the group became more positive with the exercise. With statistical significance across all the domains (relevance of IPE and simulation, communication, situation awareness, and roles/responsibilities), verbal comments were positive. A single clinical simulation-based IPE exercise improved perceptions of IPE among these students. These results provide further impetus to continue to study IPE for medical and nursing students. The findings also support the inclusion of IPE in medical education.

Interprofessional education in team communication: working together to improve patient safety

BACKGROUND

Communication failures in healthcare teams are associated with medical errors and negative health outcomes. These findings have increased emphasis on training future health professionals to work effectively within teams. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) communication training model, widely employed to train healthcare teams, has been less commonly used to train student interprofessional teams. The present study reports the effectiveness of a simulation-based interprofessional TeamSTEPPS training in impacting student attitudes, knowledge and skills around interprofessional communication.

METHODS

Three hundred and six fourth-year medical, third-year nursing, second-year pharmacy and second-year physician assistant students took part in a 4 h training that included a 1 h TeamSTEPPS didactic session and three 1 h team simulation and feedback sessions. Students worked in groups balanced by a professional programme in a self-selected focal area (adult acute, paediatric, obstetrics). Preassessments and postassessments were used for examining attitudes, beliefs and reported opportunities to observe or participate in team communication behaviours.

RESULTS

One hundred and forty-nine students (48.7%) completed the preassessments and postassessments. Significant differences were found for attitudes toward team communication (p<0.001), motivation (p<0.001), utility of training (p<0.001) and self-efficacy (p=0.005). Significant attitudinal shifts for TeamSTEPPS skills included, team structure (p=0.002), situation monitoring (p<0.001), mutual support (p=0.003) and communication (p=0.002). Significant shifts were reported for knowledge of TeamSTEPPS (p<0.001), advocating for patients (p<0.001) and communicating in interprofessional teams (p<0.001).

CONCLUSIONS

Effective team communication is important in patient safety. We demonstrate positive attitudinal and knowledge effects in a large-scale interprofessional TeamSTEPPS-based training involving four student professions.

Interprofessional Education and Practice Guide No. 1: developing faculty to effectively facilitate interprofessional education

With the growth of interprofessional education (IPE) and practice in health professional schools, faculty members are being asked to assume new roles in leading or delivering interprofessional curriculum. Many existing faculty members feel ill-prepared to face the challenges of this curricular innovation. From 2012–2013, University of Missouri – Columbia and University of Washington partnered with six additional academic health centers to pilot a faculty development course to prepare faculty leaders for IPE. Using a variety of techniques, including didactic teaching, small group exercises, immersion participation in interprofessional education, local implementation of new IPE projects, and peer learning, the program positioned each site to successfully introduce an interprofessional innovation. Participating faculty confirmed the value of the program, and suggested that more widespread similar efforts were worthwhile. This guide briefly describes this faculty development program and identifies key lessons learned from the initiative. Peer learning arising from a faculty development community, adaptation of curricula to fit local context, experiential learning, and ongoing coaching/mentoring, especially as it related to actual participation in IPE activities, were among the key elements of this successful faculty development activity.

Student perspectives on sexual health: implications for interprofessional education

Interprofessional collaboration requires that health professionals think holistically about presenting concerns, particularly for multimodal problems like sexual dysfunction. However, health professions students appear to receive relatively little sexual health education, and generally none is offered on an interprofessional basis. To assess current degree of interprofessional thinking in sexual health care, 472 health professions students in Georgia, United States, were presented with a sexual dysfunction vignette and asked to rate the relevance of, and their familiarity with, interventions offered by several professionals. They also were asked to identify the most likely cause of the sexual dysfunction. Students rated relevance and familiarity with interventions as highest for physicians and lowest for dentists, with higher ratings of nurses by nursing students. More advanced students reported greater familiarity with mental health, physician, and physical therapy interventions. Finally, nursing students were less likely to attribute the dysfunction to a physical cause. These findings indicate that students may prioritize biomedical approaches in their initial assessment and may need additional supports to consider the spectrum of biopsychosocial factors contributing to sexual functioning. To encourage interprofessional critical thinking and prepare students for interprofessional care, sexual health curricula may be improved with the inclusion of interprofessional training. Specific recommendations for curriculum development are offered.

The CanMEDS role of Collaborator: How is it taught and assessed according to faculty and residents?

OBJECTIVE

To explore the perspectives of paediatric residents and faculty regarding how the Collaborator role is taught and assessed.

METHODS

Using a constructivist grounded theory approach, focus groups at four Canadian universities were conducted. Data were analyzed iteratively for emergent themes.

RESULTS

Residents reported learning about collaboration through faculty role modelling but did not perceive that it was part of the formal curriculum. Faculty reported that they were not trained in how to effectively model this role. Both groups reported a need for training in conflict management, particularly as it applies to intraprofessional (physician-to-physician) relationships. Finally, the participants asserted that current methods to assess residents on their performance as collaborators are suboptimal.

CONCLUSIONS

The Collaborator role should be a formal part of the residency curriculum. Residents need to be better educated with regard to managing conflict and handling intraprofessional relationships. Finally, innovative methods of assessing residents on this non-medical expert role need to be created.

An interprofessional psychiatric advanced pharmacy practice experience

OBJECTIVE

To create an interprofessional psychiatry advanced pharmacy practice experience (APPE) and assess the initial outcomes.

DESIGN

An elective psychiatry APPE was developed in a setting of interdisciplinary practice. Preceptor responsibilities were shared between a psychiatric pharmacist and an attending psychiatrist or psychiatric nurse practitioner. Students were also given the opportunity to shadow and work with other health care professionals such as nurses, social workers, therapists, family nurse practitioners, and utilization review staff members.

ASSESSMENT

Midpoint and final evaluations demonstrated student advancement throughout the experience as well as the development of communication skills with patients and an increased ability to work collaboratively with other health care providers. Students rated this practice experience highly and their comments reflected achievement of the established learning objectives.

CONCLUSION

An interdisciplinary elective practice experience in psychiatry at a local teaching hospital was effective in teaching psychiatric care and interprofessional interaction. This teaching model can be adapted for use in other practice settings or specialty areas.

Preparing Nursing Students to Be Effective Health Team Partners Through Interprofessional Education

This article will provide an overview of recent significant activities related to interprofessional education to promote care quality through teamwork and collaboration, followed by a discussion of what nursing schools can do to develop the knowledge, skills, attitudes, and values to enhance health care team performance and care outcomes.