Attitudes of medical students and residents toward multidisciplinary team approach

Attitudes of health care professionals towards interprofessional teamwork in Ashanti Region, Ghana

BACKGROUND

Interprofessional collaboration ensures that high-quality health care is provided leading to improved health outcomes and provider satisfaction. Assessing the attitudes of health care professionals towards teamwork in Ghana is novel.

OBJECTIVE

To examine the attitudes of health care professionals towards interprofessional teamwork and assess specific attributes influencing these attitudes in the Ashanti region, prior to implementing an in-service interprofessional HIV training programme.

METHODS

A cross-sectional pre-training online survey using a modified Attitudes Toward Health Care Teams Scale was conducted among health care practitioners undergoing a two-day interactive interprofessional HIV training in Kumasi and Agogo from November 2019 to January 2020. Trainees were diverse health professional cadres selected from five hospitals in the Ashanti region of Ghana. Data was summarised using the mean and standard deviation for continuous variables, and frequencies and percentages for categorical variables. An exploratory factor analysis was conducted to categorise the 14 items of the modified attitudes scale. The Wilcoxon rank-sum (Mann-Whitney) and Kruskal-Wallis tests were used to test the mean attitude difference among the demographic characteristics. Statistical significance was set at p < 0.05.

RESULTS

Altogether, 302 health professionals completed the survey. The ages ranged from 20-58 years, mean age 27.96 years (standard deviation 5.90 years). Up to 95% of the trainees agreed with the 14 statements on the modified attitudes scale. Three factors were identified; "quality of care", "team efficiency", and "time constraint" with Cronbach's alpha measures of 0.73, 0.50, and 0.45 respectively. The overall mean attitude score was 58.15 ± 6.28 (95% CI, 57.42-58.88). Attitude of health care professionals towards interdisciplinary teams for patient care varied significantly by age (p = 0.014), health profession cadre (p = 0.005), facility (p = 0.037), and professional experience (p = 0.034).

CONCLUSION

Strengthening in-service interprofessional training for health practitioners especially early career professionals in the Ashanti region would be valuable.

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

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

A Mixed-Methods Evaluation of Medical Residents' Attitudes Towards Interprofessional Learning and Stereotypes Following Sonography Student-Led Point-of-Care Ultrasound Training

BACKGROUND

Point-of-care ultrasound (POCUS) training is growing across internal medicine graduate medical education, but lack of trained faculty is a barrier to many programs. Interprofessional education (IPE) may offer a solution but must overcome potential biases of trainees.

AIM

To evaluate the impact of an interprofessional POCUS training on residents' attitudes towards interprofessional learning and stereotypes.

SETTING

Midwestern health sciences university.

PARTICIPANTS

Diagnostic medical sonography (DMS) students (n = 13) served as teachers for first-year internal medicine residents (IMR) (n = 49).

PROGRAM DESCRIPTION

DMS students participated in a train-the-trainer session to learn teaching strategies via case-based simulation, then coached IMR to acquire images of the kidneys, bladder, and aorta on live models.

PROGRAM EVALUATION

Mixed-methods evaluation, including pre-/post-surveys and focus group interviews. The survey response rate was 100% (49/49 IMR). Composite survey scores evaluating residents' attitudes towards IPE and stereotyping of sonographers improved significantly following the intervention. Qualitative analysis of focus group interviews yielded four themes: enhanced respect for other disciplines, implications for future practice, increased confidence of DMS students, and interest in future IPE opportunities.

DISCUSSION

Interprofessional POCUS education can improve residents' perceptions towards IPE, increase their level of respect for sonographers, and motivate interest in future interprofessional collaboration.

The different levels of learning about dying and death: an evaluation of a personal, professional and interprofessional learning journey

BACKGROUND

Although dying and death are common in practice, medical and social work students receive limited teaching on this topic. In addition, they have minimal experience of each others' role in the process, yet respecting the roles of other professionals in this delicate area is paramount to the delivery of high standards of care. In an attempt to address this, a pilot interprofessional 3 hour dying and death workshop was developed for senior social work and medical students using a constructivist approach to explore their own personal, uniprofessional and interprofessional roles in the dying and death process.

METHODS

An expert group of health care professionals designed the workshop through an iterative process. The participants evaluated the workshop in relation to the levels of their learning journey at two time points using a combination of Likert scales and free text.

RESULTS

An afternoon workshop was created comprising a trigger exercise to ascertain the students' own feelings, simulation of the practical aspects relating to a patient's death (confirmation of death, death certification and last offices), and discussion about the grief process, followed by case studies to consolidate their learning and highlight the interprofessional aspect. Eleven final year social work students and 14 medical students in their fourth year took part. Participants felt they gained most from the interprofessional aspect of their learning journey and suggested other topics for interprofessional learning. All students would recommend the workshop to their colleagues.

CONCLUSIONS

This undergraduate interprofessional pilot dying and death workshop was well received and enabled learning on three levels--personal, professional and interprofessional. It promoted a greater understanding of the role of each student's own profession and appreciation of the role of other professionals in the dying and death process.