Decline in medical students' attitudes to interprofessional learning and patient-centredness

Exploring UK undergraduate healthcare students' perspectives on how to effectively design IPE: A qualitative study

Objectives

To explore healthcare undergraduates' views on how to design effective IPE. The need for interprofessional education implementation in undergraduate healthcare education is gaining wide recognition globally. Students' views about their learning experiences can offer useful insights to advance teaching and learning courses. Thus, in the IPE literature, students' views on how to effectively design IPE can help shape future IPE plans.

Methods

Purposeful sampling was used to recruit healthcare students who attended IPE events across three UK institutions. Virtual focus groups were conducted, and audio recorded. Transcripts were thematically analysed and relevant themes were presented under three subheadings, pre, during and post IPE session.

Results

Twenty-five students from medicine, nursing, pharmacy, midwifery and other disciplines participated in six focus groups. Students thought IPE should be offered consistently across the programme's years of study to ensure learning continuity. Students from programmes with higher placement hours (nursing and midwifery), suggested more IPE in placement. Pre-IPE sessions, introducing IPE to students attending for the first time was perceived to be important as the lack of awareness/understanding of IPE could adversely impact their willingness to attend and their engagement. During IPE, interaction with other students was perceived as the core of an effective IPE session. Students reported difficulties in communication with other students via online IPE sessions and thought they were less engaged compared to face-to-face sessions. Post-IPE, students valued reflective exercises, whereas traditional formal assessment was seen as a barrier to engagement with the learning.

Conclusion

Students considered IPE valuable to prepare for future practice. However, students felt that IPE experiences could be enhanced with proper planning to ensure regular compulsory IPE exposure. For better IPE experiences, IPE design and delivery should be in line with each healthcare programme's unique learning and training curriculum.

Capital sharing and socialization in an interprofessional student-led clinic: a Bourdieuan analysis

BACKGROUND

Interprofessional student-led clinics offer authentic clinical experiences of collaborative patient care. However, theoretical research on the sustainability of these clinics, considering forms of capital beyond the economic, remains limited. This study addresses this gap by employing Bourdieu's theoretical framework to explore how alternative conceptions of capital; both social and cultural might sustain conditions for interprofessional working in a student-led clinic serving patients living with a chronic neurological impairment.

METHODS

The teaching and learning focussed clinic was established in 2018 to mirror a clinical service. Semi-structured focus groups with participants involving 20 students from 5 professions and 11 patients gathered in-depth insights into their experiences within the clinic. A thematic analysis was guided by Bourdieu's concepts of field, habitus, and capital.

RESULTS

In the complex landscape of the student-led clinic, at the intersection of a patient support group, a hospital-based aged care facility, and university-based healthcare professions, three pivotal mechanisms emerged underpinning its sustainability: Fostering students' disposition to interprofessional care, Capitalizing on collaboration and patient empowerment, and a Culture of mutual exchange of capital. These themes illustrate how students and patients specific dispositions towards interprofessional healthcare enriched their habitus by focusing on shared patient well-being goals. Diverse forms of capital exchanged by students and patients fostered trust, respect, and mutual empowerment, enhancing the clinic experience.

CONCLUSION

This study bridges an important gap in theoretically informed explorations of the conditions for sustaining student-led clinics, drawing on Bourdieu's theory. It accentuates the significance of investment of diverse forms of capital in such clinics beyond the economic, whilst emphasizing a primary commitment to advancing interprofessional healthcare expertise. Recognizing patients as equal partners shapes clinic dynamics. In order for student clinics to thrive in a sustainable fashion, educators must shift their focus beyond solely maximizing financial resources. Instead, they should champion investments in a wider range of capital forms. This requires active participation from all stakeholders; faculties, patient partners, service providers, and students. These findings underscore the importance of investing in interprofessional learning by optimizing various forms of capital, and embracing patients as dynamic contributors to the clinic's sustainability.

Demanded interdisciplinary subjects for integration in medical education program from the point of view of graduated medical physicians and senior medical students: a nationwide mixed qualitative-quantitative study from Iran

INTRODUCTION

This study aimed to detect interdisciplinary subjects for integration into the medical education program of Iran.

METHODS

A qualitative-quantitative method was used. Firstly, interdisciplinary subjects demanded by medical graduates and senior medical students were defined by qualitative study. In the second stage, questionnaire was developed which based on the findings of qualitative stage, experts' opinion and reviewing of the national general guide of professional ethics for medical practitioners. Questionnaire consisted of demographic, occupational and thirteen interdisciplinary items. These items consisted of social determinants of health, social and economic consequences of disease, social prescribing, physicians' social responsibility, role of gender, racial, ethnic, social and economic issues in approach to patients, role of logic and mathematics in clinical decision-making, philosophy of medicine, maintaining work-life balance, self-anger management, national laws of medicine, religious law in medical practice, health system structure, and teamwork principles. Level and importance of knowledge and self-assessed educational needs were asked about each item. In the third stage, a national online survey was conducted. SPSS 25 was used for statistics.

RESULTS

By content analysis of data in qualitative stage, 36 sub-themes and 7 themes were extracted. In the quantitative part, 3580 subjects from 41 medical universities across Iran participated in this study. 2896 (80.9%) were medical graduates and 684 (19.1%) were senior medical students. Overall, knowledge about interdisciplinary items was low to intermediate, while high to very high knowledge ranged from maximally 38.7% about socioeconomic consequences of disease to minimally 17.2% about social prescribing. Participants gave the most importance to the having knowledge about self-anger management (88.3%), maintaining work-life balance (87.2%) and social determinants of health (85.8%), respectively. However, national laws of medicine (77.6%), maintaining work-life balance (75.4%) and self-anger management (74%) were the first top three educational demands by participants.

CONCLUSION

This study revealed a low to moderate level of knowledge about interdisciplinary topics among both graduated medical physicians and senior medical students. These groups showed a strong demand and tendency to know and to be educated about these topics. These findings underscore the urgency for educational reforms to meet the interdisciplinary needs of medical professionals in Iran.

Virtual and Interprofessional Objective Structured Clinical Examination in Dentistry and Dental Technology: Development and User Evaluations

BACKGROUND

Interprofessional education (IPE) facilitates interprofessional collaborative practice (IPCP) to encourage teamwork among dental care professionals and is increasingly becoming a part of training programs for dental and dental technology students. However, the focus of previous IPE and IPCP studies has largely been on subjective student and instructor perceptions without including objective assessments of collaborative practice as an outcome measure.

OBJECTIVE

The purposes of this study were to develop the framework for a novel virtual and interprofessional objective structured clinical examination (viOSCE) applicable to dental and dental technology students, to assess the effectiveness of the framework as a tool for measuring the outcomes of IPE, and to promote IPCP among dental and dental technology students.

METHODS

The framework of the proposed novel viOSCE was developed using the modified Delphi method and then piloted. The lead researcher and a group of experts determined the content and scoring system. Subjective data were collected using the Readiness for Interprofessional Learning Scale and a self-made scale, and objective data were collected using examiner ratings. Data were analyzed using nonparametric tests.

RESULTS

We successfully developed a viOSCE framework applicable to dental and dental technology students. Of 50 students, 32 (64%) participated in the pilot study and completed the questionnaires. On the basis of the Readiness for Interprofessional Learning Scale, the subjective evaluation indicated that teamwork skills were improved, and the only statistically significant difference in participant motivation between the 2 professional groups was in the mutual evaluation scale (P=.004). For the viOSCE evaluation scale, the difference between the professional groups in removable prosthodontics was statistically significant, and a trend for negative correlation between subjective and objective scores was noted, but it was not statistically significant.

CONCLUSIONS

The results confirm that viOSCE can be used as an objective evaluation tool to assess the outcomes of IPE and IPCP. This study also revealed an interesting relationship between mutual evaluation and IPCP results, further demonstrating that the IPE and IPCP results urgently need to be supplemented with objective evaluation tools. Therefore, the implementation of viOSCE as part of a large and more complete objective structured clinical examination to test the ability of students to meet undergraduate graduation requirements will be the focus of our future studies.

Effectiveness of interprofessional education for medical and nursing professionals and students on interprofessional educational outcomes: A systematic review

AIM AND BACKGROUND

Patient safety is a global health priority as unsafe care is a principal cause of death and disability. Ineffective interprofessional communication and collaboration among nursing and medical professionals and students contribute to unsafe practices. Interprofessional education provides opportunities to strengthen nurse-physician collaboration and enhance patient care. However, there is inconclusive evidence regarding interprofessional education effectiveness. This review aims to systematically evaluate interprofessional education effectiveness for nursing and medical professionals and students on interprofessional educational outcomes (interprofessional attitudes, perceptions, skills, knowledge, behaviours, and organisational and patient outcomes).

DESIGN AND METHODS

PubMed, Cochrane Library, Embase, Scopus, CINAHL, ERIC, PsycInfo, Web of Science were last searched on 13 January 2022. This review included published and unpublished randomised controlled trials, quasi-experimental and mixed-method studies in English examining interprofessional education outcomes among nursing and medical professionals and students. Two reviewers independently appraised studies using the Joanna Briggs Institute Critical Appraisal Tools and extracted data using a modified Joanna Briggs Institute data extraction form. Narrative synthesis was conducted instead of meta-analysis since majority of the included studies had quasi-experimental design, and various interventions and outcomes. Certainty of evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluations tool.

RESULTS

This review included 15 studies involving 1185 participants. Improvements were reported in each interprofessional educational outcome after interprofessional education. High-fidelity simulation with multiple scenarios, standardised communication tools, didactic and active learning methods, theoretical frameworks, debriefing sessions and provider training enhanced interprofessional education effectiveness.

CONCLUSIONS

Effectiveness of interprofessional education for nursing and medical professionals and students was demonstrated since improvements were observed for each interprofessional educational outcome. This systematic review addressed literature gaps, demonstrated effectiveness of interprofessional education in clinical practice and academic curricula and provided evidence-based insights that future research can consider to enhance global patient safety standards for optimal patient outcomes and quality of healthcare. Caution is advised in interpreting findings due to 'very low' evidence certainty and limited studies. More high-quality randomised controlled trials with longitudinal designs are needed.

Medical students' attitude toward patient-centeredness: A longitudinal study

OBJECTIVES

This study explored the trajectories of patient-centered orientation in a sample of Italian medical students throughout medical school.

METHODS

Four consecutive student cohorts were longitudinally assessed at the second (T0) and fifth year (T1) of medical school. Students completed a questionnaire including demographics and the Italian validated version of the Patient-Practitioner Orientation Scale.

RESULTS

352 students completed both administrations. Students became more patient-centered in terms of Sharing along the course of their clinical curriculum, whereas there were no significant changes in Caring. Groups with distinct developmental trajectory patterns of both Caring and Sharing were identified. Students high in patient-centeredness at T0 reported significantly lower scores at T1 while students with lower scores at T0 significantly increased from the first to the last measurement. Female students significantly outscored their male colleagues on Caring and Sharing in both administrations.

CONCLUSIONS

Findings call for innovative education strategies to sustain patient-centeredness attitudes in medical students entering hospital-based clinical medicine. Further research is needed to identify characteristics of the medical curriculum that are primarily involved in fostering students' patient-centeredness.

PRACTICE IMPLICATIONS

Including the assessment and monitoring of patient-centeredness throughout the medical school can inform tailored education aiming to foster this dimension.

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

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

AIM

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

MATERIAL AND METHODS

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

RESULTS

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

CONCLUSIONS

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

A Critical Review of Professional Identity Formation Interventions in Medical Education

PURPOSE

Professional identity formation (PIF) can be defined as the integration of the knowledge, skills, values, and behaviors of a profession with one's preexisting identity and values. Several different, and sometimes conflicting, conceptualizations and theories about PIF populate the literature; applying these different theories in PIF curricula and pedagogic strategies can profoundly impact the PIF of future physicians. The authors conducted a critical review of the recent literature on PIF interventions in medical education to explore the conceptualizations of and theoretical approaches to PIF that underlie them.

METHOD

The authors searched articles on PIF educational interventions published in 5 major medical education journals between 2010 and March 2021. The articles' context and findings were extracted, analyzed, and summarized to identify conceptualizations and theoretical approaches to PIF.

RESULTS

The authors identified 43 studies examining medical education interventions aimed at influencing PIF. The majority of the studies (n = 31) focused on undergraduate medical education. Reflective writing and the use of narrative reflections were the dominant modes of student activity in PIF interventions, supporting the dominant individualist approach to PIF. Less commonly PIF was understood as a socialization process or as an active process with both individually and socially focused influences.

CONCLUSIONS

Relying on reflective writing as the intervention of choice to impact PIF feeds the dominant individualist perspective on PIF. An unintended consequence of this individualist orientation is that cultural problems embedded in the profession can become burdens for individual physicians to personally bear. Future education and research into PIF should account for theoretical preferences and the impact of these preferences.

A transition programme to enhance ICU new graduate nurses' professional identity and intention to remain employed: A pre- and postevaluation

AIMS

To investigate the effect of a transition programme including cognitive-behaviour-based preceptorship intervention on ICU new graduate nurses' (NGNs)' professional identity and their intention to remain employed.

DESIGN

One-arm pre- and post-test design followed the TREND Statement.

METHODS

NGNs' professional identity and intention to remain employed were measured at baseline (T1), postintervention (1 month, T2) and 6-month follow-up (T3).

RESULTS

Fifty-three NGNs completed the programme, and their professional identity score significantly increased postintervention [from 111.5 (SD = 16.72) at T1 to 114.2 (SD = 9.12) at T2, p < 0.05], but decreased at T3 [105.8 (SD = 9.44) compared with T1 and T2, p < 0.05]. There was no significant difference in ICU NGNs' intention of remain employed outcomes at three time points (p > 0.05). The transition programme was effective to improve ICU NGNs' professional identity immediately after the intervention, but the increment did not maintain at the 6-month follow-up.

Exploring the impact of interprofessional simulation on the professional relationships of trainee pharmacists and medical students: a constructivist interview study

Members of clinical teams can hold stereotyped views of one another that can form barriers to interprofessional cohesion and collaboration. Interprofessional education (IPE) is often championed as a way of teaching individuals to be better team players through the adoption of collaborative attitudes and behaviours. However, the potentially detrimental effects of IPE are not well understood. This study used the social identity approach (SIA) as a lens to explore the impact of interprofessional simulation on the identities and professional relationships of trainee pharmacists and medical students.

Across three different locations in Scotland, trainee pharmacists were paired with medical students to participate in immersive simulation scenarios with post-scenario debriefs. Participants were individually interviewed shortly after their simulation session, using a semi-structured interview schedule based on SIA. Transcripts were analysed using template analysis, with sub-categorizations of SIA forming the initial coding template.

Twenty-five interviews were undertaken across both groups. The interprofessional simulation session effectively challenged pre-existing stereotypes. For the trainee pharmacists, the alteration of self-stereotypes influenced motivation through self-enhancement and, in turn, altered group norms via the promotion of genuine collaboration and joint decision-making. However, social comparisons focussed on status remained prominent.

This study has shown that interprofessional simulation can effectively challenge and alter stereotypes (including self-stereotypes), but social comparisons may be less easy to overcome in this context. As it continues to be embedded within healthcare education, the limitations of IPE must be better understood to ensure that the potential value of such opportunities is maximized.

Optimising planned medical education strategies to develop learners' person-centredness: A realist review

CONTEXT

Person-centeredness is a stated aim for medical education; however, studies suggest this is not being achieved. There is a gap in our understanding of how, why and in what circumstances medical education interventions that aim to develop person-centredness are successful.

METHODS

A realist review was conducted with a search of Medline, Embase, HMIC and ERIC databases and the grey literature using the terms 'medical education' and 'person-centred' and related synonyms. Studies that involved a planned educational intervention in medical education with data on outcomes related to person-centredness were included. The analysis focused on how and why different educational strategies interact with biomedical learner perspectives to trigger mechanisms that may or may not lead to a change in perspective towards person-centredness.

RESULTS

Sixty-one papers representing fifty-three interventions were included in the final synthesis. Nine context-intervention-mechanism-outcome configuration (CIMOc) statements generated from the data synthesis make up our refined programme theory. Where educational interventions focused on communication skills learning or experiences without person-centred theory, learners experienced dissonance with their biomedical perspective which they resolved by minimising the importance of the learning, resulting in perspective endurance. Where educational interventions applied person-centred theory to meaningful experiences and included support for sense making, learners understood the relevance of person-centeredness and felt able to process their responses to learning, resulting in perspective transformation towards person-centredness.

CONCLUSION

Our findings offer explanations as to why communication skills-based interventions may be insufficient to develop learners' person-centredness. Integrating experiential person-centred learning with theory on why person-centredness matters to clinical practice and enabling learners to make sense of their responses to learning, may support perspective transformation towards person-centredness. Our findings offer programme and policymakers testable theory to inform the development of medical education strategies that aim to support person-centredness.

Healthcare students' attitudes towards patient centred care: a systematic review with meta-analysis

BACKGROUND

Patient centred care is commonly recommended in clinical practice guidelines to improve patient outcomes and reduce healthcare costs. Identifying measurement tools used to assess healthcare students' attitudes towards patient centered care and determining their attitudes is the first step to ensuring patient centred care is provided in the future. The primary aim of this review was to describe the measurement tools used to assess healthcare students' attitudes towards patient centred care. The secondary aim was to quantify healthcare students' attitudes towards patient centred care.

METHODS

An electronic database search was conducted in MEDLINE, EMBASE, CINAHL from inception until March 1, 2021, with combined terms relating to 'patient centred care', 'attitudes', and 'healthcare students'. Studies that quantitatively assessed healthcare students' attitudes towards patient centred care were included. Measurement tools used in the included studies were qualitatively described. Meta-analysis was conducted to quantify healthcare students' attitudes towards patient centred care and assess the respective influence of gender, profession, and study geographical location on healthcare students' attitudes towards patient centred care.

RESULTS

The electronic search identified 3948 total studies. One hundred twenty-nine full texts were screened, and 49 studies were included. There were 16 measurement tools used to assess healthcare students' attitudes towards patient centered care. Most studies (53%, n = 26) used the Patient-Practitioner Orientation Scale (PPOS) to assess patient centered care. Meta-analyses of 20 studies with 26 total groups resulted in a pooled mean PPOS score of 4.16 on a 0-6 scale (95% Confidence Interval [CI]: 3.95, 4.37), indicating low attitudes towards patient centered care. Additional analyses found that women have significantly higher attitudes towards patients centred care than men (pooled effect 0.14 [95% CI: 0.05, 0.23], n = 8 studies) and mean PPOS scores appear similar among sub-groups of only medical students (pooled mean 4.13, 95% CI: 3.85, 4.42, n = 13 studies) and only American healthcare students (pooled mean 4.49, 95% CI: 4.35, 4.64, n = 5 studies).

CONCLUSIONS

Several different measurement tools have been used to assess healthcare students' attitudes towards patient centred care, but the most commonly used is the PPOS. Our results indicate that healthcare students have low attitudes towards patient centred care. Future studies should evaluate if attitudes towards patient centred care can be improved during healthcare education.

Effectiveness and Dissemination of the Interprofessional Pediatric Pain PRN Curriculum

INTRODUCTION

Cultural transformation is needed for health care to be sensitive to children's pain. The Pediatric Pain Practice Registered Nurses (PRN) Curriculum is the first free, open access, downloadable, interprofessional pain continuing education (IPPCE) curriculum developed to empower health care professionals to translate evidence-based pain care into clinical practice. To evaluate the curriculum and its experiential flipped-learning strategies, we used a mixed methods approach.

METHODS

Interprofessional pediatric teams from eight health care systems evaluated the curriculum after attending Pediatric Pain PRN Courses in the Fall of 2017 (N = 90). Qualitative methods were used to evaluate the acceptability, feasibility, and utility of the curriculum and IPPCE strategies. Pain knowledge and attitudes were measured pre-IPPCE/post-IPPCE with the Pediatric Healthcare Provider's Knowledge & Attitude Survey Regarding Pain (PHPKAS). Web analytics were used to describe dissemination for the first year after the curriculum's webpage launch.

RESULTS

Learners rated their achievement of course objectives as moderate-great. PHPKAS scores significantly increased (P < .0005); but significant differences in physician and nurse PHPKAS question responses pre-IPPCE/post-IPPCE were found. Within 2 years of the IPPCE, three health care systems were certified as Childkind Hospitals, five Pediatric Pain PRN Programs were established, and various practice changes and improved patient outcomes, such as decreased hospital lengths of stay and emergency department returns for pain, were realized. Curriculum dissemination was global.

DISCUSSION

Results support the acceptability, effectiveness, feasibility, utility, and global dissemination of the curriculum and IPPCE strategies. More rigorous patient outcome data are needed; however, this study demonstrated the benefit of a free, open-access, downloadable, interprofessional health care provider continuing education curriculum.

Attitudes towards interprofessionalism among midwife students after hybrid-simulation: A prospective cohort study

BACKGROUND

Team performance, communication and leadership enhance the quality and effectiveness of interprofessional collaborations between midwifery students and anaesthetists in obstetric emergencies. The realistic setting of hybrid simulation provides practice for interprofessional competencies in a stressful environment without putting women at risk during childbirth.

OBJECTIVES

We investigated how full-scale interprofessional hybrid simulation affects the attitudes towards interprofessionalism of final year midwife students.

DESIGN

Two-centre prospective cohort study.

SETTINGS

Bern Simulation and CPR Centre of the Department of Anaesthesiology and Pain Medicine at the Bern University Hospital (Bern, Switzerland) and Zürich University of Applied Sciences.

PARTICIPANTS

Final year midwife students from Bern University of Applied Sciences and Zürich University of Applied Sciences, both from the German-speaking Switzerland.

METHODS

One cohort was exposed to hybrid simulation and the other served as control. The simulation group filled in the German Interprofessional Attitude Scale (G-IPAS) before and after simulation, and then again three months later. The control group filled in two sets of G-IPAS questionnaires three months apart.

RESULTS

The total G-IPAS score increased significantly towards a more positive interprofessional attitude directly after the hybrid simulation. This increase was not sustained over the observation period of three months, although the score remained significantly higher than the score of the cohort without simulation.

CONCLUSIONS

A novel interprofessional hybrid simulation for obstetric emergencies for midwifery students promoted improved attitudes towards interprofessionalism immediately after simulation. These attitudes were improved compared to a control cohort without simulation, and the difference between the two cohorts remained three months after simulation. Future studies might focus on whether improved interprofessional attitudes lead to better healthcare and safety for women and children during childbirth.

Effect of COVID-19 Pandemic on the Levels of Empathy among Undergraduate Dental Students in Pakistan

Objective  The purpose of our study is to determine the effect of coronavirus disease 2019 (COVID-19) on the levels of empathy toward patients among undergraduate dental students in Pakistan.

Materials and Methods  A cross-sectional, survey-based study was conducted at Islamic International Dental College, Islamabad, Pakistan. After taking an informed consent, a validated and pretested Toronto Empathy Questionnaire (TEQ) was distributed amongst the undergraduate dental students at two points, one before the COVID-19 existed, and the other after August 7th, 2020, when the COVID-19 cases dropped in Pakistan. Responses were indicated on a five point Likert Scale.

Statistical Analysis  A one-way ANOVA (analysis of variance) was used to compare the TEQ scores between the different years of education at the dental school. Difference within the groups was analyzed using the post-hoc Tukey test. Pre- and post-COVID-19 comparison was done using the Chi-square test (significance level p < 0.05).

Results  A total of 221 out of 260 students in the pre-COVID-19 group, while 210 out of 260 students in the post-COVID-19 group enrolled in the dentistry program participated in the study. Significant difference in the empathy levels was observed in the pre- and post-COVID-19 groups of the same population, i.e., ( p < 0.05). The response rate was 85%.

Conclusions  This study showed an increase in mean empathy scores among the undergraduate dental students after COVID-19, indicating a significant improvement in their empathy levels during the time of COVID-19. It highlights the impact of the pandemic, whereby death and chaos seem to have brought about an improvement in interpersonal harmony.

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Attitudes of medical students towards interprofessional education: A mixed-methods study

BACKGROUND

Interprofessional Education (IPE) aims to improve students' attitudes towards collaboration, teamwork, and leads to improved patient care upon graduation. However, the best time to introduce IPE into the undergraduate curriculum is still under debate.

METHODS

We used a mixed-methods design based on a sequential explanatory model. Medical students from all six years at the University of Bern, Switzerland (n = 683) completed an online survey about attitudes towards interprofessional learning using a scale validated for German speakers (G-IPAS). Thirty-one medical students participated in nine semi-structured interviews focusing on their experience in interprofessional learning and on the possible impact it might have on their professional development.

RESULTS

Women showed better attitudes in the G-IPAS across all years (p = 0,007). Pre-clinical students showed more positive attitudes towards IPE [Year 1 to Year 3 (p = 0.011)]. Students correctly defined IPE and its core dimensions. They appealed for more organized IPE interventions throughout the curriculum. Students also acknowledged the relevance of IPE for their future professional performance.

CONCLUSIONS

These findings support an early introduction of IPE into the medical curriculum. Although students realise that interprofessional learning is fundamental to high-quality patient care, there are still obstacles and stereotypes to overcome.

TRIAL REGISTRATION

ISRCTN 41715934.

Are Filipino students ready to collaborate? Comparing the readiness of healthcare students for interprofessional education in the Philippines

The inclusion of interprofessional education in healthcare curricula in the Philippines has paved the way for the researchers to examine students' readiness to learn with, about, and from one another to foster collaboration in providing quality patient care. In view of this, we examined the differential attitude of 423 Filipino students to get involved in interprofessional learning using the Readiness for Interprofessional Learning Scale. Using multivariate analysis of variance, we found differences across gender, program, and year level among students from medical technology, pharmacy, physical therapy and occupational therapy in terms of teamwork and collaboration, negative professional identity, positive professional identity, and roles and responsibilities. These differences can inform the development of an intervention program to elicit a favorable attitude toward interprofessional collaboration. Theoretical, methodological, and practical implications of the findings are discussed.

Attitudes towards Interprofessional education in the medical curriculum: a systematic review of the literature

BACKGROUND

There is agreement among educators and professional bodies that interprofessional education needs to be implemented at the pre-registration level. We performed a systematic review assessing interprofessional learning interventions, measuring attitudes towards interprofessional education and involving pre-registration medical students across all years of medical education.

METHODS

A systematic literature review was performed using PubMed, PsycINFO, EThOS, EMBASE, PEDro and SCOPUS. Search terms were composed of interprofession*, interprofessional education, inter professional, inter professionally, IPE, and medical student. Inclusion criteria were 1) the use of a validated scale for assessment of attitudes towards IPE, and results for more than 35 medical students; 2) peer-reviewed articles in English and German, including medical students; and 3) results for IPE interventions published after the 2011 Interprofessional Education Collaborative (IPEC) report. We identified and screened 3995 articles. After elimination of duplicates or non-relevant topics, 278 articles remained as potentially relevant for full text assessment. We used a data extraction form including study designs, training methods, participant data, assessment measures, results, and medical year of participants for each study. A planned comprehensive meta-analysis was not possible.

RESULTS

This systematic review included 23 articles with a pre-test-post-test design. Interventions varied in their type and topic. Duration of interventions varied from 25 min to 6 months, and interprofessional groups ranged from 2 to 25 students. Nine studies (39%) reported data from first-year medical students, five (22%) from second-year students, six (26%) from third-year students, two (9%) from fourth-year students and one (4%) from sixth-year students. There were no studies including fifth-year students. The most frequently used assessment method was the Readiness for Interprofessional Learning Scale (RIPLS) (n = 6, 26%). About half of study outcomes showed a significant increase in positive attitudes towards interprofessional education after interventions across all medical years.

CONCLUSIONS

This systematic review showed some evidence of a post-intervention change of attitudes towards IPE across different medical years studied. IPE was successfully introduced both in pre-clinical and clinical years of the medical curriculum. With respect to changes in attitudes to IPE, we could not demonstrate a difference between interventions delivered in early and later years of the curriculum.

TRIAL REGISTRATION

PROSPERO registration number:  CRD42020160964 .

Attitude adjustments after global health inter-professional student team experiences

How medical inter-professional (IP) education should be introduced to students is still a matter of research. We evaluated IP student attitudes before and after a busy "hands-on" clinical experience.During 3 separate trips, first/second year medical and physician assistant students and third/fourth year nursing students traveled to Central America to work together for 1 week in an underserved clinical setting. Student opinions on inter-professional education were obtained before and after Brigade-1 using the Readiness for Inter-professional Learning Scale validated questionnaire. From these results, a modified version of the survey was developed that included quantitative and qualitative responses. For brigades-2 and -3, students received this modified version of the survey pre and post brigade. Quantitative data was analyzed via paired student t test, and qualitative data was analyzed to identify emerging themes using constant comparative methodology by three separate investigators.No significant quantitative differences between IP student groups were observed in their evaluation of the importance of inter-professional education either before or after the brigades. Qualitative data noted pre-brigade expectations of positive IP, experiential and patient-centered cultural learning. Pre- and post-brigade student perspectives maintained a strong belief that high functioning IP care benefited the patient. Post-brigade perspectives revealed a shift in attitude from purely positive expectations to more practical aspects of teamwork, respect, and interpersonal relationships.Students believe that patient care benefits from IP collaboration. After a busy clinical experience requiring collaboration, students realized that functional teams require appropriate skills, roles, and respectful interpersonal relationships.

Evaluating Attitudes Toward Interprofessional Collaboration and Education Among Health Professional Learners

BACKGROUND

An interprofessional education (IPE) workshop was established to enhance knowledge, skills, and attitudes for health professional learners to engage in interprofessional collaboration (IPC) through group-based activities. This study evaluates the IPC attitudes of learners following the IPE workshop.

METHOD

Learner attitudes were measured pre- and post-workshop with the validated ICCAS survey for years 2017 and 2018. Areas such as communication and collaboration were assessed using a 7-point Likert scale ranging from strongly agree to strongly disagree.

RESULTS

161/420 (38%) and 399/446 (89%) of surveys were completed in 2017 and 2018. Median scores were significantly higher post-workshop for both years (p < 0.001). Pre-test differences were observed between Medicine and Pharmacy in both years and post-test differences between Optometry and Nursing in 2018.

CONCLUSION

Positive outcomes are being observed among learners through IPC educational events. Further research is required to determine whether such activities promote IPC in future practice.

Adaptation and reliability of the readiness for inter professional learning scale (RIPLS) in the Chinese health care students setting

BACKGROUND

Interprofessional collaboration (IPC) primarily aims to enhance collaborative skills and to improve the awareness of teamwork and collaborative competencies of health care students. The Readiness for Interprofessional Learning Scale (RIPLS) was used to assess such skills. The aim of this study was to adapt a Chinese version of the RIPLS among Chinese health care students and to test the psychometric properties of the modified instrument.

METHODS

The questionnaire was translated following a two-step process, comprising forward and backward translations and a pilot test. The Chinese version was tested on a group of students from various health care professions. Cronbach's α coefficients were calculated for each of the four factors and also for the entire questionnaire in order to evaluate the internal consistency of the Chinese version of the RIPLS.

RESULTS

Of the 295 health care students surveyed, 282 (96.5%) completed the questionnaire. Cronbach's α coefficient for the overall scale was 0.842. Internal consistencies within each factor were good (α > 0.70) except for the factor "Roles and Responsibilities", where α = 0.216. Confirmatory factor analysis showed that the data fit the four-factor structure.

CONCLUSION

The Chinese version of the RIPLS was an acceptable instrument for evaluating the attitudes of the health care students in China. The factor "Roles and Responsibilities" requires further scrutiny and development, at least in the Chinese context.

Beyond the Lamppost: A Proposal for a Fourth Wave of Education for Collaboration

Interprofessional education (IPE) is an increasingly popular educational model that aims to educate health care students to be better collaborators by enabling them to learn with, from, and about each other. IPE's rising popularity is evident in the increase in scholarship on this topic over the last few decades. In this Perspective, the authors briefly describe three historical "waves" of IPE: managing the health workforce through shared curriculum, maximizing population health through health workforce planning, and fixing individuals to fix health care. Using insights from the social sciences and past practice, they then discuss six reasons why the current third wave of IPE is likely to fall short of meeting its goals, including that (1) IPE is logistically complex and costly, (2) IPE is developmentally inappropriate, (3) the link between IPE and key outcomes is still missing, (4) IPE insufficiently engages with theory, (5) IPE rarely addresses power and conflict, and (6) health care is an inertial system that IPE is unlikely to change. The authors conclude by sharing their vision for a fourth wave of education for collaboration, addressing workplace systems and structures, which would combine undergraduate, uniprofessional education for collaboration with practice-based interventions.

Heidelberger Interprofessionelle Ausbildungsstation (HIPSTA): a practice- and theory-guided approach to development and implementation of Germany's first interprofessional training ward

Background: Deficits in care and impaired patient-safety have been linked to inefficient interprofessional collaborative practice. Interprofessional training wards (IPTW) are an interprofessional educational intervention which aim to enable students and trainees from different health professions to work self-responsibly in order to manage the medical treatment and rehabilitation of real-life patients together as an interprofessional team. We aimed to develop and implement Germany´s first IPTW at the department of Surgery at Heidelberg University Hospital. Methods: The Kern cycle was used to develop an ITPW curriculum. Practical as well as theoretical considerations guided the design of the IPTW. Common project management tools including blueprinting and RASCI (Responsibility, Approval, Support, Consultation, Information) matrix were applied. Results: Since April 2017, 7 cohorts of students and trainees have had four-week long placements on HIPSTA. They run the IPTW in early and late shifts. Nursing and medical facilitators are supporting the IP team as needed. Learning objectives are operationalized as EPAs (entrustable professional activities) and interprofessional learning goals. Since initiation only minor modifications to the curriculum have been necessary and satisfaction of students/trainees, facilitators and patients is high. Conclusion: IPTWs can be established and run in the German health care system even in a complex clinical setting. The early involvement of all professions in a steering group seems to be key to success. Nursing and medical facilitators are of utmost importance for daily routine. The experiences outlined here could help others aiming to implement IPTWs at their sites. IPTWs might address a number of hitherto unaddressed educational needs. Trial registration: Not applicable.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

BACKGROUND

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

OBJECTIVES

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

DESIGN

Cross-sectional study.

SETTING

A Brazilian public university.

PARTICIPANTS

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

METHODS

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

RESULTS

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

CONCLUSION

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

Scaffolding Interprofessional Education: Unfolding Case Studies, Virtual World Simulations, and Patient-Centered Care

Fragmentation of health care negatively impacts quality; one of the contributing factors may be ineffective collaboration among health care professionals. This article describes the implementation of an interprofessional education curriculum for graduate students enrolled in nursing, psychology, and speech-language pathology programs. Over 3 semesters, students engaged in interprofessional collaboration modules, unfolding case studies, virtual simulation, and shared case planning experiences. The curriculum's impact on students' attitudes and values toward interprofessional collaborative practice was measured.