Interprofessional education in graduate medical education: survey study of residency program directors

Interprofessional Post-Graduate Training Model for Nurse Practitioners and Physician Trainees

CONTEXT

People living with serious illness and their care partners rely on team-based specialty hospice and palliative care (HPC) in order to achieve high quality end of life outcomes. In HPC, physician and nurse practitioner (NP) scope of practice has significant overlap so training together may offer benefits to clinicians and patients.

OBJECTIVES

Assessment of clinical competencies in a post-graduate training program consisting of NPs and physicians training and learning side-by-side.

METHODS

A crosswalk assured NP and physician HPC clinical competencies were captured in evaluation questions used by interprofessional program faculty to observe and assess trainees. Six clinical competencies were calculated based on aggregated evaluations for each physician and NP HPC post-graduate trainee at 3, 6, 9, and 12 months annually for 3 years. For NPs and physicians, the mean slopes of the best fit lines, the final numeric score, and the mean net change between 12 and three month competencies were compared. Learner experience was captured qualitatively.

RESULTS

There was no statistical difference in the change of competency scores, the final competency scores, or the trajectory of improvement in the six competencies between physician to NP trainees. Adding NP trainees was considered by post-graduate trainees as a strength of the program, and did not detract from physician competence achievement.

CONCLUSION

Assessing an IPE post-graduate training program in HPC was possible using a shared clinical competency framework, and revealed similar clinical gains for NPs and physicians enrolled in the program.

Assessment of advanced paediatric dentistry education programmes in Egypt: a survey of programme directors

BACKGROUND

Advanced paediatric dentistry education programmes (APDEPs) should follow specific standards to produce competent specialists. The current study assessed APDEPs in Egypt via an online questionnaire to programme directors.

SUBJECTS AND METHODS

An online questionnaire was distributed to the directors of fully operational degree-granting APDEPs in Egypt in June 2023. The survey instrument was based on the Accreditation Standards for Advanced Dental Education Programmes in Paediatric Dentistry developed by the Commission on Dental Accreditation (CODA).

RESULTS

Directors of the sixteen fully operational APDEPs answered the questionnaire giving a 100% response rate. APDEPs, in Egypt, varied regarding the adequacy of teaching staff, facilities and resources, didactic instruction, clinical requirements, and research activities.

CONCLUSION

The current survey provides information about the strengths and weaknesses of fully operational degree-granting APDEPs in Egypt. This information can help maintain and improve the quality of these programmes.

Ensuring the "health" of a curricular program evaluation: Alignment and analytic quality of two instruments for use in evaluating the effectiveness of an interprofessional collaboration curriculum

To cultivate competencies in interprofessional collaboration (IPC) for patient-centered, team-based care, a multi-faceted training enhancement initiative was implemented at our academic primary care residency site. Evaluation of the activities from previously collected survey data occurred upon a 2-year review. First, the evaluation team scrutinized the instruments for alignment and appropriateness with planned IPC educational learning and behavior objectives. We found the two instruments were well supported by the literature and with appropriate evidence for validation, but were not well aligned to the objectives of this IPC training initiative, reducing appropriateness of potential inferences of the findings for this context. Second, the team assessed the analytic quality of survey results in item difficulty distribution and item fit to the requirements of a Rasch measurement model. This revealed low person separation due to high overall item agreement. Most residents agreed with most items, so the measures lacked the precision necessary to capture change in residents' IPC competency. Our instrument review serves as a reminder of the need to gather validity evidence for the use of any existing tool within a new context, and offers a generalizable strategy to evaluate data sources for appropriateness and quality within a specific program.

Discussion-based interprofessional education: A positive step toward promoting shared understanding between surgical residents and nurses

Interprofessional education during medical training may improve communication by promoting collaboration and the development of shared mental models between professions. We implemented a novel discussion-based intervention for surgical residents and nurses to promote mutual understanding of workflows and communication practices. General surgery residents and inpatient nurses from our institution were recruited to participate. Surveys and paging data were collected prior to and following the intervention. Surveys contained original questions and validated subscales. Interventions involved facilitated discussions about workflows, perceptions of urgency, and technology preferences. Discussions were recorded and transcribed for qualitative content analysis. Pre and post-intervention survey responses were compared with descriptive sample statistics. Group characteristics were compared using Fisher's exact tests. Eleven intervention groups were conducted (2-6 participants per group) (n = 38). Discussions achieved three aims: Information-Sharing (learning about each other's workflows and preferences), 2) Interpersonal Relationship-Building (establishing rapport and fostering empathy) and 3) Interventional Brainstorming (discussing strategies to mitigate communication challenges). Post-intervention surveys revealed improved nurse-reported grasp of resident schedules and tailoring of communication methods based on workflow understanding; however, communication best practices remain limited by organizational and technological constraints. Systems-level changes must be prioritized to allow intentions toward collegial communication to thrive.

"A Lot to Offer": Nurses as Educators for Medical Residents in an Academic Medical Center Intensive Care Unit

INTRODUCTION

The role of fully trained interprofessional clinicians in educating residents has not been rigorously explored. The intensive care unit (ICU), where multiprofessional teamwork is essential to patient care, represents an ideal training environment in which to study this role. This study aimed to describe the practices, perceptions, and attitudes of ICU nurses regarding teaching medical residents and to identify potential targets to facilitate nurse teaching.

METHODS

Using a concurrent mixed-methods approach, we administered surveys and focus groups to ICU nurses from September to November 2019 at a single, urban, tertiary, academic medical center. Survey data were analyzed with descriptive and comparative statistics. Focus group data were analyzed using the Framework method of content analysis.

RESULTS

Of nurses surveyed, 75 of 96 (78%) responded. Nurses generally held positive attitudes about teaching residents, describing it as both important (52%, 36/69) and enjoyable (64%, 44/69). Nurses reported confidence in both clinical knowledge base (80%, 55/69) and teaching skills (71%, 49/69), but identified time, uncertainty about teaching topics, and trainee receptiveness as potential barriers. Ten nurses participated in focus groups. Qualitative analysis revealed three major themes: nurse-specific factors that impact teaching, the teaching environment, and facilitators of teaching.

DISCUSSION

ICU nurses carry positive attitudes about teaching residents, particularly when facilitated by the attending, but this enthusiasm can be attenuated by the learning environment, unknown learner needs, and trainee attitudes. Identified facilitators of nurse teaching, including resident presence at the bedside and structured opportunities for teaching, represent potential targets for interventions to promote interprofessional teaching.

Academic half days, noon conferences and classroom-based education in postgraduate medical education: a scoping review

BACKGROUND

Classroom-based education (CBE) is ubiquitous in postgraduate medical education (PGME), but to date no studies have synthesized the literature on the topic. We conducted a scoping review focusing on academic half days and noon conferences.

METHODS

We searched 4 databases (MEDLINE [OVID], Embase [OVID], ERIC [EBSCO] and Web of Science) from inception to December 2021, performed reference and citation harvesting, and applied predetermined inclusion and exclusion criteria to our screening. We used 2 frameworks for the analysis: "experiences, trajectories and reifications" and "description, justification and clarification."

RESULTS

We included 90 studies, of which 55 focused on resident experiences, 29 on trajectories and 6 on reification. We classified 44 studies as "description," 38 as "justification" and 8 as "clarification." In the description studies, 12 compared academic half days with noon conferences, 23 described specific teaching topics, and 9 focused on resources needed for CBE. Justification studies examined the effects of CBE on outcomes, such as examination scores (17) and use of teaching strategies in team-based learning, principles of adult learning and e-learning (15). Of the 8 clarification studies, topics included the role of CBE in PGME, stakeholder perspectives and transfer of knowledge between classroom and workplace.

INTERPRETATION

Much of the existing literature is either a description of various aspects of CBE or justification of particular teaching strategies. Few studies exist on how and why CBE works; future studies should aim to clarify how CBE facilitates resident learning within the sociocultural framework of PGME.

Person-centred care on the move - an interview study with programme directors in Swedish higher education

BACKGROUND

There is an increasing trend towards person-centred care (PCC) worldwide, suggesting that PCC should be mastered by future health care professionals. This study aims to explore programme directors' views on facilitators and barriers to implementing PCC in four of the largest national study programmes in Sweden training future health care professionals.

METHODS

A qualitative design was applied and interviews were conducted with 19 programme directors of Swedish national study programmes in medicine, nursing, occupational therapy and physiotherapy. The interviews were analysed using qualitative content analysis. Themes were sorted according to the Consolidated Framework for Implementation Research (CFIR) in an abductive approach. COREQ guidelines were applied.

RESULTS

The overarching theme, as interpreted from the programme directors' experiences, was 'Person-centred care is on the move at different paces.' The theme relates to the domains identified by the CFIR as outer setting, innovation, inner setting and process. PCC was understood as something familiar but yet new, and the higher education institutions were in a state of understanding and adapting PCC to their own contexts. The movement in the outer setting consists of numerous stakeholders advocating for increased patient influence, which has stirred a movement in the inner setting where the higher educational institutions are trying to accommodate these new demands. Different meanings and values are ascribed to PCC, and the concept is thus also 'on the move', being adapted to traditions at each educational setting.

CONCLUSION

Implementation of PCC in Swedish higher education is ongoing but fragmented and driven by individuals with a specific interest. There is uncertainty and ambiguity around the meaning and value of PCC and how to implement it. More knowledge is needed about the core of PCC as a subject for teaching and learning and also didactic strategies suitable to support students in becoming person-centred practitioners.

The Case for Interprofessional Teaching in Graduate Medical Education

Interprofessional education has been promoted as a strategy to dismantle professional silos and promote collaborative patient care. Citing this, medical educators have emphasized the widespread integration of interprofessional education into undergraduate medical education curricula. However, in the current residency training environment, little reinforcement exists for principles gleaned from interprofessional education, and little is known about the role that interprofessional providers have in resident education. In this perspective, we offer the concept and practice of interprofessional teaching to bolster the benefits of interprofessional education during residency training. Interprofessional teaching, relatively unexplored and potentially underutilized, may offer many of the same benefits of interprofessional education but is more readily adapted for the graduate medical education setting. The intensive care unit, characterized by a culture of multidisciplinary teamwork and complex patient care, is an ideal setting in which to use interprofessional teaching. Prior to enthusiastically implementing interprofessional teaching interventions, careful consideration should be paid to the setting, strategies, and impact on all key stakeholders.

Physician Residents Shadowing a Certified WOC Nurse to Develop Interprofessional Competencies: A Quality Improvement Project

PURPOSE

The aim of this quality improvement (QI) project was to assess a shadowing experience with a certified WOC nurse (CWOCN) on 4 interprofessional collaborative practice domains: interprofessional communication, role awareness and responsibilities, teams and teamwork, and values and ethics for interprofessional practice.

PARTICIPANTS AND SETTING

Forty-nine physician residents in Family and Internal Medicine participated in this project set at a health system in Chicago, Illinois.

APPROACH

Residents spent 16 hours shadowing a CWOCN and completed the Interprofessional Education Collaborative Competency Self-Assessment Tool (IPESAT) pre- and postshadowing that measured 4 interprofessional education (IPE) domains: interprofessional communication, role awareness and responsibilities, teams and teamwork, and values and ethics for interprofessional practice. Paired t tests were performed to determine differences in IPESAT scores before and after the shadowing experience.

OUTCOMES

Residents demonstrated significant improvement in their overall knowledge of IPE (P = .000) as well as knowledge within each of the 4 domains (P = .000). After the shadowing experience, the overall ranking improved by 7.5%; the greatest gain (10.8%) occurred in the teamwork domain.

IMPLICATIONS FOR PRACTICE

We found that even a comparatively brief shadowing experience with a CWOCN improved knowledge in IPE competencies. The shadowing experience is now permanently part of the Internal Medicine Residency program, and based on these IPE outcomes, other residency programs in our setting, such as the Rehabilitation and Family Medicine program, have increased their requests to shadow with the CWOCN.

Perspectives of Inter-professional Education Under a Global Infectious Menace

Health systems worldwide are facing unprecedented challenges, as a result of a convergence of major threats to our social and population health systems. For an epidemic of any magnitude, prevention and preparation by healthcare personnel in clinical settings are essential, both locally and globally. The need for the development of domestic and international training programs in the expanding field of emerging and reemerging infectious diseases is well recognized but particularly urgent at this time. Interprofessional education plays key roles in infectious diseases (ID) and in training the new generation of ID-related specialists.

Qualitative Study of Interprofessional Collaboration in Radiation Oncology Clinics: Is There a Need for Further Education?

PURPOSE

Interprofessional education (IPE) is gaining recognition as a means of improving health care delivery and patient outcomes. A primary goal of IPE is improved interprofessional collaboration (IPC). The multidisciplinary team in the radiation oncology clinic requires effective IPC for optimal delivery of radiation therapy. However, there are limited data on IPE and IPC in radiation oncology. This qualitative study aims to characterize IPC in radiation oncology.

METHODS AND MATERIALS

Semistructured phone interviews were performed from June to August 2019 with radiation oncologists, nurses, dosimetrists, radiation therapists, medical physicists, and medical students across a single academic medical center and affiliated network sites. Interviews were recorded, de-identified, and transcribed verbatim. Resulting transcripts were analyzed using thematic analysis.

RESULTS

Seventeen interviews were performed with 4 radiation oncologists, 2 nurses, 2 dosimetrists, 4 radiation therapists, 2 medical physicists, and 3 medical students. Thematic analysis identified 4 themes: (1) management of the radiation oncology clinic, (2) potential impact of interprofessional training in radiation oncology, (3) current climate of interprofessional education in radiation oncology, and (4) creating an interprofessional training program in radiation oncology. Each theme elicited between 2 and 7 subthemes.

CONCLUSIONS

From the analytical themes that emerged, it is hypothesized that misunderstanding professionals' roles can lead to communication breakdown, which creates less efficient clinic management and disorganized patient care. Although other medical professionals shadow physicians during their training, physicians are not learning about other professions in the same way. Interviewees from each professional category recommend a formal shadowing program for radiation oncology trainees at the medical student or resident level. Having structured opportunities for IPE is important given competing demands of learners during medical student rotations and residency. This study suggests an unmet need for exposure of radiation oncology medical trainees to IPE with the ultimate goal of improving IPC in the radiation oncology clinic.

Who is Responsible for Discharge Education of Patients? A Multi-Institutional Survey of Internal Medicine Residents

BACKGROUND

Safely and effectively discharging a patient from the hospital requires working within a multidisciplinary team. However, little is known about how perceptions of responsibility among the team impact discharge communication practices.

OBJECTIVE

Our study attempts to understand residents' perceptions of who is primarily responsible for discharge education, how these perceptions affect their own reported communication with patients, and how residents envision improving multidisciplinary communication around discharges.

DESIGN

A multi-institutional cross-sectional survey.

PARTICIPANTS

Internal medicine (IM) residents from seven US residency programs at academic medical centers were invited to participate between March and May 2019, via email of an electronic link to the survey.

MAIN MEASURES

Data collected included resident perception of who on the multidisciplinary team is primarily responsible for discharge communication, their own reported discharge communication practices, and open-ended comments on ways discharge multidisciplinary team communication could be improved.

KEY RESULTS

Of the 613 resident responses (63% response rate), 35% reported they were unsure which member of the multidisciplinary team is primarily responsible for discharge education. Residents who believed it was either the intern's or the resident's primary responsibility had 4.28 (95% CI, 2.51-7.30) and 3.01 (95% CI, 1.66-5.71) times the odds, respectively, of reporting doing discharge communication practices frequently compared to those who were not sure who was primarily responsible. To improve multidisciplinary discharge communication, residents called for the following among team members: (1) clarifying roles and responsibilities for communication with patients, (2) setting expectations for communication among multidisciplinary team members, and (3) redefining culture around discharges.

CONCLUSIONS

Residents report a lack of understanding of who is responsible for discharge education. This diffusion of ownership impacts how much residents invest in patient education, with more perceived responsibility associated with more frequent discharge communication.

Bridging the Chasm between Pregnancy and Health over the Life Course: A National Agenda for Research and Action

BACKGROUND

Many pregnant people find no bridge to ongoing specialty or primary care after giving birth, even when clinical and social complications of pregnancy signal need. Black, indigenous, and all other women of color are especially harmed by fragmented care and access disparities, coupled with impacts of racism over the life course and in health care.

METHODS

We launched the initiative "Bridging the Chasm between Pregnancy and Health across the Life Course" in 2018, bringing together patients, advocates, providers, researchers, policymakers, and systems innovators to create a National Agenda for Research and Action. We held a 2-day conference that blended storytelling, evidence analysis, and consensus building to identify key themes related to gaps in care and root causes of inequities. In 2019, more than 70 stakeholders joined six working groups to reach consensus on strategic priorities based on equity, innovation, effectiveness, and feasibility.

FINDINGS

Working groups identified six key strategic areas for bridging the chasm. These include: 1) progress toward eliminating institutional and interpersonal racism and bias as a requirement for accreditation of health care institutions, 2) infrastructure support for community-based organizations, 3) extension of holistic team-based care to the postpartum year and beyond, with integration of doulas and community health workers on the team, 4) extension of Medicaid coverage and new quality and pay-for-performance metrics to link maternity care and primary care, 5) systems to preserve maternal narratives and data across providers, and 6) alignment of research with women's lived experiences.

CONCLUSIONS

The resulting agenda presents a path forward to remedy the structural chasms in women's health care, with key roles for advocates, policymakers, researchers, health care leaders, educators, and the media.

A mixed methods approach to determine the climate of interprofessional education among medical and health sciences students

BACKGROUND

High-quality patient care is a complex phenomenon that requires collaboration among healthcare professionals. Research has shown that Interprofessional Education (IPE) carries promise to improve collaborative work and patient care. So far, collaboration among various health professionals remains a challenge. Very few focus group discussions to determine the medical students' readiness and positive attitudes towards IPE have been reported from the Arabian context.

METHODS

A two-staged sequential mixed methods study was conducted among medical, dental, pharmacy, and health sciences students of the University of Sharjah United Arab Emirates. The perspectives of students toward IPE and collaborative practice were first gathered by administering a validated instrument, Readiness for Interprofessional Learning Scale (RIPLS). This was followed by focused group discussions. A quantitative as well as a qualitative data analysis was performed.

RESULTS

This study cohort included 282 students. All respondents showed readiness to adopt IPE as all statements of the RIPLS inventory scored high median scores. All participants showed positive attitudes and readiness towards IPE. Three main domains of themes were generated from focus group discussions; prior knowledge, need for IPE framework and its implementation. Information workload, lack of clarity and less focused teaching pedagogies of IPE were considered as perceived barriers.

CONCLUSION

This study demonstrated a substantial agreement of medical and health sciences students towards readiness and perceived effectiveness of IPE. Educators are urged to embed new IPE programs into existing curricular frameworks, which can potentially enhance collaborative learning and improve quality of patient care.

Improvement in Hematology Interprofessional Care: Simulation With an Emphasis on Collaboration

INTRODUCTION

For many training programs, including hematology, there are limited structured opportunities to practice collaboration as a competency. Training is often limited to ad hoc interactions during clinical rotations. Accordingly, there is further need for immersive and standardized collaboration educational programs. This pilot study explored simulation for developing and assessing collaboration competency among hematology residents.

METHODS

Two standardized simulation center scenarios were developed that required residents to work in interprofessional teams. The objectives were to develop collaboration competence and confidence through experiential learning and facilitated reflection. Team members included education and simulation experts as well as hematology nurses as embedded participants. Case 1 presented a 72-year-old male with stage 4 lymphoma experiencing shortness of breath during a rituximab infusion. Case 2 presented a 68-year-old male who suffered a provoked pulmonary embolism. Both cases utilized a simulated clinic space. Pre, post, and 3-month questionnaires (self-assessed collaboration competency and simulation evaluation) were completed. Each session included structured debriefing with facilitated reflection focused on collaboration.

RESULTS

Seven senior hematology subspecialty residents participated. Despite residents entering the simulation cases with confidence in collaboration, higher collaboration confidence ratings were observed on postsimulation questionnaires (8.2 vs. 7.6 on a 10-point Likert scale). Residents demonstrated awareness of appropriate collaboration skills, but at times failed to implement knowledge into action. Facilitated reflection during the debrief helped residents critique their collaboration performance and develop improvement plans.

DISCUSSION

Simulation is a promising tool for teaching and assessing collaboration within hematology training.

An Integrative Review of Interprofessional Collaboration in Health Care: Building the Case for University Support and Resources and Faculty Engagement

BACKGROUND

In 2010, the World Health Organization issued a clarion call for action on interprofessional education and collaboration. This call came forty years after the concept of interprofessional collaboration (IPC) was introduced.

AIM

To conduct an integrative review of interprofessional collaboration in health care education in order to evaluate evidence and build the case for university support and resources and faculty engagement, and propose evidence-based implications and recommendations.

SEARCH STRATEGY

A literature search was conducted by an interprofessional faculty from a college of nursing and health sciences. Databases searched included CINAHL, Medline, Eric, Pubmed, Psych Info Lit., and Google Scholar. Keywords were interdisciplinary, interprofessional, multidisciplinary, transdisciplinary, health care team, teamwork, and collaboration. Inclusion criteria were articles that were in the English language, and published between 1995 and 2019.

REVIEW METHODS

Thirteen interprofessional team members searched assigned databases. Based on key words and inclusion criteria, over 216,885 articles were identified. After removing duplicates, educational studies, available as full text were reviewed based on titles, and abstracts. Thirty-two articles were further evaluated utilizing the Sirriyeh, Lawton, Gardner, and Armitage (2012) review system. Faculty agreed that an inclusion score of 20 or more would determine an article's inclusion for the final review. Eighteen articles met the inclusion score and the data was reduced and analyzed using the Donabedian Model to determine the structure, processes, and outcomes of IPC in health care education.

RESULTS

Structure included national and international institutions of higher education and focused primarily on undergraduate and graduate health care students' experiences. The IPC processes included curricular, course, and clinical initiatives, and transactional and interpersonal processes. Outcomes were positive changes in faculty and health care students' knowledge, attitudes, and skills regarding IPC, as well as challenges related to structure, processes, and outcomes which need to be addressed. Implications/Recommendations/Conclusions: The creation of a culture of interprofessional collaboration requires a simultaneous "top-down" and "bottom-up" approach with commitment by the university administration and faculty. A university Interprofessional Strategic Plan is important to guide the vision, mission, goals, and strategies to promote and reward IPC and encourage faculty champions. University support and resources are critical to advance curricular, course, and clinical initiatives. Grassroots efforts of faculty to collaborate with colleagues outside of their own disciplines are acknowledged, encouraged, and established as a normative expectation. Challenges to interprofessional collaboration are openly addressed and solutions proposed through the best thinking of the university administration and faculty. IPC in health care education is the clarion call globally to improve health care.

The decline in attitudes toward physician-nurse collaboration from medical school to residency

While interprofessional collaboration is a critical aspect of optimal patient care, practicing physicians often have sub-optimal attitudes regarding the importance of collaboration with their nursing colleagues. The impact of clinical training on medical students' and residents' attitudes toward physician-nurse collaboration has not been investigated. The primary goal of our study was to examine if learners at different stages in their medical training had more or less favorable attitudes regarding interprofessional collaboration (IPC). A secondary goal was to compare residents in procedural versus non-procedural specialties to determine if attitudes toward IPC varied by specialty type. Third-year medical students and residents at a large public university completed the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration. Student (n = 129) and resident (n = 292) scores were compared using Student's t-tests. Resident responses were further analyzed by specialty type. Students' perceptions of the physician-nurse relationship were significantly more favorable than the views of residents, particularly in the "Authority" and "Responsibility" domains. Residents in procedural specialties had less favorable attitudes toward physician-nurse collaboration than those in non-procedural specialties. Our findings highlight the importance of developing effective interventions for improving interprofessional collaboration during medical training.

Implementation of a direct observation and feedback tool using an interprofessional approach: a pilot study

Primary care trainees must learn how to communicate effectively with patients during brief outpatient encounters, and direct observation and feedback is necessary to improve these skills. At the same time, programs are seeking more interprofessional learning opportunities for skills that transcend professions. We sought to assess the feasibility of implementing a direct observation tool, the Patient Centered Observation Form (PCOF), for communication training across three professions at the graduate level. The PCOF was introduced to trainees at an interprofessional workshop, while faculty completed PCOF training online or in person. Following use of the PCOF, we surveyed participants to determine if using the PCOF increased a) trainee-reported confidence in providing patient-centered communication, and b) faculty-reported confidence in giving feedback about patient-centered communication. The PCOF appears to be a useful adjunct to standard precepting for teaching patient-centered communication skills, extending beyond medical residents to pharmacy residents and less so, to advanced practice nursing students. In addition, PCOF training and implementation can successfully occur simultaneously across disciplines, leveraging resources and encouraging interprofessional learning.

Positive and Negative Factors That Influence Health Care Faculty Intent to Engage in Interprofessional Education (IPE)

Background: This study explored the positive and negative factors that influence interprofessional education (IPE) implementation in health care education programs across the United States. Methods: The study sample consisted of 439 (response rate 8.4%) health care faculties from seven health care professions (nursing, medicine, pharmacy, physical therapy, occupational therapy, physician assistant, and social work) who were asked what the positive and negative factors are that influence their decisions to engage in IPE. Results: Three positive categories and two negative categories concerning factors that influence health care faculty (HCF) intent to engage in IPE emerged. The three major categories of positive factors emerged as patient care, which was mentioned by 196 subjects or 54% of the sample, student learning, which was mentioned by 157 subjects or 43% of the sample, and health care teams, which was mentioned by 88 subjects or 24% of the sample. The two major categories of negative factors emerged as scheduling and coordination, which was mentioned by 230 subjects or 63% of the sample, and discipline culture which was mentioned by 103 subjects or 28% of the sample. Conclusion: This study contributes to the body of knowledge concerning the factors that influence effective IPE implementation. Discussion is provided regarding the positive and negative categories that emerged and how they influence effective IPE delivery.

Interprofessional Education in U.S. Dental Hygiene Programs: Program Director Responses Before and After Introduction of CODA Standard 2-15

A 2014 survey found that dental hygiene program directors perceived interprofessional education (IPE) as a priority for themselves and the dental hygiene profession in the U.S. The aim of this study was to explore whether IPE collaborations in dental hygiene programs and program directors' attitudes changed from 2014 to 2017 since the Commission on Dental Accreditation (CODA) Standard 2-15 on IPE was introduced in August 2016. In May 2017, directors of all 325 U.S. dental hygiene programs were invited to participate in a web-based survey. A total of 117 directors responded, for a 38% response rate, and their responses were then compared with the responses in 2014 (that survey had a 33% response rate). The results showed that, while the percentage of responding dental hygiene programs with a nursing program on campus had decreased (90% to 80%; p<0.022), the likelihood of having other health care-related programs on campus did not change. In 2017 as compared to 2014, the programs were still most likely to collaborate with nursing (50% vs. 46%) and other allied health professions (44% vs. 56%) and in intraprofessional education with dental assisting programs (41% vs. 41%). IPE was still most likely to occur in volunteer activities (68% vs. 73%), basic science courses (65% vs. 60%), and communications training (63% vs. 63%). In 2017, program directors rated IPE as less challenging for programs to manage than in 2014 (on five-point scale with 1=not at all challenging: 3.31 vs. 3.62; p=0.022). However, the responding directors did not view IPE as being as important to the profession in 2017 as the respondents reported in 2014 (3.29 vs. 3.88; p<0.001). The majority in 2017 agreed/strongly agreed that Standard 2-15 will improve the profile of dental hygiene as part of the health care team (77%) and contribute to integrating dental hygiene into interprofessional care (IPC) teams (78%). Overall, this study found that the introduction of an explicit IPE dental hygiene CODA standard in 2016 had already resulted in changes after only one year. However, the responding program directors' lower agreement with statements concerning their graduates' IPC-related competence deserves further attention.