A BEME systematic review of the effects of interprofessional education: BEME Guide No. 39

Unpacking the perceptions and experiences of student facilitators in interprofessional education: a qualitative study

Enhancing health professional students' effective learning and collaborative practice requires a deep understanding of strategies for facilitating interprofessional learning. While faculty members and clinical preceptors are recognized as facilitators in interprofessional education (IPE), there is limited knowledge about the impact of student facilitators' engagement in IPE. Accordingly, this study aims to explore the perceptions and experiences of student facilitators in IPE. Thirteen student facilitators were recruited to lead an interprofessional learning program, and they were subsequently invited to participate in one-on-one interviews. An interview guide was developed to explore their motivations, expectations, engagement, effectiveness, and achievements in IPE facilitation. Thematic analysis was conducted using MAXQDA software to analyze the student facilitators' experiences and perceptions. Eight interviewees from various disciplines, including Medicine, Nursing, Pharmacy, Speech and Hearing Sciences, and Social Work, took part in the study. The findings revealed that student facilitators highly valued their IPE facilitation experience, which aligned with their expectations and led to the creation of social networks, increased confidence, improved understanding of other professions, and the development of lifelong skills. Furthermore, the student facilitators demonstrated cognitive and social congruence by establishing a relaxed learning environment, displaying empathetic and supportive behaviors, and using inclusive language to engage IPE learners in group discussions. This study provides a comprehensive understanding of the role of student facilitators in IPE, contributing to the evolving literature on IPE. A conceptual framework was developed to explore the entire facilitation experience, encompassing the motivations and expectations of student facilitators, their engagement and effectiveness, and the observed achievements. These findings can inform the development of peer teaching training in IPE and stimulate further research in identifying relevant facilitator competencies for optimal delivery of IPE.

Healthcare professionals' experiences of required competencies in mentoring of interprofessional students in clinical practice: A systematic review of qualitative studies

AIM

To synthesize evidence on healthcare professionals' experiences of competencies in mentoring undergraduate healthcare, social care and medical students during their interprofessional clinical practice.

DESIGN

This review was conducted by the JBI methodology for systematic reviews of qualitative evidence.

METHODS

Studies were included if they were based on the phenomenon of interest and used qualitative or mixed methods (qualitative share). The included studies were critically appraised using the standardized JBI Critical Appraisal Checklist. Qualitative research findings were extracted and synthesized using the meta-aggregation approach.

DATA SOURCES

Five databases (CINAHL, PubMed, Scopus, Medic and ProQuest) were systematically searched from each database's inception on 28 June 2023.

RESULTS

A total of 5164 studies were initially screened, and 25 were identified for inclusion in this review. Three synthesized findings were identified: competencies related to (1) preparing for and developing interprofessional clinical practice, (2) supporting the learning process in interprofessional clinical practice and (3) creating an interprofessional mentor identity.

CONCLUSION

Although competent mentors are essential to implementing and developing interprofessional clinical practice, some mentors find interprofessional mentoring challenging. High-quality interprofessional mentoring requires specific competence that differs from profession-specific and individual mentoring.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

To ensure that interprofessional clinical practice is of high quality and strengthens students' professional and interprofessional growth, special attention should be given to mentors' interprofessional mentoring competence, and a range of opportunities and organizational structures should be provided for competence development.

IMPACT

This systematic review provides insights into the specific competencies required for interprofessional mentoring. These findings can support healthcare professionals, educators and policymakers in developing interprofessional clinical practice and mentoring competence.

REPORTING METHOD

This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and ENTREQ reporting guidelines. No patient or public contribution.

From individual to interprofessional: characteristics of assessment tasks to assess interprofessional collaboration in healthcare education

To develop independent healthcare professionals able to collaborate in interprofessional teams, health professions education aims to support students in transitioning from an individual perspective to interprofessional collaboration. The five elements that yield the conditions for effective interprofessional collaboration are: (1) positive interdependence, (2) individual accountability, (3) promotive interaction, (4) interpersonal skills, and (5) reflection on team processes. The aim of the current study is to gain insights into how to design tasks to assess a student team as a whole on their interprofessional collaboration. This was a pilot study using a qualitative design to evaluate an interprofessional assessment task. Four interprofessional student teams, comprising physiotherapy, occupational therapy, arts therapy and nursing students (N = 13), completed this task and five assessors used a rubric to assess video recordings of the teams' task completion, and then participated in a group interview. The completed rubrics and the interview transcript were analyzed using content analysis. Findings showed that the combination of individual preparation, an interprofessional team meeting resulting in care agreements and team reflection was a strength of the assessment task, enabling the task to elicit sufficient promotive interaction between students. Areas for improvement of the assessment task were however, due to a lack of interdependence, the care agreements which now proved to be the sum of students' intraprofessional ideas rather than an interprofessional integration of agreements. Additionally, assessors suggested that a series of varying assessment tasks is required to draw conclusions about students' interprofessional competence.

Educational strategies for PET-Health Interprofessionality in Southwestern Goiás state, Brazil: a qualitative approach

This study aimed to present educational interventions in the context of the Education Program through PET-Health Interprofessionality (PET-I), carried out in teaching and in healthcare service of a municipality of Goiás state, based on the analysis of focus groups and portfolios made by participants. A descriptive exploratory study with a qualitative approach was carried out, based on the theoretical-conceptual and methodological foundations of interprofessional education, from August 2019 to November 2020. It was observed that students perceived participation in PET-I as an opportunity to interact with other professions, to associate theory with practice and to act as leading actors. Participants believe that working together to provide the best care for patients requires a basic understanding of the different perspectives and responsibilities of professionals involved. They emphasized informal conversations, meetings, and case discussions as opportunities to understand professional's opinions and assignments, and deepen their understanding of the importance of collaborative communication.

Teacher-therapist collaboration in inclusive primary schools: A scoping review

INTRODUCTION

Inclusive school environments require collaboration between teachers and allied health professionals to promote student access and participation. Collaboration is a complex phenomenon with no universally accepted definition or measurement and with many challenges to effective practice. The purpose of this scoping review is to describe what is known about interprofessional collaboration between teachers and therapists in inclusive primary schools.

METHODS

A scoping review of health and education literature was conducted using the Joanna Briggs Institute methodology. Peer-reviewed articles reporting on empirical studies with a focus on collaboration between teachers and school-based occupational therapists or speech and language therapists in inclusive primary schools were included.

RESULTS

Results summarise how collaboration is reported in the literature. Numerical and descriptive summaries describe how collaboration is defined and measured, the challenges to collaborative practice, the structures required to support effective practice, and the outcomes of such practice.

CONCLUSION

Definitions vary between studies and disciplines but contain common elements. For effective practice, the purpose of the collaboration must be clear, and the intended outcomes of the collaboration are measured. Measurement of collaboration requires further research using tools developed from robust theoretical frameworks and validated within the educational context and with professionals of different disciplines. Consistent measurement tools would allow cross-study comparisons. Barriers to collaborative practice are well documented; thus, future research should be directed to examining effective practice, investigating how professionals circumvent obstacles.

An overview of global CME/CPD systems

PURPOSE

Engagement in CME/CPD has a positive impact on healthcare professionals' (HCPs) knowledge, skills, and performance, and on patient outcomes, therefore it is critical to better understand the components of CME/CPD systems that foster engagement, high-quality education, and impact.

METHODS

An assessment of CME/CPD systems was conducted using a mixed-methods approach that included interviews with in-country subject matter experts and qualitative and quantitative data from practicing in-country physicians.

RESULTS

Results demonstrate areas of consistency in CME/CPD systems across world regions that included: types of educational providers; types of credit; educational formats; self-tracking of participation; high-degree of compliance when education is mandatory; overall satisfaction with available education; strong support for interprofessional education; and lack of alignment or evaluation of engagement in education with population health outcomes. Areas of variation included: whether engagement in education is required as a condition to practice medicine; whether regulations are uniformly applied; if mechanisms to ensure independence existed; and physician perceptions of independence.

CONCLUSION

Results of this assessment maybe used by a variety of different stakeholders to assess how well country-level CME/CPD systems are meeting the needs of practicing physicians and determine what, if any, changes might need to be implemented to improve outcomes.

Shaping tomorrow's dentists: a multi-institutional survey of undergraduate dental students' perceptions towards interprofessional education

BACKGROUND

Interprofessional education (IPE) is essential to foster collaboration among healthcare professionals for holistic patient care. However, Malaysian dental education remains discipline-centric, hindering multidisciplinary learning approaches. Hence, this study aimed to explore Malaysian undergraduate dental students' perceptions of IPE.

METHODS

The present cross-sectional study employed convenience sampling to survey undergraduate dental students from four Malaysian institutions using a modified questionnaire with 20 close-ended and 2 open-ended questions. The questionnaire covered three domains (effectiveness, preference, importance) to assess students' perceptions using a five-point Likert scale. Psychometric validation was performed to assure validity and reliability of the modified questionnaire. Quantitative analysis (descriptive and inferential statistics), and qualitative analysis (content analysis) were subsequently performed.

RESULTS

397 students responded, and positive perceptions were generally noted with mean scores ranging from 4.13 to 4.35 across all domains. Questions 2 and 3, assessing the improvement in understanding the roles and responsibilities, and communication among healthcare professionals, received the highest mean scores. Meanwhile, Question 15 concerning the incorporation of IPE into educational goals received the lowest mean score. Regression analysis identified gender and clinical phase as significant factors, with females and preclinical students exhibiting more favourable perceptions. Motivators for IPE included a keen interest in diverse perspectives and recognising the importance of teamwork, while barriers encompassed tightly packed schedules, lack of understanding about IPE, misconceptions regarding dental education, and students' nervousness and fear of participation.

CONCLUSION

This study produced a valid and reliable instrument to measure undergraduate dental students' perceptions towards IPE. Strategic planning, such as overcoming logistical challenges, improving awareness, and creating a supportive learning environment are crucial for successful IPE integration into existing curricula, especially in resource-constrained developing countries like Malaysia.

A community-based geriatric interprofessional education experience and its impact on post-graduate collaborative practice

While a growing body of interprofessional education (IPE) literature demonstrates a positive impact on learner knowledge, there is limited data on its long-term impact on collaborative practice (CP). With the growth of the aging population globally, understanding both the long-term impact on CP and sustainability of community-based geriatric experiential IPE programs are imperative. This study explores the impact of the Interprofessional Geriatric Curriculum (IPGC), a community-based geriatric IPE program, on post-graduate clinical practice among seven health professions. This study utilized a cross-sectional descriptive design, where both qualitative and quantitative data were collected in the same online survey of health professionals' to measure their perceptions of the impact IPGC has had on their respective clinical practice 1-3 years post-graduation. Forty-six per cent of health profession graduates provided clinical care for people 65 years of age or older; 81% worked in interprofessional teams; 80% reported the IPGC experience significantly impacted their practice (N = 137), and all used validated assessment tools taught in the IPGC program in their practice. Eight themes emerged from the list of what health professionals learned from IPGC that they use regularly in their clinical practice: four themes were interprofessional in nature (i.e. teamwork and team-based care, interprofessional communication, roles/responsibilities, and personal/professional) and four themes related to geriatrics (i.e. aging, screening and assessment, medications, and didactic content). This study is one of the first to describe the sustained influence of a community-based IPE program across multiple health professional disciplines on clinical geriatric practice.

A critical interpretive synthesis of interprofessional education interventions

Interprofessional practice can look quite different depending on a number of dynamics. Interprofessional education interventions may or may not orient toward this range of practice possibilities. This literature review explores: (1) how interprofessional education interventions relate to different kinds of interprofessional practice and (2) the range of interprofessional practices assumed by interprofessional education interventions. Four databases were searched for articles published between 2011-2021 describing pre-licensure level interprofessional education interventions, resulting in a dataset of 110 articles. Our analysis involved (1) descriptive summaries of the articles, and (2) content analysis of the rationale and description of the intervention. Of the articles, 93% (102/110) of interprofessional education interventions were designed and/or evaluated using the concept of interprofessional education competencies. "Teamwork" was the most relied upon competency. Most articles were not explicit about the different kinds of interprofessional practices that these competencies might be oriented toward. Our study substantiates earlier claims that interprofessional education literature tends to focus on competencies and orient toward undifferentiated understandings of "teamwork." This analysis is particularly important as interprofessional teams are engaging in increasingly complex, fluid, and distributed forms of interprofessional practice that may not be captured in an undifferentiated approach to "teamwork."

Programmatic evaluation of interprofessional education: a quality improvement tool

Robust demonstration of high-quality, fit-for-purpose interprofessional education (IPE) is essential for today's health professional students, staff, curricula, and regulatory bodies. As IPE moves from discrete "events" to fully embedded spirals of learning across degree programme curricula, effective mechanisms for monitoring continuous quality improvement are paramount. An accreditation tool was therefore developed for all learning activities contributing to the IPE curriculum of a university in Aotearoa New Zealand. We worked over 15 months, introducing a user-friendly tool to collect data, managing accreditation processes, and integrating with wider systems. We identified key levers to monitor, adjust, and continuously improve quality in IPE teaching and learning at individual-activity and programmatic levels.

Facilitating interprofessional learning: experiences of using a digital activity for training handover of critically ill patients between a primary health care centre and ambulance services - a qualitative study

OBJECTIVE

To explore students' and facilitators' experiences of using a developed digital activity for interprofessional learning (IPL) focusing on critically ill patient handovers from a primary healthcare (PHC) centre to the ambulance service.

DESIGN

A qualitative study design was employed, and the reporting of this study adheres to the Consolidated criteria for Reporting Qualitative research guidelines for qualitative studies.

SETTING

A PHC centre and the ambulance service in Stockholm, Sweden.

PARTICIPANTS

A total of 31 participants were included in the study: 22 students from five different healthcare professions, seven facilitators and two observers.

INTERVENTION

A digital IPL activity was developed to overcome geographical distances, and the scenario included the handover of a critically ill patient from personnel within the PHC centre to the ambulance service personnel for transport to an emergency department. Four digital IPL activities were conducted in 2021.

RESULTS

The digital IPL activity eliminated the issue of geographical distance for students and facilitators, and it enabled the students to find an interprofessional model for collaboration through reasoning, by communicating and sharing knowledge with the support of a common structure. Participants perceived the digital IPL activity and scenario as authentic, feasible and facilitated IPL. Using a case with an acute and life-threatening condition was a success factor for students to experience high realism in their IPL on patient safety, handover, care and treatment.

CONCLUSION

The developed digital IPL activity facilitated the students' IPL and demonstrated potential sustainability as the digital approach supported overcoming geographical distances for both students and facilitators. By using a scenario involving an authentic case focusing on handovers of a critically ill patient, IPL, feasibility and acceptability were supported. However, it is crucial to emphasise that a comprehensive evaluation, both quantitative and qualitative, over an extended period of clinical rotations and involving a larger group of students is still warranted to ensure continuous improvement and development.

Exploring dental and oral hygiene students' interprofessional readiness: a cross-sectional study in joint paediatric outreach training

BACKGROUND

Interprofessional education is vital in oral healthcare education and should be integrated into both theoretical and work-based education. Little research addresses interprofessional education in dental hands-on training in authentic oral healthcare settings. The aim of the study was to examine the readiness and attitudes of dental and oral hygiene students towards interprofessional education during joint paediatric outreach training.

METHODS

In the spring of 2022, a cross-sectional study was done involving dental and oral hygiene students using the Readiness for Interprofessional Learning Scale (RIPLS) during joint paediatric outreach training. The 19-item tool was answered on a five-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, and 5 = strongly agree). Means, standard deviations, minimums, maximums, and medians were calculated for each subscale and overall score. Students grouped according to their categorical variables were compared for statistically significant differences. The Mann-Whitney U-test was used for groups of two and the Kruskal-Wallis one-way analysis for groups of three or more. The internal consistency of the scale was measured with Cronbach's alpha. Statistical level was set at 0.05.

RESULTS

The survey included 111 participants, consisting of 51 oral hygiene students and 60 dental students, with a response rate of 93%. The questionnaire yielded a high overall mean score of 4.2. Both oral hygiene (4.3) and dental students (4.2) displayed strong readiness for interprofessional education measured by the RIPLS. The subscale of teamwork and collaboration achieved the highest score of 4.5. Students lacking prior healthcare education or work experience obtained higher RIPLS scores. Oral hygiene students rated overall items (p = 0.019) and the subscales of positive professional identity (p = < 0.001) and roles and responsibilities (p = 0.038) higher than dental students. The Cronbach's alpha represented high internal consistency for overall RIPLS scores on the scale (0.812).

CONCLUSIONS

Both oral hygiene and dental students perceived shared learning as beneficial and showcased high readiness for interprofessional education, as evident in their RIPLS scores. Integrating interprofessional learning into oral hygiene and dental curricula is important. Studying together can form a good basis for future working life collaboration.

Sharpening the lens to evaluate interprofessional education and interprofessional collaboration by improving the conceptual framework: a critical discussion

It has been difficult to demonstrate that interprofessional education (IPE) and interprofessional collaboration (IPC) have positive effects on patient care quality, cost effectiveness of patient care, and healthcare provider satisfaction. Here we propose a detailed explanation for this difficulty based on an adjusted theory about cause and effect in the field of IPE and IPC by asking: 1) What are the critical weaknesses of the causal models predominantly used which link IPE with IPC, and IPE and IPC with final outcomes? 2) What would a more precise causal model look like? 3) Can the proposed novel model help us better understand the challenges of IPE and IPC outcome evaluations? In the format of a critical theoretical discussion, based on a critical appraisal of the literature, we first reason that a monocausal, IPE-biased view on IPC and IPC outcomes does not form a sufficient foundation for proper IPE and IPC outcome evaluations; rather, interprofessional organization (IPO) has to be considered an additional necessary cause for IPC; and factors outside of IPC additional causes for final outcomes. Second, we present an adjusted model representing the "multi-stage multi-causality" of patient, healthcare provider, and system outcomes. Third, we demonstrate the model's explanatory power by employing it to deduce why misuse of the modified Kirkpatrick classification as a causal model in IPE and IPC outcome evaluations might have led to inconclusive results in the past. We conclude by applying the derived theoretical clarification to formulate recommendations for enhancing future evaluations of IPE, IPO, and IPC. Our main recommendations: 1) Focus should be placed on a comprehensive evaluation of factual IPC as the fundamental metric and 2) A step-by-step approach should be used that separates the outcome evaluation of IPE from that of IPC in the overarching quest for proving the benefits of IPE, IPO and IPC for patients, healthcare providers, and health systems. With this critical discussion we hope to enable more effective evaluations of IPE, IPO and IPC in the future.

Interprofessional learning in practice-based settings: AMEE Guide No. 169

The provision of optimum health care services requires collaboration of health care professionals in integrated interprofessional (IP) teams. This guide addresses the practical aspects of establishing and delivering pre-licensure IP programs to prepare graduates of health professional programs to work in teams and wider collaboration, and consequently enhance the quality of health care. The main updated IP frameworks are presented to highlight commonalities that represent the essential competencies and outcomes of programs implementing interprofessional education (IPE). We discuss how these may be adapted to the local context, and present examples of models of implementation to guide the initial steps of establishing similar programs. Examples of pre-licensure IP practice-based learning, such as community-based, simulation-based, student-run and led clinics, and interprofessional training wards, and post-licensure interprofessional learning (IPL), are described. We consider assessment of IPL along the continuum of learning IP. This guide also emphasises the need to tailor faculty development programs for local contexts and consider factors affecting sustainability such as funding and accreditation. We finish with the governance of IP programs and how global IP networks may support interprofessional practice-based learning from development to delivery.

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.

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSION

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

Interprofessional Curriculum Delivery: Experience of a Primary Care Education Program

Few post-graduate training programs offer a comprehensive curriculum that includes structured clinical experiences to teach interprofessional care. To address this need, the United States Department of Veterans Affairs, Office of Academic Affiliations funded the Centers of Excellence in Primary Care Education (CoEPCE) from 2011-2019 to provide interprofessional curricula for health profession trainees (HPTs), including physician residents, nurse practitioner residents, pharmacy residents, and psychology residents. We examined changes over time in curricular domains, system impacts, and program practices based on HPT survey data and the qualitative evaluation of narrative feedback. An annual survey was administered to participants. Indirect standardized ratios were calculated for interprofessional professional education (IPE) program domains, system impacts, and program practices. Qualitative responses were coded based on curricular domains and key program components. The study cohort included 369 HPTs. Site and profession standardized indirect ratios across all professions indicated improvements in curricular domains, system impacts, and program practices, with significant differences observed for associated health HPTs as compared to other HPTs for performance improvement. Qualitative data indicated that profession was associated with differences in perceptions of the curriculum. Although improvements occurred over time, our findings support the need for the thoughtful consideration of profession-specific identity characteristics when designing interprofessional curricula.

EPIS-RI: Indonesian translation, cultural adaptation and construct validation of an interprofessional identity measure

Interprofessional Education (IPE) as a preparatory stage for Interprofessional collaboration (IPC) is overlooked in some low-and middle-income countries, including Indonesia. One of the driving forces behind IPC is the development of Interprofessional Identity (IPI), which has yet to be assessed in the Indonesian context. Our study aims were translating and culturally adapting the Extended Professional Identity Scale (EPIS) and confirming its construct validity. We invited third-year students from three programs (medicine, nursing, and dietetics) without previous IPE experience to participate in the study. Using Confirmatory Factor Analysis (CFA), we examined the construct validity, analyzed internal consistency, and conducted a Kruskal-Wallis test to identify variations across professions. Of 513 students approached, 335 participated (response rate 65.3%). The CFA showed factor loadings ranging between .59 and .86, while correlations among subscales varied from .55 to .86. All five goodness-of-fit indices were sufficient. The internal consistency of subscales interprofessional belonging, commitment, and beliefs was .82, .84 and .87, respectively, and .90 for the overall scale. Interprofessional belonging and commitment were different among various students (p-value = .009 and .004) and the dietetics students had lower scores than other students. The Indonesian EPIS (EPIS-RI) demonstrated reliability and construct validity.

Interprofessional education in undergraduate courses in health in Brazil: integrative review

This integrative review aimed to synthesize the evidence regarding interprofessional education (IPE) in undergraduate health courses in Brazil. This article included original articles published between 2005 and 2020 addressing IPE in undergraduate health courses in Brazilian higher education institutions. Our search captured 333 articles in Medline, PubMed, Cochrane Library, Embase (Elsevier), Web Of Science (Main Collection), Scopus (Elsevier), Science Direct (Elsevier), ERIC, and LILACS via BVS. After applying the exclusion and inclusion criteria, the study corpus covered 34 original manuscripts. It was identified that a network is developed at the national level, and with international support, supports discussions and research on IPE. However, there is a concentration of partnerships between researchers from the Northeast, Southeast and South regions, with the need to expand studies on the country's experiences in the North and Midwest regions. There is also consistent publication of experiences concerning the implementation of IPE in undergraduate healthcare courses in Brazil. However, the uniprofessional characteristics and the lack of uniformity in the curricula are still significant, which represent essential obstacles to further IPE strengthening in Brazil. In the Brazilian literature, there is a dearth of longitudinal studies and mixed methods that assess changes in organizational practices. There remains a need for IPE studies with more rigorous designs to generate more impactful evidence.

Exploring variations in IPC competencies: a cross-sectional study among healthcare professionals in Northwest China

BACKGROUND

This cross-sectional study investigates infection prevention and control (IPC) competencies among healthcare professionals in northwest China, examining the influence of demographic factors, job titles, education, work experience, and hospital levels.

METHODS

Data from 874 respondents across 47 hospitals were collected through surveys assessing 16 major IPC domains. Statistical analyses, including Mann-Whitney tests, were employed to compare competencies across variables.

RESULTS

Significant differences were identified based on gender, job titles, education, work experience, and hospital levels. Females demonstrated higher IPC competencies, while senior positions exhibited superior performance. Higher educational attainment and prolonged work experience positively correlated with enhanced competencies. Variances across hospital levels underscored context-specific competencies.

CONCLUSION

Demographic factors and professional variables significantly shape IPC competencies. Tailored training, considering gender differences and job roles, is crucial. Higher education and prolonged work experience positively impact proficiency. Context-specific interventions are essential for diverse hospital settings, informing strategies to enhance IPC skills and mitigate healthcare-associated infections effectively.

Does UK Entry-Level Physiotherapy Education Prepare Graduates for a Future in Pediatric Clinical Practice? A Mixed-Methods Study

AIMS

Identify the perceptions and experiences of how UK entry-level programs educationally prepared pediatric physiotherapists for their first clinical role. Review the extent programs taught essential, recommended, and additional content as per the International Organisation of Physical Therapists in Pediatrics (IOPTP).

METHODS

Mixed methods design involving qualified UK pediatric physiotherapists. Forty-two physiotherapists completed an online questionnaire and nine (21%) completed a follow-up semi-structured interview.

RESULTS

All 42 respondents felt they were "Not Well" (median 2, IQR 1.75-2.75) prepared for clinical practice. Not enough curricula emphasis was given to pediatric content (100%), with 31% (n = 13, CI 95% 19-46) reporting no pediatric content throughout their program. Only 15 (36%, 23-51) respondents experienced a pediatric placement. Themes from the follow-up interviews were (1) UK programs are adult focused; (2) placements are the only meaningful opportunity to develop competency; (3) programs lacked non-clinical content; and (4) experiencing pediatric patients was overwhelming due poor preparation. The majority of the IOPTP curriculum guidance is not embedded within UK curriculums.

CONCLUSIONS

Respondents reported they were not well prepared for pediatric clinical practice. Some entry-level programs did not include any pediatric teaching throughout the entirety of the course.

Exploring Perceptions and Practices of Interprofessional Shared Decision-Making Education in Palliative Care Settings

Background

Palliative care teams provide support to patients and their caregivers during terminal illness, which requires interprofessional collaboration. One of the foundational skills is to assist patients with decision-making. This can be facilitated through interprofessional shared decision-making (IP-SDM). So far, IP-SDM education frameworks have only been used to a limited extent in the area of palliative care.

Aim

This study aims to explore perceptions and practices of faculty members, health professionals, and students toward IP-SDM education in palliative care and to indicate associated factors to implement an IP-SDM in undergraduate health professions education in palliative care settings.

Methods

We used a cross-sectional study design in which the data was obtained via an online self-administered questionnaire adapted from existing validated tools. The questionnaire was distributed to faculty members and health professionals (n = 125) and students (n = 334) at King Abdulaziz Medical City in Jeddah, Saudi Arabia. The sampling technique was a non-probability convenience sampling. Bivariate statistics, such as independent sample t-tests, one-way ANOVA, correlation coefficient, and linear multiple regression were conducted.

Findings

The response rate was 54% (85 faculty members and health professionals and 164 students). Perceptions on IP-SDM did not differ between participants. From those who had previous experience with IP-SDM, the mean practices score was slightly higher for faculty members and health professionals (M = 83.1, SD = 15.9) than for students (M = 74.1, SD = 11.5), which was significant (p < 0.05). Factors such as gender, age, discipline, nationality, level of education, years of study, and previous experience that were associated with perceptions and practices were varied among participants.

Conclusion

The findings show high levels of perception with low levels of practice of IP-SDM in palliative care. Other factors that could be associated with the topic should be addressed in further studies.

Examining the Outcomes of Project ECHO® as an Interprofessional Community of Practice for Pediatric Feeding Clinicians

Project ECHO® is a virtual, interprofessional, cased-based peer-learning model. To date, no studies have explored ECHO as a model for pediatric feeding education. This study examined the outcomes of establishing a pediatric feeding ECHO network. Using a prospective, mixed-methods design, two cohorts of allied health professionals were recruited. Each cohort participated in eight, 90-min videoconference sessions incorporating a didactic presentation and clinical case presentation. The case was presented by a participant, with questions and recommendations provided by the ECHO network. Participants completed: (1) a learning needs analysis before the ECHO series, (2) a self-reported confidence questionnaire pre, post, and 3-month post, (3) a satisfaction questionnaire after each session, and (4) an overall satisfaction questionnaire post-ECHO series. Time spent by hospital allied health clinicians providing impromptu phone/email feeding support to external clinicians was recorded for 8 weeks prior to and 8 weeks during the ECHO series. Forty-seven participants were included in the study, attending an average of 5.8 sessions. Significant improvements in self-reported confidence were observed across the three time points (p < 0.01) with less experienced participants demonstrating greater improvements. Participants reported high satisfaction with ECHO, with 93% (40/43) wanting continued access to ECHO in future. The multidisciplinary format, interactivity, structure, and case-based nature of ECHO were considered beneficial. A 75% reduction in requests for support from clinicians in the same catchment area was noted during the ECHO series. Results demonstrated that Project ECHO is a viable model for pediatric feeding education for clinicians working in the field. Further research is needed to investigate the long-term effects and impacts on clinical care.

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.

Interprofessional education for healthcare professionals. A BEME realist review of what works, why, for whom and in what circumstances in undergraduate health sciences education: BEME Guide No. 83

AIM

To provide an evidence-informed program theory (PT) for Interprofessional Education (IPE) that adds to the knowledge base of how IPE in undergraduate health sciences education works.

METHODS

We undertook a realist review of the literature and synthesis of the evidence combined with stakeholder experience. Our initial program theory (IPT), built around development, delivery and evaluation of IPE interventions, was tested and refined following an in-depth search of the literature and consultation with stakeholders. The literature (2010-2022) was selected based on the realist criteria of relevance and rigor, as well as on conceptual richness of the studies.

RESULTS

Our PT is built upon 124 CMOs (Context of IPE interventions, Mechanisms that fired within that context, and IPE Outcomes), from 58 studies. Our PT comprises an array of elements found in the Context, including traits and behavioral displays of students and facilitators, and discusses four Mechanisms (feeling responsible, feeling enthusiastic/excited, feeling safe to take risks, and feeling ready), which are likely to lead to outcomes related to the Interprofessional Education Collaborative (sub)competencies.

DISCUSSION

Results were linked to learning theories to further build our understanding. The PT can serve as a guide for the development, delivery, and evaluation of IPE interventions.

Interprofessional collaboration skills and motivation one year after an interprofessional educational intervention for undergraduate medical and nursing students

BACKGROUND

The increasingly complex patient care in the twenty-first century is delivered by interprofessional health care teams. Interprofessional collaboration can be taught during interprofessional education. However, whether a long-term change in collaborative competencies can be achieved by interprofessional education has not been studied sufficiently. Our research questions were: How does motivation for interprofessional collaboration and interprofessional collaborative skills change up to one year after an interprofessional educational intervention? How are they related to each other?

METHODS

During a one-year period, undergraduate medical and nursing students attended four interprofessional (intervention) or uniprofessional (control group) education sessions. Self-determination Theory was used as the theoretical framework. Autonomous and controlled motivation scores for interprofessional collaboration were calculated using the Academic Self-Regulation Questionnaire, before (T1), directly after (T2) and one year post-intervention (T3). At T3, the students also filled out the Interprofessional Collaborative Competencies Attainment Survey (ICCAS), which measured the perceived attainment of collaborative competencies by a retrospective pre-test/post-test design. We used linear mixed effects models to analyse the motivation scores and linear regression for the relation between motivation and competence.

RESULTS

In the interprofessional group, autonomous motivation scores of the participants were significantly lower at T2 vs. T1. Controlled motivation scores were significantly higher at T3 vs. T1. Controlled motivation scores for T2 were significantly higher in the uniprofessional group than in the interprofessional group. Perceived competence was related to higher autonomous motivation scores. At T3 the interprofessional collaborative competencies seemed to have grown more among students in the interprofessional group.

CONCLUSIONS

The perceived growth in interprofessional collaboration competence lasted at least up to one year after the intervention, and was measurable with the ICCAS. The growth was significantly more in the IPE students than in the UPE students. The few differences found in motivation scores for interprofessional collaboration were probably caused by an imbalance of nursing versus medical students over the different time points. This finding indicates that classroom based IPE can contribute to interprofessional collaboration skills of nursing and medical students at least up to one year after an intervention.

Exploring factors influencing implementation of interprofessional education in undergraduate healthcare programmes: a multiple-case study

Interprofessional education (IPE) can help prepare future graduates to work collaboratively in healthcare teams. Using a multiple-case study approach, we explored IPE across four United Kingdom (UK) Higher Education Institutions (HEIs) to identify factors affecting IPE implementation and outcomes. For each site, educators involved with IPE were surveyed and interviewed to explore IPE implementation. To examine outcomes, students took part in focus groups and accreditation reports published by professional regulators were explored. A total of five IPE courses were surveyed, six IPE leads were interviewed, three focus groups were conducted with students, and sixteen reports were reviewed. Regulators' standards mandating IPE and directives by the Deans were the main triggers for IPE initiation. In sites where the regulator's standards were perceived by educators as non-mandating IPE, some staff were less inclined to engage with IPE initiation, which adversely affected IPE planning and delivery. Students from such sites were less satisfied with their IPE experiences and uncertain about the purpose of IPE. Senior management (i.e. Dean) commitment and support is needed to establish IPE initiatives across the institution and cultivate a collaborative culture. The presence of a collaborative culture was associated with positive feedback from regulators and students regarding IPE.

A realist synthesis of interprofessional patient safety activities and healthcare student attitudes towards patient safety

Interprofessional education (IPE) has been used for instilling a positive safety culture within healthcare, yet what interventions work to change healthcare student attitudes and how improved patient safety outcomes are best achieved with this intervention, is unclear and challenging to evaluate. A realist synthesis was undertaken to ascertain how, why, and in what circumstances IPE activities result in a positive change to student attitudes to patient safety. Database searches of CINAHL, MEDLINE, Scopus, and Eric were undertaken in April 2022 to identify relevant studies. Synthesis with a realist framework of analysis, coupled with the development of a program theory was conducted to identify interactions among contexts, intervention, mechanisms, and outcomes (CIMO). Twenty-three articles eligible for inclusion articulated environments in which varied contexts, interventions, and mechanisms were activated to influence student attitudes to patient safety. Findings from this realist synthesis informs awareness into the methods of delivering and evaluating IPE activities and offers new perspectives for educators in planning and evaluating future IPE from a collaborative and positive safety culture perspective.

Twelve tips for designing, implementing and sustaining interprofessional training units on hospital wards

Dedicated Interprofessional Training Units (ITUs) in hospital wards are one way to prepare healthcare students for Interprofessional patient-centered care. Based on theoretical foundations, research, and our lived experiences of successes as well as failures, we propose 12 tips on how to prepare, implement, and sustain a dedicated ITU, combining the Grol & Wensing model for planning change with the Self-determination Theory of motivation. Start with a steering group, with a dedicated project leader, to translate awareness of the need for an ITU into wider awareness and motivation among stakeholders, with the ITU being a solution to authentic problems. Create shared ownership by jointly formulating feasible educational goals and starting with a pilot to provide opportunities for change. Motivate all stakeholders by stimulating their autonomy, interprofessional competence as well as relatedness to each other, in line with the Self-determination Theory. Confirm the value of the ITU at all stages and embed the ITU in the organizational strategy.

The interprofessional practice experiences of final-semester prelicensure BSN students completing clinical immersion: A descriptive qualitative study

BACKGROUND

The goal of interprofessional practice experiences in health professions programs is to develop interprofessional collaborative practice skills.

PURPOSE

The purpose of the study was to explore the meaning final-semester Bachelor of Science in Nursing students attributed to interprofessional practice experiences during clinical immersion.

METHODS

The theoretical framework for this descriptive qualitative study was experiential learning theory. A sample of 12 participants was drawn from final-semester prelicensure Bachelor of Science in Nursing students at a college of nursing at a public research university. Data were collected through one-on-one semi-structured interviews and analyzed through inductive thematic analysis.

RESULTS

The analysis yielded four themes: professional and interprofessional identity, working with team members, communication practices, and trusting relationships. Patterns across themes were clinical environment culture, nursing school preparation, nurse preceptor role, fear/concern/worry, and night shift.

CONCLUSION

Consistency in preceptors, welcoming clinical environments, and opportunities to practice communicating with team members contributed to interprofessional collaborative practice skill development and improved perceptions of readiness for practice. Academic and clinical educators may use findings to (a) identify immersion placements for interprofessional practice experiences, (b) design curricula reflective of interprofessional practice, (c) advance teaching strategies to promote interprofessional practice, and (d) create learning environments that aid in professional and interprofessional identity formation.

Insights of undergraduate health sciences students about a French interprofessional training initiative

BACKGROUND

Incorporating interprofessional collaboration within healthcare is critical to delivery of patient-centered care. Interprofessional Education (IPE) programs are key to promoting such collaboration. The 'Public Health Service' (PHS) in France is a mandatory IPE initiative that embodies this collaborative spirit, bringing together students from varied health undergraduate training programs-nursing, physiotherapy, pharmacy, midwifery, and medicine- in a common training program focused on primary prevention. The aim of the study was to assess the experience and attitudes of students in the five health training programs regarding the interest of IPEs in the PHS.

METHODS

A cross-sectional survey was administered to 823 students from the 2022-2023 cohort at a French university. The questionnaire was designed with 12 Likert-scale questions specifically created to evaluate the students' experiences, knowledge, and attitudes focused on IPE during the practical seminars, school interventions, and the overall PHS. Additionally, an open-ended question was utilized to gather qualitative data. Statistical analyses assessed satisfaction levels across undergraduate training programs, while thematic analysis was applied to the qualitative responses.

RESULTS

Within the surveyed cohort, 344 students responded to the survey. The findings showed that students were satisfied with the interprofessional collaboration, both in practical teaching sessions (75% satisfaction) and in primary prevention projects conducted in schools (70% satisfaction), despite their having faced challenges with coordination. Pharmacy students, in particular, highlighted the need for adjustments in program scheduling. The qualitative feedback underscored the positive value of IPE, notwithstanding the organizational difficulties stemming from different academic timetables.

CONCLUSION

The student feedback indicated a high level of satisfaction with the interprofessional work carried out in both the practical teaching and the primary prevention projects. To further enhance the educational impact and address the scheduling complexities, it is recommended that program refinements be made based on student feedback and pedagogical best practices.

Behavioural outcomes of interprofessional education within clinical settings for health professional students: A systematic literature review

Interprofessional education facilitates collaborative practice, which promotes high-quality patient care and patient safety. Interprofessional education (IPE) experiences within clinical settings provide an opportunity for the development of interprofessional collaborative practice competence. The aim of this systematic review was to review the literature evaluating interprofessional education for health professional students within clinical settings and summarize the behavioral outcomes. Databases searched were PubMed, Embase, Scopus, Web of Science, Taylor & Francis Online, ERIC and PsycINFO. Full-text articles were independently screened by two reviewers and included if agreed. Outcomes were analyzed using Kirkpatrick's model modified for IPE. Studies with behavioral change outcomes were analyzed and synthesized using narrative methods. Included studies provided evidence that IPE experiences in clinical settings can enable students to develop and integrate interprofessional collaborative practice competencies, across diverse types of settings. Key tasks enabling students to achieve these learning outcomes included synchronous patient consultations, collaborative development of integrative health-care plans outside of patient consultations, and participation in socialization with health-care teams. There were limitations in the methodological design of the included studies, with limited use of comparator groups and validated tools, high usage of self-report data and serious risk of bias identified across all quantitative included studies. In conclusion, high-quality research designed to measure the construct of behavioral change is lacking. Such research could further investigate the key tasks in IPE experiences in clinical settings that are necessary for students to develop the range of required collaborative practice competencies and integrate these. This could provide clarification regarding if and how this could be achieved across different types of clinical placements.

Inter-Professional Education Interventions, and Practice Outcomes Related to Healthcare Setting and Patients Within Mental Healthcare: A Scoping Review

Introduction

This scoping review aimed to examine 1) types of inter-professional (IPE) interventions using Strosahl's typology framework, 2) practice outcomes related to healthcare setting and patients using Kirkpatrick's model of training evaluation, and 3) enablers and challenges related to the effectiveness of IPE interventions specific to the mental healthcare setting in order to guide the development of such future programs.

Methods

This scoping review was conducted in accordance with the methodology of the Joanna Briggs Institute for scoping reviews. Several databases were searched for relevant studies from database inception until December 2023. Articles were included if it 1) involved IPE interventions within mental healthcare, 2) reported practice outcomes related to healthcare setting and patients, and 3) was published in English. Variables of interest included the mode of IPE intervention using Strosahl's typology, enablers, and challenges related to IPE interventions.

Results

Overall, 16 studies were included. IPE intervention outcomes within healthcare setting related to shifts in practice culture, engagement with family members, and increased collaborations with other inter-professional groups. Reported patient outcomes included clinical improvements (e.g., reduced depression and anxiety, psychotropic drug use, better psychosocial functioning), patient empowerment, satisfaction, and confidence in treatment. The enablers and challenges included resource limitations, inter-professional group and individual participation, and pedagogy.

Discussion

Future efforts in IPE mental healthcare practice can focus on garnering sustained institutional support, identifying and investing in committed faculty, encouraging greater learner participation, and making iterative changes to the IPE program structure to facilitate involvement of inter-professional disciplines for better patient care.

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.

Exploring experiential learning within interprofessional practice education initiatives for pre-licensure healthcare students: a scoping review

BACKGROUND

Interprofessional collaborative team-based approaches to care in health service delivery has been identified as important to health care reform around the world. Many academic institutions have integrated interprofessional education (IPE) into curricula for pre-licensure students in healthcare disciplines, but few provide formal initiatives for interprofessional practice (IPP). It is recognized that experiential learning (EL) can play a significant role supporting IPP education initiatives; however, little is known of how EL is used within education for IPP in healthcare settings.

METHODS

We conducted a scoping review to map peer-reviewed literature describing IPP education initiatives involving EL for pre-licensure students in healthcare disciplines. A literature search was executed in MEDLINE, CINAHL, EMBASE, ERIC, PsycINFO, Scopus, and Social Services Abstracts. After deduplication, two independent reviewers screened titles and abstracts of 5664 records and then 252 full-text articles that yielded 100 articles for data extraction. Data was extracted using an Excel template, and results synthesized for presentation in narrative and tabular formats.

RESULTS

The 100 included articles represented 12 countries and IPP education initiatives were described in three main typologies of literature - primary research, program descriptions, and program evaluations. Forty-three articles used a theory, framework, or model for design of their initiatives with only eight specific to EL. A variety of teaching and learning strategies were employed, such as small interprofessional groups of students, team huddles, direct provision of care, and reflective activities, but few initiatives utilized a full EL cycle. A range of perspectives and outcomes were evaluated such as student learning outcomes, including competencies associated with IPP, impacts and perceptions of the IPP initiatives, and others such as client satisfaction.

CONCLUSION

Few educational frameworks specific to EL have been used to inform EL teaching and learning strategies to consolidate IPE learning and prepare students for IPP in healthcare settings. Further development and evaluation of existing EL frameworks and models would be beneficial in supporting robust IPP educational initiatives for students in healthcare disciplines. Intentional, thoughtful, and comprehensive use of EL informed by theory can contribute important advances in IPP educational approaches and the preparation of a future health care workforce.

Interprofessional Education in Child Protection for Preservice Health and Allied Health Professionals: A Scoping Review

Health and allied health professionals are uniquely positioned to collaborate in prevention, early intervention and responses to child maltreatment. Effective collaboration requires comprehensive interprofessional education (IPE), and inadequate collaboration across sectors and professions continually contributes to poor outcomes for children. Little is known about what interprofessional preparation health and allied health professionals receive before initial qualification (preservice) that equips them for interprofessional collaboration and provision of culturally safe care in child protection. This scoping review aimed to identify what is known internationally about IPE in child protection for preservice health and allied health professionals. Thirteen manuscripts reporting 12 studies met the inclusion criteria and were included in the synthesis. Key characteristics of the educational interventions are presented, including target disciplines, core content and their learning objectives and activities. Findings demonstrated primarily low-quality methodologies and educational interventions that had not been replicated beyond their initial context. Many educational interventions did not provide comprehensive content covering the spectrum of prevention, early intervention and responses for all types of child maltreatment, and/or did not clearly indicate how IPE was achieved. Key challenges to delivering comprehensive interprofessional child protection include lack of institutional support and competing priorities across disciplines who must meet requirements of separate regulatory bodies. Consequently, there is a need for further development and robust evaluation of educational interventions to explore how interprofessional collaborative skills for child protection can be developed and delivered in preservice health and allied health professional education.

Enhancing interprofessional education readiness in undergraduate dental students: a scenario-based peer learning programme

BACKGROUND

Interprofessional Education (IPE) is an educational approach that brings together students from different healthcare professions to foster collaborative learning and teamwork. Before integrating IPE into the curriculum of health preprofessional students, it is necessary to increase their readiness for IPE. Dentistry increasingly values interprofessional collaboration and teamwork for enhanced patient care and healthcare team competencies, an emphasis also echoed by recent dental education authorities. The aim of this quasi-experimental research was to assess the influence of Scenario Based Learning Peer Learning (SBPL) programme, which involved scenarios necessitating interprofessional communication, on the readiness for IPE among a cohort of undergraduate dental students studying within the framework of the European Higher Education Area (EHEA).

METHODS

This study investigates undergraduate dental students' readiness for IPE and the influence of SBPL programme on their readiness. Participants (n = 25) from 18 EHEA countries completed the Readiness for Interprofessional Learning Scale (RIPLS) before and after SBPL programme, held at the 70th European Dental Students' Association (EDSA) meeting. Data were analyzed using the Wilcoxon Signed Rank Test (p = 0.05).

RESULTS

After the SBPT programme, there was a statistically significant increase (p < 0.05) in the mean of the total scale, teamwork and collaboration, roles and responsibilities and professional identity subscale. In general, SBPL programme showed a constructive effect on interprofessional readiness. Although there was no statistically significant increase only in items 9,12,18 of the 19 items of the RIPLS, there was an increase in the averages in all except item 12.

CONCLUSION

Our research emphasizes the importance of diverse perspectives and IPE in the realm of dental education. Within the limits of this study, it showcases the efficacy of a brief half-day SBPL programme with interprofessional scenarios in enhancing participants' readiness. The programme notably enhanced dental students' readiness in grasping crucial aspects of IPE: teamwork and collaboration, professional identity, and roles and responsibilities. However, this study does not delve into the potential impact of a comprehensive, long-term curriculum integrating IPE principles. This gap underscores the need for further exploration into the sustained influence of IPE on the interprofessional skills of dental school graduates.

Feasibility testing of an interprofessional education intervention to support collaborative practice in home care for older stroke survivors with multiple chronic conditions

This mixed-methods study examined the feasibility of implementing a new six-month, theory-based, interprofessional education intervention, and explored its effects and impact on collaborative practice among home care providers caring for older adult stroke survivors (≥65) with multiple chronic conditions. The evaluation utilized a qualitative descriptive and one group repeated measures design which included participant questionnaires, focus groups and field notes. Participants included 37 home care providers (registered nurses, physiotherapists, occupational therapists, personal support workers, care coordinators, and their supervisors) in Ontario, Canada. The intervention was feasible and acceptable to home care providers. Perceived benefits included improved communication and collaboration within teams, enhanced role understanding, increased learning with and from each other, and increased appreciation of all team members' expertise. From 3 to 6 months post initial IPE training, there was a statistically significant improvement in three domains of collaborative practice as measured by the Collaborative Practice Assessment Tool (communication/information exchange; community linkage and coordination of care; decision-making and conflict management) and one domain of collaborative practice, as measured by the 19-item Team Climate Inventory (task orientation). Implications for implementing interprofessional education in home care practice settings are described. Further testing in other populations and settings is warranted.

The status and outcomes of interprofessional health education in sub-Saharan Africa: A systematic review

The increasing burden of chronic diseases, and shortage of health care workers especially in Low and Middle Income countries (LMICs) requires greater collaborative working between health professions. There is a growing body of evidence that interprofessional education (IPE) and interprofessional continuous education (IPCE) can improve collaborative practice thus strengthening health care delivery in low resource settings. The World Health Organization (WHO) promotes this educational strategy in these regions as part of wider programs to improve health care. The purpose of this systematic review was to summarize IPE and IPCE activities in sub-Saharan Africa (SSA) and its outcomes; including practice, service and patient outcomes. Standard guidelines for conducting and reporting systematic reviews were followed. The online databases searched included MEDLINE, Embase, Education Resources Information Centre (ERIC), the Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Science Direct. The Kirkpatrick model was used to classify IPE outcomes reported from literature. Following full text screening, 41 articles were selected for data extraction. It was found that IPE/IPCE is still a relatively new concept in SSA with 93% of studies published after 2012. Furthermore, IPE is concentrated predominantly in undergraduate institutions and mainly implemented to improve collaborative practice and address important public health concerns. Positive reaction and outcomes of IPE/IPCE were reported in terms of change of attitude and perception toward collaborative practice as well as knowledge and skills acquisition. Few studies in SSA sought to understand and measure the outcomes of IPE/IPCE relating to health care practice. More work in this important potential outcome of IPE/IPCE is recommended.

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.

Mapping the Terrain of Faculty Development for Simulation: A Scoping Review

ABSTRACT

Understanding what interventions and approaches are currently being used to improve the knowledge, skills, and effectiveness of instructors in simulation-based education is an integral step for carving out the future of simulation. The current study is a scoping review on the topic, to uncover what is known about faculty development for simulation-based education.We screened 3259 abstracts and included 35 studies in this scoping review. Our findings reveal a clear image that the landscape of faculty development in simulation is widely diverse, revealing an array of foundations, terrains, and peaks even within the same zone of focus. As the field of faculty development in simulation continues to mature, we would hope that greater continuity and cohesiveness across the literature would continue to grow as well. Recommendations provided here may help provide the pathway toward that aim.

A qualitative study to explore student learning and development of interprofessional collaboration during an online interprofessional education intervention

Interprofessional education (IPE) during undergraduate education and training has been found to improve collaboration between health care students. This supports interprofessional working in clinical practice to enhance patient safety and care delivery.Undergraduate students from pharmacy and medical programmes worked online in pairs to review notes of hospital patients due to be discharged. Students were tasked to complete a discharge letter and undertake an online consultation with a simulated patient prior to discharge. Online interactions were recorded and assessed using a validated tool to measure interprofessional professionalism. Students undertook this intervention in different pairings with different patient cases for three iterations after receiving feedback and undertaking a reflective exercise.The aim was to investigate the student learning and development that could be used to inform intervention optimisation and scale-up.Qualitative data were collected from different sources. Method triangulation was employed to develop a comprehensive understanding of the student learning and development. Data was collected from written feedback provided by the assessment team, student reflections on their performance, and from semi-structured interviews conducted with the student pairs and one to one with the assessment team. Content and thematic analysis was used to analyse these data and the Kirkpatrick/Barr evaluation model provided a framework to organise the themes.Eighteen students (nine from each professional programme) completed the study and a total of 27 IPE sessions were conducted. The assessment team completed 54 assessment tools and 31 student reflections were received (from a maximum of 36). Students were interviewed in their interprofessional pairs to yield nine interview transcripts and one interview was conducted with the assessment team.Students reported and were observed to improve in interprofessional collaboration over the three iterations following feedback and rehearsal opportunities. Longitudinal observation and assessment of student interprofessional working in changing teams provided the opportunity to capture the influence of interdependence on student performance and assessment of competence.

Factors influencing teamwork in healthcare applicable to interventional and diagnostic radiology

Teamwork in healthcare has been analysed extensively in the literature, mainly in acute healthcare settings such as the operating room, emergency room, and intensive care unit, with limited evidence related to diagnostic and interventional radiology. Multiple factors that affect teamwork in different domains have been described, such as communication, hierarchy, and distractions. Teamwork is an important patient safety, job satisfaction and patient outcome determinant, with interprofessional and interdisciplinary healthcare education playing a relevant role in the different domains affecting team performance. The aim of this article is to review the literature to describe domains and specific factors that influence teamwork in diagnostic and interventional radiology practice. This is of particular interest for radiologist involved in quality improvement and/or patient safety initiatives development and implementation. The review will conclude with a summary table highlighting the most important factors that, according to the authors, appear relevant to the radiology practice.

"Ego massaging that helps": a framework analysis study of internal medicine trainees' interprofessional collaboration approaches

INTRODUCTION

Patient care depends on collaborative practice. Debate remains as to the best approach to providing education for collaboration, with educational interventions often far removed from the realities of the clinical workplace. Understanding the approaches used for collaboration in clinical practice could inform practical strategies for training. For internal medicine trainees, this involves collaboration with other professions but also with other specialties. This study aimed to explore the approaches that internal medicine trainees use for interprofessional collaboration and the ways that these approaches vary when internal medicine trainees interact with different healthcare provider groups.

METHODS

Following ethical approval and participant consent, interprofessional communication workshops between August 2020 and March 2021 were audio recorded and transcribed verbatim. Workshops involved groups of internal medicine trainees discussing collaboration challenges and the approaches they use in clinical practice. This framework analysis study used the interprofessional collaboration framework described by Bainbridge and Regehr (building social capital, perspective taking and negotiating priorities and resources), and cross-referenced the categorised data with the healthcare groups that trainees collaborate with, to look for patterns in the data.

RESULTS

Seventeen workshops, involving 100 trainees, were included. Trainees described relationship building, perspective taking and negotiating priorities and resources. Relationship building was a modification to the original framework domain of building social capital. Themes of power and civility transcended domains with evidence of using hierarchy as leverage when negotiating and employing civility as a tactical approach throughout.

DISCUSSION

This bi-dimensional analysis highlights patterns of perspective taking when collaborating with other specialties and professions, and the approaches to negotiation of courting favour and coercion when interacting with other specialties. This study provides evidence of the strategies currently utilised by internal medicine trainees, with different healthcare groups, and presents a modified framework which could inform the development of training for collaboration.

Evaluation of student-perceived competence of interprofessional working in Gerodontology

OBJECTIVE

To evaluate pharmacy, dental and dental therapy undergraduate students' perceived competence of interprofessional working before and after attending an interprofessional education (IPE) Gerodontology workshop.

BACKGROUND

Whilst there is international recognition of the importance of collaboration between the dental profession and systemic healthcare providers to enhance patient care, there remains a paucity of research into IPE in Gerodontology.

MATERIALS AND METHODS

Pharmacy, dental and dental therapy undergraduate students attended a 2-hour Gerodontology case-based workshop. Students completed anonymised Interprofessional Collaborative Competencies Attainment Surveys (ICCAS) before and after attendance.

RESULTS

108 questionnaires were received, 7 were withdrawn (1 incomplete with only pre-workshop side completed, 6 did not identify degree programme). From 101 included questionnaires, 37 were from pharmacy, 56 dental and 8 dental therapy students resulting in response rates of 84%, 82% and 67%, respectively. Each student group recorded an increase in positive reflective competence median (IQR) after taking part in the workshop. Overall median (IQR) reflective competence before the workshop was 6 (1), 5 (2) and 6 (2) for pharmacy, dental and dental therapy students, respectively, which increased to 7 (1) for all groups. There was variability in reflective competence before attending the workshop between dental and pharmacy students for two questions, and dental and dental therapy students for two different questions.

CONCLUSION

All students reported increased reflective competence of interprofessional working following the workshop. These findings suggest that introduction of IPE events into Gerodontology curricula may improve student understanding and appreciation of interprofessional working when providing care for older people.

Stepping into the shoes of older people: a scoping review of simulating ageing experiences for healthcare professional students

BACKGROUND

Ageing simulation suits and equipment give healthcare professional (HCP) students the opportunity to experience what it might feel like to be an older person with age-related disability or illness. Ageing simulation experiences, where students complete activities of daily living (ADL) tasks, aim to reproduce the challenges an older person may face.

OBJECTIVES

We undertook a scoping literature review to establish, from the evidence base, what is known about simulating ageing experiences for HCP students and its impact on attitudes towards older patients.

METHODS

We applied Arksey and O'Malley's scoping literature review framework to achieve relevant articles. Four databases (MEDLINE, Embase, Web of Science and Cumulative Index to Nursing and Allied Health Literature) were searched resulting in 114 citations. After screening and applying our exclusion criteria, 14 articles were selected for inclusion.

RESULTS

Fifty percent of studies were mixed-methods, 35% quasi-experimental, 7% quantitative and 7% qualitative. Two types of simulation experience were identified: (i) workshop based and (ii) ageing games. Simulated impairments included vision, hearing and mobility issues. Most common ADLs simulated were managing medications, finances and functional ability. The majority of studies reported a positive impact on knowledge, attitudes and empathy towards older people.

CONCLUSIONS

Teaching in Care of Older People is important in HCP undergraduate curricula and should be a positive experience promoting successful ageing while raising awareness of ageism. Ageing suits have a positive impact on students' attitudes and empathic skills towards older people. Future research should include interprofessional education with HCP students learning together throughout undergraduate training.

From self-regulation to co-regulation: refining learning presence in a community of inquiry in interprofessional education

INTRODUCTION

Online interprofessional education is a collaborative process that emphasizes both individual reflection and shared discourses. A useful analytical tool for understanding the complex dynamics of online collaborative learning is the community of inquiry (CoI) framework, which originally held that there are three types of presence in such learning: teaching, cognitive, and social. However, it was later revised to include learning presence, which is characterized by self-regulated learning. Our study aims to refine the construct of learning presence through a clearer understanding of how self- and co-regulation jointly influence learning outcomes.

METHODS

We surveyed 110 people involved with an online interprofessional medical-education curriculum at a university in Hong Kong. Path analysis was adopted to explore the relationships among 1) the three original presences of CoI; 2) learning presence (i.e., for this purpose, a combination of self-regulation and co-regulation); and 3) two learning outcomes: perceived progress and learner satisfaction.

RESULTS

The results of path analysis indicated that teaching presence had a significant indirect effect, through co-regulation, on perceived progress. In terms of direct relationships, co-regulation significantly and positively influenced both self-regulation and cognitive presence; and social presence had both positive influence on learners' satisfaction and perceived progress.

DISCUSSION

This study's findings suggest the important role of co-regulation in supporting self-regulation, especially in online collaborative-learning environments. Learners' self-regulation skills are shaped by their social interactions and regulatory activities with others. This further implies that health-professions educators and instructional designers should create learning activities that facilitate the development of co-regulatory skills, as a means of improving learning outcomes. As self-regulation is an important skill for health professions learners' lifelong learning, and because their future workplaces will be interdisciplinary in nature, it is critical to provide interactive and collaborative learning environments that will promote co-regulation and self-regulation.

Evaluation of a newly developed flipped-classroom course on interprofessional practice in health care for medical students

Interprofessional education is expected to promote collaborative practice and should therefore be included in health professionals' curricula. Reports on interprofessional curricular development and its evaluation are rare. We therefore undertook a comprehensive quantitative and qualitative evaluation of a new, mandatory course on interprofessional collaboration for medical students during their third year of the Bachelor of Medicine study programme. The newly developed and implemented course spans over six weeks and was designed in a hybrid, flipped-classroom format. It incorporates experience- and case-based learning as well as interactions with other health professionals. Each student completes an eLearning and a clinical workshadowing individually before attending the - due to the pandemic - virtual live lectures. To assess quality and usefulness of teaching-learning formats and course structure to learn about interprofessional collaboration and to develop interprofessional competencies and identity, a quantitative and qualitative evaluation was performed with more than 280 medical students and 26 nurse educators from teaching hospitals using online surveys (open & closed-ended format). Data were analyzed descriptively and using content analysis processes. Students appreciated the flipped-classroom concept, the real-world case-based learning scenarios with interprofessional lecturer teams, and the possibility of an experience-based learning opportunity in the clinical setting including interaction with students and professionals from other health professions. Interprofessional identity did not change during the course. Evaluation data showed that the course is a promising approach for teaching-learning interprofessional competencies to medical students. The evaluation revealed three factors that determined the success of this course, namely, a flipped-classroom concept, the individual workshadowing of medical students with another health professional, mainly nurses, and live sessions with interprofessional teaching-learning teams. The course structure and teaching-learning methods showed potential and could serve as a template for interprofessional course development in other institutions and on other course topics.

Do Regulatory and Curriculum Requirements for Interprofessional Practice Align?

Background

While interprofessional (IP) competency and Interprofessional Education (IPE) has received increasing attention in health, agreement on specific competencies and teaching approaches is frequently limited by profession-specific understandings. As part of a quality improvement initiative focused on improving delivery of IPE offerings, this enquiry maps current regulatory and curricula requirements for IP practice to health professional students from 12 professions trained across Aotearoa New Zealand's national vocational education provider.

Methods

Requirements for IP competency in national accreditation documents and in an operative teaching curricula were mapped for 12 professions, namely, clinical exercise physiology, counselling, massage, medical radiology, midwifery, nursing, occupational therapy, osteopathy, paramedicine, physiotherapy, social work, and sport and exercise science. A desk audit was conducted to identify the presence of core IP competencies for each profession. This involved a four-step process 1) Examination of regulatory standards for each profession to confirm IP requirements for each profession; 2) Examination of an operative curricula from each profession to identify the presence and translation of IP regulatory requirements to each of the profession-specific programs of study; 3) Mapping to identify within domains the core (common) IP competencies across the professions, and 4) Consideration of the similarities and differences between accreditation documents and curricula.

Results

Of 12 professions, 10 clearly identified IP competency as an expectation. Clinical Exercise Physiology and Counselling were exceptions with explicit requirement for IP competency not evident. Coordination and collaboration were the most identified competency domains in accreditation documents and curricula. In descending order of prevalence, communication, shared values, reflexivity, role-understanding, and teamwork were also identified requirements amongst the 10 professions with IP competency requirements.

Conclusion

The IP competencies identified as common across professions can be used to inform development of teaching and assessment. Greater alignment between teaching curricula and required competency standards in this area is recommended.

Characterization of interprofessional education experiences in health education at the University of São Paulo

OBJECTIVE

To map the experiences of Interprofessional Education (IPE) in Health at the São Paulo campus of the University of São Paulo.

METHOD

This is a descriptive, exploratory study with a quantitative approach and data collection through an online questionnaire addressed to teachers from eight teaching units and 14 health courses. The data was analyzed using absolute and percentage frequencies.

RESULTS

The majority of teachers do not take part in IPE experiences (70.4%). Most of the experiences are between six and ten years old, involving up to four teachers and small groups of students, mostly extracurricular or extension activities. The teaching and assessment strategies are diverse and open to students of all years.

CONCLUSION

IPE experiences involve a small number of students and teachers and, although consolidated in terms of the time they have been offered, are limited to extracurricular spaces. Factors such as improvements in institutional support and teacher development are pointed out as important for making progress in strengthening IPE in the analyzed context.