Current trends in interprofessional education of health sciences students: a literature review

Mindfulness training in healthcare professions: A scoping review of systematic reviews

PURPOSE

The effectiveness of mindfulness training (MT) on mental health and wellbeing in different groups and contexts is well-established. However, the effect of MT on different healthcare professionals' (HCPs) mental health and wellbeing needs to be synthesised, along with a focus on outcomes that are specifically relevant to healthcare settings. The aim of this study is to summarise the effect of MT interventions on HCPs' mental health and wellbeing, to explore its effect on communication skills and to identify potential gaps in the literature.

METHODS

A scoping review of systematic reviews (SRs) investigating MT interventions in HCPs was conducted. A comprehensive systematic search was conducted from database inception to 22 February 2023 on Ovid MEDLINE, Ovid Embase, Scopus, Cochrane (CENTRAL), EBSCHOhost CINAHL, Ovid PsycINFO, Web of Science (Core Collection), OpenGrey, TRIP Database and Google Scholar. Snowballing of reference lists and hand-searching were utilised. Risk of bias and quality of included SRs were assessed using the ROBIS and AMSTAR2 tools.

RESULTS

Sixteen SRs were included in this review. We found substantial evidence for MT interventions improving mental health and wellbeing across different HCPs, with the exception of burnout, where evidence is mixed. There is a paucity of SRs evaluating communication skills other than empathy. However, the available evidence is suggestive of improvements in self-reported empathy. Details of MT fidelity and dosage are largely absent in the SRs, as is study populations from representative EDI samples.

CONCLUSIONS

Synthesis of SRs suggests that MT improves mental health and wellbeing in HCPs. The exception is burnout, where results are inconclusive. Insufficient data exists to evaluate effects of MT on the full spectrum of communication skills. Other HCPs than medicine and nursing are inadequately represented. Further research is required that considers the specific target population of HCPs and MT curriculum, and reports on fidelity, dosage and the effects on communication skills.

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.

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.

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.

Dying and Death in a Pediatric Cardiac ICU: Mixed Methods Evaluation of Multidisciplinary Staff Responses

OBJECTIVES

Understanding factors influencing quality of pediatric end-of-life (EOL) care is necessary to identify interventions to improve family and staff experiences. We characterized pediatric cardiac ICU (PCICU) staff free-text survey responses to contextualize patterns in quality of dying and death (QODD) scoring.

DESIGN

This mixed methods study reports on a cross-sectional survey of PCICU staff involved in patient deaths.

SETTING

Single, quaternary PCICU from 2019-2021.

PARTICIPANTS

Multidisciplinary staff (bedside nurses, allied health professionals, and medical practitioners) rated QODD and voluntarily added free-text responses. We derived descriptive categories of free-text responses using content analysis. Response sentiment was classified as positive, negative or both positive and negative. We compared category and sentiment frequency by discipline, EOL medical intensity, years of experience and QODD score quartiles.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Of 60 deaths and 713 completed staff surveys, 269 (38%) contained free-text responses, including 103 of 269 (38%) from nurses. Of six qualitative categories (i.e., relational dynamics, clinical circumstances, family experiences, emotional expressions, temporal conditions, and structural/situational factors), relational dynamics was most frequent (173 responses). When compared by discipline, family experiences were more common in nursing responses than medical practitioners or allied health. High intensity was associated with infrequent discussion of family experience and greater focus on temporal conditions and clinical circumstances. Emotional expressions and temporal conditions were more common in lowest QODD quartile surveys. Although 45% staff responses contained both sentiments, relational dynamics and family experiences were more likely positive. Negative sentiments were more common in the lowest QODD quartile surveys and responses containing temporal conditions or structural/situational factors.

CONCLUSIONS

Synergistic relationships between the multidisciplinary team and family shaped clinician's positive responses. Attention to team dynamics may be a crucial ingredient in interventions to improve EOL care. Our data support that team-based education initiatives should consider differential foci between disciplines and EOL characteristics.

Clinical Interprofessional Education in Inpatient Pharmacy: Findings From a Secondary Analysis of a Scoping Review

OBJECTIVES

Clinical interprofessional education (IPE) is defined as learning that occurs within clinical learning environments such as hospitals, primary care clinics, and long-term care facilities where learners collaborate to deliver care to real patients. The objective of this secondary analysis of a scoping review is to identify, characterize, and summarize evidence from the published literature regarding clinical IPE for pharmacy learners in the inpatient setting.

FINDINGS

PubMed, CINAHL, and Scopus databases were searched for clinical IPE articles that met the following inclusion criteria: ≥ 2 health professions, ≥ 2 learner groups, and involvement of real patients/patient care. For this secondary analysis, 12 articles involving pharmacy learners in an inpatient setting were included. The most common interprofessional partner was medicine (66%), and the median number of student participants involved in the activity was 19 (range, 10-525). Five studies conducted clinical IPE in the context of advanced pharmacy practice experiences. Clinical IPE activities were described primarily as inpatient rounding with the medical team, but were often outside the normal clinical workflow (66%). Incorporation of Interprofessional Education Collaborative competencies was limited, as was the use of validated IPE assessment tools to measure outcomes.

SUMMARY

Current literature is limited in reports of pharmacy learner involvement in inpatient clinical IPE. Expansion of pharmacy partnerships and alignment of team outcomes with the Interprofessional Education Collaborative competencies are needed to demonstrate the relationship between clinical IPE and patient care outcomes within established workflows.

Students' Perception of Servant Leadership by Physical Therapy Faculty Mentors Is Associated With Interprofessional Socialization

INTRODUCTION

Promoting interprofessional collaborative practice (IPCP) is necessary. Consequently, investigating strategies associated with increased interprofessional socialization, the beliefs, behaviors, and attitudes underlying socialization toward IPCP is suggested. The purpose of this study was to examine the relationship, in the presence of control variables, between students' perception of servant leadership by physical therapy faculty mentors and interprofessional socialization.

REVIEW OF THE LITERATURE

Although faculty mentors are associated with influencing students' socialization process and servant leadership is suggested to support collaborative care, investigations exploring these concepts within physical therapy education are limited.

SUBJECTS

Three cohorts of students (60 each) at an entry-level physical therapist education program in the Midwest of the United States. One hundred seventy individuals completed an anonymous paper-based composite survey, with 117 identifying the presence of an informal physical therapy faculty mentor.

METHODS

This cross-sectional survey study, inclusive of student demographic control variables, examined the relationship between interprofessional socialization and perceptions of physical therapy faculty mentors, as measured by the Interprofessional Socialization and Valuing Scale (ISVS-21) and the Servant Leadership Measure (SL-7), respectively. Multiple linear regression was used to obtain the semi-partial correlation (sr) between the SL-7 and the ISVS-21, with significance accepted at P < .05.

RESULTS

Upon necessary assumptions being met, 114 participants were included with an analysis of variance identifying the model to be significant (F(8,105) = 2.59, P = .01). Multiple linear regression analysis found that the SL-7, in the presence of control variables, was associated with a significant proportion of ISVS-21 scores (R2 = 0.17, F(8,105) = 2.59, P = .01). Notably, only the SL-7 demonstrated a significant contribution to ISVS-21 estimates (β = 0.358, P < .001), with a significant and positive sr of 0.34 (P < .001).

DISCUSSION AND CONCLUSION

Perceptions of servant leadership by faculty mentors were positively correlated with interprofessional socialization. Findings bolster the theoretical link between servant leadership and interprofessional socialization, servant leadership in the development of faculty and mentorship programs, and the relevance of informal social interactions.

Perception of Interprofessional Education among Students Following Pharmacy Studies

INTRODUCTION

Interprofessional Education (IPE) activities are a first experience of real-world patient care practice for students, where collaboration with different professions is appreciated. Methods and timing of inclusion of IPE are not well-defined, and it is interesting to assess students' perception on IPE activities.

OBJECTIVE

To assess changes in pharmacy students' perception of IPE before (t0) and after (t1) an IPE activity.

METHODS

The 'Student Perceptions of Interprofessional Clinical Education-Revised 2' (SPICE-R2) tool was adopted to assess perception of IPE activities in third year pharmacy students, final year pharmacy students and in postgraduate Doctorate in Pharmacy (PharmD) students at t0 and t1.

RESULTS

The SPICE-R2 tool was completed at t0 and t1 by 61 students: 12 third year pharmacy students, 13 final year students and 36 PharmD students. A significant improvement between t0 and t1 (P < .05) was measured in the three groups of students for all three subscales of the tool. The largest improvement was observed in the 'Roles/Responsibilities for Collaborative Practice' subscale in all three groups of students.

CONCLUSION

Perception of IPE was positively increased in all three student groups. The results could be useful to support the design of IPE activities within pharmacy programmes.

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.

Development of a pilot interprofessional education workshop for healthcare students and assessment of interprofessional collaborative competency attainment

We describe the development and student evaluation of a collaborative health service provider and higher education institution initiative designed to deliver an Interprofessional Education (IPE) pilot workshop program for healthcare students. The aim was to investigate whether an IPE workshop would result in improved student confidence in self-reported interprofessional competencies using the Interprofessional Collaborative Competency Attainment Scale (ICCAS) tool. The workshops involved interprofessional student groups working on a patient case followed by a facilitator-led discussion and patient representative interaction. There were three different voluntary, extra-curricular workshops. A total of 99 students registered, from 3rd to 5th year undergraduate and 2nd year graduate entry healthcare programs at a single Irish university in February 2022. Ninety-three post-workshop survey responses showed statistically significant improvements in the ICCAS subscales of Communication, Collaboration, Roles and Responsibilities, Collaborative Patient/Family-Centered Approach, and Team Functioning; Conflict Management showed less change. Students reported positively on the benefit of the patient representative, the workshop format, and the opportunity to collaborate with students from other professions. Our findings indicate that this was a beneficial and effective way to deliver IPE across a range of healthcare professions that led to improvements in self-reported interprofessional competencies.

Shared understanding and task-interdependence in nursing interns' collaborative relations: A social network study of vocational health care internships in the Netherlands

Shared understanding among collaborators is a key element of delivering successful interprofessional care and a main challenge for professional education concerns nurturing such understanding among students. We assessed how nursing students perceived different levels of shared understanding in their collaborations with others in clinical internships. We analyse the collaborative networks of interns to examine whether individual factors (attitudes, perceptions of collaborative cultures, and motivation) or relational factors among collaborators (task-interdependence, cooperation frequency, and interprofessional and hierarchical roles) affect shared understanding among 150 Dutch nursing interns and their collaborators (n = 865). Theoretically, we stress the importance of focusing on collaborative relations in interprofessional care settings. Multilevel models distinguish two levels in explaining the variation in shared understanding, nesting collaborative relationships within individuals. Results indicate merely 37.4% of found variation of shared understanding could be attributed to individual-level factors (variation between interns), while 62.6% of variation is found within interns, showing that shared understanding differs substantially between the collaborations one intern engages in. Multilevel models reveal that task-interdependence strongly predicts shared understanding in inter- and intraprofessional collaborations. We conclude that focusing on collaborative relations is essential to foster shared understanding in vocational internship programmes, and that health care organisations should pay explicit attention to task-interdependence in interns' collaborations.

Are the stars aligned? Healthcare students' conditions for negotiating tasks and competencies during interprofessional clinical placement

BACKGROUND

Healthcare students must learn to collaborate across professional boundaries so they can make use of each other's knowledge and competencies in a way that benefits the patient. One aspect of interprofessional collaboration implies negotiating what needs to be done and by whom. Research, focused on the conditions under which students perform this negotiation when they are working together during interprofessional clinical placement, needs to be further developed. The study therefore aimed to explore students' negotiation of tasks and competencies when students are working together as an interprofessional team during clinical placement.

METHODS

The study was designed as a focused ethnographic observational study. Two Nordic sites where final-year healthcare students perform clinical interprofessional education were included. Data consists of fieldnotes, together with informal conversations, group, and focus group interviews. In total, 160 h of participating observations and 3 h of interviews are included in the study. The analysis was informed by the theory on communities of practice.

RESULTS

Students relate to intersecting communities of practice when they negotiate what they should do to help a patient and who should do it. When the different communities of practice align, they support students in coming to an agreement. However, these communities of practice sometimes pulled the students in different directions, and negotiations were sometimes interrupted or stranded. On those occasions, observations show how the interprofessional learning practice conflicted with either clinical practice or one of the student's profession-specific practices. Conditions that had an impact on whether or not communities of practice aligned when students negotiated these situations proved to be 'having time to negotiate or not', as well as 'feeling safe or not'.

CONCLUSIONS

Final-year healthcare students can negotiate who in the team has the competence suited for a specific task. However, they must adapt their negotiations to different communities of practice being enacted at the same time. Educators need to be attentive to this and make an effort to ensure that students benefit from these intersecting communities of practice, both when they align and when they are in conflict.

Who Is Teaching Residents in the Intensive Care Unit? Perceptions of Interprofessional Teaching at an Academic Medical Center

Background

Teamwork is essential for high-quality care in the intensive care unit (ICU). Interprofessional education has been widely endorsed as a way of promoting collaborative practice. Interprofessional providers (IPPs), including nurses, pharmacists, and respiratory therapists (RTs), routinely participate in multidisciplinary rounds in the ICU, but their role in teaching residents at academic medical centers has yet to be characterized.

Objective

To characterize perceptions of interprofessional teaching during and outside of rounds in the ICU.

Methods

The authors conducted a cross-sectional survey of critical care physicians, internal medicine residents, nurses, pharmacists, and RTs across three ICUs at a tertiary academic medical center from September 2019 to March 2020. The frequency of different types of rounds contributions was rated on a Likert scale. Means and medians were compared across groups.

Results

A total of 221 of 285 participants completed the survey (78% response rate). All IPPs described that they report data, provide clinical observations, and make recommendations frequently during ICU rounds, but teaching occurred infrequently (mean values, nurses = 2.9; pharmacists = 3.5; RTs = 3.7; 1 = not at all; 5 = always). Nurses were least likely to report teaching (P = 0.0017). From residents' and attendings' perspectives, pharmacists taught most frequently (mean values, 3.7 and 3.4, respectively). RTs self-report of teaching was higher than physicians' reports of RT teaching (P < 0.0001). Outside of rounds, residents reported a low frequency of teaching by nurses and RTs (means, nurses = 3.1; RTs = 3.1), but they reported a high rate of teaching by pharmacists (mean, 4.4).

Conclusion

Nonphysician IPPs routinely participate in ICU rounds but teach medical trainees infrequently. Physicians' perception of IPP teaching frequency was generally lower than self-reports by IPPs. Exploring modifiers of interprofessional teaching may enhance education and collaboration.

Determining the impact of an interprofessional learning in practice model on learners and patients

The Institute of Medicine recently expressed a need to measure the impact of interprofessional education (IPE) on health professions collaborative behavior in practice environments and patient outcomes, and the National Center for Interprofessional Practice and Education has focused research efforts to connect interprofessional practice and education. We describe a model intentionally designed to link interprofessional practice experience in ambulatory care setting and an IPE curriculum for students, called the Interprofessional Learning in Practice (ILIP) model. The study objective was to determine the impact of the ILIP model on student and patient outcomes during a 24-month intervention period. Student satisfaction was collected through a brief survey administered post-ILIP model. Patient outcomes were collected from before and after the intervention period through a retrospective chart review of patients who received care through the ILIP model. For the study, disease indicators for the top three chronic diagnoses of depression, hypertension, and type 2 diabetes mellitus were chosen as the patient outcomes. Student outcomes were analyzed using descriptive statistics and the Mann-Whitney U test. Patient outcomes were analyzed using McNemar's test and paired t-tests. Of the 382 students who participated in the ILIP model during the study period, 179 completed surveys, indicating that they valued the experience, valued learning from interprofessional preceptors, and gained interprofessional skills to use in their future practice. During the 24-month intervention, 401 patients were evaluated post-ILIP model, statistically significant results demonstrated HbA1c values for patients with diabetes were reduced by 0.5% and depression screening improved from 9% to 91%. Additionally, patients' hypertension control was similar to baseline and diabetes control (as defined as HbA1c ≤8%) was improved compared to baseline but did not reach statistical significance. By aligning interprofessional practice and education in the ILIP model, students had a positive experience, gained interprofessional collaboration skills, and provided value-added benefits to improve patient outcomes.

Interprofessional Team Conflict Resolution: A Critical Literature Review

INTRODUCTION

Although concern related to conflicts within health care teams has been discussed in the literature, most studies have focused on individuals' personal conflict management style identification or on managers resolving workplace conflicts between parties. The purpose of this review was to identify significant components in the field of conflict with particular attention to conceptual findings that may be integrated into understanding interprofessional health care team conflict and its resolution.

METHODS

A critical review of the conflict literature across many fields was undertaken using the method identified by Grant and Booth, incorporating literature-search, appraisal, synthesis, and analysis.

RESULTS

This critical review explored existing models and schools of thought to provide an overview of how conflict is conceptualized, its focus on interpersonal and workplace issues, team conflict application and training in team conflict resolution, and finally a summary of this review's contribution to interprofessional health care team conflict and its resolution.

CONCLUSIONS

Team conflict is comprised of three forms-relationship, task, and process. When team building occurs that incorporates training in the use of an adapted constructive controversy approach, there is a greater opportunity to enhance the quality of a cooperative approach to patients' care planning. Training in team conflict resolution is needed as a key ingredient to ensure all team members can enhance the effectiveness and quality of interprofessional client-centered collaborative practice. This benefits not only the health providers in the team, but also their clients/patients who are recipients of their shared teamwork.

Towards a global partnership model in interprofessional education for cross-sector problem-solving

OBJECTIVES

A partnership model in interprofessional education (IPE) is important in promoting a sense of global citizenship while preparing students for cross-sector problem-solving. However, the literature remains scant in providing useful guidance for the development of an IPE programme co-implemented by external partners. In this pioneering study, we describe the processes of forging global partnerships in co-implementing IPE and evaluate the programme in light of the preliminary data available.

METHODS

This study is generally quantitative. We collected data from a total of 747 health and social care students from four higher education institutions. We utilized a descriptive narrative format and a quantitative design to present our experiences of running IPE with external partners and performed independent t-tests and analysis of variance to examine pretest and posttest mean differences in students' data.

RESULTS

We identified factors in establishing a cross-institutional IPE programme. These factors include complementarity of expertise, mutual benefits, internet connectivity, interactivity of design, and time difference. We found significant pretest-posttest differences in students' readiness for interprofessional learning (teamwork and collaboration, positive professional identity, roles, and responsibilities). We also found a significant decrease in students' social interaction anxiety after the IPE simulation.

CONCLUSIONS

The narrative of our experiences described in this manuscript could be considered by higher education institutions seeking to forge meaningful external partnerships in their effort to establish interprofessional global health education.

Potentialities and limitations of Interprofessional Education during graduation: a systematic review and thematic synthesis of qualitative studies

BACKGROUND

Rapid demographic, epidemiological, technological, cultural/behavioural, and educational transitions, as they become more complex, demand new integrated and complementary professional skills and abilities. Interprofessional Education (IPE) is a promising alternative to deal with these changes, especially in courses in the health area. This systematic review was to explore the potentialities and limitations of IPE, from the perspective of undergraduate students, through a thematic synthesis of qualitative studies.

METHODS

A thematic synthesis of qualitative studies was conducted. The question elaborated for this review was: "What is the impact of interprofessional education on the teaching and learning of students in the health area inserted in Higher Education Institutions?". The search strategy was performed in the electronic databases PubMed, Latin American and Caribbean Literature in Health Sciences (LILACS), Cochrane Library, and Scientific Electronic Library Online (SciELO). In addition, searches were carried out in grey literature on the ERIC platforms, ProQuest Disserts and Theses, and Academic Google. The assessment of the quality of the studies was carried out using the Critical Appraisal Skills Programme tool. Data were summarized through thematic synthesis. From the databases, 8,793 studies were identified. After standardized filters procedures, critical summaries, and assessment of relevance to the eligibility criteria, 14 articles were included.

RESULTS

The synthesis of the studies revealed the potential of this teaching approach, arranged in three analytical themes: learning from each other and about them; the value of education and interprofessional practice; patient-centred health care. On the other hand, some limitations were also identified, such as barriers related to EIP; the difficulties related to teaching methodologies.

CONCLUSION

Overcoming the identified limitations can enhance the results of the IPE, in view of its impact on the education of students and on the health care of the population.

Patient-centered simulation: Practicing interprofessional teamwork with standardized patients

The simulation environment provides opportunities for students to practice interprofessional skills in an authentic, yet safe setting. We discuss an interprofessional learning activity called Team Care Planning designed to teach interprofessional teamwork using a simulated discharge meeting involving an elderly female patient who had a cerebral vascular accident (stroke) and her adult daughter, played by standardized patients Interprofessional teams of health professions students work together to discuss the discharge plan and meet with the patient/family. Teamwork is evaluated using the Jefferson Teamwork Observation Guide®, completed by the students, faculty observers, and standardized patients. Students also report their perception of knowledge and skills gained from the interprofessional activity in an electronic evaluation. Analysis of the data indicates the initial goals of the program are being met. Students report greater understanding of roles/responsibilities of team members; and students, faculty, and standardized patients rate the experience high in terms of the quality of the teamwork. Debriefing with faculty observers promotes student reflection on performance. Receiving feedback from the standardized patients informs student personal and professional development.

Realist review of interprofessional education for health care students: What works for whom and why

Interprofessional education (IPE) programs, are complex, logistically challenging, and can be expensive to deliver, but these matters are offset by the perceived benefits of IPE. There is little clarity regarding how IPE contributes to the desirable development of collaborative practitioners. To guide educators in the design of IPE programs there is a need to understand the elements that promote optimal learning. A realist review was conducted to identify the mechanisms and resources that contribute to IPE outcomes. Four databases were searched until April 2020 for empirical studies describing mandatory IPE for pre-registration medical, nursing and other health professional students. Twelve articles met the inclusion criteria. Two novel learning design elements were identified; interdependence, where there is a need for genuine contribution of skills and knowledge from the professions learning together to successfully complete tasks, and embodiment, where through being immersed in an authentic scenario, learners feel what it is like to work in their professions. Other observations supported previous research findings such as the importance of skilled facilitators to promote interaction and reflection. Interprofessional interventions incorporating these specific learning design features seem likely to enhance the impact of IPE, thus making the best use of limited institutional resources and student time.

Exploring the opportunities and challenges to implementing interprofessional education in Saudi Arabia: a qualitative study among faculty

Interprofessional education (IPE) has potential benefits for improving the quality of patient care, but its implementation is challenged with multiple barriers. The primary objectives of this study were to explore the challenges, benefits, and incentives to establishing IPE from the perspective of healthcare faculty at King Saud University. Forty-five faculty members attended six focus groups, each consisting of 6-8 faculty members representing the five colleges. The focus group interview guide included the benefits of and barriers to establishing IPE in this academic institution, curricular design, and the feasibility of support from the colleges and University administration. A SWOC (Strengths, Weaknesses, Opportunities, Challenges) frame work was utilized to guide the focus group discussions, and the data were analyzed inductively using thematic analysis. Three main themes emerged and were related to (i) barriers, (ii) benefits, (iii) opportunities to facilitate the introduction of IPE, and (iv) suggestions on how to implement IPE and overcome challenges to establish an IPE curriculum. Participants were generally supportive of IPE and aware of the constraints that might impede its implementation. Moreover, they identified potential barriers and incentives to promote IPE. Although participants appreciated the long-term benefits of IPE, creating a supportive environment will require the involvement of the academic community, including students, faculty members, and the University's top management.

Connecting knowledge: First-year health care students' learning in early interprofessional tutorials

Collaboration across professional boundaries is an essential aspect of health care, and interprofessional education (IPE) is a common way to help increase students' collaborative abilities. Research on how and when IPE should be arranged in a curriculum remains, however, inconclusive. How students actually develop interprofessional competencies have been difficult to demonstrate and is still an under-researched area. Studying IPE in context is therefore important to understand its full complexity. This paper examines how students work with scenarios from professional health care contexts when learning together in interprofessional problem-based learning tutorials during the first year of undergraduate education. The data are video-recorded tutorials of students from medicine, nursing, occupational therapy, speech and language pathology, and physiotherapy programmes. The analysis focuses on students' discussing their readings of the literature. Drawing on "Communities of Practice," findings show that students discuss and connect professional knowledge, with "brokers" (the tutors) and "boundary objects" (scenarios) supporting the emergence of students' professional knowledge. The scenarios, as boundary objects, also enabled the students to turn into brokers themselves. The paper contributes to research on interprofessional learning and offers support for implementing IPE in the early stages of undergraduate education.

Interprofessional peer-assisted learning and tutor training practices in health professions education-A snapshot of Germany

Peer-assisted learning (PAL)-especially peer tutorials-are gaining momentum in health professions education, particularly in interprofessional education. As little is known about the use of peer tutorials or the preparation of tutors in this context in Germany and in other countries, this study aims to provide an overview of these interventions. A cross-sectional study with a descriptive-exploratory design was conducted. German institutions for health professions education were contacted, and individuals with pedagogical responsibilities were invited to participate in an online survey. The survey was informed by two studies in which seven domains were identified as important. These included facts about the institution, the offer of PAL, the use of tutorials, and the design of tutor training. The survey used mostly closed-ended questions. The questionnaire was completed by n = 100 participants. Overall, n = 46 participants indicated that PAL was offered at their institution. Of these 46 participants, 32 (70%) indicated that uniprofessional PAL was offered, 2 (4%) indicated that interprofessional PAL was offered, and 12 (26%) indicated that both forms of PAL were offered. Peer tutoring was the most common format in both cases (73% for uniprofessional and 64% for interprofessional PAL), and mandatory interventions were mostly used to prepare the tutors. These interventions were held by educators or lecturers and were offered mostly face-to-face as workshops or as discussions. Deepening the tutors' social competencies through training was given high relevance. Regarding content, focus was placed on communication, (self-)reflection, and group management. Eighty-eight participants expressed recommendations for future directions in terms of preparing tutors for interprofessional PAL. Minor differences between the use of uniprofessional and interprofessional PAL and tutor training were found. Nevertheless, implementation strategies varied. In future, preparatory measures for tutors should be more uniformly designed and geared to the specific requirements of uniprofessional and interprofessional learning, and that at best on an empirical basis.

Developing an interprofessional education programme for a health science faculty in South Africa: A multi-method study

Objective

Work-ready graduates need to be equipped with expertise and therefore, critical changes are required in the curricula for health professions. Here, we aimed to review the design of an interprofessional education programme (IPE) with regards to appropriateness and implementation for the Faculty of Health Sciences at North-West University, South Africa.

Methods

This study employed a sequential multi-method design to develop an IPE programme for a health science faculty in South Africa. A scoping review was conducted to synthesise the structure, development and implementation processes of IPE programmes globally. This was followed by an analysis of IPE programmes from institutions on five continents. Subsequently, the perspectives of international experts on the development and implementation of IPE programmes were explored in a qualitative study. This was followed by a university context analysis and the development of a draft IPE programme was designed based on the data synthesised from all preliminary studies. The programme was presented to faculty to evaluate and provide input by applying a nominal group technique.

Results

For the scoping review, ten steps to the IPE programme development process were developed. For the qualitative document analysis, a step-by-step guide and to-do list were provided to guide educators in conceptualising, developing, implementing and reviewing their IPE programmes. For the qualitative exploratory descriptive design, four themes were identified after the analysis of transcripts. An optional 3-year IPE programme was developed to serve as a precursor for full credit integration of the IPE into the faculty of health science curricula during future development of the health science curricula.

Conclusion

The optional 3-year IPE programme developed will serve as a precursor for the integration of a credit-bearing IPE programme into the Faculty of Health Sciences curricula during future development.

Long-term clinical clerkship improves medical students' attitudes toward team collaboration

OBJECTIVES

To examine the related factors associated with medical students' attitudes toward team collaboration.

METHODS

This cross-sectional study targeted medical students, residents, and doctors. A survey was conducted from 2016 to 2017 using the Japanese version of the Jefferson Scale of Attitudes Toward Interprofessional Collaboration (JeffSATIC-J), which evaluated "working relationship" and "accountability." We analyzed 2409 questionnaire responses with JeffSATIC-J items and the gender item. Analysis of variance was used for factors associated with the JeffSATIC-J score and Spearman's rank correlation coefficient for the relationship between educational intervention and the JeffSATIC-J score.

RESULTS

First-year students' scores were the highest (F_{(2, 2045)} = 13.42 to 18.87, p < .001), and female students' scores were significantly higher than those of male students (F_{(1, 2045)} = 21.16 to 31.10, p < .001). For residents' scores, the institution was not a significant variable. Female "accountability" scores were significantly higher than those of males (F _(1,108) = 4.95, p = .03). Gender was not a significant variable for doctors' scores. Sixth-year students' scores were significantly correlated with the length of clinical clerkship (r₍₅₎=.78 to .96, p<.05), with the exception of females' "working relationship" scores. The medical school with the highest JeffSATIC-J scores had the longest clinical clerkship in the community.

CONCLUSIONS

These results indicate that long-term clinical clerkship in the community at higher grades is important in improving medical students' attitudes toward team collaboration. A qualitative study is required to confirm our findings.

Ten-year mixed-method evaluation of prelicensure health professional student self-reported learning in an interfaculty pain curriculum

Introduction:

Student perspectives on interprofessional pain education are lacking.

Objectives:

The purpose of this study was to evaluate ratings of knowledge acquisition and effective presentation methods for prelicensure health professional students attending the University of Toronto Centre for the Study of Pain Interfaculty Pain Curriculum (Canada).

Methods:

A 10-year (2009–2019) retrospective longitudinal mixed-methods approach comprising analysis and integration of quantitative and qualitative data sets was used to evaluate 5 core University of Toronto Centre for the Study of Pain Interfaculty Pain Curriculum learning sessions.

Results:

A total of 10, 693 students were enrolled (2009–2019) with a mean annual attendance of 972 students (±SD:102). The mean proportion of students rating “agree/strongly agree” for knowledge acquisition and effective presentation methods across sessions was 79.3% (±SD:3.4) and 76.7% (±SD:6.0), respectively. Knowledge acquisition or presentation effectiveness scores increased, respectively, over time for 4 core sessions: online self-study pain mechanisms module (P = 0.03/P < 0.001), online self-study opioids module (P = 0.04/P = 0.019), individually selected in-person topical pain sessions (P = 0.03/P < 0.001), and in-person patient or interprofessional panel session (P = 0.03). Qualitative data corroborated rating scores and expanded insight into student expectations for knowledge acquisition to inform real-world clinical practice and interprofessional collaboration; presentation effectiveness corresponded with smaller session size, individually selected sessions, case-based scenarios, embedded knowledge appraisal, and opportunities to meaningfully interact with presenters and peers.

Conclusion:

This study demonstrated positive and increasing prelicensure student ratings of knowledge acquisition and effective presentation methods across multifaceted learning sessions in an interfaculty pain curriculum. This study has implications for pain curriculum design aimed at promoting students' collaborative, patient-centered working skills.

See commentary: Trouvin A-P. “Ten-year mixed method evaluation of prelicensure health professional student self-reported learning in an interfaculty pain curriculum”: a view on pain education. PAIN Rep 2022;7:e1031.

Students attending learning sessions at the University of Toronto Interfaculty Pain Curriculum (2009–2019) in Toronto, Canada, self-report high ratings of knowledge acquisition and effective presentation methods.

Outcomes From an Interprofessional Geriatric Outreach and Training Program

Background and Objectives

Interprofessional education (IPE) is necessary to train health care professionals to work collaboratively for the care of older adults. Geriatric Outreach and Training with Care! (GOT Care!) was an innovative academic training program designed to provide an IPE opportunity for health care students and faculty while providing care to community-dwelling older adults. The objectives of this program evaluation were to: (a) examine students’, older adult participants’, and primary care providers’ (PCPs) perceptions toward their participation GOT Care! and (b) examine patient outcomes to identify program strengths and areas for improvement.

Research Design and Methods

Formative and summative program evaluation methods were utilized to evaluate student, older adult participant, and provider perceptions of participating in GOT Care!. A total of 221 pharmacy, physical therapy, nursing, social work, medicine, and public health students from a single public university in northeastern United States, 38 community-dwelling older adults, and 33 PCPs were included. Means, standard deviations, and percentages were computed for survey data. The contextual data gathered from interviews and open-ended questions were analyzed using Borkan’s immersion–crystallization approach to generate themes.

Results

Overall, the students, older adults, and PCPs appreciated GOT Care!. Students reported learning about the unique challenges to geriatric care and how to communicate with other professionals. The older adults appreciated the thorough interprofessional assessment and that the students could learn from them. The PCPs noted the unique insights into their patients’ health that would not present at a typical office visit.

Discussion and Implications

GOT Care! leveraged academic and community partnerships to provide an IPE opportunity and care to vulnerable older adults. Positive outcomes such as older adult, student, and PCP satisfaction, and a reduction in emergency department visits support ongoing utilization and evaluation of these IPE programs.

Medical and pharmacy students' perspectives of remote synchronous interprofessional education sessions

BACKGROUND

Interprofessional education (IPE) at university level is an essential component of undergraduate healthcare curricula, as well as being a requirement of many associated regulatory bodies. In this study, the perception of pharmacy and medical students' of remote IPE was evaluated.

METHODS

A series of IPE sessions took place via Zoom and students' feedback was collected after each session. Both qualitative and quantitative data were collected and analysed.

RESULTS

72% (23/32) of medical students strongly agreed that the sessions had helped to improve their appreciation of the role of pharmacists, whereas 37% (22/59) of pharmacy students strongly agreed, reporting a median response of 'somewhat agreeing', that their appreciation of the role of general practitioners had improved. This difference was found to be statistically significant (p = 0.0143). Amongst students who responded, 55% (53/97) identified remote teaching as their preferred mode of delivery for an IPE session.

CONCLUSIONS

The survey demonstrated that the students valued the development of their prescribing skills as well as the ancillary skills gained, such as communication and teamwork. Remote IPE can be a practical means of improving medical and pharmacy students' understanding of each other's professional roles, as well as improving the skills required for prescribing.

Using Q-methodology to determine students' perceptions of interprofessional anatomy education

Interprofessional education (IPE) prepares healthcare students for collaboration in their future careers. The purpose of this study was to determine which aspects of the IPE Program in Anatomy at McMaster University contributed to the development of healthcare student's interprofessional skills. Q-methodology was used to identify the students' common viewpoints of the IPE experience. A total of 26/28 (93%) of students in the course from the medical, nursing, midwifery, physician assistant, occupational therapy, and physiotherapy programs participated in this study. Students were asked to sort a Q-sample of 43 statements about the IPE dissection course derived from previous qualitative studies of the program. Using the centroid factor extraction and varimax rotation, three salient factors (groups) emerged, namely: (1) Anatomy IPE Enthusiasts, (2) Practical IPE Advocates, and (3) Skeptical IPE Anatomists. The Anatomy IPE Enthusiasts believed that students from different disciplines brought unique anatomical knowledge and each group member guided others through difficult material. The Practical IPE Advocates expressed that they would be stronger advocates for interprofessional teams in the future because of the course. The Skeptical IPE Anatomists strongly disagreed that learning with students from different disciplines helped them gain an understanding of their roles in the context of other healthcare professionals and felt that there was little benefit from the IPE program compared to other non-interprofessional programs. These findings about student attitudes are critical to drive an evidence-based evolution of the IPE dissection course, since students' perceptions can have a profound influence on interprofessional collaboration in the workplace.

Advance Care Planning and Communication Skills Improve after an Interprofessional Team Simulation with Standardized Patients

Background:

Improving rates of advance care planning (ACP) and advance directive completion is a recognized goal of health care in the United States. No prior study has examined the efficacy of standardized patient (SP)-based student interprofessional ACP trainings.

Objectives:

The present study aims to evaluate an interprofessional approach to ACP education using SP encounters.

Design:

We designed a pre–post evaluation of an innovative interprofessional ACP training curriculum using multimodal adult learning techniques to test the effects of completing ACP discussions with SPs. Three surveys (pre-training T1, post-training T2, and post-clinical encounter T3) evaluated student knowledge, Communication Self-Efficacy (CSES), ACP self-efficacy, and interprofessional teamwork (using SPICE-R2).

Setting/Subjects:

Students from the schools of medicine, nursing, and social work attended three training modules and two SP encounters focused on ACP.

Measurements/Results:

During academic year 2018–2019, 36 students participated in the training at University of Maryland. Results demonstrated statistically significant improvements in ACP self-efficacy, M_T1 = 2.9 (standard deviation [SD]_T1 = 0.61) compared with M_T3 = 3.9 (SD_T3 = 0.51), p < 0.001, and CSES, M_T1 = 4.6 (SD_T1 = 1.35) versus M_T3 = 7.3 (SD_T3 = 0.51), p < 0.001, from T1 to T3. There was a medium-to-large improvement in knowledge from an average score of 4.3 (SD = 1.0) at T1 to an average score of 5.5 (SD = 1.4) at T2, p = 0.005, d = 0.67.

Conclusions:

Our interprofessional training module and SP encounter was successful in improving medical, social work, and nursing students' self-reported communication skills and knowledge regarding ACP.

Can interprofessional education change students' attitudes? A case study from Lebanon

BACKGROUND

Interprofessional collaboration is key to improving the health of individuals and communities. It is supported by provision of Interprofessional education (IPE) which has recently emerged in the Middle East region. This study investigated changes in healthcare students' attitudes towards interprofessional collaboration after undertaking the Interprofessional Education and Collaboration (IPEC) course.

METHODS

A paper-based anonymous survey using the Interprofessional Attitude Scale (IPAS) was administered to a sample of 346 health students (nursing, medicine, and public health) pre/post undertaking the IPEC course. Less than half of the students provided a post response, with pre/post survey results of 111 pairs subsequently matched and analyzed.

RESULTS

Results showed elevated pre-course scores, an improvement in students' attitudes towards the interprofessional biases domain of the IPAS, and a slight decline in their scores in the remaining 4 domains (team roles and responsibilities, patient centeredness, community centeredness, and diversity and ethics). These changes were not statistically significant, except for the patient centeredness domain (p = 0.003**).

CONCLUSIONS

The study provided important results about attitudes towards interprofessional collaboration. These findings are essential because our institution is one of few in Lebanon that provides this mandatory course to a large group of health professionals. Future studies should investigate these changes in attitude scores in a larger sample size, and how these attitudes would influence collaboration post-graduation.

Optimising care coordination strategies for physical activity referral scheme patients by Australian health professionals

Physical activity (PA) has been identified as an essential tool for the prevention and management of multi-morbidity in patients. Coordination of patients’ care through interventions like physical activity referral schemes (PARS) could foster the utilization of PA. This study explored the views of General Practitioners (GPs) and Exercise Physiologists (EPs) as key stakeholders, for optimizing patient care and efficiency of PARS. Sequential explanatory mixed methods design was used to explore the perceptions of these health professionals on PA and coordination strategies for PARS patient care. Data analyses included descriptive and inferential statistics for questionnaires and theoretical framework analysis for the semi-structured interviews. Participants demonstrated a good knowledge of PA and valued PARS. However, the findings unravelled external factors, inter-organisational mechanisms, and relational coordination obstacles that hinder efficient coordination of PARS patient care and delay/limit beneficial health outcomes for patients. Incentivising the PARS initiative and empowering patients to seek referral into the programme, are strategies that could boost PARS efficiency. Improving inter-professional relationships between GPs and EPs could lead to enhanced PARS functionality and efficient coordination of care for patients with chronic diseases.

Interprofessional communication in medical simulation: findings from a scoping review and implications for academic medicine

BACKGROUND

Interprofessional communication is fundamental to the delivery of healthcare and can be taught in medical school and other health professional schools through interprofessional education (IPE) activities. Simulation centers have become a predominant location for simulation IPE activities with infrastructure able to support high fidelity activities in a controlled environment. In this secondary analysis of a scoping review conducted on simulation-based IPE, we describe the characteristics of previously reported simulation IPE activities involving undergraduate medical students in a simulation center focused on interprofessional communication.

METHODS

Electronic searches of PubMed, CINAHL, and ERIC databases in accordance with PRISMA-ScR guidelines were conducted to isolate relevant articles from 2016-2020. In total, 165 peer-reviewed articles met inclusion criteria and data extraction linked to four research questions was applied by one individual and the accuracy was confirmed by a second individual. A secondary analysis was performed to describe what existing approaches for simulation IPE in simulation center settings have been used to explicitly achieve interprofessional communication competencies in undergraduate medical education. A sub-dataset was developed from the original scoping review and identified 21 studies describing simulation IPE activities that took place in dedicated simulation centers, targeted the IPEC interprofessional communication domain, and involved undergraduate medical students.

RESULTS

Though diverse, the majority of simulation IPE activities described high-fidelity approaches involving standardized patients and utilized assessment tools with established validity evidence in IPE activities to measure learning outcomes. A minority of simulation IPE activities were described as hybrid and utilized more than one resource or equipment for the activity and only two were longitudinal in nature. Learning outcomes were focused predominantly on modification of attitudes/perceptions and few targeted higher levels of assessment.

CONCLUSIONS

Educators charged with developing simulation IPE activities for medical students focused on interprofessional communication should incorporate assessment tools that have validity evidence from similar activities, target higher level learning outcomes, and leverage hybrid models to develop longitudinal simulation IPE activities. Though an ideal environment to achieve higher level learning outcomes, simulation centers are not required for meaningful simulation IPE activities.

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

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

Patient Safety Education in Entry to Practice Pharmacy Programs: A Systematic Review

OBJECTIVES

The aim of this systematic review was to synthesize, summarize, and evaluate the quality of extant quantitative and qualitative literature related to patient safety in pharmacy education. This systematic review included literature that targeted the content, delivery, and outcomes of patient safety in addition to literature that explored the perspectives of pharmacy students and faculty on how patient safety is integrated within their curricula.

METHODS

A systematic review was conducted. Four electronic databases were searched for articles published between 2000 and 2019: PubMed, MEDLINE, EMBASE, and ScienceDirect. Selection was based on prespecified criteria and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Two independent reviewers selected articles, extracted data, and assessed articles' qualities using the Crowe Critical Appraisal Tool. Discrepancies were resolved by consensus or by consulting a third reviewer. Descriptive synthesis of data was performed.

RESULTS

Twenty-five eligible articles were included. The majority of studies originated from United States (n = 15). Educational content involved principles of patient safety, and identification, disclosure, and management of medication errors. There was a lack of standardization on how patient safety is incorporated into the pharmacy curricula. Eleven articles (64%) were interprofessional in nature, delivered as a patient safety course (n = 6), through simulation (n = 3), as seminars (n = 1), or as part of student experiential learning (n = 1). Of the 7 articles discussing delivery of patient safety through courses or modules, 4 (57%) were offered as elective courses. Students' perceptions and attitudes significantly improved after all patient safety interventions, reflecting the importance of addressing patient safety in education to ensure optimum future practice.

CONCLUSIONS

This systematic review demonstrated how patient safety education was incorporated into pharmacy programs in terms of the content and methods of delivery. It was promising to see patient safety content being delivered interprofessionally and in experiential education. Students and faculty regarded implementing patient safety in education as an essential act to meet future work demands. Longitudinal studies to assess the long-term impact of incorporating patient safety on student behaviors upon graduation and health outcomes are needed.

Interprofessional education in the clinical learning environment: a mixed-methods evaluation of a longitudinal experience in the primary care setting

Team collaboration in our healthcare workforce is necessary to effectively address multifaceted medical and social needs, especially for those impacted by systemic inequities. Effective interprofessional practice and education models including curricula are needed to prepare a practice ready healthcare workforce for team collaboration. Most healthcare trainee interprofessional experiences take place episodically in classroom settings. However, creating a culture that supports team-based learning and interprofessional clinical practice requires teaching skills (e.g., communication, collaboration, shared decision-making, coordination of care) longitudinally in the clinical setting. A weekly interprofessional clinic for patients/clients with chronic health conditions was organized in three primary care practices. Trainees from nutrition, social work, medicine, and physician assistant programs worked with supervising clinicians from each field. Surveys, interviews, and focus groups assessed the effects of interprofessional education and training in the primary care setting. Results show the longitudinal experiential IPE program significantly improved knowledge, attitudes, skills, and values addressing key interprofessional competencies. Qualitative results complement survey data and highlight key themes addressing patient-centered care and team dynamics. These findings demonstrate the importance of longitudinal, immersive team-based interprofessional training in the clinical learning environment.

Contemporary Challenges for Veterinary Medical Education: Examining the State of Inter-Professional Education in Veterinary Medicine

Educational training in professional programs forms the foundation for how a person problem-solves throughout their career. However, training focused on only one profession ignores the value realized through collaborations among multiple professions for solving health-related problems. This is at the core of inter-professional education (IPE). Effective IPE programs can result in inter-professional collaboration and translation science endeavors across the health sciences and beyond. Recent events such as the COVID-19 pandemic and the opioid crisis highlight the importance of veterinary medicine in advancing One Health through IPE. The prevalence of IPE programs in veterinary curricula, and the process by which these have been established, has not been widely described in the literature. Through an 18-question survey sent to associate deans (ADs) of 50 veterinary schools, we sought to determine the status of IPE in the veterinary curriculum. Thirty-nine schools agreed to participate, representing primarily United States Doctor of Veterinary Medicine public and private programs with some representation from Canadian, United Kingdom, and Australasian programs. Schools that provide IPE courses developed their programs in collaboration with other health sciences programs across the 4-year curriculum. The perceived barriers for IPE offerings were no different between schools with or without opportunities; however, a lack of faculty and student-perceived value and lack of adequate space in the academic schedule were common threads. Our findings provide a snapshot of the current state of IPE in veterinary medical curricula, with a particular emphasis on the United States, and point to areas of programmatic need for the field.

Mapping student perceptions of experiential interprofessional learning to the Interprofessional Education Collaborative (IPEC) competencies

INTRODUCTION

Introductory pharmacy practice experiences (IPPEs) and advanced pharmacy practice experiences (APPEs) provide opportunities for interprofessional education (IPE) in doctor of pharmacy (PharmD) programs by facilitating student engagement with other healthcare professionals. It is unknown how well these experiences align with competencies required for interprofessional collaborative practice. This study describes the alignment of student reflections from experiential rotations with the Interprofessional Education Collaborative (IPEC) competencies.

METHODS

Following completion of experiential rotations from June 2017 to August 2019, a retrospective analysis of IPE surveys submitted by students was performed to assess types of interprofessional interactions and alignment of student reflections with IPEC competencies.

RESULTS

A total of 1360 surveys were analyzed. More than 75% of all PharmD students enrolled in IPPEs or APPEs during the study period completed at least one survey. Across all experiences, survey responses mapped to IPEC competencies at the following rates: Values/Ethics (25%), Roles/Responsibilities (48%), Interprofessional Communication (36%), and Teams/Teamwork (48%). More reflections from inpatient experiences, compared to outpatient experiences, aligned with Roles/Responsibilities and Teams/Teamwork, while fewer inpatient experience reflections aligned with Interprofessional Communication. Active engagement with other health professions increased as students progressed from IPPEs to APPEs.

CONCLUSIONS

As PharmD students progress through the experiential curriculum, they engage with IPEC competencies during each professional year. Inpatient and outpatient experiences may highlight different aspects of the IPEC competencies and advanced rotations are more likely to facilitate active engagement with other healthcare professionals.

Advancing Social Mission Research: A Call to Action

Social mission efforts in health professions education are designed to advance health equity and address the health disparities of the society in which they exist. While there is growing evidence that social mission-related interventions are associated with intended outcomes such as practice in underserved communities, student diversity, and students graduating with skills and knowledge that prepare them to address societal needs, critical evidence gaps remain that limit the possibility of generalizing findings and using social mission strategically to advance health equity. At a time when COVID-19 has been laying bare health disparities related to systemic racism and maldistribution of resources, understanding how health professions training can produce the workforce needed to advance health equity becomes even more imperative. Yet, data and methods limitations are hindering progress in this critical research. The authors present an overview of the social mission research landscape; their review of the research led them to conclude that more rigorous research and data collection are needed to determine the link between social mission activities in health professions education and advances in health equity. To accelerate understanding of how health professions education and training can advance health equity, the authors propose a social mission research road map that includes (1) creating a social mission research community by consolidating stakeholders, (2) building a solid foundation for the research through development of a consensus-driven logic framework and research agenda, and (3) laying out the data and methodological needs that are imperative to strengthening the social mission evidence base and identifying opportunities to address these needs. Core to achieving these milestones is leadership from an organizing body that can serve as a hub for social mission research and engage stakeholder groups in building the evidence base for social mission strategies that will ultimately advance health equity.

The Brief Attitudes Survey for Interprofessional Collaborative Learning: The Design, Reliability, and Validation of a New Instrument

This paper describes the development and validation of a new questionnaire designed to measure and investigate attitudes towards interprofessional education (IPE) among health professions students. After a thorough literature review and survey of prior instruments, we created an instrument built around a single construct domain: attitudes toward interprofessional collaborative learning. Through a rigorous design methodology rooted in behavior change theory and an iterative question development process, we launched the 11-item "Brief Attitudes Survey for Interprofessional Collaborative Learning" (BASIC-L). Implemented as part of a "toolbox" for assessing the progress of learners in IPE, the questionnaire was then administered to a large cohort of medical and nursing students. Its reliability, validity, and fit with our one-domain model were evaluated via thorough psychometric analysis, including computation of reliability coefficients and a Rasch analysis. These analyses indicate strong reliability, validity, and fit of the questions with our one-domain model. The analyses also included assessment for any sources of measurement error, which were not significant. The BASIC-L appears to be a useful, valid, and reliable instrument for the assessment of attitudes toward interprofessional collaborative learning among students in the health professions, especially as part of a larger multidimensional assessment process.

Measuring the Impact of the National Train-the-Trainer Interprofessional Team Development Program (T3-ITDP) on the Implementation of Interprofessional Education and Interprofessional Collaborative Practice

Background

In order to prepare current and future educators and clinicians to lead interprofessional education (IPE) and interprofessional collaborative practice (IPCP), faculty and staff need training in collaborative approaches to developing, implementing, assessing, and sustaining high quality IPE across the interprofessional learning continuum. The Train-the-Trainer Interprofessional Team Development Program (T3-ITDP) is a 3.5-day program designed to develop expert IPE teams through interactive workshops, coaching, and the development and implementation of an IPE or IPCP (IPECP) project for their home institutions.

Purpose

The purpose of this research was to assess the impact of the T3-ITDP on the development and implementation of IPECP projects by participating teams.

Methods

The T3-ITDP impact survey was created and administered to collect data on the scope and impact of participant teams' projects, including learner and project outcomes, training methods, dissemination plans, assessment strategies, and teams' intentions to continue working together beyond the initial project. With human subject's approval, we invited 55 T3-ITDP participant teams to complete the impact survey. These teams were at least one year post-completion of the in-person portion of the program and thus had time to initiate their IPECP projects.

Results

Forty-one (74.5%) teams responded to the survey. Of those teams, 31 (76%) used T3-ITDP content and/or approaches to develop their IPECP projects that targeted learners across the interprofessional learning continuum. Sustainability of IPECP projects was supported through several mechanisms, including institutional support or incorporating IPECP activities into existing courses. Almost half of the teams worked together on new projects, and 74% of teams planned to repeat a newly developed activity.

Discussion & Conclusions

Results of the T3-ITDP impact survey demonstrated that team-based, project-focused professional development catalyzed the development, implementation, and sustainment of new IPECP projects at academic and community institutions throughout the U.S.

Evaluation of Inter-Professional Education (IPE) with medical, nursing and pharmacy students through a simulated IPL Educational Intervention

INTRODUCTION

Inter-Professional Education (IPE) is becoming an integral part of many professional programmes throughout the United Kingdom, ensuring health professionals are competent to work as part of an inter-professional team upon entry into their profession. IPE has become a fundamental component of curriculum content in health and social care degrees.

AIMS

Research aim - to evaluate a simulated IPE intervention.

METHODS

A one day IPE intervention, "Evening On-Call" was run involving nursing and medical students and pre-registration pharmacists (student pharmacists in year 5 of training) in an on-call setting. This IPE incorporated manikin and actor patients in a simulated ward. During the intervention, the 3 groups of students are assessed under observation on their clinical, prioritisation and communication skills. Participants perceptions of this intervention were evaluated by completion of a questionnaire to capture their perceptions regarding the experience, the pre-IPL briefing and post-IPL feedback and perceived relevance of this training. Free text sections collected additional comments and a follow-up questionnaire was sent 6 months later.

RESULTS

Initial questionnaire feedback was predominantly positive for each professional group. The majority perceived the simulated IPL had given them a greater understanding of other professionals' roles, had enhanced their professional confidence and would help them prioritise workload once qualified. The 6-months follow-up questionnaire supported the initial questionnaire findings. Some responses highlighted that participants believed the simulated IPL had helped them work more effectively with other healthcare professionals, communicate more effectively and better prioritise their workload. There may be some evidence of sustained self-reported effectiveness in teaching certain professional and clinical skills to participants using this type of simulated intervention.

"We're Performing Improvisational Jazz": Interprofessional Pediatric Palliative Care Fellowship Prepares Trainees for Team-Based Collaborative Practice

CONTEXT

Interprofessional education (IPE) prepares clinicians for collaborative practice, yet little is known about the effectiveness of postgraduate IPE.

OBJECTIVES

This is the first study to describe educational outcomes of an interprofessional fellowship in pediatric palliative care. Objectives were to understand the experiences of postgraduate trainees in an interprofessional, clinical environment and to evaluate program effect on interprofessional competencies.

METHODS

In this mixed-methodology study, we surveyed former fellows from 2002 to 2018 about their fellowship experience and perceived change in interprofessional skills. We performed qualitative semantic content analysis of fellows' responses about learning in an interprofessional context. We compared fellows' self-rated ability (5-point Likert scale), before and after fellowship, in 10 interprofessional competencies selected from the Interprofessional Education Collaborative's core competencies.

RESULTS

Response rate was 87% (41/47). Fifty-one percent of respondents were physicians, 29% were social workers, and 20% were nurse practitioners. Respondents reported significant improvement in all 10 competencies, with summed mean scores of 2.8 ± 0.6 prefellowship ("not very well prepared") and 4.4 ± 0.4 postfellowship ("very well" to "extremely well prepared") (t = 15.6, P< 0.0001). Effect size for each competency was greater than 1.9 (strong positive impact). The fellowship experience was characterized by dynamic educational relationships: peer relationships with interprofessional co-fellows, mentoring relationships with faculty, clinical relationships with patients and families, and collaborative relationships with the healthcare system. Benefits and challenges of IPE were associated with interprofessional roles, teamwork, patient care, and educational needs.

CONCLUSION

This study demonstrates the feasibility and effectiveness of an interprofessional postgraduate fellowship in preparing clinicians for collaborative practice.

Impact of interprofessional education on the teaching and learning of higher education students: A systematic review

AIM

This systematic review was to explore the potentialities and limitations of Interprofessional Education (IPE), from the perspective of undergraduate students.

BACKGROUND

The increasing complexity in health increasingly demand professionals with the capacity to act in the face of new global challenges. Thus, this pedagogical approach presents itself as one of the most promising choices in facing these new obstacles.

DESIGN

A synthesis of quantitative studies and mixed methods.

METHODS

Studies involving quantitative analyzes were included, with no restriction on the date of publication and language. The search strategy was carried out in the electronic databases: PubMed, Latin American and Caribbean Literature in Health Sciences (LILACS), Cochrane Library and Scientific Electronic Library Online (SciELO). In addition, searches were carried out in gray literature on the ERIC platforms (ProQuest), ProQuest Disserts and Theses Full text and Academic Google. The assessment of the quality of the studies was carried out using the instrument by Downs and Black. The risks of bias in the studies were examined with the aid of the adapted version of the Cochrane Collaboration tool, with the domains of the Downs and Black instrument.

RESULTS

After standardized filter procedures, critical summaries and assessment of relevance to the eligibility criteria, 11 articles were included. The results showed that most students have a positive perception of IPE, with different factors influencing this research finding. The need to develop more robust assessment instruments is highlighted, in view of the insufficiency of tools with sufficient methodological rigor to measure real changes in attitudes among different groups of students.

CONCLUSION

More consistent research is needed, which assesses, in a longitudinal way, the effects that the IPE has on the teaching and learning of undergraduate students and its impact after professional training.

Can interprofessional case conferences effectively teach interprofessional core competencies? A case study

BACKGROUND

The establishment of interprofessional education (IPE) as an effective method for training future health care providers, the subsequent establishment of IPE requirements in accreditation standards, and the challenges to integrating IPE into professional-centric curricula have created an environment that encourages opportunity for innovation and collaboration in curriculum design.

INTERPROFESSIONAL EDUCATION ACTIVITY

Interprofessional Education Collaborative (IPEC) Core Competencies were integrated into an Interprofessional Case Conference (ICC) model that included six annual case conferences involving students from eight health professions across multiple campuses. Students worked in groups of eight with no more than two students from each profession per group. Interprofessional teams facilitated live progressive cases consisting of iterative guided student discussion alternating with group problem solving, followed by "talk-show style" reports. A retrospective pre-post study design using the validated IPEC Competency Self-Assessment V3 and Student Perspective of Interprofessional Clinical Education tools assessed student perspectives of the ICC model. The online survey was sent to participants who attended at least one ICC in 2015-2016 and 2016-2017.

DISCUSSION

Pre-/post-data was available from 94 students. Results revealed modest, but significant, score changes across both instruments, confirming the value of IPE and the ICC training model.

IMPLICATIONS

The ICC formula allowed flexibility in applying IPE, resolved scheduling and resources challenges, complemented other IPE programming, and assisted in meeting pharmacy accreditation requirements and the diverse IPE needs of health professions education. The model is flexible, inexpensive, and could be readily replicated at other institutions.