Interprofessional Education and Practice Guide No. 3: Evaluating interprofessional education

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.

Characterization and analysis of the proposals submitted to the PET-Health Interprofessionality in Brazil: advancements and future directions

The Program of Education through Work for Health (PET-Health), with a focus on interprofessionality, is one of the actions of the Plan for the Strengthening of Interprofessional Education in Brazil. This research aimed to systematically analyze the characteristics of the proposals submitted to the public notice of the PET-Health Interprofessionality specifically in relation to the theoretical-conceptual and methodological alignment of interprofessional education (IPE). The study is a qualitative document content analysis. We analyzed one hundred and twenty projects submitted to the selection process from institutions participating in the PET-Health Interprofessionality. Content analysis followed three steps: pre-analysis, exploration of the material, and treatment and interpretation of results. Seven categories were identified: a) alignment with the theoretical-conceptual frameworks of IPE, b) curriculum changes, c) faculty development with a focus on IPE, d) articulation among objectives, actions, and results expected related to IPE, e) strategies for monitoring and evaluation, f) involvement of users/families and community, and g) development of collaborative competencies. We conclude that while some advancements have been made, there remains a need for more in-depth discussion in Brazil to ensure the development of competencies capable of assuring more integral, resolute, and safer healthcare services, with capacity to (re)signify user-centered care in the planning and delivery of healthcare.

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.

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.

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

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

A systematic review and quality appraisal of interprofessional behavioral assessment instruments for nursing education

Instruments to assess interprofessional behaviors in prelicensure interprofessional education (IPE) lack validity and reliability data. No individual behavioral assessment instrument met all standards of the Quality Appraisal of Interprofessional Learning Scales (QuAILS) checklist (Oates & Davidson, 2015). The IPA and iSOFT instruments provided the most substantial validity and reliability evidence. Future validation research studies of interprofessional education (IPE) behavioral instruments that evaluate interprofessional professionalism (IPP) domains are needed in nursing 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.

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.

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.

Evidence of successful interprofessional education programs-models, barriers, facilitators and success: a systematic review of European studies

PURPOSE

Interprofessional education (IPE) has been highly promoted as a means of enhancing interprofessional practice and thereby having a positive impact on healthcare systems and patient outcomes. Various documents mention that sufficient evidence has been accumulated to demonstrate the effectiveness of IPE, yet it is not completely clear what type of evidence is being alluded to. The objective of this review was to gather evidence about IPE programs that resulted in effective long-term outcomes in healthcare. Secondary outcomes included identification of the types of models that met the success criteria, barriers and facilitators of such successful programs if any.

DESIGN/METHODOLOGY/APPROACH

A systematic search was conducted in PubMed, Web of Science, CINAHL and Scopus. The review considered studies that targeted undergraduate and postgraduate students among more than one health profession and included those in the English language published between 2010 and end of 2020.

FINDINGS

Five studies have been identified and described in this review. These papers evaluated different IPE programs and models.

RESEARCH LIMITATIONS/IMPLICATIONS

1. This systematic review investigated the evidence of the existence of IPE programs and the findings show there is no robust specific evidence of long-term impact on healthcare and on patients' outcomes. 2. The conclusion from this review is that it is still unclear what format constitutes a successful and efficient program. 3. Appropriate longitudinal studies need to be designed to identify the impact of IPE on long-term health outcomes.

ORIGINALITY/VALUE

Overall, the studies show that although there is an emphasis on practice-based learning, there is no robust specific evidence of long-term impact on healthcare and on patients' outcomes. Appropriate longitudinal studies need to be designed to identify the impact of IPE on long-term health outcomes.

Alignment of an interprofessional student learning experience with a hospital quality improvement initiative

Assessment of interprofessional education (IPE) frequently focuses on students' learning outcomes including changes in knowledge, skills, and/or attitudes. While a foundational education in the values and information of their chosen profession is critical, interprofessional learning follows a continuum from formal education to practice. The continuum increases in significance and complexity as learning becomes more relationship based and dependent upon the ability to navigate complex interactions with patients, families, communities, co-workers, and others. Integrating IPE into collaborative practice is critical to enhancing students' experiential learning, developing teamwork competencies, and understanding the complexity of teams. This article describes a project that linked students with a hospital-based quality-improvement effort to focus on the acquisition and practice of teamwork skills and to determine the impact of teamwork on patient and quality outcome measures. A hospital unit was identified with an opportunity for improvement related to quality care, patient satisfaction, employee engagement, and team behaviours. One hundred and thirty-seven students from six health profession colleges at the Medical University of South Carolina underwent TeamSTEPPS® training and demonstrated proficiency of their teamwork-rating skills with the TeamSTEPPS® Team Performance Observation Tool (T-TPO). Students observed real-time team behaviours of unit staff before and after staff attended formal TeamSTEPPS® training. The students collected a total of 778 observations using the T-TPO. Teamwork performance on the unit improved significantly across all T-TPO domains (team structure, communication, leadership, situation monitoring, and mutual support). Significant improvement in each domain continued post-intervention and at 15-month follow-up, improvement remained significant compared to baseline. Student engagement in TeamSTEPPS® training and demonstration of their reliability as teamwork-observers was a valuable learning experience and also yielded an opportunity to gather unique, and otherwise difficult to attain, data from a hospital unit for use by quality managers and administrators.

Interprofessional transformation of clinical education: The first six years of the Veterans Affairs Centers of Excellence in Primary Care Education

This paper describes the Centers of Excellence in Primary Care Education (CoEPCE), a seven-site collaborative project funded by the Office of Academic Affiliations (OAA) within the Veterans Health Administration of the United States Department of Veterans Affairs (VA). The CoEPCE was established to fulfill OAA's vision of large-scale transformation of the clinical learning environment within VA primary care settings. This was accomplished by funding new Centers within VA facilities to develop models of interprofessional education (IPE) to teach health professions trainees to deliver high quality interprofessional team-based primary care to Veterans. Using reports and data collected and maintained by the National Coordinating Center over the first six years of the project, we describe program inputs, the multicomponent intervention, activities undertaken to develop the intervention, and short-term outcomes. The findings have implications for lessons learned that can be considered by others seeking large-scale transformation of education within the clinical workplace and the development of interprofessional clinical learning environments. Within the VA, the CoEPCE has laid the foundation for IPE and collaborative practice, but much work remains to disseminate this work throughout the national VA system.

A pilot study evaluating the feasibility of assessing undergraduate pharmacy and medical students interprofessional collaboration during an online interprofessional education intervention about hospital discharge

BACKGROUND

Interprofessional education (IPE) has been identified as a strategy towards improving competence at interprofessional working and collaboration within teams. Entrustable professional activities (EPAs) provide a framework for translating competencies into elements of clinical practice, some of which in healthcare are inherently interprofessional. However, it is challenging to reconcile that entrustment decisions about student competence in an interprofessional activity are made about an individual without considering the dynamics and tensions between interprofessional team members and the task itself. This can influence students' development and demonstration of competence at interprofessional collaboration.

METHODS

In this study, undergraduate medical and pharmacy students worked in pairs online (Zoom) to undertake the hospital discharge process (a professional activity reliant on interprofessional collaboration) for a simulated patient, producing a hospital discharge letter and completing a consultation with the simulated patient. The online sessions were recorded and interprofessional behaviours were assessed using a validated scale completed by an interprofessional assessment team. Students undertook this IPE intervention three times after receiving feedback and a period of reflection each time.

RESULTS

Eighteen students participated across the entire intervention and 27 one-hour online IPE sessions were completed and recorded. Students demonstrated statistically significant improvements in interprofessional behaviours across the three iterations (p < 0.05 for all the sessions). The discharge letter students produced also improved over the three sessions (p = 0.01). Students found the educational sessions useful and relevant.

CONCLUSION

This online IPE intervention provided the students with an authentic opportunity to work collaboratively. At the end of each iteration, students received feedback about their work as a team and about the discharge letter, helping students to reflect and purposefully develop their performance. The IPE intervention with this assessment strategy is feasible and allows student development to be captured but has proved to be time and resource intensive.

Effects of a virtual simulation-based interprofessional education activity for rehabilitation nursing using shared resources: A quasi-experimental study

BACKGROUND

Interprofessional education (IPE) is crucial for effective clinical practice but remains challenging to be implemented. The IPE activity using virtual simulation (VS) may potentially solve the time and space challenges of in-person interprofessional simulations. Using shared VS resources may increase the popularity of virtual teaching in conditions of limited resources.

OBJECTIVES

Using shared resources, this study aimed to design and implement a VS-based IPE activity for undergraduate healthcare students, exploring the effects.

DESIGN

A quasi-experimental design was used, with assessments conducted before and after the activity.

SETTINGS

One university and its affiliated hospitals in south China.

PARTICIPANTS

Forty-two undergraduate students majoring in nursing, clinical medicine, and rehabilitation therapy participated in this study.

METHODS

A test composed of ten questions was used to evaluate knowledge of rehabilitation. The Chinese version of Critical Thinking Disposition Inventory (CTDI-CV) and the Chinese version of Assessment of Interprofessional Team Collaboration in Student Learning Scale (AITCS-II (Student)-CV) were used to evaluate critical thinking and interprofessional collaboration. Participants' opinions about the activity were assessed, considering satisfaction, perceived effectiveness, the ease of shared VS platform use, and suggestions about the activity.

RESULTS

Significant improvements were shown in pre- and post-test total scores on knowledge of rehabilitation, mean scores for overall critical thinking disposition, and mean item scores on overall interprofessional team collaboration.

CONCLUSIONS

The study provides a reference for designing and implementing VS-based IPE but the effects of this innovative pedagogy on students' rehabilitation knowledge, critical thinking, and interprofessional collaboration ability still need to be further confirmed. Most of the students gave positive feedback on the activity. Technical issues should be addressed to decrease their impacts on the VS practice experience.

The effect of interprofessional simulation practice on collaborative learning: A randomized controlled trial

This study examined the effect of simulation on readiness for collaborative practice and learning using a randomized-controlled trial design that used the same education protocol with interprofessional and uniprofessional groups. The sample consisted of 43 students from four different majors. The students were assessed with the Readiness for Interprofessional Learning Scale, and a care plan measurement instrument. The interprofessional group showed a small increase (0.1 ± 0.43; p = .02) in readiness for teamwork and collaboration; the uniprofessional group showed a smaller increase for teamwork and collaboration (0.04 ± 0.31; p = .04) and for patient-centred care (0.0 ± 0.35; p = .01). The enriching work of interprofessional learning was evident within the care plan activity, suggesting that interprofessional simulation is an effective learning method for interprofessional education.

Using Rasch measurement for instrument rating scale refinement

OUR SITUATION

Rasch measurement is an analysis tool that can provide validity evidence for instruments that attempt to measure student learning or other psychosocial behaviors, regardless if tools are newly created, modified, or previously developed. Rating scales are exceedingly common among psychosocial instruments and properly functioning rating scales are critical to effective measurement. Rasch measurement can help investigate this.

METHODOLOGICAL LITERATURE REVIEW

Aside from using Rasch measurement from the beginning to help create rigorous new measurement instruments, researchers can also benefit from employing Rasch measurement on previously developed instruments that had not included Rasch measurement during development. This article is focused on Rasch measurement's unique analysis of rating scales. That is, Rasch measurement can uniquely help examine if and how an instrument's rating scale is functioning among newly studied respondents (who will likely differ from the originally researched sample).

OUR RECOMMENDATIONS AND THEIR APPLICATION

After reviewing this article, the reader should be able to describe Rasch measurement, including how it is focused on fundamental measurement and how it differs from classical test theory and item-response theory, and reflect on situations in their own research where a Rasch measurement analysis might be helpful for generating validation evidence with a previously developed instrument.

POTENTIAL IMPACT

In the end, Rasch measurement can offer a helpful, unique, rigorous approach to further developing instruments that scientifically measure, accurately and precisely.

Importance of Interprofessional Education for Occupational Therapy

The purpose of this position statement is to provide recommendations for educators on best practices to embed interprofessional education (IPE) into today's occupational therapy curricula, whether entry level or postprofessional, to bridge academic and clinical learning environments.

Together or not together: Paving the way to boundary crossing

The authors discuss how interprofessional education could ease the transition into collaborative practice by laying the foundation for interprofessional boundary crossing, suggesting that virtual IPE be used to nurture interprofessional feedback‐seeking behaviours.

Why an IPE Team Matters… Improvement in Identification of Hospital Hazards: A Room of Horrors Pilot Study

Purpose

To evaluate student performance in a simulation-based interprofessional learning activity that focused on identifying patient safety hazards in a simulated patient's hospital room.

Participants and Methods

Students from nursing, occupational therapy, physiotherapy, radiography, social education, social work, biomedical laboratory science, dental hygiene, and medicine participated in this two-phased study. In the first phase, students worked alone to identify safety hazards. In the second phase, students worked in interprofessional teams. Following each phase, students completed a structured questionnaire to report their findings. In addition, following the first phase, each student wrote down the hazards they identified in an unstructured essay format.

Results

Out of 48 intended hazards, individual students identified 10.7% on the open essay and 42.6% on the questionnaire, and interprofessional teams identified 90.1%.

Conclusion

The number of hospital hazards identified increased considerably when working in interprofessional teams. A room of horrors exercise expands participants' observational skills. With some modifications, this pilot study can be implemented on a wider scale with the goal of increasing interprofessional students' awareness of hospital hazards.

Optimizing the integration of family caregivers in the delivery of person-centered care: evaluation of an educational program for the healthcare workforce

Background

While family caregivers provide 70-90% of care for people living in the community and assist with 10-30% of the care in congregate living, most healthcare providers do not meaningfully involve family caregivers as partners in care. Recent research recommends that the healthcare workforce receive competency-based education to identify, assess, support, and partner with family caregivers across the care trajectory.

Objective

This paper reports a mixed-methods evaluation of a person-centered competency-based education program on Caregiver-Centered Care for the healthcare workforce.

Methods

This foundational education was designed for all healthcare providers and trainees who work with family caregivers and is offered free online (caregivercare.ca). Healthcare providers from five healthcare settings (primary, acute, home, supportive living, long-term care) and trainees in medicine, nursing, and allied health were recruited via email and social media. We used the Kirkpatrick-Barr health workforce training evaluation framework to evaluate the education program, measuring various healthcare providers’ learner satisfaction with the content (Level 1), pre-post changes in knowledge and confidence when working with family caregivers (Level 2), and changes in behaviors in practice (Level 3).

Results

Participants were primarily healthcare employees (68.9%) and trainees (21.7%) and represented 5 healthcare settings. Evaluation of the first 161 learners completing the program indicated that on a 5-point Likert scale, the majority were satisfied with the overall quality of the education (Mean(M) = 4.69; SD = .60). Paired T-tests indicated that out of a score of 50, post-education changes in knowledge and confidence to work with family caregivers was significantly higher than pre-education scores (pre M = 38.90, SD = 6.90; post M = 46.60, SD = 4.10; t(150) = − 16.75, p < .0001). Qualitative results derived from open responses echoed the quantitative findings in satisfaction with the education delivery as well as improvements in learners’ knowledge and confidence.

Conclusion

Health workforce education to provide person-centered care to all family caregivers is an innovative approach to addressing the current inconsistent system of supports for family caregivers. The education program evaluated here was effective at increasing self-reported knowledge and confidence to work with family caregivers.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-07689-w.

Clinical outcomes of patients treated on the Heidelberg interprofessional training ward vs. care on a conventional surgical ward: A retrospective cohort study

Interprofessional training wards (IPTW) are a form of interprofessional education enabling trainees of different healthcare professions to work together in teams. Concerns about patient safety are a major barrier to the implementation of IPTWs. The objective of this retrospective study was to analyze patient relevant clinical outcomes on Germany's first IPTW (Heidelberger Interprofessionelle Ausbildungsstation; HIPSTA) in the Department of Surgery at University Hospital Heidelberg in comparison to a conventional surgical ward (CSW). The setting is a large tertiary care center with a focus on major oncological surgery. The endpoints were postoperative complications according to the Dindo-Clavien Classification and a set of patient-safety outcomes. In total, 232 patients treated on HIPSTA were retrospectively compared with 465 patients on a CSW. Baseline characteristics were comparable between groups. No significant difference between rate or severity of overall postoperative complications was observed. In-hospital mortality did not significantly differ between groups. However, the mean length of hospital stay was significantly shorter on HIPSTA. Furthermore, HIPSTA patients had less frequent reoperations. Patient safety in surgical IPTW was not compromised in comparison to a CSW, and there were some areas where significantly better outcomes were identified.

Translation and validation of the Swedish version of the IPECC-SET 9 item version

Interprofessional Education (IPE) is essential to prepare future health-care professionals for collaborative practice, but IPE requires evaluation. One psychometrically sound instrument is the Interprofessional Education Collaborative Competence Self-Efficacy Tool consisting of nine items (IPECC-SET 9). This tool does not, to date, exist in a Swedish version. Therefore, the aim of this study was to translate and validate the Swedish version of the IPECC-SET 9. The English version was translated into Swedish and tested among 159 students in the 3-year Bachelor Programs in Nursing and in Biomedical Laboratory Science. The psychometric analysis was guided by a Rasch model, which showed that the items functioned well together, confirming unidimensionality, and that the person misfit was also lower than the set criterion. The separation index was 2.98, and the Rasch-equivalent Cronbach-alpha measure was estimated to .92, supporting internal consistency. No systematic differences on item level in IPECC-SET 9 further supported fairness in testing. The Swedish IPECC-SET 9 demonstrates sound psychometric properties and has the potential to be used as a measure of self-efficacy for competence in interprofessional collaborative practice among health profession students. However, the IPECC-SET 9 is recommended to be further tested in larger samples representing the entirety of health-care teams.

Ten years of interfaculty pain curriculum at the University of Toronto: impact on student learning

Supplemental Digital Content is Available in the Text.

The University of Toronto Interfaculty Pain Curriculum has significantly improved students' pain knowledge and ability to develop interprofessional care plans over the period 2009 to 2019.

Introduction:

Delivery of interprofessional pain education for prelicensure healthcare professionals is strongly recommended to advance a workforce ready for collaborative practice and to improve the quality and outcomes of pain care.

Objectives:

We report a 10-year (2009–2019) longitudinal evaluation of a 20-hour undergraduate Interfaculty Pain Curriculum (IPC) delivered to students in the Faculties of Dentistry, Nursing, Pharmacy, and Medicine (also including the Departments of Physical Therapy, Occupational Therapy and Physician Assistant) at the University of Toronto, Canada. The IPC follows a constructivist approach to facilitate interactive and multifaceted learning.

Methods:

Evaluation methods based on the Kirkpatrick model were used to appraise changes in participating students' pain knowledge and beliefs and their ability to collaboratively develop an interprofessional pain management plan.

Results:

A total of 10,693 students participated over the 10-year study period. The mean annual attendance was 972 students and participation to the program increased significantly over the years. Overall, the IPC was effective in improving students' mean pain knowledge and beliefs scores; however, the mean knowledge score gains were negatively correlated with time, likely related to increased uniprofessional pain education. Although an increasing trend in mean interprofessional pain management plan scores was observed, the scores were not significantly correlated with time.

Conclusions:

The interactive and multifaceted IPC is consistently effective in improving knowledge and beliefs and interprofessional pain management care plan development among participating student cohorts. Future inquiry is required to better understand the mechanisms behind student learning in interprofessional pain education to enhance pain curriculum development and delivery.

Clinical interprofessional education in the health professions: a scoping review protocol

OBJECTIVE

The objective of this scoping review is to identify, characterize, and summarize evidence from the published literature on clinical interprofessional education.

INTRODUCTION

Clinical interprofessional education refers to learning within clinical learning environments such as hospitals, primary care clinics, and long-term care facilities. The learning involves direct interaction with real patients, where learners collaborate to deliver care and improve health outcomes.

INCLUSION CRITERIA

This scoping review will consider clinical interprofessional education activities in the context of patient care. Criteria include two or more health professions, two or more learner groups, and involvement of real patients/patient care.

METHODS

This review will be conducted in accordance with the JBI methodology for scoping reviews. Databases searched will include PubMed, CINAHL, and Scopus. Results will be limited to English language publications from 2015 to the present. Extracted data will include the different types of clinical learning environments, the professions involved, the targeted learning/competency outcomes, and the measurement tools used by the authors. Titles/abstracts and full texts of articles will be screened by two reviewers for potential inclusion, with discrepancies resolved by a third reviewer if necessary. Extracted data will be presented in diagrammatic or tabular format. A narrative summary will accompany the tabulated and/or charted results, describing how the results relate to the review objective and research questions, and how the results might inform future clinical interprofessional education in health professions education.

Simulation interprofessional education in health professions education: a scoping review protocol

OBJECTIVE

The objective of this scoping review is to identify, collate, and map the evidence on simulation interprofessional education activities in any setting for the education of health professional students.

INTRODUCTION

Simulation interprofessional education activities comprise in-person and collaborative online learning embedded in formal curricula. Though the number of simulation interprofessional education activities has increased with the knowledge of the importance of effective interprofessional collaboration, the literature still lacks a description of the characteristics of existing activities.

INCLUSION CRITERIA

This scoping review will consider interprofessional education activities taking place within a simulation environment. Included papers will report on activities with two or more types of learners in health professional programs.

METHODS

The proposed scoping review will be conducted in accordance with the JBI methodology for scoping reviews. Databases searched will include PubMed, CINAHL, and ERIC. Results will be limited to English-language publications from 2016 to the present year. Data extraction will be performed using a purposefully developed data extraction tool. Teams of reviewers will screen abstracts and full texts of articles for potential inclusion, and decisions will be determined via consensus of two out of three reviewers. Extracted data will be presented in diagrammatic or tabular form in a manner that aligns with the objective of this scoping review. A narrative summary will accompany the tabulated and/or charted results and will describe how the results relate to the review's objective and questions, and how the results might inform future simulation interprofessional education activities in health professions education.

A Theory-Based Approach for Identifying Nurse and Team Member Contributions in the Electronic Health Record

INTRODUCTION

Team-based care delivered by an interprofessional team has been shown to be an effective strategy for caring for diverse, complex patient populations. Interprofessional teams can improve outcomes, reduce costs, and enhance the patient experience through patient-centered care. Nurses are essential members of healthcare teams within and across settings.

BACKGROUND

It is imperative for practicing nurses, educators, and researchers to be able to identify and report the contributions of nurses to team performance and care outcomes to prepare students for high-performance teamwork to improve practice and influence healthcare policy. Currently, the work of many nurses and other team members is not discoverable in electronic health records. Methods used to identify all members of the healthcare team may not be aligned with theories and definitions of teamwork embedded in emerging nursing and interprofessional accreditation guidelines.

PURPOSE

This paper describes a promising new, theoretically grounded approach to identify team members, including nurses, in electronic health records.

METHODS

Using operational constructs from a common team definition, grounded in theory, primary care teams were data mined from EHR data to find the hidden members of the team.

DISCUSSION/CONCLUSION

Further testing and use of this approach have the potential to provide a robust strategy to identify and distinguish each team member's contributions to clinical outcomes while laying the foundation for a meaningful study of teams in large data sets like the electronic health record.

CLINICAL RELEVANCE

New strategies to study nursing and team member contributions utilizing EHR data may lead to improved clinical outcomes. A better understanding of how teams are structured may enhance the understanding of each team member's contribution to outcomes and lead to more equitable recognition and reimbursement for all team members.

Intraprofessional workplace learning in postgraduate medical education: a scoping review

BACKGROUND

Residents need to be trained across the boundaries of their own specialty to prepare them for collaborative practice. Intraprofessional learning (i.e. between individuals of different disciplines within the same profession) has received little attention in the postgraduate medical education literature, in contrast to the extensive literature on interprofessional learning between individuals of different professions. To address this gap, we performed a scoping review to investigate what and how residents learn from workplace-related intraprofessional activities, and what factors influence learning.

METHODS

The PRISMA guidelines were used to conduct a scoping review of empirical studies on intraprofessional workplace learning in postgraduate medical education published between 1 January 2000 to 16 April 2020 in Pubmed, Embase, PsycINFO, ERIC and Web of Science. This study applied 'best fit' framework-based synthesis to map the existing evidence, using the presage-process-product (3P) model developed by Tynjälä (2013).

RESULTS

Four thousand three hundred thirty records were screened, and 37 articles were included. This review identified influencing (presage) factors that derived from the sociocultural environment, learner and learning context. Studies described that complexity of care can both facilitate and hinder learning. Furthermore, intraprofessional learning is threatened by professional stereotyping and negative perceptions, and awareness of learning opportunities and explicit reflection are critical in intraprofessional workplace learning. Studies described a range of informal and formal intraprofessional activities (process) under the headings of collaboration in clinical practice, rotations or placements, formal educational sessions and simulated workplace training. In general, learners responded well and their attitudes and perceptions improved, learners reported increased knowledge and skills and positive behavioural changes (product). Learning outcomes were reported in the domains of patient-centred care, collaborative attitudes and respect, mutual knowledge and understanding, collaborative decision making, communication, leadership, teamwork and reflexivity.

CONCLUSIONS

This review gives insight into the high learning potential of intraprofessional activities. Many of the included studies relied on self-reported perceptions of change, therefore, future research should focus on generating more robust evidence including objectively examined outcome measures. This review offers a comprehensive overview of the factors that influence intraprofessional workplace learning in postgraduate medical education. Finally, we provide recommendations for enhancing intraprofessional learning in clinical practice.

Effectiveness of Interprofessional Manikin-Based Simulation Training on Teamwork Among Real Teams During Trauma Resuscitation in Adult Emergency Departments: A Systematic Review

STATEMENT

This systematic review synthesizes the relevant evidence about the effectiveness of interprofessional manikin-based simulation training on teamwork among real teams during trauma resuscitation in adult civilian emergency departments. A systematic literature search was conducted in MEDLINE, CINAHL, EMBASE, EBM reviews, PsycINFO, and Web of Science with no time limit. Only experimental and quasi-experimental studies were included. Effects of the simulation intervention on teamwork were categorized according to a modified version of the Kirkpatrick's model. From the 1120 studies found, 11 studies were included for synthesis. All studies showed immediate improvement in teamwork after training, but divergent results were found regarding skills retention. Although this review focused on interprofessional manikin-based simulations in real trauma teams, the results are similar to previous systematic reviews including different types of simulation. This raises significant questions regarding the importance of simulation design characteristics to improve teamwork in trauma care.

Nurse's Role from Medical Students' Perspective during Their Interprofessional Clinical Practice: Evidence from Lithuania

Background: Attitudes towards interprofessional education are key factors that shape students' behaviour during interprofessional practice. An interprofessional approach to training and practice is "unique", important, and challenging. Interprofessional education allows for a deeper understanding and analysis of problems from perspectives different to those of "us". The aim of the study was to assess medical students' attitudes toward the nurse's role during their interprofessional clinical practice. Methods: This study used a descriptive, correlational design. Results: Lithuanian medical students were statistically significantly more likely to think that the role of a nurse was clear and transparent to other professionals and that nurses exuded a high degree of professionalism, sought a high degree of involvement with the patient, and built deep relationships with the patients. Foreign medical students were statistically significantly more likely to believe that nurses worked more effectively alone than in a team and that they worked with the patients within their own professional field of knowledge rather than referring patients to other professionals. Conclusions: After 6 months of interprofessional training with nurses in the hospital, medical students gain a more clear professional picture of the role of the nurse.

Assessment tools in pre-licensure interprofessional education: A systematic review, quality appraisal and narrative synthesis

OBJECTIVES

Interprofessional education (IPE) aims to provide students with the opportunity to develop and demonstrate the team working behaviours and skills that will lead to positive patient outcomes. This systematic review aims to identify and critically appraise the assessment tools used after a pre-licensure IPE intervention and provide guidance on which tool to use according to the focus of the intervention.

METHODS

In July 2019, the following electronic databases were searched: MEDLINE, ERIC, CINHAL, EMBASE and NEXUS website. All studies involving pre-licensure health care students exposed to an IPE intervention and undertook an assessment measuring student knowledge, skills, behaviour, or change in organisational practice or a benefit to patients were included. Studies that used tools relying on self-assessment only were excluded. Constructive alignment of the IPE intervention with the assessment was evaluated and quality assessment of the studies and critical appraisal of the validity evidence for the tools was undertaken.

RESULTS

From 9502 returned studies, 39 studies met the inclusion criteria and were analysed. These were rated as good in terms of methodological quality. Acquisition of knowledge was the most commonly assessed outcome, mainly with pre/post knowledge tests, followed by behaviour change, which was measured by a range of validated tools. Patient benefit was defined as change in clinical effectiveness, patient safety or patient satisfaction. Constructive alignment of the IPE aim with the assessment was limited due to issues with study reporting. Tools measuring behaviour change demonstrate mixed adherence to quality standards around reliability, validity and scales and scoring.

CONCLUSIONS

Various methods have been used to identify change following IPE; however, choosing the most appropriate tool to support and align with the aim of the IPE intervention is crucial. We have critically appraised the available tools and offered an indication of their quality. This has informed the production of a decision aid to support the selection of the appropriate IPE assessment tool depending on the purpose of the intervention. More studies using these tools in rigorous study designs are required to substantiate the evidence base.

Spanish version of the readiness for interprofessional learning scale (RIPLS) in an undergraduate health sciences student context

The Readiness for Interprofessional Learning Scale (RIPLS) has been widely used to measure students' and professionals' attitudes toward interprofessional learning. However, inconsistencies have been reported concerning its validity and reliability. This study aimed to translate, adapt, and validate the RIPLS questionnaire to be applied to Spanish-speaking health sciences students in Chile. Content and construct validity evidence of the newly created Spanish version of the RIPLS scale were analyzed. An exploratory (EFA) and confirmatory (CFA) analysis were conducted, determining goodness-of-fit indexes. Reliability was evaluated through Cronbach's Alpha Coefficient. We assessed sensitivity to change of the RIPLS scale by comparing pre- and post-interprofessional education workshop scores. The EFA showed that there were three factors. In the CFA, most of the standardized factor loadings were higher than 0.3. Regarding internal consistency, Cronbach's Alpha was 0.86. The differences between the total RIPLS scores before and after the workshops were statistically significant. The Spanish version of RIPLS showed evidence of validity and reliability for use amongst health sciences students. The construct was adequately measured and was shown that it could be used to assess the impact of interprofessional education workshops.

Impact Evaluation of the Kenya Frontline Field Epidemiology Training Program: Repeated-Measures Study

BACKGROUND

In 2014, Kenya's Field Epidemiology and Laboratory Training Program (FELTP) initiated a 3-month field-based frontline training, Field Epidemiology Training Program (FETP-F), for local public health workers.

OBJECTIVE

This study aimed to measure the effect of FETP-F on participant workplace practices regarding quality and consistency of public health data, critical interaction with public health data, and improvements in on-time reporting (OTR).

METHODS

Between February and April 2017, FELTP conducted a mixed methods evaluation via online survey to examine outcomes achieved among all 215 graduates from 2014 and 2015. Data quality assessment (DQA) and data consistency assessment (DCA) scores, OTR percentages, and ratings of the training experience were the quantitative measures tracked from baseline and then at 6-month intervals up to 18 months postcompletion of the training. The qualitative component consisted of semistructured face-to-face interviews and observations. Quantitative data were analyzed using descriptive statistics and one-way analysis of variance (ANOVA). Qualitative data were transcribed and analyzed to identify key themes and dimensions.

RESULTS

In total, 103 (47%) graduates responded to the survey. Quantitative analyses showed that the training significantly increased the mean DQA and OTR scores but there was a nonsignificant increase in mean DCA scores. Qualitative analyses found that 68% of respondents acquired new skills, 83% applied those skills to their day-to-day work, and 91% improved work methods.

CONCLUSIONS

FETP-F improved overall data quality and OTR at the agency level but had minimal impact on data consistency between local, county, and national public health agencies. Participants reported that they acquired practical skills that improved data collation and analysis and OTR.

Interprofessional Education: Psychology Trainee Experiences and Perspectives on Team Skills

Interprofessional education (IPE) is defined as educational activities involving trainees from two or more professions learning about, from, and with each other with the goal of building team-based collaboration skills. The degree to which psychology trainees are involved in IPE is unknown. A national survey was distributed to gather information regarding the nature and prevalence of IPE experiences and psychology trainees' perceived competence in collaboration skills. Participant responses (n = 143) are presented overall and by training level. Some respondents reported no IPE activities in their training, especially trainees earlier in their training. Highest rated competencies were in acting with honesty and integrity and developing/maintaining mutual respect and trust of other professions. Lowest rated were in giving feedback to others and managing differences in opinion. More research related to the nature and impact of IPE on psychology trainees is critical.

Student-Reported Attitudes during an Interprofessional Palliative Care Learning Experience: Implications for Dual-Professional Identity, Interdisciplinary Bias, and Patient Outcomes

Background: The geriatric population in the United States is in need of palliative care (PC), yet it is not consistently established in the curriculum across health care training programs. There is a clarion call to reform the education of health care students using interprofessional education (IPE). The Joint Commission reported that communication errors represent two-thirds of the causes behind provider sentinel events in health care. Objective: The purpose of this study was to design, implement, and assess an IPE curriculum on PC to understand interprofessional student attitudes. Design/Setting: Three professors conducted a mixed-methods study at a California university involving an IPE PC event for 40 nursing and speech-language pathology students, and administered the Interprofessional Attitudes Survey (IPAS) and reflective questions. Results: Qualitative findings indicated that students increased their knowledge about PC and the purpose/value of IPE. Four out of the five IPAS subscales had positive outcomes: teamwork and roles/responsibilities, patient-centeredness, diversity/ethics, and community-centeredness. Interprofessional-biases subscale revealed that 33% of the participants reported biases toward students from other health care disciplines, and 35% reported that students from other health care disciplines held similar biases toward them. However, only 25% did not believe that the interdisciplinary biases interfered with patient outcomes. Conclusion: The study identified the existence of interprofessional biases and prejudices that may impede collaboration among health care professionals resulting in reduced health care outcomes. Faculty and health educators are encouraged to embed IPE into a multidisciplinary curriculum that dismantles preexisting interdisciplinary biases and stereotypes, and constructs dual-professional identity. IRB ID #904203-1.

Supporting migrants and refugees with posttraumatic stress disorder: development, pilot implementation, and pilot evaluation of a continuing interprofessional education for healthcare providers

BACKGROUND

Refugees and migrants face an increased risk of developing posttraumatic stress disorder (PTSD). Adequate care can be insufficient due to language barriers, cultural differences, and knowledge deficits of health service providers. Therefore, professional associations requested that healthcare providers to be educated to provide culturally sensitive care. An evidence-based educational intervention in the form of a continuing interprofessional education (CIPE) for healthcare providers on the topic of PTSD in migrants and refugees was developed, pilot-implemented, and evaluated according to the first two levels of the Kirkpatrick evaluation model (reaction and learning).

METHODS

The development of a curriculum for the CIPE intervention was based on a narrative literature review. Its content was validated by experts (N = 17) in an online survey and analyzed using both the Content Validity Index and a thematic analysis. The evaluation of the CIPE intervention was performed by conducting a pilot study with a quasi-experimental single group, using a pre-posttest design. In total, there were 39 participants distributed among three pilot courses. We collected and analyzed data on satisfaction, knowledge, and feasibility.

RESULTS

The curriculum for a half-day course, consisting of 8 modules, showed almost excellent content validity (S-CVI = 0.92). In the pilot-implementation phase, participants were "very satisfied" with the pilot courses and a positive effect on their knowledge was detected. No correlation between satisfaction and knowledge gain was found.

CONCLUSIONS

The CIPE intervention can be considered feasible and seems promising in its effects on satisfaction and knowledge. The insights gained in this study can be used to adapt and optimize the educational intervention, whereby the feedback from course attendees is particularly useful. Future studies need to further examine the effects in larger samples and more robust study designs.

A school-based, interprofessional approach to sustaining oral health on an Island community

A school-based oral health promotion program was established on a Bahamian island that lacks access to dental care. An interprofessional team of dental hygiene (DH) and occupational therapy (OT) students and faculty delivered an annual service program from 2016 to 2018 based on the Ecological Model of School-Based Health Promotion. The interprofessional team provided oral preventative services and class-based lessons to children to reinforce positive oral health behaviors. Efforts to sustain the program involved partnering with the Bahamian community stakeholders to expand networks of influence, developing effective communication systems, and integrating oral health into the school curriculum. The interprofessional approach enabled a sustained and comprehensive program. This report describes the unique DH and OT interprofessional collaboration and program sustainability efforts.

Writing for publication: increasing the likelihood of success

The aim of this paper is to help writers at all levels improve their likelihood of success in having papers accepted by academic peer-reviewed journals, including the Journal of Interprofessional Care. We discuss the importance of reading both in your own discipline and also more widely across disciplines and fields of study. There are sections on the attributes of good authors, how to choose a journal, types of articles that are published and the structure of these, the contrast between research and evaluation, and how to plan a paper. We stress the importance of reading and complying with a journal's author guidelines and answering the 'so what' question by the end of the article. There is more detail about the main elements of a paper and what should be included in the introduction, methods, results (findings) and discussion to improve the quality of the reporting. As well as content we also focus on the style of writing. We finish with a discussion of the submission and review processes, why papers may be rejected and how to manage decisions on papers. Dissemination of scholarly work is paramount to the advancement of the interprofessional field; we invite authors to consider our advice and in so doing help strengthen the quality and rigor of interprofessional scholarship.

Top tips for interprofessional education and collaborative practice research: a guide for students and early career researchers

Interprofessional research within the contexts of education and health and social care practice has grown exponentially within the past three decades. To maintain the momentum of high-quality research, it is important that early career researchers embarking on their first research journey and new to interprofessional education or interprofessional collaborative practice feel supported in making their contribution to the field. This guide, developed by the Center for the Advancement of Interprofessional Education (CAIPE) Research Group, has been written with these groups in mind who are embarking on their first research journey, and new to the interprofessional field. It aims to raise awareness of academic resources and share practical advice from those who have previously experienced problems when undertaking interprofessional research in education or health and social care practice.

Professional and interprofessional identities: a scoping review

Identity development within the interprofessional field is an emerging area of research. This scoping review aims to establish how professional and interprofessional identities are defined, conceptualized, theorized and measured within the interprofessional literature. Six databases were systematically searched for papers focusing on professional and/or interprofessional identities in interprofessional healthcare and education using a scoping review methodology. A total of 84 papers were included. Most papers discussed professional identity only; the minority discussed both identities. There were three key findings. First, no universal definition of interprofessional identity exists. Second, there is no shared understanding of interprofessional identity and its relationship with professional identity. Third, poor alignment between definitions, conceptualizations, theories and measures of interprofessional identity exists. The absence of a psychometrically robust instrument that specifically measures interprofessional identity and the short-term focus of current interprofessional identity research further limits understanding. Research that critically examines professional and interprofessional identity development should be underpinned by clear definitions, concepts, theories and measures of both identities. High-quality research will allow greater understanding of interprofessional identity development and its impact on interprofessional practice.

Longitudinal evaluation of attitudes to interprofessional collaboration: time for a change?

Longitudinal evaluation of interprofessional programming is necessary to understand the impact of interprofessional education (IPE) for collaborative practice. Attitude is one measure of intended behavior. The Interprofessional Attitude Scale (IPAS) was developed as an improved measure to examine the readiness for interprofessional education and collaborative practice. As a means to pilot a protocol for a longitudinal comprehensive evaluation of an interprofessional program with 13 health professional programs in 6 health science faculties, the IPAS was administered over a 3-year period to three cohorts of students. The results of the IPAS indicated no significant differences detected across the 3 years. Although there was a significant difference on the Patient Centredness subscale for Cohorts 2 and 3 the effect size was small. Previous experience in an interprofessional course was a predictor of more positive patient centeredness attitudes, but other IPE experience and years of education were not predictors of any interprofessional attitudes. Students from the Medicine & Dentistry (M&D) faculty ranked significantly lower on the teamwork roles and responsibilities subscale compared to the other faculties, except Rehabilitation Medicine (RM). However, once the outliers in RM were removed, there was a significant difference on this subscale between RM and M&D. This paper outlines the challenges with using the IPAS as part of a comprehensive program evaluation and identifies issues with longitudinal data collection for evaluation with large student cohorts.

Investigating online interprofessional learning and communication using social network analysis: a study protocol

Interprofessional education (IPE) via the use of online learning environments (OLEs) can help improve patient outcomes, interprofessional attitudes, and behaviors while providing education at a distance. Studies of interprofessional learning often examine communication and its relation to learning outcomes qualitatively. OLEs allow researchers to examine these communication patterns quantitatively, through social network analysis (SNA), and answer questions regarding the nature of communication between interprofessional learners and how this may impact interprofessional attitudes and behaviors. In this paper, we present a study that aims to track interprofessional communication within a cancer care course using SNA and examine how it relates to professional attitudes and collaboration. Using pre and post-course surveys as well as numerous SNA metrics derived from course discussion board posts, we hope to show how communication between interprofessional learners may mediate outcomes. This work will add to the existing IPE literature by providing an added quantitative layer to a largely qualitative literature and encourage future studies in this area.

Physical therapy and pharmacy interprofessional education in the context of a university pro bono physical therapy setting

Interprofessional care is the standard for quality in healthcare. Interprofessional education (IPE) is an accreditation requirement in many health-care fields. This qualitative study evaluated the benefits of an interprofessional education program for Doctor of Physical Therapy (DPT) and Doctor of Pharmacy (PharmD) students in the context of a pro bono physical therapy setting focused on reducing fall risk among older adults. For each pro bono participant, PharmD and DPT students worked together to analyze fall risk of the participating older adults. PharmD students completed a medication review while the DPT students completed balance assessments. Each profession recommended adjustments to care and presented their findings to peers, faculty, and participants. Following completion of the IPE program, students completed a voluntary evaluation with seven questions requiring semi-structured written reflection regarding their IPE experience. Student reflective responses from 2014-2016 were coded by IPE faculty using a coding guide collaboratively developed by the study team. Descriptive analysis included a summary of code frequency by year, discipline and Interprofessional Education Collaborative core competency: Values and Ethics, Communication, Teams and Teamwork, and Roles and Responsibilities. Values and Ethics were the most frequently coded core competency. Students consistently noted the importance of valuing the other profession, understanding each other's roles, having good interprofessional communication, and working within a health-care team. Additional codes emerged during the analysis process. Written reflective findings suggest that hands-on collaboration, focused on a real-world problem (fall risk) relevant to both PharmD and DPT students, enabled interprofessional care that benefited students through real-world practice of skills learned during coursework, and benefited clinical participants through increased awareness of physical function and medication factors that could affect fall risk. Findings indicate that a pro bono physical therapy setting can provide hands-on learning that meets IPE accreditation requirements and student learning needs while addressing a public health concern.

Use of reflective writing within interprofessional education: a mixed-methods analysis

Nurturing student's development of interprofessional collaboration is fundamental. Assessment-For-Learning can use reflection as one technique to support students' growth. Thus, we investigated using reflective-writing within an interprofessional education (IPE) course using an exploratory mixed-methods design. In 2015, student-nurses, student-pharmacists, and student-physicians participated in an IPE course and completed self-assessments of student learning objectives (SLOs). In 2016, new cohorts of student-nurses, student-pharmacists, and student-physicians participated in the course and completed their self-assessments of SLOs; however, student-nurses and student-pharmacists also reflectively-wrote. Quantitatively comparing SLOs from 2015 cohorts with 2016 cohorts, we found that the effect-sizes (magnitude of difference) for those who reflectively-wrote (student-nurses and student-pharmacists) grew more than historical controls, whereas the effect-sizes remained unchanged for a control group (student-physicians) who did not reflectively-write. Qualitatively, initial and final reflective-writings were explored using content analysis. Initial reflective-writings helped students create a baseline for their final reflective-writings. In final reflective-writings, most students discussed their growth in understanding roles/responsibilities and communication, though limited growth was discussed for teams/teamwork and values/ethics. Thus, initial and final reflective-writings appeared useful within this IPE course. Initial reflective-writing further enhanced students' self-assessed IPE improvement and recorded students' baseline perceptions for later review, while final reflective-writings documented students' self-actualized IPE development.

Interprofessional education and practice guide: interprofessional team writing to promote dissemination of interprofessional education scholarship and products

Collaborations to develop, implement, evaluate, replicate, and write about interprofessional education (IPE) activities within and across institutions are wonderful opportunities to experience teamwork, team communication, ethics and values, and the roles and responsibilities of interprofessional team writing. Just as effective communication in interprofessional team-based care is essential for providing safe, high-quality health care, similar communication strategies are necessary to produce high-quality scholarship of IPE curricula and activities. Relationship and communication issues that affect health care teams' abilities to work together effectively (e.g., hierarchy, exclusion, assumptions, non-responsiveness, biases, stereotypes and poor hand-offs of information) can also occur in interprofessional team writing. Between 1970 and 2010, interprofessional practice research publications increased by 2293%. Although there has been tremendous growth in the IPE literature, especially of articles that require collaborative writing, there have not been any papers addressing the challenges of interprofessional team writing. As more teams collaborate to develop IPE, there is a need to establish principles and strategies for effective interprofessional team writing. In this education and practice guide, a cross-institutional team of faculty, staff, and graduate students who have collaborated on externally funded IPE grants, conferences, products, and workshops will share lessons learned for successfully collaborating in interprofessional team writing.

Unmet need for interprofessional education in paediatric cancer: a scoping review

PURPOSE

Despite improved treatment and care, children and adolescents diagnosed with cancer continue to die, while many of those cured are burdened by treatment-related sequelae. The best clinical management of children and adolescents with cancer depends on healthcare professionals with various skills and expertise. Complex treatment, care and rehabilitation require collaboration between healthcare professionals. The purpose of this scoping review is to identify and evaluate existing interprofessional education in paediatric cancer.

METHODS

We utilised the scoping review methodology and searched PubMed, Scopus and Education Resources Information Center. Inclusion criteria were postgraduate studies targeting more than one profession and evaluation of the educational intervention. We applied Kirkpatrick's modified interprofessional education outcomes model to systematise outcomes.

RESULTS

Of 418 references, nine studies fulfilled the inclusion criteria. The design, strategy and content of all the studies were heterogeneous. None of the interprofessional educations systematically evaluated knowledge, skills, attitudes or the effects on patient outcomes or quality of care.

CONCLUSION

There is a lack of well-structured, interprofessional education in paediatric cancer that has undergone evaluation. Paediatric cancer may benefit from systematic education and evaluation frameworks since interprofessional education could potentially strengthen the treatment, care and rehabilitation for children and adolescents with cancer.