Examining the influence of professional identity formation on the attitudes of students towards interprofessional collaboration

Understanding and barriers of professional identity formation among current students and recent graduates in nursing and midwifery in low resource settings in two universities: a qualitative study

INTRODUCTION

In the changing healthcare landscape, a strong professional identity serves as a cornerstone for nurses. Therefore, transformative educational approaches that include professional judgement, reasoning, critical self-evaluation and a sense of accountability are required to foster professional identity. We explored the understanding and barriers to professional identity formation among recent graduates and students of midwifery and nursing in Uganda.

METHODS

A descriptive qualitative research design employing focus groups was used to collect data from student nurses and midwives from Makerere University, Mbarara University, and recent graduates in nursing and midwifery programs attending their internship training at Mulago National and Mbarara Regional Referral hospitals. Thematic analysis was used to analyse the data.

RESULTS

A total of 33 students and 26 recent graduates participated in the study. The participants who reported understanding Professional identity in nursing and midwifery mentioned that these are principles, characteristics and values, competencies, ethics and code of conduct, sense of belonging and professionalism that define the nursing profession and practice. Barriers to the formation of professional identity were provided under two themes: education and health service delivery. The education theme included subthemes like nursing educators not working in clinical settings and inadequate clinical mentoring. Under the health service delivery theme, subthemes emerged included high workload, lack of interprofessional collaboration, many levels of nursing and midwifery practice, no clear scope of practice for different levels of nursing and midwifery practice, Low esteem among nurses and midwives, media and lack of policy implementation.

CONCLUSION AND RECOMMENDATION

Participants were knowledgeable about professional identity in nursing/midwifery. They faced several challenges and barriers in professional identity formation during their training and internship. We recommend a need to streamline the scope of practice and enhance clinical mentorship and engagement of leadership in nursing in developing professional identity among students.

Student perceptions of hybrid delivery of interprofessional anatomy-The best of both worlds?

Interprofessional anatomy dissection (IAD) courses increase students' readiness for interprofessional education (IPE) both in-person and online. During the COVID-19 pandemic, virtual environments for anatomy learning were perceived as less effective. Hybrid instruction approaches emerged but have been scarcely evaluated. This study assessed students' experiences with a hybrid IAD course's virtual and in-person components. A hybrid IAD course consisting of virtual and in-person anatomy laboratory-based instruction was offered to 32 students from different health sciences programs. Before and after the full course, students completed the Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS). After the virtual and the in-person course components, students completed a Q-methodology survey to assess their perceptions of the course. Twenty-eight students (20 females; 24.8 ± 6.3 years old) from different programs (4 Physician Assistant; 2 Midwifery; 3 Speech-Language Pathology; 4 Physiotherapy; 3 Occupational therapy; 4 Nursing; 8 Medicine) participated. The total RIPLS score improved after the 8-week course (Median 84 interquartile range [78-87] vs. 87 [85-90]; p = 0.0145). The Q-methodology identified three factors: IPE & Virtual Enthusiasts, Introspective Learners, and IPE & Virtual Skeptics. Factors represented different levels of students' engagement with the IPE and virtual environment. The transition to in-person resulted in all factors praising the experience. Health science students showed improvements in their readiness for IPE after an 8-week hybrid IAD course. The main differences in the evaluations of the virtual and in-person components were related to engagement and the ability to learn anatomy; no differences were noted between settings regarding engagement in IPE.

Interprofessional Identity in Health and Social Care: Analysis and Synthesis of the Assumptions and Conceptions in the Literature

Interprofessional identity (IPI) development is considered essential in reducing incongruency and improving interprofessional collaboration. However, noticeable differences in conceptualizations are being put forward in the literature, hindering interpretation of research findings and translation into practice. Therefore, a Concept Analysis and Critical Interpretative Synthesis of empirical research articles were conducted to explore the assumptions and conceptions of IPI. Independent literature screening by two researchers led to the inclusion and extraction of 39 out of 1334 articles. Through critical analysis, higher order themes were constructed and translated to a synthesizing argument and a conceptual framework depicting what constitutes IPI (attributes), the boundary conditions (antecedents) and the outcomes (consequences) of its development. The attributes refer to both IPI's structural properties and the core beliefs indicative of an interprofessional orientation. The antecedents inform us on the importance of IPI-fitting constructivist learning environments and intergroup leadership in enabling its development. This development may lead to several consequences with regard to professional wellbeing, team effectiveness and the quintuple aim. Given the educational orientation of this study, ways for facilitating and assessing the development of IPI among learners across the professional continuum have been proposed, although empirical research is needed to further validate links and mediating and moderating variables.

Enablers and barriers of first-year common semesters and semester-long courses aimed at interprofessional collaborative practice capability development: A scoping review

Designing a first-year undergraduate common semester aimed at developing interprofessional collaborative practice (IPCP) capabilities is challenging. A scoping review was conducted to identify enablers and barriers for common semesters. Due to limited numbers of eligible studies, the review was expanded to include studies of semester-long first-year courses aimed at IPCP development. Key enablers of common semesters or courses in 35 included studies were: real-world, problem-solving, hands-on, interprofessional teamwork aligned with graduate practice capabilities relevant across disciplines; continuous feedback and critical evaluation; relationship building amongst students and staff; cohesive, well-trained interprofessional teams of staff and leaders; secure, supportive institutional policies and structures. Key barriers included: students' lack of preparation, perceptions of irrelevance, and misaligned expectations; variable student capability and response amongst professions; miscommunicated or misaligned course outcomes; course, faculty or institutional non-integration; and cost, logistic, and evaluation issues. Outcomes were mainly positive improvements in self-evaluated student IPCP skills and understanding, variability between professions, and persistent misconceptions. Scales measuring capabilities lacked uniformity, and few studies were comparative or observational. Overall, the review suggests noncompetitive undergraduate first-year common semesters or courses positively impact IPCP capability development when robustly assessed, clearly evaluated, and supported by an integrated IPE culture.

Exploring interprofessional identity development in healthcare graduates and its impact on practice

Interprofessional identity development is an emerging area of research. Whilst there is a growing body of studies exploring interprofessional identity development and interprofessional education, little is known about interprofessional identity development in healthcare professionals and the impact of interprofessional identity on practice. This study explored interprofessional identity development in graduates during their first year of work as health professionals and the influence of this on practice. All graduates had prior interprofessional education as students. Fourteen interviews with eight graduates were conducted. Data was analysed cross-sectionally using inductive thematic analysis. Three inter-related themes were developed: ‘growing confidence,’ ‘commitment to client-centred care,’ and ‘maintaining dual identification in different contexts.’ These themes demonstrated that, first, interprofessional identity development occurred along a continuum influenced by the practice context and the individual’s commitment to client-centred care. Second, confidence identifying and practising as a healthcare professional facilitates further interprofessional identity development. Third, maintaining identification as an interprofessional practitioner involves developing an increasingly sophisticated understanding of interprofessional practice by viewing interprofessional identity through increasingly complex meaning-making lenses consistent with the constructive developmental theory of self. Findings support the inclusion of pre-licensure interprofessional education and inform further interprofessional identity research in professionals beyond their first year of practice.

Perception and readiness for inter-professional education of health discipline students: A cross-sectional study

BACKGROUND

Interprofessional education (IPE) is a concept focusing on the improvement of a good teamwork environment bringing professionals from diffferent professions together to obtain high-quality health care and improve health outcomes. Determining health discipline students' IPE perceptions and readiness is important to develop, implement and maintain effective IPE programs.

OBJECTIVES

This study aims to determine perception and readiness for interprofessional education of health discipline students.

DESIGN

This study utilized a descriptive and cross-sectional design.

SETTINGS

A public university in Turkey. The study was conducted with students enrolled in Faculty of Health Sciences, Medical Faculty, Faculty of Dentistry, or Vocational School of Health Services.

PARTICIPANTS

The participants included 646 health discipline students who were enrolled in nursing, midwifery, medical, dentistry, medical imaging technology, first and emergency aid, and elderly care departments.

METHODS

Data were collected through the "Data Collection Form", the "Interdisciplinary Education Perception Scale (IEPS-TR)" and the "Readiness for Inter-professional Learning Scale (RIPLS)".

RESULTS

The participants' IEPS-TR and RIPLS total mean scores were found 65.81 ± 19.86 and 67.90 ± 13.53, respectively. The IEPS-TR and RIPLS mean scores and the variables such as choosing the department willingly and being satisfied with the department indicated a statistically significant correlation (p < 0.05). In addition, RIPLS mean scores and the variables such as age, and willingness to take classes with other healthcare students indicated a statistically significant correlation (p < 0.05). However, no statistically significant correlation was found between the IEPS-TR and RIPLS total mean scores and department-related variables (p > 0.05). The participants' IEPS-TR and RIPLS mean scores demonstrated a positive and significant relationship (r = 0.314, p < 0.001).

CONCLUSIONS

This study showed that health discipline students had a high level of perception of interdisciplinary education and were ready for interprofessional education. The study also demonstrated that students' perception of interdisciplinary education increased with the increase in their readiness for this education.

The personal dimension of allied health professional identity: A scoping review in health sciences literature / Die persönliche Dimension der beruflichen Identität von Gesundheitsfachkräften: ein Scoping-Review in der gesundheitswissenschaftlichen Literatur

Introduction

With a shift in healthcare from diagnosis-centered to human- and interprofessional-centered work, allied health professionals (AHPs) may encounter dilemmas in daily work because of discrepancies between values of learned professional protocols and their personal values, the latter being a component of the personal dimension. The personal dimension can be defined as a set of personal components that have a substantial impact on professional identity. In this study, we aim to improve the understanding of the role played by the personal dimension, by answering the following research question: What is known about the personal dimension of the professional identity of AHPs in (allied) health literature?

Methods

In the scoping review, databases, CINAHL, ERIC, Medline, PubMed, and PsychINFO were searched for studies focusing on what is regarded as ‘the personal dimension of professional identity’ of AHPs in the health literature; 81 out of 815 articles were included and analyzed in this scoping review. A varying degree of attention for the personal dimension within the various allied health professions was observed.

Result

After analysis, we introduce the concept of four aspects in the personal dimension of AHPs. We explain how these aspects overlap to some degree and feed into each other. The first aspect encompasses characteristics like gender, age, nationality, and ethnicity. The second aspect consists of the life experiences of the professional. The third involves character traits related to resilience and virtues. The fourth aspect, worldview, is formed by the first three aspects and consists of the core beliefs and values of AHPs, paired with personal norms.

Discussion

These four aspects are visualized in a conceptual model that aims to make AHPs more aware of their own personal dimension, as well as the personal dimension of their colleagues intra- and interprofessionally. It is recommended that more research be carried out to examine how the personal dimension affects allied health practice.

Socialisation into interprofessional teams: A mixed-methods study among early health professional learners who engaged in a teams and teamwork module / Sozialisierung in interprofessionellen Teams: Eine Mixed-Methods-Studie zum Effekt eines Team- und Teamwork-Moduls bei Auszubildenden im Gesundheitswesen

Introduction

Early health profession learners hold stereotypes about their own and other professions. Socialising students through interprofessional education (IPE) early in their training facilitates the development of their beliefs and values surrounding their professional and interprofessional identities. This study evaluates the effect of a 3-week, virtual IPE intervention in early health professional learners.

Methods

Students reflected on their functioning as an interprofessional team through discussion and written prompts which were coded by two faculty members for themes and trends. Exposure to developing an interprofessional identity and socialisation within an IPE team were measured through pre- and post-intervention surveys containing the Interprofessional Socialisation and Valuing Scale (ISVS).

Results

Students increased their positive attitudes towards IPE from pre- to post-intervention module as well as socialisation and readiness across all ISVS subscales: self-perception of working together, value, and comfort (all p < .001). Students reflected that ‘taking time to get to know each other’ (n = 23 teams; 42%) and ‘allowing everyone to contribute’ (= 17; 31%) were key factors for team development. Individual reflections on what students would work on the next time they worked in an interprofessional team revealed ‘communication’ as important (n = 87; 45%).

Discussion

Health profession students who engaged in the module reflected on how their interprofessional team functioned and identified what helped or hindered them to work as a team. The opportunities to reflect on how their own professional identity within the context of an interprofessional team led to evidence of socialising into an interprofessional team. Students who are challenged to socialise into a team early in their education will better understand their beliefs and values surrounding interprofessional collaboration.

Early-learners' expectations of and experience with IPE: A multi-institutional qualitative study

BACKGROUND

Multi-institutional qualitative studies are scarce within the interprofessional education (IPE) literature; such a report would provide comprehensive evidence for the application of interprofessional instruction among earlier learners.

OBJECTIVE

This investigation explored students' expectations of and barriers to introductory IPE across four institutions.

DESIGN

Qualitative inductive content analysis was utilized to interpret students' narrative responses to assigned pre- and post-survey questions.

SETTING

Health science schools of four U.S. institutions at Institution A, Institution B, Institution C, and Institution D.

PARTICIPANTS

Twenty-two percent (n = 385) of eligible participants completed both pre- and post-surveys. Nursing student participation was greatest (n = 113, 33%), followed by occupational therapy (n = 44, 13%), and physical therapy (n = 36, 10%). All other program participation was <10%. In total, students' narrative comments from 19 degree programs were a part of the data set.

METHODS

Responses from one pre-survey question on expectations of introductory IPE and two post-survey questions on IPE benefits and barriers were studied using qualitative inductive thematic analysis.

RESULTS

Four themes emerged as IPE learning expectations and benefits: my own professional role, professional role of others, teamwork, and communication. The theme of interacting with peers surfaced as an additional IPE benefit. There were four themes noted as IPE barriers: course logistics, lack of context, course content, and social dynamics.

CONCLUSION

This multi-institutional qualitative study adds to the literature by providing empirical evidence regarding early learner perceptions of IPE experiences. Student expectations and benefits of their introductory IPE course/curriculum aligned. Perceived barriers are useful in informing future IPE implementation and research.

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.

From uniprofessionality to interprofessionality: dual vs dueling identities in healthcare

Healthcare systems are at times still viewed as siloed performances of single professions, wherein some groups hold hierarchical positions based on their expertise and prestige, rather than a collective functioning of interprofessional teams. Current policies, procedures, and regulations in healthcare education and practice seem to contribute to this context in which the various health and social care professions are set in opposition to one another. The historical, and still prominent, uniprofessional education and socialization practices position health and social care professions to view each as rivals and threats toward achieving their profession/al advancement and growth. The transformation from uniprofessionality to interprofessionality in healthcare requires the application of interprofessional socialization not just at the individual level, but also at the professional and system levels. In this process of interprofessional socialization, we need to embrace the uniqueness of each profession while cultivating an interprofessional collaboration culture in the system (dual identity). In so doing, we can facilitate a shifting mind-set, culture, operations, and policies in healthcare to recognize and foster the contribution and accountability of each profession toward achieving the quadruple aim of better care, better health, better value, and better work experience.

A longitudinal, narrative study of professional socialisation among health students

PURPOSE

Interprofessional collaboration (IPC) among health professionals is well-recognised to enhance care delivery and patient outcomes. Emerging evidence suggests that the early socialisation of students in health professional programmes to teamwork may have a positive impact on their future as collaborative practitioners. With a purpose of contributing to growing evidence on the processes of professional identity construction, and to explore how early expectations and perceptions of IPC develop during professional socialisation and pre-licensure education, our study examined the early professional socialisation experiences among five groups of health professional students.

METHOD

A qualitative, narrative approach was used to examine early professional socialisation among five programmes of health professional students (dentistry, medicine, nursing, pharmacy, physiotherapy) at an Atlantic Canadian University. In March and October 2016, students participated in interviews after first term (n = 44) and first year of study (n = 39). Interviews focused on participants' professional identify formation, as well as their perceptions and experiences of IPC. The authors analysed interview transcripts using narrative analysis.

RESULTS

Findings identify that despite the espoused importance of IPC within health professional training, students have a limited understanding of their professional roles and are largely focused on developing a uniprofessional, vs. interprofessional identity. Clinical experiences, role models and exposure to teamwork are critical to contextualise collaborative practice and enhance the development of an interprofessional identity.

CONCLUSIONS

Findings can be used to guide the development of curricula that promote interprofessional identity development and IPC during early professional socialisation.

Facilitating interprofessional identity development in healthcare students through dedicated interprofessional placements

There is a growing body of research evidencing the benefits of dedicated interprofessional placements in preparing healthcare students for interprofessional practice. However, little is known about if and how students develop their interprofessional identity during interprofessional placements. This study addresses this knowledge gap by exploring final-year students' interprofessional identity development during dedicated interprofessional placement(s). Thirty-eight students from five health professions were interviewed and data analyzed inductively to identify themes. Participants also drew images representing their perceptions of interprofessional identity and its relationship to professional identity as part of the data collection. The themes showed participants progressed from conceptualizing interprofessional identity as a requirement of the placement at the start of the placement, toward internalizing an interprofessional identity by the end of their placement. Context influences interprofessional identity salience. A commitment from healthcare professionals to model interprofessional practice, combined with explicitly facilitating interprofessional identity development, is recommended to facilitate continued interprofessional identity development in different contexts post placement.

Interprofessional teamwork: the role of professional identity and signature pedagogy - a mixed methods study

PURPOSE

One overlooked determinant of interprofessional teamwork is the mobilisation of professional identity. Taking a health or social care practitioner out of their professional silo and placing them in an interprofessional team setting will challenge their professional identity. The theory of signature pedagogy was used to investigate the challenges and what is needed to support practitioners to mobilise their professional identity to maximise teamwork.

DESIGN/METHODOLOGY/APPROACH

A cross-sectional mixed methods study was undertaken in the form of three focus groups, with members of health and social care teams in Wales, UK. Using nominal group technique, participants explored and ranked the challenges and benefits of mobilising their professional identity within an interprofessional setting.

FINDINGS

Findings on mobilising professional identity were found to be aligned closely with the three signature pedagogy apprenticeships of learning to think and to perform like others in their profession and to act with moral integrity. The biggest challenge facing practitioners was thinking like others in their profession while in an interprofessional team.

RESEARCH LIMITATIONS/IMPLICATIONS

The focus of this study is health and social care teams within Wales, UK, which may limit the results to teams that have a similar representation of professionals.

PRACTICAL IMPLICATIONS

Healthcare leaders should be aware of the opportunities to promote mobilisation of professional identity to maximise teamwork. For example, at induction, by introducing the different roles and shared responsibilities. Such practical implications do have consequences for policy as regards interprofessional team development and organisational commitments to adult learning and evaluation.

ORIGINALITY/VALUE

This is the first study of professional identity of interprofessional healthcare and social professionals using signature pedagogy to gain a better understanding of teamwork.

Attitude towards shared learning activities and Interprofessional education among dental students in South India

BACKGROUND

Interprofessional Education (IPE) and Interprofessional Collaboration (IPC) are being introduced in healthcare institutions gradually to enable comprehensive learning and its application to enhance community health outcomes.

OBJECTIVES

To assess the attitude of dental students towards Interprofessional Education (IPE) and Interprofessional Collaboration (IPC) To assess whether Readiness for Interprofessional Learning Scale (RIPLS) is a suitable instrument to measure the attitude of under graduate dental students towards IPE. To assess how the study year and gender affect the attitude of under graduate dental students towards IPE.

METHODS AND MATERIALS

The research design was a cross-sectional survey. The dental students of first to fifth year based on availability of students and the existing academic calendar were participated in the study. A total number of 417 validated RIPLS questionnaire were distributed to dental students studying in two dental institutions at Manipal in South India in the year 2017 with the collected response rate of 81.53%. Principal component analysis of the responses was applied to the data along with Varimax rotation and Cronbach alpha to confirm the internal consistency of the questionnaire. Independent sample t test and ANOVA were used to assess the differences between the groups.

RESULTS

Seventy five percent of the respondents were females, and the mean age was 21.26 years (SD = 1.34). The mean scores in RIPLS and all its subscales were high. The mean scores were also higher as the year of study increased and with female students. Senior and female dental students had more encouraging attitudes towards shared learning.

CONCLUSIONS

The RIPLS can be utilised to determine the different subscales of learning namely learning behaviour, attitudes, teamwork and collaboration, professional identity perspectives, and roles and responsibilities towards interprofessional education of dental students. The dental students with an Indian outlook, perspective and training had a favourable attitude towards interprofessional learning.

Use of profession-role exchange in an interprofessional student team-based community health service-learning experience

BACKGROUND

During interprofessional clinical practice, compared to understanding of one's own professional role and function, it might be more difficult to clarify the roles and contributions of the other health-care team members because of the inter-professional barrier. In order to provide students the opportunity for real experience with other professions in team environments and enhance their perceptions of other professions' roles, this study developed a comprehensive and multi-dimension extracurricular interprofessional education (IPE) model through designing and integrating a profession-role exchange component, that was medical students as pharmacists or nurses, pharmacy students as physicians or nurses, and nursing students as physicians or pharmacists in the interprofessional health-care student team, into the service learning experience in a real community setting.

METHODS

In this pre/post-intervention study, the effect of integrated profession-role exchange experiences on the students' attitudes towards interprofessional collaboration and their role clarification was evaluated among 60 student volunteers (20 medical students, 20 pharmacy students and 20 nursing students). All involved students were divided into the profession-role exchange intervention group and the control group. Subjects in the control group did not participate the profession-role exchange experiences, the other IPE procedures were the same for both groups. Three survey instruments for attitudes toward interprofessional clinical collaboration were respectively used to measure the students' attitudes toward physician-pharmacist, physician-nurse and nurse-pharmacist collaborations. "Roles and responsibilities" subscale of Readiness for Interprofessional Learning Scale was used to evaluate the overall role clarification during IPE.

RESULTS

Compared to the control IPE activity, the addition of profession-role exchange component resulted in the significant increase in students' positive attitudes towards interprofessional collaboration, and the enhancement of students' role awareness.

CONCLUSIONS

The profession-role exchange might be more effective and better initiate students to the practice of interprofessional collaboration, and could be used as an effective IPE tool for improving the role awareness of health-care students.

Exploring interprofessional collaboration and attitudes of health sciences librarians

Objective:

This study assessed health sciences librarians' attitudes toward interprofessional collaboration using the Interdisciplinary Education Perception Scale (IEPS) and gathered information on their involvement with interprofessional activities.

Methods:

The authors sent a survey to librarians in the Medical Library Association's (MLA's) Interprofessional Education Special Interest Group and Research Section consisting of the IEPS and questions about their prior and current experiences with interprofessional practice and education (IPE). We compared mean IEPS scores between each MLA group and several other demographic factors to assess differences in attitudes. We also compared librarians' IEPS scores with those of previously published health professional students' IEPS scores and thematically analyzed two open-ended questions.

Results:

Health sciences librarians' scores on the IEPS indicated positive attitudes toward IPE. There were no statistically significant differences between any group. Health sciences librarians' mean IEPS score was similar to the mean score of health professions students from a prior study. The most commonly reported interprofessional activity was teaching or facilitating learning activities for health professions students; fewer served on committees or engaged in non-curricular activities such as grand rounds and book clubs.

Conclusion:

Health sciences librarians in this study reported positive attitudes toward IPE, in line with the majority of other previously studied health professionals. Years of experience, previous health professional careers, and experience supporting IPE as a librarian had little bearing on the responses to the survey. This suggests that health sciences librarians have positive attitudes toward IPE, regardless of whether they directly support IPE programs or participate in interprofessional activities.

Evaluating Attitudes Toward Interprofessional Collaboration and Education Among Health Professional Learners

BACKGROUND

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

METHOD

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

RESULTS

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

CONCLUSION

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

Quality of contact counts: The development of interprofessional identity in first year students

BACKGROUND

Little is known about how nursing and other healthcare students develop professional and interprofessional identities.

OBJECTIVES

This study a) measures changes in students' professional and interprofessional identities between the start and end of a faculty-wide interprofessional first year programme, and b) identifies factors influencing interprofessional identity strength at the end of the programme.

PARTICIPANTS

One hundred and eight first year nursing, medicine and allied health students.

METHODS

A single-group pre-post-test design was used. Students completed an online survey at the start and end of the year-long programme. The survey comprised measures of professional and interprofessional identity, stereotypes, contact and demographics. The same survey was used twice.

RESULTS

There was a small decline in professional identity and a large decline in interprofessional identity across the year. Nursing students, the only group involved in clinical practicums, were exempt from the large fall in interprofessional identity. Quality of contact with students from other professions and autostereotypes about own profession were predictors of interprofessional identity strength at the end of the programme, consistent with intergroup contact theory.

CONCLUSIONS

Introductory interprofessional education programmes should include opportunities for quality contact with students from other professions, and for students to develop a clear understanding of their own profession.

A J curve of interprofessional change: co-locating non-health partners in an oncology unit

BACKGROUND

Internationally, clinicians face increased demand, pressure on resources and unmet patient needs. A community social support service was co-located within cancer clinics in Glasgow, Scotland to help address some of these needs.

AIM

To analyse the impact of the service on clinical staff and to propose an explanatory theory of change.

METHOD

Qualitative exploratory design, using thematic analysis of semistructured interviews with 8 nurse specialists and 2 medical oncologists from lung, breast, head and neck, and gastrointestinal oncology teams in Glasgow in 2018-2019.

FINDINGS

Four themes captured this process: 'The conversation', 'A better experience', 'Freedom to focus' and 'Working hand in hand'.

CONCLUSION

Together, these four themes explained the process of effective interprofessional working. This process would have been predicted by the J-curve literature on diffusion of innovations. Linking J-curve theory to this successful process provides new understanding that could prove essential for clinical teams who are implementing change within their practice.

The development and psychometric evaluation of an interprofessional identity measure: Extended Professional Identity Scale (EPIS)

The purpose of this study was to develop and evaluate an interprofessional identity measurement instrument based on Extended Professional Identity Theory (EPIT). The latter states that interprofessional identity is a social identity superordinate to a professional identity consisting of three interrelated interprofessional identity characteristics: belonging, commitment and beliefs. Scale development was based on five stages: 1) construct clarification, 2) item pool generation, 3) review of initial item pool, 4) shortening scale length (EFA to determine top four highest factor loadings per subscale; 97 dental and dental hygiene students), and 5) cross-validation and construct validity confirmation (CFA; 152 students and 48 teachers from six curricula). Explained variance of the EPIS was 65%. Internal consistency of the subscales was 0.79, 0.81 and 0.80 respectively and 0.89 of the overall scale. CFA confirmed three-dimensionality as theorized by EPIT. Several goodness-of-fit indexes showed positive results: CFI = 0.968 > 0.90, RMSEA = 0.039 < 0.05, and SRMR = 0.056 ≤ 0.08. The factor loadings of the CFA ranged from 0.58 to 0.80 and factors were interrelated. The Extended Professional Identity Scale (EPIS) is a 12-item measurement instrument with high explained variance, high internal consistency and high construct validity with strong evidence for three-dimensionality.

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.

Professionalism dilemmas experienced by health professions students: a cross-sectional study

Health professions students will invariably confront professionalism dilemmas. These early encounters significantly influence future professional attitudes and behaviours. Heretofore, studies concerning professionalism dilemmas experienced by health professions students across disciplines have been limited. To address this issue, we recruited 56 students with clinical experience from the National Taiwan University College of Medicine in the nursing, dentistry, pharmacy, medical technology, occupational therapy, and physiotherapy programs to participate in this research to compare health professions students' understandings of professionalism and their experiences of professionalism dilemmas. We used group interviews to uncover students' experiences of professionalism dilemmas. We identified the six most commonly reported professionalism dilemmas and found that interprofessional dilemmas were the dominant workplace professionalism dilemma for health professions students. We also identified significant disciplinary differences regarding dilemma types and frequencies. We employed the framework of dual identity development to better understand the role of professional and interprofessional identities in interprofessional dilemmas. The professionalism dilemmas that individual students encountered were shaped by disciplinary differences. Our findings suggest that the development of a sense of belonging to both their own profession and a broader interprofessional care team in health professions students can increase the effectiveness of interprofessional healthcare teams.

Nursing and medical students near-peer activity in the anatomy laboratory: format for success

BACKGROUND/AIMS

An anatomy interprofessional near-peer learning activity (AIP-NPLA) between nursing and medical students was piloted to assess its implementability. This study aimed to: (1) identify key factors of feasibility and (2) describe student-group perceptions of their experience of the interprofessional education (IPE) activity.

METHODS

A total of 59 medical and 179 nursing students participated in the AIP-NPLA whereby medical students were asked to facilitate and lead group discussions with their nursing students colleagues on an anatomical topic using a donor cadaver. Each AIP-NPLA session lasted a total of two hours. A mixed methods approach was employed using both quantitative and qualitative means of assessment. Variables such as Readiness for Interprofessional Learning, Professional Self-Identity, Clinical Teaching Preference, and Near-Peer Teaching and Learning Experience were assessed quantitatively using validated surveys. Qualitative measures included thematic content analysis of focus group interviews conducted following the AIP-NPLA to capture the perceptions of the student groups' experience in the IPE activity.

RESULTS

The results of this investigation demonstrated that there are key factors to consider when designing successful and sustainable IPE activities; the level of clinical exposure and therefore student-group pairing based on professional self-identify scores, optimal tutor-to-tutee group ratios and an activity format that maintained an informal, flexible and free forum for discussion on a topic of common knowledge. Focus group interviews also revealed reflections on professional stereotypes.

CONCLUSION

These findings suggest that early implementation of IPE activities outside of a clinical setting are beneficial and can foster both learning from one another and positive perceptions of interprofessional roles when carefully designed.

"Two heads are better than one"- pharmacy and nursing students' perspectives on interprofessional collaboration utilizing the RIPE model of learning

BACKGROUND

Simulation is an effective strategy for enhancing interprofessional education (IPE) and collaboration (IPC).

OBJECTIVES

A novel interprofessional learning model, The RIPE Model (Reflective Interprofessional Education Model) was applied for a pilot study during a simulation laboratory aimed to (i) enhance pharmacy and nursing students' understanding of the roles and responsibilities of professions within the multidisciplinary healthcare team; and (ii) enhance the importance of working collaboratively in team-based care.

METHODS

The pilot study using a mixed-methods approach, including the administration of a 6-item student survey on a 6-point Likert-type scale as a pre-test (prior to participation in the simulation laboratory) and post-test (after participation in the simulation laboratory), and a debriefing session eliciting a follow up written reflective statement.

RESULTS

Sixty-four students (n = 56 pharmacy; n = 8 nursing) participated in the study which resulted n = 52 pharmacy students and n = 8 nursing students matched data to a pre-test and post-test survey, analyzed via paired t-tests. Statistically significant results (p < 0.05) reported a positive increase in pharmacy students' perceptions from the pre-test and post-test survey for all six items indicating the extent of agreement of IPC; and for one item on the nursing student survey. Qualitative analysis of reflective statements (n = 62) was conducted via thematic analysis utilizing Braun and Clarke's 6-phase process. Thematic analysis generated one overarching theme: IPC: Developing appreciation and respect for healthcare team members to improve patient outcomes; and three subthemes: (i) Enhanced decision-making; (ii) Communication and collaboration; (iii) New understandings of roles and responsibilities.

CONCLUSIONS

Students perceived that utilizing the RIPE Model of learning involving simulation to enhance interprofessional collaboration assisted their understanding of the roles, functions and responsibilities of other healthcare professionals involved the patient care team. Effective collaboration was perceived to be beneficial to enhancing confidence with engagement and communication, appreciation and respect for the expertise of other healthcare professions.

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

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

Implementing an interprofessional information literacy course: impact on student abilities and attitudes

OBJECTIVES

The authors investigated the impact of an interprofessional, freshman-level, information literacy course on nursing, pharmacy, and allied health professions students by examining whether students successfully met learning objectives in the course related to interprofessional attitudes, identification of research study types, and ability to relate evidence-based practice questions to their disciplines.

METHODS

Student posters (n=20) completed in a team project were evaluated to determine whether students were able to accurately identify the type of evidence, population, intervention, and primary outcome of studies (n=192). Additionally, posters (n=78) were evaluated to assess whether students could identify a relevant foreground question and link it to their disciplines. Students also completed the Readiness for Interprofessional Learning Scale (RIPLS) before (n=413) and after (n=352) the course to determine whether their attitudes toward interprofessional learning changed.

RESULTS

Students performed well on learning outcomes in the course, with most teams identifying relevant evidence-based practice questions (83.8%) and effectively connecting questions with their disciplines (65.4%). Students correctly identified the type of evidence, population, intervention, and primary outcome for 70.0%, 81.8%, 76.0%, and 74.0% of cited studies, respectively. Student attitudes after the course did not significantly change.

CONCLUSION

Interprofessional information literacy education can generate positive learning experiences for freshman health care professions students to increase their beginning-level understanding of research in the health care professions and to prepare them for participation in future interprofessional courses and health care teams.

Perspectives of pharmacy students in Qatar toward interprofessional education and collaborative practice: a mixed methods study

In an IPE environment, students are expected to have better understanding of the roles, responsibilities, and contribution of other health care professions to enhance interprofessional working and collaboration with an end result of improving patient-centred and team-based care. Although many studies have investigated students' attitudes, very few employ a mixed methods design and hardly are from Middle Eastern countries. A two-staged sequential explanatory mixed method design was used to comprehensively capture the perspectives of pharmacy students toward IPE and collaborative practice. A quantitative survey was conducted as the first stage of the study, followed by an in-depth discussion of these perspectives through a qualitative phase by conducting two focus groups. For the quantitative surveys, the overall response rate was 102/132 (77%) for pharmacy students in Qatar. This was followed by two focus groups with a total of 27 participants from senior and junior students. In exploring the qualitative data, three main themes were identified in relation to the pharmacy students' perspectives. These were on the pharmacy students' perception on the enablers (professional related benefits, patient-related benefits and current positive influences), barriers (previous IPE experiences, educational related issues and current working practices and processes), and recommendations to implementing IPE and collaborative practice (future IPE and pharmacy profession).Overall, the results demonstrate a strong readiness and positive perception by pharmacy students toward IPE and collaborative practice. This study has highlighted different dimensions in pharmacy students' perceptions. It also provided a useful insight into the readiness of pharmacy students in a Middle Eastern university. Students are seeking more IPE experiences formally incorporated into their curriculum and hence educators should capitalise on these positive and enthusiastic attitudes to identify the most effective means for delivering IPE and inform curricula planning. Collaborative practice-ready graduates will produce better-educated professionals delivering higher quality care.

Defining and understanding the relationship between professional identity and interprofessional responsibility: implications for educating health and social care students

This paper is concerned with exploring the relationship between perceptions of professional identities, interprofessional education (IPE) and collaborative practice. It seeks to introduce the concept of interprofessional responsibility as both a shift in the way in which to conceptualise the professional identity of Health and Social Care (H&SC) staff and as a new set of practices that help to inform the way in which students are prepared for collaborative working. The presented research, undertaken as part of a Ph.D. study, is based upon semi-structured interviews (n = 33) with H&SC staff who were recruited from both the United Kingdom (UK) Health Service and UK universities. Drawing upon thematic analysis of the data, the results of the research identified that previous conceptualisations of professional identity aligned to a whole profession do not relate to the way in which professionals perceive their identities. Senior professionals claimed to be more comfortable with their own professional identity, and with working across professional boundaries, than junior colleagues. Academic staff also identified that much IPE currently taught in universities serves the purpose of box-ticking rather than being delivered in meaningful way. It is proposed that the findings have implications for the way in which IPE is currently taught, and that adoption of the proposed concept of 'interprofessional responsibility' may help address some of the concerns these findings raise.

What did first-year students experience during their interprofessional education? A qualitative analysis of e-portfolios

Interprofessional collaboration is an essential approach to comprehensive patient care. As previous studies have argued, interprofessional education (IPE) must be integrated in a stepwise, systematic manner in undergraduate health profession education programmes. Given this perspective, first-year IPE is a critical opportunity for building the foundation of interprofessional collaborative practice. This study aims to explore the first-year students' learning processes and the longitudinal changes in their perceptions of learning in a year-long IPE programme. Data were collected at a Japanese medical university, in which different pedagogical approaches are adopted in the IPE programme. Some of these approaches include interprofessional problem-based learning, early exposure, and interactive lecture-based teaching. The students are required to submit written reflections as a formative assessment. This study conducted an inductive thematic analysis of 104 written reflections from a series of e-portfolios of 26 first-year students. The themes related to learning outcomes from student perspectives included communication (e.g., active listening and intelligible explanation), teams and teamwork (e.g., mutual engagement and leadership), roles/responsibilities as a group member (e.g., self-directed learning and information literacy), and roles/responsibilities as a health professional (e.g., understanding of the student's own professional and mutual respect in an interprofessional team). The study also indicated three perspectives of students' learning process at different stages of the IPE, i.e., processes by which students became active and responsible learners, emphasised the enhancement of teamwork, and developed their own interprofessional identities. This study revealed the first-year students' learning processes in the year-long IPE programme and clarified the role of the first-year IPE programme within the overall curriculum. The findings suggest that the students' active participation in the IPE programme facilitated their fundamental understanding of communication/teamwork and identity formation as a health professional in interprofessional collaborative practice.

The effectiveness of interprofessional education in healthcare: A systematic review and meta-analysis

Interprofessional education (IPE) emphasizes collaborative practice that aims at promoting the working relationships between two or more healthcare professions. However, there is paucity of literature about the effectiveness of IPE program in the healthcare. This systematic review and meta-analysis aims to objectively determine the effectiveness of IPE in that field in terms of the improvement of students' knowledge, skills and attitudes. The databases of OVID, ISI Knowledge of Science, and Medline (PubMed) were searched for the full-text English language articles published during 2000-2016 using the MeSH terms "interprofessional education" AND "healthcare professionals" AND "multi-professional" AND "impact" AND "effectiveness" OR "collaborative practice" OR "medical students" in Endnote X7. A systematic search finally selected 12 articles for detailed review and meta-analysis. The effect summary value of 1.37 with confidence interval of 0.92-1.82 identifies statistically significant effectiveness of intervention by IPE program in healthcare. The Z test value of 5.99, significant at 5% level of significance, also shows a significant impact of IPE intervention as calculated by the random-effects model. This meta-analysis shows a positive impact and effectiveness of educational intervention by IPE program in various disciplines of healthcare. However, analysis of further clinical trials may be helpful in identifying the effect of IPE program on the students' clinical competence.

A team-based interprofessional education course for first-year health professions students

BACKGROUND AND PURPOSE

Interprofessional education (IPE) is required within pharmacy education, and should include classroom-based education along with experiential interprofessional collaboration. For classroom-based education, small-group learning environments may create a better platform for engaging students in the essential domain of interprofessional collaboration towards meaningful learning within IPE sub-domains (interprofessional communication, teams and teamwork, roles and responsibilities, and values and ethics). Faculty envisioned creating a small-group learning environment that was inviting, interactive, and flexible using situated learning theory. This report describes an introductory, team-based, IPE course for first-year health-professions students; it used small-group methods for health-professions students' learning of interprofessional collaboration.

EDUCATIONAL ACTIVITY AND SETTING

The University of Toledo implemented a 14-week required course involving 554 first-year health-sciences students from eight professions. The course focused on the Interprofessional Education Collaborative's (IPEC) Core Competencies for Interprofessional Collaboration. Students were placed within interprofessional teams of 11-12 students each and engaged in simulations, standardized-patient interviews, case-based communications exercises, vital signs training, and patient safety rotations. Outcomes measured were students' self-ratings of attaining learning objectives, perceptions of other professions (from word cloud), and satisfaction through end-of-course evaluations.

FINDINGS

This introductory, team-based IPE course with 554 students improved students' self-assessed competency in learning objectives (p < 0.01, Cohen's d = 0.9), changed students' perceptions of other professions (via word clouds), and met students' satisfaction through course evaluations.

DISCUSSION AND SUMMARY

Through triangulation of our various assessment methods, we considered this course offering a success. This interprofessional, team-based, small-group strategy to teaching and learning IPE appeared helpful within this interactive, classroom-based course.