1
|
Nagel DA, Penner JL, Halas G, Philip MT, Cooke CA. Exploring experiential learning within interprofessional practice education initiatives for pre-licensure healthcare students: a scoping review. BMC MEDICAL EDUCATION 2024; 24:139. [PMID: 38350938 PMCID: PMC10863283 DOI: 10.1186/s12909-024-05114-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/30/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Interprofessional collaborative team-based approaches to care in health service delivery has been identified as important to health care reform around the world. Many academic institutions have integrated interprofessional education (IPE) into curricula for pre-licensure students in healthcare disciplines, but few provide formal initiatives for interprofessional practice (IPP). It is recognized that experiential learning (EL) can play a significant role supporting IPP education initiatives; however, little is known of how EL is used within education for IPP in healthcare settings. METHODS We conducted a scoping review to map peer-reviewed literature describing IPP education initiatives involving EL for pre-licensure students in healthcare disciplines. A literature search was executed in MEDLINE, CINAHL, EMBASE, ERIC, PsycINFO, Scopus, and Social Services Abstracts. After deduplication, two independent reviewers screened titles and abstracts of 5664 records and then 252 full-text articles that yielded 100 articles for data extraction. Data was extracted using an Excel template, and results synthesized for presentation in narrative and tabular formats. RESULTS The 100 included articles represented 12 countries and IPP education initiatives were described in three main typologies of literature - primary research, program descriptions, and program evaluations. Forty-three articles used a theory, framework, or model for design of their initiatives with only eight specific to EL. A variety of teaching and learning strategies were employed, such as small interprofessional groups of students, team huddles, direct provision of care, and reflective activities, but few initiatives utilized a full EL cycle. A range of perspectives and outcomes were evaluated such as student learning outcomes, including competencies associated with IPP, impacts and perceptions of the IPP initiatives, and others such as client satisfaction. CONCLUSION Few educational frameworks specific to EL have been used to inform EL teaching and learning strategies to consolidate IPE learning and prepare students for IPP in healthcare settings. Further development and evaluation of existing EL frameworks and models would be beneficial in supporting robust IPP educational initiatives for students in healthcare disciplines. Intentional, thoughtful, and comprehensive use of EL informed by theory can contribute important advances in IPP educational approaches and the preparation of a future health care workforce.
Collapse
Affiliation(s)
- Daniel A Nagel
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
| | - Jamie L Penner
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Gayle Halas
- Rady Chair in Interprofessional Collaborative Practice, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Mark T Philip
- College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Carol A Cooke
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, Canada
| |
Collapse
|
2
|
Erumeda NJ, Jenkins LS, George AZ. Workplace-based learning opportunities in a South African family medicine training programme. Afr J Prim Health Care Fam Med 2023; 15:e1-e13. [PMID: 37916718 PMCID: PMC10623584 DOI: 10.4102/phcfm.v15i1.4073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 06/09/2023] [Accepted: 06/16/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Workplace-based learning (WBL) provides authentic learning opportunities to develop fit-for-practice healthcare workers. Different types of WBL opportunities have been described in high-income countries, but the opportunities in the district health systems of sub-Saharan Africa have not been characterised. AIM This study explored family physicians' (FPs) and registrars' perceptions of WBL opportunities in a decentralised postgraduate family medicine registrar training programme. SETTING The study was conducted at five decentralised training sites across two provinces affiliated with the University of the Witwatersrand in South Africa. METHODS This instrumental case study involved semi-structured qualitative interviews with 11 FPs and 11 registrars purposively sampled across the training sites. The verbatim transcripts were thematically analysed using Braun and Clark's six-step approach. RESULTS Workplace-based learning opportunities were grouped into four themes: Learning from interpersonal interactions, learning from district activities, self-directed learning and contextual influences on learning opportunities. Registrars learnt from patients, peers, FPs and other professionals. Feedback, self-reflection, portfolio use, involvement in various district events, such as student and staff teaching, and continuous medical education augmented learning. Contextual influences originated from health facilities, resource availability, district management and university support, excessive workload and a need for standardised district learning opportunities. CONCLUSION Registrars are exposed to several types of WBL opportunities in district health systems. Effective engagement with available opportunities and addressing contextual challenges could enhance registrar learning.Contribution: Maximising learning opportunities to promote registrars' acquisition of required skills and competencies to efficiently address community needs in a middle-income country such as South Africa.
Collapse
Affiliation(s)
- Neetha J Erumeda
- Department of Family Medicine and Primary Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; and Gauteng Department of Health, Ekurhuleni District Health Services, Germiston.
| | | | | |
Collapse
|
3
|
Num KSF, Aizuddin AN, Tong SF, Mohamed Said MS. A grounded theory research protocol on an attempt to practice interprofessional collaborative care by a primary care clinic health professional fresh graduate in diabetes care. Front Med (Lausanne) 2023; 10:1133948. [PMID: 37601799 PMCID: PMC10435291 DOI: 10.3389/fmed.2023.1133948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/06/2023] [Indexed: 08/22/2023] Open
Abstract
Interprofessional collaborative care (IPCC) can improve the quality of care in patients with chronic diseases in primary care settings. In Malaysia, many medical and healthcare universities have adopted the concept of the interprofessional collaborative practice (IPCP) framework by the World Health Organization (WHO) and implemented interprofessional learning (IPL) in their curriculum to prepare fresh graduates for interprofessional collaboration (IPC) in the health workforce albeit in various degrees. However, there are potential challenges in putting what they have learned into practice, especially in managing chronic diseases due to the complexity of behavior changes required. Diabetes care is a classic example of such chronic disease management. This article presents a qualitative research protocol exploring the processes and challenges of fresh graduates attempting to practice IPC when managing diabetes mellitus (DM) in primary care clinics. A grounded theory (GT) approach will be adopted.
Collapse
Affiliation(s)
- Kelly Sze Fang Num
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Azimatun Noor Aizuddin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- International Centre for Casemix and Clinical Coding, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia
| | - Seng Fah Tong
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Shahrir Mohamed Said
- Department of Internal Medicine, Universiti Kebangsaan Malaysia Medical Center (UKMMC), Kuala Lumpur, Malaysia
| |
Collapse
|
4
|
Kiguli-Malwadde E, Forster M, Martin S, Chilemba E, Couper I, Motlhatlhedi K, Celentano J, Haruzivishe C, Sears D, Budak JZ, Khanyola JN, Von Zinkernagel D, Molwantwa M, Semitala F, de Villiers M, Reid M, Kazembe A. Evaluating the impact of a multicountry interprofessional training programme to improve HIV knowledge and clinical confidence among healthcare workers in sub-Saharan Africa: a cohort study. BMJ Open 2022; 12:e060079. [PMID: 35858724 PMCID: PMC9305810 DOI: 10.1136/bmjopen-2021-060079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To assess the impact of an interprofessional case-based training programme to enhance clinical knowledge and confidence among clinicians working in high HIV-burden settings in sub-Saharan Africa (SSA). SETTING Health professions training institutions and their affiliated clinical training sites in 12 high HIV-burden countries in SSA. PARTICIPANTS Cohort comprising preservice and in-service learners, from diverse health professions, engaged in HIV service delivery. INTERVENTION A standardised, interprofessional, case-based curriculum designed to enhance HIV clinical competency, implemented between October 2019 and April 2020. MAIN OUTCOME MEASURES The primary outcomes measured were knowledge and clinical confidence related to topics addressed in the curriculum. These outcomes were assessed using a standardised online assessment, completed before and after course completion. A secondary outcome was knowledge retention at least 6 months postintervention, measured using the same standardised assessment, 6 months after training completion. We also sought to determine what lessons could be learnt from this training programme to inform interprofessional training in other contexts. RESULTS Data from 3027 learners were collected: together nurses (n=1145, 37.9%) and physicians (n=902, 29.8%) constituted the majority of participants; 58.1% were preservice learners (n=1755) and 24.1% (n=727) had graduated from training within the prior year. Knowledge scores were significantly higher, postparticipation compared with preparticipation, across all content domains, regardless of training level and cadre (all p<0.05). Among 188 learners (6.2%) who retook the test at >6 months, knowledge and self-reported confidence scores were greater compared with precourse scores (all p<0.05). CONCLUSION To our knowledge, this is the largest interprofessional, multicountry training programme established to improve HIV knowledge and clinical confidence among healthcare professional workers in SSA. The findings are notable given the size and geographical reach and demonstration of sustained confidence and knowledge retention post course completion. The findings highlight the utility of interprofessional approaches to enhance clinical training in SSA.
Collapse
Affiliation(s)
- Elsie Kiguli-Malwadde
- Director of Health Workforce and Development, African Centre for Global Health and Social Transformation, Kampala, Uganda
| | - Maeve Forster
- Institute of Global Health Sciences, UCSF, San Francisco, California, USA
| | - Shayanne Martin
- Institute of Global Health Sciences, UCSF, San Francisco, California, USA
| | - Evelyn Chilemba
- College of Nursing, Kamuzu University of Health Sciences, Kamuzu, Malawi
| | - Ian Couper
- Ukwanda Centre for Rural Health, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South Africa
| | - Keneilwe Motlhatlhedi
- Faculty of Medicine, University of Botswana Faculty of Health Sciences, Gaborone, Gaborone, Botswana
| | - Jessica Celentano
- Institute of Global Health Sciences, UCSF, San Francisco, California, USA
| | - Clara Haruzivishe
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Harare, Zimbabwe
| | - David Sears
- Medicine, UCSF, San Francisco, California, USA
| | - Jehan Z Budak
- Division of Allergy and Infectious Diseases, Department of Medicine, University of Washington Seattle Campus, Seattle, Washington, USA
| | - Judy N Khanyola
- School of Nursing, University of Global Health Equity, Kigali, Gasabo, Rwanda
| | | | - Mmoloki Molwantwa
- Faculty of Medicine, University of Botswana Faculty of Health Sciences, Gaborone, Gaborone, Botswana
| | - Fred Semitala
- Department of Internal Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Marietjie de Villiers
- Division of Family Medicine and Primary Care, Stellenbosch University Faculty of Medicine and Health Sciences, Cape Town, Western Cape, South Africa
| | | | - Abigail Kazembe
- College of Nursing, Kamuzu University of Health Sciences, Kamuzu, Malawi
| |
Collapse
|