Using a Mixed Methods Approach to Explore Perceptions of Early Learners in Classroom-Based Interprofessional Education Experiences

How does interprofessional education affect attitudes towards interprofessional collaboration? A rapid realist synthesis

Interprofessional collaboration (IPC) in healthcare is regarded as important by professionals, as it increases the quality of care while decreasing costs. Interprofessional education (IPE) is a prerequisite for IPC and influences learners' attitudes, knowledge, and collaboration skills. Since attitudes shape behavior, understanding how they are formed is crucial for influencing IPC in learners' professional practice. We investigated what kind of IPE works, for which students, how, and in what circumstances to develop positive attitudes towards IPC. Using realist synthesis, we extracted causal mechanisms that produce positive attitude outcomes and the conducive contexts that trigger them. Our analysis resulted in six plausible context-mechanism-outcome configurations that explain positive attitude development. Positive IPC attitudes are more likely to arise in contexts where IPE provides time and facilities for formal and informal interactions, as this allows learners to get to know each other both professionally and personally, fostering trust, respect, and mutual liking. Additionally, positive attitudes are more likely in contexts where the IPE curriculum is perceived as career-relevant and boosts confidence. Key mechanisms of positive attitude development include getting to know the other learners professionally and personally, experiencing positive affect during IPE, and learners experiencing mutual dependence. Sustained positive attitudes are more likely to develop when there is organizational support for IPC and professionals attend IPE on an ongoing basis, allowing the attitudes and values expected in IPC to be positively reinforced and eventually integrated into the learners' personal value system.

Impact of Just-in-Time TeamSTEPPS Training on Team Performance in a Pediatric Escape Room Interprofessional Experience

OBJECTIVE

To compare differences in observed and self-reported team dynamics between those who received versus those who did not receive TeamSTEPPS training prior to an interprofessional escape room scenario.

METHODS

Final-year pharmacy (N = 27) and physician assistant (N = 88) students participated in an escape room featuring pediatric dosing, asthma, otitis media, type 1 diabetes, and vaccine fundamentals. In total, 29 teams were randomized to control (14) or intervention arm (15). The control group went to the escape room and then returned to the classroom for a team-building module including TeamSTEPPS training. The intervention group started with the team-building module then went to the escape room. One faculty observer was assigned to each team and utilized the Performance Assessment Communication and Teamwork (PACT) expert-observer form to assess team performance. Post-event, students completed an abbreviated PACT post-assessment and a self-reflection on the prompt "What were the most important takeaways from today's interprofessional education experience?"

RESULTS

On the PACT expert-observer form, significantly higher global scores were noted for the intervention arm on all items except situation monitoring. On the aggregate observer data from all stations, leadership emerged as statistically different between the 2 groups. On the PACT post-assessment, the intervention arm reported significantly more leadership during the simulation. On the self-reflections, 70.9% versus 64% in the control arm recognized the importance of teamwork in managing patients.

CONCLUSIONS

Just-in-time TeamSTEPPS training improved observed and to a lesser extent, self-reported teamwork and communication skills. Incorporating TeamSTEPPS training immediately prior to an interprofessional education experience may enhance team performance.

Perception of Interprofessional Education among Students Following Pharmacy Studies

INTRODUCTION

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

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.

Effect of Interprofessional Clinical Debates on Attitudes of Interprofessional Teams

Introduction

Current evidence supports the notion of debates as a pedagogical method to teach literature evaluation skills in health care education; however, there are no reports of this method as an interprofessional approach and its potential benefits. The aim of this study was to assess the impact of interprofessional clinical debates on attitudes toward interprofessional teamwork and perceived literature evaluation skills.

Methods

We invited third-year family medicine residents and fourth-year pharmacy students to complete a survey before and after participating in an interprofessional clinical debate. The anonymous survey was composed of the Students' Perceptions of Interprofessional Clinical Education-Revised (SPICE-R2) instrument to evaluate perceptions of interprofessional teamwork, literature evaluation, and other skills gained through the process. We evaluated matched responses for change in attitudes toward interprofessional teams.

Results

We evaluated 41 matched responses, which indicated improvement in attitudes toward interprofessional teams and was statistically significant ( P<.001). This finding held true for subscales of roles/responsibilities for collaborative practice and patient outcomes from collaborative practice (P<.001). Participants also perceived improvements in literature evaluation, problem-solving, critical thinking, teamwork, and communication skills.

Conclusion

The interprofessional clinical debate activity positively impacted medical residents and pharmacy students, and improved attitudes toward interprofessional teams.