Professional Stereotypes of Interprofessional Education Naive Pharmacy and Nursing Students

Interprofessional education and collaborative practice in Nigeria - Pharmacists' and pharmacy students' attitudes and perceptions of the obstacles and recommendations

INTRODUCTION

Many countries have implemented interprofessional education (IPE) and interprofessional collaborative practice (IPCP), but there is a dearth of information on the state of IPE in Nigeria. We evaluated the attitude of Nigerian pharmacy students and pharmacists towards IPE and IPCP and the perceived barriers to and recommendations for the implementation of IPE and IPCP.

METHODS

A cross-sectional survey of 238 community and hospital pharmacists and 765 pharmacy students in Nigeria was conducted with an online questionnaire using the Interprofessional Attitude Scale. Information on the perceived barriers to and recommendations for implementing IPE was also collected.

RESULTS

Two hundred and seven pharmacists (87%) and 629 (82.2%) pharmacy students agreed that it is necessary for health profession students to learn together. Perceived barriers to the implementation of IPE and IPCP included professional pride [pharmacists = 51 (21.42%), pharmacy students = 55 (7.19%)], prejudice against other health professions [pharmacists = 35 (14.7%), pharmacy students = 74 (9.67%)], uni-professional training [pharmacists = 5 (2.1%), pharmacy students = 7 (0.92%)], and government policies that discourage IPE and IPCP [pharmacists = 10 (4.2%), pharmacy students = 20 (2.61%)]. Recommendations proposed were the integration of IPE in undergraduate pharmacy curricula, cooperation among health professionals to curb professional rivalry, and the provision of necessary facilities and resources by the government.

CONCLUSIONS

Nigerian pharmacists and pharmacy students had positive attitudes towards IPE and IPCP. The perceived barriers to implementing IPE in Nigeria include discouraging government policies. Deliberate and implementable government policies on IPE are needed.

Interprofessional education (IPE) in medical radiation science: A scoping review

INTRODUCTION

Interprofessional education (IPE) in medical radiation education is designed to enhance both student and longer-term patient outcomes. This scoping review aims to provide an overview of the available evidence and examine the effectiveness of IPE strategies used to enhance the development of medical radiation science (MRS) students.

METHODS

Medline, CINAHL, Cochrane Library and Emcare were searched for articles which employed an experimental study design to quantitatively assess the effectiveness of IPE for MRS students. Two reviewers screened and extracted relevant data independently. Critical appraisal was conducted using the JBI critical appraisal tool.

RESULTS

Eighteen studies were included in this review. Diverse approaches to IPE were discovered, particularly in terms of the method of delivery, setting and duration of interventions. MRS students interact with many professions, particularly medical doctors and nurses. All studies which employed a control arm demonstrated statistically positive findings favoring IPE intervention(s). In pre-post studies, most IPE interventions reported significant positive differences after IPE was implemented. This entailed an enhanced perceived knowledge and understanding of other professions, and ability to undertake their role in the team.

CONCLUSION

IPE was shown to be effective in enhancing students' perceptions and attitudes and to a limited extent, improve knowledge acquisition. Future research should assess long-term effects and patient-related outcomes.

IMPLICATIONS FOR PRACTICE

IPE in a variety of formats demonstrates positive results for MRS students; however, interventions which are longer-term, conducted in small groups, and performed earlier in the educational pathway, may demonstrate greater effectiveness.

Overcoming Past Perceptions and a Profession-Wide Identity Crisis to Reflect Pharmacy's Future

The profession of pharmacy has come to encompass myriad identities, including apothecary, dispenser, merchandiser, expert advisor, and health care provider. While these identities have changed over time, the responsibilities and scope of practice have not evolved to keep up with the goals of the profession and the level of education of practicing pharmacists in the United States. By assuming that the roles of the aforementioned identities involve both product-centric and patient-centric responsibilities, our true professional identity is unclear, which can be linked to the prevalence of the impostor phenomenon within the profession. For pharmacy to truly move forward, a unified definition for the profession is needed by either letting go of past identities or separating these identities from each other by altering standards within professional degree programs and practice models. Without substantial changes to the way we approach this challenge as a profession, the problems described will only persist and deepen.

Attitudes and Beliefs of Portuguese and American Nursing Students about Patients’ Sexuality

Nursing school graduates must be prepared to interact comfortably and effectively with patients about their sexual health. This study analyses the attitudes and beliefs about patient sexuality held by Portuguese and American nursing students. Objective: In Portuguese and American nursing students, (1) we analyzed students’ attitudes and beliefs towards sexuality using the Sexuality Attitudes and Beliefs Survey (SABS); (2) we identified nationality, socio-demographic information, and affective-sexual beliefs and attitudes. Method: Quantitative, cross-sectional study; convenience sample of 296 students (63.2% Portuguese; 36.8% American); mean age: 21.9 years (SD = 3.12); two-way ANOVA and multiple correspondence analyses were performed. Results: Attitudes and beliefs toward sexuality: Portuguese women are more liberal than men, contrary to American students. Among both nationalities, participants with multiple sexual partners held more conservative attitudes. Sexual orientation: bisexual American students and homosexual Portuguese students are conservative. Multiple correspondence analysis revealed two profiles: (1) Portuguese students: liberal-tolerant in attitudes towards patient sexuality, live with family/roommate, 18 to 21 years old, no or one sexual partner; (2) US students: traditionalist attitudes towards patient sexuality, share house, 22 and 23 years old, multiple partners. Conclusion: Human sexuality must be addressed in nursing education curricula.

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.

Teaching Intellectual Humility Is Essential in Preparing Collaborative Future Pharmacists

Interprofessional teams contribute significantly to patient care and safety. However, barriers to effective interdisciplinary collaboration have been identified, such as power dynamics and mistrust among team members, contrasting ideologies, interests and levels of engagement of clinicians, and disciplinary territoriality, which could negatively impact patient care. Teaching current health professional students behaviors and personal values that promote collaboration is critical in equipping them to function effectively in an interdisciplinary care setting. In this commentary, we put forward the idea that teaching intellectual humility is important in preparing collaborative future pharmacists. The core dimensions of intellectual humility, namely, open-mindedness, intellectual modesty, engagement, and corrigibility are important behaviors that could address the above-mentioned barriers, and promote successful interdisciplinary collaboration. Furthermore, we suggest strategies through which student pharmacists could be taught intellectual humility, mainly within the interprofessional education setting.

Interprofessional education-relevant accreditation standards in Canada: a comparative document analysis

BACKGROUND

Increasing evidence suggests that sustainable delivery of interprofessional education (IPE) has the potential to lead to interprofessional collaborative practice (IPCP), which in turn has the potential to lead to enhanced healthcare systems and improved patient-centered care health outcomes. To enhance IPE in Canada, the Accreditation of Interprofessional Health Education (AIPHE) project initiated collaborative efforts among accrediting organizations of six health professions to embed IPE language into their respective accreditation standards. To further understand the impact of the AIPHE project, this study evaluated the accountability of the IPE language currently embedded in Canadian health professions' accreditation standards documents and examined whether such language spanned the five accreditation standards domains identified in the AIPHE project.

METHODS

We conducted a comparative content analysis to identify and examine IPE language within the "accountable" statements in the current accreditation standards for 11 Canadian health professions that met our eligibility criteria.

RESULTS AND DISCUSSION

A total of 77 IPE-relevant accountable statements were identified across 13 accreditation standards documents for the 11 health professions. The chiropractic, pharmacy, and physiotherapy documents represented nearly 50% (38/77) of all accountable statements. The accountable statements for pharmacy, dentistry, dietetics, and nursing (registered) spanned across three-to-four accreditation standards domains. The remaining nine professions' statements referred mostly to "Students" and "Educational program." Furthermore, the majority of accreditation standards documents failed to provide a definition of IPE, and those that did, were inconsistent across health professions.

CONCLUSIONS

It was encouraging to see frequent reference to IPE within the accreditation standards of the health professions involved in this study. The qualitative findings, however, suggest that the emphasis of these accountable statements is mainly on the students and educational program, potentially compromising the sustainability and development, implementation, and evaluation of this frequently misunderstood pedagogical approach. The findings and exemplary IPE-relevant accountable statements identified in this paper should be of interest to all relevant stakeholders including those countries, where IPE accreditation is still emerging, as a means to accelerate and strengthen achieving desired educational and health outcomes.

Auto- and hetero-stereotypes in radiography students: perspectives and comparisons

Introduction:

How groups view themselves and each other is very important in order to promote effective work practices. These views can be tribal in nature and lead to stereotyping which may affect how we communicate and act with other groups. This study primarily aims to identify how student radiographers view their own and other radiographic profession.

Method:

A survey was undertaken using the Student Stereotypes Rating Questionnaire with all radiographic training sites in England. The questionnaire was given to radiography students training as either diagnostic radiographers or therapeutic radiographers. It asked students to rate four professions: doctors, diagnostic radiographers, therapeutic radiographers and nurses on nine characteristics.

Results:

The online survey was open between February and July 2019 and elicited 233 responses. Overall, the radiography students’ perceptions of their own profession and the other non-radiography professions were generally positive; however, each radiographic profession’s view on the other radiographic professions was less favourable, the scores being significantly lower than for other professions. The professions each identified unique attributes (interpersonal skills, being a team player and independent working) that separated the professions from each other. Differences and similarities in stereotypes appeared not to change with time, although gender differences for certain attributes did exist.

Conclusion:

Students appear to have preconceived positive stereotype of their own profession and a more negative stereotype of the other radiography profession that appears relatively stable during their training period and was unaffected by interprofessional education.

Professional Attitudes in Health Professions' Education: The Effects of an Anatomy Near-Peer Learning Activity

Interprofessional attitudes existing between healthcare disciplines can negatively impact communication and collaboration in the clinical setting. While human anatomy is a topic central to healthcare trainees, the potential of the anatomy laboratory to minimize negative interprofessional attitudes has yet to be characterized. This study aimed to assess the effects of an anatomy interprofessional near-peer learning activity (AIP-NPLA) on medical and nursing students' interprofessional attitudes at McGill University. The authors employed a convergent parallel mixed methods study to explore participants' AIP-NPLA experiences. The Attitudes to Health Professionals Questionnaire (AHPQ) was used pre- and post-AIP-NPLA to assess participants' attitudes toward their own and their counterpart profession. In addition, a focus group was held immediately following the AIP-NPLA to explore participants' experiences and interprofessional perceptions. Quantitative results using a principal components analysis demonstrated significant changes in nursing students' responses between pre- and post-AIP-NPLA scoring, rating the medical profession as being more caring overall. Medical students' responses pre- and post-AIP-NPLA demonstrated no significant differences. Qualitative results also suggested a breakdown of negative attitudes, an increased understanding of inter- and intra-professional roles, and the importance of interprofessional collaboration and mutual learning for their careers. These findings revealed that attitudes among healthcare trainees may be positively restructured in the anatomy laboratory, allowing for collaborative care to predominate in current and future clinical practices.

Stereotypes among health professions in Indonesia: an explorative study

PURPOSE

Effective and efficient health services require efforts to increase collaboration among health professionals. One of the barriers to effective collaboration is stereotypes. Stereotypes represent perceptions or perspectives about a person or group of people. This study aims to explore the perceptions of health professional students and practitioners regarding stereotypes.

METHODS

This was a qualitative study using a phenomenology approach. A sample of health professions students from both preclinical and clinical stages, as well as health practitioners, was selected using a maximum variation sampling method. Primary data collection was conducted through focus group discussions. Data obtained were analyzed using thematic analysis. A total of nine focus group discussions were conducted.

RESULTS

Four themes were identified from this study, including the types of stereotypes, factors affecting stereotype formation, the implications of stereotypes, and how to overcome stereotypes. Stereotype formation was affected by the lack of understanding of other health professions' roles, hierarchical culture, personal experience in receiving healthcare, and community view. Stereotypes among health professionals created obstacles to healthcare team communication and reduced self-confidence in certain health professionals. These stereotypes may be overcome through competency development and knowledge sharing among professionals as well as through education on other health care professionals' roles and competencies so that each profession possessed similar goals for patient safety.

CONCLUSION

Both positive and negative stereotypes negatively affected collaboration. Stereotypes were greatly affected by multifactorial causes. Therefore, understanding other professions' roles and conducting interprofessional education are important to overcome stereotypes.

Are Filipino students ready to collaborate? Comparing the readiness of healthcare students for interprofessional education in the Philippines

The inclusion of interprofessional education in healthcare curricula in the Philippines has paved the way for the researchers to examine students' readiness to learn with, about, and from one another to foster collaboration in providing quality patient care. In view of this, we examined the differential attitude of 423 Filipino students to get involved in interprofessional learning using the Readiness for Interprofessional Learning Scale. Using multivariate analysis of variance, we found differences across gender, program, and year level among students from medical technology, pharmacy, physical therapy and occupational therapy in terms of teamwork and collaboration, negative professional identity, positive professional identity, and roles and responsibilities. These differences can inform the development of an intervention program to elicit a favorable attitude toward interprofessional collaboration. Theoretical, methodological, and practical implications of the findings are discussed.

What participants learn, with, from and about each other during inter-professional education encounters: A qualitative analysis

BACKGROUND

Safe healthcare requires teamwork and collaboration. To meet the needs of healthcare organizations and professionals, inter-professional education, is no longer an optional educational trend but rather a mandate of accrediting health education agencies.

OBJECTIVE

In an effort to better understand the impact of inter- professional educational activities, this study sought to explore via qualitative methods what nursing and medical students learn with, from, and about one another during a week - long simulation-based inter-profession education course.

DESIGN

A convenience sample of post-course survey responses from students participating in a week-long, inter-professional, simulation-based patient safety course was used to longitudinally explore what participants learn with, from, and about each other.

SETTINGS

The setting for this study was a research university located in the southeast United States.

PARTICIPANTS

The participants included a total of 272 second semester accelerated option Bachelor of Nursing students and 599 medical students entering the 3rd year of their program that participated in an annual patient safety course. The study analyzed responses of students to questions in a post-course survey regarding educational outcomes while learning with students from a different profession.

RESULTS

In the responses from 871 students collected over four years, the following key themes emerged. Students: 1) articulated learning the importance of contributions of other professions to the healthcare team, 2) expressed an appreciation for areas where their colleagues' training was superior to their own; and 3) identified deficiencies in their own knowledge and skill sets.

CONCLUSION

The findings of this study provide a basis for developing more specific curricular content as part of inter-professional education endeavors to strengthen constructive views of healthcare professions, foster a more collaborative shared mental model, and to correct perceived misconceptions.

Does the delivery of interprofessional education have an effect on stereotypical views of healthcare students in Qatar?

Interprofessional education (IPE) is an evolving educational approach for preparing healthcare professional students to provide patient care in a collaborative team atmosphere. One of the important outcomes to be achieved is understanding the stereotypical views of health professionals held by themselves and by others to eventually reduce negative and harmful stereotypes and to foster an environment of mutual respect and trust amongst healthcare professionals. The primary aim of this study was to investigate whether there is a change in healthcare students' stereotypical belief about the characteristics of healthcare professionals before and after an IPE activity focused on smoking cessation. The Student Stereotype Rating Questionnaire (SSRQ) was used to assess the students' stereotype ratings of their professions and other healthcare professions before and after the IPE activity. The ratings were made in relation to nine attributes. Sixty-eight students from five different majors (Medicine, Nursing, Pharmacy, Public Health, and Respiratory Therapy) participated in the IPE activity. All the students involved in the activity responded to both the pre and post surveys (response rate, 100%). The participating students' combined ratings revealed a significant change in the perspectives of medical, pharmacy, and respiratory therapy students in all of the nine attributes. While for public health students, differences were significant in two aspects: professional competence and practical skills. Three central themes emerged after the IPE session from the open-ended questions: roles and responsibilities, patient-centered care, and integrated healthcare team. Overall, the findings from this study suggest that stereotyping exists among different healthcare profession student groups in Qatar and that IPE can impact both hetero-stereotypes and auto-stereotypes. The positive change in perception following the IPE activity indicates the effectiveness and the value of these short duration IPE activities in negating stereotypical views.

Evaluation of pharmacy student perceptions and stereotypes of healthcare professionals before and after an internal medicine advanced pharmacy practice experience

BACKGROUND

A focus of delivering effective patient-centered care is working as an interprofessional team. Pharmacy students may harbor stereotypes of other healthcare professions that could impede collaboration. The objective of this study was to assess pharmacy student ratings of pharmacists and other healthcare professionals' characteristics before and after their internal medicine advanced pharmacy practice experience (APPE) to determine if the APPE altered their stereotypes. A pre- and post-survey utilizing the Student Stereotypes Rating Questionnaire (SSRQ) was used to carry out the study goals.

IMPACT

Students had more interactions with pharmacists, physicians, and nurses than with other professionals. Pharmacy students' perceptions of their own profession (autostereotypes) were higher compared to the other disciplines, with a movement towards equality following APPE completion. Students also rated professionals lower if they completed the survey in earlier APPE blocks. These results are limited by the lack of coupling between surveys, a low response rate, and incomplete surveys.

RECOMMENDATIONS

Methods that would have strengthened results include focusing on the healthcare professionals that students interacted with most, quantifying the number of experiences they had with each group before and after the rotation, requiring answers to all survey questions, and a strategy to match pre- and post-survey results.

DISCUSSION

Despite the limitations of the study, the experiences gained during the APPE positively impacted student perceptions and attitudes towards other healthcare disciplines. This experience type may be a key component to producing pharmacy graduates who are prepared to work collaboratively with other professionals.

Health professions students' attitudes and perceptions of interprofessional biases

OBJECTIVE

The purpose of this study was to examine attitudes toward interprofessional, team-based care in first-year health professions students.

METHODS

A cross-sectional questionnaire was administered to all first-year health professions students in their first semester at one university using the Interprofessional Attitudes Scale (IPAS). Kruskal-Wallis tests were used to analyze the data.

KEY FINDINGS

Results indicated only two significant differences among students in IPAS subdomains: teamwork (χ²  = 13.11, df = 3, P = 0.004) and patient-centredness (χ²  = 40.75, df = 3, P < 0.0001).

CONCLUSIONS

Not all health professions students come into their formal education with the same level of attitudes toward team-based care. Educators should consider this when designing IPE activities.

Interprofessional Pharmacokinetics Simulation: Pharmacy and Nursing Students' Perceptions

Interprofessional practice between pharmacists and nurses can involve pharmacokinetic dosing of medications in a hospital setting. This study describes student perceptions of an interprofessional collaboration pharmacokinetics simulation on the Interprofessional Education Collaborative (IPEC) 2016 Core Competencies. The investigators developed a simulation activity for senior undergraduate nursing and second-year pharmacy students. Nursing and pharmacy students (n = 54, 91 respectively) participated in the simulation using medium-fidelity manikins. Each case represented a pharmacokinetic dosing consult (vancomycin, tobramycin, phenytoin, theophylline, or lidocaine). Nursing students completed head-to-toe assessment and pharmacy students gathered necessary information and calculated empiric and adjusted doses. Students communicated using SBAR (Situation, Background, Assessment, and Recommendation). Students participated in debrief sessions and completed an IRB-approved online survey. Themes from survey responses revealed meaningful perceptions in all IPEC competencies as well as themes of safety, advocacy, appreciation, and areas for improvement. Students reported learning effectively from the simulation experience. Few studies relate to this type of interprofessional education experience and this study begins to explore student perceptions of interprofessional education (IPE) in a health sciences clinical context through simulation. This real-world application of nursing and pharmacy interprofessional collaboration can positively affect patient-centered outcomes and safety.