Design and evaluation of an interprofessional education workshop series for preclinical and prelicensure health professional students

BACKGROUND

There are a variety of designs and implementation strategies reported for interprofessional education (IPE); however, most of these descriptions lack robust evaluations of interprofessional (IP) outcomes.

INTERPROFESSIONAL EDUCATION ACTIVITY

An IPE Workshop Series was implemented for preclinical and prelicensure students in eight health professions, consisting of four sessions: health professionals' roles and responsibilities (1A); introduction to patient safety (1B); IP diabetes management (2A); and IP pain management in the opioid epidemic (2B). For Workshops 2A and 2B, student perceptions of IPE were measured using the validated Students Perceptions of Interprofessional Clinical Education Revised Version 2 and IP team care plans were assessed with a rubric. Five hundred twenty-seven students attended all four workshops and completed all surveys. Student perceptions of IPE and collaboration were significantly increased after completing the IPE Workshop Series. Most teams met or exceeded expectations on the diabetes team care plans for collaboration, addressing patient concerns, and gaps in care; however, most teams needed improvement on addressing additional workup and management. The pain management team care plans were below expectations for most teams.

DISCUSSION

Student perceptions of IP collaboration increased and were maintained longitudinally indicating a positive impact on this IPE outcome; however, performance on team care plans did not meet faculty expectations suggesting areas for improvement in the design and evaluation for this outcome.

IMPLICATIONS

These findings reinforce the importance of evaluation to ensure IPE curricula are achieving IP outcomes, notably, utilizing validated instruments and incorporating faculty assessments that are appropriately leveled for learners.

Exploring second professional year pharmacy student reflections after an interprofessional shadowing experience with nursing students in critical care units: a qualitative study

Accreditation standards for pharmacy and nursing education require interprofessional education (IPE) as a key component in both curricula. There is increasing evidence for using interprofessional shadowing as a learning modality for IPE; reflection can be used to enhance learning from these experiences. We explored pharmacy student-reported reflections from an interprofessional shadowing experience with nursing students through qualitative content analysis of reflective statements. We found that pharmacy students gained knowledge of nursing roles and areas of expertise, awareness of how the team provides care, and awareness of the importance of communication and mutual respect to improve both team performance and patient safety. Additionally, we were able to assess interprofessional sub-competencies that were met as a result of the interprofessional shadowing experience, specifically, pharmacy students gained knowledge and skills across all four IPEC Core Competencies. Interprofessional shadowing combined with reflection can enhance learning, and thematic analysis of these reflections can be utilized to assess IPE outcomes.

Nurses' attitudes and behaviors on patient medication education

BACKGROUND

Medication education is vital for positive patient outcomes. However, there is limited information about optimal medication education by nurses during hospitalization and care transitions.

OBJECTIVE

Examine nurses' attitudes and behaviors regarding the provision of patient medication education. The secondary objectives were to determine if nurses' medication education attitudes explain their behaviors, describe nurses' confidence in patient medication knowledge and abilities, and identify challenges to and improvements for medication education.

METHODS

A cross sectional survey was administered to nurses servicing internal medicine, cardiology, or medical-surgical patients.

RESULTS

Twenty-four nurses completed the survey. Greater than 90% of nurses believed it is important to provide information on new medications and medical conditions, utilize resources, assess patient understanding and adherence, and use open ended question. Only 58% believed it is important to provide information on refill medications. Greater than 80% of nurses consistently provided information on new medications, assessed patient understanding, and utilized resources, but one-third or less used open-ended questions or provided information on refill medications. Most nurses spend 5-9 minutes per patient on medication education and their attitudes matched the following medication education behaviors: assessing adherence (0.57; p<0.01), providing information on new medications (0.52; p<0.05), using open-ended questions (0.51; p<0.01), and providing information on refill medications (0.39; p<0.05). Nurses had higher confidence that patients can understand and follow medication instructions, and identify names and purpose of their medications. Nurses had lower confidence that patients know what to expect from their medication or how to manage potential side effects. Communication, including language barriers and difficulty determining the patient's understanding of the information, was the most common challenge for nurses and they suggested utilization of translator services and patient-friendly drug information resources as a way to improve.

CONCLUSION

Nurses have positive attitudes toward patient medication education. However, their attitudes do not fully explain their behaviors and many nurses are spending limited time with patients on medication education. Enhancements to medication education could include resources on communication and collaboration with pharmacists.

A Cross-Sectional Study Evaluating the Impact of One Year versus Two Years of Exposure to Interprofessional Education on Student Perceptions of Physician-Pharmacist Interprofessional Clinical Education (SPICE)

Background: Evaluating student perceptions of interprofessional education (IPE) is important to meet accreditation standards. The objective of this study was to evaluate the impact of one year versus two years of exposure to IPE on student perceptions, as well as evaluate differences between professions. Methods: In this cross-sectional study, first and second year medical and pharmacy students enrolled in an interprofessional experiential course series at each of their respective institutions completed a perceptions instrument prior to a standardized objective behavioral assessment. Student demographics and perception scores were summarized using descriptive statistics. Chi-squared tests and Cochran-Mantel-Haenszel tests were used to assess differences in demographic variables. Between-group differences in perception scores were assessed using Wilcoxon Rank-Sum tests. Results: 155 students completed the instrument out of the 163 students enrolled in the course series. Overall, the median scores were ≥4 (4=Agree, 5=Strongly Agree) for all SPICE items and factors. No significant differences were observed between first and second year students in response to any of the SPICE items or factors. When comparing professions, significant differences were observed between pharmacy students and medical students that IPE “enhances my education” (p=0.003), “improves patient satisfaction” (p=0.001), and “enhances my future ability to collaborate” (p=0.001). Significant differences were also observed between pharmacy students and medical students for 2 of the 3 factors: teamwork (p=0.001) and patient outcomes (p=0.005). For all of the differences in items and factors, pharmacy students reported higher levels of agreement. Conclusions: Two years of exposure to IPE compared to one year (i.e. second year students vs. first year students) did not result in higher levels of agreement; however, agreement was high across all students which may have limited the ability to detect a difference. When perceptions are high early in the curriculum, maintaining the same level of agreement longitudinally may be a more appropriate educational outcome. Pharmacy students had higher levels of agreement compared to medical students for certain items. Further research is needed to determine if these differences have an impact on interprofessional collaboration. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received), employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties.   Type: Original Research

Designing and Evaluating an Interprofessional Experiential Course Series Involving Medical and Pharmacy Students

Objective. To prepare first-year and second-year pharmacy and medical students to build effective collaborative health care teams by participating in an interprofessional experiential 6-semester course series. Design. An interprofessional experiential course series was designed using a variety of teaching methods to achieve both interprofessional and experiential learning outcomes. A standardized objective behavioral assessment was developed to measure team performance of interprofessional communication and teamwork. In addition, student perceptions were measured using a validated instrument. Assessment. A majority of teams demonstrated appropriate competence with respect to interprofessional communication and teamwork. Additionally, a majority of students expressed positive perceptions of interprofessional collaboration with respect to teamwork, roles and responsibilities, and patient outcomes. Conclusion. An interprofessional experiential course series can be successfully implemented to achieve both interprofessional and experiential learning outcomes. Highly collaborative teams and positive student perceptions provide evidence of achievement of interprofessional education learning outcomes.

Implications of incretin-based therapies on cardiovascular disease

BACKGROUND

Incretin-based therapies offer another treatment option for patients with type 2 diabetes. Agents that provide glycaemic control in addition to attenuating cardiovascular disease (CVD) risk factors are important for diabetes management. This review will focus on the off-target effects of incretin-based therapies on CVD risk factors [body weight, blood pressure (BP), lipid profile and albuminuria], major adverse cardiovascular events (MACE), heart failure (HF) and beta-cell preservation.

METHODS

A literature search was conducted to identify English-language publications for incretin-based therapies evaluating the following off-target end-points: body weight, BP, lipid profile, albuminuria, MACE, HF and beta-cell function. Randomised controlled trials (RCTs) were prioritised as the primary source of information.

RESULTS

Overall, incretin-based therapies have shown beneficial effects on CVD risk factors, and glucagon-like peptide 1 (GLP-1) receptor agonists appear to have a more pronounced effect compared with dipeptidyl peptidase-4 inhibitors. RCTs are being conducted to determine if these positive effects on CVD risk factors translate to a reduction in MACE. To date, these studies have not shown an increase in MACE. A signal of increased hospitalisations for HF was observed with saxagliptin, warranting continued evaluation and vigilance in high-risk patients. In addition, incretin-based therapies have shown positive effects on measures of beta-cell function supporting their durability in the management of diabetes.

CONCLUSIONS

Incretin-based therapies are an important treatment option for patients with type 2 diabetes, offering beneficial effects on CVD risk factors without increasing MACE.