Interdisciplinary Education and Health Care in Geriatric Dental Medicine

Geriatric patients are more likely to have multiple medical comorbidities, physical limitations, and mental impairments that warrant careful consideration while providing patient care. Dentistry, along with other health care professional programs, incorporate interprofessional education (IPE) experiences to provide students with skills they need to deliver collaborative care in their future practice. Health professional programs should consider geriatric training in simulated learning environments, adult day programs, nursing homes, long-term care facilities, and home care experiences to provide students valuable IPE experiences. Lastly, this article presents a call to action for professional organizations to consider offering continuing education courses in IPE.

Evaluating an interprofessional pharmacy and dental hygiene case-based learning activity with student reflections

BACKGROUND AND PURPOSE

Interprofessional collaboration between dentistry and pharmacy has great value but is often lacking in didactic and experiential education, particularly in dental hygiene programs.

EDUCATIONAL ACTIVITY AND SETTING

A case-based interprofessional assignment was implemented into the dental hygiene curriculum. Students reflected on their experiences and completed the International Collaborative Competencies Attainment Survey (ICCAS) to assess changes in self-reported interprofessional competencies following the activity.

FINDINGS

Reflections revealed knowledge gain themes, with medication-related oral health concerns most frequent (53), followed by systemic adverse effects of medications (31), impact of systemic health on oral health (21), drug-drug interactions (17), and drug information (2). Additionally, students identified both future plans to collaborate with a pharmacist (25) and application of clinical knowledge gained (25). Scores from the ICCAS increased significantly in most of the domain statements following the interprofessional activity.

DISCUSSION

This interprofessional education (IPE) activity increased student knowledge of the pharmacy profession and provided an experience with interprofessional communication. Students identified the impact of medications on oral health, as well as the value of interprofessional collaboration and communication.

SUMMARY

This IPE activity positively impacted student perceptions of interprofessional collaboration with pharmacists.

Teaching the Nutrition Focused Physical Exam (NFPE) To Medical Students Using an Interdisciplinary Approach

Nutritional status greatly affects the health of patients, yet the time devoted to nutrition curriculum in medical school is minimal. We implemented a novel approach of teaching the Nutrition Focused Physical Exam (NFPE) as a tool to demonstrate the importance of assessing the nutritional status of patients and learning about malnutrition and nutrient deficiencies.

Interprofessional educators' competencies, assessment, and training - IPEcat: protocol of a global consensus study

Contemporary practice in interprofessional education (IPE) has evolved predominantly focusing on the competencies for interprofessional collaboration (IPC) that learners must acquire. Competencies that educators need to successfully deliver IPC have been overlooked. This lack of attention is further confounded by a field replete with inconsistent terminology and standards and no global consensus on the core competencies needed for IPE facilitation. There are no globally accepted tools to assess interprofessional educators' competencies nor are there established training programmes that might be used as the basis for a collective global approach to these issues. The International Working Group for Interprofessional Educators Competencies, Assessment, and Training (IWG_IPEcat) seeks to address this gap using a sequential mixed-method approach, to deliver globally developed, empirically derived tools to foster IPE educator competencies. This article presents the protocol of the research project.

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.

Interdisciplinary Education and Health Care in Geriatric Dental Medicine

Geriatric patients are more likely to have multiple medical comorbidities, physical limitations, and mental impairments that warrant careful consideration while providing patient care. Dentistry, along with other health care professional programs, incorporate interprofessional education (IPE) experiences to provide students with skills they need to deliver collaborative care in their future practice. Health professional programs should consider geriatric training in simulated learning environments, adult day programs, nursing homes, long-term care facilities, and home care experiences to provide students valuable IPE experiences. Lastly, this article presents a call to action for professional organizations to consider offering continuing education courses in IPE.

Large-group, asynchronous, interprofessional simulation: Identifying roles and improving communication with student pharmacists and student nurses

BACKGROUND

Accreditation standards for health professions training programs continue to require interprofessional education (IPE) activities. Therefore, it is important for faculty collaboration to satisfy these requirements and provide meaningful, mutually beneficial opportunities for students to participate and learn. The medication use process is an integral component of nursing and pharmacy education. When feasible, asynchronous IPE activities that promote medication administration safety and facilitate equal contribution from involved students should be introduced into respective curricula.

INTERPROFESSIONAL EDUCATIONAL ACTIVITY

This study employed a retrospective, pretest-posttest design to measure confidence, satisfaction, and communication. The asynchronous simulation included first-year (junior) student nurses (n = 126) and first year (P1) student pharmacists (n = 152). The simulation focused on the role-related knowledge, skills, and attitudes required to accurately call-in, retrieve, and fill a prescription. Details regarding design, setting, participants, facilitation of the simulation, and barriers overcome are described.

DISCUSSION

Descriptive statistics are provided for satisfaction and confidence, with changes in confidence analyzed using binomial probability confidence intervals. This IPE simulation was an efficient and effective model for introducing students to the specific activity of communicating prescriptions among key members of the interprofessional team.

IMPLICATIONS

Students reported increased confidence and satisfaction with this activity, which supports future iterations of the asynchronous simulation.

An interprofessional cohort analysis of student interest in medical ethics education: a survey-based quantitative study

Background

There is continued need for enhanced medical ethics education across the United States. In an effort to guide medical ethics education reform, we report the first interprofessional survey of a cohort of graduate medical, nursing and allied health professional students that examined perceived student need for more formalized medical ethics education and assessed preferences for teaching methods in a graduate level medical ethics curriculum.

Methods

In January 2018, following the successful implementation of a peer-led, grassroots medical ethics curriculum, student leaders under faculty guidance conducted a cross-sectional survey with 562 of 1357 responses received (41% overall response rate) among students enrolled in the School of Medicine, College of Nursing, Doctor of Physical Therapy and BS/(D) MD Professional Scholars programs at The Medical College of Georgia at Augusta University. An in person or web-based questionnaire was designed to measure perceived need for a more in-depth medical ethics curriculum.

Results

The majority of respondents were female (333, 59.3%), white (326, 58.0%) and mid-20s in age (340, 60.5%). Almost half of respondents (47%) reported no prior medical ethics exposure or training in their previous educational experience, while 60% of students across all degree programs reported an interest in more medical ethics education and 92% noted that an understanding of medical ethics was important to their future career. Over a quarter of students (28%) were interested in pursuing graduate-level training in medical ethics, with case-based discussions, small group peer settings and ethics guest lectures being the most desired teaching methods.

Conclusions

The future physician, nursing and physical therapist workforce in our medical community demonstrated an unmet need and strong interest for more formal medical ethics education within their current coursework. Grassroots student-driven curricular development and leadership in medical ethics can positively impact medical education. Subsequent integration of interprofessional training in medical ethics may serve as a vital curricular approach to improving the training of ethically competent healthcare professionals and overcoming the current hierarchical clinical silos.

Enhancing pre-licenced pharmacists' communication and interprofessional collaboration utilizing the RIPE model of interprofessional learning: A qualitative study

BACKGROUND

Interacting and engaging with other health care professionals can enhance communication and collaboration within the multidisciplinary healthcare team, contributing to improved patient safety and patient outcomes.

OBJECTIVE

To explore the student learning experience utilizing the Reflective Interprofessional Education Model (RIPE) model of interprofessional learning.

METHODS

Qualitative study utilizing data from seven (7) focus groups sessions. Data were transcribed verbatim using a transcribing service; and analyzed using Braun and Clarke's 6-phase process for thematic analysis.

RESULTS

Fifty-five Master of Pharmacy pre-licenced students (male n = 25; female: n = 30) participated in the study. The 7 focus groups consisted of 6-8 participants ranging between 18 and 28 min in duration. Thematic analysis generated four key themes: (i) Time management: managing interruptions in a time pressured acute care environment is challenging but necessary; (ii) Learning the Lingo: patient-centered communicating and engaging patients and family in care; (iii) Communication: developing interprofessional communication as a vital skill for healthcare professionals; and (iv) Teamwork: recognizing the importance of teamwork, relationships and respect.

CONCLUSIONS

Students found the simulated, acute care setting challenging for effective communication and collaboration with other health professional team members. It was also perceived that critical patient information can be lost or misinterpreted if there is poor interprofessional communication and collaboration, contributing to iatrogenesis and poor patient outcomes. Effective collaboration was perceived to be beneficial to enhancing confidence with engagement and communication, appreciation and respect for the expertise of other healthcare professions.

"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.

Development and evaluation of a primary care interprofessional education intervention to support people with dementia

International policy documents emphasize the need to develop interprofessional education (IPE) to support collaborative dementia care in the community. The aim of this short report is to describe the development and pilot evaluation of an interprofessional dementia education workshop for primary care healthcare professionals. A three-hour workshop was iteratively developed through consultation with an expert reference group and people with dementia. The workshop was piloted with three separate primary care teams. A total of fifty-four primary care based healthcare staff who represented fourteen different health care roles in primary care participated in the pilot evaluation. The pilot workshops were evaluated using a mixed method approach which included post-workshop questionnaires for participants (n= 54)and a post-workshop focus group (n=8) with the program design team and workshop facilitators. The results of the pilot phase indicated that the workshop was useful and feasible. The workshop improved participants' self-reported knowledge, understanding and confidence to support people with dementia and their families.Areas for improvement were identified and will be used to inform improvements to the workshop content and delivery in advance of a national roll-out. Future evaluations of the implementation of this interprofessional educational workshop will focus on its impact on healthcare professional behavior and outcomes for the person with dementia and their families.

Interprofessional education through a telehealth team based learning exercise focused on pharmacogenomics

BACKGROUND

Traditional interprofessional educational (IPE) exercises are those where learning exists "about, from, and with" trainees in two or more professions in order to prepare health sciences professionals to work on interprofessional teams. One emerging difficulty with IPE is the paucity of health profession students at single institutions, and the geographic and financial constraints of multi-institutional collaboration.

INTERPROFESSIONAL EDUCATION ACTIVITY

To circumvent these barriers, we developed a multi-institution telehealth team-based learning (TBL) event between medical and pharmacy students on the topic of pharmacogenomics (PGx). Using a validated pre-post survey design, student attitudes and perceptions were measured before and after an educational intervention designed to simulate interprofessional telehealth collaboration. The survey results showed significant improvement across all areas of student attitudes toward interprofessional collaboration. Also, medical student PGx confidence increased substantially during the exercise even though the only PGx instruction they received was from pharmacy students.

DISCUSSION

These data demonstrate that learning exists "about, from, and with" trainees in other professions, even if they do not physically train in the same location. Free tools are available to create virtual interactions between students on different campuses, and telehealth exercises using these tools are a valid way to conduct IPE across different campuses. The instructional experience does not need to be identical for all participants in the IPE event; rather, tailoring the educational experience to each group of students provides opportunities for inter-student teaching.

Understanding students' readiness for interprofessional learning in an Asian context: a mixed-methods study

BACKGROUND

Healthcare is generally provided by various health professionals acting together. Unfortunately, poor communication and collaboration within such healthcare teams often prevent its members from actively engaging in collaborative decision-making. Interprofessional education (IPE) which prepares health professionals for their collaborative role in the healthcare system may partially address this problem. This study aimed to investigate: 1) students' readiness for IPE in an Asian context, 2) the most important factors influencing students' perceptions of IPE, 3) the reasons underlying such perceptions, and 4) the factors mitigating or promoting their sense of readiness.

METHODS

To identify students' perceptions of IPE, we administered the Readiness for Interprofessional Learning Scale (RIPLS) to 398 in approximately 470 students from a range of health professions (medicine, nursing, midwifery and dentistry). The questionnaire included factors that could potentially influence readiness for IPE as found in the literature (GPA, etc.). To enhance our understanding of the responses to the RIPLS and to explore the reasons underlying them, we conducted 4 mono-professional focus group discussions (FGDs). We ran a statistical analysis on the quantitative data, while performing a thematic content analysis of the qualitative data using ATLAS.ti (version 7).

RESULTS

Medical students seemed to be the most prepared for IPE. Students' perceptions of IPE were conditioned by the study programme they took, their GPA, intrinsic motivation and engagement in the student council connoting experience of working with students from different programmes. Focus groups further revealed that: 1) early exposure to clinical practice triggered both positive and negative perceptions of IPE and of its importance to learning communication and leadership skills, 2) medical students caused insecurity and disengagement in other students, 3) medical students felt pressured to be leaders, and 4) there was a need to clarify and understand each other's profession and the boundaries of one's own profession.

CONCLUSION

Students were generally favourable to IPE, appreciating the opportunity it offered them to hone their interprofessional leadership, collaboration and communication skills and to learn to address the problem of role blurring. Hence, we judge the Asian context ready to implement IPE, allowing health professions students in Asian countries to reap its benefits. The present study revealed several important reasons underlying students' positive and negative perceptions of IPE implementation which may be addressed during the interprofessional learning process.

Perceived benefits and challenges of interprofessional education based on a multidisciplinary faculty member survey

OBJECTIVE

To identify differences among faculty members in various health professional training programs in perceived benefits and challenges of implementing interprofessional education (IPE).

METHODS

A 19-item survey using a 5-point Likert scale was administered to faculty members across different health disciplines at a west coast, multicollege university with osteopathic medicine, pharmacy, and physician assistant programs.

RESULTS

Sixty-two of 103 surveys (60.2%) were included in the study. Faculty members generally agreed that there were benefits of IPE on patient outcomes and that implementing IPE was feasible. However, group differences existed in belief that IPE improves care efficiency (p=0.001) and promotes team-based learning (p=0.001). Program divergence was also seen in frequency of stressing importance of IPE (p=0.009), preference for more IPE opportunities (p=0.041), and support (p=0.002) within respective college for IPE.

CONCLUSIONS

Despite consensus among faculty members from 3 disciplines that IPE is invaluable to their curricula and training of health care students, important program level differences existed that would likely need to be addressed in advance IPE initiatives.