The Trends of Attitude Change and Interprofessional Collaboration Competencies among Medical and Nursing Students of Iran University of Medical Sciences

Background

Nurses' and physicians' collaboration is a precedent for patient care. This study examined attitude change and interprofessional collaboration competencies among medical and nursing students of Iran University of Medical Sciences.

Methods

This study was quantitative cross-sectional. The study tools were two questionnaires, Attitudes Toward Interprofessional Education and IPEC Interprofessional Collaborative Competencies, which were completed by 211 medical and nursing students in online or in-person forms. The collected quantitative data were analyzed by SPSS 19 software.

Results

The results showed that nurses and physicians constituted 35.5% and 64.5% of the sample. The results of the independent T-test displayed no statistically significant difference in the mean age of both groups (P = 0.054). There was a statistically significant difference in the participants' attitudes toward interprofessional learning, and the medical group (46.68) obtained a higher mean score than the nurse group (34.92) (P = 0.001). The two groups with varying mean scores (179.34 for medical students and 131.72 for nursing students) were significantly different in their interpersonal collaboration competencies (P = 0.001). Considering Mauchly's test, there were statistically significant differences among medical students of varying academic years in their attitudes toward interprofessional education (P < 0.001). Nursing students were also different in their attitudes toward interprofessional education based on their academic years.

Conclusion

The results of this study showed that the attitude of nursing students towards interprofessional education and interpersonal collaboration competencies should be increased in line with medical students in order to improve the quality of medical and health services.

Australian chiropractic and osteopathic graduates' perceptions of readiness for transition to practice

OBJECTIVE

This is the second phase of a project. The aim was to explore Australian chiropractic and osteopathic new graduates' readiness for transition to practice concerning their clinical skills, professional behaviors, and interprofessional abilities. Phase 1 explored final year students' self-perceptions, and this part uncovered their opinions after 6 months or more in practice.

METHODS

Interviews were conducted with a self-selecting sample of phase 1 participant graduates from 2 Australian chiropractic and 2 osteopathic programs. Results of the thematic content analysis of responses were compared to the Australian Chiropractic Standards and Osteopathic Capabilities, the authority documents at the time of the study.

RESULTS

Interviews from graduates of 2 chiropractic courses (n = 6) and 2 osteopathic courses (n = 8) revealed that the majority had positive comments about their readiness for practice. Most were satisfied with their level of clinical skills, verbal communication skills, and manual therapy skills. Gaps in competence were identified in written communications such as case notes and referrals to enable interprofessional practice, understanding of professional behaviors, and business skills. These identified gaps suggest that these graduates are not fully cognizant of what it means to manage their business practices in a manner expected of a health professional.

CONCLUSION

This small study into clinical training for chiropractic and osteopathy suggests that graduates lack some necessary skills and that it is possible that the ideals and goals for clinical education, to prepare for the transition to practice, may not be fully realized or deliver all the desired prerequisites for graduate practice.

Communities of Practice in Acute and Forensic Psychiatry: Lessons Learned and Perceived Effects

In the Netherlands, two new approaches have been developed for acute and forensic psychiatry, called High and Intensive Care (HIC) and Forensic High and Intensive Care (FHIC). The models provide standards for temporary high-quality clinical care for patients in crisis and combine practices to reduce seclusion. To support the implementation of these approaches, Communities of Practice (CoPs) were created, including peer providers, mental health nurses, psychiatrists and managers. CoPs are increasingly used in healthcare. However, CoPs vary greatly in form and objective, and more insight is needed in the organisation and facilitation of CoPs. Therefore, the aim of this study is to gain insight into the lessons learned and perceived effects of the CoPs. A qualitative approach was used. Data were collected through focus groups (n = 3) with participants in the CoPs, feedback meetings with teams implementing HIC (n = 78) or FHIC (n = 23), and observations by the researchers. Data were analysed thematically. Lessons learned are: 1) create an ambassador role for CoP participants, 2) organize concrete activities, 3) take care of a multidisciplinary composition, and 4) foster shared responsibility and work on sustainability. Perceived effects of the CoPs were: 1) support of HIC and FHIC implementation, 2) creation of a national movement, and 3) further development of the HIC and FHIC approaches. The audits served as an important vehicle to activate the CoPs, and stimulated the implementation of HIC and FHIC. The findings may help others in creating a CoP when it comes to the implementation of best practices and improving healthcare.

Interprofessional education clinical placement program: a qualitative case study approach

The goal of health professional education programs is to produce competent graduates, with an ability to work collaboratively as effective healthcare team members. We explored the reflections of students and clinical facilitators, in response to participation in a structured interprofessional education (IPE) clinical placement program. In our qualitative study we used an exploratory case study design. In our analysis, we highlight the benefits of interprofessional practice. Key themes identified by students included: limited opportunities to engage in IPE across their course; lack of clarity around IPE; value of IPE for students, practitioners, and patient outcomes; and need for IPE opportunities to be integrated into placements. Key themes identified by the clinical facilitators included: being reminded of the value of IPE for students and patients; preparation for IPE placements need to be embedded in curricula; coordination and communication of IPE learning activities need to be clear for staff and students; and IPE should continue as part of the broader clinical education agenda. Our findings reinforce the notion that students and clinical facilitators value the importance of IPE for student learning within the clinical placement setting. The outcomes offer valuable insights for universities and hospital and health care contexts for setting up and implementing IPE activities, and we provide recommendations for improving ongoing IPE efforts within clinical placement setting.

Inter-professional practice in the prevention and management of child and adolescent self-harm: foster carers' and residential carers' negotiation of expertise and professional identity

Inter-professional collaboration remains a significant concern within healthcare and social care. However, there has been scant attention paid to practices at the interface of clinicians and carers, namely foster carers and residential carers. The present study considers child and adolescent self-harm management and prevention practices as a site of empirical interest due to reports that multi-agency teams are not effectively operating. Drawing upon a grounded theory approach, data were generated via semi-structured interviews and focus groups with residential carers (n = 15) and foster carers (n = 15) in Wales. Themes were developed through axial coding. The results present two central themes to explain the nature and perceived causes of inter-professional discord. First, there are clear contestations in expertise, with carers challenging clinicians' propositional knowledge in favour of their own experiential expertise. However, participants simultaneously endorse medical dominance, which contributes to their sense of disempowerment and marginalisation. Second, is the preclusion of carers' professional identity, primarily due to inadequate professionalisation procedures. Meanwhile, the privileging of their parenting role is perceived to support the perpetuation of courtesy stigma. Carers are then compelled to undertake the effortful labour of legitimisation. Together these thematic insights provide direction on mechanisms to improve inter-professional interactions, notably around training and accreditation.

The effects of an IPS-based IPE program on interprofessional socialization and dual identity development

The purpose of this study was to assess the effect of an interprofessional socialization (IPS) based interprofessional education (IPE) program intervention on health professions students' IPS process and dual identity development. Despite the growing acknowledgment of IPS in recent literature, there is a paucity of research investigating socialization processes learners move through in order to develop dual identity - professional and interprofessional. A concurrent embedded mixed-method design was used. One hundred and eight pre-licensure students from seven different health professions completed the IPS program intervention. Latent Growth Curve (LGC) modeling and thematic content analysis were used to analyze the quantitative and qualitative data, respectively. A significant and consistent growth rate in dual identity was found among the participants. The thematic analysis resulted in four emerging themes (uniprofessional education as a barrier, IPS program as an eye-opener, learning to collaborate, and collective unified team). The integrated findings provide support for the use of the interprofessional socialization framework.

The Interprofessional Clinical Experience: Introduction to Interprofessional Education Through Early Immersion in Health Care Teams

INTRODUCTION

The ability to collaborate as a member of interprofessional teams is essential for patient care and a core competency for students in health professions education. We developed a yearlong course, the Interprofessional Clinical Experience (ICE), to introduce first-year medical students to team-based aspects of the health care environment and provide them with a foundation upon which later experiences can grow.

METHODS

The course uses experiential learning and critical reflection through reflective writing to orient students to working with care teams. Students receive assessments from faculty and various health care professionals. The course requires students to describe the roles and responsibilities of a variety of health care professionals, utilize effective communication with other health professionals on health care teams, demonstrate the ability to work on an interprofessional team, and examine their own and others' perspectives by engaging in self-directed learning and reflective practice.

RESULTS

Annual course evaluations revealed that the majority of students agreed or strongly agreed that ICE contributed to their understanding of the health care team's roles and improved their ability to communicate with health care professionals, their understanding of health care systems, and their ability to work on an interprofessional team. The course also provides curricular content for the newly implemented Liaison Committee for Medical Education's accreditation requirement on interprofessional collaborative skills.

DISCUSSION

The first implementation of this resource demonstrated that students met the educational objectives of the ICE and gained a better sense of the health care system and teams.