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Vaughan B, Moore K, Macfarlane C, Grace S. Australian osteopathic students' perceptions of interprofessional relationships. INT J OSTEOPATH MED 2017. [DOI: 10.1016/j.ijosm.2016.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Vyt A. Development and validation of a questionnaire to self-assess the quality of interprofessional team meetings in primary and community healthcare. J Interprof Care 2017; 31:140-146. [DOI: 10.1080/13561820.2016.1269058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Andre Vyt
- Faculty of Medicine and Health Sciences, Ghent University and Artevelde University College Ghent, Ghent, Belgium
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Sheridan J, Adams P, Bullen C, Newcombe D. An evaluation of a harm reduction Summer School for undergraduate health professional students. DRUGS-EDUCATION PREVENTION AND POLICY 2017. [DOI: 10.1080/09687637.2016.1262824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Janie Sheridan
- Faculty of Medical and Health Sciences, Centre for Addiction Research,
- School of Pharmacy, Faculty of Medical and Health Sciences,
| | - Peter Adams
- Faculty of Medical and Health Sciences, Centre for Addiction Research,
- School of Population Health, Faculty of Medical and Health Sciences, and
| | - Chris Bullen
- Faculty of Medical and Health Sciences, Centre for Addiction Research,
- National Institute for Health Innovation, Faculty of Medical and Health Sciences, the University of Auckland, Auckland, New Zealand
| | - David Newcombe
- Faculty of Medical and Health Sciences, Centre for Addiction Research,
- School of Population Health, Faculty of Medical and Health Sciences, and
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Welsch LA, Rutledge C, Hoch JM. The Modified Readiness for Interprofessional Learning Scale in Currently Practicing Athletic Trainers. ACTA ACUST UNITED AC 2017. [DOI: 10.4085/120110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Context:
Athletic trainers are encouraged to work collaboratively with other health care professionals to improve patient outcomes. Interprofessional education (IPE) experiences for practicing clinicians should be developed to improve interprofessional collaborative practice postcertification. An outcome measure, such as the modified Readiness for Interprofessional Learning Scale (mRIPLS), could be used to determine the clinician's attitudes toward IPE and to determine the effectiveness of the experience.
Objective:
To determine select psychometric properties of the mRIPLS in practicing athletic trainers.
Design:
Cross-sectional.
Setting:
Online survey.
Patients or Other Participants:
A survey was sent to 2000 randomly selected practicing athletic trainers. A total of 173 (8.7%) participated, and complete data were available for 145 (7.3%).
Intervention(s):
The survey consisted of a demographic section and the mRIPLS. The mRIPLS consists of 23 statements scored on a 5-point Likert scale divided into 3 subscales: teamwork and collaboration (TWC), patient-centeredness (PC), and sense of professional identity (PI).
Main Outcome Measure(s):
Cronbach α was used to examine the internal consistency. The presence of a ceiling effect (>50% respondents selected the highest score) was determined for each question by examining means and percentages.
Results:
The overall internal consistency of the mRIPLS was acceptable (α = 0.872) along with the TWC (α = 0.917) and PC (α = 0.862) subscales. The PI subscale (α = 0.632) was not acceptable. A ceiling effect was identified for 10 questions, and ≥70% of respondents selected highly agree or agree for 22 questions.
Conclusions:
While the mRIPLS demonstrated overall acceptable internal consistency, all 3 subscales did not. In addition, the presence of a ceiling effect makes the use of this instrument as an outcome measure trivial. Therefore, the current version of the mRIPLS may not be the best outcome to assess openness for IPE or to measure the effectiveness of IPE experiences in practicing athletic trainers.
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Woermann U, Weltsch L, Kunz A, Stricker D, Guttormsen S. Attitude towards and Readiness for Interprofessional Education in Medical and Nursing Students of Bern. GMS JOURNAL FOR MEDICAL EDUCATION 2016; 33:Doc73. [PMID: 27990469 PMCID: PMC5135421 DOI: 10.3205/zma001072] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 04/11/2016] [Accepted: 08/16/2016] [Indexed: 05/30/2023]
Abstract
Objectives: Interprofessional collaboration is becoming increasingly important in health care for various reasons. Interprofessional Education (IPE) can provide a basis for this. The aim of our study was to find out how medical (MS) and nursing students (NS) think about their own and other professions, what they know about each other, how strong their willingness to embrace IPE is, and what forms of IPE they deem useful. Methodology: Seven IPE experts rated the two measuring instruments, Readiness for Interprofessional Learning Scale RIPLS, and Interdisciplinary Education Perception Scale IEPS in terms of relevance of the items, and the quality of translation into German. Nine RIPLS items and 13 IEPS items were considered content-valid. All MS of the University of Bern and NS of the two Bernese educational institutions for nursing were invited to the online survey in the fall of 2014 by email. Results: 498 (254 MS, 244 NS) of the 2374 invited students completely filled in the questionnaire (21%). The results of the reduced RIPLS allowed no conclusive statements. When assessing their own occupational group in the IEPS, the MS attributed "competence and autonomy" to themselves significantly more frequently, while to the NS, the same was true for the item, "actual cooperation". MS know significantly less about the training of other health professionals. NS show a significantly higher willingness to embrace IPE. Teaching ethics, communication, team training, and clinical skills are deemed suitable for IPE by both groups. From the comments it appears that in both groups a majority welcomes IPE; however, the various arguments had different prevalence in both groups. Both groups fear that IPE leads to heightened stress during the study. A subgroup of MS fears a lowering of academic level. Conclusion: The results of this survey of Bernese MS and NS concerning IPE provide important information for the planning and implementation of IPE. Important steps in the introduction of IPE will be a clear justification and the definition of its objectives. These must be explicitly communicated to all students.
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Affiliation(s)
- Ulrich Woermann
- University of Bern, Institute for Medical Education IML, Education and Media Unit AUM, Bern, Switzerland
| | | | - Alexandra Kunz
- University of Bern, Institute for Psychology, Bern, Switzerland
| | - Daniel Stricker
- University of Bern, Institute for Medical Education IML, Bern, Switzerland
| | - Sissel Guttormsen
- University of Bern, Institute for Medical Education IML, Bern, Switzerland
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Beck Dallaghan GL, Lyden E, Meza J, Stoddard H, Bevil C, Collier D, Winnicki M, Nickol D. The Nebraska interprofessional education attitudes scale: A new instrument for assessing the attitudes of health professions students. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.xjep.2016.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Irons B, Evans L, Bogschutz R, Panasci K, Sun G. Utilising Medicare annual wellness visits to implement interprofessional education in the primary care setting. J Interprof Care 2016; 30:529-31. [DOI: 10.3109/13561820.2016.1152235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Bode SFN, Giesler M, Heinzmann A, Krüger M, Straub C. Self-perceived attitudes toward interprofessional collaboration and interprofessional education among different health care professionals in pediatrics. GMS JOURNAL FOR MEDICAL EDUCATION 2016; 33:Doc17. [PMID: 27280128 PMCID: PMC4895846 DOI: 10.3205/zma001016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 02/22/2016] [Accepted: 03/10/2016] [Indexed: 05/25/2023]
Abstract
Interprofessional education (IPE) is the basis for interprofessional collaboration (IPC) in health care systems. It has beneficial effects for both patients and health care professionals. IPC is paramount for adequate care of patients and their families, especially in pediatrics. To determine the attitudes of medical doctors (n=121), nurses (n=15), psychologists (n=14), and social workers (n=19) toward IPE and IPC in a tertiary pediatric university teaching hospital, as well as the inpatient and outpatient settings in pediatrics, we developed a questionnaire with 21 items in four categories based on established questionnaires. All participants worked as part of interprofessional teams, and the overwhelming majority valued IPC highly. Most competencies important for IPC were acquired on the job. There was a substantial lack of interprofessional education, especially for medical doctors and psychologists. IPE still needs to be established as part of the undergraduate curriculum at German universities.
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Affiliation(s)
| | - Marianne Giesler
- University Hospital Freiburg, Competency Centre for Evaluation in Medicine, Baden-Württemberg, Freiburg, Germany
| | - Andrea Heinzmann
- University Hospital Freiburg, Center for Pediatrics and Adolescent Medicine, Freiburg, Germany
| | - Marcus Krüger
- University Hospital Freiburg, Center for Pediatrics and Adolescent Medicine, Freiburg, Germany
| | - Christine Straub
- University Hospital Freiburg, Center for Pediatrics and Adolescent Medicine, Freiburg, Germany
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Hallam KT, Livesay K, Morda R, Sharples J, Jones A, de Courten M. Do commencing nursing and paramedicine students differ in interprofessional learning and practice attitudes: evaluating course, socio-demographic and individual personality effects. BMC MEDICAL EDUCATION 2016; 16:80. [PMID: 26940858 PMCID: PMC4778286 DOI: 10.1186/s12909-016-0605-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 02/24/2016] [Indexed: 05/25/2023]
Abstract
BACKGROUND Interprofessional education (IPE) requires health students to learn with, from and about each other in order to develop a modern workforce with client-centred care at its core. Despite the client centred focus of IPE, training programs often utilize standard approaches across student cohorts without consideration of discipline, sociodemographic and personality variability that attract students to different health disciplines. Knowing the students who engage in IPE to tailor training may prove as beneficial as knowing the client to delivered individualized client centred care in interprofessional practice (IPP). This research investigates whether students commencing undergraduate nursing and paramedicine degrees ener training with existing demographic and personality differences and, if these are associated with different attitudes towards health care teams and interprofessional education. METHOD This online study recruited 160 nursing and 50 paramedicine students in their first week of their undergraduate course. Students completed questionnaires regarding their background, personality (General Perceived Self Esteem Scale, International Mini Markers) and the attitudes towards health care teams scale (ATHCTS) and interprofessional education perception scale (IEPS). RESULTS Results show that commencing nursing and paramedicine students are demographically different on education, gender, speaking a language other than English at home (LOTE) and their own experience with healthcare. The results further demonstrate that LOTE, discipline being studied and personality factors play a role in perceptions regarding interprofessional training whilst discipline being studied impacted on attitudes towards health care teams in the workforce. CONCLUSION These results highlight a number of existing personal and psychological differences between individuals who choose to train in these selected professions. This suggests a need for tertiary education IPE programs to move towards tailoring their education to value this student diversity in the same client centred manner that students are asked to develop clinically.
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Affiliation(s)
- Karen T Hallam
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, PO Box 14428, Melbourne, Victoria, 8001, Australia.
| | - Karen Livesay
- Interprofessional Education and Practice Program, Victoria University, PO Box 14428, Melbourne, Victoria, 8001, Australia.
- Discipline of Nursing, College of Health and Biomedicine, Victoria University, PO Box 14428, Melbourne, Victoria, 8001, Australia.
| | - Romana Morda
- Discipline of Psychology, College of Arts, Victoria University, PO Box 14428, Melbourne, Victoria, 8001, Australia.
| | - Jenny Sharples
- Discipline of Psychology, College of Arts, Victoria University, PO Box 14428, Melbourne, Victoria, 8001, Australia.
| | - Andi Jones
- Victoria University Interprofessional Clinic, Victoria University, PO Box 14428, Melbourne, Victoria, 8001, Australia.
| | - Maximilian de Courten
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, PO Box 14428, Melbourne, Victoria, 8001, Australia.
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62
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Gustafsson L, Hutchinson L, Theodoros D, Williams K, Copley A, Fagan A, Desha L. Healthcare students’ experiences of an interprofessional, student-led neuro-rehabilitation community-based clinic. J Interprof Care 2016; 30:259-61. [DOI: 10.3109/13561820.2015.1086730] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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63
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Nørgaard B, Draborg E, Sørensen J. Adaptation and reliability of the Readiness for Inter professional Learning Scale in a Danish student and health professional setting. BMC MEDICAL EDUCATION 2016; 16:60. [PMID: 26879933 PMCID: PMC4754854 DOI: 10.1186/s12909-016-0591-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 02/06/2016] [Indexed: 05/04/2023]
Abstract
BACKGROUND Shared learning activities aim to enhance the collaborative skills of health students and professionals in relation to both colleagues and patients. The Readiness for Interprofessional Learning Scale is used to assess such skills. The aim of this study was to validate a Danish four-subscale version of the RIPLS in a sample of 370 health-care students and 200 health professionals. METHODS The questionnaire was translated following a two-step process, including forward and backward translations, and a pilot test. A test of internal consistency and a test-retest of reliability were performed using a web-based questionnaire. RESULTS The questionnaire was completed by 370 health care students and 200 health professionals (test) whereas the retest was completed by 203 health professionals. A full data set of first-time responses was generated from the 570 students and professionals at baseline (test). Good internal association was found between items in Positive Professional Identity (Q13-Q16), with factor loadings between 0.61 and 0.72. The confirmatory factor analyses revealed 11 items with factor loadings above 0.50, 18 below 0.50, and no items below 0.20. Weighted kappa values were between 0.20 and 0.40, 16 items with values between 0.40 and 0.60, and six items between 0.60 and 0.80; all showing p-values below 0.001. CONCLUSION Strong internal consistency was found for both populations. The Danish RIPLS proved a stable and reliable instrument for the Teamwork and Collaboration, Negative Professional Identity, and Positive Professional Identity subscales, while the Roles and Responsibility subscale showed some limitations. The reason behind these limitations is unclear.
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Affiliation(s)
- Birgitte Nørgaard
- Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9B, 5000, Odense C, Denmark.
| | - Eva Draborg
- Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9B, 5000, Odense C, Denmark.
| | - Jan Sørensen
- Institute of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9B, 5000, Odense C, Denmark.
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Stull CL, Blue CM. Examining the influence of professional identity formation on the attitudes of students towards interprofessional collaboration. J Interprof Care 2016; 30:90-6. [DOI: 10.3109/13561820.2015.1066318] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Cynthia L. Stull
- Primary Dental Care, Division of Dental Hygiene, University of Minnesota, Minneapolis, Minnesota, USA
| | - Christine M. Blue
- Primary Dental Care, Division of Dental Hygiene, University of Minnesota, Minneapolis, Minnesota, USA
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Williams B, Teese D. A cross-institutional analysis of Australian undergraduate paramedic students’ attitudes towards interprofessional collaboration. J Interprof Care 2016; 30:97-102. [DOI: 10.3109/13561820.2015.1070132] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Brett Williams
- Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, Victoria, Australia
| | - Drew Teese
- Department of Community Emergency Health and Paramedic Practice, Monash University, Frankston, Victoria, Australia
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S. Tsang E, C. Cheung C, Sakakibara T. Perceptions of interprofessionalism in health professional students participating in a novel community service initiative. J Interprof Care 2016; 30:132-4. [DOI: 10.3109/13561820.2015.1055717] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Erica S. Tsang
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christopher C. Cheung
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Todd Sakakibara
- Department of Family Practice, Three Bridges Clinic, University of British Columbia, Vancouver, British Columbia, Canada
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Wershofen B, Heitzmann N, Beltermann E, Fischer MR. Fostering interprofessional communication through case discussions and simulated ward rounds in nursing and medical education: A pilot project. GMS JOURNAL FOR MEDICAL EDUCATION 2016; 33:Doc28. [PMID: 27280139 PMCID: PMC4895862 DOI: 10.3205/zma001027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 01/08/2016] [Accepted: 02/09/2016] [Indexed: 05/13/2023]
Abstract
BACKGROUND Poor communication between physicians and nursing staff could result in inadequate interprofessional collaboration with negative effects on patient health. In order to ensure optimal health care for patients, it is important to strengthen interprofessional communication and collaboration between physicians and nurses during their education. AIM The aim of this project is to foster communication for medical and nursing students through interprofessional case discussions and simulated ward rounds as a form of training. METHOD In 2013-15 a total of 39 nursing students and 22 medical students participated in eight seminars, each covering case discussions and simulated ward rounds. The seminar was evaluated based on student assessment of the educational objectives. RESULTS Students who voluntarily signed up for the seminar profited from the interprofessional interaction and gathered positive experiences working in a team. CONCLUSION Through practicing case discussions and ward rounds as a group, interprofessional communication could be fostered between medical and nursing students. Students took advantage of the opportunity to ask those from other profession questions and realized that interprofessional interaction can lead to improved health care.
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Affiliation(s)
- Birgit Wershofen
- Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Germany
- *To whom correspondence should be addressed: Birgit Wershofen, Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, Ziemssenstraße 1, D-80336 München, Germany, Phone: +49 (0)89/4400-57207, Fax: +49 (0)89/4400-57202, E-mail:
| | - Nicole Heitzmann
- Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Germany
| | - Esther Beltermann
- Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Germany
| | - Martin R. Fischer
- Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Germany
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Lui JK, Philbin M, Lau S, Philip PA, Yazdani M, Hatem D. Interprofessionalism between physicians and nurses: Moving forward. Int J Nurs Stud 2015; 52:1785-8. [DOI: 10.1016/j.ijnurstu.2015.09.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 09/13/2015] [Accepted: 09/15/2015] [Indexed: 10/23/2022]
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Byakika-Kibwika P, Kutesa A, Baingana R, Muhumuza C, Kitutu FE, Mwesigwa C, Chalo RN, Sewankambo NK. A situation analysis of inter-professional education and practice for ethics and professionalism training at Makerere University College of Health Sciences. BMC Res Notes 2015; 8:598. [PMID: 26498749 PMCID: PMC4619574 DOI: 10.1186/s13104-015-1577-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 10/14/2015] [Indexed: 11/10/2022] Open
Abstract
Background Students at Makerere University College of Health Sciences (MakCHS) are introduced to ethics and professionalism using the inter-professional education (IPE) model. Ethics and professionalism should be running themes throughout succeeding years of study during which students are expected to develop qualities and skills for future inter-professional practice (IPP). We performed a situation analysis of IPE and IPP among students and teaching health professionals at MakCHS to guide development of a relevant training curriculum of ethics and professionalism. Methods A cross sectional study with quantitative and qualitative methods which included questionnaires, focus group discussions and key informant interviews. Results We interviewed 236 undergraduate students (148, 63 % male) and 32 teaching health professionals (25, 78 % male). Two hundred fifteen (91 %) students indicated they had joint learning activities with students of other professions and 166 (70 %) stated there was benefit in having an IPE model training curriculum. Most students (140, 59 %) strongly agreed that learning with other students will make them more effective members of the health team. Whereas the respondents reported inter professionalism as being well articulated in their course curricula, more than half said IPE is only implemented in the pre-clinical years of study. They noted that IPE and IPP concepts were not well programmed, health professionals engaged in teaching had poor attitudes towards IPE and IPP, there were limited numbers of skilled health care workers to implement IPP and there was poor communication between students and teaching health professionals. Majority of teaching health professionals noted challenges in implementation of IPE such as poor coordination and large student population and major factors influencing ethics and professionalism in healthcare such as limited government support, low pay for the health care workers, disrespect and lack of appreciation of the health workers by the public. Conclusions Our findings demonstrate that IPE, IPP, ethics and professionalism are not emphasized in the clinical years of study at MakCHS. We recommend increased sensitization on the concepts of IPE and IPP plus enhanced mentorship for both students and teaching health professionals. Innovative strategies of implementation of IPE and IPP for training in ethics and professionalism must be introduced.
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Affiliation(s)
- Pauline Byakika-Kibwika
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
| | - Annet Kutesa
- School of Health Sciences, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Rhona Baingana
- School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Christine Muhumuza
- School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Freddy Eric Kitutu
- School of Health Sciences, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Catherine Mwesigwa
- School of Health Sciences, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Rose Nabirye Chalo
- School of Health Sciences, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Nelson K Sewankambo
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
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Zanotti R, Sartor G, Canova C. Effectiveness of interprofessional education by on-field training for medical students, with a pre-post design. BMC MEDICAL EDUCATION 2015; 15:121. [PMID: 26220412 PMCID: PMC4518727 DOI: 10.1186/s12909-015-0409-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 07/07/2015] [Indexed: 05/20/2023]
Abstract
BACKGROUND Interprofessional Education (IPE) implies how to achieve successful teamwork, and is based on collaborative practice which enhance occasions for relationships between two or more healthcare professions. This study evaluates the effectiveness of IPE in changing attitudes after a training recently introduced to medical education for second-year students at the University of Padova, Italy. METHODS All medical students following a new program for IPE were enrolled in this study. The Interdisciplinary Education Perception Scale (IEPS) was administered before and after training, according to observation-based and practice-based learning. Data were analysed with Student's paired t-test and Wilcoxon's signed rank test. RESULTS 277 medical students completed both questionnaires. Statistically significant improvements were found in students' overall attitudes as measured by the IEPS and four subscale scores. Gender-stratified analyses showed that improvements were observed only in female students in subscale 4 ("Understanding Others' Values"). Students who had a physician and/or health worker in their family did not show any improvement in subscales 2 ("Perceived need for cooperation") or 4 ("Understanding Others' Values"). CONCLUSIONS Our results indicate that IPE training has a positive influence on students' understanding of collaboration and better attitudes in interprofessional teamwork. More research is needed to explore other factors which may influence specific perceptions among medical students.
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Affiliation(s)
- Renzo Zanotti
- Department of Molecular Medicine, University of Padova, Via Loredan 18, 35131, Padova, Italy.
| | - Giada Sartor
- Department of Pediatrics, Hospital of Treviso, PiazzaleOspedale 1, 31100, Treviso, Italy.
| | - Cristina Canova
- Department of Molecular Medicine, University of Padova, Via Loredan 18, 35131, Padova, Italy.
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Abstract
BACKGROUND Interprofessional collaboration is key to quality outcomes in the health-care systems of today. Simulation is a common tool in podiatric medical education, and interprofessional education has become more common in podiatric medicine programs. Interprofessional simulation is the blending of these educational strategies. METHODS A quantitative design was used to determine the impact of an isolated interprofessional podiatric surgical simulation between nurse anesthesia and podiatric medical students. RESULTS Statistically significant differences were observed among participants between preintervention and postintervention surveys using the revised Interdisciplinary Education Perception Scale. CONCLUSIONS Interprofessional simulation can be an effective educational opportunity for podiatric medical and nurse anesthesia students.
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Affiliation(s)
| | - Donald Curtis
- Arizona School of Podiatric Medicine, College of Health Sciences, Midwestern University, Glendale, AZ
| | - Jeffrey C. Page
- Arizona School of Podiatric Medicine, College of Health Sciences, Midwestern University, Glendale, AZ
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Fernandes AR, Palombella A, Salfi J, Wainman B. Dissecting through barriers: A mixed-methods study on the effect of interprofessional education in a dissection course with healthcare professional students. ANATOMICAL SCIENCES EDUCATION 2015; 8:305-16. [PMID: 25641912 DOI: 10.1002/ase.1517] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 12/12/2014] [Accepted: 12/22/2014] [Indexed: 05/25/2023]
Abstract
Healthcare delivery is reliant on a team-based approach, and interprofessional education (IPE) provides a means by which such collaboration skills can be fostered prior to entering the workplace. IPE within healthcare programs has been associated with improved collaborative behavior, patient care and satisfaction, reduced clinical error, and diminished negative professional stereotypes. An intensive interprofessional gross anatomy dissection course was created in 2009 to facilitate IPE at McMaster University. Data were collected from five cohorts over five years to determine the influence of this IPE format on the attitudes and perceptions of students towards other health professions. Each year, 28 students from the medicine, midwifery, nursing, physician's assistant, physiotherapy, and occupational therapy programs were randomly assigned into interprofessional teams for 10 weeks. Sessions involved an anatomy and scope-of-practice presentation, a small-group case-based session, and a dissection. A before/after design measured changes in attitudes and perceptions, while focus group data elaborated on the student experience with the course. Pre- and postmatched data revealed significant improvements in positive professional identity, competency and autonomy, role clarity and attitudes toward other health professions. Qualitative analysis of intraprofessional focus group interviews revealed meaningful improvements in a number of areas including learning anatomy, role clarity, and attitudes towards other health professions.
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Affiliation(s)
- Alisha Rebecca Fernandes
- Faculty of Health Sciences, Department of General Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Andrew Palombella
- Faculty of Health Sciences, Education Program in Anatomy, McMaster University, Hamilton, Ontario, Canada
| | - Jenn Salfi
- Faculty of Applied Health Sciences, Department of Nursing, Brock University, St. Catharines, Ontario, Canada
| | - Bruce Wainman
- Faculty of Health Sciences, Education Program in Anatomy, McMaster University, Hamilton, Ontario, Canada
- Faculty of Health Sciences, Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
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Oates M, Davidson M. A critical appraisal of instruments to measure outcomes of interprofessional education. MEDICAL EDUCATION 2015; 49:386-98. [PMID: 25800299 DOI: 10.1111/medu.12681] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 09/08/2014] [Accepted: 12/15/2014] [Indexed: 05/04/2023]
Abstract
CONTEXT Interprofessional education (IPE) is believed to prepare health professional graduates for successful collaborative practice. A range of instruments have been developed to measure the outcomes of IPE. An understanding of the psychometric properties of these instruments is important if they are to be used to measure the effectiveness of IPE. OBJECTIVES This review set out to identify instruments available to measure outcomes of IPE and collaborative practice in pre-qualification health professional students and to critically appraise the psychometric properties of validity, responsiveness and reliability against contemporary standards for instrument design. METHODS Instruments were selected from a pool of extant instruments and subjected to critical appraisal to determine whether they satisfied inclusion criteria. The qualitative and psychometric attributes of the included instruments were appraised using a checklist developed for this review. RESULTS Nine instruments were critically appraised, including the widely adopted Readiness for Interprofessional Learning Scale (RIPLS) and the Interdisciplinary Education Perception Scale (IEPS). Validity evidence for instruments was predominantly based on test content and internal structure. Ceiling effects and lack of scale width contribute to the inability of some instruments to detect change in variables of interest. Limited reliability data were reported for two instruments. Scale development and scoring protocols were generally reported by instrument developers, but the inconsistent application of scoring protocols for some instruments was apparent. CONCLUSIONS A number of instruments have been developed to measure outcomes of IPE in pre-qualification health professional students. Based on reported validity evidence and reliability data, the psychometric integrity of these instruments is limited. The theoretical test construction paradigm on which instruments have been developed may be contributing to the failure of some instruments to detect change in variables of interest following an IPE intervention. These limitations should be considered in any future research on instrument design.
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Affiliation(s)
- Matthew Oates
- Department of Nutrition, Rehabilitation & Sport, College of Science, Health, and Engineering, La Trobe University, Bundoora, Victoria, Australia
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Caylor S, Aebersold M, Lapham J, Carlson E. The Use of Virtual Simulation and a Modified TeamSTEPPS™ Training for Multiprofessional Education. Clin Simul Nurs 2015. [DOI: 10.1016/j.ecns.2014.12.003] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Storrs MJ, Alexander H, Sun J, Kroon J, Evans JL. Measuring team-based interprofessional education outcomes in clinical dentistry: psychometric evaluation of a new scale at an Australian dental school. J Dent Educ 2015; 79:249-258. [PMID: 25729018 DOI: 10.1002/j.0022-0337.2015.79.3.tb05879.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 07/22/2014] [Indexed: 01/23/2025]
Abstract
Previous research on interprofessional education (IPE) assessment has shown the need to evaluate the influence of team-based processes on the quality of clinical education. This study aimed to develop a valid and reliable instrument to evaluate the effectiveness of interprofessional team-based treatment planning (TBTP) on the quality of clinical education at the Griffith University School of Dentistry and Oral Health, Queensland, Australia. A scale was developed and evaluated to measure interprofessional student team processes and their effect on the quality of clinical education for dental, oral health therapy, and dental technology students (known more frequently as intraprofessional education). A face validity analysis by IPE experts confirmed that items on the scale reflected the meaning of relevant concepts. After piloting, 158 students (61% response rate) involved with TBTP participated in a survey. An exploratory factor analysis using the principal component method retained 23 items with a total variance of 64.6%, suggesting high content validity. Three subscales accounted for 45.7%, 11.4%, and 7.5% of the variance. Internal consistency of the scale (α=0.943) and subscales 1 (α=0.953), 2 (α=0.897), and 3 (α=0.813) was high. A reliability analysis yielded moderate (rs=0.43) to high correlations (0.81) with the remaining scale items. Confirmatory factor analyses verified convergent validity and confirmed that this structure had a good model fit. This study suggests that the instrument might be useful in evaluating interprofessional or intraprofessional team-based processes and their influence on the quality of clinical education in academic dental institutions.
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Affiliation(s)
- Mark J Storrs
- Dr. Storrs is an associate member of the Population and Social Health Research Program, Griffith Health Institute and Lecturer, School of Dentistry and Oral Health, Griffith University, Queensland, Australia; Dr. Alexander is Associate Professor and Portfolio Leader for Program and Teaching Quality, Learning Futures, Griffith University, Queensland, Australia; Dr. Sun is a member of the Griffith Health Institute and Senior Lecturer in Biostatistics, School of Medicine, Griffith University, Queensland, Australia; Dr. Kroon is a member of the Population and Social Health Research Program, Griffith Health Institute and Associate Professor in Public Health, Community, and Preventive Dentistry, School of Dentistry and Oral Health, Griffith University, Queensland, Australia; and Dr. Evans is a member of the Population and Social Health Research Program, Griffith Health Institute and Senior Lecturer in Dental Technology, School of Dentistry and Oral Health, Griffith University, Queensland, Australia.
| | - Heather Alexander
- Dr. Storrs is an associate member of the Population and Social Health Research Program, Griffith Health Institute and Lecturer, School of Dentistry and Oral Health, Griffith University, Queensland, Australia; Dr. Alexander is Associate Professor and Portfolio Leader for Program and Teaching Quality, Learning Futures, Griffith University, Queensland, Australia; Dr. Sun is a member of the Griffith Health Institute and Senior Lecturer in Biostatistics, School of Medicine, Griffith University, Queensland, Australia; Dr. Kroon is a member of the Population and Social Health Research Program, Griffith Health Institute and Associate Professor in Public Health, Community, and Preventive Dentistry, School of Dentistry and Oral Health, Griffith University, Queensland, Australia; and Dr. Evans is a member of the Population and Social Health Research Program, Griffith Health Institute and Senior Lecturer in Dental Technology, School of Dentistry and Oral Health, Griffith University, Queensland, Australia
| | - Jing Sun
- Dr. Storrs is an associate member of the Population and Social Health Research Program, Griffith Health Institute and Lecturer, School of Dentistry and Oral Health, Griffith University, Queensland, Australia; Dr. Alexander is Associate Professor and Portfolio Leader for Program and Teaching Quality, Learning Futures, Griffith University, Queensland, Australia; Dr. Sun is a member of the Griffith Health Institute and Senior Lecturer in Biostatistics, School of Medicine, Griffith University, Queensland, Australia; Dr. Kroon is a member of the Population and Social Health Research Program, Griffith Health Institute and Associate Professor in Public Health, Community, and Preventive Dentistry, School of Dentistry and Oral Health, Griffith University, Queensland, Australia; and Dr. Evans is a member of the Population and Social Health Research Program, Griffith Health Institute and Senior Lecturer in Dental Technology, School of Dentistry and Oral Health, Griffith University, Queensland, Australia
| | - Jeroen Kroon
- Dr. Storrs is an associate member of the Population and Social Health Research Program, Griffith Health Institute and Lecturer, School of Dentistry and Oral Health, Griffith University, Queensland, Australia; Dr. Alexander is Associate Professor and Portfolio Leader for Program and Teaching Quality, Learning Futures, Griffith University, Queensland, Australia; Dr. Sun is a member of the Griffith Health Institute and Senior Lecturer in Biostatistics, School of Medicine, Griffith University, Queensland, Australia; Dr. Kroon is a member of the Population and Social Health Research Program, Griffith Health Institute and Associate Professor in Public Health, Community, and Preventive Dentistry, School of Dentistry and Oral Health, Griffith University, Queensland, Australia; and Dr. Evans is a member of the Population and Social Health Research Program, Griffith Health Institute and Senior Lecturer in Dental Technology, School of Dentistry and Oral Health, Griffith University, Queensland, Australia
| | - Jane L Evans
- Dr. Storrs is an associate member of the Population and Social Health Research Program, Griffith Health Institute and Lecturer, School of Dentistry and Oral Health, Griffith University, Queensland, Australia; Dr. Alexander is Associate Professor and Portfolio Leader for Program and Teaching Quality, Learning Futures, Griffith University, Queensland, Australia; Dr. Sun is a member of the Griffith Health Institute and Senior Lecturer in Biostatistics, School of Medicine, Griffith University, Queensland, Australia; Dr. Kroon is a member of the Population and Social Health Research Program, Griffith Health Institute and Associate Professor in Public Health, Community, and Preventive Dentistry, School of Dentistry and Oral Health, Griffith University, Queensland, Australia; and Dr. Evans is a member of the Population and Social Health Research Program, Griffith Health Institute and Senior Lecturer in Dental Technology, School of Dentistry and Oral Health, Griffith University, Queensland, Australia
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Changes in Attitudes Toward Interprofessional Learning and Collaboration Among Physical Therapy Students Following a Patient Code Simulation Scenario. Cardiopulm Phys Ther J 2015. [DOI: 10.1097/cpt.0000000000000003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hunter JP, Stinson J, Campbell F, Stevens B, Wagner SJ, Simmons B, White M, van Wyk M. A novel pain interprofessional education strategy for trainees: assessing impact on interprofessional competencies and pediatric pain knowledge. Pain Res Manag 2015; 20:e12-20. [PMID: 25144859 PMCID: PMC4325895 DOI: 10.1155/2015/159580] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Health care trainees⁄students lack knowledge and skills for the comprehensive clinical assessment and management of pain. Moreover, most teaching has been limited to classroom settings within each profession. OBJECTIVES To develop and evaluate the feasibility and preliminary outcomes of the 'Pain-Interprofessional Education (IPE) Placement', a five-week pain IPE implemented in the clinical setting. The utility (content validity, readability, internal consistency and practical considerations) of the outcome measures was also evaluated. METHODS A convenience sample of 21 trainees from eight professions was recruited over three Pain-IPE Placement cycles. Pre- and postcurriculum assessment included: pain knowledge (Pediatric Pain Knowledge and Attitudes Survey), IPE attitudes (Interdisciplinary Education Perception Scale [IEPS]) and IPE competencies (Interprofessional Care Core Competencies Global Rating Scales [IPC-GRS]), and qualitative feedback on process⁄acceptability. RESULTS Recruitment and retention met expectations. Qualitative feedback was excellent. IPE measures (IEPS and IPC-GRS) exhibited satisfactory utility. Postcurriculum scores improved significantly: IEPS, P<0.05; IPC-GRS constructs, P<0.01; and competencies, P<0.001. However, the Pediatric Pain Knowledge and Attitudes Survey exhibited poor utility in professions without formal pharmacology training. Scores improved in the remaining professions (n=14; P<0.01). DISCUSSION There was significant improvement in educational outcomes. The IEPS and IPC-GRS are useful measures of IPE-related learning. At more advanced training levels, a single pain-knowledge questionnaire may not accurately reflect learning across diverse professions. CONCLUSION The Pain-IPE Placement is a successful collaborative learning model within a clinical context that successfully changed interprofessional competencies. The present study represents a first step at defining and assessing change in interprofessional competencies gained from Pain-IPE.
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Affiliation(s)
- Judith P Hunter
- Department of Physical Therapy, Faculty of Medicine, University of Toronto
| | - Jennifer Stinson
- Center for Nursing, The Hospital for Sick Children, and Lawrence S Bloomberg Faculty of Nursing, University of Toronto
- Child Health Evaluative Sciences, University of Toronto, Toronto, Ontario
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario
| | - Fiona Campbell
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, University of Toronto, Toronto, Ontario
- Faculty of Medicine, University of Toronto, Toronto, Ontario
| | - Bonnie Stevens
- Center for Nursing, The Hospital for Sick Children, and Lawrence S Bloomberg Faculty of Nursing, University of Toronto
- Child Health Evaluative Sciences, University of Toronto, Toronto, Ontario
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario
| | - Susan J Wagner
- Department of Speech-Language Pathology, Faculty of Medicine, University of Toronto, Toronto, Ontario
- Centre for Interprofessional Education, University of Toronto, Toronto, Ontario
| | - Brian Simmons
- Centre for Interprofessional Education, University of Toronto, Toronto, Ontario
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario
- Department of Pediatrics, Sunnybrook Health Science Centre, Toronto, Ontario
| | - Meghan White
- Child Health Evaluative Sciences, University of Toronto, Toronto, Ontario
| | - Margaret van Wyk
- Department of Physical Therapy, Faculty of Medicine, University of Toronto
- Child Health Evaluative Sciences, University of Toronto, Toronto, Ontario
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Miller R, Combes G, Brown H, Harwood A. Interprofessional workplace learning: a catalyst for strategic change? J Interprof Care 2014; 28:186-93. [PMID: 24428770 DOI: 10.3109/13561820.2013.877428] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The integrated care development programme (ICDP) was a continuing interprofessional educational programme for health and social care managers and commissioners. Multi-professional strategic teams from a single locality participated in university and workplace-based learning activities centred on the development of an integrated business plan to address a local priority for improvement. The evaluation used participant self-assessment, semi-structured interviews and group discussions to assess achievement of expected impacts on the participants, their organisations and partnerships, and patient/service user outcomes. The findings indicate that whilst those employed in management and commissioning roles had considerable experience of working across professional and agency boundaries they derived individual benefits from a workplace IPE programme. The principles of design and delivery developed in pre-registration and clinician/practitioner IPE courses also applied to those working at a more strategic level. Organisational impacts were reported, but 6 months post-programme evidence was not yet available of significant improvements in patient outcomes and /or financial efficiencies. Individual motivation, team dynamics and support from line managers all affected the extent to which individual and organisational impacts were achieved.
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Affiliation(s)
- Robin Miller
- Health Services Management Centre, University of Birmingham , Edgbaston, Birmingham , UK
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da Costa MV, Vilar MJ, de Azevedo GD, Reeves S. Interprofessional education as an approach for reforming health professions education in Brazil: emerging findings. J Interprof Care 2014; 28:379-80. [PMID: 24383408 DOI: 10.3109/13561820.2013.870984] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Interprofessional education (IPE) is an important issue to insert in the debate on the reform of the education of health professions in Brazil. This paper provides details on an emerging study, based in Brazil, whose aim is to explore the use of IPE as a strategy to reform health professional education to become more collaborative in nature. The study has adopted a sequential mixed-methods approach, and will conduct focus groups, individual interviews and surveys with students, teachers and administrators based in two universities. Initial findings have indicated that, at present, participants were not aware of systematic strategies to bring students from different courses together for IPE, which has created problems for the development of knowledge and skills for collaborative work. Further data will be gathered to expand this analysis. Nevertheless, there is already clear evidence that there is a need to integrate and strengthen the use of IPE in Brazil, as a key route forward to strengthening the process of reorientation training of health professionals.
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Affiliation(s)
- Marcelo Viana da Costa
- Postgraduate Program in Health Sciences, Federal University of Rio Grande do Norte , Natal , Brazil
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Yuasa M, Nagoshi M, Oshiro-Wong C, Tin M, Wen A, Masaki K. Standardized patient and standardized interdisciplinary team meeting: validation of a new performance-based assessment tool. J Am Geriatr Soc 2014; 62:171-4. [PMID: 24383978 DOI: 10.1111/jgs.12604] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The interdisciplinary team (IDT) approach is critical in the care of elderly adults. Performance-based tools to assess IDT skills have not been well validated. A novel assessment tool, the standardized patient (SP) and standardized interdisciplinary team meeting (SIDTM), consisting of two stations, was developed. First, trainees evaluate a SP hospitalized after a fall. Second, trainees play the role of the physician in a standardized IDT meeting with a standardized registered nurse (SRN) and standardized medical social worker (SMSW) for discharge planning. The SP-SIDTM was administered to 52 fourth-year medical students (MS4s) and six geriatric medicine fellows (GMFs) in 2011/12. The SP, SRN, and SMSW scored trainee performance on dichotomous checklists of clinical tasks and Likert scales of communication skills, which were compared according to level of training using t-tests. Trainees rated the SP-SIDTM experience as moderately difficult, length of time about right, and believability moderate to high. Reliability was high for both cases (Cronbach α = 0.73-0.87). Interobserver correlation between SRN and SMSW checklist scores (correlation coefficient (r) = 0.82, P < .001) and total scores (r = 0.69, P < .001) were high. The overall score on the SP-SIDTM case was significantly higher for GMF (75) than for MS4 (65, P = .002). These observations support the validity of this novel assessment tool.
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Affiliation(s)
- Misuzu Yuasa
- Department of Geriatric Medicine, John A. Hartford Foundation Center of Excellence in Geriatrics, Honolulu, Hawaii
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81
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Kim K, Ko J. Attitudes toward interprofessional health care teams scale: a confirmatory factor analysis. J Interprof Care 2013; 28:149-54. [DOI: 10.3109/13561820.2013.857645] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lie DA, Fung CC, Trial J, Lohenry K. A comparison of two scales for assessing health professional students' attitude toward interprofessional learning. MEDICAL EDUCATION ONLINE 2013; 18:21885. [PMID: 24300749 PMCID: PMC3849511 DOI: 10.3402/meo.v18i0.21885] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 09/05/2013] [Accepted: 10/24/2013] [Indexed: 05/31/2023]
Abstract
RATIONALE The validated 19-item Readiness for Interprofessional Learning Scale (RIPLS) is often used for assessing attitudes toward interprofessional education (IPE). The 12-item Interdisciplinary Education Perception Scale (IEPS), also used for this purpose, has not been validated among the professions of medicine, pharmacy, and physician assistants (PAs). The discriminatory ability of the two scales has not been directly compared. Comparison of the two will aid educators in selecting the optimal scale. OBJECTIVE To compare psychometric properties of the RIPLS and IEPS and to examine the ability of each scale to discriminate mean scores among student subgroups (gender, profession, seniority, and prior IPE exposure). METHOD We conducted a cross-sectional (Qualtrics(©)) survey (RIPLS and IEPS) of junior and senior students in medicine (n=360), pharmacy (n=360), and the PA profession (n=106). Descriptive statistics were used to report aggregate mean scores of subgroups. The internal consistency of each scale was assessed using Cronbach's α. Concurrent validity was measured by Pearson's correlation coefficients. Independent-sample t-tests and analysis of variances (ANOVAs) were performed to assess the discriminatory ability of each scale. Cohen's d effect sizes were calculated for all significant pair-wise comparisons. RESULTS Response rate was 82%. Cronbach's α was 0.85 (RIPLS) and 0.91 (IEPS). The RIPLS discriminated scores by gender among junior students only, and scores by IPE exposure among all students. The IEPS distinguished score differences for the three professions among junior students and by prior IPE exposure for all three professions. Neither scale detected differences in mean scores by profession among all students or by level of training among the three professions. CONCLUSIONS Neither the RIPLS nor the IEPS has greater discriminatory ability for detecting attitude differences among the student subgroups. Reason for differences may be explained by slightly different scale constructs. The RIPLS is designed to assess students' own attitude toward interprofessional learning, while the IEPS discerns perceived attitudes about team collaboration for students' own professions and may be more appropriate for more advanced students.
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Affiliation(s)
- Désirée Annabel Lie
- Department of Family Medicine, Keck School of Medicine of the University of Southern California, University of Southern California, Los Angeles, California, USA;
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Pittenger AL, Westberg S, Rowan M, Schweiss S. An interprofessional diabetes experience to improve pharmacy and nursing students' competency in collaborative practice. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2013; 77:197. [PMID: 24249859 PMCID: PMC3831408 DOI: 10.5688/ajpe779197] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 04/17/2013] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To improve pharmacy and nursing students' competency in collaborative practice by having them participate in an interprofessional diabetes experience involving social networking. DESIGN An existing elective course on diabetes management was modified to include interprofessional content based on Interprofessional Education Collaborative (IPEC) competency domains. Web-based collaborative tools (social networking and video chat) were used to allow nursing and pharmacy students located on 2 different campuses to apply diabetes management content as an interprofessional team. ASSESSMENT Mixed-method analyses demonstrated an increase in students' knowledge of the roles and responsibilities of the other profession and developed an understanding of interprofessional communication strategies and their central role in effective teamwork. CONCLUSION Interprofessional content and activities can be effectively integrated into an existing course and offered successfully to students from other professional programs and on remote campuses.
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Affiliation(s)
- Amy L. Pittenger
- University of Minnesota College of Pharmacy, Minneapolis, Minnesota
| | - Sarah Westberg
- University of Minnesota College of Pharmacy, Minneapolis, Minnesota
| | - Mary Rowan
- University of Minnesota School of Nursing, Minneapolis, Minnesota
| | - Sarah Schweiss
- University of Minnesota College of Pharmacy, Duluth, Minnesota
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Williams B, Boyle M, Brightwell R, McCall M, McMullen P, Munro G, O'Meara P, Webb V. A cross-sectional study of paramedics' readiness for interprofessional learning and cooperation: results from five universities. NURSE EDUCATION TODAY 2013; 33:1369-1375. [PMID: 22818954 DOI: 10.1016/j.nedt.2012.06.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Revised: 06/15/2012] [Accepted: 06/29/2012] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Healthcare systems are evolving to feature the promotion of interprofessional practice more prominently. The development of successful and functional interprofessional practice is best achieved through interprofessional learning. Given that most paramedic programmes take an isolative uni-professional educational approach to their healthcare undergraduate courses, serious questions must be raised as to whether students are being adequately prepared for the interprofessional healthcare workplace. The objective of this study was to assess the attitudes of paramedic students towards interprofessional learning across five Australian universities. METHODS Using a convenience sample of paramedic student attitudes towards interprofessional learning and cooperation were measured using two standardised self-reporting instruments: Readiness for Interprofessional Learning Scale (RIPLS) and Interdisciplinary Education Perception Scale (IEPS). RESULTS Students' readiness for interprofessional learning did not appear to be significantly influenced by their gender nor the type of paramedic degree they were undertaking. As students progressed through their degrees their appreciation for collaborative teamwork and their understanding of paramedic identity grew, however this appeared to negatively affect their willingness to engage in interprofessional learning with other healthcare students. The tertiary institute attended also appeared to influence students' preparedness and attitudes to shared learning. CONCLUSIONS This study has found no compelling evidence that students' readiness for interprofessional learning is significantly affected by either their gender or the type of degree undertaken. By contrast it was seen that the tertiary institutions involved in this study produced students at different levels of preparedness for IPL and cooperation.
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Affiliation(s)
- Brett Williams
- Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia.
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Pittenger AL. The use of social networking to improve the quality of interprofessional education. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2013; 77:174. [PMID: 24159215 PMCID: PMC3806958 DOI: 10.5688/ajpe778174] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 04/18/2013] [Indexed: 05/11/2023]
Abstract
OBJECTIVE To evaluate the feasibility and effectiveness of using an online social networking platform for interprofessional education. DESIGN Three groups of 6 students were formed with 1 student in each group from medicine, nursing, dentistry, pharmacy, veterinary medicine, and public health. Each group followed a different collaborative educational model with a unique pedagogical structure. Students in all groups interacted via an online social networking platform for a minimum of 15 weeks and met in person once at the end of the 15-week experience for a focus group session. The students were tasked with developing a collaborative recommendation for using social networking in interprofessional education programs. ASSESSMENT Most of the students who reported in a post-experience survey that their expectations were not met were in the minimally structured group. Almost all students in the facilitated and highly structured groups indicated that this experience positively impacted their knowledge of other health professions. Most students stated that interacting within a social networking space for 15 weeks with other members of the university's health professions programs was a positive and effective interprofessional education experience. CONCLUSION Social networking is feasible and can be used effectively within an overall strategy for interprofessional education, but design and placement within a core content course is critical to success.
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Affiliation(s)
- Amy L Pittenger
- University of Minnesota College of Pharmacy, Minneapolis, Minnesota
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Williams B, Webb V. Examining the measurement properties of the Interdisciplinary Education Perception Scale (IEPS) in paramedic education. NURSE EDUCATION TODAY 2013; 33:981-5. [PMID: 23159166 DOI: 10.1016/j.nedt.2012.10.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Revised: 09/01/2012] [Accepted: 10/24/2012] [Indexed: 05/04/2023]
Abstract
BACKGROUND Healthcare systems are continuing searching for alternative service delivery models while at the same time also promoting interprofessional practice and cooperation among workers. One scale that aims to measure interprofessional cooperation is the Interdisciplinary Education Perception Scale (IEPS), although limited psychometric testing on its validity and reliability has been carried out. Therefore the aim of this study was to investigate the dimensionality and internal consistency of the IEPS (suggested by McFadyen and colleagues) when completed by a group of paramedic undergraduates. METHODS Data from the IEPS were analysed with a factor analysis using a Principal Axis Factoring (PAF) with Oblique Oblimin rotation. RESULTS A total of (n=303) undergraduate paramedic students participated in the study who reported having positive attitudes towards interprofessional cooperation. Factor analysis of the 12-items revealed two factors with eigenvalues above 1, accounting for 53.85% of the total variance. Items with loadings greater than ±.30, with the factor in question were used to describe the two factors: Cooperation and Teamwork, and Positivity. CONCLUSION While data from this study produced a multi-dimensional scale with adequate eigenvalues and communalities, improvements to the scales internal consistency can be made with future data sets. The results from the IEPS suggest that undergraduate paramedics have positive regard towards interprofessional cooperation.
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Affiliation(s)
- Brett Williams
- Monash University, Department of Community Emergency Health and Paramedic Practice, P.O. Box 527, Frankston 3199, Victoria, Australia.
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Efstathiou N, Walker WM. Interprofessional, simulation-based training in end of life care communication: a pilot study. J Interprof Care 2013; 28:68-70. [DOI: 10.3109/13561820.2013.827163] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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88
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Leitch J. Exploring psychometric properties of the interdisciplinary education perception scale in health graduate students. J Interprof Care 2013; 28:52-7. [DOI: 10.3109/13561820.2013.820691] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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89
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Fitzsimmons A, Cisneros B, Samore J. A learner developed longitudinal interprofessional education curriculum. J Interprof Care 2013; 28:66-7. [PMID: 23905603 DOI: 10.3109/13561820.2013.820692] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Increased patient safety requires interprofessional collaboration, now critical given rising healthcare costs and an aging population with complex and chronic conditions. One way in which to educate future health care team members about team dynamics is to have them learn through active participation on a team. Six students representing the five health professions programs at the University of California, San Francisco formed a curriculum development team that created a novel yearlong interprofessional education curriculum and assessed its impact on knowledge, skills and attitudes of first-year learners in medicine, physical therapy, dentistry, nursing, and pharmacy (n = 480). Through their participation on the curriculum development team and reflection on their roles, responsibilities, communication and negotiation, the six students developed the inter-personal and intra-personal skills required for successful interprofessional collaboration.
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Affiliation(s)
- Amber Fitzsimmons
- UCSF, Physical Therapy and Rehabilitation Sciences , San Francisco, CA , USA
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90
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Kenaszchuk C, Rykhoff M, Collins L, McPhail S, van Soeren M. Positive and null effects of interprofessional education on attitudes toward interprofessional learning and collaboration. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2012; 17:651-69. [PMID: 22160643 DOI: 10.1007/s10459-011-9341-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Accepted: 11/26/2011] [Indexed: 05/04/2023]
Abstract
Interprofessional education (IPE) for health and social care students may improve attitudes toward IPE and interprofessional collaboration (IPC). The quality of research on the association between IPE and attitudes is mediocre and IPE effect sizes are unknown. Students at a college in Toronto, Canada, attended an IPE workshop. A comparison group of non-attenders was formed. Both groups completed pre- and post-workshop questionnaires and two measurement scales for IPE attitudes-the Interprofessional Education Perceptions Scale and the University of West England questionnaire. Eight multiple linear regressions modeled post-workshop attitude scores as a function of workshop attendance, pre-workshop attitudes, and background factors. Workshop effect sizes and relative importance of variables were estimated. Published results were used to calculate IPE effect sizes in other studies. Pre-workshop measures of post-workshop attitudes were dominant, positive predictors of outcomes; other predictors were subordinate to them. The relationship between workshop attendance and IPE attitudes was positive in seven models, statistically significant in four (P < 0.05), and not statistically significant in four. In hierarchical regressions the average workshop effect was small, about 0.08 in ΔR(2) terms, amounting to about one-quarter of a model's explained variance. The workshop was associated with improved IPE and IPC attitudes in some domains but not others. The results should help educators focus IPE efforts on IPE/IPC attitudes where small, short-term improvements can be obtained.
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Affiliation(s)
- Chris Kenaszchuk
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
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91
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Pettersen G, Rosenvinge JH, Thune-Larsen KB, Wynn R. Clinical confidence following an interprofessional educational program on eating disorders for health care professionals: a qualitative analysis. J Multidiscip Healthc 2012; 5:201-5. [PMID: 22936849 PMCID: PMC3426273 DOI: 10.2147/jmdh.s33089] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
There are an increasing number of educational programs to improve clinical competence and skills to treat mental disorders. For complex disorders there is also a focus on improving the quality of interprofessional work. This paper reports on interprofessional outputs of an educational program on eating disorders. A total of 207 professionals who completed the program were requested to describe up to 12 possible scenarios depicted as realistic prospects for their future work within this field. Analyzing the scenarios resulted in three categories of describing the participants’ preferences: (1) interprofessional interventions and treatment; (2) the further development of competence; and (3) organization of the health care system. The findings showed that the participants were considering working across new lines in their current workplaces or crossing borders to new frontiers in the execution of competence. Our findings may be summarized into the concept of “clinical confidence.” This concept has so far been understood as some kind of personal trait, disposition, or attitude. The present findings add nuances to this concept in terms of state-dependent encouragement, engagement, and a potential to act and to cross professional borders in order to better treat complex mental disorders.
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Affiliation(s)
- Gunn Pettersen
- Faculty of Health Sciences, University of Tromsø, Tromsø, Norway
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92
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Mohaupt J, van Soeren M, Andrusyszyn MA, MacMillan K, Devlin-Cop S, Reeves S. Understanding interprofessional relationships by the use of contact theory. J Interprof Care 2012; 26:370-5. [DOI: 10.3109/13561820.2012.673512] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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93
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Pinto A, Lee S, Lombardo S, Salama M, Ellis S, Kay T, Davies R, Landry MD. The Impact of Structured Inter-professional Education on Health Care Professional Students' Perceptions of Collaboration in a Clinical Setting. Physiother Can 2012; 64:145-56. [PMID: 23450044 DOI: 10.3138/ptc.2010-52] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To examine how a structured inter-professional education (IPE) clinical placement influences health care professional (HCP) students' perceptions of inter-professional collaboration (IPC) relative to that of students in a traditional clinical placement. METHODS This study used a mixed-methods design. The Interdisciplinary Education Perception Scale (IEPS) was administered to HCP students (n=36) in two Toronto hospitals before and after a structured 5-week IPE clinical placement to examine changes in their perceptions of IPC. Students in a traditional clinical placement (n=28) were used as a control group. Focus groups were then conducted with seven students who took part in the structured IPE clinical placement. A coding framework was devised a priori, and the qualitative results were used to explain the quantitative findings. RESULTS There were no statistically significant differences between groups after the structured IPE clinical placement, but the intervention group showed a greater positive trend in total IEPS scores from baseline to follow-up. Qualitative data suggest that students valued the knowledge and skills gained through the structured IPE clinical placement. CONCLUSIONS Findings suggest that structured IPE clinical placements may provide students with valuable collaborative learning opportunities, enhanced respect for other professionals, and insight into the value of IPC in healthcare delivery. More research is needed to explore other factors that influence specific perceptions among physical therapy students. Purpose: To examine how a structured inter-professional education (IPE) clinical placement influences health care professional (HCP) students' perceptions of inter-professional collaboration (IPC) relative to that of students in a traditional clinical placement. Methods: This study used a mixed-methods design. The Interdisciplinary Education Perception Scale (IEPS) was administered to HCP students (n=36) in two Toronto hospitals before and after a structured 5-week IPE clinical placement to examine changes in their perceptions of IPC. Students in a traditional clinical placement (n=28) were used as a control group. Focus groups were then conducted with seven students who took part in the structured IPE clinical placement. A coding framework was devised a priori, and the qualitative results were used to explain the quantitative findings. Results: There were no statistically significant differences between groups after the structured IPE clinical placement, but the intervention group showed a greater positive trend in total IEPS scores from baseline to follow-up. Qualitative data suggest that students valued the knowledge and skills gained through the structured IPE clinical placement. Conclusions: Findings suggest that structured IPE clinical placements may provide students with valuable collaborative learning opportunities, enhanced respect for other professionals, and insight into the value of IPC in healthcare delivery. More research is needed to explore other factors that influence specific perceptions among physical therapy students.
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Affiliation(s)
- Alison Pinto
- Department of Physical Therapy, Faculty of Medicine, University of Toronto
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Jones KJ, Vandenberg EV, Bottsford L. Prevalence, formation, maintenance, and evaluation of interdisciplinary student aging interest groups. GERONTOLOGY & GERIATRICS EDUCATION 2011; 32:321-41. [PMID: 22087779 DOI: 10.1080/02701960.2011.618958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The authors describe the prevalence, formation, maintenance, and evaluation of student aging interest groups. They conducted a cross-sectional electronic survey of the 46 academic medical centers funded by the Donald W. Reynolds Foundation. To evaluate their group of approximately 50 students, the authors conducted an electronic pretest and posttest of attitudes toward interdisciplinary education and knowledge about aging. Twenty-nine of 32 responding institutions funded by the Reynolds Foundation conducted a group; only medical students participated in one half of these groups. Panel presentations were the most prevalent group activity. Evaluation of their group revealed that an interprofessional service learning experience had the greatest impact on student perceptions of the educational preparation and competency of other disciplines. At posttest, medical students in their group had significantly less positive perceptions of actual cooperation between disciplines than did physical therapy or pharmacy students. Aging interest groups conducted by institutions funded by the Reynolds Foundation did not have a high level of interdisciplinary participation. Intermittent exposure to other disciplines during a small number of group activities may be insufficient to overcome "disciplinary split" and achieve interprofessional team orientation without changes in the structure of medical education.
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Affiliation(s)
- Katherine J Jones
- Department of Physical Therapy Education, University of Nebraska Medical Center, Omaha, Nebraska 68198-6155, USA
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95
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Thannhauser J, Russell-Mayhew S, Scott C. Measures of interprofessional education and collaboration. J Interprof Care 2010; 24:336-49. [DOI: 10.3109/13561820903442903] [Citation(s) in RCA: 124] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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96
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Pathak S, Holzmueller CG, Haller KB, Pronovost PJ. A Mile in Their Shoes: Interdisciplinary Education at the Johns Hopkins University School of Medicine. Am J Med Qual 2010; 25:462-7. [DOI: 10.1177/1062860610366591] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Sujay Pathak
- Johns Hopkins University School of Medicine, Baltimore, MD,
| | | | | | - Peter J. Pronovost
- Center for Innovation in Quality Patient Care, Johns Hopkins Medicine, Baltimore, MD, The Johns Hopkins University, Baltimore, MD
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97
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McFadyen AK, Webster VS, Maclaren WM, O'neill MA. Interprofessional attitudes and perceptions: Results from a longitudinal controlled trial of pre-registration health and social care students in Scotland. J Interprof Care 2010; 24:549-64. [DOI: 10.3109/13561820903520369] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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98
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Margalit R, Thompson S, Visovsky C, Geske J, Collier D, Birk T, Paulman P. From professional silos to interprofessional education: campuswide focus on quality of care. Qual Manag Health Care 2009; 18:165-73. [PMID: 19609186 DOI: 10.1097/qmh.0b013e3181aea20d] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The Institute of Medicine called for the integration of interprofessional education (IPE) into health professions curricula, in order to improve health care quality. In response, we developed, implemented, and evaluated a campus wide IPE program, shifting from traditional educational silos to greater collaboration. METHODS Students (155) and faculty (30) from 6 academic programs (nursing, medicine, public health, allied health, dentistry, and pharmacy) engaged with a university hospital partner to deliver this program. The content addressed principles of IPE, teamwork development and 2 common quality care problems: hospital-acquired infections and communication errors. Pre-/post-surveys, the Readiness for Interprofessional Learning Scale, and the Interprofessional Education Perception Scale, were used for descriptive assessment of student learning. RESULTS Students demonstrated increased understanding of health care quality and interprofessional teamwork principles and reported positive attitudes toward shared learning. While responses to the Readiness for Interprofessional Learning Scale grew more positive after the program, scores on the Interprofessional Education Perception Scale were more homogeneous. Both students and faculty highly evaluated the experience. CONCLUSION This program was a first step in preparing individuals for collaborative learning, fostering awareness and enthusiasm for IPE among students and faculty, and demonstrating the feasibility of overcoming common barriers to IPE such as schedule coordination and faculty buy-in.
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Affiliation(s)
- Ruth Margalit
- Department of Health Promotion, Social & Behavioral Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198-6075, USA.
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Sheward L, Hagen S, McFadyen A. Revisiting the UDI and IIQ: proposed more stable models. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2008. [DOI: 10.1111/j.1749-771x.2007.00039.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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