Are female students in general and nursing students more ready for teamwork and interprofessional collaboration in healthcare?

Comparison of the Readiness for Interprofessional Learning and the rate of contact among students from nine different healthcare courses

BACKGROUND

Despite the growth in the interprofessional literature, there are still few studies that have evaluated the differences among courses and periods in relation to Readiness for Interprofessional Learning. Likewise, the relationship between the influences of contact among students from different professions is still controversial.

OBJECTIVES

To evaluate whether greater contact among students from diverse health courses could be associated with improved Readiness for Interprofessional Learning (RIPLS) at the undergraduate level and to compare the RIPLS among healthcare courses, analyzing differences among courses and periods of their academic training.

DESIGN

Cross-sectional study.

SETTING

A Brazilian public university.

PARTICIPANTS

Students enrolled in the first and final periods of nine healthcare courses.

METHODS

The rates of contact between students and the Readiness for Interprofessional Learning were assessed. A comparison between students from these nine healthcare courses was carried out.

RESULTS

A total of 545 (73.45%) students answered the questionnaire. The highest RIPLS scores were from Nursing (42.39), Dentistry (41.33) and Pharmacy students (40.72) and the lowest scores were from Physical Education (38.02), Medicine (38.17) and Psychology (38.66) students. The highest rates of contact between students (RC) were from Physical Education, Nutrition and Psychology students and the lowest RC were from Pharmacy, Social service and Dentistry. There was a significant effect of "healthcare course" on RIPLS. Comparing RIPLS and RC between the first and final years we found that, considering all courses, there was an increase in the RC, whereas a decrease in RIPLS scores. No correlation was found between RIPLS and RC in general.

CONCLUSION

The current study found that RIPLS scores are very different between healthcare students. Although we found a significant increase in the RC, there was a decrease in the RIPLS scores. These findings lead to a greater understanding of the difficulties facing and potential for interprofessional education.

Characteristics of two questionnaires used to assess interprofessional learning: psychometrics and expert panel evaluations

BACKGROUND

Interprofessional learning activities are included in many curricula but are difficult to assess. For languages that are not widely spoken such as Swedish, few validated questionnaires exist that relate to interprofessional outcomes. Therefore, the aim was to examine two such questionnaires in relation to interprofessional competence domains.

METHODS

Psychometric characteristics, such as homogeneity of items and internal consistency, were assessed for the Swedish versions of the Jefferson Scale of Attitudes Towards Physician-Nurse Collaboration (JSAPNC) and the Readiness for Interprofessional Learning Scale (RIPLS). The questionnaires were distributed directly following IPL activities. Mokken scale analysis based on Loevinger's coefficient for homogeneity and Cronbach's alpha were used to evaluate the scales. Two expert panels performed a qualitative analysis of items in relation to four internationally defined interprofessional competences.

RESULTS

In total, 88 and 84 responded to the JSAPNC and RIPLS questionnaires, respectively. Estimates of homogeneity were low for both the JSAPNC (H = 0.16) and the RIPLS (H = 0.21). Reliabilities were weak (0.62 and 0.66, respectively) for the total scales. The expert panels categorised 68% of items into similar competence domains. However, their discussion revealed ambiguous wordings and imbalances in the two questionnaires in relation to domains.

CONCLUSION

Interprofessional competence domains are defined but few validated tools exist to assess them. Examined tools relating to interprofessional learning in Swedish do not qualify for assessing overarching IPL outcomes, and summed scores from these tools should be used with caution.

Cooperative learning in 'Special Needs in Dentistry' for undergraduate students using the Jigsaw approach

INTRODUCTION

The goals of this study were to (i) describe the use of the Jigsaw approach for the resolution of clinical cases by undergraduate students in the subject 'Special Needs in Dentistry' and (ii) assess the impact of its implementation on academic performance and the students' perception.

MATERIALS AND METHODS

The Jigsaw approach was applied to the fifth-year in the subject 'Special Needs in Dentistry', as part of the Dentistry degree curriculum of the University of Santiago de Compostela, during the academic years 2012/2013 and 2013/2014. A total of 109 dental students were enrolled in the study, and the final marks of the Jigsaw (n = 55) and the non-Jigsaw groups (n = 54) were compared. Students' perceptions on the Jigsaw technique were assessed using a 13-question questionnaire.

RESULTS

Academic performance based on the final examination mark for the Jigsaw and non-Jigsaw groups was 6.45 ± 1.49 and 6.13 ± 1.50, respectively. There were not students in the Jigsaw group who failed to attend the mandatory examination (0% vs. 12.96% in the non-Jigsaw group, P = 0.006). The questionnaire's internal consistency was 0.90. The mean value for all the questionnaire items was 3.80, with the highest response score of 4.35 for the statement 'I have seen the complexity that the resolution of a clinical case can involve'.

CONCLUSION

Based on the students' perceptions, the Jigsaw approach could contribute to a better understanding of the complexity of solving clinical cases in the subject 'Special Needs in Dentistry'. However, further investigations should be conducted to analyse the influence of this technique on students' academic performance in the field of clinical dentistry.

Perception of Interprofessional Collaboration and Co-Location of Specialists and Primary Care Teams in Youth Mental Health

OBJECTIVES

Interprofessional collaboration is a cornerstone of youth mental health collaborative care models. This article presents quantitative results from a mixed-methods study. It analyses the organizational predictors of the perception of interprofessional collaboration of professionals comparing two models of services within recently constituted youth mental health collaborative care teams.

METHODS

Professionals (n=104) belonging to six health and social services institutions completed an online survey measuring their perceptions of interprofessional collaboration through a validated questionnaire, the PINCOM-Q.

RESULTS

Results suggest that the integrated model of collaborative care in which specialized resources are co-located with the primary care teams is the main significant predictor of positive perception of interprofessional collaborations in the youth mental health team.

CONCLUSION

More research on the relation between service delivery models and interprofessional relations could help support the successful implementation of collaborative care in youth mental health.

A concordance-based study to assess doctors' and nurses' mental models in Internal Medicine

Interprofessional collaboration between doctors and nurses is based on team mental models, in particular for each professional’s roles. Our objective was to identify factors influencing concordance on the expectations of doctors’ and nurses’ roles and responsibilities in an Internal Medicine ward. Using a dataset of 196 doctor-nurse pairs (14x14 = 196), we analyzed choices and prioritized management actions of 14 doctors and 14 nurses in six clinical nurse role scenarios, and in five doctor role scenarios (6 options per scenario). In logistic regression models with a non-nested correlation structure, we evaluated concordance among doctors and nurses, and adjusted for potential confounders (including prior experience in Internal Medicine, acuteness of case and gender). Concordance was associated with number of female professionals (adjusted OR 1.32, 95% CI 1.02 to 1.73), for acute situations (adjusted OR 2.02, 95% CI 1.13 to 3.62), and in doctor role scenarios (adjusted OR 2.19, 95% CI 1.32 to 3.65). Prior experience and country of training were not significant predictors of concordance. In conclusion, our concordance-based approach helped us identify areas of lower concordance in expected doctor-nurse roles and responsibilities, particularly in non-acute situations, which can be targeted by future interprofessional, educational interventions.

Factors affecting a face-to-face learning event

BACKGROUND

Pharmacy professionals have multiple opportunities to attend learning events run by a series of providers. However, there has never been a large-scale evaluation of events. Currently, formats of learning sessions differ by provider with no optimum model identified. Pharmacy Education South London was formed in April 2014 for the provision of education and training for pharmacy professionals in South London, running sessions multiple times across various locations.

OBJECTIVE

The objective of this work was to identify factors that influence the perceived success of a face-to-face supplementary education and training event from the perspective of attendees.

METHODS

Evaluation forms from 600 participants at training events followed by semi-structured individual interviews with 11 participants.

KEY FINDINGS

Participants over 55 years were more likely to attend lecture style events versus those aged under 25 years who attended more workshops (P < 0.001); there was no correlation with gender. About 57.3% (n = 344) of participants agreed fully that the event increased their understanding of the topics, although only 38.5% (n = 231) stated that it would change their practice. Themes influencing an event fell into three broad themes: personal reasons affecting attendance, success factors for the session and application of learning, all with related subthemes. Subthemes included commitments, convenience, awareness, topic and personal relevance, content and delivery and reference, review and action.

CONCLUSIONS

In publicising events, the topic, including the driver for the topic and the skills that will be obtained, the speaker and their experience plus how learning can be applied after the event should be included.

Teamwork: relevance and interdependence of interprofessional education

OBJECTIVE

Determine the perception of university students regarding interprofessional and interdependent work between team members in their inclusion in primary care.

METHODS

Analytical cross-sectional study. The sampling had a probabilistic, stratified random type with 95% confidence and 5% margin of error. Seven-hundred and four students of Public Universities in Santiago (Chile) answered self-administered questionnaire.

RESULTS

Ninety-seven point eight of students say that interprofessional work is important; 27.1% of them declare that their university did not seem to show that their study plans were important. The professionals listed as most important in teams are physicians and nurses.

CONCLUSIONS

Spaces for development and institutional support are key elements to promote interprofessional work. If this competence can involve each academic unit in their different formative spaces there will be a significant contribution to said promotion. Teamwork is a pending task.

Does gender matter? Differences between students at an interprofessional training ward

Studies on graduates' transitions from education into clinical work highlight inequalities concerning how women and men experience their professional learning and development. This study explores how female and male students from different programs within the health care education system (i.e. medicine, nursing, occupational therapy, and physiotherapy programmes) experience an interprofessional training ward (IPTW) as a part of their professional identity formation. Students from the medicine, nursing, physiotherapy, and occupational therapy programmes collaborate in teams during two weeks at one of three IPTWs at the medical school, Linköping University. They together take the responsibility for diagnosis, treatment, and rehabilitation of the patients, albeit with professional supervisors as support. During 2010 to 2011, 454 (93%) of the 488 students who practiced at the IPTWs answered a questionnaire on their experiences of the IPTW. The students stated that the IPTW had positively influenced their professional development. The female and male medical students were significantly less positive than other female and male students, respectively, concerning the value of IPTW. The male students from all programmes were slightly, but significantly, less positive than all the female students. These findings show that students "do gender" as an integral part of the educational practice. It is important to scrutinise the IPTW as an educational practice, influencing students' preparation for future work. Gender should be discussed not only during the IPTW rotation but also in general during the curriculum for all healthcare programmes.

Attitudes and Readiness of Students of Healthcare Professions towards Interprofessional Learning

OBJECTIVES

To evaluate the attitudes and readiness of students of healthcare professions towards interprofessional learning.

METHODOLOGY

A cross-sectional study design was used. Two different scales were used to measure the readiness for and perception of interprofessional learning; these were the 'Readiness for Interprofessional Learning Scale' and the 'Interdisciplinary Education Perception Scale'. A convenience sampling method was employed. The sample was drawn from undergraduate students enrolled in years 1 to 5 of medical, dental, pharmacy and health sciences programme. Descriptive and inferential statistics were used to analyse the data.

RESULTS

The overall response rate was 83%. The students mentioned that shared learning with other healthcare professional students will increase their ability to understand clinical problems. The students also mentioned that such shared learning will help them to communicate better with patients and other professionals. The students preferred to work with individuals from their own profession. Participants from medical, dental, pharmacy, and health sciences had a difference in opinion about 'negative professional identity', a domain of the Readiness for Interprofessional Learning Scale. Based on the different year of study of the students, 'team work and collaboration', 'negative professional identity' and 'roles and responsibility' were the Interdisciplinary Education Perception Scale domains where students had a difference in opinion.

CONCLUSIONS

Attitudes and readiness towards interprofessional learning showed significant differences among students of various healthcare professions; these differences also depended on the students' year of study. Interprofessional learning should be incorporated in the curriculum of all healthcare professional programs, which may foster students to become competent healthcare providers and understand each profession's role.

Measuring interprofessional competencies and attitudes among health professional students creating family planning virtual patient cases

BACKGROUND

The Virtual Interprofessional Patients-Computer-Assisted Reproductive Health Education for Students (VIP-CARES) Project took place during the summers of 2010-2012 for eight weeks each year at the University of British Columbia (UBC). Undergraduate health care students worked collaboratively to develop virtual patient case-based learning modules on the topic of family planning. The purpose of this study was to evaluate the changes in perception towards interprofessional collaboration (IPC) among the participants, before and after the project.

METHODS

This study utilized a mixed methods evaluation using self-assessment survey instruments, semi-structured interviews, and reflective essays. Pre- and post- project surveys were adapted from the Canadian Medical Education Determinants (CanMEDS) and Canadian Interprofessional Health Collaborative (CIHC) frameworks, as well as the Memorial University Interprofessional Attitudes (IPA) questionnaire. The survey results were analyzed as mean (M) and standard deviation (SD) on Likert scales. The non-parametric Wilcoxon signed-rank test was used to determine if any significant changes were measured between each participant's differences in score (p ≤ 0.05). Post-project interview transcripts and essays were analyzed using recursive abstraction to elicit any themes.

RESULTS

Altogether, 26 students in medicine, pharmacy, nursing, midwifery, dentistry, counselling psychology, and computer science participated in VIP-CARES, during the three years. Student attitudes toward IPC were positive before and after the project. At the project's conclusion, there was a statistically significant increase in the participants' self-assessment competency scores in the CanMEDS roles of health advocate (p = 0.05), manager (p = 0.02), and medical expert (p = 0.03), as well as the CIHC domains of interprofessional communication (p = 0.04), role clarification (p = 0.01), team functioning (p = 0.05), and collaborative leadership (p = 0.01). Qualitative evaluations yielded three major themes: communication and respect as key to team functioning, importance of role clarification within the team, and existence of inherent challenges to IPC. From the reflections, students generally felt more comfortable with their improvements in the CIHC domains of interprofessional communication, team functioning, and role clarification.

CONCLUSION

After working within an interdisciplinary team developing virtual patient learning modules on family planning, the student participants of the VIP-CARES Project indicated general improvement in the skills necessary for effective interprofessional collaboration. Triangulation of the overall data suggests this was especially observed within the areas of interprofessional communication, team functioning, and role clarification.

Readiness for interprofessional learning among healthcare professional students

OBJECTIVE

The purpose of this study was to investigate attitudes toward interprofessional learning among first year medical, nursing, and physician associate students at an American university at the start of their training.

METHODS

First year medical (n=101), nursing (n=81), and physician associate (n=35) students were invited to complete an anonymous online survey which included items related to demographic information and the Readiness for Interprofessional Learning Scale. Scores were compared by the general linear model and Duncan's multiple range test while controlling for demographic differences.

RESULTS

All three groups scored in the high range, indicating readiness for shared learning. Female students, those with advanced degrees, and those with healthcare experience prior to enrolment in health professional school had significantly higher scores than their counterparts. After controlling for differences in demographic factors, nursing students scored significantly higher than physician associate and medical students (F = 6.22, 0.0025).

CONCLUSIONS

Health professions students demonstrated readiness for interprofessional learning early in their academic programs, however important differences in baseline readiness emerged. These findings suggest that educators consider baseline attitudes of students when designing interprofessional education curricula, and use caution when extrapolating data from other geographies or cultures.

Examining the effects of interprofessional problem-based clinical ethics: Findings from a mixed methods study

Understanding how interprofessional education (IPE) works in learning clinical ethics via problem-based learning (PBL) and how different professions' perspectives influence each other in this setting may inform future IPE. Eighty-nine students participated in a clinical ethics PBL and were assigned into three study groups, i.e., medical, nursing, and interprofessional groups. This study applied an explanatory sequential mixed methods design. The quantitative phase involved observation of the learning process in PBL tutorial with checklists to code students' performance of learning behaviour, ethics discussion skills, learning content explored, and analysis through comparison of accumulative percentage of the coded performance between groups. Content analysis of post-PBL homework self-reflections from interprofessional group was conducted as the following explanatory qualitative phase. Quantitative results indicated that nursing students performed favourably on course engagement, caring, and communication while medical students performed positively on issue identification and the life science aspect. Interprofessional group showed the strength of the both professions and performed best through the learning process. Content analysis revealed that students in the interprofessional group achieved interprofessional learning from recognizing the differences between to appreciating learning from each other and to sense the need of future collaboration. With early exposure to IPE, undergraduate students may learn to balance their socialized viewpoints by seeing ethical dilemmas from each other's standpoint.

The Health Needs of Young Women: Applying a Feminist Philosophical Lens to Nursing Science and Practice

Ongoing development of nursing science requires attention to the philosophical and theoretical bases upon which the science is built. A feminist theoretical perspective offers a useful lens for understanding the needs of both nurses and their clients. Adolescent and young adult women are an underserved and understudied population for whom nursing care can be especially beneficial. Considering the needs of this population from a philosophical perspective, through a feminist lens, is one effective means of developing nursing science approaches that contribute to and ultimately improve care for adolescent and young adult women.

The effectiveness of a shared conference experience in improving undergraduate medical and nursing students' attitudes towards inter-professional education in an Asian country: a before and after study

BACKGROUND

In recent years, increasing emphasis has been placed on the importance of collaboration within multi-disciplinary healthcare teams, so as to facilitate holistic patient care and thus allow improved treatment outcomes. There is hence an urgent need to educate healthcare undergraduates early in their professional careers on the importance of and complexities involved in cooperating with counterparts from other allied healthcare professions. In conjunction with this, a milestone student-led conference for undergraduate students, the 9th Student Medical-Nursing Education Conference (SMEC), was organised in 2013 to provide a unique opportunity for shared learning among the entire cohort of undergraduate medical and nursing students in Singapore matriculating in that year.

METHODS

This study evaluated the effectiveness of the 9th SMEC 2013 as a shared conference experience in improving the attitudes of undergraduate medical and nursing students in Singapore towards inter-professional education (IPE). A 19-point Readiness for Inter-Professional Learning Scale (RIPLS) questionnaire comprising three subscales was administered to participants both before and after the conference. 352 responses were collected, giving a response rate of 75.1 %. Results were analysed using paired-samples t-tests with statistical significance set at p = 0.05.

RESULTS

Improvements in overall scores for both medical and nursing students were reported for all three RIPLS subscales. Examining the RIPLS items individually, significant improvement in scores for both medical and nursing students was obtained in all 19 items. Prior exposure to IPE activities was not a predictor of improvement in IPE attitudes.

CONCLUSION

The authors propose that student-led jointly-organised conference experiences are effective in improving healthcare students' attitudes towards IPE. This study provides valuable insights to facilitate the development of further IPE programs to allow for the rapid and effective promotion of cooperation and collaboration between students across various healthcare disciplines.

Adaptação transcultural e validação da Readiness for Interprofessional Learning Scale no Brasil

RESUMO Objetivo Realizar a adaptação transcultural e a validação da versão de 29-itens daReadiness for Interprofessional Learning Scale (RIPLS) para língua portuguesa falada no Brasil. Método Foram adotadas cinco etapas: três traduções, síntese, três retrotraduções, avaliação por especialistas e pré-teste. A validação contou com 327 estudantes de 13 cursos de graduação de uma universidade pública. Foram realizadas análises paralelas com o software R e a análise fatorial utilizando Modelagem de Equações Estruturais. Resultados A análise fatorial resultou em uma escala de 27 itens e três fatores: Fator 1 – Trabalho em equipe e colaboração com 14 itens (1-9, 12-16), Fator 2 – Identidade profissional, oito itens (10, 11, 17, 19, 21-24), e Fator 3 – Atenção à saúde centrada no paciente, cinco itens (25-29). Alfa de Cronbach dos três fatores foi respectivamente: 0,90; 0,66; 0,75. Análise de variância mostrou diferenças significativas nas médias dos fatores dos grupos profissionais. Conclusão Foram identificadas evidências de validação da versão em português da RIPLS em sua aplicação no contexto nacional.

Attitude of Basic Science Medical Students Toward Interprofessional Collaboration

Purpose: Interprofessional collaboration (IPC) and interprofessional education (IPE) are increasingly emphasized in the education of health professions. Xavier University School of Medicine, a Caribbean medical school admits students from the United States, Canada, and other countries to the undergraduate medical course. The present study was carried out to obtain information about the attitude toward IPC among basic science medical students and note differences, if any, among different subgroups.

Methods: The study was conducted among first to fifth semester students during July 2015 using the previously validated Jefferson Scale of Attitudes Toward Interprofessional Collaboration (JeffSATIC). Gender, age, semester, and nationality were noted. Participants’ agreement with a set of 20 statements was studied. Mean total scores, working relationship, and accountability scores were calculated and compared among different subgroups of respondents (p<0.05).

Results: Sixty-seven of the 71 students (94.4%) participated. Cronbach’s alpha value of the questionnaire was 0.827, indicating good internal consistency. The mean total score was 104.48 (maximum score 140) while the working relationship and accountability scores were 63.51 (maximum score 84) and 40.97 (maximum score 56), respectively. Total scores were significantly higher among third-semester students and students of Canadian nationality. Working relationship and accountability scores were higher among first and third-semester students.

Conclusion: The total working relationship and accountability scores were lower compared to those obtained in a previous study. Opportunities for IPE and IPC during the basic science years should be strengthened. Longitudinal studies in the institution may be helpful. Similar studies in other Caribbean medical schools are required.

A national study of paramedic and nursing students' readiness for interprofessional learning (IPL): Results from nine universities

BACKGROUND

The development of successful and functional interprofessional practice is best achieved through interprofessional learning (IPL). Given that many paramedic programmes still take an isolative uni-professional educational approach to their undergraduate courses, it is unclear on their preparedness for students' IPL. Therefore, the objective of this study was to assess the attitudes of undergraduate paramedic and nursing/paramedic students from nine Australian universities towards IPL over a two year period.

METHODS

Using a convenience sample of paramedic and nursing/paramedic students-attitudes towards IPL was measured using the Readiness for Interprofessional Learning Scale (RIPLS) 5-point Likert-scale (1=strongly disagree and 5=strongly agree).

RESULTS

A total of 1264 students participated (n=303 in 2011 and n=961 in 2012) in this study, consistent with a 43% response rate. Surveyed students were predominantly first year n=506 (40.03%), female n=748 (59.2%) and undertaking single paramedic degrees n=948 (75.0%). Nursing/paramedic students demonstrated significantly lower Negative Professional Identity (M=6.26, p=0.004) and Roles and Responsibilities means (M=6.87, p<0.0001) and higher Positive Professional Identity means (M=15.68, p=0.011) compared with paramedic students.

CONCLUSIONS

The impact of nursing/paramedic education was shown to significantly enhance student attitudes towards interprofessionalism and the individual universities involved in this study generated students at varying stages of IPL preparedness. Students' year level appeared to influence IPL readiness, yet there are compelling paradoxical arguments for both earlier and later inclusion of IPL within curricula.

Effectiveness of interprofessional education by on-field training for medical students, with a pre-post design

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.

Implementation and evaluation of an interprofessional simulation-based education program for undergraduate nursing students in operating room nursing education: a randomized controlled trial

BACKGROUND

The present study was designed to implement an interprofessional simulation-based education program for nursing students and evaluate the influence of this program on nursing students' attitudes toward interprofessional education and knowledge about operating room nursing.

METHODS

Nursing students were randomly assigned to either the interprofessional simulation-based education or traditional course group. A before-and-after study of nursing students' attitudes toward the program was conducted using the Readiness for Interprofessional Learning Scale. Responses to an open-ended question were categorized using thematic content analysis. Nursing students' knowledge about operating room nursing was measured.

RESULTS

Nursing students from the interprofessional simulation-based education group showed statistically different responses to four of the nineteen questions in the Readiness for Interprofessional Learning Scale, reflecting a more positive attitude toward interprofessional learning. This was also supported by thematic content analysis of the open-ended responses. Furthermore, nursing students in the simulation-based education group had a significant improvement in knowledge about operating room nursing.

CONCLUSIONS

The integrated course with interprofessional education and simulation provided a positive impact on undergraduate nursing students' perceptions toward interprofessional learning and knowledge about operating room nursing. Our study demonstrated that this course may be a valuable elective option for undergraduate nursing students in operating room nursing education.

A critical appraisal of instruments to measure outcomes of interprofessional education

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.

Creating an environment for patient safety and teamwork training in the operating theatre: A quasi-experimental study

INTRODUCTION

Positive safety and a teamwork climate in the training environment may be a precursor for successful teamwork training. This pilot project aimed to implement and test whether a new interdisciplinary and team-based approach would result in a positive training climate in the operating theatre.

METHOD

A 3-day educational module for training the complete surgical team of specialist nursing students and residents in safe teamwork skills in an authentic operative theatre, named Co-Op, was implemented in a university hospital. Participants' (n=22) perceptions of the 'safety climate' and the 'teamwork climate', together with their 'readiness for inter-professional learning', were measured to examine if the Co-Op module produced a positive training environment compared with the perceptions of a control group (n=11) attending the conventional curriculum.

RESULTS

The participants' perceptions of 'safety climate' and 'teamwork climate' and their 'readiness for inter-professional learning' scores were significantly higher following the Co-Op module compared with their perceptions following the conventional curriculum, and compared with the control group's perceptions following the conventional curriculum.

CONCLUSION

The Co-Op module improved 'safety climate' and 'teamwork climate' in the operating theatre, which suggests that a deliberate and designed educational intervention can shape a learning environment as a model for the establishment of a safety culture.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Improvement of quality and safety in health care as a new interprofessional learning module - evaluation from students

BACKGROUND

Interprofessional teamwork is in many ways a norm in modern health care, and needs to be taught during professional education.

DESCRIPTION

This study is an evaluation of a newly introduced and mandatory learning module where students from different health profession programs used Improvement of Quality and Safety as a way to develop interprofessional competence in a real-life setting. The intention of this learning module was to integrate interprofessional teamwork within the students' basic education, and to give students a basic knowledge about Improvement of Quality and Safety. This report focuses on evaluations from the participating students (n=222), mainly medical and nursing students.

MATERIALS AND METHODS

To evaluate this new learning module, a questionnaire was developed and analyzed using a mixed methods design, integrating both qualitative and quantitative methods. The evaluation addressed learning concepts, learning objectives, and interprofessional and professional development.

RESULTS AND CONCLUSION

A majority of students responded positively to the learning module as a whole, but many were negative towards specific parts of the learning module and its implementation. Medical students and male students were less positive towards this learning module. Improvements and alterations were suggested.

Internal consistency of the readiness for interprofessional learning scale in German health care students and professionals

BACKGROUND

The implementation of a bachelor degree in "Interprofessional Health Care" at the University of Heidelberg, Germany has fostered the need to evaluate the impact of this innovative programme. The Readiness for Interprofessional Learning Scale (RIPLS) was developed by Parsell and Bligh (1999) to assess student's attitudes towards interprofessional education. The RIPLS consists of 19 items and four subscales were identified by McFadyen (J Interprof Care19:595-603, 2005): "teamwork and collaboration", "negative professional identity", "positive professional identity" and "roles and responsibilities". The RIPLS has been translated into a number of languages and used in a variety of different educational settings. A German version of the RIPLS was not available. Aim of the study was the translation of the RIPLS into German and testing of internal consistency.

METHODS

The RIPLS was translated to German according to international guidelines and its psychometric properties were assessed in two online surveys with two different samples a) health care graduates and b) health care students. Descriptive analysis (mean, SD, corrected item-total correlation) of the Readiness for Interprofessional Learning Scale - German (RIPLS-D) was performed for item characteristics and Cronbach's Alpha was calculated for internal consistency of overall and subscales of the RIPLS-D.

RESULTS

Each sample consisted of 76 datasets. Reliability for the RIPLS-D overall scale was 0.83 in both samples. The subscales displayed internal consistency between 0.42 and 0.88. Corrected item-total correlation showed low values in two subscales in the sample of graduates.

CONCLUSIONS

While the overall RIPLS-D scale is reliable, several subscales showed low values and should be used with caution to measure readiness for interprofessional learning in the German health care context. Internal consistency of the instrument does not seem to be given in health care professionals at different stages of their professional career. In particular the sub-scale "roles and responsibilities" was problematic. For these reasons, the RIPLS-D cannot be recommended for use to assess this concept.

Health care interprofessional education: encouraging technology, teamwork, and team performance

It is critical to prepare nurses for future practice to work in teams by engaging students in interprofessional education (IPE) that fosters positive attitudes toward teamwork. The purpose of this study was to examine the effects of computer-supported IPE on students’ attitudes and perceptions toward health care teamwork and team performance. A hybrid approach to IPE was used to provide students with an educational experience that combined the benefits of traditional face-to-face communication methodology with a computer-mediated platform that focused on reflection and team building. A statistically significant difference was found in students’ perceptions of team performance after engaging in computer-supported IPE. No statistically significant difference in students’ pretest–posttest composite attitude toward teamwork scores was noted; however, there was a positive trend toward improved scores.

Students' readiness for and perception of inter-professional learning: a cross-sectional study

BACKGROUND

Inter-professional education is a critical pedagogical approach aiming at preparing healthcare students for providing patient care in a collaborative team atmosphere.

OBJECTIVES

To investigate the readiness for and perception of inter-professional learning and their relationship among healthcare students.

DESIGN

It was a correlational, cross-sectional study.

PARTICIPANTS

Two hundred and fifty undergraduate medical, B.Sc. nursing, and B.Sc. science in surgical technology students participated in this study.

SETTING AND SAMPLES

The samples were selected from the colleges affiliated to Shiraz University of Medical Sciences using stratified random sampling.

METHODS

The Readiness for Inter-Professional Learning Scale (RIPLS) and Interdisciplinary Education Perception Scale (IEPS) were used to measure the readiness for and perception of inter-professional leaning. The data were analyzed using One-way Analysis of Variance (ANOVA) and independent sample T-test.

RESULTS

The total mean scores of readiness for and perception of inter-professional learning were 82.40 (SD=23.16) and 74.04 (SD=14.26), respectively. Besides, the medical students' total mean score of readiness was significantly lower than that of the nursing and science in surgical technology students (F=76.73, P<0.0001). The results showed a significant difference between the current years of study regarding RIPLS and IEPS (P<0.0001). Also, a significant difference was demonstrated among the three fields concerning IEPS and its four subscales. Moreover, the total score of RIPLS was associated with that of IEPS (r=0.43, P<0.0001).

CONCLUSION

This study indicated that the medical students had the lowest RIPLS. In addition, the nursing students reported the lowest IEPS; therefore, this group's curriculum is suggested to be revised. For evidence based practice, other studies are recommended to improve inter-professional learning.

Interprofessional experiences and attitudes toward interprofessional health care teams among health sciences students

This study examined how the interprofessional experience, including education and practice, affects graduate health science students' attitudes toward interprofessional practice in health care teams. Data were collected from 227 graduate students, using the Attitudes toward Health Care Teams (ATHCT) scale. Both social work and other health science students had positive attitudes toward interprofessional collaboration with regard to its ability to improve the quality of a patient's care. The results from hierarchical linear regression analyses demonstrated that female students, older students, and students with longer interprofessional practice experiences had more positive attitudes toward interprofessional collaboration in health care teams. Based on these results, implications for interprofessional education are discussed.

The perceived importance of anatomy and neuroanatomy in the practice of speech-language pathology

The purpose of this study was to examine the application of anatomy and neuroanatomy knowledge to current practice of speech-language pathology (SLP), based on the perceptions of practicing SLPs, and to elicit information on participants' experiences of learning these subjects in their primary SLP degree with a view to inform potential curriculum development. A qualitative approach was taken to the collection of data. Eight practicing SLPs from four settings were interviewed. The critical incident technique, together with further probing, was used to elicit information. Interviews were transcribed and later thematically analyzed. This study found that knowledge of anatomy and neuroanatomy was perceived to be important by SLPs across all settings, to varying degrees, with a greater application in acute hospital settings. Negative experiences in studying this material were reported across all settings regardless of country of study. Participants discussed ways to increase students' motivation to learn this challenging material. Relevance of material demanded by students may be enhanced if active learning methods were used to teach anatomy/neuroanatomy, including case-based learning and with vertical and horizontal integration of material to provide a cohesive, spiral curriculum.

A comparison of two scales for assessing health professional students' attitude toward interprofessional learning

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.

A cross-sectional study of paramedics' readiness for interprofessional learning and cooperation: results from five universities

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.

Prior experience of interprofessional learning enhances undergraduate nursing and healthcare students' professional identity and attitudes to teamwork

BACKGROUND

How willing are today's medical, nursing and other healthcare students to undertake some of their studies as shared learning? There is a lack of evidence of students' views by discipline despite this being a priority task for higher education sectors. This study explored the views of nursing, midwifery, nursing-emergency health (paramedic), medical, physiotherapy and nutrition-dietetics students.

METHODS

Senior undergraduate students from six disciplines at one university completed the Readiness for Interprofessional Learning Scale prior to participating in interprofessional clinical learning modules.

RESULTS

For 741 students, the highest ranked response was agreement about a need for teamwork (mean 4.42 of 5 points). Nursing students held significantly more positive attitudes towards Teamwork/Collaboration, and were more positive about Professional Identity than medical students (p < .001). Midwifery and nursing-emergency-health students rejected uncertainty about Roles/Responsibilities compared with medical students (p < .001). One-third of all students who had prior experience of interprofessional learning held more positive attitudes in each of four attitude domains (p < .05).

CONCLUSION

Overall, students' attitudes towards interprofessional learning were positive and all student groups were willing to engage in learning interprofessionally. Early introduction of IPL is recommended. Further studies should explore the trajectory of students' attitudes throughout the university degree.

Physician's Perceptions of Interprofessional Collaboration in Clinical Training Hospitals in Northeastern Japan

Background

Effective and efficient interprofessional collaboration (IPC) is needed between departments in a healthcare setting. Although Japanese physicians are expected to provide leadership in IPC, it has been suggested that their perception of IPC is more negative than among other healthcare professionals. The purpose of this study was to clarify Japanese physician’s perceptions of IPC and what factors influenced their views.

Methods

This cross-sectional study surveyed 732 medical doctors at a university hospital and six foundation hospitals in a prefecture located in Tohoku district, northeastern Japan. Those hospitals were approved for delivery of postgraduate clinical training. Physician’s perceptions of IPC were investigated for three items, namely providing patient-centered care, preventing medical accidents, and improving the quality of medical care. A total of 409 doctors who were engaged in clinical practice, responded adequately to the survey. Factors associated with negative perceptions towards IPC among physicians were analyzed using a logistic regression model.

Results

The proportion of negative perceptions of IPC for providing patient-centered care, preventing medical accidents, and improving the quality of medical care were 41.1%, 34.0% and 33.7%, respectively. Negative perceptions of IPC for providing patient-centered care were associated with older age (50 + years; odds ratio (OR): 2.73; 95% confidence interval (CI): 1.11 - 6.68) and a lower frequency of interprofessional meetings (no meetings; OR: 2.95; 95%CI: 1.43 - 6.08). Negative perceptions of IPC for preventing medical accidents were associated with a lower frequency of interprofessional meetings (no meetings, OR: 3.23; 95%CI: 1.58 - 6.62). Negative perceptions of IPC for improving the quality of medical care were associated with middle age (40 - 49 years, OR: 2.93; 95%CI: 1.20 - 7.12) and a lower frequency of interprofessional meetings (no meetings; OR: 2.75; 95%CI: 1.34 - 5.66).

Conclusions

Physician’s negative perceptions of IPC in our study were associated with age and a lower frequency of interprofessional meetings. Our findings suggest that effective regular interprofessional meetings serve to share information about patients, and to allow physicians to understand each other better, which should have a positive impact on the quality of patient-centered care.

Swedish nursing and medical students' high vaccination adherence during the influenza A (H1N1) pandemic 2009: insights for pandemic preparedness

The aim of this study was to analyze Swedish health science student decision-making regarding vaccination against pandemic influenza during a national mass vaccination campaign. A questionnaire was distributed to 430 students during the influenza A (H1N1) pandemic in 2009. The data from medical and nursing students were compared and a multiple logistic regression model was applied to identify items independently associated with the decision to be vaccinated. The overall survey response rate was 90%. More medical (93.2%) than nursing students (84.8%) reported that they had received the vaccine (p < 0.01). Only the perception that benefits can outweigh possible side effects was significantly (p < 0.001) associated with the decision to get vaccinated. We recommend that, during pandemics, health science universities focus vaccination information for students on objective risk communication. It should be taken into account that the pandemic information provided by authorities to the general public also affects health care students.