The Readiness for interprofessional learning scale: A possible more stable sub-scale model for the original version of RIPLS

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.

Interprofessional education in team communication: working together to improve patient safety

BACKGROUND

Communication failures in healthcare teams are associated with medical errors and negative health outcomes. These findings have increased emphasis on training future health professionals to work effectively within teams. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) communication training model, widely employed to train healthcare teams, has been less commonly used to train student interprofessional teams. The present study reports the effectiveness of a simulation-based interprofessional TeamSTEPPS training in impacting student attitudes, knowledge and skills around interprofessional communication.

METHODS

Three hundred and six fourth-year medical, third-year nursing, second-year pharmacy and second-year physician assistant students took part in a 4 h training that included a 1 h TeamSTEPPS didactic session and three 1 h team simulation and feedback sessions. Students worked in groups balanced by a professional programme in a self-selected focal area (adult acute, paediatric, obstetrics). Preassessments and postassessments were used for examining attitudes, beliefs and reported opportunities to observe or participate in team communication behaviours.

RESULTS

One hundred and forty-nine students (48.7%) completed the preassessments and postassessments. Significant differences were found for attitudes toward team communication (p<0.001), motivation (p<0.001), utility of training (p<0.001) and self-efficacy (p=0.005). Significant attitudinal shifts for TeamSTEPPS skills included, team structure (p=0.002), situation monitoring (p<0.001), mutual support (p=0.003) and communication (p=0.002). Significant shifts were reported for knowledge of TeamSTEPPS (p<0.001), advocating for patients (p<0.001) and communicating in interprofessional teams (p<0.001).

CONCLUSIONS

Effective team communication is important in patient safety. We demonstrate positive attitudinal and knowledge effects in a large-scale interprofessional TeamSTEPPS-based training involving four student professions.

French translation and validation of the Readiness for Interprofessional Learning Scale (RIPLS) in a Canadian undergraduate healthcare student context

The Canadian Interprofessional Health Collaborative recommends that future professionals be prepared for collaborative practice. To do so, it is necessary for them to learn about the principles of interprofessional collaboration. Therefore, to ascertain if students are predisposed, their attitude toward interprofessional learning must be assessed. In the French Canadian context such a measuring tool has not been published yet. The purpose of this study is to translate in French an adapted version of the RIPLS questionnaire and to validate it for use with undergraduate students from seven various health and social care programmes in a Canadian university. According to Vallerand's methodology, a method for translating measuring instruments: (i) the forward-backward translation indicated that six items of the experimental French version of the RIPLS needed to be more specific; (ii) the experimental French version of the RIPLS seemed clear according to the pre-test assessing items clarity; (iii) evaluation of the content validity indicated that the experimental French version of the RIPLS presents good content validity and (iv) a very good internal consistency was obtained (α = 0.90; n = 141). Results indicate that the psychometric properties of the RIPLS in French are comparable to the English version, although a different factorial structure was found. The relevance of three of the 19 items on the RIPLS scale is questionable, resulting in a revised 16-item scale. Future research aimed at validating the translated French version of the RIPLS could also be conducted in another francophone cultural context.

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.

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.

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.

An interprofessional diabetes experience to improve pharmacy and nursing students' competency in collaborative practice

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.

Development and validation of the student perceptions of physician-pharmacist interprofessional clinical education (SPICE) instrument

OBJECTIVES

To describe the development and validation of an instrument designed to assess student perceptions of physician-pharmacist interprofessional clinical education (SPICE).

METHODS

Faculty members from pharmacy and medical schools developed items for the instrument, and 179 medical and pharmacy students completed the scale. Psychometric properties, including reliability and construct validity, were assessed using confirmatory factor analysis.

RESULTS

The final instrument consisted of 10 items with 3 subscales measuring student perceptions of interprofessional teamwork and team-based practice, roles/responsibilities for collaborative practice, and patient outcomes from collaborative practice. Validity and reliability of the instrument were demonstrated.

CONCLUSION

The SPICE instrument demonstrated promise as a valid and reliable measure of pharmacy and medical student perceptions of interprofessional clinical education. SPICE may serve as a useful instrument for educational researchers in assessing the impact of interprofessional educational experiences.

The use of social networking to improve the quality of interprofessional education

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.

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.

Instructional insight into interprofessional education (IPE)

Working with other health science professionals in order to promote positive client outcomes is common practice in many rehabilitation delivery areas. The evolution of health care delivery seems to expect more efficient and cost effective client care, therefore the introduction of blended professional teams is moving to the forefront of professional education. As such, providing opportunities to health science students to experience the roles and practice of other professions during the academic portion of their education, Interprofessional Education (IPE), has become and expectation of accrediting bodies. The Accreditation Council for Occupational Therapy Education (ACOTE) has included standards related to IPE (ACOTE, 2012). The most recent ACOTE standards, effective July 2013, require occupational therapy educators to provide interprofessional collaborative situations to increase student awareness of and participation in interprofessional learning (ACOTE, 2012). This article describes some of the IPE experiences of one small university as well as provides suggestion for other occupational therapy educational programs to move forward to meeting the newly established accreditation standards.

Undergraduate students' perceptions of and attitudes toward a simulation-based interprofessional curriculum: the KidSIM ATTITUDES questionnaire

INTRODUCTION

Existing attitude scales on interprofessional education (IPE) focus on students' attitudes toward the concepts of teamwork and opportunities for IPE but fail to examine student perceptions of the learning modality that also plays an important role in the teaching and learning process. The purpose of this present study was to test the psychometric characteristics of the KidSIM Attitude Towards Teamwork in Training Undergoing Designed Educational Simulation (ATTITUDES) questionnaire developed to measure student perceptions of and attitudes toward IPE, teamwork, and simulation as a learning modality.

METHODS

A total of 196 medical, nursing, and respiratory therapy students received a 3-hour IPE curriculum module that focused on 2 simulation-based team training scenarios in emergency and intensive care unit settings. Each multiprofessional group of students completed the 30-item ATTITUDES questionnaire before participating in the IPE curriculum and the same questionnaire again as a posttest on completion of the high-fidelity simulation, team-based learning sessions.

RESULTS

The internal reliability of the ATTITUDES questionnaire was α = 0.95. The factor analysis supports a 5-factor solution accounting for 61.6% of the variance: communication (8 items), relevance of IPE (7 items), relevance of simulation (5 items), roles and responsibilities (6 items), and situation awareness (4 items). Aggregated and profession-specific analysis of students' responses using paired sample t tests showed significant differences from the pretest to the posttest for all questionnaire items and subscale measures (P < 0.001).

CONCLUSIONS

The KidSIM ATTITUDES questionnaire provides a reliable and construct valid measure of student perceptions of and attitudes toward IPE, teamwork, and simulation as a learning modality.

Evaluating the impact of interdisciplinary networking in environmental geochemistry and health: reviewing SEGH conferences and workshops

The Society for Environmental Geochemistry and Health (SEGH) is a forum for multidisciplinary interaction relating the geochemical environment to health. With national funding, SEGH identified collaborative opportunities through the MULTITUDE series of workshops (2007-2011). We reviewed the meetings by electronic questionnaire (39 % response). Smaller meetings saw most returning delegates, suggesting networking and personal interaction is a key positive feature of SEGH; 31 % of practitioners and 25 % of academics participated in more than one meeting. Collaboration between SEGH participants resulted in joint funding (13 academics, 4 practitioners, 1 other) and joint papers (19, 5, 3). Evidence of behavioural change was seen in comments in five themes regarding the impacts of the conferences: support for current direction; impact on education practice (academics); new approaches; networking; multidisciplinary work. Multidisciplinary meetings and resulting networking were seen as having real value by many respondents, who encouraged further active pursuit of these activities. SEGH is eager to continue these activities which transform research, education and practice, resulting in a better understanding of the structure and processes comprising the broad geochemical environment on health. Comments showed the value and strength of small, well-organised conferences, bringing together a mixed group of disciplines, both research and applied, in a relaxed atmosphere. The absence of serious negative critique along with clear, positive comments suggests that there is a substantial level of support for, and even pleasure in, SEGH multidisciplinary conferences and workshops over the past years. It is encouraging that annual European conferences are viewed as such a positive achievement.

Continuing differences between health professions' attitudes: the saga of accomplishing systems-wide interprofessionalism

OBJECTIVE

To compare four health professions' attitudes towards interprofessional collaboration (IPC) and their evaluations of a programme aimed at enhancing IPC across a health system.

DESIGN

Questionnaire survey.

SETTING

Australian Capital Territory health services.

PARTICIPANTS

Sample of medical (38), nursing (198), allied health (152) and administrative (30) staff.

INTERVENTION

s) A 4-year action research project to improve IPC.

MAIN OUTCOME MEASURE

Questionnaire evaluating the project and responses to the 'Attitudes toward Health Care Teams' and 'Readiness for Interprofessional Learning' scales.

RESULTS

Significant professional differences occurred in 90% of the evaluation items. Doctors were the least and administrative staff most likely to agree project aims had been met. Nurses made more favourable assessments than did allied health staff. Doctors made the most negative assessments and allied health staff the most neutral ratings. Improved interprofessional sharing of knowledge, teamwork and patient care were among the goals held to have been most achieved. Reduction in interprofessional rivalry and improved trust and communication were least achieved. Average assessment of individual goals being met was agree (31.9%), neutral (56.9%) and disagree (11.2%). On the two attitude scales, allied health professionals were most supportive of IPC, followed by nurses, administrators and doctors.

CONCLUSIONS

Although overall attitudes towards IPC were favourable, only a third of participants reported that project goals had been achieved indicating the difficulties of implementing systems change. The response profiles of the professions differed. As in the previous research, doctors were least likely to hold favourable attitudes towards or endorse benefits from social or structural interventions in health care.

Cultural adaptation and validating a Japanese version of the readiness for interprofessional learning scale (RIPLS)

Readiness for interprofessional education (IPE) can be an important factor to evaluate because of the influences of attitudes toward the outcomes of interprofessional learning activities. However, a dearth of Japanese evaluation tools hinders its evaluation. The readiness for interprofessional learning scale (RIPLS) was selected, because it has been validated in different countries and its items reflected our local situation best. This research aimed to develop and validate a Japanese version of the original 19-item RIPLS. We developed a Japanese RIPLS employing forward/backward translation. Reliability of the Japanese version was studied using classical test theory and structural equation modeling to construct a model to inform curriculum development. We obtained a 0.74 Cronbach's α, which indicates adequacy. Subscales of "interprofessional education opportunities" (α = 0.90) and "uniqueness of profession" (α = 0.60) have relatively little weight compared to "teamwork and collaboration" (α = 0.92). A one-way structure suggests that readiness for interprofessional learning starts with "teamwork & collaboration" followed by changes in "learning opportunities" and subsequently "uniqueness of profession" (root mean square error of approximation = 0.06, comparative fit index = 0.93). This Japanese RIPLS can be used in undergraduate health sciences students with appropriate caution. Further development of the subscales and a client-centered subscale would be beneficial to fully achieve its potential. The need for further research into its reliability and validity is identified. Recommendations are provided for cross-cultural adaptation and for establishing validity across different contexts.

A four-year, systems-wide intervention promoting interprofessional collaboration

Background

A four-year action research study was conducted across the Australian Capital Territory health system to strengthen interprofessional collaboration (IPC) though multiple intervention activities.

Methods

We developed 272 substantial IPC intervention activities involving 2,407 face-to-face encounters with health system personnel. Staff attitudes toward IPC were surveyed yearly using Heinemann et al's Attitudes toward Health Care Teams and Parsell and Bligh's Readiness for Interprofessional Learning scales (RIPLS). At study's end staff assessed whether project goals were achieved.

Results

Of the improvement projects, 76 exhibited progress, and 57 made considerable gains in IPC. Educational workshops and feedback sessions were well received and stimulated interprofessional activities. Over time staff scores on Heinemann's Quality of Interprofessional Care subscale did not change significantly and scores on the Doctor Centrality subscale increased, contrary to predictions. Scores on the RIPLS subscales of Teamwork & Collaboration and Professional Identity did not alter. On average for the assessment items 33% of staff agreed that goals had been achieved, 10% disagreed, and 57% checked neutral. There was most agreement that the study had resulted in increased sharing of knowledge between professions and improved quality of patient care, and least agreement that between-professional rivalries had lessened and communication and trust between professions improved.

Conclusions

Our longitudinal interventional study of IPC involving multiple activities supporting increased IPC achieved many project-specific goals. However, improvements in attitudes over time were not demonstrated and neutral assessments predominated, highlighting the difficulties faced by studies targeting change at the systems level and over extended periods.

A cross-institutional examination of readiness for interprofessional learning

This paper examines the readiness for and attitudes toward interprofessional (IP) education in students across four diverse educational institutions with different educational mandates. The four educational institutions (research-intensive university, baccalaureate, polytechnical institute and community college) partnered to develop, deliver and evaluate IP modules in simulation learning environments. As one of the first steps in planning, the Readiness for Interprofessional Learning Scale was delivered to 1530 students from across the institutions. A confirmatory factor analysis was used to expand upon previous work to examine psychometric properties of the instrument. An analysis of variance revealed significant differences among the institutions; however, a closer examination of the means demonstrated little variability. In an environment where collaboration and development of learning experiences across educational institutions is an expectation of the provincial government, an understanding of differences among a cohort of students is critical. This study reveals nonmeaningful significant differences, indicating different institutional educational mandates are unlikely to be an obstacle in the development of cross-institutional IP curricula.

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

BACKGROUND

Interprofessional Education (IPE) is now spreading worldwide and many universities are now including IPE in their curricula. The aim of this study was to investigate whether or not such student characteristics as gender, previous working experience in healthcare, educational progress and features of the learning environment, such as educational programmes and curriculum design, have an impact on their open-mindedness about co-operation with other professions.

METHODS

Medical and nursing students at two Swedish universities were invited to fill in the Readiness for Interprofessional Learning Scale (RIPLS). Totally, 955 students were invited and 70.2% (n=670) participated in the study. A factor analysis of the RIPLS revealed four item groupings (factors) for our empirical data, but only one had sufficient internal consistency. This factor was labelled "Team Player".

RESULTS

Regardless of the educational programme, female students were more positive to teamwork than male students. Nursing students in general displayed more positive beliefs about teamwork and collaboration than medical students. Exposure to different interprofessional curricula and previous exposure to interprofessional education were only to a minor extent associated with a positive attitude towards teamwork. Educational progress did not seem to influence these beliefs.

CONCLUSIONS

The establishment of interprofessional teamwork is a major challenge for modern healthcare. This study indicates some directions for more successful interprofessional education. Efforts should be directed at informing particularly male medical students about the need for teamwork in modern healthcare systems. The results also imply that study of other factors, such as the student's personality, is needed for fully understanding readiness for teamwork and interprofessional collaboration in healthcare. We also believe that the RIPL Scale still can be further adjusted.

An interprofessional learning module on asthma health promotion

OBJECTIVE

To develop, implement, and evaluate a new interprofessional learning module that focused on asthma health promotion called Taking Action Together for Asthma.

DESIGN

Faculty members in medicine, nursing, and pharmacy courses recruited 10 students each to participate in a 3-day interprofessional learning module. Students received extensive materials including a workbook to document their expectations and experience; completed a 1-day interprofessional workshop; received training in the Triple A (Adolescent Asthma Action) program; and went into high schools and taught the Triple A program to students in interprofessional teams.

ASSESSMENT

Before and after participating in the module, students completed a questionnaire consisting of 3 previously validated instruments: the Asthma Knowledge for Health Professionals Scale, Attitudes Toward Health Care Teams Scale, and Readiness for Interprofessional Learning Scale (RIPLS). Seventeen students completed both the pre- and post-module scales and significant changes were seen only in means scores for the Attitude Toward Healthcare Teams (81.0 ± 4.7 to 85.2 ± 5.9) and the Teamwork and Collaboration subscale of the RIPLS (41.4 ± 2.7 to 43.2 ± 2.7).

CONCLUSION

Health promotion activities offer a viable mechanism for fostering interprofessional learning among health professions students.

From professional silos to interprofessional education: campuswide focus on quality of care

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.

Are senior UAE medical and nursing students ready for interprofessional learning? Validating the RIPL scale in a Middle Eastern context

The success of interprofessional education initiatives depends substantially on attitudes and readiness of health care students to this type of learning. To our knowledge, nothing is known about this subject in a non-western educational context. Using a self-administered extended 29 item version of the Readiness for Interprofessional Learning Scale (RIPLS), this study examined attitudes and readiness for interprofessional education of senior medical (n = 90) and nursing (n = 88) students' from the United Arab Emirates University and Institute of Nursing. The researchers also tested the validity of the RIPLS in this Middle Eastern context. Three main factors, comprising 20 statements emerged from statistical analysis of the data. Sub-scales were labelled "teamwork and collaboration", "professional identity" and "patient-centredness" and each had a strong internal consistency (0.86, 0.80, 0.80 respectively). Both groups of students believed that there are potential academic and clinical benefits of interprofessional learning. Nevertheless, analysis of variance indicated significant differences between the two groups of students in respect of key statements on each factor. The extended RIPLS was validated for use in an undergraduate Middle Eastern community and thus provides programme developers and evaluators with a useful tool to assess medical and nursing students' readiness for interprofessional learning in this context.

The test-retest reliability of a revised version of the Readiness for Interprofessional Learning Scale (RIPLS)

The original version of the Readiness for Interprofessional Learning Scale (RIPLS) was published by Parsell and Bligh in 1999. The only aspect of reliability considered by the authors was the internal consistency. A revised version for use with undergraduate students was published in 2005 (McFadyen et al., 2005). That paper also reported internal consistency of the revised version. Subsequently a sample from one professional group (n = 65) was used to assess test-retest reliability, over a one week period, of each of the 19 items and of the sub-scale totals, using Weighted Kappa and the intra-class correlation (ICC) respectively, and these results are reported in the present paper. The test-retest reliability of the individual items using Weighted Kappa was satisfactory, with the exception of two items (Items 11 and 12). The ICC results for the sub-scale totals were all in excess of 0.60 with the exception of sub-scale two. This revised version of RIPLS would appear to have good reliability in three of its sub-scales but further research, with larger samples, is required before the fourth sub-scale can be reliably assessed.

Interprofessional education and working in mental health: in search of the evidence base

AIM

To explore interprofessional attitudes arising from shared learning in mental health.

BACKGROUND

Inter-professional education in healthcare is a priority area for improving team-working and communication. Many studies have attempted to evaluate its benefits and challenges, although few emanate from the mental health arena. However, producing evidence to link educational input with clinical outcomes is notoriously difficult. This project attempted to produce evidence for changes in interprofessional attitudes and stereotypes.

METHOD(S)

Mental health nursing students and clinical psychology trainees participated in inter-professional education. An evaluation tool was designed to evaluate the experience and outcomes, and to consider implications for interprofessional working.

RESULTS

There was an increase in clarity regarding roles, approaches and resources, and how to collaborate in practice. There was no significant change in professional identity. Many challenges were identified, including differences in academic level, previous experience, expectations, assessment, motivation and effort.

CONCLUSION

Despite the challenges, it remains important to offer collaboration with future mental health colleagues as a foundation for effective team-working. Recommendations are made for creating inter-professional education opportunities for diverse student groups.

IMPLICATIONS FOR NURSING MANAGEMENT

Mental health professionals need to work effectively in multidisciplinary teams. Drawing on available guidance, managers should encourage and support team members to undertake shared learning where possible, both within clinical settings and through more formal educational provision. In this way, managers can facilitate collaborative relationships which will pay dividends for the provision of effective mental health care. This project adds to the limited knowledge currently available on interprofessional learning and attitudes within a mental health context.

Preparing for the dental team: investigating the views of dental and dental care professional students

There is growing evidence to support the contention that interprofessional education (IPE) at both pre and post-qualification levels will improve professionals' abilities to work more effectively in a team and to communicate more effectively with colleagues and patients. This body of evidence, however, is primarily concerned with nursing, medical and associated professionals and students, and there are few studies that include dental students and particularly where learning occurs with the dental care professions (DCP). The purpose of this study was to examine the attitudes of dental and DCP students to IPE and to highlight some of the barriers to developing programmes for these students. It was also intended to examine the students' awareness of dental and DCP roles and responsibilities. Two questionnaires, the Readiness for Interprofessional Learning Scale (RIPLS) and a dental roles and responsibilities questionnaire, were distributed to all 5 years of dental students (n = 189) based at Queen's University Belfast (QUB), both years of the dental hygiene students (n = 8) also based at QUB, as well as to final year dental nursing students based at Belfast Institute of Further and Higher Education (BIFHE) (n = 64). The results indicated that dental and DCP students had a positive attitude to IPE as a means to improve teamwork and communication skills but there are potential obstacles as demonstrated by the differing perceptions of each of the three groups about the roles of the other. Some aspects of practice, involving personal care and advice to patients, were regarded by all groups as a shared role but the dental hygiene students regarded themselves as having a shared role in several tasks identified by dental and dental nurse students as the sole role of the dentist. Dental hygiene students in this study did not see their role as primarily to support the dentist but more as a partner in care. Professional identity and its development are issues that must be considered by dental and DCP educators developing IPE initiatives.

The Interdisciplinary Education Perception Scale (IEPS): an alternative remodelled sub-scale structure and its reliability

The original 4 sub-scale version of the Interdisciplinary Education Perception Scale (IEPS) was published by Luecht et al. (1990, Journal of Allied Health, 181 - 191). There appears however to be a lack of evidence of the stability of the original instrument and of the test-retest reliability of the items and sub-scales when used with undergraduates. Given that during its development only 143 subjects completed the questionnaire which contained 18 items the generalizability of the instrument should perhaps have been investigated further. The Interprofessional Learning Group (IPL) at Glasgow Caledonian University has been using both the IEPS and the Readiness for Interprofessional Learning Scale (RIPLS) (Parsell & Bligh, 1999, Medical Education, 33, 95 - 100) to monitor changes in attitudes and perceptions of undergraduate students from eight different health and social care programmes. This paper reports the development of an alternative sub-scale model for the IEPS based on a sample of 308 students. Various aspects of the reliability of this revised model based on a subsequent data set of 247 students are also reported. This revised model appears to be stable for use with undergraduate students yielding Cronbach Alpha values for two of the sub-scales greater than 0.80 and test-retest weighted kappa values for items being fair to moderate.