Students' perceptions of interprofessional education in geriatrics: A qualitative analysis

Pharmacy Students' Initial Interest in Working With Older Adults and Their Relationship to Change in Attitudes After Required Curricula on Aging

Background There is an urgent need to prepare our health care workforce for the aging population. Pharmacy programs should equip students with foundational knowledge about aging and therapeutic skills for the rising demands of health care for older adults. Objectives This study examined the relationship between initial student interest in working with older adults and change in attitudes toward aging and providing pharmacy services to older patients after participation in required aging-focused curricula. Methods We measured student pharmacists' interest and attitudes regarding aging and care of older adults in required aging-focused courses in five PharmD programs in the United States and Canada. The University of Arizona Aging and Health Care-Pharmacy (UA AHC-Pharmacy) survey, containing one student-interest question and a 40-item attitudes scale, was used. Pre- and post comparisons were used for the matched student data. The University of Arizona Institutional Review Board (IRB) approved the study (#1912243064), and other colleges received permission to participate from their college or university IRB. Results After completing the required aging-focused course, PharmD students' interest and attitudes toward aging and providing health care to older adults improved significantly compared with the beginning of the course. Less agreement with negative stereotypes of older adults and working with this population was shown. Even those with initially low interest had significantly increased attitude scores post-course. Conclusion Assessment of the impact of aging-focused curricula on student pharmacists' interest and attitudes toward aging and caring for older adults may facilitate meeting the health care demands of the growing older population.

A scoping review of interprofessional education in healthcare: evaluating competency development, educational outcomes and challenges

BACKGROUND

Interprofessional education (IPE) is essential in healthcare to enhance collaboration, communication and teamwork among health professions education students. This review aimed to map out the core competencies health professions education students develop during IPE and identify the positive and negative educational outcomes.

METHODS

A comprehensive search strategy was developed and reported in accordance with the PRISMA ScR guidelines. The search was conducted across five electronic databases (Medline, Scopus, Web of Science, PsycINFO and EBSCO) for peer-reviewed articles published in English within the last 20 years. Data was extracted and core competencies were categorised into four defined areas-roles and responsibilities; interprofessional communication; values for interprofessional practice; teams and teamwork. The frequency of occurrence of each core competency, along with the positive and negative outcomes of IPE were analysed. Mixed methods analysis was used to integrate both qualitative and quantitative data.

RESULTS

Team and teamwork emerged as the most frequently attained core competency in IPE. The positive impacts of IPE include significant improvements in role clarity, communication skills, and teamwork dynamics. However, negative impacts were also noted, such as logistical challenges and interpersonal issues like power dynamics and communication barriers, which impeded the personal professional growth and professional interactional skill-related benefits of IPE. Additionally, some participants reported feeling overwhelmed by the extra workload required for IPE activities.

CONCLUSION

IPE is a valuable component of health professions education, significantly contributing to the development of core competencies necessary for interprofessional collaborative practice. Addressing the challenges and implementing best practices can further enhance the effectiveness of IPE programs, ultimately improving healthcare outcomes. The implications for practice, training of healthcare students and future research are discussed.

Geriatric education for pharmacy students: A scoping review

BACKGROUND

Comprehensive medication management for older adults requires specific knowledge and skills. Therefore, pharmacy curricula should include appropriate strategies to prepare students for care of this population. This scoping review aimed to identify how geriatric concepts, such as geriatric topics and competencies, are included in pharmacy curricula, and to map current literature on preferred teaching and assessment methods related to geriatric pharmacy education.

METHODS

Four databases were searched to identify papers involving pharmacy learners, education, and geriatrics. Selection process was a two-step approach, involving independent title/abstract screening by two reviewers, then full-text retrieval for eligibility assessment. All types of articles were considered except opinion papers. Data extraction included details on methodology, participants, setting, educational activity, teaching method, and outcomes assessed.

RESULTS

A total of 2537 articles were identified from which 189 met the inclusion criteria: 221 documents after citation and gray literature searching. Articles were grouped for analysis as education-related intervention articles (studies, n = 100 or descriptive articles/case reports, n = 49), studies not including an education-related intervention (n = 49), and others (e.g., reviews, position papers/statements, n = 23). Various teaching methods were reported including experiential, didactic, interprofessional, or simulation. Most articles reported positive outcomes on skills, knowledge, or attitudes, but few articles used a validated assessment tool. Curricula and student's surveys were consistent with suboptimal geriatric education, with few programs offering mandatory dedicated geriatric courses or rotations.

CONCLUSIONS

Gaps remain regarding geriatric inclusion in pharmacy curricula despite decades of evidence, advocacy, and frameworks to guide its development. A wide diversity of teaching methods has been described and their combination may be considered for skills and competency development. There is a need for the scholarship of teaching and learning to be applied to pharmacy programs in order to prepare future pharmacists for an aging society.

Enhancing the effectiveness of interprofessional education in health science education: a state-of-the-art review

BACKGROUND

In order to foster effective collaboration and improve healthcare outcomes, students from multiple health professions engage in interprofessional education (IPE), learning together and from each other. Existing literature explores the effectiveness of IPE within health sciences but presents varied findings. The purpose of this study is to The effectiveness of IPE is defined as the four levels of training evaluation delineated by Kirkpatrick: reaction, learning, behavior, and results. Affecting factors are defined as elements directly influencing IPE effectiveness, while intermediating factors are influenced by these affecting factors, subsequently impacting overall IPE effectiveness.

METHODS

A state-of-the-art review was conducted using medical databases PubMed, MEDLINE, PsycINFO, Web of Science, and Scopus. Search terms included: (interprofessional learning) OR (interprofessional education) AND (higher education) within the time frame of 2017 to 2022. The methodological quality of the included studies was assessed using Joanna Briggs Institute checklists for quasi-experimental and qualitative studies. Study features were evaluated using a coding scheme, and qualitative analysis of the included studies was performed.

RESULTS

Fifty-four studies met the inclusion criteria after screening. Qualitative analysis revealed four affecting factors: 1) Community-based learning approach, 2) Problem-based learning approach, 3) Experiential learning approach, and 4) Technology-based learning approach. Intermediating factors included student and team characteristics, such as boundary crossing, team leadership, readiness, educational discipline and background, and interprofessional attitudes. Additionally, educational design characteristics, like intervention duration, facilitation, and authenticity of learning experiences, served as intermediating factors. Organizational characteristics, such as organizational culture and logistics, were identified as further intermediating factors.

CONCLUSION

This study provides insight on factors affecting and intermediating IPE effectiveness, vital in the design of IPE programs. Based on the findings we formulated six practical tips to enhance IPE effectiveness.

Interprofessional education for healthcare professionals. A BEME realist review of what works, why, for whom and in what circumstances in undergraduate health sciences education: BEME Guide No. 83

AIM

To provide an evidence-informed program theory (PT) for Interprofessional Education (IPE) that adds to the knowledge base of how IPE in undergraduate health sciences education works.

METHODS

We undertook a realist review of the literature and synthesis of the evidence combined with stakeholder experience. Our initial program theory (IPT), built around development, delivery and evaluation of IPE interventions, was tested and refined following an in-depth search of the literature and consultation with stakeholders. The literature (2010-2022) was selected based on the realist criteria of relevance and rigor, as well as on conceptual richness of the studies.

RESULTS

Our PT is built upon 124 CMOs (Context of IPE interventions, Mechanisms that fired within that context, and IPE Outcomes), from 58 studies. Our PT comprises an array of elements found in the Context, including traits and behavioral displays of students and facilitators, and discusses four Mechanisms (feeling responsible, feeling enthusiastic/excited, feeling safe to take risks, and feeling ready), which are likely to lead to outcomes related to the Interprofessional Education Collaborative (sub)competencies.

DISCUSSION

Results were linked to learning theories to further build our understanding. The PT can serve as a guide for the development, delivery, and evaluation of IPE interventions.

The Virtual Geriatric Assessment Interdisciplinary Team Project: Interprofessional Geriatric Training Against the Backdrop of COVID-19

Interprofessional geriatric education programs enhance trainees' knowledge of older adults, and the valuable contributions health and social care practitioners make to their well-being when specialists work collaboratively. In response to the 2020 COVID-19 pandemic restrictions, in-person geriatric interprofessional education (IPE) programs were redesigned for virtual delivery. Nineteen virtual programs were held between September 2020 and December 2022. Of the 369 health and social care trainees who participated, 67.2% completed both pre- and post-program surveys. Survey instruments included the Interprofessional Collaborative Competency Attainment Survey (ICASS), which measures perceptions associated with patient-centered, team-based, collaborative care. Significant differences were obtained across ICASS domains, including communication, conflict management/resolution, and team functioning, suggesting that virtual programs may enhance attitudes and perceived abilities for interprofessional collaborative practice. Furthermore, participants' perceived understanding of older adult needs improved, as did their interest in geriatrics. Results illustrate that virtual geriatric interprofessional (IP) programs may be viable alternatives to in-person opportunities.

A student-led Geriatric Assessment Clinic: Interprofessional education with an older adult population

Healthcare students have expressed a need for more education on the aging adult population. Interprofessional education (IPE) is a well-known educational model intended to increase students' knowledge, skill, and abilities to use evidence-based practice for improved patient outcomes. At a Midwestern, urban-based university, we have implemented an interprofessional, student-led Geriatric Assessment Clinic in order to allow students in six health professions (including medicine, nutrition, occupational therapy, physical therapy, social work, and speech language pathology) to practically apply their skills in the aging adult population while learning to work with other healthcare professionals. This holistic clinic is free of cost to the aging adults who participate in it. The following article discusses the purpose, implementation, benefits, and limitations of such a clinic as it relates to both the patients who attend and the students who participate.

Engaging post-secondary students in a multidisciplinary aging studies interest group

Little is known about student aging interest groups (AIGs) in post-secondary institutions. Our study evaluated awareness of a student aging interest group at a western Canadian university with no gerontology program. Additional goals included assessing interest in joining the AIG, participation rates among group members, and preferences for group activities. Using a mixed method approach we analyzed 13 years of administrative data recording 65 meetings and conducted a survey among group members and nonmember students across the university with a potential interest in aging (n = 52). Almost two-thirds of respondents (n = 33) were nonmembers with most of these (n = 24) having no prior knowledge of the AIG; 77% of students already aware of the AIG learned about it from a professor. Sixty per cent of respondents were in health-related faculties, with the remainder representing multiple disciplines and faculties. Group attendance was strongly influenced by student workloads and schedules, with average attendance rising by 27.3% during the shift to virtual meetings in 2020-21. Our results highlight the interdisciplinary nature of aging studies, the key role faculty members play in informing students about AIGs, and the broad range of interests that students have in issues related to age and aging.

Importance of Interprofessional Education for Occupational Therapy

The purpose of this position statement is to provide recommendations for educators on best practices to embed interprofessional education (IPE) into today's occupational therapy curricula, whether entry level or postprofessional, to bridge academic and clinical learning environments.

An Interprofessional Yearlong Geriatrics Fellowship Program for Advanced Practice Nursing and Social Work Students

BACKGROUND

The care of older adults with complex medical conditions requires effective team-based care.

PROBLEM

Nursing and social work students need a curriculum that provides them with immersive experiences in geriatrics to prepare them for competent practice.

APPROACH

This Geriatric Workforce Enhancement Program supported 5 advanced practice nursing (APN) and 5 master of social work (MSW) student fellows in a 2-semester program, with 3 cohorts completing the fellowship over 3 years (N = 30).

OUTCOMES

By the completion of the fellowship, students had (1) demonstrated increased knowledge of age-related changes and health problems experienced by older adults, (2) developed clinical competencies in providing patient-centered health care for older adults, and (3) assessed the fellowship as helpful in preparing for interprofessional team care.

CONCLUSIONS

An interprofessional gerontology fellowship for APN and MSW students can develop knowledge and skills in team-based care for older adults. Recommendations for creating a fellowship curriculum are provided.

Interprofessional Education and Older Adults in the Shared Virtual Classroom: Lessons Learned During the COVID-19 Pandemic

The current article provides an overview of an interprofessional service-learning course that became virtual in the setting of the coronavirus disease 2019 pandemic. Telehealth video technologies were used to build an intergenerational, virtual classroom and increase engagement of older adults with interdisciplinary health professional students. The virtual classroom involved group health education sessions, individualized Medicare wellness visits, and a clinical huddle. The course addressed the public health need for reliable health information during the early days of the pandemic, social connection, and meeting the educational goals for health care students and older adults in a novel virtual setting. Lessons learned for the interdisciplinary team and for engaging older adults included the need for preparation reading, team building exercises, training videos, and telehealth competency checklists. Beyond the pandemic, adoption of virtual methods enables hybrid approaches to interprofessional education and builds competencies for delivery of telehealth and computer-based visits in professional practice settings. [Journal of Gerontological Nursing, 48(8), 52-56.].

The impact of interprofessional education on students' current and desired competence in diabetes care

AIM

To explore the impact of interprofessional education (IPE) on undergraduate nursing and medical students' knowledge, competence and targeted competence in diabetes care.

DESIGN

Mixed methods design.

METHODS

A voluntary IPE course of diabetes management was organized for nursing (n = 15) and medical (n = 15) students, who performed a diabetes knowledge test and self-evaluation of diabetes competence before and after the course and were compared with non-participating students. The participating students' focus-group interviews were analysed using inductive content analysis.

RESULTS

The IPE course improved nursing students' diabetes knowledge and self-evaluated competence among nursing and medical students. The baseline differences in self-evaluated competence between the groups disappeared. The non-participating students evaluated their competence higher than the participants, though they scored lower or equally in the knowledge test. In conclusion, IPE showed potential in increasing students' self-evaluated competence, motivation to learn more and nursing students' diabetes knowledge, offering better prospects for future interprofessional diabetes management.

Interdisciplinary trainee networks to promote research on aging: Facilitators, barriers, and next steps

Interdisciplinary education and research foster cross disciplinary collaboration. The study of age and aging is complex and needs to be carried out by scholars from myriad disciplines, making interdisciplinary collaboration paramount. Non-formal, extracurricular, and interdisciplinary networks are increasingly filling gaps in academia's largely siloed disciplinary training. This study examines the experiences of trainees (undergraduate, graduate, and post-graduate students) who belonged to one such network devoted to interdisciplinary approaches to education and research on aging. Fifty-three trainees completed the survey. Among respondents, some faculties (e.g., Health Sciences) were disproportionately represented over others (e.g., Business, Engineering, and Humanities). Most trainees valued their participation in the interdisciplinary network for research on aging. They also valued expanding their social and professional network, the nature of which was qualitatively described in open-text responses. We then relate our findings to three types of social capital: bonding; bridging; and linking. Finally, we conclude with recommendations for the intentional design and/or refinement of similar networks to maximize value to trainees, provide the skills necessary for interdisciplinary collaboration, and foster egalitarian and representative participation therein.

A scoping review of the changing landscape of geriatric medicine in undergraduate medical education: curricula, topics and teaching methods

PURPOSE

The world's population is ageing. Therefore, every doctor should receive geriatric medicine training during their undergraduate education. This review aims to summarise recent developments in geriatric medicine that will potentially inform developments and updating of undergraduate medical curricula for geriatric content.

METHODS

We systematically searched the electronic databases Ovid Medline, Ovid Embase and Pubmed, from 1st January 2009 to 18th May 2021. We included studies related to (1) undergraduate medical students and (2) geriatric medicine or ageing or older adults and (3) curriculum or curriculum topics or learning objectives or competencies or teaching methods or students' attitudes and (4) published in a scientific journal. No language restrictions were applied.

RESULTS

We identified 2503 records and assessed the full texts of 393 records for eligibility with 367 records included in the thematic analysis. Six major themes emerged: curriculum, topics, teaching methods, teaching settings, medical students' skills and medical students' attitudes. New curricula focussed on minimum Geriatrics Competencies, Geriatric Psychiatry and Comprehensive Geriatric Assessment; vertical integration of Geriatric Medicine into the curriculum has been advocated. Emerging or evolving topics included delirium, pharmacotherapeutics, healthy ageing and health promotion, and Telemedicine. Teaching methods emphasised interprofessional education, senior mentor programmes and intergenerational contact, student journaling and reflective writing, simulation, clinical placements and e-learning. Nursing homes featured among new teaching settings. Communication skills, empathy and professionalism were highlighted as essential skills for interacting with older adults.

CONCLUSION

We recommend that future undergraduate medical curricula in Geriatric Medicine should take into account recent developments described in this paper. In addition to including newly emerged topics and advances in existing topics, different teaching settings and methods should also be considered. Employing vertical integration throughout the undergraduate course can usefully supplement learning achieved in a dedicated Geriatric Medicine undergraduate course. Interprofessional education can improve understanding of the roles of other professionals and improve team-working skills. A focus on improving communication skills and empathy should particularly enable better interaction with older patients. Embedding expected levels of Geriatric competencies should ensure that medical students have acquired the skills necessary to effectively treat older patients.

Promoting Older Adult Health with Interprofessional Education through Community Based Health Screening

IPHARM (ImProving Health Among Rural Montanans) is a university-based community health screening program that provides valuable interprofessional teamwork and clinical skills training for health care students while addressing the health of older adults. Students perform a variety of health care screenings dependent on the health care professions present and the requests of the community group served. Education, counseling, and recommendations for participants are provided by the interprofessional student teams under supervision and guidance from faculty and clinicians. Supported in part by federal grants such as the Health Service and Resource Administration Geriatric Workforce Enhancement Program (HRSA GWEP), IPHARM has provided interprofessional training for over 2100 students and conducted over 30,000 health screenings at 814 different community events. Surveys from students indicate that the experience promotes effective interprofessional team skills related to communication, an increased understanding of the roles and responsibilities of the health care team, and how to positively impact the health of older adults. These interprofessional screening events for older adults, conducted in the community by health professions students and faculty, help prepare the future workforce for collaborative and effective health care delivery. The purpose of this article is to describe the IPHARM objectives, methods, and impact this program has had on the health of older adults and the training of our future health care workforce.

Perceptions and knowledge of older adults: an analysis of interprofessional education and medically underserved populations

This study explored an academic Interprofessional Geriatric Case Competition (IGCC) experience with a focus on medically underserved populations. Our aims were to assess: the perceptions of and knowledge of older adult populations; and the overall IPE (Interprofessional Education) experience of the IGCC participants. A multi-method study approach was used, the Facts on Aging Quiz assessed knowledge and the Carolina Opinions on Care of Older Adults (COCOA) assessed perceptions. A qualitative thematic approach was utilized to explore the themes of the IPE experience. There was a moderate correlation (0.37, p < .001) between perception and knowledge data of the respondents (N = 94), current professionals (54%) and enrolled students (46%). The three emerged themes were as follows: interprofessional/holistic practice; culturally responsive/older adult centered practice; and the impact of Covid-19. The implementation of IPE that centers medically underserved populations has the potential to: enhance students learning, influence the quality of care, and provide pathways to working within these specific populations.

Knowledge and Attitude of Pharmacy Students Regarding Geriatric Care: Questionnaire-Based Analysis in Malaysia

INTRODUCTION

There is a predicted growth of up to 17% in an older adult of Malaysian above 60 years of age by 2040. This will increase the workload of almost every healthcare provider to ensure optimal geriatric care.

PURPOSE

This study aimed to assess pharmacy students' knowledge and attitudes towards geriatric pharmacy education and older patients to determine their preparation in delivering appropriate medical care to the geriatric population.

METHODS

Self-administered questionnaires were distributed among pharmacy students in different Malaysian universities. The survey included several sections to assess multiple aspects such as sociodemographic information, assessment of knowledge using a validated 28-item Geriatric Knowledge Assessment Scale (GKAS), and attitudes towards geriatrics education.

RESULTS

The response rate was around 70% of the respondents. The mean (± standard deviation) age of the cohort was 22.28 (±1.12) years. Despite around 78% of pharmacy students claiming that their knowledge of geriatric care is adequate, their GKAS score showed that only around 20% have high geriatric knowledge. Around 80% of them showed a positive attitude on the importance of taking courses focused on geriatric care and demonstrated interest to further knowledge and training in geriatric care. However, more than half of the students were uncertain of their answers towards their attitudes regarding older patients.

CONCLUSION

Given the growing role of pharmacists in the ageing population, this study highlights the importance of geriatric care education among potential pharmacists. Therefore, we urge the need to improve/develop geriatrics education and training into the pharmacy curriculum to ensure sufficient preparation for actual practice after graduation.

Preparing advanced learners for geriatric team care: A short-term curricular model that works

Health outcomes for complex older adults are enhanced by interprofessional collaboration. Funded by a Geriatrics Workforce Enhancement Program (GWEP), an interprofessional team of educators developed a short-term geriatrics experience, including four hours of pre-clinical education and 12-20 hours of immersion in team-based care for advanced learners in nursing (n = 70 APN), social work (n = 48 MSW), and medicine (n = 122 medical students). Content focused on five areas: medication management, dementia, depression, falls, and myths about aging. Learners completed pre/post surveys measuring knowledge of geriatrics, attitudes toward geriatric patients and team care, and post-surveys regarding perceptions of the overall clinical experience. Results showed significant improvement in knowledge and attitudes toward older adults and interprofessional (IP) team practice. Qualitative comments reflected increased empathy toward and enthusiasm for working with older adults, valuing IP teams, and a desire for geriatrics content earlier in their respective curricula.

Interprofessional education for complex neurological cases

There is a growing necessity for healthcare professionals to collaborate across disciplines in order to adequately treat patients. Interprofessional education (IPE) is one strategy that can be used to strengthen student attitudes, skill mastery, and preparedness toward working in interprofessional teams prior to joining the healthcare workforce. The current study evaluated the effects of a four-session IPE training program for students from four New England universities across nine different health professions. Participants (N = 46) were placed into teams to create an assessment plan, evaluated their patient volunteer, developed a treatment plan, and presented treatment plan decisions to the group. Students reported attitudes, skills and readiness to work on interprofessional teams before and after the training; additionally, students completed a free-response posttest questionnaire. Paired samples t-tests, repeated measures ANCOVA, and thematic analysis were conducted to analyze the data. Results showed that following program completion, participants expressed more positive attitudes toward team collaboration and demonstrated higher skill mastery to function within healthcare teams. The presence of prior IPE experience did not positively or negatively influence changes in attitudes, skills, or readiness from pretest to posttest. Results suggest that this IPE program demonstrated preliminary feasibility and effectiveness by actively improving the attitudes and skills of healthcare students to engage in interprofessional teamwork.

Geriatric Care Boot Camp Series: Interprofessional education for a new training paradigm

Interprofessional education of health care professionals caring for older adults is critical to address the unique needs of geriatric patients. An interprofessional education program - the Geriatric Care Boot Camp Series ("Series") - was designed for health care professionals to fill this education gap. The program consisted of three half-day, intensive boot camps conducted over a one-year period. A total of 112 learners participated; more than half were nurses. Data analysis revealed statistically significant increases following each boot camp in attendees' reported knowledge about caring for older adults; statistically significant increases in comfort caring for older adults were also seen among participants in two boot camps. Attendees found the interprofessional nature of the program beneficial and said they would attend a similar program again. The Series is easily replicable, appealing to the target audience, and fulfills the need to better educate health care professionals on caring for older adults.