Pharmacy students’ attitudes towards physician–pharmacist collaboration: Intervention effect of integrating cooperative learning into an interprofessional team-based community service

Analyzing readiness for interprofessional education among health program students using hierarchical clustering

This study employs a clustering approach to assess the readiness for interprofessional education (IPE) among students enrolled in health-related study programs in Albania. Among a sample of 1470 students, complete data were available for 1383 participants, while 87 cases had missing data. Three distinct clusters were identified using hierarchical clustering analysis based on age and readiness domains: Teamwork (TW) and Professional Practice Identity (PPI). The average scores for TW and PPI were 4.4 ± 0.51 and 4.3 ± 0.51, respectively. Cluster A, consisting of 123 students, exhibited lower scores in both domains and a higher proportion of male students, while Clusters B (846 students) and C (414 students) demonstrated greater readiness for IPE and a higher representation of female students. These findings highlight varying perceptions and values associated with IPE across genders and health-related study programs, emphasizing the necessity for tailored and gender-aware IPE-enhancing interventions. Furthermore, our research underscores the importance of introducing IPE early in the healthcare curriculum and utilizing student clustering to tailor interventions, thus laying the foundation for broader research endeavors. Future studies are recommended to delve deeper into these results and assess the effectiveness of tailored interventions based on this approach in fostering readiness for IPE.

Exploring experiential learning within interprofessional practice education initiatives for pre-licensure healthcare students: a scoping review

BACKGROUND

Interprofessional collaborative team-based approaches to care in health service delivery has been identified as important to health care reform around the world. Many academic institutions have integrated interprofessional education (IPE) into curricula for pre-licensure students in healthcare disciplines, but few provide formal initiatives for interprofessional practice (IPP). It is recognized that experiential learning (EL) can play a significant role supporting IPP education initiatives; however, little is known of how EL is used within education for IPP in healthcare settings.

METHODS

We conducted a scoping review to map peer-reviewed literature describing IPP education initiatives involving EL for pre-licensure students in healthcare disciplines. A literature search was executed in MEDLINE, CINAHL, EMBASE, ERIC, PsycINFO, Scopus, and Social Services Abstracts. After deduplication, two independent reviewers screened titles and abstracts of 5664 records and then 252 full-text articles that yielded 100 articles for data extraction. Data was extracted using an Excel template, and results synthesized for presentation in narrative and tabular formats.

RESULTS

The 100 included articles represented 12 countries and IPP education initiatives were described in three main typologies of literature - primary research, program descriptions, and program evaluations. Forty-three articles used a theory, framework, or model for design of their initiatives with only eight specific to EL. A variety of teaching and learning strategies were employed, such as small interprofessional groups of students, team huddles, direct provision of care, and reflective activities, but few initiatives utilized a full EL cycle. A range of perspectives and outcomes were evaluated such as student learning outcomes, including competencies associated with IPP, impacts and perceptions of the IPP initiatives, and others such as client satisfaction.

CONCLUSION

Few educational frameworks specific to EL have been used to inform EL teaching and learning strategies to consolidate IPE learning and prepare students for IPP in healthcare settings. Further development and evaluation of existing EL frameworks and models would be beneficial in supporting robust IPP educational initiatives for students in healthcare disciplines. Intentional, thoughtful, and comprehensive use of EL informed by theory can contribute important advances in IPP educational approaches and the preparation of a future health care workforce.

Factors influencing behavioral intentions of graduating pharmacy students regarding interprofessional collaboration - a theory-driven qualitative study

BACKGROUND

Interprofessional collaboration enhances the use of competencies of different medical team members. Additionally, pharmacists' involvement in patient care has been shown to improve their outcomes and seems particularly valuable in chronic diseases. Therefore, due to the aging of society and the increasing prevalence of chronic diseases, efforts are needed to involve pharmacists more broadly in patient care. However, there is a limited understanding of what factors could influence their willingness to participate in an interprofessional care team, especially among pharmacy students only entering the profession. This study aimed to fill these knowledge gaps by exploring graduating pharmacy students' intentions in this regard guided by the theory of planned behavior.

METHODS

We conducted seventeen semi-structured interviews with graduating pharmacy students of Poznan University of Medical Sciences, which were then thematically analyzed by two researchers.

RESULTS

Positive attitudes of respondents, who mentioned the possibility of acquiring new knowledge, skills, and competencies, increased prestige and appreciation of the pharmacist's profession, a better quality of patient care, and the support and relief offered to other team members as a result of collaboration, seem to strengthen their intentions. However, they also expressed their worries about potential errors and knowledge gaps, which constituted an example of some existing negative feelings. The identified sources of generally mixed social pressure toward the behavior included other pharmacists and pharmacy students, physicians, patients, their relatives and friends, and the decision and policymakers. Finally, their intentions may also be weakened by the mentioned perceived behavioral control aspects, like their level of pharmaceutical and clinical knowledge, skills, and experience, their knowledge of representatives of other professions and collaboration, the atmosphere at their future place of work, co-workers' potential reluctance to collaborate with them, finding time for collaboration, the existence of incentives and gratification system, and existing legal regulations.

CONCLUSIONS

The attitudes of graduating pharmacy students toward interprofessional collaboration seem mostly positive, but their intentions might be weakened by the mixed sense of social pressure and factors decreasing their perceived behavioral control.

Interprofessional education for shared decision making in drug therapy: a scoping review

The current complex scenario of medication use calls for the implementation of interprofessional education (IPE) initiatives focused on shared decision making (SDM) in drug therapy. A scoping review was conducted to collate, summarize, and report the evidence available on IPE teaching and learning approaches in this context, involving pre-licensure healthcare students. Searches were conducted in seven electronic databases, with 21 articles meeting the inclusion criteria. This review examines educational strategies employed for interprofessional SDM as well as characteristics of students, teachers, and tutors involved in IPE interventions. The reviewed studies lack detailed description of the students' decision-making process, and none addresses aspects related to patient preferences as a part of learning outcomes. We identified shortcomings in how IPE interventions are assessed and reported. Only a few of the studies explicitly describe the use of competency-based frameworks proposed by national and international organizations, and less than 60% describe learning outcomes. The absence of experiences focused on interprofessional SDM in drug therapy suggests a gap that needs to be addressed with future studies evaluated in a robust way. We argue that such experiences enable students, as a team, to learn to share decisions with the patient as an effective team member.

[Evaluation of simulation-based training program intended to improve interprofessional communication skills of community pharmacy and general medicine students]

OBJECTIVES

The objective of this work is to assess the impact of a simulation session on the ability of pharmacy and medicine students in general practice to communicate in the resolution of patient-facing situations.

METHODS

The evaluation of the impact of the session on the representation of the professions used a questionnaire to be completed before and after the session by the students. The evaluation of the impact of the session on the perception of communication and associated skills was based on an audio recording of the debriefings, which, after transcription and thematic analysis, was used as a preliminary analysis for the drafting of a questionnaire proposed the following year. This questionnaire focused on the issues of interprofessional communication and on the seminar process.

RESULTS

During the 2018 and 2019 seminars, 518 students attended, 39% were pharmacy students (n=201) and 61% were medical students (n=317). The majority of medical students initially responded that physician-pharmacist communication was confraternal and rare. More pharmacy students felt that the quality of the physician-pharmacist relationship was poor. However, there was a marked improvement for all students on this aspect of communication after the seminar. Both groups also generally agreed that this relationship could be improved.

CONCLUSIONS

The evaluation shows that an interprofessional simulation program improves the ability of pharmacy and general practice students to communicate in patient-facing situations.

Virtual Simulation in Undergraduate Medical Education: A Scoping Review of Recent Practice

Virtual simulation (VS) as an emerging interactive pedagogical strategy has been paid more and more attentions in the undergraduate medical education. Because of the fast development of modern computer simulation technologies, more and more advanced and emerging VS-based instructional practices are constantly increasing to promote medical education in diverse forms. In order to describe an overview of the current trends in VS-based medical teaching and learning, this scoping review presented a worldwide analysis of 92 recently published articles of VS in the undergraduate medical teaching and learning. The results indicated that 98% of included articles were from Europe, North America, and Asia, suggesting a possible inequity in digital medical education. Half (52%) studies reported the immersive virtual reality (VR) application. Evidence for educational effectiveness of VS in medical students' knowledge or skills was sufficient as per Kirkpatrick's model of outcome evaluation. Recently, VS has been widely integrated in surgical procedural training, emergency and pediatric emergency medicine training, teaching of basic medical sciences, medical radiation and imaging, puncture or catheterization training, interprofessional medical education, and other case-based learning experiences. Some challenges, such as accessibility of VS instructional resources, lack of infrastructure, "decoupling" users from reality, as well as how to increase students' motivation and engagement, should be addressed.

Progress on Pharmaceutical Sciences/Pharmacy Postgraduate Education: a Bibliometric Perspective

OBJECTIVE

The study quantitatively investigated the related research progress in pharmaceutical sciences/pharmacy education from a bibliometric angle and provided feasible suggestions to facilitate the development of pharmaceutical sciences/pharmacy postgraduate education.

METHODS

Bibliometric analysis was conducted using the database of Web of Science Core Collection. The literature published in 1985-2021 was screened and selected. The overall profile description, citation analysis, and research hotspot mining were performed using the citation report of Clarivate Analytics, bibliometrics online platform, and VOSviewer software. The bibliometric results and profiles were plotted and illustrated.

RESULTS

The bibliometric analysis of 485 papers of interest showed that the research frontier was continuously expanding; especially the institutions from the USA were the main contributors. The numbers of citing papers have been ascending, and a considerable part of citations were from the areas other than the education research. Mining results showed that the in-school and residency education of pharmacy postgraduates was a research hotspot, as well as interprofessional training and new education styles for Coronavirus Disease 2019 (COVID-19) therapy were the emerging trends in the field.

CONCLUSION

Through the analysis of the studies, it was found that encouraging relevant research programs, establishing financial supports, and launching specified publication sources could be helpful to boost the development of pharmaceutical sciences/pharmacy postgraduate education. Besides, the results suggested that this was a less discussed topic and was worthy for the investigators to pay more attention to such an issue.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12247-021-09611-z.

[Engagement of students enrolled in fifth year of pharmacy studies in their academic or salaried pharmaceutical activities during the first period of lockout due to the COVID-19 pandemic (16th March-11th May 2020)]

OBJECTIVES

To characterize the engagement of students enrolled in the fifth year of pharmaceutical studies in the management of the health crisis due to the COVID-19 pandemic, and to identify some determinants of this engagement during this period.

METHODS

With the health crisis, new missions have been entrusted during hospital internships, whereas certain internship sites were removed in hospitals and as part of the health service organization. In addition, some students who were no longer in internship returned to the hospital setting for helping in critical activities. Student engagement was studied with a questionnaire and focus groups including six or seven students in each group.

RESULTS

Forty-three students participated to the study. The answers to the questionnaire highlighted that they were engaged, that they usually did not wait for compensation, and that most of them were satisfied by their activity during the crisis. The thematic analysis demonstrated that despite a feeling of frustration, which was often associated with the interruption of rewarded activities, and despite a stress due to the particular context, student engagement was supported by a better consideration of the pharmacist's role as a professional in public health and by a better acknowledgement of this role by other health professionals.

CONCLUSION

This level of engagement is particularly encouraging because it is the witness of the ability of pharmacists to mobilize for general interest, even in adverse context.

Developing a Japanese version of the 'scale of attitudes toward pharmacist-physician collaboration'

There are many reports that pharmacotherapy has been optimized to ensure collaboration between physicians and pharmacists. Various scales assess the relationship between physicians and pharmacists as well as medical students and pharmacy students. The Scale of Attitudes Toward Physician-Pharmacist Collaboration (SATP²C) can be applied not only to the physician-pharmacist relationship but also to the medical-pharmacy student relationship. As there is no Japanese version of the SATP²C, we developed one and examined its psychometric properties. SATP²C scores were measured before and after interprofessional education (IPE) to verify responsiveness. The scale showed confirmed reliability: Cronbach's alphas were 0.79 for Responsibility and Accountability, 0.68 for Shared Authority, and 0.67 for Interdisciplinary Education. Pre and post-IPE, each mean subscale score increased: Responsibility and Accountability, 0.7 ± 0.4; Shared Authority, 0.2 ± 0.3; and Interdisciplinary Education, 0.3 ± 0.2. Although the total score increased (1.2 ± 0.7), this was non-significant. The Japanese version of the SATP²C can be considered, at least initially, to have reached an acceptable level of reliability and validity. The new measure is currently the only scale in Japan that can evaluate attitudes toward physician-pharmacist collaboration regarding IPE. Further studies are needed to confirm responsiveness pre- and post-IPE.

Use of profession-role exchange in an interprofessional student team-based community health service-learning experience

BACKGROUND

During interprofessional clinical practice, compared to understanding of one's own professional role and function, it might be more difficult to clarify the roles and contributions of the other health-care team members because of the inter-professional barrier. In order to provide students the opportunity for real experience with other professions in team environments and enhance their perceptions of other professions' roles, this study developed a comprehensive and multi-dimension extracurricular interprofessional education (IPE) model through designing and integrating a profession-role exchange component, that was medical students as pharmacists or nurses, pharmacy students as physicians or nurses, and nursing students as physicians or pharmacists in the interprofessional health-care student team, into the service learning experience in a real community setting.

METHODS

In this pre/post-intervention study, the effect of integrated profession-role exchange experiences on the students' attitudes towards interprofessional collaboration and their role clarification was evaluated among 60 student volunteers (20 medical students, 20 pharmacy students and 20 nursing students). All involved students were divided into the profession-role exchange intervention group and the control group. Subjects in the control group did not participate the profession-role exchange experiences, the other IPE procedures were the same for both groups. Three survey instruments for attitudes toward interprofessional clinical collaboration were respectively used to measure the students' attitudes toward physician-pharmacist, physician-nurse and nurse-pharmacist collaborations. "Roles and responsibilities" subscale of Readiness for Interprofessional Learning Scale was used to evaluate the overall role clarification during IPE.

RESULTS

Compared to the control IPE activity, the addition of profession-role exchange component resulted in the significant increase in students' positive attitudes towards interprofessional collaboration, and the enhancement of students' role awareness.

CONCLUSIONS

The profession-role exchange might be more effective and better initiate students to the practice of interprofessional collaboration, and could be used as an effective IPE tool for improving the role awareness of health-care students.

Preparing Pharmacists for Collaborative/Integrated Health Settings

Pharmacy practice is changing to accommodate the need for pharmacists to be better team members in newly emerging collaborative care and integrated health systems. Pharmacy schools could lead this change by educating students to be effective participants in these relatively new models of care. Schools are encouraged to follow the approach outlined in the recent guidance published by the Health Professions Accreditors Collaborative (HPAC) for interprofessional practice and education (“the new IPE”). This approach includes articulating an IPE plan, establishing goals, assessing student achievement of the necessary IPE competencies, developing educational plans that are multi-faceted and longitudinal, and modifying the existing assessment/evaluation process to ensure the quality of the IPE effort. These curricular decisions should be based on existing and new research on the effectiveness of IPE on student’s attitudes, knowledge, skills, and behavior. A key decision is how to create effective interactions between pharmacy students and those of other professions. Educational emphasis should be directed toward team building skills, not just individual competencies. The pharmacy faculty probably need to enhance their teaching abilities to accommodate this change, such as learning new technology (e.g., simulations, managing online exchanges) and demonstrating a willingness to teach students from other professions.

Interprofessional pharmacotherapy workshop: intervention to improve health professionals' and students' attitudes towards collaboration between physicians and pharmacists

Collaboration between physicians and pharmacists is recognized as an important factor for reducing medication errors and improving patient outcomes. Therefore, two pharmacotherapy workshops were delivered in Croatia - one for pre-registration medical (n=42, 4th-6th year) and pharmacy (n=38, 4th-5th year) students, and the other one for physicians (n=18) and pharmacists (n=23). The purpose of this study was to determine whether participation in common pharmacotherapy workshop could improve attitudes among participants towards interprofessional collaboration between pharmacists and physicians. Attitudes were measured by validated questionnaire "Scale of Attitudes Towards Collaboration Between Pharmacists and Physicians" at the beginning and at the end of the workshops. Three complex clinical scenarios were presented during the workshops. Participants were given general information about cases (all participants) and 2 groups of specific information (only for medical students/physicians and only for pharmacy students/pharmacists). For the first scenario, medical and pharmacy students/professionals were not allowed to exchange their specific information. However, participants collaborated for the 2nd and 3rd scenarios in order to achieve the hypothesized therapeutic goals. Before the workshops, pharmacists and pharmacy students showed more positive attitudes than physicians and medical students. However, the workshop contributed in closing the gap by equating health care professionals' attitudes. Additionally, students' attitudes were more positive after the workshop with an increase of 10% for medical and 2.2% for pharmacy students. This study indicates that interprofessional pharmacotherapy workshops could significantly improve attitudes toward collaboration between physicians and pharmacists for both students and practicing professionals.

Evaluation of students' attitudes towards pharmacist-physician collaboration in Brazil

OBJECTIVE

To measure undergraduate pharmacy and medical students' collaborative attitudes regarding Pharmacist-Physician collaboration.

METHODS

A cross-sectional descriptive study was conducted from September 2016 to February 2017 in Northeast Brazil. Pharmacy and medical students from the first and the last year of courses were invited to complete Portuguese version of Scale of Attitudes Toward Pharmacist-Physician Collaboration (SATP2C). Descriptive and comparative analyses were performed using IBM SPSS (22 version). Differences were considered significant when p<0.05.

RESULTS

Three hundred seventy students completed the SATP2C. Overall, the students had positive attitudes towards physician-pharmacist collaboration. There was no significant correlation between age and score (p=0.79). Women showed a more positive collaborative attitude than men (53.1, SD=6.8 vs. 55.1, SD=6.3). Pharmacy students had a higher score than medical students (57.5, SD=4.7, vs. 51.1, SD=6.4). The first-year medical students had a higher score than last-year medical students (52.3, SD=6.0 vs. 49.5, SD=6.6; p<0.007). There was no significant difference in the attitudes between the first and last year pharmacy students (p<0.007).

CONCLUSIONS

Pharmacy and medical students showed positive attitudes towards physician-pharmacist collaboration. However, pharmacy students presented more collaborative attitudes than medical ones. Additionally, the first-year medical students had more collaborative attitudes than last-year medical students. Studies should be conducted to provide recommendations to improve interprofessional education efforts to further enhance the positive attitudes toward physician-pharmacist collaboration.

Pharmacy and nursing students' attitudes toward nurse-pharmacist collaboration at a Chinese university

BACKGROUND

The collaborative working relationship of nurses with pharmacists has increasingly captured considerable attention. This study measured pharmacy and nursing students' attitudes toward nurse-pharmacist collaboration at a university in China.

METHODS

This cross-sectional study was conducted to assess the attitudes toward nurse-pharmacist collaboration using a self-developed scale delivered to a sample involving 202 nursing students and 258 pharmacy students enrolled in Wuhan University of Science and Technology.

RESULTS

Completed instruments were returned by 192 nursing students (95.0% effective response rate) and 249 pharmacy students (96.5% effective response rate). The average students' score of attitudes toward nurse-pharmacist collaboration was 78.85 out of a total of 100. No significance was found for the attitudes toward nurse-pharmacist collaboration between two professions or between gender. The college freshmen (first-year) students had the maximum scores suggesting the most positive attitude toward nurse-pharmacist collaboration, followed by second- and third-year students, while final-year (fourth-year) students had the least.

CONCLUSION

The students had somewhat positive attitudes toward nurse-pharmacist collaboration, but there is still room for improvement.

Designing and Evaluating an Interprofessional Practice Experience Involving Dental and Pharmacy Students

Objective. To prepare pharmacy and dental students to collaborate as members of an interprofessional team by participating in an interprofessional practice experience. Methods. An interprofessional practice experience was implemented within a dental admissions clinic. Pharmacy and dental students collaboratively conducted medical histories and provided tobacco cessation education. Pharmacy student performance was measured using a standardized assessment rubric; pharmacy and dental student perceptions were measured using the SPICE-R tool; and faculty feedback was captured for evaluation purposes. Results. Pharmacy students achieved performance expectations upon completion. There was a statistically significant increase in the mean scores for a majority of the SPICE-R factors for pharmacy and dental students. Overall, faculty perceptions of the practice experience were positive. Conclusion. A collaboration between pharmacy and dental schools is a novel approach to meeting interprofessional and experiential curricular goals. Evaluating performance in practice experiences and perceptions can be used to demonstrate learner outcomes within interprofessional education. Furthermore, faculty feedback should be used to improve practice experiences.

Interprofessional Collaboration between General Physicians and Emergency Department Teams in Belgium: A Qualitative Study

This study aimed to assess interprofessional collaboration between general physicians and emergency departments in the French speaking regions of Belgium. Eight group interviews were conducted both in rural and urban areas, including in Brussels. Findings showed that the relational components of collaboration, which are highly valued by individuals involved, comprise mutual acquaintanceship and trust, shared power and objectives. The organizational components of collaboration included out-of-hours services, role clarification, leadership and overall environment. Communication and patient's role were also found to be key elements in enhancing or hindering collaboration across these two levels of care. Relationships between general physicians and emergency departments' teams were tightly linked to organizational factors and the general macro-environment. Health system regulation did not appear to play a significant role in promoting collaboration between actors. A better role clarification is needed in order to foster multidisciplinary team coordination for a more efficient patient management. Finally, economic power and private practice impeded interprofessional collaboration between the care teams. In conclusion, many challenges need to be addressed for achievement of a better collaboration and more efficient integration. Not only should integration policies aim at reinforcing the role of general physicians as gatekeepers, also they should target patients' awareness and empowerment.

Indonesian pharmacists' and pharmacy students' attitudes towards collaboration with physicians

BACKGROUND

Recent implementation of national health coverage and the increasing health burden in Indonesia require health professionals, including pharmacists, to work more collaboratively to improve access and quality of health care. Nevertheless, relatively little is known about Indonesian pharmacists' attitude towards collaboration.

OBJECTIVE

To assess and compare the attitude of Indonesian pharmacy students and pharmacists towards collaboration with physicians.

METHODS

A survey of 95 pharmacy students (Universitas Surabaya) and 114 pharmacists (public health facilities in East Java) in Indonesia was conducted using the validated questionnaire, Scale of Attitudes Toward Physician-Pharmacist Collaboration (SATP2C), which was translated in Bahasa Indonesia. The questionnaire contained 16 items which were based on a 4-point Likert scale. Descriptive statistics were used to summarise the responses, (i.e., individual scores, factor scores and total scores).

RESULTS

Response rates of 97.9% and 65.8% were reported for students and pharmacists, respectively. The mean total score of SATP2C among Indonesian students and pharmacists were 56.53 versus 56.77, respectively; indicating positive attitudes toward collaboration. Further analysis of each item of SATP2C confirmed the positive attitudes in which mean and median scores of ≥3 were reported for most items in both groups. Significant differences between students and pharmacists were found regarding the following items: (i) 'there are many overlapping areas of responsibility between pharmacists and physicians' (3.28 versus 2.89, respectively; p<0.001), (ii) 'pharmacist should clarify a physician's order' (3.54 versus 3.71, respectively; p=0.046); and (iii) 'physicians should consult with pharmacists about adverse reactions or refractory to drug treatment' (3.60 versus 3.44, respectively; p=0.022).

CONCLUSIONS

Indonesian pharmacists reported positive attitudes toward collaboration with physicians. Further research is needed to understand other factors contributing in translating those positive attitudes into actual practice, and thus, providing a good foundation for policy makers, researchers and practitioners to support pharmacist-physician collaboration in Indonesia.