Impact of team composition on student perceptions of interprofessional teamwork: A 6-year cohort study

Evaluation of a newly developed flipped-classroom course on interprofessional practice in health care for medical students

Interprofessional education is expected to promote collaborative practice and should therefore be included in health professionals' curricula. Reports on interprofessional curricular development and its evaluation are rare. We therefore undertook a comprehensive quantitative and qualitative evaluation of a new, mandatory course on interprofessional collaboration for medical students during their third year of the Bachelor of Medicine study programme. The newly developed and implemented course spans over six weeks and was designed in a hybrid, flipped-classroom format. It incorporates experience- and case-based learning as well as interactions with other health professionals. Each student completes an eLearning and a clinical workshadowing individually before attending the - due to the pandemic - virtual live lectures. To assess quality and usefulness of teaching-learning formats and course structure to learn about interprofessional collaboration and to develop interprofessional competencies and identity, a quantitative and qualitative evaluation was performed with more than 280 medical students and 26 nurse educators from teaching hospitals using online surveys (open & closed-ended format). Data were analyzed descriptively and using content analysis processes. Students appreciated the flipped-classroom concept, the real-world case-based learning scenarios with interprofessional lecturer teams, and the possibility of an experience-based learning opportunity in the clinical setting including interaction with students and professionals from other health professions. Interprofessional identity did not change during the course. Evaluation data showed that the course is a promising approach for teaching-learning interprofessional competencies to medical students. The evaluation revealed three factors that determined the success of this course, namely, a flipped-classroom concept, the individual workshadowing of medical students with another health professional, mainly nurses, and live sessions with interprofessional teaching-learning teams. The course structure and teaching-learning methods showed potential and could serve as a template for interprofessional course development in other institutions and on other course topics.

Interprofessional education: a necessity in Alzheimer's dementia care-a pilot study

Introduction

Interprofessional collaboration is seen as an indispensable prerequisite for high-quality health services and patient care, especially for complex diseases such as dementia. Thus, the current project aimed to extend interprofessional and competency-based education in the field of dementia care to the previously understudied therapy professions of nutrition, speech-language pathology, and physiotherapy.

Methods

A three-day workshop was designed to provide specific learning objectives related to patient-centered dementia care, as well as competences for interprofessional collaboration. Teaching and learning approaches included case-based learning in simulated interprofessional case-conferences and peer-teaching. A total of 42 students (n = 20 nutrition therapy and counseling, n = 8 speech-language pathology, n = 14 physiotherapy), ranging from first to seventh semester, finished the whole workshop and were considered in data analysis. Changes in self-perceived attitudes toward interprofessional collaboration and education were measured by the German version of the UWE-IP. An in-house questionnaire was developed to evaluate knowledge and skills in the field of dementia, dementia management and interprofessional collaboration.

Results

Participation in the workshop led to significant improvements in the total scores of the UWE-IP-D and the in-house questionnaire, as well as their respective subscales. Moderate to large effect sizes were achieved. All professions improved significantly in both questionnaires with large effect sizes. Significant differences between professions were found in the UWE-IP-D total score between students of speech-language pathology and physiotherapy in the posttest. Students of nutrition therapy and counseling revealed a significant lower level of self-perceived knowledge and skills in the in-house questionnaire pre- and post-testing.

Discussion

The pilot-study confirms the effectiveness of interprofessional education to promote generic and interprofessional dementia care competencies and to develop positive attitudes toward interprofessional learning and collaboration in the therapy professions, thus increasing professional diversity in interprofessional education research. Differences between professions were confounded by heterogenous semester numbers and participation conditions. To achieve a curricular implementation, interprofessional education should be expanded to include a larger group of participants belonging to different professions, start early in the study program, and be evaluated over the long term.

Ten-year mixed-method evaluation of prelicensure health professional student self-reported learning in an interfaculty pain curriculum

Introduction:

Student perspectives on interprofessional pain education are lacking.

Objectives:

The purpose of this study was to evaluate ratings of knowledge acquisition and effective presentation methods for prelicensure health professional students attending the University of Toronto Centre for the Study of Pain Interfaculty Pain Curriculum (Canada).

Methods:

A 10-year (2009–2019) retrospective longitudinal mixed-methods approach comprising analysis and integration of quantitative and qualitative data sets was used to evaluate 5 core University of Toronto Centre for the Study of Pain Interfaculty Pain Curriculum learning sessions.

Results:

A total of 10, 693 students were enrolled (2009–2019) with a mean annual attendance of 972 students (±SD:102). The mean proportion of students rating “agree/strongly agree” for knowledge acquisition and effective presentation methods across sessions was 79.3% (±SD:3.4) and 76.7% (±SD:6.0), respectively. Knowledge acquisition or presentation effectiveness scores increased, respectively, over time for 4 core sessions: online self-study pain mechanisms module (P = 0.03/P < 0.001), online self-study opioids module (P = 0.04/P = 0.019), individually selected in-person topical pain sessions (P = 0.03/P < 0.001), and in-person patient or interprofessional panel session (P = 0.03). Qualitative data corroborated rating scores and expanded insight into student expectations for knowledge acquisition to inform real-world clinical practice and interprofessional collaboration; presentation effectiveness corresponded with smaller session size, individually selected sessions, case-based scenarios, embedded knowledge appraisal, and opportunities to meaningfully interact with presenters and peers.

Conclusion:

This study demonstrated positive and increasing prelicensure student ratings of knowledge acquisition and effective presentation methods across multifaceted learning sessions in an interfaculty pain curriculum. This study has implications for pain curriculum design aimed at promoting students' collaborative, patient-centered working skills.

See commentary: Trouvin A-P. “Ten-year mixed method evaluation of prelicensure health professional student self-reported learning in an interfaculty pain curriculum”: a view on pain education. PAIN Rep 2022;7:e1031.

Students attending learning sessions at the University of Toronto Interfaculty Pain Curriculum (2009–2019) in Toronto, Canada, self-report high ratings of knowledge acquisition and effective presentation methods.

Socialisation into interprofessional teams: A mixed-methods study among early health professional learners who engaged in a teams and teamwork module / Sozialisierung in interprofessionellen Teams: Eine Mixed-Methods-Studie zum Effekt eines Team- und Teamwork-Moduls bei Auszubildenden im Gesundheitswesen

Introduction

Early health profession learners hold stereotypes about their own and other professions. Socialising students through interprofessional education (IPE) early in their training facilitates the development of their beliefs and values surrounding their professional and interprofessional identities. This study evaluates the effect of a 3-week, virtual IPE intervention in early health professional learners.

Methods

Students reflected on their functioning as an interprofessional team through discussion and written prompts which were coded by two faculty members for themes and trends. Exposure to developing an interprofessional identity and socialisation within an IPE team were measured through pre- and post-intervention surveys containing the Interprofessional Socialisation and Valuing Scale (ISVS).

Results

Students increased their positive attitudes towards IPE from pre- to post-intervention module as well as socialisation and readiness across all ISVS subscales: self-perception of working together, value, and comfort (all p < .001). Students reflected that ‘taking time to get to know each other’ (n = 23 teams; 42%) and ‘allowing everyone to contribute’ (= 17; 31%) were key factors for team development. Individual reflections on what students would work on the next time they worked in an interprofessional team revealed ‘communication’ as important (n = 87; 45%).

Discussion

Health profession students who engaged in the module reflected on how their interprofessional team functioned and identified what helped or hindered them to work as a team. The opportunities to reflect on how their own professional identity within the context of an interprofessional team led to evidence of socialising into an interprofessional team. Students who are challenged to socialise into a team early in their education will better understand their beliefs and values surrounding interprofessional collaboration.

Development of interprofessional healthcare teamwork skills: mapping students' process of learning

Higher education institutions commonly prepare future healthcare workers to engage in increasingly complex, interprofessional healthcare environments through interprofessional education. Development of appropriate teamwork skills is complex and takes time. However, much of the research on student engagement with teamwork in higher education has been focused on the end goal of teamwork. This obscures the process of how students learn to work in interprofessional healthcare teams and in what ways, over time. The current study used an exploratory interpretive approach to obtaining students' experiences, perceptions and developing understanding of teamwork from the start of their undergraduate studies, through to completion of five semesters of group or teamwork projects. Through qualitative methodology, educators explored student experiences of teamwork, their focus at designated points of their undergraduate teamwork, and the meaning they attributed to being a member of a team. Student perceptions of successful teamwork developed over time to a positive and purposeful orientation toward teamwork, learner attributes that enhanced team function, and a growing awareness of how the assessment context affected team function. By mapping these processes of learning over time, educators can gain a clearer understanding of influences and experiences that impact on student learning in teamwork.

Clinical inter-professional education activities: Students' perceptions of their experiences

Background and purpose

Students from different health disciplines should learn together during certain periods of their education to acquire skills necessary for solving the health problems. The Faculty of Health Sciences of University of the Witwatersrand created inter-professional education (IPE) activities for students to assess clinical IPE groups' perceptions of IPE experiences and to identify lessons learnt during IPE sessions.

Methods

This was a qualitative study with review of the students' post IPE feedback forms. The students were granted 'protected time' of three full days over a period of two months to participate in IPE activities.

Results

Students felt that knowledge about health team members was gained and that IPE groups should have more than one person from each field with the same level of clinical exposure. The students indicated the need to have regular IPE activities and if possible to incorporate this into clinical practice for them to experience it in daily clinical practice.

Conclusion

Participating in the IPE activity made students gain appreciation and respect for other health professionals' roles and scope. When student groups are big, patient observations can be done as this does not compromise IPE learning outcomes. Group composition should be kept in mind to cater for the learning needs of all students. If it is not possible to meet the needs of all professions, smaller groups with professions applicable to case can be created.

A Delphi Study to Determine Leveling of the Interprofessional Core Competencies for Four Levels of Interprofessional Practice

INTRODUCTION

Although the Core Competencies for Interprofessional Education (IPE) provide guidance in developing interprofessional learning experiences, the literature is sparse in how to incorporate them across varying levels of learning activities. Thus, the purpose of this study was to explore consensus for leveling the IPEC Core Competencies for use across four levels of interprofessional practice. Initially, Benner's novice to expert theory was used to develop a leveling document for planning educational experiences appropriate for pre-licensure through practice learners. Using this document, a Delphi study was conducted to gain consensus on leveling the Core Competencies.

METHODS

A modified Delphi technique was employed using an expert panel of 48 healthcare faculty experienced in interprofessional education. Participants were asked to select their opinion of the level of learner for which each of the competencies were most appropriate.

RESULTS

After three rounds of questionnaires, 34 of the 38 competencies achieved consensus at a 70% agreement. Four competencies did not reach consensus.

CONCLUSIONS

Using a developmental approach, this study provides a foundational point for establishing guidelines for progressive organization and consistency in interprofessional learning activities. Although four competencies did not reach consensus, the results suggest that leveling is possible. Ongoing research is needed to further validate or revise the findings from this study.

Interprofessional student meetings in municipal health service - Mutual learning towards a Community of Practice in patient care

Mutual engagement is fundamental in interprofessional collaboration. This paper investigated how mutual engagement evolves in interprofessional student meetings when medical, nursing, occupational therapy and physiotherapy students shape their own collaboration and learning in patient care. We conducted a qualitative study with an ethnographic design. The data material consists of 200 hours of observations across nine student groups and two informal conversations with each student group during a two-week clinical placement in the period of 2014-2015. The interprofessional student meetings and the informal conversations were audio recorded, and field notes were prepared from our observations of the student activities. In the data analysis, we relied on an interpretative thematic analysis and used the sociocultural theory of learning as an interpretative framework. The analysis showed that mutuality evolved through three types of mutual engagement: facilitating interactions, actual interactions and clarifying further interactions. In conclusion, complex mutual engagement in patient care evolved and was maintained in interprofessional student meetings when the students had an explicit opportunity to shape their own interprofessional collaboration and learning. The students' opportunity to shape the interprofessional collaborative practice in patient care themselves appeared to be a criterion for success.

Using interprofessional medication management simulations to impact student attitudes toward teamwork to prevent medication errors

BACKGROUND

We developed and implemented a project incorporating ACPE Standard 11 and all Core IPEC competencies at a public University located at a medical center. The project was a collaboration between the colleges of nursing, pharmacy, and medicine at a distance campus location.

INTERPROFESSIONAL EDUCATION ACTIVITY

Our Interprofessional Education Activity, which targeted all three elements of ACPE Standard 11, provided TeamSTEPPS^® training followed by four medical error simulations. A debriefing took place after each scenario within a team as well as with all four groups following each simulation session. The Teamwork Attitudes Questionnaire (TTAQ) was used to evaluate the activity.

DISCUSSION

Findings from our interprofessional education activity indicate that while students entered the activity already perceiving teamwork as a positive aspect of safe care delivery, significant improvement in attitudes post training toward specific team constructs was seen across all five domains. The project helped inform the structure of a replication of this effort that is currently underway, with a focus on embedding it in the curricula of all three programs (medicine, pharmacy, and nursing) across campuses.

IMPLICATIONS

In summary, working collaboratively in a team while being exposed to a series of medication management scenarios enhances teamwork attitudes as well as potentially improving performance. Based on the positive initial results, plans have begun to extend the experience to other campuses and include a wider group of students.