Teamwork, collaboration and networking: self-reported behavioural change following pre-licensure interprofessional clinical learning

From classroom to collaboration: how pre-graduation interprofessional learning shapes health professional graduates' interactions in practice

Interprofessional education (IPE) aims to prepare health professional students with the knowledge, attitudes and skills required for collaborative healthcare practice. Although positive outcomes have been documented at the completion of university-based IPE experiences, or longitudinally across health care degrees, the literature is unclear on how university-based IPE influences graduate practice. This study therefore explores how health professional graduates experience interprofessional interactions in practice and how these may be connected to their university-based IPE experiences. Interviews with seven health professional graduates who had participated in an 11-week IPE course as part of their pre-licensure degrees were analyzed using interpretative phenomenological analysis. The participants were able to articulate instances of effective and less effective collaboration from their professional experiences, making sense of these experiences with explicit reference to the themes of role understanding, collaborative working relationships, interprofessional communication, patient-centered care and contextual influences; all ideas introduced in their university-based IPE. They connected their understanding of roles, collaborative working relationships and interprofessional communication explicitly to their prior university-based IPE, identifying these learnings as foundational knowledge. This connection was not as explicit for patient-centered care and contextual issues. These findings highlight the critical importance of IPE in preparing health professionals for high-quality contemporary practice.

Healthcare professionals' experiences of required competencies in mentoring of interprofessional students in clinical practice: A systematic review of qualitative studies

AIM

To synthesize evidence on healthcare professionals' experiences of competencies in mentoring undergraduate healthcare, social care and medical students during their interprofessional clinical practice.

DESIGN

This review was conducted by the JBI methodology for systematic reviews of qualitative evidence.

METHODS

Studies were included if they were based on the phenomenon of interest and used qualitative or mixed methods (qualitative share). The included studies were critically appraised using the standardized JBI Critical Appraisal Checklist. Qualitative research findings were extracted and synthesized using the meta-aggregation approach.

DATA SOURCES

Five databases (CINAHL, PubMed, Scopus, Medic and ProQuest) were systematically searched from each database's inception on 28 June 2023.

RESULTS

A total of 5164 studies were initially screened, and 25 were identified for inclusion in this review. Three synthesized findings were identified: competencies related to (1) preparing for and developing interprofessional clinical practice, (2) supporting the learning process in interprofessional clinical practice and (3) creating an interprofessional mentor identity.

CONCLUSION

Although competent mentors are essential to implementing and developing interprofessional clinical practice, some mentors find interprofessional mentoring challenging. High-quality interprofessional mentoring requires specific competence that differs from profession-specific and individual mentoring.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

To ensure that interprofessional clinical practice is of high quality and strengthens students' professional and interprofessional growth, special attention should be given to mentors' interprofessional mentoring competence, and a range of opportunities and organizational structures should be provided for competence development.

IMPACT

This systematic review provides insights into the specific competencies required for interprofessional mentoring. These findings can support healthcare professionals, educators and policymakers in developing interprofessional clinical practice and mentoring competence.

REPORTING METHOD

This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement and ENTREQ reporting guidelines. No patient or public contribution.

The effect of interprofessional education on the work environment of health professionals: a scoping review

To explore the existing literature on the effect of Interprofessional Education (IPE) on the work environment of health professionals. The research question was systematized according to the PCC (Population, Concept, and Context) format. A scoping review was performed. A search of multiple bibliographic databases identified 407 papers, of which 21 met the inclusion criteria. The populations of the 21 studies reviewed were composed of professionals in the fields of medicine, nursing, psychology, occupational therapy, physiotherapy, and social work, among others. The study contexts were both academic and nonacademic hospitals, mental health institutions, and community settings, and the topics examined were organizational climate, organizational culture, organizational attachment and job satisfaction. The findings from the reviewed studies showed positive effects of IPE interventions on organizational climate and culture, but the results on job satisfaction and organizational attachment were mixed (i.e., positive and no effects following IPE interventions). Research on IPE is worth more attention as IPE could be an effective alternative for the fulfillment of the Quadruple Aim and achieving the third of the United Nations Sustainable Development Goals, aimed at improving health and well-being. It seems critical for IPE to be positioned as a trend in global health, aiming at boosting human health resources as one of its building blocks and calling the attention of health decision-makers.

Behavioural outcomes of interprofessional education within clinical settings for health professional students: A systematic literature review

Interprofessional education facilitates collaborative practice, which promotes high-quality patient care and patient safety. Interprofessional education (IPE) experiences within clinical settings provide an opportunity for the development of interprofessional collaborative practice competence. The aim of this systematic review was to review the literature evaluating interprofessional education for health professional students within clinical settings and summarize the behavioral outcomes. Databases searched were PubMed, Embase, Scopus, Web of Science, Taylor & Francis Online, ERIC and PsycINFO. Full-text articles were independently screened by two reviewers and included if agreed. Outcomes were analyzed using Kirkpatrick's model modified for IPE. Studies with behavioral change outcomes were analyzed and synthesized using narrative methods. Included studies provided evidence that IPE experiences in clinical settings can enable students to develop and integrate interprofessional collaborative practice competencies, across diverse types of settings. Key tasks enabling students to achieve these learning outcomes included synchronous patient consultations, collaborative development of integrative health-care plans outside of patient consultations, and participation in socialization with health-care teams. There were limitations in the methodological design of the included studies, with limited use of comparator groups and validated tools, high usage of self-report data and serious risk of bias identified across all quantitative included studies. In conclusion, high-quality research designed to measure the construct of behavioral change is lacking. Such research could further investigate the key tasks in IPE experiences in clinical settings that are necessary for students to develop the range of required collaborative practice competencies and integrate these. This could provide clarification regarding if and how this could be achieved across different types of clinical placements.

The Evaluation of an Interprofessional QI Program: A Qualitative Study

Background: Quality Improvement (QI) is the key for every healthcare organization. QI programs may help healthcare professionals to develop the needed skills for interprofessional collaboration through interprofessional education. Furthermore, the role of diversity in QI teams is not yet fully understood. This evaluation study aimed to obtain in-depth insights into the expectations and experiences of different stakeholders of a hospital-wide interprofessional QI program. Methods: This qualitative study builds upon 20 semi-structured interviews with participants and two focus groups with the coaches and program advisory board members of this QI program. Data were coded and analyzed using thematic analysis. Results: Three themes emerged from the analysis: "interprofessional education", "networking" and "motivation: presence with pitfalls". Working within interprofessional project groups was valuable, because participants with different experiences and skills helped to move the QI project forward. It was simultaneously challenging because IPE was new and revealed problems with hierarchy, communication and planning. Networking was also deemed valuable, but a shared space to keep in contact after finalizing the program was missing. The participants were highly motivated to finish their QI project, but they underestimated the challenges. Conclusions: A hospital-wide QI program must explicitly pay attention to interprofessional collaboration and networking. Leaders of the QI program must cherish the motivation of the participants and make sure that the QI projects are realistic.

Exploring interprofessional identity development in healthcare graduates and its impact on practice

Interprofessional identity development is an emerging area of research. Whilst there is a growing body of studies exploring interprofessional identity development and interprofessional education, little is known about interprofessional identity development in healthcare professionals and the impact of interprofessional identity on practice. This study explored interprofessional identity development in graduates during their first year of work as health professionals and the influence of this on practice. All graduates had prior interprofessional education as students. Fourteen interviews with eight graduates were conducted. Data was analysed cross-sectionally using inductive thematic analysis. Three inter-related themes were developed: ‘growing confidence,’ ‘commitment to client-centred care,’ and ‘maintaining dual identification in different contexts.’ These themes demonstrated that, first, interprofessional identity development occurred along a continuum influenced by the practice context and the individual’s commitment to client-centred care. Second, confidence identifying and practising as a healthcare professional facilitates further interprofessional identity development. Third, maintaining identification as an interprofessional practitioner involves developing an increasingly sophisticated understanding of interprofessional practice by viewing interprofessional identity through increasingly complex meaning-making lenses consistent with the constructive developmental theory of self. Findings support the inclusion of pre-licensure interprofessional education and inform further interprofessional identity research in professionals beyond their first year of practice.

What characterize high and low achieving teams in Interprofessional education: A self-determination theory perspective

OBJECTIVES

Calls to promote team-based interprofessional collaborative practice in managing patients with complex health problems are ubiquitous. However, the literature remains silent on what characterises successful teams in interprofessional education (IPE) and on profiling successful teams. To help conceptualise successful teams, this study investigated the differences in attitudes and achievement between high- and low-performing teams in an online asynchronous and synchronous IPE programme, and the role of autonomous motivation in determining team membership.

METHODS

Using extreme case sampling involving health and social care students, we identified ten high-performing teams and seven low-performing teams based on their team composite scores on three interprofessional collaborative outcomes: team effectiveness, goal achievement, and scores on the readiness assurance test. Each team had five to seven members of diverse backgrounds. Independent t-tests were performed to identify differences in interprofessional collaborative outcomes, namely teamwork and collaboration, patient-centredness, diversity and ethics, community-centeredness, and interprofessional biases for the affective domain and application exercise for the cognitive domain. We employed logistic regression in which autonomous motivation was used to predict group membership.

RESULTS

High-performing teams were characterised as those whose members endorsed or valued "teamwork and collaboration" in IPE simulations. Compared with the low-performing groups, they better recognised and endorsed diversity and ethics, patient-centeredness, and community-centeredness. Membership to high- and low-performing teams was linked to autonomous motivation.

CONCLUSIONS

High-performing teams have higher favourable valuing of important interprofessional collaborative competencies, and membership to which is predicted by autonomous motivation. The results suggest the need to pay special attention to struggling teams to facilitate desirable collaborative competencies, especially in terms of members' motivation. Theoretical, methodological, and practical implications are discussed.

A preliminary simulation-based qualitative study of healthcare students’ experiences of interprofessional primary care scenarios

Background

Introducing interprofessional education (IPE) in healthcare curricula can prepare students for healthcare practices that have become increasingly complex. The use of simulation is promoted to support IPE. This study explores healthcare students’ experiences of participating in common, sub-acute patient scenarios that routinely occur in clinical practice in primary care. More specifically, it looks at how sub-acute patient scenarios from primary care can help develop interprofessional collaborative competence.

Methods

Medical students (N = 10), master’s students in advanced geriatric nursing (N = 8) and bachelor’s students in nursing (N = 9) participated in the simulations. The students were in their last or second-to-last year of education. We conducted five semi-structured focus group interviews with the participants’ directly after the simulation training to elicit experiences related to the scenarios, the simulation and interprofessional collaboration. The transcripts were analysed using systematic text condensation. To supplement the focus group interviews, the students also completed the interprofessional collaborative competency attainment survey (ICCAS), which measures the students’ self-assessed interprofessional competence.

Results

Three main themes emerged from the analysis of the focus group interviews: realism, uncertainty and reflection. The students emphasised the importance of authentic and recognisable scenarios. They said the vague and unspecific patient symptoms created uncertainty in the situation, making it difficult to understand the patient’s diagnosis. Despite that uncertainty, they described the experience as positive. Further, the students expressed that the simulation increased their confidence in interprofessional collaboration and prepared them for future work. The results from the ICCAS questionnaire showed that the students reported a subjective positive change in their interprofessional competence after participating in the scenarios.

Conclusions

This study showed that simulation-based IPE with sub-acute primary care scenarios contributes to develop interprofessional collaborative competence in healthcare education. Sub-acute scenarios can supplement the more common approaches with acute care scenarios and aid in developing the collaborative competence required to work in healthcare teams.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41077-022-00204-5.

' … breaks down silos': allied health clinicians' perceptions of informal interprofessional interactions in the healthcare workplace

Informal interprofessional interactions have gained interest in recent interprofessional care, education, health services and social sciences research literature. Some of the established benefits associated with these interactions include enhanced communication, teamwork, research translation and the provision of safer care. Limited evidence about how informal interprofessional interactions are perceived by the allied health workforce, exists. The survey conducted at a large Australian health service explored allied health clinicians' perceptions of the benefits, challenges and enablers of informal interprofessional interactions and their recommendations to improve opportunities for these workplace interactions. Sixty-four responses were analysed descriptively (for close-ended questions) and using a framework analysis approach, informed by Bourdieu's social space theory (for open-ended questions). Perceived benefits were aligned with three themes: teams and organisations, individual clinicians and service-users. Challenges to, and enablers of, informal interprofessional interactions were identified according to five themes: socio-cultural practices, physical environment, timing-related factors, individual and organisational factors. Participant recommendations to increase opportunities for informal interprofessional workplace interactions for allied health reflected three of the aforementioned themes: socio-cultural practices, physical environment and organisational factors. This theoretically-informed analysis may aid in the development of strategies to support these types of workplace interactions and realise the benefits identified.

Facilitating interprofessional identity development in healthcare students through dedicated interprofessional placements

There is a growing body of research evidencing the benefits of dedicated interprofessional placements in preparing healthcare students for interprofessional practice. However, little is known about if and how students develop their interprofessional identity during interprofessional placements. This study addresses this knowledge gap by exploring final-year students' interprofessional identity development during dedicated interprofessional placement(s). Thirty-eight students from five health professions were interviewed and data analyzed inductively to identify themes. Participants also drew images representing their perceptions of interprofessional identity and its relationship to professional identity as part of the data collection. The themes showed participants progressed from conceptualizing interprofessional identity as a requirement of the placement at the start of the placement, toward internalizing an interprofessional identity by the end of their placement. Context influences interprofessional identity salience. A commitment from healthcare professionals to model interprofessional practice, combined with explicitly facilitating interprofessional identity development, is recommended to facilitate continued interprofessional identity development in different contexts post placement.

Interprofessional education clinical placement program: a qualitative case study approach

The goal of health professional education programs is to produce competent graduates, with an ability to work collaboratively as effective healthcare team members. We explored the reflections of students and clinical facilitators, in response to participation in a structured interprofessional education (IPE) clinical placement program. In our qualitative study we used an exploratory case study design. In our analysis, we highlight the benefits of interprofessional practice. Key themes identified by students included: limited opportunities to engage in IPE across their course; lack of clarity around IPE; value of IPE for students, practitioners, and patient outcomes; and need for IPE opportunities to be integrated into placements. Key themes identified by the clinical facilitators included: being reminded of the value of IPE for students and patients; preparation for IPE placements need to be embedded in curricula; coordination and communication of IPE learning activities need to be clear for staff and students; and IPE should continue as part of the broader clinical education agenda. Our findings reinforce the notion that students and clinical facilitators value the importance of IPE for student learning within the clinical placement setting. The outcomes offer valuable insights for universities and hospital and health care contexts for setting up and implementing IPE activities, and we provide recommendations for improving ongoing IPE efforts within clinical placement setting.