Sustainable interprofessional learning on clinical placements: the value of observing others at work

Rethinking IPE duration: a five-year comparative analysis of competency development across two introductory IPE course models

Best practices have not yet been established in the interprofessional education (IPE) literature to guide the ideal dose and duration of IPE experiences across the curriculum. As such, the content, structure, and delivery format of IPE offerings vary significantly across institutions. The University of Minnesota had the rare opportunity to evaluate learner-perceived collaborative competency outcomes due to the transition of its centrally offered introductory IPE course. Data were collected consistently, longitudinally, and for a high volume of learners and professions across two IPE course models applied within the same academic institution. Retrospective analysis of pre-post interprofessional collaborative competency scores collected for over 5,000 learners from 17 health profession degree programs demonstrated nearly identical self-reported competency attainment for both a 12- and 4-hour introductory IPE offering, assessed using the ICCAS tool over the course of 5-year format transition. If student-reported competency attainment is the same following an introductory IPE experience regardless of the dosage, then academic IPE programs may be better positioned by decreasing their introductory emphasis and instead focus their resources on exploring innovative workplace-based and competency-based IPE strategies in line with contemporary recommendations. Further studies are needed to explore the implications of and next steps in this line of research.

Exploring Structures and Processes Supporting Interprofessional Education During Experiential Learning Placements for Student Pharmacists

OBJECTIVE

To explore stakeholder views on the structures and processes supporting planned and unplanned interprofessional education (IPE) during experiential learning (EL) placements for student pharmacists in Scotland.

METHODS

Online semistructured group interviews were conducted with academic staff, practice educators, and EL facilitators (preceptors). Recordings were transcribed verbatim and analyzed thematically. Systems theory underpinned the study. Ethical approval was granted by the School of Pharmacy and Life Sciences Ethics Review Committee at Robert Gordon University.

RESULTS

Three main themes were identified: current IPE delivery and context, factors affecting IPE delivery and student pharmacist learning, and rethinking current IPE provision. Stakeholder views provided valuable insights into presage factors relating to contextual elements (cultural, logistical, regulatory) and their influence on IPE delivery and interprofessional learning. EL facilitator and student pharmacist characteristics were also highlighted as influencing factors; process factors included examples of planned and unplanned IPE experiences on offer in community, hospital, primary care, and specialist areas of pharmacy practice; product factors highlighted the importance of IPE to support the development of collaborative competencies. Future developments need to focus on a continuum of IPE learning and a coordinated approach between higher education institutions and placement providers and interprofessional practice teams.

CONCLUSION

Curricular development and implementation of new IPE is not without its challenges. This study has provided a strong foundation that will inform future developments to ensure new initiatives are conducive to supporting effective interprofessional learning during placements.

The interprofessional practice experiences of final-semester prelicensure BSN students completing clinical immersion: A descriptive qualitative study

BACKGROUND

The goal of interprofessional practice experiences in health professions programs is to develop interprofessional collaborative practice skills.

PURPOSE

The purpose of the study was to explore the meaning final-semester Bachelor of Science in Nursing students attributed to interprofessional practice experiences during clinical immersion.

METHODS

The theoretical framework for this descriptive qualitative study was experiential learning theory. A sample of 12 participants was drawn from final-semester prelicensure Bachelor of Science in Nursing students at a college of nursing at a public research university. Data were collected through one-on-one semi-structured interviews and analyzed through inductive thematic analysis.

RESULTS

The analysis yielded four themes: professional and interprofessional identity, working with team members, communication practices, and trusting relationships. Patterns across themes were clinical environment culture, nursing school preparation, nurse preceptor role, fear/concern/worry, and night shift.

CONCLUSION

Consistency in preceptors, welcoming clinical environments, and opportunities to practice communicating with team members contributed to interprofessional collaborative practice skill development and improved perceptions of readiness for practice. Academic and clinical educators may use findings to (a) identify immersion placements for interprofessional practice experiences, (b) design curricula reflective of interprofessional practice, (c) advance teaching strategies to promote interprofessional practice, and (d) create learning environments that aid in professional and interprofessional identity formation.

Implementation of interprofessional learning in hospital practice

AIM

Some universities of applied science struggle with implementing interprofessional learning due to a lack of diversity in professions. The aim of this study was to investigate whether an interprofessional learning model with an informational letter describing interprofessional learning opportunities can provide nursing students in rural areas with sufficient interprofessional learning during internships.

DESIGN

This qualitative study utilized a hermeneutical approach.

METHODS

A total of 17 individuals participated in focus groups, group interviews and written responses. The data collection: January 2019.

RESULTS

Four categories were observed: (a) assumptions about interprofessional learning, (b) available interprofessional learning opportunities, (c) hindrances to interprofessional learning and (d) stimulation of interprofessional learning. The conclusion was that interprofessional learning can be implemented to some extent in areas where different professions work, even when only one student is present. A focus on interprofessional collaboration, patient safety and patient flow are valuable interprofessional learning objectives. An informational letter with suggestions for interprofessional learning, such as shadowing, was considered valuable by the participants.

Psychosocial interprofessional perinatal education: Design and evaluation of an interprofessional learning experience to improve students' collaboration skills in perinatal mental health

BACKGROUND

Perinatal mental health disorders are one of the leading causes of maternal illness and suffering and care and services need to be well coordinated by an interprofessional team who are skilled in working collaboratively.

AIM

The aim of this paper is to describe the design and evaluation of an innovative interprofessional education initiative to increase midwives and other health professional students' knowledge and skills in caring collaboratively for women with psychosocial issues in the perinatal period, including women experiencing domestic and family violence.

METHODS

The Psychosocial Interprofessional Perinatal Education workshop was designed for midwifery, psychology, social work and medical students. It provided a simulated learning experience with case studies based on real life situations. Students undertook pre and post surveys to measure changes in students' perceptions of interprofessional collaboration and their experiences of participating in the interprofessional simulation-based learning activity. Quantitative survey data were analysed using paired t-tests and a qualitative content analysis was undertaken on the open-ended questions in the survey.

FINDINGS

Comparison of pre and post surveys found students from all disciplines reported feeling more confident working interprofessionally following the workshop. The following categories were generated from analysis of the open ended survey data: Greater understanding of each others' roles; Recognising benefits of interprofessional collaboration; Building on sense of professional identity; Respecting each other and creating a level playing field; and Filling a pedagogical gap.

CONCLUSION

Through this innovative, simulated interprofessional education workshop students developed skills essential for future collaborative practice to support women and families experiencing psychosocial distress.

Student pharmacist practice-based interprofessional education in Scotland: a qualitative study of stakeholders' views and experiences

Scottish Government funding supports practice-based experiential learning (EL) for student pharmacists. We explored views and experiences of key stakeholders on current practice and future development of interprofessional education (IPE) in EL including barriers and enablers. A pre-piloted schedule was used for online qualitative semi-structured interviews. eMail invitations were sent to 37 stakeholders with an information sheet and consent process. Interviews were analyzed thematically by two researchers independently. Recruitment continued until data saturation and wide representation were achieved. Twenty interviews were conducted with eight EL facilitators, seven faculty and five policy stakeholders. "Nature and experience of current IPE in EL activities" and "Future developments" were the two main themes. Barriers and enablers were also identified at macro, meso, and micro socio-institutional levels. The essence of the analysis highlighted stakeholders' views of the importance of building on current IPE while challenging the ethos and culture of EL practices. All stakeholders should be involved in co-production, training, piloting, and evaluation of curricular developments to overcome logistic barriers and enhanced enablers. Finally, the importance of workload management strategies and continuity of funding for success was also stressed by those interviewed. Future research could include designing frameworks for developing and implementing IPE within EL.

Placement Architectures in Practice: An Exploration of Student Learning during Non-Traditional Work-Integrated Learning in Rural Communities

BACKGROUND

Work-integrated learning (WIL) in rural communities provides students with important learning opportunities while also providing a service to those communities. To optimise the potential benefits of work-integrated learning for health students and rural communities it is important to explore the practices and outcomes of these experiences.

METHODS

This study used a qualitative research design underpinned by the theoretical framework of Theory of Practice Architectures to examine the way students learn during these placements. Purposive sampling was used to identify students for participation in the study. Seven students from the disciplines of paramedicine, physiotherapy, and speech pathology participated in semi-structured interviews. Data were analysed using inductive thematic analysis.

RESULTS

The learning described by the students was examined, followed by a critical interrogation of the data to assess how these learnings and associated practices were made possible given the site-specific practice architectures. The findings of the research are represented by three themes: learning affordances related to placement design, learning through relationships between people and professions, and learning through rural embeddedness.

CONCLUSION

Being embedded in rural communities gave the students access to several arrangements that fostered learning, particularly through the sayings, relatings and doings that the students engaged with. This research demonstrates the transformative potential of rural WIL opportunities for learning and future rural practice.

Mapping student perceptions of experiential interprofessional learning to the Interprofessional Education Collaborative (IPEC) competencies

INTRODUCTION

Introductory pharmacy practice experiences (IPPEs) and advanced pharmacy practice experiences (APPEs) provide opportunities for interprofessional education (IPE) in doctor of pharmacy (PharmD) programs by facilitating student engagement with other healthcare professionals. It is unknown how well these experiences align with competencies required for interprofessional collaborative practice. This study describes the alignment of student reflections from experiential rotations with the Interprofessional Education Collaborative (IPEC) competencies.

METHODS

Following completion of experiential rotations from June 2017 to August 2019, a retrospective analysis of IPE surveys submitted by students was performed to assess types of interprofessional interactions and alignment of student reflections with IPEC competencies.

RESULTS

A total of 1360 surveys were analyzed. More than 75% of all PharmD students enrolled in IPPEs or APPEs during the study period completed at least one survey. Across all experiences, survey responses mapped to IPEC competencies at the following rates: Values/Ethics (25%), Roles/Responsibilities (48%), Interprofessional Communication (36%), and Teams/Teamwork (48%). More reflections from inpatient experiences, compared to outpatient experiences, aligned with Roles/Responsibilities and Teams/Teamwork, while fewer inpatient experience reflections aligned with Interprofessional Communication. Active engagement with other health professions increased as students progressed from IPPEs to APPEs.

CONCLUSIONS

As PharmD students progress through the experiential curriculum, they engage with IPEC competencies during each professional year. Inpatient and outpatient experiences may highlight different aspects of the IPEC competencies and advanced rotations are more likely to facilitate active engagement with other healthcare professionals.

Nurse/Resident Reciprocal Shadowing to Improve Interprofessional Communication

OBJECTIVES

Poor communication is a major contributor to sentinel events in hospitals. Suboptimal communication between physicians and nurses may be due to poor understanding of team members' roles. We sought to evaluate the impact of a shadowing experience on nurse-resident interprofessional collaboration, bidirectional communication, and role perceptions.

METHODS

This mixed-methods study took place at 2 large academic children's hospitals with pediatric residency programs during the 2018-2019 academic year. First-year residents and nurses participated in a reciprocal, structured 4-hour shadowing experience. Participants were surveyed before, immediately after, and 6 months after their shadowing experience by using an anonymous web-based platform containing the 20-item Interprofessional Collaborative Competency Attainment Survey, as well as open-ended qualitative questions. Quantitative data were analyzed via linear mixed models. Qualitative data were thematically analyzed.

RESULTS

Participants included 33 nurses and 53 residents from the 2 study sites. The immediate postshadowing survey results revealed statistically significant improvements in 12 Interprofessional Collaborative Competency Attainment Survey question responses for nurses and 19 for residents (P ≤ .01). Subsequently, 6 questions for nurses and 17 for residents revealed sustained improvements 6 months after the intervention. Qualitative analysis identified 5 major themes related to optimal nurse-resident engagement: effective communication, collaboration, role understanding, team process, and patient-centered.

CONCLUSIONS

The reciprocal shadowing experience was associated with an increase in participant understanding of contributions from all interprofessional team members. This improved awareness may improve patient care. Future work may be conducted to assess the impact of spread to different clinical areas and elucidate patient outcomes that may be associated with this intervention.

'It benefits patient care': the value of practice-based IPE in healthcare curriculums

BACKGROUND

Practice-based interprofessional education (IPE) is essential to prepare students for collaborative working. Pockets of practice-based IPE are integrated into healthcare curriculums in some regions. Yet practice-based IPE is not globally valued as a key element of healthcare curriculums. As students and clinical educators are key stakeholders, this study presents a case example of their experiences in a country where practice-based IPE is at an emergent stage. Their experiential knowledge generated important insights into how practice-based IPE is perceived. This learning can be applied, both locally and further afield, by those seeking to embed practice-based IPE in their placement curriculums.

METHODS

A qualitative case study was conducted at a school of allied health and partner placement sites in Ireland. Data collection comprised two participant observations, 13 interviews and 12 document analyses. Inductive thematic analysis and deductive framework analysis, underpinned by activity theory and Hofstede's cultural dimensions, informed data analysis and interpretations.

RESULTS

Participants are grappling to establish the value of practice-based IPE, illustrated in three themes: clarifying the concept of practice-based IPE, mapping IPE activities and diversifying interprofessionalism. First, ambiguous conceptualisation of why and how to implement practice-based IPE was identified. Highlighting how practice-based IPE improved patient care and safety created a clear rationale for implementation. It was also helpful to demonstrate how adaptations to existing practice education models, rather than entirely new models, could achieve high-quality practice-based IPE. Second, the positioning of practice-base IPE in the placement curriculum was unclear. Overt mapping of practice-based IPE activities onto learning outcomes within assessment tools enhanced its value within practice education. Third, varying levels of professional engagement were noted, perpetuating stereotypes. Creating diverse educator networks and embedding practice-based IPE in organisational strategy may incentivise engagement across a greater range of professions.

CONCLUSIONS

Implementing these recommendations could enhance the value of practice-based IPE and optimise student preparation for collaborative working. Practice-based IPE remains a complex model and the trajectory of embedding in healthcare curriculums will differ globally.

Attitudes and Behavior towards Interprofessional Collaboration among Healthcare Professionals in a Large Academic Medical Center

The increasing rates of comorbidities among patients and the complexity of care have warranted interprofessional collaboration (IPC) as an important component of the healthcare structure. An initial step towards assessing the effectiveness of collaboration requires the exploration of the attitudes and experience of healthcare professionals towards IPC. This online survey aimed to examine the attitudes of healthcare professionals working in a large public academic medical center toward IPC in patient care and the healthcare team, and their behavior and experience regarding IPC. The rankings, according to the perceived importance among the respondents, of the four Interprofessional Education Collaborative (IPEC) core competencies (values/ethics, roles/responsibilities, interprofessional communication, teams/teamwork) were assessed. There were strong but varying levels of consensus among healthcare professionals (N = 551) that IPC facilitates efficient patient care, improves patient problem-solving ability, and increases better clinical outcomes for patients. They acknowledged that IPC promotes mutual respect within the healthcare team and providers’ ability to make optimal patient care decisions. However, overall more than 35% of the respondents did not attend multidisciplinary education sessions (grand rounds, seminars, etc.), and about 23% did not participate in bedside patient care rounds. Interprofessional communication was ranked as the most important IPEC core competence. Although the attitude towards IPC among healthcare professionals is strongly positive, many healthcare professionals face challenges in participating in IPC. Institutional policies that facilitate interprofessional learning and interactions for this group of healthcare professionals should be formulated. Online distance learning and interactions, and simulation-enhanced interprofessional education, are options for addressing this barrier. Hospital administrators should facilitate conducive work environments that promote IPC, based on IPEC core competencies, and promote programs that address the challenges of IPC.