The effects of an IPS-based IPE program on interprofessional socialization and dual identity development

What about us?: a call to include oral health professions within interprofessional education for collaborative practice

Interprofessional collaboration (IPC) among the health professions is recognised as a vital component of efficient health systems and comprehensive healthcare teams. Interprofessional education for collaborative practice (IPECP) is foundational for health professional students to gain an understanding of professional roles, responsibilities, and the value of other professions to patient care. Oral health professionals are highly skilled and knowledgeable experts who recognise the oral-systemic health link. However, they have been largely excluded from, and underutilised within primary healthcare settings and interprofessional teams. Given that oral health is a key indicator of overall health and wellbeing, there is a need mobilise oral health professionals within primary healthcare practice. Yet, advancements for IPECP in oral health education face significant barriers which impede the integration of the oral health professions within interprofessional teams. Collaborative approaches across health programmes to devise intentional, authentic, and transformative strategies for IPECP are needed to bridge gaps in patient care and to dismantle problematic perceptions of 'oral health' as distinct from overall health and wellbeing in contemporary healthcare practice.

Learning theories and their applications in interprofessional education (IPE) to foster dual identity development

Interprofessional teaching and learning is a key component of interprofessional education for collaborative practice (IPECP), which aims to prepare health professional students and practitioners to work effectively and collaboratively with each other and with patients to address the Quintuple Aim (better health, better care, better value, better work experience, and better health equity). However, interprofessional teaching and learning is complex and challenging, as learners come together with diverse professional knowledge, skills, and experience; potential preconceived notions and prejudices against each other, and diverse expectations and conditions in which learning will occur. As a result of this complexity, there is no one-size-fits-all IPECP intervention as the current literature and practice lack a clear, consistent theoretical foundation, and guidance for interprofessional teaching and learning. This article aims to critically analyze and apply the main four learning theories (behaviorism, cognitivism, constructivism, and humanism) in interprofessional education (IPE). The article discusses the views of learning theories and explains the nature of interprofessional teaching and learning, and the process of designing and implementing interprofessional learning experiences that foster dual (professional and interprofessional) identity in developing future interprofessional practitioners.

Becoming Interprofessional: A Longitudinal Study of Professional and Interprofessional Identity Development Across Five Health Professions

Interprofessional collaborative practice (IPC) occurs when health professions work collaboratively to improve quality of care and enhance patient outcomes. Yet myriad challenges to enacting collaborative practice exist. Interprofessional education for collaborative practice (IPECP) is foundational for promoting collaboration among health professions, yet there is a gap in understanding how students perceive their readiness for IPC and how early socialization experiences may contribute to developing a dual-uni-professional and interprofessional-identity. This study seeks to understand how new practitioners perceive and experience IPC upon entry to practice, and identify individual and systemic factors that facilitate and impede dual identity development. An interpretive, narrative methodology was used to understand the IPC and early professional practice experiences of 24 individuals from a longitudinal study of five health professions. Facilitators to interprofessional identity development included exposure to/working with interprofessional teams, settings, role models, and directly experiencing benefits of collaborative practice during patient care. Impediments include settings and situations where professional stereotyping and hierarchies were reinforced by the dominant uni-professional culture of work environments. Interprofessional socialization and identity development are contingent on exposure to interprofessional role models and settings. Healthcare professionals' dual identity development begins in pre-licensure IPECP but is shaped by socialization experiences within practice. Healthcare institutions need to provide nourishing collaborative environments (time, settings, and contexts) that foster interprofessional collaboration and behaviors and empower dual identity formation. Post-licensure IPECP for healthcare professionals to continue to learn with, from, and about one another in practice is essential for collaborative interprofessional healthcare teams/systems.

Participation in a pre-registration student interprofessional education (IPE) society: influence on subsequent professional practice

Background

Student interprofessional education (IPE) societies or organizations are popular ways to support pre-registration health professions students to develop the understanding and skills needed for collaborative working. Our experience with the University of Birmingham Knowledge and Skills Exchange (KASE) is that, whilst such societies can be excellent vehicles for IPE, sustaining them can be challenging; and that consistent faculty support, adequate resource and a focus for society activities are needed for them to flourish. Whilst the longer term impact of pre-registration IPE has been demonstrated, less is known about the influence of student IPE society membership on participants' subsequent professional practice. To inform institutional decisions about establishing and maintaining a student IPE society, we have investigated the perceptions of early career health professionals who were KASE members during their pre-registration training.

Methods

KASE alumni working as early career health professionals were invited to participate in the study. Their perceptions of the influence of KASE on their transition to practice and experience as early career health professionals were explored through online semi-structured interviews and interview transcripts analyzed thematically. Resulting themes were reviewed for relevance to the University of Birmingham (UK) IPE Framework, which uses the competency domains of the Canadian Interprofessional Health Collaborative Competency Framework as the required learning outcomes for IPE at Birmingham.

Results

Eight interviews with former KASE members were conducted between November 2022 and March 2023. Interviewees had between 2 and 5 years of experience in their professional role. Six themes relating to the influence of KASE on their subsequent professional practice were identified: interprofessional communication, teamworking, patient-centered care, leadership and organizational skills, confidence and resilience. Three of these themes related to required IPE learning outcomes. Two further themes: time to build relationships; and informality and autonomy, suggested possible reasons for such influence.

Conclusion

Early career health professionals considered that participation in the KASE student IPE society helped their transition into the healthcare work environment and encouraged them to adopt a more collaborative and patient-centered approach. Benefits reported suggest that faculty support for institutional student IPE societies is worthy of consideration.

Cross-cultural adaptation and validation of a teaching questionnaire measuring facilitator competencies and characteristics of interprofessional clinical educators in an Asian setting

This study aimed to validate an Indonesian version of the teaching questionnaire measuring the competencies of interprofessional education (IPE) facilitators and the characteristics of good clinical educators described by Kerry et al. (2021). A cross-cultural adaptation was developed and consisted of the following steps: forward-backward translation, content validity index measurement, cognitive interviews and a pilot study to measure content validity and reliability, exploratory factor analysis (EFA) to identify the new dimensionality, and confirmatory factor analysis (CFA) to confirm the measurement model. The pilot study results confirmed that the Indonesian version of the questionnaire assessing teaching competencies had good internal consistency (ω= .74 for the competencies of facilitators and ω= .88 for the characteristics of good clinical educators). The questionnaire was then administered to 209 clinical educators from five health professions. The EFA revealed two factors for the competencies (ω1= .86, ω2 = .70) and one factor for the characteristics of good IPE clinical educators (ω= .90). The CFA showed that the proposed model had a good fit with the observed data with (chi-square test: p > .05; CMIN/df, TLI, CFI, GFI, and AGFI were within the expected ranges; and RMSEA approximately .05).

Strategies for Health: a game-based, interprofessional approach to teaching social determinants of health: a randomized controlled pilot study

Knowledge of social determinants of health (SDH) can help students reduce health disparities and advance health equity and quality of life. This pilot study aimed to assess the effectiveness of Strategies for Health, an interprofessional game, in improving student knowledge regarding SDH as well as attitudes toward interprofessional collaboration when compared to or combined with didactic coursework. A mixed methods approach was utilized. Participants (N = 42) were divided into one of four groups: Control (A), gameplay (B), didactic module (C), and a combined didactic module followed by gameplay (D). Data was collected using a knowledge base test of SDH, the Interprofessional Attitudes Scale (IPAS), and qualitative feedback during gameplay and debriefing. SDH results indicated no significant differences within groups, but a combined pre-post indicated a significant improvement among Group D (p = .04). IPAS results indicated a statistically significant improvement in interprofessional attitudes of teamwork, roles, and responsibilities among Groups B and D. A combination of didactic learning and gameplay was the most effective approach to improving and maintaining SDH knowledge and attitudes toward IPE over time. These findings inform the need for interprofessional curricula that aim to improve health outcomes and advance health equity.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

Clinician experience of being interprofessional: an interpretive phenomenological analysis

Clinicians are increasingly required to work and learn interprofessionally, yet few studies explore the nature of being interprofessional. The purpose of this study was to explore the lived experience of clinicians who identify as interprofessional or have an interprofessional identity. Interpretive phenomenological analysis (IPA) was applied as a qualitative research approach and analytical method. Fifteen key informants from a range of professions, settings, and roles were recruited via purposive sampling. Data was collected via semi-structured interviews, observation of participants' day-to-day practice, and review of organizational documents, and analyzed using IPA. Six interdependent Group Experiential Themes were developed: (i) The power of person-centered holistic care, (ii) Learning and growth through curiosity, reflection, and willingness to be vulnerable, (iii) Welcomes, values, and empowers all others, (iv) Trust and mutual respect through belonging and connection, (v) The contribution of background and previous experiences, and (vi) The influence of workplace context. Each Group Experiential Theme had between two and nine sub-themes. Results support the value of understanding and making explicit the concepts that comprise clinician interprofessional identity. The findings can be used to support clinicians, educators, leaders, and policy makers to develop and sustain interprofessional identity, and subsequently cultivate a culture of interprofessional collaborative practice. Future research is needed to further explore the themes, investigate their inter-relationships, and present the concepts that comprise clinician interprofessional identity in a way that is accessible to healthcare professionals and facilitates their integration into practice.

A longitudinal study of interprofessional education experiences among health professional graduates

Effective teamwork and collaboration among health professionals is a well-recognized strategy toward enhancing patient outcomes. However, there is a lack of understanding on how to best prepare health professionals for collaborative practice. The aim of this research is to gain a better understanding of how graduates of five health professions (dentistry, medicine, nursing, pharmacy, physiotherapy) perceive and experience interprofessional education for collaborative practice (IPECP) throughout their health professions journey, with a focus on transition to practice. This longitudinal study employed an interpretive, narrative methodology to understand interprofessional identity development of 24 individuals who had recently graduated from a health professions program (dentistry, medicine, nursing, pharmacy, physiotherapy) at a Canadian university. Participant experiences were analyzed using narrative analysis. Participants' narratives provided insight into the context, factors and curricular experiences needed for interprofessional identity development and preparedness for collaborative practice. Participants identified the importance of socialization and connection with others, collaborative role models and exposure to collaborative experiences and settings for interprofessional practice. Participants expressed some dissatisfaction with their earliest IPECP experiences and most valued their exposure to 'real-life' practice examples and clinical scenarios. Participants desired more authentic experiences of interprofessional collaboration during their programs. Improving health professionals' interprofessional socialization and collaborative experiences within IPECP is critical to improving patient outcomes. Study findings can inform future curricula and IPECP strategies that create conditions to enhance collaborative practice and ensure the preparedness of a future health workforce with a strong collaborative identity.

First-year health professions students' interprofessional identity development following participation in a brief introductory interprofessional activity: a qualitative study

Healthcare providers need to simultaneously identify with their own profession and the broader interprofessional group to improve interprofessional team functioning and collaboration. The purpose of this study was to explore firstyear healthcare students' interprofessional identity development following a brief introductory interprofessional activity. The Extended Professional Identity Theory (EPIT) served as the framework for this qualitative study. The sample included 1,047 students from 19 different health professions at one institution in the first semester of their professional program. Deductive content analysis was used to analyze students' reflections from two reflective questions in a mandatory course evaluation survey. The 24-item version of the Extended Professional Identity Scale was used as a structured categorization matrix for deductive coding of student reflections to the three EPIT constructs: interprofessional belonging, commitment, and beliefs. Participant responses, spanning all three EPIT constructs, support the ability of early health professions learners to demonstrate the development of an emerging interprofessional identity. Future research is needed to assess IPI at various points across the curriculum and to explore between profession differences and the implications for foundational IPE design and learning along the continuum into practice.

Barcamps or unconferences as an emerging paradigm in medical education: Insights from a pilot and feasibility mixed methods study

Medical education is experiencing a paradigm shift towards more interactive and collaborative pedagogical approaches. Barcamps, also known as unconferences, offer an interactive, participant-driven learning approach. This study aims to evaluate the feasibility of using barcamps as an educational model in medical education. Furthermore, the possibility of establishing barcamps in medical education as a pedagogical tool is discussed. The study integrates two evaluations to achieve a multifaceted understanding: a pilot study conducted in 2022 and a subsequent feasibility study in 2023. Participation in the barcamps and their evaluations was voluntary. We combined quantitative data, primarily from post-event evaluations, and qualitative data from open-ended survey questions. These methods were designed to capture a broad range of participant experiences and perceptions. The pilot study in 2022 included 11 participants and produced a response rate for the evaluations. The feasibility study in 2023 had 34 participants but a lower evaluation response rate of 53%. Both barcamps were generally positively evaluated by the participants, indicating a high level of satisfaction and perceived value. Regarding the active participation of participants, the wide range of presented topics highlights the adaptability and flexibility of the barcamp model. Attendees at the pilot mentioned a significantly higher previous experience with barcamps. The study suggests that barcamps are generally well received as an interactive and collaborative educational tool in medical education, reflected by high participant evaluation scores. The wide range of topics presented and discussed indicates that barcamps can accommodate diverse educational needs and interests. However, the study also identified areas for improvement, most notably in the structure of topic plans and the overall learning environment. Finally, the principals for barcamps might adapt to other educational methods by adding more interaction, choice, collaboration, communication, critical thinking, creativity, and caring to the learning process.

Interprofessional Team Conflict Resolution: A Critical Literature Review

INTRODUCTION

Although concern related to conflicts within health care teams has been discussed in the literature, most studies have focused on individuals' personal conflict management style identification or on managers resolving workplace conflicts between parties. The purpose of this review was to identify significant components in the field of conflict with particular attention to conceptual findings that may be integrated into understanding interprofessional health care team conflict and its resolution.

METHODS

A critical review of the conflict literature across many fields was undertaken using the method identified by Grant and Booth, incorporating literature-search, appraisal, synthesis, and analysis.

RESULTS

This critical review explored existing models and schools of thought to provide an overview of how conflict is conceptualized, its focus on interpersonal and workplace issues, team conflict application and training in team conflict resolution, and finally a summary of this review's contribution to interprofessional health care team conflict and its resolution.

CONCLUSIONS

Team conflict is comprised of three forms-relationship, task, and process. When team building occurs that incorporates training in the use of an adapted constructive controversy approach, there is a greater opportunity to enhance the quality of a cooperative approach to patients' care planning. Training in team conflict resolution is needed as a key ingredient to ensure all team members can enhance the effectiveness and quality of interprofessional client-centered collaborative practice. This benefits not only the health providers in the team, but also their clients/patients who are recipients of their shared teamwork.

Comparing quantitative outcomes of synchronous online versus in-person interprofessional symposium

Healthcare and educational practices changed due to COVID-19. Interprofessional education (IPE) events during the pandemic were canceled or presented through online platforms. Fortunately, IPE using online platforms had been growing during the decade prior to the pandemic. However, few publications document quantitative outcomes of online IPE, and most report qualitative outcomes of student reactions. The purpose of this study was to determine if student outcomes from an online IPE symposium were similar to the positive outcomes from prior in-person IPE symposia. A Community of Inquiry (CoI) model within a synchronous Zoom platform was developed with intentional design supporting cognitive, instructional, and social presence; interprofessional socialisation; and collaboration. Utilising a standardised instrument, student attitudes about healthcare teams were assessed comparing pretest and posttest. Students who participated in the online IPE displayed similar improvements in attitudes towards interprofessional teams at posttest. Hence, this study supports the use of a brief, synchronous, online IPE symposium.

'They're not doing too much are they?' How the socialization of registered nurses perpetuates status differences with certified nursing assistants: A qualitative study

BACKGROUND

Limited knowledge exists about how the socialization of vocationally trained registered nurses both at school and during internships in the community of practice influences their perception of, and working relationship with certified nursing assistants.

OBJECTIVES

This paper studies, first, how registered nurse students internalize the perceptions and discourses about certified nursing assistants conveyed by teachers, mentors and other students during their socialization at school and in the community of practice. Second, it examines how this socialization forms student's perception of, and actual working relationship with certified nursing assistants.

DESIGN

Qualitative descriptive and exploratory study using an interpretative framework.

METHODS

Individual in-depth interviews were conducted with 15 registered nurse students that were in their third or fourth year of training.

RESULTS

The findings reveal that at school the division of tasks and working relationship between registered nurse students and certified nursing assistants was very rarely discussed explicitly. However, teachers and students implicitly and explicitly conveyed that certified nursing assistants have lower status, describing the latter's role as inferior and as assisting to the role of registered nurses. During internships in the community of practice, some students initially adjust this perception when directly working with certified nursing assistants, who generally are their mentor in the first years of training, consider certified nursing assistants as equal and highlight the interdependence of the two occupational groups. Yet, further in their training, registered nurse students start to relate more to graduated registered nurses and reproduce the dominant perception and discourse that certified nursing assistants are inferior and supposed to support registered nurses, thereby perpetuating pervasive status differences and inequality.

CONCLUSION

Findings will assist nurse educators both in training centers and in the community of practice to understand how education can be used to end pervasive status differences and foster mutual respect and equity between different designations in nursing.

A longitudinal, narrative case-study of interprofessional socialization among pharmacy students

INTRODUCTION

Despite growing evidence that interprofessional education (IPE) develops students' attitudes and competencies towards collaboration, there is a lack of theoretical, longitudinal research to inform the development of IPE initiatives. The purpose of this study was to examine pharmacy student interprofessional identity development during early professional and interprofessional socialization experiences in the pharmacy curriculum and at early entry into pharmacy practice.

METHODS

This longitudinal, narrative case study used one-on-one, semi-structured interviews conducted at four time points; pre-entry, end of first term, end of first year, and two years post-graduation. Data were analyzed by narrative analysis.

RESULTS

Three participants completed interviews at all four time points. Narratives revealed that participants focused on understanding the roles of pharmacists and other health professionals during early pharmacy curriculum and IPE experiences. Expansion of profession-specific role understanding and confronting pre-existing views or stereotypes were an emphasis early in the curriculum. Participants most valued IPE opportunities that allowed them to enact their own role while working with others in authentic case-based, simulated, or experiential experiences that enabled the development of professional relationships. Interprofessional identity development early upon entry into pharmacy practice varied based on the practice setting context and the ability to form relationships with other health care providers.

CONCLUSIONS

This study provides a preliminary exploration into the process of early interprofessional socialization for pharmacy students. Understanding the process of interprofessional identity development may affirm or enhance understanding of IPE curricula; further exploration in pharmacy curricula and practice is warranted.

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.

Which learning experiences support an interprofessional identity? A scoping review

In recent years, health professions researchers have suggested that a dual identity that includes both a professional and interprofessional identity is essential to interprofessionality. This scoping review sought to describe the learning experiences that may support the development of an interprofessional identity, providing direction for future research. A scoping review was conducted to identify papers published between 2000 and 2020 that provided empiric evidence to support the impact of planned or spontaneous learning experiences involving two or more healthcare professions that fostered the development of an "interprofessional identity," or a sense of belonging to an interprofessional community. Twelve papers were identified for inclusion. Articles varied regarding both the professional groups studied and the developmental levels of their participants. A wide variety of learning experiences were described in the identified studies, including designed activities and programs, as well as those occurring spontaneously in authentic clinical environments. Examples of longitudinal and integrated programs were also identified. The construct of an interprofessional identity and its potential impact on interprofessional practice has yet to be sufficiently studied. The results of this scoping review suggest that a variety of experiences that occur throughout the professional development trajectory may foster an interprofessional identity. Longitudinal, integrated interprofessional learning programs may result in a more long-lasting impact on interprofessional identity and these types of programs should be the focus of future research.

Inter-Disciplinary Work in the Context of Integrated Care - a Theoretical and Methodological Framework

Inter-disciplinary team working is an essential mechanism for the delivery of integrated care. This paper summarises a narrative review of the research on the 'work' that teams do to develop inter-disciplinary practices, addressing the question 'How do interdisciplinary teams 'become' in the context of models of integrated care?'. The narrative review identities a gap in our understanding of the active boundary work that different disciplines working together to deliver care integration engage in when creating new interdisciplinary knowledge, creating an inter-disciplinary team identity and negotiating new social and power relations. This gap is particularly significant in relation to the role played by patients and care-givers. This paper presents a way of examining inter-disciplinary working as a process of creating knowledge, identity and power relations both in terms of a theoretical lens, circuits of power, and a methodology, institutional ethnography. An explicit focus on understanding power relations within inclusive inter-disciplinary teams in care integration will contribute to our understanding of the gap between theory and implementation of care integration by focusing on the 'work' that teams do to create new knowledge.

Exploring the experiences of the team members in the interprofessional socialization process for becoming a interprofessional Collaborator

BACKGROUND

The current study aimed to explore the team members' experiences in the socialization process for becoming a collaborator in an interprofessional team.

METHOD

This qualitative study is conducted using an inductive qualitative content analysis approach. Participants consisted of 32 physicians (n = 16) and nurses (n = 16) who participated by purposeful sampling. Data were collected through in-depth semi-structured interviews and analyzed by Graneheim and Lundman approach.

RESULTS

In the study, "the perceived confrontation between interprofessional professionalism and uni-professionalism in the interprofessional socialization process" is explored as the theme, including two categories: "interprofessional professionalism commitment" as a facilitator and "uni-professional centrism" as a barrier.

CONCLUSION

A reciprocal dimension in interprofessional socialization was explored. Interprofessional professionalism adherence and team-centered accountability among team members were explored as a facilitator. The uni-professional culture and immature interprofessional collaboration competencies of team members disrupted the interprofessional socialization process.

Interprofessional Identity in Health and Social Care: Analysis and Synthesis of the Assumptions and Conceptions in the Literature

Interprofessional identity (IPI) development is considered essential in reducing incongruency and improving interprofessional collaboration. However, noticeable differences in conceptualizations are being put forward in the literature, hindering interpretation of research findings and translation into practice. Therefore, a Concept Analysis and Critical Interpretative Synthesis of empirical research articles were conducted to explore the assumptions and conceptions of IPI. Independent literature screening by two researchers led to the inclusion and extraction of 39 out of 1334 articles. Through critical analysis, higher order themes were constructed and translated to a synthesizing argument and a conceptual framework depicting what constitutes IPI (attributes), the boundary conditions (antecedents) and the outcomes (consequences) of its development. The attributes refer to both IPI's structural properties and the core beliefs indicative of an interprofessional orientation. The antecedents inform us on the importance of IPI-fitting constructivist learning environments and intergroup leadership in enabling its development. This development may lead to several consequences with regard to professional wellbeing, team effectiveness and the quintuple aim. Given the educational orientation of this study, ways for facilitating and assessing the development of IPI among learners across the professional continuum have been proposed, although empirical research is needed to further validate links and mediating and moderating variables.

Interprofessional identity in clinicians: A scoping review

Interprofessional collaborative practice (IPCP) has been recognized as invaluable in delivering safe, high-quality patient care with finite resources. However, despite a decade of advances in interprofessional (IP) research, policy, and competency frameworks, IPCP does not always occur in practice. One reason may be the influence of a clinician's identity in an IP context. The purpose of this scoping review was to understand the nature of IP identity in healthcare clinicians. The PRISMA framework was used to support a comprehensive search strategy and screening of 1746 articles. Inclusion criteria included original research, theses, and reviews, a primary focus on IP identity or professional identity (PI) in an IP team, and a focus on health professionals, including students transitioning to practice. Ninety-five papers met the eligibility criteria, though once charted, just four of the 95 papers focused on IP identity in clinicians. Three further papers examined shared team identity, 25 papers referred to, but did not focus on IP identity, and the remaining 63 papers explored PI in an IP team. While limited studies on clinician IP identity restrict conclusive findings, patterns were identified to direct further research on the nature of IP identity in clinicians. These include values and beliefs, individual and personal factors, profession and professional experience, education, socialization, context, leadership, and the process of IP identity development. While identity is undeniably central to being a clinician, the values, beliefs, attributes, and experiences that contribute to clinician IP identity, how clinician IP identity develops, and factors that influence IP identity remain unclear. The results of this review highlight the value of further investigation of the nature of IP identity, the interplay between PI and IP identity, and identity in an IP context.

Adaptation and validation of the Interprofessional Socialization and Valuing Scale (ISVS) in Spanish university health sciences students

Many interprofessional education programs are being designed to help students improve their collaborative practice. Traditionally, the evaluation of these programs is focused on attitudes, knowledge and skills, but according to some authors, the evaluation of these activities should be expanded to include the evaluation of the development of an interprofessional identity. The Interprofessional Socialization and Valuing Scale (ISVS) is a self-report tool used to measure interprofessional socialization, but it has not been validated with Spanish students. In this study, the tool was translated into Spanish and administered to a sample of 645 undergraduate students. The data were analyzed to estimate structural validity, internal consistency and convergent validity. Regarding the structural validity, our data supported the unidimensional model found in the English version of the ISVS-21 (normed chi-square = 2.3, RMSEA = 0.045, SRMR = 0.087, CFI = 0.963 and TLI = 0.969). The internal consistency reliability of the scale was adequate, Cronbach α = 0.913 [95% CI 0.903, 0.923]. The Spanish version of the ISVS-21 shows adequate psychometric properties in terms of the construct validity (structural validity and convergent validity) and internal consistency of its scores. This study provides the Spanish-speaking population with an adaptation of the only instrument that has been specifically developed to assess interprofessional socialization.

Undergraduate-level teaching and learning approaches for interprofessional education in the health professions: a systematic review

BACKGROUND

Although most systematic reviews of interprofessional education (IPE) evaluated the impact of IPE on the students' acquisition of knowledge in relation to other professions, the development of teamwork skills, and the changes in collaborative behaviour, the processes involved in IPE (i.e., approaches to teaching and learning) are under-researched. The purpose of the study was to conduct a systematic review to establish how IPE has been implemented in university-based undergraduate curricula, focusing on the teaching and learning approaches.

METHODS

The systematic review was performed in 2020 with three databases: PubMed, Science Direct, and the Cochrane Library. Titles and abstracts were included based on pre-identified eligibility criteria. We used the article entitled 'Systematic reviews in medical education: a practical approach: AMEE guide 94' as the basis to establish the aim and methods of the current systematic review from 2010 to 2019.

RESULTS

We found 16 articles that met the inclusion criteria and reported the implementation process of IPE in universities from Western, Asian, and African countries. A combination of at least two teaching and learning approaches was used to deliver IPE. The findings indicated that of all the teaching and learning approaches, simulation-based education, e-learning, and problem-based learning were the most prevalent approaches used to deliver IPE. This systematic review also revealed a lack of IPE programmes in the Middle East region.

CONCLUSIONS

The evidence synthesised in the current systematic review could support IPE curriculum planners and educators when planning an IPE programme. More global IPE initiatives are required to meet the global health workforce needs. Further studies are required to identify the effectiveness of the different teaching and learning approaches in the development of IPE competencies.

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.

Towards equitable learning environments for medical education: Bias and the intersection of social identities

CONTEXT

Medical educators are increasingly paying attention to how bias creates inequities that affect learners across the medical education continuum. Such bias arises from learners' social identities. However, studies examining bias and social identities in medical education tend to focus on one identity at a time, even though multiple identities often interact to shape individuals' experiences.

METHODS

This article examines prior studies on bias and social identity in medical education, focusing on three social identities that commonly elicit bias: race, gender and profession. By applying the lens of intersectionality, we aimed to generate new insights into intergroup relations and identify strategies that may be employed to mitigate bias and inequities across all social identities.

RESULTS

Although different social identities can be more or less salient at different stages of medical training, they intersect and impact learners' experiences. Bias towards racial and gender identities affect learners' ability to reach different stages of medical education and influence the specialties they train in. Bias also makes it difficult for learners to develop their professional identities as they are not perceived as legitimate members of their professional groups, which influences interprofessional relations. To mitigate bias across all identities, three main sets of strategies can be adopted. These strategies include equipping individuals with skills to reflect upon their own and others' social identities; fostering in-group cohesion in ways that recognise intersecting social identities and challenges stereotypes through mentorship; and addressing intergroup boundaries through promotion of allyship, team reflexivity and conflict management.

CONCLUSIONS

Examining how different social identities intersect and lead to bias and inequities in medical education provides insights into ways to address these problems. This article proposes a vision for how existing strategies to mitigate bias towards different social identities may be combined to embrace intersectionality and develop equitable learning environments for all.

Early-learners' expectations of and experience with IPE: A multi-institutional qualitative study

BACKGROUND

Multi-institutional qualitative studies are scarce within the interprofessional education (IPE) literature; such a report would provide comprehensive evidence for the application of interprofessional instruction among earlier learners.

OBJECTIVE

This investigation explored students' expectations of and barriers to introductory IPE across four institutions.

DESIGN

Qualitative inductive content analysis was utilized to interpret students' narrative responses to assigned pre- and post-survey questions.

SETTING

Health science schools of four U.S. institutions at Institution A, Institution B, Institution C, and Institution D.

PARTICIPANTS

Twenty-two percent (n = 385) of eligible participants completed both pre- and post-surveys. Nursing student participation was greatest (n = 113, 33%), followed by occupational therapy (n = 44, 13%), and physical therapy (n = 36, 10%). All other program participation was <10%. In total, students' narrative comments from 19 degree programs were a part of the data set.

METHODS

Responses from one pre-survey question on expectations of introductory IPE and two post-survey questions on IPE benefits and barriers were studied using qualitative inductive thematic analysis.

RESULTS

Four themes emerged as IPE learning expectations and benefits: my own professional role, professional role of others, teamwork, and communication. The theme of interacting with peers surfaced as an additional IPE benefit. There were four themes noted as IPE barriers: course logistics, lack of context, course content, and social dynamics.

CONCLUSION

This multi-institutional qualitative study adds to the literature by providing empirical evidence regarding early learner perceptions of IPE experiences. Student expectations and benefits of their introductory IPE course/curriculum aligned. Perceived barriers are useful in informing future IPE implementation and research.

From uniprofessionality to interprofessionality: dual vs dueling identities in healthcare

Healthcare systems are at times still viewed as siloed performances of single professions, wherein some groups hold hierarchical positions based on their expertise and prestige, rather than a collective functioning of interprofessional teams. Current policies, procedures, and regulations in healthcare education and practice seem to contribute to this context in which the various health and social care professions are set in opposition to one another. The historical, and still prominent, uniprofessional education and socialization practices position health and social care professions to view each as rivals and threats toward achieving their profession/al advancement and growth. The transformation from uniprofessionality to interprofessionality in healthcare requires the application of interprofessional socialization not just at the individual level, but also at the professional and system levels. In this process of interprofessional socialization, we need to embrace the uniqueness of each profession while cultivating an interprofessional collaboration culture in the system (dual identity). In so doing, we can facilitate a shifting mind-set, culture, operations, and policies in healthcare to recognize and foster the contribution and accountability of each profession toward achieving the quadruple aim of better care, better health, better value, and better work experience.

The short version of students' perceptions of interprofessional clinical education-revised (SPICE-R3): a confirmatory factor analysis

The Students' Perceptions of Physician-Pharmacist Interprofessional Clinical Education and its revision (SPICE, SPICE-R) were designed to understand medicine and pharmacy students' perceptions of interprofessional education and collaborative practice in managing complex health problems. The SPICE-R authors, however, suggested for additional items for subscales "roles and responsibilities for collaborative care" and "patient outcomes from collaborative practice". We added two items and introduced SPICE-R3 to differentiate it from the 10-item SPICE-R2 and to adapt the scale to a wider range of healthcare members. We administered the SPICE-R3 to healthcare students at the height of the COVID-19 outbreak in Hong Kong in February 2020. Using data from 225 students from Chinese medicine, medicine, nursing, and pharmacy, confirmatory factor analysis indicated nine items having acceptable item coefficients. Our data obtained a good fit to the three-factor, nine-item model suggesting construct validity. Results of the between-network analysis suggest that the three subscales of SPICE-R3 correlated systematically with other theoretically relevant variables in the nomological network suggesting convergent validity. The SPICE-R3 is a valid measure to examine Hong Kong healthcare students' interprofessional attitudes in online interprofessional education even during the pandemic. Implications and directions for future research are provided.

A longitudinal, narrative study of professional socialisation among health students

PURPOSE

Interprofessional collaboration (IPC) among health professionals is well-recognised to enhance care delivery and patient outcomes. Emerging evidence suggests that the early socialisation of students in health professional programmes to teamwork may have a positive impact on their future as collaborative practitioners. With a purpose of contributing to growing evidence on the processes of professional identity construction, and to explore how early expectations and perceptions of IPC develop during professional socialisation and pre-licensure education, our study examined the early professional socialisation experiences among five groups of health professional students.

METHOD

A qualitative, narrative approach was used to examine early professional socialisation among five programmes of health professional students (dentistry, medicine, nursing, pharmacy, physiotherapy) at an Atlantic Canadian University. In March and October 2016, students participated in interviews after first term (n = 44) and first year of study (n = 39). Interviews focused on participants' professional identify formation, as well as their perceptions and experiences of IPC. The authors analysed interview transcripts using narrative analysis.

RESULTS

Findings identify that despite the espoused importance of IPC within health professional training, students have a limited understanding of their professional roles and are largely focused on developing a uniprofessional, vs. interprofessional identity. Clinical experiences, role models and exposure to teamwork are critical to contextualise collaborative practice and enhance the development of an interprofessional identity.

CONCLUSIONS

Findings can be used to guide the development of curricula that promote interprofessional identity development and IPC during early professional socialisation.

The COVID-19 crisis silver lining: interprofessional education to guide future innovation

Globally, the advent and rapid spread of the COVID-19 virus has created significant disruption to health professions education and practice, and consequently interprofessional education, leading to a model of learning and practicing where much is unknown. Key questions for this ongoing evolution emerge for the global context leading to reflections on future directions for the interprofessional education field and its role in shaping future practice models. Health professions programs around the world have made a dramatic shift to virtual learning platforms in response to closures of academic institutions and restrictions imposed on learners accessing practice settings. Telemedicine, slow to become established in many countries to date, has also revolutionized practice in the current environment. Within the state of disruption and rapid change is the awareness of a silver lining that provides an opportunity for future growth. Key topics explored in this commentary include reflection on the application of existing competency frameworks, consideration of typology of team structures, reconsideration of theoretical underpinnings, revisiting of core dimensions of education, adaptation of interprofessional education activities, and the role in the future pandemic planning. As an international community of educators and researchers, the authors consider current observations relevant to interprofessional education and practice contexts and suggest a response from scholarship voices across the globe. The current pandemic offers a unique opportunity for educators, practitioners, and researchers to retain what has served interprofessional education and practice well in the past, break from what has not worked as well, and begin to imagine the new.