Models of interprofessional education for healthcare students: a scoping review

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.

Active methodologies in teaching the nursing process: Scoping review

AIM

To map the use of active methodologies in nursing education for teaching the nursing process.

BACKGROUND

The nursing process is a systematic approach essential for clinical reasoning, guiding nursing diagnoses and care planning, execution and evaluation. Its teaching requires strategies that engage students in active learning to foster evidence-based practice.

DESIGN

Scoping review performed according to the Joanna Briggs Institute Manual for Evidence Synthesis.

METHODS

The review involved seven steps: defining review questions, establishing eligibility criteria, designing search strategies, screening and selecting evidence, extracting data, analyzing results and presenting findings. Searches were conducted in July 2023 and updated in February 2024 on the databases Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Literature on Health Sciences, Excerpta Medica dataBASE, Medical Literature Analysis and Retrieval System Online, Scopus, Web of Science and Google Scholar. The review targeted graduate and undergraduate nursing students (Population), the nursing process (Concept) and active teaching methodologies (Context), guided by the PCC framework.

RESULTS

The 101 included studies present key active strategies such as clinical simulation, case-based learning, web-based learning, problem-based learning, concept mapping, virtual simulation, electronic record systems, clinical practice and laboratory activities. Nursing assessment was the most frequently taught step, followed by diagnosis, interventions, evaluation and outcomes.

CONCLUSION

Active methodologies consistently demonstrated positive impacts on critical competencies, fostering critical thinking, clinical reasoning and judgment. Integrating these strategies with traditional approaches in undergraduate nursing curricula enhances the application of theoretical knowledge in clinical practice.

Enhancing the understanding of safety and the quality of patient care among medical and health sciences students in interprofessional climate: an interventional study

BACKGROUND

Interprofessional education (IPE) plays an essential role in improving healthcare outcomes through achieving shared understanding. Unfortunately, most healthcare professionals have not received training for patient safety (PS) in an interprofessional setting, which can meet the societal medical needs. This study aimed to foster the understanding of senior medical, dental, pharmacy and health sciences students about PS and quality of care at the University of Sharjah (UoS) in UAE.

METHODS

Using a convenience sampling technique, we recruited students from the College of Medicine (CoM), College of Pharmacy (CoP), College of Dental Medicine (CDM), and College of Health Sciences (CHS) of UoS. The study was conducted in spring 2023, and an ethical approval was obtained from the UoS Research Ethics Committee (REC-21-12-12). After a thorough literature search, a bespoke English language questionnaire was developed covering three domains-medical professionalism, leadership in healthcare, and precision medicine. To ensure its validity across different settings, cultural adaptation was ensured with reiterative revision among the panel of experts. The online synchronous real-time workshop included interactive resource sessions, breakout room discussions using real clinical cases, and pre-post surveys using the questionnaire.

RESULTS

A total of 248 students and 20 facilitators participated in the workshop. CoM had the highest representation (47.5%), followed by CoP (36.5%), CHS (13.3%), and CDM (2.7%). There was a statistically improved understanding of the participants, as reflected by significantly high scores of post-test survey in all domains of PS across all colleges (p < 0.001). Notably, students in years four and five from CoM and CoP showed significant improvement in their perceptions than other colleges (p < 0.001). The participants encountered challenges of weak internet connections, software issues, technical failures, and power outages during the workshop.

CONCLUSION

This study highlights the positive impact of an IPE-based interventional workshop on students' attitudes, perceptions, and insights about PS and quality of care. Students' understanding and insights of PS and quality of care underscore the paramount role of IPE in improving perceptions and approaches towards PS in the context of healthcare education.

Background and Foreground: Connections and Distinctions When Health Professions Faculty Teach Both Interprofessional Collaborative Practice and Quality Improvement-A Case Study

OBJECTIVES

Despite decades of effort, programs continue to struggle to integrate competencies related quality improvement (QI) and interprofessional collaborative practice (ICP) into health professions education. Additionally, while QI and ICP may seem intuitively linked and there exists some examples of a coordinated approach, the literature regarding competencies, including knowledge, skills, and attitudes (KSAs), is still largely focused on QI and ICP as separate fields of knowledge and practice. This study explored distinctions and connections between quality improvement (QI) and interprofessional collaborative practice (ICP) competency domains in health professions education.

METHODS

The authors used a qualitative case study approach with an instrumental case, that is, the University of Missouri-Columbia (MU), where QI and ICP were intentionally integrated as part of core curricula in health professional schools and programs. Eleven faculty members from medicine, nursing, pharmacy, and health care administration participated in interviews exploring their teaching choices in either classroom or clinical settings.

RESULTS

Study participants defined the goal of teaching QI and ICP as enabling learners to deliver safe and patient-centered care and described the knowledge and skills required for QI and the attitudes and skills required for ICP. Furthermore, they described the relationship between QI and ICP as one mediated by systems thinking, where ICP is backgrounded as a critical pre-requisite and QI is foregrounded as a vector for developing interprofessional competencies.

CONCLUSIONS

The MU case elucidates the potential synergies that occur when faculty address quality improvement and interprofessional collaborative practice competencies with an integrated approach that leverages connections, while also respecting distinctions. For health professions education programs looking to improve the effectiveness and efficiency of their curricular approach to these fields, it may be fruitful to consider ICP as background and QI as foreground, remembering that without each other, ICP risks losing meaning and QI risks losing impact.

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.

Comparing paper-based and mobile application for rank-based peer assessment in interprofessional education: before, during, and after the COVID-19 pandemic

BACKGROUND

Education was affected during the COVID-19 pandemic, and there was a need to adapt the learning approaches to the situation. At the University of Gadjah Mada, many essential soft skills of healthcare professionals are taught using the interprofessional education (IPE) approach on-site. Our university responded to this crisis by offering online classes and similar types of training. Post-administration of the course, a peer-assessment was conducted, and it was used to provide feedback on the work or performance of peers among students. Peer assessment was done using paper-based and a mobile application during COVID-19. This study aimed to share a best practice for the implementation of a rank-based peer-assessment application for longitudinal interprofessional education in the community setting and to compare the score distribution of a rank-based peer-assessment before and after using mobile application.

METHODS

Quantitative research design was used by processing secondary data on student peer assessment scores from 3 bachelor programs (medicine, nursing, nutritionist) Community and Family Health Care with Interprofessional Education (CFHC-IPE) in Faculty of Medicine, Nursing, and Public Health, Universitas Gadjah Mada. 4,790 students from 2018 to 2022 (5 years) were tracked before, during, and after the COVID-19 pandemic. The assessments carried out were offline, online, and blended learning, respectively. The assessment was carried out using a paper-based method before and during the pandemic, online-based with a mobile application was used. Thus, the peer-assessment was conducted manually or using paper-based method using a 5-rank scoring system. In 2019, the peer assessment was carried out using a mobile application and applied a 10-rank scoring system.

RESULTS

The rank-based peer assessment can be well implemented to make students assess their friends more objectively, with an average score 82.02 ± 8.68. The rightward shift in the distribution of scores indicates that the average score has improved after using the mobile application compared to before its use. (82.02 ± 8.68 vs. 62.39 ± 11.13, p < 0.05).

CONCLUSION

The implementation of rank-based peer-assessment using a mobile application was well received during and after the pandemic by interprofessional undergraduate students. The online system made the assessment more objective and the average grades were seen to be better.

Perceptions and influencing factors of interprofessional collaboration in final-year health science students

Interprofessional education (IPE) is vital for preparing a competent health workforce. Despite the proven benefits of interprofessional collaborative practice (IPCP), barriers to its implementation persist. Given the importance of health professionals' perspectives for IPCP success, we investigated the perceptions of IPCP among final-year health science students at Khon Kaen University, Thailand, while they transition into practice. A cross-sectional online survey conducted from February to April 2023 included 989 students across six health science disciplines, with a response rate of 57.8%. Using the SPICE-R2 questionnaire on a five-point Likert-type scale, we assessed perceptions related to interprofessional teamwork, roles and responsibilities, and patient outcomes. Results showed significant diversity in IPCP perceptions and experiences with IPE. Nursing students consistently demonstrated the highest IPCP perceptions, while medical and public health students scored the lowest. Positive perceptions about IPCP were notably associated with nursing students and those satisfied with the learning process. Dentistry students and those with IPE experience also exhibited more favorable views on teamwork. This study suggests the need to address disparities in IPCP perceptions among student groups, which is essential for enhancing interprofessional collaboration in future health professionals.

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.

The next frontier: utilizing eLearning as an innovative approach to advance and sustain interprofessionalism

The challenges to sustaining interprofessional education (IPE) are numerous and well-documented. These challenges include crowded curricula, scheduling conflicts, lack of physical space, faculty availability, and financial considerations. In turn, IPE is often viewed and treated as an add-on rather than an integral part of healthcare education, leading to sporadic implementation and vulnerability to institutional changes. The concept of eLearning, utilizing electronic technologies for education, emerges as a potential solution to these challenges and could serve as the "next frontier" for IPE. eLearning offers a flexible and scalable platform to deliver IPE, transcending geographical and time constraints. Recent research highlights the benefits of eLearning-based IPE, including enhanced collaboration, learner satisfaction, and clinical application. eLearning allows learners to engage in virtual simulations, reflexive exercises, and collaborative problem-solving, fostering essential skills for future healthcare teams. Interprofessional eLearning courses can seamlessly integrate into existing health professions curricula, catering to busy professionals and students. Most importantly, eLearning promotes consistent and purposeful embedding of interprofessional values and competencies throughout education, training, and professional development. In this Short Report, we utilize the Center for Advancing Interprofessional Practice, Education, and Research (CAIPER) at Arizona State University as a rudimentary "critical instance" case study for advancing and sustaining IPE through eLearning program development. CAIPER exemplifies this approach by constructing engaging evidence-based eLearning IPE courses ranging from examining and applying interprofessionalism in primary care to empathy and humility team-based training. CAIPER's eLearning courses have reached a global audience of over 65,000 learners highlighting the reach, impact, and viability of eLearning for sustainable IPE. Although further research is needed, eLearning presents a promising solution to the systemic challenges of IPE, and by embracing eLearning and embedding interprofessional eLearning courses in existing curricula, institutions can ensure the consistent, accessible, and sustainable delivery of high-quality IPE experiences.

Evaluation of a virtual interprofessional oral-systemic health simulation experience in nursing, dentistry, medicine, and pharmacy education

PURPOSE

The annual teaching oral-systemic health (TOSH) virtual clinical simulation and case study activity exposes interprofessional teams of nurse practitioner, nurse midwifery, dental, medical, and pharmacy students to a virtual clinical simulation experience that uses oral-systemic health as a clinical exemplar for promoting interprofessional core competencies. The present study examines changes in participating students' self-reported interprofessional competencies following participation in virtual TOSH from 2020 to 2022. These findings are also compared to those from in-person TOSH (2019) to examine the equivalence of student outcomes of both the in-person and virtual programs.

METHODS

A pre- and post-test evaluation design was used to examine the effectiveness of exposure to the TOSH program on self-reported attainment of interprofessional competencies for participating students using the interprofessional collaborative competency attainment scale.

RESULTS

Analysis of pre- and post-surveys demonstrated statistically significant improvement in students' self-rated interprofessional experience competencies following the virtual TOSH program, which aligns with results from the in-person cohorts. Similar findings between the in-person and virtual cohorts indicated no statistically significant difference between the two formats.

CONCLUSION

These findings demonstrate the success of TOSH in promoting attainment of interprofessional competencies among future health professionals. We encourage administrators and faculty who lead health professional programs to take advantage of using virtual simulations as an integral component of interprofessional oral health clinical experiences where students from different health professions learn from and about each other in assessing and treating patients across the lifespan.

Exploring a revised interprofessional learning curriculum in undergraduate health education programs at Linköping University

BACKGROUND

Interprofessional education aiming at providing competencies require evaluation in order to ensure that outcomes match the needs and ambitions. Health professionals today need a broad range of skills and competencies in order to provide high quality care, including interprofessional competence. Linköping University has been a pioneer in interprofessional learning for decades and this study provides one example of how a curriculum revision can be carried out. The aim of this study was to study the intentions and outcomes of a revised interprofessional learning curriculum in health professions education programs.

METHODS

This was a qualitative study, including documents (n = 143) and complementary interviews with key individuals (n = 4). Data included syllabuses, study guides, educational program plans, supervisor guides, and interview transcripts. A qualitative document analysis and a content analysis with a directed approach was used, applying a theoretical framework for curriculum development that guided the analysis.

RESULTS

The analysis resulted in one overarching theme named "A planned, lived, and attended curriculum" including four main categories inspired by a theoretical framework. The findings demonstrate a variety of aspects relating to the why and how of curriculum revision. The introduction of a programme director in interprofessional learning, with a mandate equal to respective program directors, seemed to contribute to legitimacy. Further, the partnership between the university and the healthcare sector had an impact on the curriculum revision, in that healthcare had a say in the revision regarding what suggestions to implement or not. The expectations of the teachers involved were high, although clear support structures seemed to be lacking.

CONCLUSIONS

This study has identified some of the important links between teachers, organizational prerequisites, and healthcare when revising an existing fully integrated curriculum in interprofessional learning for health professions education programs. The aim of this curriculum revision was to legitimize and provide education that is up to date with current healthcare needs and to provide students with competencies to collaborate in teams to ensure patient safety. When redesigning a curriculum there seems to be a fine balance between pedagogical innovation and pragmatism. This study identified that the links provided between organizational support structures and the expectations on teachers were not aligned.

Social Network Analysis in Undergraduate and Postgraduate Medical Education: A Scoping Review

PURPOSE

Social network analysis (SNA) is a theoretical framework and analytical approach used to study relationships among individuals and groups. While SNA has been employed by many disciplines to understand social structures and dynamics of interpersonal relationships, little is known about its use in medical education. Mapping and synthesizing the scope of SNA in undergraduate and postgraduate medical education can inform educational practice and research.

METHOD

This scoping review was based on searches conducted in Medline, Embase, Scopus, and ERIC in December 2020 and updated in March 2022. After removal of duplicates, the search strategy yielded 5,284 records, of which 153 met initial inclusion criteria. Team members conducted full-text reviews, extracted relevant data, and conducted descriptive and thematic analyses to determine how SNA has been used as a theoretical and analytical approach in undergraduate and postgraduate medical education.

RESULTS

Thirty studies, from 11 countries, were retained. Most studies focused on undergraduate medical students, primarily in online environments, and explored students' friendships, information sharing, and advice seeking through SNA. Few studies included residents and attending staff. Findings suggested that SNA can be a helpful tool for monitoring students' interactions in online courses and clinical clerkships. SNA can also be used to examine the impact of social networks on achievement, the influence of social support and informal learning outside the classroom, and the role of homophily in learning. In clinical settings, SNA can help explore team dynamics and knowledge exchange among medical trainees.

CONCLUSIONS

While SNA has been underutilized in undergraduate and postgraduate medical education, findings indicate that SNA can help uncover the structure and impact of social networks in the classroom and the clinical setting. SNA can also be used to help design educational experiences, monitor learning, and evaluate pedagogical interventions. Future directions for SNA research in medical education are described.

Shared understanding and task-interdependence in nursing interns' collaborative relations: A social network study of vocational health care internships in the Netherlands

Shared understanding among collaborators is a key element of delivering successful interprofessional care and a main challenge for professional education concerns nurturing such understanding among students. We assessed how nursing students perceived different levels of shared understanding in their collaborations with others in clinical internships. We analyse the collaborative networks of interns to examine whether individual factors (attitudes, perceptions of collaborative cultures, and motivation) or relational factors among collaborators (task-interdependence, cooperation frequency, and interprofessional and hierarchical roles) affect shared understanding among 150 Dutch nursing interns and their collaborators (n = 865). Theoretically, we stress the importance of focusing on collaborative relations in interprofessional care settings. Multilevel models distinguish two levels in explaining the variation in shared understanding, nesting collaborative relationships within individuals. Results indicate merely 37.4% of found variation of shared understanding could be attributed to individual-level factors (variation between interns), while 62.6% of variation is found within interns, showing that shared understanding differs substantially between the collaborations one intern engages in. Multilevel models reveal that task-interdependence strongly predicts shared understanding in inter- and intraprofessional collaborations. We conclude that focusing on collaborative relations is essential to foster shared understanding in vocational internship programmes, and that health care organisations should pay explicit attention to task-interdependence in interns' collaborations.

FINCA - a conceptual framework to improve interprofessional collaboration in health education and care

The health care system in Germany and in many other countries is facing fundamental challenges due to demographic change, which require new integrated care concepts and a revision of the collaboration between health care professions in everyday clinical practice. Internationally, several competency framework models have been proposed, but a framework that explicitly conceptualizes collaborative activities to improve interprofessional problem-solving competency in health care is still missing. Such a framework should define contextual, person-related, process-related, and outcome-related variables relevant to interprofessional problem solving in health care. Against this background, we present a conceptual framework to improve interprofessional collaboration in health education and care (FINCA) developed with scientific consideration of empirical data and various theoretical references. FINCA reflects an interprofessional learning and interaction process involving two persons from different health care professions and with different individual learning prerequisites. These two initially identify a problem that is likely to require interprofessional collaboration at some point. FINCA acknowledges the context of interprofessional learning, teaching, and working as well as its action-modifying context factors. We follow the reasoning that individual learning prerequisites interact with the teaching context during learning activities. At the heart of FINCA are observable collaborative activities (information sharing and grounding; negotiating; regulating; executing interprofessional activities; maintaining communication) that can be used to assess individuals' cognitive and social skills. Eventually, the framework envisages an assessment of the outcomes of interprofessional education and collaboration. The proposed conceptual framework provides the basis for analysis and empirical testing of the components and variables it describes and their interactions across studies, educational interventions, and action-modifying contexts. FINCA further provides the basis for fostering the teaching and learning of interprofessional problem-solving skills in various health care settings. It can support faculty and curriculum developers to systematize the implementation and improvement of interprofessional teaching and learning opportunities. From a practical perspective, FINCA can help to better align curricula for different health professions in the future. In principle, we also see potential for transferability of the framework to other areas where different professions collaborate.

Exploring the awareness, attitude, and inclination of healthcare students towards interprofessional education: A cross-sectional study in Saudi Arabia

Background

Interprofessional education (IPE) is acknowledged to enhance understanding between professionals and to facilitate learning. Healthcare professionals may be better equipped to accept and esteem other healthcare professionals, if interprofessional education is incorporated into undergraduate curricula. The management of challenging patient issues may also significantly benefit from this. As a result, the current study examined interprofessional education in their institutions and students' knowledge of and attitudes toward it.

Methodology

We conducted a cross-sectional questionnaire-based study among students from a university in the southwest of Saudi Arabia, who were enrolled in courses in medical, pharmacy, nursing, dentistry, allied health, and public health. Following validation, the questionnaire included six questions to probe their knowledge, ten questions to gauge their attitude, and eleven questions to inquire about the growth and use of IPE in their institutions. Multiple regression and the Kruskal-Wallis test were used to examine the data.

Results

The survey involved 600 students, and 66.8% of the respondents were male. Less than one-third of students studying medicine replied to the survey, while students in the public health department had the lowest response rate. Compared to students in other programs, pharmacy students achieved a higher mean attitude score toward IPE (P < 0.001). Additionally, nursing and pharmacy students' mean IPE awareness scores were higher than those of medical students (P < 0.001). However, all program participants firmly agreed that integrating IPE into the curriculum was a good idea.

Conclusions

The study found that students of a few programs had awareness and a positive attitude toward interprofessional education. Nonetheless, all of them favored its inclusion in their curriculum. They also stressed the need to educate teaching faculty on interprofessional education, to develop skilled facilitators within their institutions.

Introspective Learning From Interprofessional Virtual Grand Rounds

BACKGROUND

Interprofessional collaboration in health care settings improves patient safety and outcomes, yet collaboration among health professionals requires specific competencies and skills. Providing nursing students with interprofessional learning experiences with multiple health professions is possible yet challenging.

PROBLEM

Opportunities for effective online interprofessional learning are lacking.

APPROACH

This article explores nursing students' reflections on how an interprofessional learning experience, Virtual Grand Rounds (VGRs), influenced their personal development and provided meaningful learning that they can use in their practices as professional nurses. Thematic analysis was done on the open-ended questions in students' final reflection assignment.

OUTCOMES

Analysis of student reflections identified 5 learning themes including the value of teamwork and collaboration, the importance of communication skills, professional identity, plans to engage diverse health professions, and the desire for future learning.

CONCLUSIONS

Student reflections indicate the VGR was an effective method for nursing students to experience collaboration with multiple health professions without disrupting curriculums.

Future physicians' behavioral intentions towards collaborative practice - a qualitative study on polish final-year medical students guided by the theory of planned behavior

BACKGROUND

Interprofessional collaboration constitutes a vital part of modern patient care, and many of its benefits for patients, medical staff, and the healthcare system have been described. However, little is known about factors influencing medical students' intentions to work in a collaborative practice after graduation. Therefore, with the theory of planned behavior by Ajzen as a framework, this study aimed to evaluate their intentions and identify factors that influence their attitudes, subjective norms, and perceived behavioral control.

METHODS

For this purpose, eighteen semi-structured interviews were conducted with medical students following a thematic guide developed according to the theory. They were thematically analyzed by two independent researchers.

RESULTS

The results showed that their attitudes contained positive (better patient care, comfort and safety of work, learning and development opportunities) and negative examples like the fear of conflicts, losing authority and mistreatment. Sources of social pressure regarding the behavior (subjective norms) involved their peers, other physicians, representatives of other medical professions, patients, and managing bodies. Finally, perceived behavioral control included limited occasions for contacts and interprofessional learning during the studies, existing stereotypes and prejudices, legal regulations and systemic solutions, organizational aspects, and existing relations at the ward.

CONCLUSIONS

Analysis showed that Polish medical students generally seem to hold positive views on interprofessional collaboration and feel positive social pressure to get involved in interprofessional teams. However, factors listed in perceived behavioral control may act as barriers in the process.

Connecting knowledge: First-year health care students' learning in early interprofessional tutorials

Collaboration across professional boundaries is an essential aspect of health care, and interprofessional education (IPE) is a common way to help increase students' collaborative abilities. Research on how and when IPE should be arranged in a curriculum remains, however, inconclusive. How students actually develop interprofessional competencies have been difficult to demonstrate and is still an under-researched area. Studying IPE in context is therefore important to understand its full complexity. This paper examines how students work with scenarios from professional health care contexts when learning together in interprofessional problem-based learning tutorials during the first year of undergraduate education. The data are video-recorded tutorials of students from medicine, nursing, occupational therapy, speech and language pathology, and physiotherapy programmes. The analysis focuses on students' discussing their readings of the literature. Drawing on "Communities of Practice," findings show that students discuss and connect professional knowledge, with "brokers" (the tutors) and "boundary objects" (scenarios) supporting the emergence of students' professional knowledge. The scenarios, as boundary objects, also enabled the students to turn into brokers themselves. The paper contributes to research on interprofessional learning and offers support for implementing IPE in the early stages of undergraduate education.

Can We Realize Our Collaborative Potential? A Critical Review of Faculty Roles and Experiences in Interprofessional Education

PURPOSE

Faculty within interprofessional education (IPE) are essential contributors to IPE implementation efforts. Although the majority of existing IPE literature consists of reports on IPE innovations, few insights are available into the experiences of the faculty members who deliver IPE. This critical narrative review was designed to synthesize the knowledge available about (1) roles assigned to IPE educators and (2) IPE faculty members' experiences of fulfilling these roles.

METHOD

Six databases for English-language studies published between 2000 and March 2021 were searched: PubMed, Embase, Web of Science, MEDLINE, CINAHL, PsycINFO, ERIC, and MedEdPortal. A total of 1,717 manuscripts were identified for possible inclusion. After applying inclusion/exclusion criteria, 214 articles constituted the final literature corpus. Harden and Crosby's original framework of 6 roles of medical educators augmented with the manager role introduced in Harden and Lilley's 2018 framework informed the analysis.

RESULTS

IPE faculty take on all 6 roles identified by Harden and Crosby: facilitator, planner, information provider, examiner, role model, and resource developer, as well as the manager role. Faculty were most commonly identified as facilitator and planner, and rarely as role models. The authors identified 3 main struggles experienced by IPE faculty: personal (e.g., confidence as a cross-professions educator), interpersonal (e.g., co-teaching IPE), and institutional (e.g., supporting IPE logistics).

CONCLUSIONS

This review highlights the complexity of the roles taken on by IPE faculty and the struggles they experience in the process. The results suggest that attention to the different roles that IPE faculty play in educational interventions and to equipping faculty with the necessary competencies, tools, and support, is fundamental to the success of IPE. Future research should harness the explanatory power of theories to help explain dynamics at play between personal, interpersonal, and institutional barriers to identify interventions that can aid IPE faculty in delivering collaboration-ready professionals.

Perceptions and barriers of health-care professionals to develop and implement interprofessional education in UAE: A qualitative study

BACKGROUND

This study aimed to determine the perception, perspectives, and behaviors of health-care providers, as well as cues to action toward interprofessional education (IPE).

MATERIALS AND METHODS

The interview sessions were conducted from August 2020 to November 2020 at the College of Pharmacy, Gulf Medical University (GMU), Ajman. The invited participants belonged to all the colleges which are a part of GMU, providing academic and practice support to the university. All were residents of UAE, and both genders were considered for qualitative assessment. The sample size based on data saturation plus two as standard guidelines in qualitative res earch. All the interviews were audiotaped for verbatim transcriptions. All the recorded interviews were transcribed to avoid bias. The prepared transcripts were then verified for accuracy by the relevant participant and after approval, data were analyzed. In case of an emergent theme, all the investigators were focused on refining the analysis.

RESULTS

A total of 17 health-care professionals (HCPs) were interviewed. The participants were chosen from five different colleges at GMU. All the participants had similar perceptions about IPE, as it is a collaboration between different HCPs to achieve better patient outcomes. A diversity in perspectives toward IPE was found among the participants. Several barriers were identified during the interview session and also highlighted the importance of choosing the right topic for IPE, as it affects planning of the activities greatly. The participants also stressed that the lack of communication also contributes to decreased involvement of HCPs.

CONCLUSION

This study identified inefficient implementation of IPE. The barriers were lack of team effort, lack of communication within the institute, and administrative support, despite the availability of resources and infrastructure in the university.

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.

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.

Attitudes of nurses and physicians toward nurse-physician interprofessional collaboration in different hospitals of Islamabad-Rawalpindi Region of Pakistan

Interprofessional collaboration (IPC) is crucial to efficient patient management in the modern healthcare setting. We sought to determine the attitudes of physicians and nurses working in different hospitals in the Islamabad-Rawalpindi region of Pakistan. We employed the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration (JSAPNC), a 15-item questionnaire that quantifies these attitudes in a meaningful way. Higher scores indicate a more positive attitude toward IPC. Four domains (shared education and teamwork, caring vs. curing, nurses' autonomy, and physicians' dominance) represent the intricate factors that influence IPC in a hospital setting. A total of 374 healthcare professionals responded. Nurses had significantly better opinions about IPC compared to physicians (mean: 50.81 vs. 47.48, p<.01). Nurses also outscored physicians in all four domains of the JSAPNC (education and collaboration 24.87 vs. 23.72 p<.001, caring vs. curing 10.88 vs. 9.42 p<.001, nurse's autonomy 10.89 vs. 10.51 p=.004, and physician's authority 4.17 vs. 3.82 p=.044). The results show that nurses in Pakistan value IPC more than their physician colleagues. Inculcating the importance of IPC through educational methods might help improve these attitudes.

'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.