Interprofessional education: a unique approach to addressing the challenges of student assessment

Interprofessional supervision among allied health professionals: a systematic scoping review

Clinical supervision typically occurs between clinicians who are trained in the same discipline, and this assumption is present across much of the relevant literature. However, the use of interprofessional supervision (IPS), wherein clinicians do not share the same discipline, has increased in recent years. As IPS increases in usage, it is key that the implications of this approach are explored. In order to map the existing evidence, a scoping review was conducted to explore what is known about the use of IPS across five allied health professions (psychology, speech and language therapy, occupational therapy, physiotherapy and social work). A systematic literature search of four electronic databases was conducted, with 27 articles meeting the inclusion criteria. The data were analyzed using thematic synthesis. Six key themes were identified relating to factors impacting the appropriateness of IPS, necessary steps in the IPS process, and impacts of IPS for clinicians. Limited application of standardized tools and theoretical frameworks within the existing research was highlighted. The findings identified within this review present a broad overview of the existing research relating to IPS, which can be used to inform future research in this area.

The Balancing Act of Assessment Validity in Interprofessional Healthcare Education: A Qualitative Evaluation Study

CONSTRUCT & BACKGROUND

In order to determine students' level of interprofessional competencies, there is a need for well-considered and thoroughly designed interprofessional assessments. Current literature about interprofessional assessments focuses largely on the development and validation of assessment instruments such as self-assessments or questionnaires to assess students' knowledge or attitudes. Less is known about the design and validity of integral types of assessment in interprofessional education, such as case-based assessments, or performance assessments. The aim of this study is to evaluate the evidence for and threats to the validity of the decisions about students' interprofessional performances based on such integral assessment task. We investigated whether the assessment prototype is a precursor to practice (authenticity) and whether the assessment provides valid information to determine the level of interprofessional competence (scoring).

APPROACH

We used a design-based qualitative research design in which we conducted three group interviews with teachers, students, and interprofessional assessment experts. In semi-structured group interviews, participants evaluated the evidence for and threats to the validity of an interprofessional assessment task, which were analyzed using deductive and inductive content analysis.

FINDINGS

Although both evidence for and threats to validity were mentioned, the threats refuting the assessment's validity prevailed. Evidence for the authenticity aspect was that the assessment task, conducting a team meeting, is common in practice. However, its validity was questioned because the assessment task appeared more structured as compared to practice. The most frequently mentioned threat to the scoring aspect was that the process of interprofessional collaboration between the students could not be evaluated sufficiently by means of this assessment task.

CONCLUSIONS

This study showed that establishing interprofessional assessment validity requires three major balancing acts. The first is the balance between authenticity and complexity. As interprofessional practice and competencies are complex, interprofessional tasks require build-up or guidance toward this complexity and chaotic practice. The second is that between authenticity and scoring, in which optimal authenticity might lead to threats to scoring and vice versa. Simultaneous optimal authenticity and scoring seems impossible, requiring ongoing evaluation and monitoring of interprofessional assessment validity to ensure authentic yet fair assessments for all participating professions. The third balancing act is between team scoring and individual scoring. As interprofessional practice requires collaboration and synthesis of diverse professions, the team process is at the heart of solving interprofessional tasks. However, to stimulate individual accountability, the individual performance should not be neglected.

The VOTIS, part 1: development and pilot trial of a tool to assess students' interprofessional skill development using video-reflexive ethnography

This paper explores the development and evaluation of the video Observation Tool for Interprofessional Skills (VOTIS). We describe the development of an authentic interprofessional assessment tool that incorporates video reflection and allows formative and summative assessment of individual learners' interprofessional skills within an authentic interprofessional context. We then investigate its validity and reliability. The VOTIS was developed using a modified Delphi technique. The tool was piloted with 61 students and 11 clinical educators who completed the VOTIS following team meetings where students interacted about their interprofessional clinical work. The following were calculated: internal consistency; students' proficiency levels; inter-rater reliability between students and clinical educators; and inter-rater reliability between clinical educators and an independent rater. Results indicate that the VOTIS has acceptable internal consistency and moderate reliability and has value in evaluating students' interprofessional skills. Study outcomes highlight the need for more explicit wording of tool content and instructions and further clinical educator training to increase the utility and reliability of the VOTIS as a learning and assessment tool.

Design guidelines for assessing students' interprofessional competencies in healthcare education: a consensus study

INTRODUCTION

Healthcare systems require healthcare professionals and students educated in an interprofessional (IP) context. Well-designed assessments are needed to evaluate whether students have developed IP competencies, but we currently lack evidence-informed guidelines to create them. This study aims to provide guidelines for the assessment of IP competencies in healthcare education.

METHODS

A qualitative consensus study was conducted to establish guidelines for the design of IP assessments using the nominal group technique. First, five expert groups (IP experts, patients, educational scientists, teachers, and students) were asked to discuss design guidelines for IP assessment and reach intra-group consensus. Second, one heterogeneous inter-group meeting was organized to reach a consensus among the expert groups on IP assessment guidelines.

RESULTS

This study yielded a comprehensive set of 26 guidelines to help design performance assessments for IP education: ten guidelines for both the IP assessment tasks and the IP assessors and six guidelines for the IP assessment procedures.

DISCUSSION

The results showed that IP assessment is complex and, compared to mono-professional assessment, high-quality IP assessments require additional elements such as multiple IP products and processes to be assessed, an IP pool of assessors, and assessment procedures in which standards are included for the IP collaboration process as well as individual contributions. The guidelines are based on expert knowledge and experience, but an important next step is to test these design guidelines in educational practice.

Enablers and barriers of first-year common semesters and semester-long courses aimed at interprofessional collaborative practice capability development: A scoping review

Designing a first-year undergraduate common semester aimed at developing interprofessional collaborative practice (IPCP) capabilities is challenging. A scoping review was conducted to identify enablers and barriers for common semesters. Due to limited numbers of eligible studies, the review was expanded to include studies of semester-long first-year courses aimed at IPCP development. Key enablers of common semesters or courses in 35 included studies were: real-world, problem-solving, hands-on, interprofessional teamwork aligned with graduate practice capabilities relevant across disciplines; continuous feedback and critical evaluation; relationship building amongst students and staff; cohesive, well-trained interprofessional teams of staff and leaders; secure, supportive institutional policies and structures. Key barriers included: students' lack of preparation, perceptions of irrelevance, and misaligned expectations; variable student capability and response amongst professions; miscommunicated or misaligned course outcomes; course, faculty or institutional non-integration; and cost, logistic, and evaluation issues. Outcomes were mainly positive improvements in self-evaluated student IPCP skills and understanding, variability between professions, and persistent misconceptions. Scales measuring capabilities lacked uniformity, and few studies were comparative or observational. Overall, the review suggests noncompetitive undergraduate first-year common semesters or courses positively impact IPCP capability development when robustly assessed, clearly evaluated, and supported by an integrated IPE culture.

Inside-out: normalising practice-based IPE

Practice-based interprofessional education (IPE), a key feature in developing a collaboration-ready workforce, is poorly integrated in healthcare curriculums. This study aimed to synthesise educator perspectives on implementing practice-based IPE and develop recommendations to inform sustainable practice-based IPE. An ethnographic case study was carried out at a school of allied health. Data collection involved six observations, 11 interviews and a review of eight documents. Reflexive thematic analysis, informed by Normalisation Process Theory, established two key themes. First, we found that strategic planning is needed, with a coherent implementation agenda and planned reflection on activities. Second, building partnerships with placement partners was identified as essential. This can be achieved by supporting and championing practice-based IPE activities developed by placement sites and establishing how university and clinical educators can work collaboratively to deliver sustainable practice-based IPE. These conditions create a favourable environment for normalising practice-based IPE in healthcare curriculums, benefitting students, patients, and the overall healthcare service.