Impact of an interprofessional training ward on interprofessional competencies – a quantitative longitudinal study

A scoping review of interprofessional education in healthcare: evaluating competency development, educational outcomes and challenges

BACKGROUND

Interprofessional education (IPE) is essential in healthcare to enhance collaboration, communication and teamwork among health professions education students. This review aimed to map out the core competencies health professions education students develop during IPE and identify the positive and negative educational outcomes.

METHODS

A comprehensive search strategy was developed and reported in accordance with the PRISMA ScR guidelines. The search was conducted across five electronic databases (Medline, Scopus, Web of Science, PsycINFO and EBSCO) for peer-reviewed articles published in English within the last 20 years. Data was extracted and core competencies were categorised into four defined areas-roles and responsibilities; interprofessional communication; values for interprofessional practice; teams and teamwork. The frequency of occurrence of each core competency, along with the positive and negative outcomes of IPE were analysed. Mixed methods analysis was used to integrate both qualitative and quantitative data.

RESULTS

Team and teamwork emerged as the most frequently attained core competency in IPE. The positive impacts of IPE include significant improvements in role clarity, communication skills, and teamwork dynamics. However, negative impacts were also noted, such as logistical challenges and interpersonal issues like power dynamics and communication barriers, which impeded the personal professional growth and professional interactional skill-related benefits of IPE. Additionally, some participants reported feeling overwhelmed by the extra workload required for IPE activities.

CONCLUSION

IPE is a valuable component of health professions education, significantly contributing to the development of core competencies necessary for interprofessional collaborative practice. Addressing the challenges and implementing best practices can further enhance the effectiveness of IPE programs, ultimately improving healthcare outcomes. The implications for practice, training of healthcare students and future research are discussed.

Interprofessional training ward: impact on students, facilitators, and patients

Interprofessional Training Wards (IPTWs) have become a future-oriented, effective form of interprofessional (IP) education. This paper focuses on the quantitative pre-post analysis of a mixed-methods evaluation study to assess the impact of 3-to-4-week placements on the first IPTW in Switzerland on students, facilitators, and patients. Outcomes for students and facilitators were measured using the University of the West of England Interprofessional Questionnaire (UWE-IP) for communication and teamwork skills as well as attitudes to collaborative learning and working, and the Fragebogen zur Arbeit im Team (FAT) to address team-development. Moreover, patient satisfaction was assessed, using a self-developed questionnaire. 63 students, 31 facilitators and 91 patients placed on the IPTW between 2018 and 2022 were included into the study, along with 71 healthcare professionals and 50 patients of the control-wards. UWE-IP and FAT were analyzed using Wilcoxon signed-rank test for pre-post-IPTW comparison and Kruskal-Wallis independent sample test for differences between post-IPTW and post-control. Mann-Whitney U-test was applied to determine differences in patient satisfaction between IPTW and control-ward. Statistically significant positive effects were seen pre-post IPTW for students and facilitators for two subscales of UWE-IP (Communication & Teamwork, and IP Relationship), as well as for FAT, with effect size up to r = 0.681. Control-ward staff scored significantly lower than post-IPTW participants on two UWE-IP subscales (IP Learning, and IP Relationship) and on FAT. Patient satisfaction exhibited non-significant difference across IPTWs and controls. In conclusion, IPTW-placement benefited students' and facilitators' interprofessional teamwork skills, while keeping patient satisfaction high.

Learning and working on an interprofessional training ward in neonatology improves interprofessional competencies

Introduction

Interprofessional education (IPE) is essential for healthcare professionals to prepare them for future interprofessional collaboration (IPC). Interprofessional training wards (ITWs) have been set up for IPE and results have been published. There are no published studies on ITWs in neonatology. We have designed and established the Interprofessional Training Ward in Neonatology (IPANEO) for nursing trainees (NT) and medical students (MS) in a neonatological intermediate care (IMC) ward. We report on the concept and the results with regard to the interprofessional competencies of the participants, including parent satisfaction.

Methods

Supervision by medical and nursing learning facilitators, 2week blocks each with 2 NT (n = 30) and 2 MS (n = 23) in their final year, ward-in-ward concept, 3 patients cared for. Evaluation of the participants (pre/post) with the Interprofessional Socialisation and Valuing Scale (ISVS), the Interprofessional Collaboration Scale (ICS) with questions on IP communication, accommodation and isolation as well as with an IPANEO-specific evaluation (IPQ), an external evaluation with the "Observational Questionnaire for Learning Facilitators" (OQLF) and a "Questionnaire on Parent Satisfaction" (PSQ) (n = 33).

Results

IPANEO participants showed significant increases in competencies in IP communication, accomodation and isolation (ICS), a better IP-collaboration and a higher role definition (IPANEO specific questionnaire). The ISVS 9A/B global scores increased. According to the self-assessment there were significant improvements in the external evaluation in all IP-categories (OQLF). The feedback from the parents was significantly positive (PSQ).

Conclusion

Interprofessional learning and working on IPANEO had a positive impact on interprofessional competencies with high parent satisfaction.

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

AIM

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

DESIGN

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

METHODS

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

DATA SOURCES

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

RESULTS

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

CONCLUSION

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

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

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

IMPACT

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

REPORTING METHOD

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

Interprofessional learning in practice-based settings: AMEE Guide No. 169

The provision of optimum health care services requires collaboration of health care professionals in integrated interprofessional (IP) teams. This guide addresses the practical aspects of establishing and delivering pre-licensure IP programs to prepare graduates of health professional programs to work in teams and wider collaboration, and consequently enhance the quality of health care. The main updated IP frameworks are presented to highlight commonalities that represent the essential competencies and outcomes of programs implementing interprofessional education (IPE). We discuss how these may be adapted to the local context, and present examples of models of implementation to guide the initial steps of establishing similar programs. Examples of pre-licensure IP practice-based learning, such as community-based, simulation-based, student-run and led clinics, and interprofessional training wards, and post-licensure interprofessional learning (IPL), are described. We consider assessment of IPL along the continuum of learning IP. This guide also emphasises the need to tailor faculty development programs for local contexts and consider factors affecting sustainability such as funding and accreditation. We finish with the governance of IP programs and how global IP networks may support interprofessional practice-based learning from development to delivery.

Impact of an interprofessional training on students' attitudes toward interprofessional education

In Lausanne, Switzerland, Interprofessional Education (IPE) is embedded in the curriculum of every undergraduate healthcare student. Since 2011, five educational and healthcare institutions have implemented a short interprofessional education course to bring together 2307 undergraduates from six different disciplines (medicine, midwifery, nursing, occupational therapy, physiotherapy, medical radiology technician) between 2017 and 2020. This pre-post study aimed to explore how this course influenced students' attitudes toward IPE using a French translation of the validated questionnaire called the "University West of England Interprofessional Questionnaire." Students were asked to complete an online survey prior to and at the end of the IPE course to measure students' attitudes toward interprofessional (IP) relationships and collaborative learning. A total of 942 students answered the survey between 2017 and 2020, before and after the course. Each year, students' attitudes toward IP relationships improved after the course whereas a positive change in students' attitudes toward IP learning was observed only in 2020. A short exposure to an IPE course could improve students' attitudes toward IPE and, more specifically, toward IP relationships. Our findings could inform IP leaders to design repetitive, various, and longitudinal IPE experiences to balance the development of uniprofessional and interprofessional identity.

Patients' experiences of involvement at a clinical training ward: a qualitative interview study

Interprofessional education aims to foster healthcare students' ability to collaborate in interprofessional teams with the patients at the center of care as active participants. However, little is known about how patients experience this collaboration. Therefore, this study aimed to explore patients' experiences of being involved in the interprofessional team of healthcare students at a clinical training ward in Sweden. A descriptive design with a qualitative approach was used. Data were collected through semi-structured individual interviews with 22 patients. Braun and Clarke's reflexive thematic analysis was used. The main finding was that patients were only included as passive participants. Although most patients wanted to be involved, they were hindered due to their health condition or excluded from care planning and decision-making. The patients needed family members' support to be involved. However, this need was not recognised by the interprofessional team of healthcare students. Patient involvement must be highlighted as an important component of interprofessional education initiatives. Further research is needed to explore family members' perspectives on involvement in interprofessional training ward settings.

Exploring the "led" in health professional student-led experiences: a scoping review

To support a complex health system, students are expected to be competent leaders as well as competent clinicians. Intentional student leadership development is needed in health professional education programs. Student-led experiences such as student-run clinics and interprofessional training wards, are practice-based learning opportunities where learners provide leadership to clinical services and/or address a gap in the system. Given the absence of leadership definitions and concepts, this scoping review explored how student leadership is conceptualized and developed in student-led experiences. The review was conducted in accordance with best practices in scoping review methodology within the scope of relevant practice-based student-led experiences for health professional students. The research team screened 4659 abstracts, identified 315 articles for full-text review and selected 75 articles for data extraction and analysis. A thematic analysis produced themes related to leadership concepts/theories/models, objectives, facilitation/supervision, assessment and evaluation of curriculum. While responding to system gaps within health professional care, student-led experiences need to align explicit leadership theory/concepts/models with curricular objectives, pedagogy, and assessments to support health professional education. To support future student-led experiences, authors mapped five leadership student role profiles that were associated with student-led models and could be constructively aligned with theory and concepts. In addition to leveraging a student workforce to address system needs, student-led experiences must also be a force for learning through a reciprocal model of leadership and service to develop future health professionals and leaders.

ALLin4IPE- an international research study on interprofessional health professions education: a protocol for an ethnographic multiple-case study of practice architectures in sites of students' interprofessional clinical placements across four universities

BACKGROUND

The global discourse on future health care emphasises that learning to collaborate across professions is crucial to assure patient safety and meet the changing demands of health care. The research on interprofessional education (IPE) is diverse but with gaps in curricula design and how IPE is enacted in practice.

PURPOSE AND AIMS

This research project will identify. 1) how IPE in clinical placements emerges, evolves, and is enacted by students when embedded in local health care practices, 2) factors critical for the design of IPE for students at clinical placements across the four countries.

METHODS

A study involving four countries (Sweden, Norway, Australia and New Zealand) using the theory of practice architectures will be undertaken between 2023 and 2027. The project is designed as an international, collaborative multiple-case ethnographic study, using the theoretical framework of practice architectures (TPA). It will include four ethnographic case studies of IPE, one in each country. Data will be collected in the following sequence: (1) participant observation of students during interprofessional placements, (2) interviews with students at clinical placement and stakeholders/professionals, (3) Non-clinical documents may be used to support the analysis, and collection of photos may be use as memory aids for documenting context. An analysis of "sayings, doings and relatings" will address features of the cultural- discursive, material-economic, social-political elements making up the three key dimensions of TPA. Each of the four international cases will be analysed separately. A cross case analysis will be undertaken to establish common learning and critical IPE design elements across the four collaborating universities.

DISCUSSION

The use of TPA framework and methodology in the analysis of data will make it possible to identify comparable dimensions across the four research sites, enabling core questions to be addressed critical for the design of IPE. The ethnographic field studies will generate detailed descriptions that take account of country-specific cultural and practice contexts. The study will also generate new knowledge as to how IPE can be collaboratively researched.

Interprofessional collaboration skills and motivation one year after an interprofessional educational intervention for undergraduate medical and nursing students

BACKGROUND

The increasingly complex patient care in the twenty-first century is delivered by interprofessional health care teams. Interprofessional collaboration can be taught during interprofessional education. However, whether a long-term change in collaborative competencies can be achieved by interprofessional education has not been studied sufficiently. Our research questions were: How does motivation for interprofessional collaboration and interprofessional collaborative skills change up to one year after an interprofessional educational intervention? How are they related to each other?

METHODS

During a one-year period, undergraduate medical and nursing students attended four interprofessional (intervention) or uniprofessional (control group) education sessions. Self-determination Theory was used as the theoretical framework. Autonomous and controlled motivation scores for interprofessional collaboration were calculated using the Academic Self-Regulation Questionnaire, before (T1), directly after (T2) and one year post-intervention (T3). At T3, the students also filled out the Interprofessional Collaborative Competencies Attainment Survey (ICCAS), which measured the perceived attainment of collaborative competencies by a retrospective pre-test/post-test design. We used linear mixed effects models to analyse the motivation scores and linear regression for the relation between motivation and competence.

RESULTS

In the interprofessional group, autonomous motivation scores of the participants were significantly lower at T2 vs. T1. Controlled motivation scores were significantly higher at T3 vs. T1. Controlled motivation scores for T2 were significantly higher in the uniprofessional group than in the interprofessional group. Perceived competence was related to higher autonomous motivation scores. At T3 the interprofessional collaborative competencies seemed to have grown more among students in the interprofessional group.

CONCLUSIONS

The perceived growth in interprofessional collaboration competence lasted at least up to one year after the intervention, and was measurable with the ICCAS. The growth was significantly more in the IPE students than in the UPE students. The few differences found in motivation scores for interprofessional collaboration were probably caused by an imbalance of nursing versus medical students over the different time points. This finding indicates that classroom based IPE can contribute to interprofessional collaboration skills of nursing and medical students at least up to one year after an intervention.

"Everyone who wants to can practice on me"- a qualitative study of patients' view on health profession students' learning in an interprofessional clinical placement

INTRODUCTION

Healthcare services face significant challenges due to the aging population, increasing complexity of health issues, and a global shortage of health professionals. Health professions education needs to adapt and develop with healthcare services' needs. Interprofessional education and patient partnership are two trends that are increasingly being reinforced. Health professions students worldwide are expected to acquire competencies in interprofessional collaboration through undergraduate and postgraduate studies. Developing interprofessional collaborative skills in clinical placements is crucial. This study aims to explore two patients' meetings with an interprofessional student team and better understand how the patient can participate actively in the students´ learning processes.

METHODS

This is a small single-case study. Two patients participated. Data was generated through participant observation and qualitative interviews. A practical iterative framework for qualitative data analysis inspired the analysis.

RESULTS

The patients observed and reflected on the interprofessional students' learning process and felt responsible for contributing to their learning. The patients contributed to students' learning by making themselves available for practicing and sometimes giving feedback. They considered it a win-win situation to be involved in the interprofessional learning activity as they perceived being taken seriously by the students when addressing their problems and experienced positive outcomes for their situation, such as better physical functioning and adjustments to assistive devices. Patients emphasized the importance of learning collaboration between health professionals and how this could contribute to them feeling safer as patients.

DISCUSSION

This study highlights the importance of including patients in interprofessional students' learning processes. Patients' active participation in interprofessional clinical placements can empower them, improve their self-efficacy, and potentially shift the power dynamic between patients and healthcare professionals. The study emphasizes the importance of the patient perspective in future research on interprofessional education in clinical settings. The study also highlights the need for clinical supervisors to facilitate patient involvement in interprofessional clinical placements and reinforce patients' feedback for the student team.

CONCLUDING COMMENTS

Overall, this study contributes to the growing body of research on interprofessional education and patient partnership and emphasizes the importance of including patients in health professions education.

Evaluating the impact of interprofessional training wards on patient satisfaction and clinical outcomes: a mixed-methods analysis

Introduction

Interprofessional teamwork is pivotal in modern healthcare, prompting the establishment of interprofessional training wards since 1996. While these wards serve as hubs for optimizing healthcare professional collaboration and communication, research into patient outcomes remains notably sparse and geographically limited, predominantly examining patient satisfaction and sparingly exploring other metrics like mortality or self-discharge rates. This study seeks to bridge this gap, comparing patient outcomes in interprofessional training wards and conventional wards under the hypothesis that the former offers no disadvantage to patient outcomes.

Materials and methods

We explored patient outcomes within an interprofessional student ward called A-STAR at a University Hospital from October 2019 to December 2022. Engaging with patients discharged between May 2021 and April 2022, we utilized digital and paper-based anonymous questionnaires, catering to patient preference, to gather pertinent data.

Results

Analysis of outcomes for 1,482 A-STAR (interprofessional student ward) and 5,752 conventional ward patients revealed noteworthy findings. A-STAR patients tended to be younger (59 vs. 61 years, p < 0.01) and more frequently male (73.5% vs. 70.4%, p = 0.025). Vital clinical outcomes, such as discharges against medical advice, complication-driven readmissions, and ICU transfers, were statistically similar between groups, as were mortality rates (1.2% vs. 1.3%, p = 0.468). A-STAR demonstrated high patient satisfaction, underscored by positive reflections on team competence, ward atmosphere, and responsiveness to concerns, emphasizing the value placed on interprofessional collaboration. Patient narratives commended team kindness, lucid explanations, and proactive involvement.

Discussion

This data collectively underscores the safety and reliability of patient care within training wards, affirming that patients can trust the care provided in these settings. Patients on the interprofessional ward demonstrated high satisfaction levels: 96.7% appreciated the atmosphere and conduct of ward rounds. In comparison, 98.3% were satisfied with the discussion and information about their treatment during their hospital stay.

"It is great what we have learned from each other!" - Bedside teaching in interprofessional small groups using the example of Parkinson's disease

Background

While patient care often involves interprofessional collaboration, interprofessional teaching formats with participants from medical and physiotherapy fields are still rare. Furthermore, interprofessional education often takes place as separate courses and is not integrated into the clinical curriculum. Therefore, the goal of this project was to develop and implement interprofessional content into bedside teaching.

Course development

The clinical subject of the course was "Parkinson's disease", as this condition allowed for the exemplary demonstration of interprofessional teamwork and different competencies. Through interprofessional bedside teaching and a specific clinical context, interprofessionalism was intended to be integrated and experienced as natural part of clinical practice. The bedside teaching was complemented with work in break-out groups and a lecture.

Evaluation

The course was first conducted in the winter semester 2021/22. Participants were medical and physiotherapy students. Teaching teams were also interprofessional. A concurrent evaluation was carried out using the University of the West of England Interprofessional Questionnaire (UWE-IP) before and after course participation. UWE-IP scores in all sub-scales indicated a positive attitude, except for the "Interprofessional Learning" scale among physiotherapy students, which reflected a neutral attitude. Significant group differences were observed in the same scale at the pre-course time point between medical and physiotherapy students (p<0.01) and among medical students before and after course participation (p=0.02).

Conclusion

The course proved to be well-suited for integrating interprofessional content into clinical education and can serve as a model for future teaching units. The evaluation reflected a positive attitude toward interprofessional learning.

Social and healthcare students' competence in patient-oriented care enhanced during interprofessional practice: A scoping review

AIM

This scoping review aimed to synthesise the findings of previous literature related to social and healthcare students' competence in patient-oriented care in interprofessional practice by attending multidisciplinary student teams.

BACKGROUND

Learning about patient-oriented care requires the comprehensive consideration of patients' physical, emotional, social and economic aspects to offer the best need-based care. Multidisciplinary student teams in the clinical practice may support learning patient-oriented care; however, the current knowledge is fragmented.

DESIGN

Scoping review METHODS: Data (N = 1548) were gathered from four databases, PubMed, MEDLINE, SocIndex and CINAHL, without start-date limitation until the end of December 2022. One article was found on the publisher's webpage recommendations. The selected studies (N = 15) answered the research questions and met the inclusion criteria. Quality assessment of the studies was conducted using the Joanna Briggs Institute (JBI) Quality Assessment Checklist. A thematic analysis process was used for data extraction and synthesis of results.

RESULTS

Perspectives on patient-oriented care competencies were analysed for both students and patients cared for by a multidisciplinary student team. The themes described students' profound understanding of professional roles and responsibilities in patient-oriented care, collaborative patient-oriented care skills, improved interprofessional communication and reported patient experiences.

CONCLUSIONS

Interprofessional practice versatility develops students' competence in patient-oriented care. Guaranteeing patient-oriented care requires a broad understanding of patients' comprehensive care needs, which can be addressed through multidisciplinary collaboration. Patients' experiences toward interprofessional student practice are mainly positive. Further research is needed to assess the impact of different interprofessional education methods on students' patient-oriented care competence using valid instruments and the long-term effects of students' competence in patient-oriented care.

Development of individual competencies and team performance in interprofessional ward rounds: results of a study with multimodal observations at the Heidelberg Interprofessional Training Ward

Introduction

Interprofessional training wards (IPTW) aim to improve undergraduates' interprofessional collaborative practice of care. Little is known about the effects of the different team tasks on IPTW as measured by external assessment. In Heidelberg, Germany, four nursing and four medical undergraduates (= one cohort) care for up to six patients undergoing general surgery during a four-week placement. They learn both professionally and interprofessionally, working largely on their own responsibility under the supervision of the medical and nursing learning facilitators. Interprofessional ward rounds are a central component of developing individual competencies and team performance. The aim of this study was to evaluate individual competencies and team performance shown in ward rounds.

Methods

Observations took place in four cohorts of four nursing and four medical undergraduates each. Undergraduates in one cohort were divided into two teams, which rotated in morning and afternoon shifts. Team 1 was on morning shift during the first (t0) and third (t1) weeks of the IPTW placement, and Team 2 was on morning shift during the second (t0) and fourth (t1) weeks. Within each team, a tandem of one nursing and one medical undergraduate cared for a patient room with three patients. Ward round observations took place with each team and tandem at t0 and t1 using the IP-VITA instrument for individual competencies (16 items) and team performance (11 items). Four hypotheses were formulated for statistical testing with linear mixed models and correlations.

Results

A total of 16 nursing and medical undergraduates each were included. There were significant changes in mean values between t0 and t1 in individual competencies (Hypothesis 1). They were statistically significant for all three sum scores: "Roles and Responsibilities", Patient-Centeredness", and "Leadership". In terms of team performance (Hypothesis 2), there was a statistically significant change in mean values in the sum score "Roles and Responsibilities" and positive trends in the sum scores "Patient-Centeredness" and "Decision-Making/Collaborative Clinical Reasoning". Analysis of differences in the development of individual competencies in the groups of nursing and medical undergraduates (Hypothesis 3) showed more significant differences in the mean values of the two groups in t0 than in t1. There were significant correlations between individual competencies and team performance at both t0 and t1 (Hypothesis 4).

Discussion

The study has limitations due to the small sample and some sources of bias related to the external assessment by means of observation. Nevertheless, this study offers insights into interprofessional tasks on the IPTW from an external assessment. Results from quantitative and qualitative analysis of learners self-assessment are confirmed in terms of roles and responsibilities and patient-centeredness. It has been observed that medical undergraduates acquired and applied skills in collaborative clinic reasoning and decision-making, whereas nursing undergraduates acquired leadership skills. Within the study sample, only a small group of tandems remained constant over time. In team performance, the group of constant tandems tended to perform better than the group of random tandems. The aim of IPTW should be to prepare healthcare team members for the challenge of changing teams. Therefore, implications for IPTW implementation could be to develop learning support approaches that allow medical and nursing undergraduates to bring interprofessional competencies to team performance, independent of the tandem partner or team.

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.

[Measuring individual competencies and team performance in clinical learning settings of interprofessional collaborative practice: Empirical development of the Interprofessional Ward Round Individual and Team Assessment Tool (IP-VITA)]

BACKGROUND

Interprofessional training wards (IPTW) can contribute to the development of interprofessional competencies. In order to evaluate the acquisition of competencies, instruments are needed that record both team performance and individual competencies in the clinical teaching setting in third-party assessment. This paper describes the Interprofessional Ward Round Individual and Team Assessment-Tool, IP-VITA ("Interprofessionelle Visiten Individual und Team Assessment Tool") and its development.

METHOD

Based on the empirical exploration of the three observation instruments "Teamwork Assessment Scale" (TAS), "McMaster-Ottawa Scale" and "Individual Teamwork Observation and Feedback Tool" (iTOFT) in at least four rounds each at the HIPSTA (with n=8 students and trainees each), a preliminary version of the IP-VITA was created. This preliminary version was then refined in subsequent empirical steps: a consensual validation in the research team was followed by a "member check" with the clinical colleagues of the HIPSTA, the input from external experts and an empirical test in an alternative setting.

RESULTS

The IP-VITA is an empirically developed multimodal instrument to assess the interprofessional competencies of trainees and students as well as their team performance in clinical settings with patient interaction. It comprises three parts. In part A, structural data, the persons involved and the essential patient characteristics are recorded. Part B consists of 12 items and a free-text field for recording behaviour at the individual level. Part C also consists of 12 items and evaluates behaviour at team level.

DISCUSSION

The IP-VITA instrument was developed specifically for the context of evaluating interprofessional ward rounds in a clinical educational setting. The instrument takes into account the ambiguous position of the assessment of interprofessional collaboration between individual competence and team performance. Beyond the HIPSTA, it can be used as a formative assessment instrument, and it may also be useful for summative assessments.

How do former medical and nursing undergraduates describe their learning on an interprofessional training Ward 12-18 months later? - A retrospective qualitative analysis

BACKGROUND

Interprofessional training wards (IPTWs) seem to deliver good results in terms of development of interprofessional competencies. However, evidence of long-term effects of these training wards on learners' competency development is lacking and little is known about retrospective evaluation of IPTWs. Therefore, this study aimed to explore the retrospective evaluation of competency development and interprofessional collaboration of former undergraduates 12 or more months after a placement on an IPTW.

METHODS

Eight follow-up interviews were conducted with four nursing and four medical professionals 12-18 months after they had finished a placement on an ITPW throughout their vocational training. Interviews were translated verbatim and analysed deductively and inductively based on qualitative content analysis.

RESULTS

The qualitative content analyses deductively identified two main categories regarding the research question, namely the uniqueness of the programme and interprofessional competencies developed by the Interprofessional Education Collaborative. Sub categories were identified inductively, representing the perceived competency development and the learning opportunities on the IPTW as compared to other clinical placements throughout vocational training and in transition to practice. Interviewees seemed to have developed competencies that are important for interprofessional collaboration such as communication, roles and responsibilities, as well as competencies in patient care and management. Considered beneficial for learning were the opportunity to work self-responsibly and the interprofessional collaboration on the IPTW, both of which were neither possible in almost any other placement nor in transition to practice.

CONCLUSION

Findings show that IPTWs can be sufficient in competency development and role clarification and are perceived positively by learners, but structures in clinical practice can impede sustaining competency development and efficient interprofessional collaboration.

Nurses' perspective on team learning in interprofessional teams

AIM

The aim of this study is to find out what learning activities in interprofessional teams and what influencing factors for team learning activities in interprofessional teams can be described by nurses working in interprofessional teams.

DESIGN

We conducted a descriptive interview study.

METHODS

We used a semi-structured interview guideline and interviewed 10 nurses (N = 10) working in interprofessional teams. We analyzed our data using a qualitative content analysis.

RESULTS

Nurses describe team learning activities of knowledge sharing, team reflection, and storing and retrieving. Furthermore, our results show that team stability is important for interprofessional teams.

PATIENT OR PUBLIC CONTRIBUTION

Our results can be helpful for hospitals to improve organizational structures that help interprofessional teams to work together. Furthermore, vocational education and training for nurses should offer possibilities for nursing students to learn together with students of other fields.

'We just did it as a team': Learning and working on a paediatric interprofessional training ward improves interprofessional competencies in the short- and in the long-term

PURPOSE

Interprofessional (IP) education is essential for healthcare professionals to prepare them for future IP collaboration. IP training wards (ITWs) have been established for work-based IP education. Short-term effects of ITW placements have been published but long-term results are scarce. There are no reports on ITWs in paediatrics. We established the Interprofessional Training Ward in Paediatrics (IPAPAED) for paediatric nursing trainees and medical students. The aim of the study is to evaluate both short- and long-term outcomes regarding IP competencies of IPAPAED participants.

METHODS

The study was designed as a prospective, non-randomized trial, using a mixed-methods design. The Interprofessional Socialization and Valuing Scale (ISVS-9A/B) and the Interprofessional Collaboration Scale (ICS) were used for quantitative evaluation, qualitative data were gathered from structured group discussions and free-text comments. Data were collected from 68 IPAPAED participants, before and after the rotation, and 6-34 months later.Results: IPAPAED participants showed increased global scores in the ISVS 9 A/B and rated their communication competencies and their accommodation in IP teams better (ICS). Improvements in communication competency and accommodation persisted at 6-34 months.Conclusions: IP learning and working on IPAPAED had positive short-term effects on interprofessional competencies. Some of these effects persisted on a long-term.

Assessment of final-year medical students' entrustable professional activities after education on an interprofessional training ward: A case-control study

INTRODUCTION

Interprofessional training wards (ITWs) are implemented to provide medical students with a holistic and authentic health care experience to improve their clinical competencies. Controlled outcome studies assessing students' competencies after ITW-training are uncommon. In this case-control study, we assessed final-year medical students who received ITW-training regarding entrustable professional activities (EPAs) and communicative as well as social competencies.

METHODS

In March 2021, 32 final-year students, 16 with (ITW group) and 16 without (control group) a previous four-week placement on an ITW participated in a training simulating the first day of residency. The simulated patients assessed students' communication and interpersonal skills for history taking with the ComCare index after every consultation. Twelve prospective EPAs were assessed by three senior physicians after watching videos of the students' case presentations.

RESULTS

While baseline characteristics and ComCare index ratings were not significantly different between the two groups, the overall mean entrustment level for the 12 EPAs was significantly higher (p < 0.001) in the ITW group compared to the control group (median = 3.15 versus 2.22). The interrater reliability for all EPAs was high and entrustment in students from the ITW group was significantly higher in 10 out of 12 EPAs.

DISCUSSION

ITW training seems to prepare medical students well to practice competencies which are relevant for prospective entrustment decisions and can be deduced by senior physicians from case presentations. Further studies with larger student cohorts are needed to corroborate this finding and observable EPAs could also be defined to assess students' competencies after ITW training.

Discovering new perspectives - strengthening autonomy. Students from different healthcare professions interact with patients and provide care in a self-determined and interprofessional manner

The Careum Summer School (CSS) is a learning setting that enables self-regulated learning in an environment in which trainees and students from the various medical, nursing and therapeutic healthcare professions taught in the Swiss education system (upper secondary and tertiary levels A and B) develop project ideas together with patients and their caregivers. The aim of this learning setting is to promote a positive attitude among trainees and students towards interprofessional collaboration that includes patients as cooperation partners. Objective: The evaluation examines the extent to which trainees' and students' attitudes towards interprofessional collaboration changed. Information was also obtained on the experiences patients and their caregivers had during their participation in the CSS programme. Methodology: A total of 69 trainees and students were given access to an online survey in the form of the German version of the University of the West of England Interprofessional Questionnaire (UWE-IP) one week before the CSS programme began and six weeks after it concluded. Problem-focused interviews were also conducted with 11 patients and their caregivers. Results: The attitudes of the trainees and students in the UWE-IP Interprofessional Learning Scale improved significantly after the CSS programme was conducted (median t1=22.0/t2=16.0). The effect size was r=0.839 (Wilcoxon test for dependent samples). No significant results could be identified for the other three UWE-IP scales. Patients and their caregivers reported that they were able to actively participate in the CSS programme and felt valued and appreciated. Conclusion: The CSS offered a learning environment in which all participants were able to exchange knowledge and information in an interprofessional manner and work collaboratively on the development of a project idea - for example an interprofessional competency passport with a spider diagram.

Opening up a tailored tutor qualification program for medical students to other healthcare students - a mixed-method study

BACKGROUND

Peer-led tutorials are widely used in medical education to promote practical skills acquisition and support faculty staff. Typically, student tutors are custom trained for this specific task. We investigated whether opening up an existing medical tutor qualification program to other degree programs is successful in terms of acceptance among students, acquisition of tutor-specific and interprofessional competencies, and which factors contribute to success or failure.

METHODS

We developed a two-day tutor qualification program and conducted it annually from 2016 to 2020 with medical and other healthcare students. At the end of each course, we administered a written survey in which the participants rated the following items: their attitudes towards interprofessional learning (using the UWE-IP-D Interprofessional Learning Scale), the interprofessional learning setting, the teaching approach, and their competency acquisition (each on a five-point Likert scale; 1 = strongly agree, 5 = strongly disagree). Furthermore, we assessed participants' qualitative feedback in free-text fields and performed inductive content analyses.

RESULTS

The study participation rate was high (response rate 97%; medical students: n = 75; healthcare students: n = 22). Participants stated high levels of competency acquisition (total M = 1.59, individual items' M's ranging from 1.20 to 2.05) and even higher satisfaction with the teaching approach (total M = 1.28, individual items' M's ranging from 1.43 to 1.05). Overall satisfaction with the training was M = 1.22; SD = 0.58. No significant differences in ratings were found between the student groups. The qualitative results showed that students appreciated the interprofessional setting and experienced it as enriching. The most positive feedback was found in didactics/teaching methods on role-plays and group work; most suggestions for improvement were found in the area of structure and organisation on breaks and time management.

CONCLUSIONS

Opening up an existing medical tutor qualification program to other student groups can be seen as fruitful to teach not only tutor-related aspects but also interprofessional competencies. The results demonstrate the importance of detailed planning that considers group composition and contextual conditions and provides interactive teaching methods to promote interprofessional experiences. This study offers important information about prerequisites and methodological implementation that could be important for the interprofessional redesign of existing training programs.

Clinical outcomes of patients treated on the Heidelberg interprofessional training ward vs. care on a conventional surgical ward: A retrospective cohort study

Interprofessional training wards (IPTW) are a form of interprofessional education enabling trainees of different healthcare professions to work together in teams. Concerns about patient safety are a major barrier to the implementation of IPTWs. The objective of this retrospective study was to analyze patient relevant clinical outcomes on Germany's first IPTW (Heidelberger Interprofessionelle Ausbildungsstation; HIPSTA) in the Department of Surgery at University Hospital Heidelberg in comparison to a conventional surgical ward (CSW). The setting is a large tertiary care center with a focus on major oncological surgery. The endpoints were postoperative complications according to the Dindo-Clavien Classification and a set of patient-safety outcomes. In total, 232 patients treated on HIPSTA were retrospectively compared with 465 patients on a CSW. Baseline characteristics were comparable between groups. No significant difference between rate or severity of overall postoperative complications was observed. In-hospital mortality did not significantly differ between groups. However, the mean length of hospital stay was significantly shorter on HIPSTA. Furthermore, HIPSTA patients had less frequent reoperations. Patient safety in surgical IPTW was not compromised in comparison to a CSW, and there were some areas where significantly better outcomes were identified.

Improving Community Health Workers' Attitudes toward Collaborative Practice in the Care of Older Adults: An In-Service Training Intervention Trial in the Philippines

The objective of this study was to evaluate the efficacy of an in-service, short-term training program in improving the attitudes toward, and readiness and activities for collaboration among community health workers (CHWs) in a primary care setting in the Philippines. A randomized controlled trial was adopted dividing participants into an intervention (n = 42) and a control group (n = 39). Attitudes toward, and readiness and activities for collaboration were measured using three standardized scales before and at 6 months after the training. A significant difference (p < 0.001) was observed in the Attitudes Toward Health Care Teams Scale (ATHCTS) scores between pre- and post-test in the intervention (6.3 ± 8.3 [Mean ± SD]) and control groups (0.7 ± 8.2). Multivariate linear regression analysis showed an independent positive association between the intervention and greater improvement in the ATHCTS score (Coefficient β = 6.17; 95% CI = 0.82, 11.53; p = 0.03) at follow-up, after adjustment for age, years in current occupation, and social support role of participants. The results demonstrated the efficacy of the intervention for improving the attitudes of CHWs toward collaborative practice in the care of older adults.

Gaining interprofessional knowledge and interprofessional competence on a training ward

BACKGROUND

Since 2017, interprofessional training wards have been established in Germany. On these wards, different health professions collaboratively provide patient care supervised by facilitators from the background. We investigated the gains in interprofessional knowledge and interprofessional competence reported after the mandatory placements on Mannheim's Interprofessional Training Ward MIA. We also compared these levels of knowledge and competence at the end of the placement with control groups.

METHODS

In a quasi-randomized controlled study, we used a questionnaire to collect self-reported data on the interprofessional learning outcome. We used t-tests to compare (a) pretest and posttest data in the experimental group and (b) the levels of interprofessional knowledge and competence between the experimental and control groups.

RESULTS

The results confirmed that the MIA participants perceived a significant increase in interprofessional knowledge and competence during the placement on the training ward. MIA participants also reported significantly higher levels of interprofessional knowledge and competence than the control groups.

CONCLUSIONS

Placements on an interprofessional training ward make it possible to experience and practise interprofessional collaboration in real patient care. They help to prepare all future health professionals to assume their professional role in an interprofessional team to provide the best possible patient care.