Interprofessional education in geriatric medicine: towards best practice. A controlled before-after study of medical and nursing students

Engaging post-secondary students in a multidisciplinary aging studies interest group

Little is known about student aging interest groups (AIGs) in post-secondary institutions. Our study evaluated awareness of a student aging interest group at a western Canadian university with no gerontology program. Additional goals included assessing interest in joining the AIG, participation rates among group members, and preferences for group activities. Using a mixed method approach we analyzed 13 years of administrative data recording 65 meetings and conducted a survey among group members and nonmember students across the university with a potential interest in aging (n = 52). Almost two-thirds of respondents (n = 33) were nonmembers with most of these (n = 24) having no prior knowledge of the AIG; 77% of students already aware of the AIG learned about it from a professor. Sixty per cent of respondents were in health-related faculties, with the remainder representing multiple disciplines and faculties. Group attendance was strongly influenced by student workloads and schedules, with average attendance rising by 27.3% during the shift to virtual meetings in 2020-21. Our results highlight the interdisciplinary nature of aging studies, the key role faculty members play in informing students about AIGs, and the broad range of interests that students have in issues related to age and aging.

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.

Readiness for Interprofessional Learning Among Students of Four Undergraduate Health Professions Education Programs

BACKGROUND

In interprofessional learning, students from different professions learn about, from, and with each other so that they can collaborate effectively, deliver high-quality healthcare, and achieve positive health outcomes. This study aimed to explore the readiness of students from four health professions education programs for interprofessional learning.

METHODS

A cross-sectional descriptive study was carried out on 339 students. The Readiness for Interprofessional Learning Scale (RIPLS) was used to collect data. Descriptive statistics were used. Paired-samples t-test and ANOVA test were used to compare the responses of participants. Correlations between dependent and independent variables were explored by Pearson's correlation test. The statistical significance level was set at p < 0.05.

RESULTS

The reliability study of the collected data showed excellent internal consistency (Cronbach's ɑ = 0.819). Results revealed a statistically significant difference between the responses of students from the four programs regarding the "Roles and Responsibilities" subscale (p = 0.000). A statistically significant difference between male and female students regarding two statements within the "Teamwork and Collaboration" subscale and one statement within the "Negative Professional Identity" subscale (p < 0.05) was also detected. The correlation study showed a weak but statistically significant correlation between RIPLS mean scores and the students' study program (p < 0.015).

CONCLUSION

In conclusion, the students showed readiness for IPL as evidenced by their positive perception of the interprofessional learning concepts.

La educación interprofesional en el desarrollo de la identidad profesional en terapia ocupacional: una revisión de alcance

Resumen Objetivo analizar el desarrollo histórico, la naturaleza y el volumen de la literatura científica de la Investigación sobre Educación Interprofesional en terapia ocupacional, así como los tipos de intervenciones que se desarrollan. Método Se utilizó un scoping review con un marco metodológico de cuatro etapas para capturar la evidencia que describe cómo las Investigación sobre Educación Interprofesional y la identidad profesional ha sido conceptualizada e integradas en la terapia ocupacional. Las bases de datos incluidas fueron MEDLINE, EMBASE, PubMed, Pubmed Central, ERIC, PsychInfo, Cinahl, Ciberindex, Dialnet, Scopus, Web of Science, Cochrane y Scielo. Como criterios de inclusión los artículos debían describir conceptos relacionados con la terapia ocupacional y otras disciplinas, identidad profesional y la educación interprofesional en estudiantes y/o profesionales. Del listado final se analizaron las variables: información demográfica, objetivo/propósito del estudio, detalles metodológicos, tipos de intervenciones realizadas y resultados/hallazgos principales. Resultados 18 artículos cumplieron los criterios y 16 se tuvieron en cuenta para la síntesis cualitativa. Predomina la investigación universitaria (92,3%). El 75% de la muestra de las investigaciones se concentra en estudiantes. La investigación mixta representa el 50% del estudio. Las intervenciones más numerosas en Investigación sobre Educación Interprofesional son prácticas en el aula (62,5%) frente a prácticas de campo (37,5%). Conclusión este estudio muestra la fortaleza de las prácticas ligadas a la educación interprofesional y su vínculo para desarrollar la identidad profesional. La formación de colaboración interprofesional en comparación con la educación clínica tradicional, aumenta la identidad profesional a través de la autoeficacia percibida de los estudiantes.

Beyond 'born not made': challenging character, emotions and professionalism in undergraduate medical education

In this article we explore the historical antecedents and ongoing perpetuation of the idea that medical professionals must adhere to a specific 'character'. In the late nineteenth century, an ideal of the medical student as 'born not made' was substantiated through medical school opening addresses and other medical literature. An understanding prevailed that students would have a natural inclination that would suit them to medical work, which was predicated on class structures. As we move into the twentieth-century context, we see that such underpinnings remained, even if the idea of 'character' becomes 'characteristics'. This was articulated through emerging psychological and sociological perspectives on education, as well as medical school admission processes. The significance ascribed to character and characteristics-based suitability continues to exclude and limits who can access medical careers. In the final part of the article, we argue that a framework of uncertainty can and should be mobilised to re-evaluate the role of doctors' education and critique long-standing notions of professional identity, via the integration of medical humanities and clearer professionalism teaching within medical curricula.

Research to inform health systems' responses to rapid population ageing: a collection of studies funded by the WHO Centre for Health Development in Kobe, Japan

Population ageing is a global phenomenon that has profound implications for all aspects of health systems development. Research is needed to understand and improve the health system response to this demographic shift, especially in low- and middle-income countries where the change is happening rapidly. This Supplement was organized by the WHO Centre for Health Development in Kobe, Japan (WHO Kobe Centre) whose mission is to promote innovation and research for equitable and sustainable universal health coverage considering the impacts of population ageing. The Supplement features 10 papers all based on studies that were funded by the WHO Kobe Centre in recent years. The studies involve a diverse set of 10 countries in the Asia Pacific (Cambodia, Japan, the Lao People's Democratic Republic, Malaysia, Mongolia, Myanmar, the Philippines, Singapore, Thailand and Viet Nam); address various aspects of the health system including service delivery, workforce development and financing; and utilize a wide range of research methods, including economic modelling, household surveys and intervention evaluations. This introductory article offers a brief description of each study's methods, key findings and implications. Collectively, the studies demonstrate the potential contribution that health systems research can make toward addressing the challenges of ensuring sustainable universal health coverage even while countries undergo rapid population ageing.

Application of problem-based learning combined with a virtual simulation training platform in clinical biochemistry teaching during the COVID-19 pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has had a great impact on the traditional teaching mode (Lecture-based Learning, LBL) and laboratory teaching. To address this challenge, the researchers conducted online Problem-based learning (PBL) teaching and virtual simulation laboratory teaching through DingTalk, and evaluated the effectiveness of this method in teaching clinical biochemistry.

METHODS

With the method of cluster sampling, the researchers randomly selected 60 students from two classes of the Class 2019 as the experimental group for this prospective experimental study. The theory class was taught online PBL through DingTalk, and experimental lectures were given by virtual simulation. After the experimental teaching, students were assessed for theory and operation. Self-administered questionnaires were administered through DingTalk. 65 students from our 2018 medical laboratory class were randomly selected as the control group, and offline LBL and traditional experimental teaching methods were used. Examination results were obtained through teaching portfolios.

RESULTS

The experimental group had significantly better examination scores in theoretical knowledge and experimental operational skills than the control group (87.45 ± 5.91 vs. 83.52 ± 9.94, P = 0.0095; 87.08 ± 12.42 vs. 80.18 ± 14.04, P = 0.0044). The results of the questionnaire survey revealed that the experimental group was more receptive to the DingTalk-PBL teaching method and virtual simulation laboratory teaching. Moreover, this hybrid teaching method was more effective in promoting basic knowledge understanding (95.0%, 57/60), facilitating the mastery of operational skills (93.3, 56/60), cultivating interest in learning (96.7%, 58/60), training clinical thinking (95.0%, 57/60), improving communication skills (95.0%, 57/60), and enhancing self-learning ability (91.7%, 55/60) and was more satisfying than traditional teaching method (all P < 0.05).

CONCLUSION

The DingTalk-based PBL method combined with virtual simulation experiments was an effective and acceptable teaching strategy during the pandemic compared with the traditional teaching method.

The impact of interprofessional education on students' current and desired competence in diabetes care

AIM

To explore the impact of interprofessional education (IPE) on undergraduate nursing and medical students' knowledge, competence and targeted competence in diabetes care.

DESIGN

Mixed methods design.

METHODS

A voluntary IPE course of diabetes management was organized for nursing (n = 15) and medical (n = 15) students, who performed a diabetes knowledge test and self-evaluation of diabetes competence before and after the course and were compared with non-participating students. The participating students' focus-group interviews were analysed using inductive content analysis.

RESULTS

The IPE course improved nursing students' diabetes knowledge and self-evaluated competence among nursing and medical students. The baseline differences in self-evaluated competence between the groups disappeared. The non-participating students evaluated their competence higher than the participants, though they scored lower or equally in the knowledge test. In conclusion, IPE showed potential in increasing students' self-evaluated competence, motivation to learn more and nursing students' diabetes knowledge, offering better prospects for future interprofessional diabetes management.

Promoting Older Adult Health with Interprofessional Education through Community Based Health Screening

IPHARM (ImProving Health Among Rural Montanans) is a university-based community health screening program that provides valuable interprofessional teamwork and clinical skills training for health care students while addressing the health of older adults. Students perform a variety of health care screenings dependent on the health care professions present and the requests of the community group served. Education, counseling, and recommendations for participants are provided by the interprofessional student teams under supervision and guidance from faculty and clinicians. Supported in part by federal grants such as the Health Service and Resource Administration Geriatric Workforce Enhancement Program (HRSA GWEP), IPHARM has provided interprofessional training for over 2100 students and conducted over 30,000 health screenings at 814 different community events. Surveys from students indicate that the experience promotes effective interprofessional team skills related to communication, an increased understanding of the roles and responsibilities of the health care team, and how to positively impact the health of older adults. These interprofessional screening events for older adults, conducted in the community by health professions students and faculty, help prepare the future workforce for collaborative and effective health care delivery. The purpose of this article is to describe the IPHARM objectives, methods, and impact this program has had on the health of older adults and the training of our future health care workforce.

[Interprofessional teaching in geriatrics : Overview of the international development in comparison to the current situation in Germany]

The involvement of physicians, nurses, social workers, physiotherapists, occupational therapists and other professional groups, adopting a patient-centered interprofessional approach, is an essential component of successful treatment. In this context interprofessional teaching plays an increasingly more important role. This article presents a review of the international literature since 2016. In this study 25 lecturers in geriatrics at German universities were asked whether interprofessional teaching takes place at their site and 6 sites were identified. Furthermore, three educational units were identified where theoretical knowledge is practically implemented in a structured manner. Interprofessional teaching can be implemented in geriatric training; however, there was no evidence about best practice and the most suitable methods.

Evaluation in health professions education-Is measuring outcomes enough?

INTRODUCTION

In an effort to increase the rigour of evaluation in health professions education (HPE), a range of evaluation approaches are used. These largely focus on outcome evaluation as opposed to programme evaluation. We aim to review and critique the use of outcome evaluation models, using the Kirkpatrick Model as an example given its wide acceptance and use, and advocate for the use of programme evaluation models that help us understand how and why outcomes are occurring.

METHODS

We systematically searched OVID medline, Scopus, CINAHL and Pubmed, and hand searched six leading HPE journals to provide an overview of the use of the Kirkpatrick Model as well as a range of programme evaluation models in HPE. In addition to this, we synthesised the existing critiques of the Kirkpatrick Model as an example of outcome evaluation, to highlight the limitations of such models.

RESULTS

The use of the Kirkpatrick Model in HPE is widespread and increasing; however, studies focus on categorising outcomes, rather than explaining how and why they occur. The main criticisms of the model are as follows: it is outcomes focused and fails to consider factors that can impact training outcomes; it assumes positive casual linkages between the levels; there is an assumption that the higher-level outcomes are more important; and unintended impacts are not considered. The use of the Kirkpatrick Model by the MERSQI, BEME and WHO contribute to the myth that the Kirkpatrick Model is the gold standard for programme evaluation.

DISCUSSION

Moving forward, evaluations of HPE interventions must shift from focusing largely on measuring outcomes of interventions with little consideration for how and why these outcomes are occurring to programme evaluation that investigates what contributes to these outcomes. Other models that facilitate the evaluation of the complex processes that occur in HPE should be used instead of Kirkpatrick's.

Effects of Home-Based Care Inter-Professional Education on Students' Outcomes: Mahasarakham University Experiences

This mixed-method research aimed to implement inter-professional education (IPE) as a training process for producing and shaping health and social sciences professionals in three faculties: Medicine, Pharmacy, and Architecture, Urban Design and Creative Arts in Mahasarakham University (MSU), Thailand. Two hundred thirty-two students who registered as second-year students in the 2015 academic year, and third-year students in the 2016 academic year, and fifty patients in six catchment areas of the Faculty of Medicine Hospital, MSU, participated in the study. Six steps of IPE implementation were involved. They were conducted by twenty-four teachers from three faculties, twelve health volunteers in six communities, and five municipality officers. After the IPE activities, students showed significant improvement in their attitudes towards collaborative teamwork. Their performance with regard to IPE home-based care for medical patients improved substantially from year 2 to year 3 (73.4% and 80.9%, p = 0.001). Patients and community representatives were satisfied with students' home visits, and scored them at > 80%. The after-action review among all of the teachers provided information about their views on IPE projects and their recommendations with respect to inter-professional education. IPE schemes can produce beneficial effects for students, teachers, and patients in the community. As a study result of MSU experience, we recommended IPE for higher education institutions.