Students´ perception of interprofessional education in the bachelor programme "Interprofessional Health Care" in Heidelberg, Germany: an exploratory case study

Experiences of interprofessional learning among students in primary healthcare settings: a scoping review

OBJECTIVE

Previous research on interprofessional learning in primary healthcare has been focused on students' learning in the encounter with the patient. However, the research is limited, and a review of the experiences of patients, students, and supervisors of interprofessional learning in primary healthcare is lacking. The focus of this scoping review is to describe the current knowledge and also to identify knowledge gaps.

DESIGN

A scoping review in which blocks of keywords and synonyms were used for achieving a high level of subject precision together with a qualitative thematic analysis for the presentation of the results.

DATA SOURCES

Publications from 2012 to 2024 were searched for in the PubMed, CINAHL and ERIC databases.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Peer-reviewed studies with a qualitative design describing the experiences of patients, students and supervisors of interprofessional learning in primary healthcare were included.

DATA EXTRACTION AND SYNTHESIS

The articles were retrieved, stored and reviewed in a shared online folder. All the authors participated in the scoping review. The decisions on inclusion/exclusion were made after a systematic, multidisciplinary team approach, which involved all the authors in the discussions to reach a consensus.

RESULTS

The results showed that interprofessional learning helped the students to focus on the patient and that the students broadened their perspectives when working together. The results showed that supervisors planned for interprofessional learning by setting aside time for the students to get to know each other. The supervisors confirmed that interprofessional learning contributed to the primary healthcare employees remaining abreast with high professional standards, with updated knowledge, more resources and the implementation of several organisational changes.

CONCLUSIONS

Interprofessional learning contributed to a patient-centred approach that provided new insights and expanded knowledge for students in professional training. More research is needed to understand how interprofessional learning between different professions can be developed.

Evaluating interdisciplinary breastfeeding and lactation knowledge, attitudes and skills: An evaluation of a professional graduate programme for healthcare professionals

Breastfeeding theoretical and skills training is important for health care professionals engaging with the mother infant dyad to increase breastfeeding exclusivity and duration. The aim of this study was to evaluate the knowledge, attitudes and practices (KAPs) of health care professionals following completion of a university professional graduate programme in breastfeeding and lactation. A pre and post-educational study design was used. All students enrolled in a six month programme were invited to complete an online anonymous survey at two time points: January 2023 and July 2023. Ethical approval (LS-C-23-17) was obtained in January 2023. Descriptive statistics were utilised to report percentages and means, and independent T tests were used to report mean differences between variables on knowledge, attitude and practices. All students completed the module. The pre survey participant response rate was n = 55 (92.82%) and the post survey participant response rate n = 33 (60%). Comparison of the pre and post questionnaire report nine statistically significant results following completion of the university breastfeeding and lactation programme. Knowledge scores increased specifically with higher mean knowledge scores for reporting "I am confident with my knowledge about breastfeeding" and statistically significant mean difference of 0.29 following completion of the module (95% CI, 0.13 to 0.45) (t (64) = 3.59, p = 0.001). The programme evaluation identifies the importance of a professional graduate breastfeeding and lactation education programme for interdisciplinary health care professionals increasing knowledge, attitudes and practices and ultimately increasing breastfeeding rates in the short and long term, with improved maternal and child health outcomes.

Interprofessional Team Training With Virtual Reality: Acceptance, Learning Outcome, and Feasibility Evaluation Study

Background

Effective interprofessional teamwork is vital for ensuring high-quality patient care, especially in emergency medicine. However, interprofessional education often fails to facilitate meaningful interaction among health care disciplines. It is therefore imperative to afford early opportunities for cultivating interprofessional teamwork skills. While in-person simulation-based training has been shown to improve performance, this is resource-intensive, especially if it involves multiple professions. Virtual reality (VR)-based training is an innovative instructional approach that demands fewer resources and offers the flexibility of location-independent learning.

Objective

This study aimed to develop and evaluate the acceptance, learning outcome, and feasibility of an interprofessional team (INTEAM) training course that included a VR simulation of a neurological emergency case.

Methods

This 1-group study used a pre- and posttest design to evaluate the 2-hour INTEAM training course for nursing and medical students. The course included an e-learning part, VR simulation, and debriefing. The main learning objectives were derived from the entrustable professional activity 6, namely to handle a common problem in emergency medicine (headache due to subarachnoid hemorrhage and epileptic seizure) that requires interprofessional collaboration, including a structured handover. We used validated and self-constructed questionnaires, pre- and posttests, and open questions to assess the acceptance, learning outcome, and feasibility of the course.

Results

The data of 42 students (21 nursing and 21 medical students) were analyzed and showed good usability in the System Usability Scale (median 72.5, IQR 65-80). The perception of usefulness (median 6, IQR 5.8-6.9) and ease of use (median 5.9, IQR 5.1-6.3) was good among all students. There was a significant increase in the handover performance from pre- (median 8, IQR 6-9) to posttraining (median 8, IQR 7-9; z=-2.01; P=.045; r=0.33) and of the confidence in caring for patients with seizures (median 3, IQR 2-3 and median 3.5, IQR 3-4, respectively; z=-3.8; P<.001; r=0.60). In 67% (14/21) of the simulations, technical issues occurred, but all simulations could be carried out completely.

Conclusions

The new INTEAM training course was well received by nursing and medical students. The handover skills and confidence in caring for patients with seizures were improved after the course. Despite technical challenges with the VR simulations, none required termination, and this demonstrates that our approach is feasible. These promising results encourage the use of VR simulations for team training in the education of nursing and medical students.

Exploring perception and attitude of nursing students towards interprofessional education in Saudi Arabia

INTRODUCTION

Interprofessional education is a process designed to facilitate knowledge exchange between healthcare professionals with the aim of improving learning, collaboration, and patient care. It helsps students gain a better understanding of communication, teamwork, and each profession's role. This study aims to examine Saudi undergraduate nursing students' attitudes and readiness for engagement in high-fidelity simulation interprofessional education and practice after training nurse educators in HFS.

METHODOLOGY

A descriptive cross-sectional study was conducted among 311 nursing students. The process of sampling was done by convenience and was not probabilistic. Participants were asked to complete a self-administered questionnaire. The survey included demographic information as well as the Readiness for Interprofessional Learning Scale.

RESULTS

There was a positive attitude toward Interprofessional education among nursing students and a reasonable level of readiness. The Readiness for Interprofessional Learning Scale score was significantly associated with academic years (p ≤ 0.05).

CONCLUSION

Nursing students have a positive attitude towards interprofessional education and are willing to engage in high-fidelity simulation activities. The integration of high-fidelity simulation in interprofessional education can significantly benefit nursing students by enhancing their clinical skills, decision-making abilities, and teamwork dynamics in a controlled environment.

Interprofessional education during international electives: Perceptions of health professions students from selected institutions in Africa

Although international electives provide important opportunities for the development of interprofessional education and collaboration practice skills, there is limited literature that describes students' perceptions in various training institutions in Africa. This study aimed to address this gap by establishing the student's perceptions of interprofessional education during international electives from four African health professional training universities. This was a cross-sectional quantitative study. Data were collected online using the Readiness for Interprofessional Learning Scale from 135 student participants. Linear regression and multilinear regression were used to establish relationships between socio-demographic characteristics and the student's perception of interprofessional education during international electives. There was a high overall positive perception (76 SD± 8.1) among the student participants of interprofessional education during international electives. Almost all the students (88.9% n = 120) thought interprofessional education during international electives would help them become better team workers during future practice and enhance their communication skills. There were high mean scores regarding positive perceptions of teamwork and collaboration (39.5 SD± 4.9), positive professional identity 17.6 (SD± 2.6), and understanding roles and responsibilities (7.4 SD± 2.0). There is a generally positive perception of interprofessional education during international electives among health professions students from various African university institutions.

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.

Interdisciplinary educational approaches in Healthcare Organizations

Background: Healthcare professionals’ perception of Interdisciplinary Education is an essential factor that affects their acceptance of this approach to education. From the literature related to patient safety, it has been identified widely that healthcare team communication and performance are critical to providing safe care to the patient. Poor organization and team dynamics among healthcare professionals appear to impact the safety and quality of patient care. The lack of Interdisciplinary Education in healthcare institutions in the Kingdom of Saudi Arabia negatively impacts the work dynamics of the healthcare team. Results: The study results showed that the majority of health care workers showed a high awareness level for IPE. Therefore, female nurses who have been working in special units and have experience of more than five years are perceived more than other specialties. Also, health workers in special units showed a higher percentage than in the general wards, and females were ready more than males. Only one item helped to determine the differences in perception which is the “perceived need for cooperation”. Conclusions: IPC should be initiated by universities than by health organizations starting at the level of leaders of medicine, nursing, and other disciplines who should be aware of the importance of IPC that would benefit patients as well as health institutions. Leaders must take IPC cooperation seriously by putting it into consideration in the vision of departments and thus starting to establish small-cooperated teams, which include various specialties.

Nursing Students’ Experiences in Consecutive Clinical Interprofessional Education in Japan: Application of the IPE in Nursing Colleges

Aim: To document nursing students’ experiences of continuous participation in a clinical interprofessional education (IPE) program with the Faculty of Pharmacy of other universities in Japan, which had been incorporated into the existing practicum program, and consider how to develop a one-shot clinical IPE program. Methods: The study participants were two nursing students from a single-department college; they were participating in a clinical IPE program—the first IPE program they had ever participated in—during an area-based practicum in Year 3. Subsequently, in Year 4, a semi-structured interview was conducted, and these interview data were qualitatively and inductively analyzed. Results: Seven categories were identified, and it was found that through continuous participation in the IPE program, there was a change from “clinical IPE is stuck at the back of their mind as a bitter experience” to “the process of clinical IPE stimulates their maturity as a nursing student” and “cultivates attitudes necessary for cooperation”. Conclusion: Consecutive years of continuous clinical IPE helps students deepen their understanding of learning content by reducing the physical and mental burden of multidisciplinary cooperation and collaboration. For difficulties with regard to step-by-step IPE, it is suggested that one-shot clinical IPE can be conducted for the upper grades along with continuous reflection activities for teams and individuals.

Psychiatric mental health nurse practitioner student perceptions of integrated collaborative care

OBJECTIVES

To explore the outcomes of threading the Patient-Centered Integrated Behavioral Health Care Principles and Tasks Checklist (AIMS Checklist) into the curricula and experiential setting.

METHODS

A qualitative exploratory descriptive method with a constructivist epistemology was used to obtain in-depth student perspectives about their understanding, experiences, and process of applying Integrated Collaborative Care within the clinical setting.

RESULTS

24 Psychiatric Mental Health Nurse Practitioner Students (PMHNP) were divided into focus groups that yielded seven main themes and seven subthemes. Three of the identified themes emerged as opportunities for curriculum enhancement.

CONCLUSIONS

The checklist was found to be a valuable tool in not only evaluating collaborative care but in closing the gap between didactic and clinical education in fostering student-preceptor discussion.

Identifying barriers and facilitators to recognition and response to patient clinical deterioration by clinicians using a behaviour change approach: A qualitative study

BACKGROUND

Failure of clinicians to recognise and respond to patient clinical deterioration is associated with increased hospital mortality. Emergency response teams are implemented throughout hospitals to support direct-care clinicians in managing patient deterioration, but patient clinical deterioration is often not identified or acted upon by clinicians in ward settings. To date, no studies have used an integrative theoretical framework in multiple sites to examine why clinicians' delay identification and action on patients' clinical deterioration.

AIM

To identify barriers and facilitators that influence clinicians' absent or delayed response to patient clinical deterioration using the Theoretical Domains Framework.

METHODS

The Theoretical Domains Framework guided: (a) semi-structured interviews with clinicians, health consumers and family members undertaken at two sites; (b) deductive analyses of inductive themes to identify barriers and facilitators to optimal care. This study complied with the COREQ research guidelines.

FINDINGS

Seven themes identified: (a) information transfer; (b) ownership of patient care; (c) confidence to respond; (d) knowledge and skills; (e) culture; (f) emotion; and (g) environmental context and resources.

DISCUSSION

The Theoretical Domains Framework identified traditional social and professional hierarchies and limitations due to environmental contexts and resources as contributors to diminished interprofessional recognition and impediments to the development of effective relationships between professional groups. Communication processes were impacted by these restraints and further confounded by inadequate policy development and limited access to regular effective team-based training. As a result, patient safety was compromised, and clinicians frustrated.

CONCLUSIONS

These results inform the development, implementation and evaluation of a behaviour change intervention and increase knowledge about barriers and facilitators to timely response to patient clinical deterioration.

RELEVANCE TO CLINICAL PRACTICE

Results contribute to understanding of why clinicians delay responding to patient clinical deterioration and suggest key recommendations to identify and challenge traditional hierarchies and practices that prevent interdisciplinary collaboration and decision-making.

Home visits as an interprofessional learning activity for students in primary healthcare

Aim:

To evaluate person-centred home visits as an interprofessional learning (IPL) activity for undergraduate students during clinical placements in primary healthcare.

Background:

Interprofessional collaboration is known to improve patient safety, increase job satisfaction, and reduce stress among healthcare professionals. Students should already during their basic training experience interprofessional collaboration.

Methods:

Students from six different educational programmes and supervisors and adjunct clinical lecturers from different professions participated in the learning activity. The students read a description of the patient history before the visit together with a supervisor. During the home visit, the students were responsible for history-taking and for performing relevant examinations. Afterwards, the students made a joint care plan for the patient. Students, supervisors, and adjunct clinical lecturers discussed the outcomes in a seminar and reflected on each other’s professional roles. The students and the patients answered a questionnaire about the activity, and the supervisors and the adjunct clinical lecturers were interviewed in focus groups.

Findings:

Thirty interprofessional home visits were conducted, involving 109 students from six different healthcare professions. The students reported that they had gained insights into how different professions could collaborate and an increased understanding of teamwork. All patients were satisfied with the visits and felt that they had been listened to. The interview analysis showed one overarching theme: ‘Interprofessional home visits in primary healthcare were an appreciated and effective pedagogical learning activity with a sustainability dependent on organisational factors’.

Conclusions:

The students felt that participation in the activity increased their understanding of collaboration and of other professions’ skills. The supervisors found the home visits to be an appreciated and effective learning activity. The results indicate that this learning activity can be used in primary healthcare settings to promote students’ IPL, but organisational factors need to be considered in order to support sustainability.

An Integrative Review of Interprofessional Collaboration in Health Care: Building the Case for University Support and Resources and Faculty Engagement

BACKGROUND

In 2010, the World Health Organization issued a clarion call for action on interprofessional education and collaboration. This call came forty years after the concept of interprofessional collaboration (IPC) was introduced.

AIM

To conduct an integrative review of interprofessional collaboration in health care education in order to evaluate evidence and build the case for university support and resources and faculty engagement, and propose evidence-based implications and recommendations.

SEARCH STRATEGY

A literature search was conducted by an interprofessional faculty from a college of nursing and health sciences. Databases searched included CINAHL, Medline, Eric, Pubmed, Psych Info Lit., and Google Scholar. Keywords were interdisciplinary, interprofessional, multidisciplinary, transdisciplinary, health care team, teamwork, and collaboration. Inclusion criteria were articles that were in the English language, and published between 1995 and 2019.

REVIEW METHODS

Thirteen interprofessional team members searched assigned databases. Based on key words and inclusion criteria, over 216,885 articles were identified. After removing duplicates, educational studies, available as full text were reviewed based on titles, and abstracts. Thirty-two articles were further evaluated utilizing the Sirriyeh, Lawton, Gardner, and Armitage (2012) review system. Faculty agreed that an inclusion score of 20 or more would determine an article's inclusion for the final review. Eighteen articles met the inclusion score and the data was reduced and analyzed using the Donabedian Model to determine the structure, processes, and outcomes of IPC in health care education.

RESULTS

Structure included national and international institutions of higher education and focused primarily on undergraduate and graduate health care students' experiences. The IPC processes included curricular, course, and clinical initiatives, and transactional and interpersonal processes. Outcomes were positive changes in faculty and health care students' knowledge, attitudes, and skills regarding IPC, as well as challenges related to structure, processes, and outcomes which need to be addressed. Implications/Recommendations/Conclusions: The creation of a culture of interprofessional collaboration requires a simultaneous "top-down" and "bottom-up" approach with commitment by the university administration and faculty. A university Interprofessional Strategic Plan is important to guide the vision, mission, goals, and strategies to promote and reward IPC and encourage faculty champions. University support and resources are critical to advance curricular, course, and clinical initiatives. Grassroots efforts of faculty to collaborate with colleagues outside of their own disciplines are acknowledged, encouraged, and established as a normative expectation. Challenges to interprofessional collaboration are openly addressed and solutions proposed through the best thinking of the university administration and faculty. IPC in health care education is the clarion call globally to improve health care.

The impact of an interprofessional training ward on the development of interprofessional competencies: study protocol of a longitudinal mixed-methods study

BACKGROUND

To meet the patients' needs and to provide adequate health care, students need to be prepared for interprofessional collaborative practice during their undergraduate education. On interprofessional training wards (IPTW) undergraduates of various health care professions potentially develop a mutual understanding and improve their interprofessional competencies in clinical practice. To enhance collaboration of 6th-year medical students and nursing trainees in the third year of their vocational training an IPTW (Heidelberger Interprofessionelle Ausbildungsstation - HIPSTA) was implemented at the University Hospital Heidelberg, Germany. On HIPSTA future physicians and nurses take care of the patients self responsibly and in close interprofessional collaboration, supervised by facilitators of both professions. Although there are positive experiences with IPTWs internationally, little is known about the impact of IPTW on the acquisition of interprofessional competencies. For future interprofessional training and implementation of IPTWs evaluation of interprofessional learning and collaborative practice on Germany's first IPTW is of high relevance.

METHODS

To evaluate the acquisition of interprofessional competencies the study follows a mixed-methods approach. Quantitative data is collected from undergraduate participants, staff participants and facilitators on HIPSTA (intervention group) and undergraduate participants and staff participants on a comparable 'conventional' ward without special interprofessional training (comparison group) immediately pre and post HIPSTA and, as follow-up, after three to six months (T0, T1, T2), using three questionnaires, namely the University of the West of England Interprofessional Questionnaire (UWE-IP), the Interprofessional Socialization and Valuing Scale (ISVS) and the Assessment of Interprofessional Team Collaboration Scale (AITCS). Qualitative data is gathered in form of interviews and focus groups based on semi structured guidelines, video recordings of handovers and overt non-participant observations of daily rounds. Quantitative data will be analysed in a longitudinal comparison, presented descriptively and tested with an analysis of variance. Qualitative data will be analysed deductively and inductively.

DISCUSSION

The results of the evaluation will give insight in undergraduates', staff's and facilitators' experiences and their self-perception of competency development. In addition the results will help identify benefits, challenges and areas for modification when implementing and establishing similar interprofessional training wards.