Evaluating an interprofessional education curriculum: A theory-informed approach

Where is the voice of lived experience in interprofessional education? A scoping review

The main goal of interprofessional education (IPE) is to improve services and the quality of care for patients, their families, and communities. Enabling different professional learners, or others with relevant care roles, to learn together, is expected to advance care delivery. For both pre and post-registration learning, it therefore follows that listening to and working with service users is essential to underpin interprofessional learning. We completed a scoping review to identify how service users were involved in the design, delivery, and management of IPE. We searched the literature from the rise of curriculum alignment for IPE in 2000 to 2023, we identified 13 papers. Our analysis of these 13 papers showed that pre-registration students appreciated learning from service users' experiences of care but often the user input was not combined with a deeper appreciation for what this means for effective interprofessional practice. Post-qualified clinical teams involved service users in the design and development of services, often with care and support. Theoretical understandings about service user involvement in IPE for how learning took place or to explain the concepts involved, were limited. Where service users were involved in IPE, there was often little support with little attention to the skills of interprofessional facilitation. Theoretically informed research on the involvement of the service users voice in IPE requires further consideration.

Interprofessional learning to integrate care: organic strategic and systemic responses for change

In the first of three articles, we scanned global and national sources to help understand the concept and scope of integrated care. New policy directives seek closer working relationships between health and social care systems and practitioners to tackle modern challenges relating to the ageing population, poverty, disadvantage, and mental health. We identified that the practitioner workforce has not been fully considered or prepared for large shifts in working practices, often bringing new practitioners' roles to address local needs in newly managed interprofessional working systems for integrated care. In this second article, we consider the major themes identified by our review of integrated care policy to explore their implications for interprofessional learning, drawing on developmental pathways for interprofessional education from organic to strategic and systemic responses, to ask in what ways we will need to prepare our learners for these new ways of delivering integrated care.

How does interprofessional education affect attitudes towards interprofessional collaboration? A rapid realist synthesis

Interprofessional collaboration (IPC) in healthcare is regarded as important by professionals, as it increases the quality of care while decreasing costs. Interprofessional education (IPE) is a prerequisite for IPC and influences learners' attitudes, knowledge, and collaboration skills. Since attitudes shape behavior, understanding how they are formed is crucial for influencing IPC in learners' professional practice. We investigated what kind of IPE works, for which students, how, and in what circumstances to develop positive attitudes towards IPC. Using realist synthesis, we extracted causal mechanisms that produce positive attitude outcomes and the conducive contexts that trigger them. Our analysis resulted in six plausible context-mechanism-outcome configurations that explain positive attitude development. Positive IPC attitudes are more likely to arise in contexts where IPE provides time and facilities for formal and informal interactions, as this allows learners to get to know each other both professionally and personally, fostering trust, respect, and mutual liking. Additionally, positive attitudes are more likely in contexts where the IPE curriculum is perceived as career-relevant and boosts confidence. Key mechanisms of positive attitude development include getting to know the other learners professionally and personally, experiencing positive affect during IPE, and learners experiencing mutual dependence. Sustained positive attitudes are more likely to develop when there is organizational support for IPC and professionals attend IPE on an ongoing basis, allowing the attitudes and values expected in IPC to be positively reinforced and eventually integrated into the learners' personal value system.

What interprofessional education teaching and learning approaches are being implemented in baccalaureate health professional curricula in wound care education? A scoping review

AIM

This scoping review aimed to explore the interprofessional curriculum content and teaching approaches specific to wound care education in baccalaureate health courses internationally.

BACKGROUND

Interprofessional education is defined as occurring when future health practitioners learn with, from and about each other with the goal of improving health outcomes. The management of wounds is a global public health issue with the World Health Organization recognising wound care is best managed by an interprofessional team. The preparedness of health professional graduates to engage in interprofessional education is essential to design and deliver coordinated health services that are person-centred and improve health outcomes. There is a lack of evidence however about how to prepare baccalaureate students in an interprofessional context, specifically in wound care.

DESIGN

A scoping review was conducted using the framework of Arksey and O'Malley and reported using the PRISMA checklist for scoping reviews.

METHODS

A comprehensive search of the literature was conducted in MEDLINE (via EBSCOhost), CINAHL PLUS (via EBSCOhost), Pubmed and Embase databases published between 2012 and October 2023. Reference lists of included studies were also searched. Studies which were peer reviewed, written in English with a focus on interprofessional education in wound care were included in the review. The process of reviewing titles and abstracts was conducted by two independent reviewers. Data were extracted, key characteristics mapped and a narrative analysis of findings was reported.

RESULTS

Three studies were included in this review. All the reviewed papers reported collaborative learning activities between different health professional groups relating to wound care, although there was no consistent approach to what wound care content was delivered or how it was delivered. Only one study reported that the delivery of content was completed by staff from multiple professional groups. Evaluation of the included studies related to either the effectiveness of the interprofessional education or wound care rather than both concepts.

CONCLUSIONS

Due to the limited number of studies included in this review, it was difficult to draw conclusions about the effectiveness of interprofessional approaches to wound care. It may be possible that interprofessional wound care is currently being undertaken but not formally evaluated. This itself is problematic. It is imperative to equip healthcare students with the knowledge and skills necessary to provide safe, effective interprofessional care. Evidence on the effectiveness of educational programs is urgently needed.

REGISTRATION NUMBER

to be included in abstract after acceptance.

Variations in measurement of interprofessional core competencies: a systematic review of self-report instruments in undergraduate health professions education

Educating health care professionals for working in interprofessional teams is a key preparation for roles in modern healthcare. Interprofessional teams require members who are competent in their roles. Self-assessment instruments measuring interprofessional competence (IPC) are widely used in educational preparation, but their ability to accurately and reliably measure competence is unknown. We conducted a systematic review to identify variations in the characteristics and use of self-report instruments measuring IPC. Following a systematic search of electronic databases and after applying eligibility criteria, 38 articles were included that describe 8 IPC self-report instruments. A large variation was found in the extent of coverage of IPC core competencies as articulated by the Interprofessional Education Collaborative. Each instrument's strength of evidence, psychometric performance and uses varied. Rather than measuring competency as "behaviours", they measured indirect proxies for competence, such as attitudes towards core interprofessional competencies. Educators and researchers should identify the most appropriate and highest-performing IPC instruments according to the context in which they will be used.Systematic review registration: Open Science Framework (https://archive.org/details/osf-registrations-vrfjn-v1).

Realist review of interprofessional education for health care students: What works for whom and why

Interprofessional education (IPE) programs, are complex, logistically challenging, and can be expensive to deliver, but these matters are offset by the perceived benefits of IPE. There is little clarity regarding how IPE contributes to the desirable development of collaborative practitioners. To guide educators in the design of IPE programs there is a need to understand the elements that promote optimal learning. A realist review was conducted to identify the mechanisms and resources that contribute to IPE outcomes. Four databases were searched until April 2020 for empirical studies describing mandatory IPE for pre-registration medical, nursing and other health professional students. Twelve articles met the inclusion criteria. Two novel learning design elements were identified; interdependence, where there is a need for genuine contribution of skills and knowledge from the professions learning together to successfully complete tasks, and embodiment, where through being immersed in an authentic scenario, learners feel what it is like to work in their professions. Other observations supported previous research findings such as the importance of skilled facilitators to promote interaction and reflection. Interprofessional interventions incorporating these specific learning design features seem likely to enhance the impact of IPE, thus making the best use of limited institutional resources and student time.

The utility of an interprofessional education framework and its impacts upon perceived readiness of graduates for collaborative practice. A multimethod evaluation using the context, input, process, product (CIPP) model

BACKGROUND

Frameworks in higher education can support strategic curriculum change in complex systems. The impact of these frameworks in achieving their stated purpose is less known. An interprofessional education (IPE) framework and related multi-activity curriculum designed to develop health profession graduates with the requisite skills for collaborative care, was introduced in a large university, across eleven health professions.

OBJECTIVE

To determine the utility of an interprofessional framework and impact upon perceived work readiness for collaborative practice.

METHOD

A multimethod design using the context, input, process, product (CIPP) evaluation model was selected taking a social constructivist theoretical stance. Data collection included staffing allocation to IPE, curriculum audit, and reflections from representatives of all health professions courses offered at the institution. Data was analyzed using framework analysis.

PARTICIPANTS

Interviews or focus groups were undertaken with academic Faculty (n = 13), recent graduates (n = 24) and clinical supervisors/employers of recent graduates (n = 17).

RESULTS

The framework assisted the systematic implementation of interprofessional curriculum across the different health courses at the university. Collaborative work-ready learning outcomes were identified in graduates where targeted curriculum had been implemented across all four domains of the framework. Gaps identified in framework implementation were consistent with gaps identified in graduate knowledge and skills related to collaborative practice. The combination of formal university-based IPE and informal workplace learning as part of clinical placements contributed to achieving the desired learning outcomes.

CONCLUSIONS

These findings offer insights into the use of shared frameworks to drive specific learning activities related to collaborative practice.

State of the science: Quality improvement of medical curricula-How should we approach it?

INTRODUCTION

Quality improvement (QI) of the medical curriculum is generally regarded as a continuous process of evaluating whether the specific curriculum meets relevant educational and professional standards, implementing new activities or other measures to address perceived deficiencies, and subsequently re-evaluating the quality of the curriculum. QI is of consequence to medical learners, educators, patients, carers, specific disciplines and specialties, regulators and funders.

METHODS

To address how we should approach QI of medical curricula, a narrative review was undertaken, drawing mainly on medical/health professions education literature, identified through searches of the MEDLINE, EMBASE, PUBMED and ERIC databases, and also on exemplar curricular frameworks and evaluation reports. Assumptions and practices in QI of medical curricula were explored critically.

RESULTS

The review compares alternative conceptualisations of QI; asks questions about priorities and perspectives in what we choose to evaluate; reflects on standards used to guide QI; critically discusses methods, models and theoretical approaches to the generation of evaluation data; and considers ownership of, and engagement with QI of medical curricula.

CONCLUSIONS

Recommendations for curriculum teams include that discourse is necessary to achieve transparency and a shared understanding of continuous QI in a particular curricular context. Continuous QI requires data collection methods aligned to specific evaluation questions/foci; multiple methods for data collection, from different stakeholders; and appropriate evaluation models and theory to provide a framework for QI. Embracing a quality culture approach may increase the sense of ownership experienced by stakeholders. Mechanisms include creating democratic-collegiate cultures for multiple stakeholders to collaborate in QI; engaging stakeholders in QI activities and (e.g. SoTL) projects that contribute to holistic continuous QI; and proactively embedding quality in the (co-)creation of curriculum components and resources.

Flexible interprofessional student encounters based on virtual patients: a contribution to an interprofessional strategy

It is challenging to organize interprofessional activities in terms of coordinating students' various schedules. These challenges can be overcome by providing flexible online opportunities based on virtual patients (VPs). This study set out to study feasibility of using a blended approach based on virtual patients and a flexible interprofessional student encounter. The encounter was arranged in pairs or triads between nursing and medical students from two separate courses. Data were gathered through a questionnaire and followed up with group interviews. Reflective texts from the interprofessional encounters were analyzed in relation to descriptions of interprofessional competence. The great majority (86%) chose to meet online due to its flexibility. The participants gained an understanding of the other profession's roles and competences and a holistic patient awareness. Given its flexible and scalable opportunities, the blended online virtual patient approach provides a valuable contribution to an interprofessional programme.

A Multilevel Model for Evaluating Interprofessional Learning

Medical schools should engage in best practices for evaluating preclinical interprofessional collaborative programs. This innovation models a multilevel program evaluation of Interprofessional Clinical Experience (ICE), a required course for all first-year medical students. Data from student course evaluations and preceptor surveys determined that the course was effective at teaching interprofessional practices. Competency assessments showed nearly all students achieved the expected level. On the Readiness for Interprofessional Learning Scale, students increased their self-reported attitudes around interprofessional practices. Improvements to the ICE course will continue based on student and preceptor feedback from this multilevel program evaluation.

An Interprofessional Simulation-Based Orientation Program for Transitioning Novice Nurses to Critical Care Roles in the Emergency Department: Pilot Implementation and Evaluation

BACKGROUND

The emergency department (ED) relies on high-functioning teams to deliver consistent and safe patient care. Experts recommend that both emergency physicians and ED nurses participate in team training. However, there are currently no nationally accepted curricula for either profession to embed this training in their professional development, particularly for health workers who are novice or transitioning into critical care roles.

METHODS

An interprofessional educator team designed and embedded a series of simulation scenarios within a novel orientation program for novice nurses transitioning to critical care roles in the ED to teach clinical and teamwork skills for conjoint groups of resident physician and novice nurse learners. The team created four interprofessional simulations to represent the acuity and breadth of patient populations in the ED critical care bays.

INTERVENTION/REFINEMENT

To date, the team has conducted 24 two-week orientation sessions for 48 nurses and 51 resident physicians. Overall mean scores for the Debriefing Assessment for Simulation in Healthcare (DASH) instrument from nursing participants in the first 18 sessions were high. Qualitative evaluation data from both nurses and physicians demonstrated a positive impact of the simulations and provided insight into respective roles, identities, and priorities across professions. Participant feedback led to iterative steps in refinement of the simulations, including adjustments in debriefings and logistics of the orientation program.

IMPLICATIONS FOR PRACTICE

A team-based interprofessional simulation program was found to be feasible and acceptable for practicing novice physicians and nurses as part of a nursing critical care orientation program in the ED. Future work will assess the program's long-term impact on teamwork and safety in the actual clinical environment.

Quality of contact counts: The development of interprofessional identity in first year students

BACKGROUND

Little is known about how nursing and other healthcare students develop professional and interprofessional identities.

OBJECTIVES

This study a) measures changes in students' professional and interprofessional identities between the start and end of a faculty-wide interprofessional first year programme, and b) identifies factors influencing interprofessional identity strength at the end of the programme.

PARTICIPANTS

One hundred and eight first year nursing, medicine and allied health students.

METHODS

A single-group pre-post-test design was used. Students completed an online survey at the start and end of the year-long programme. The survey comprised measures of professional and interprofessional identity, stereotypes, contact and demographics. The same survey was used twice.

RESULTS

There was a small decline in professional identity and a large decline in interprofessional identity across the year. Nursing students, the only group involved in clinical practicums, were exempt from the large fall in interprofessional identity. Quality of contact with students from other professions and autostereotypes about own profession were predictors of interprofessional identity strength at the end of the programme, consistent with intergroup contact theory.

CONCLUSIONS

Introductory interprofessional education programmes should include opportunities for quality contact with students from other professions, and for students to develop a clear understanding of their own profession.

Organization and system theories in interprofessional research: a scoping review

In recent years, there has been an increasing impetus to define and develop theoretical foundations for interprofessional research. Currently, the theories cited in such research have often focused on individual and group learning. By comparison, organization and systems theories (OST) enable consideration of system and organization level factors. A scoping review was conducted to explore the use of OST in interprofessional research published between 2013 and 2019. Thirty-two studies were included and 13 OST were identified. Activity theory and complexity theory were the most commonly used OST. OST are relatively well integrated into data analysis and reporting of research findings, with less consideration given to how OST can support research designs. A primary reason researchers cited for selecting OST was that such theories could best reflect the complexity of interprofessional activities. OST provide a mechanism for understanding the nuances and multifactorial issues impacting interprofessional research. OST can thus address some of the challenges of introducing and sustaining interprofessional initiatives and should be further utilized within interprofessional research.

'Bumping along': a qualitative metasynthesis of challenges to interprofessional placements

CONTEXT

Interprofessional practice is required to manage complex health care needs globally. It is well established that interprofessional placements (IPP) prepare students to work collaboratively, yet IPP implementation remains limited and disjointed.

OBJECTIVES

This review synthesised student, educator and service user perspectives in order to better understand challenges of IPP and provide recommendations for sustainable IPP implementation.

METHODS

A systematic metasynthesis of qualitative literature sourced from databases including CINAHL, Embase and PsycINFO was completed. Studies that incorporated student, educator and/or service user perspectives on IPP experiences were included. We focused specifically on factors limiting implementation of IPP. The presage-process-product (3P) theory provided the theoretical framework for inductive synthesis of 41 empirical studies. A confidence rating for findings was formulated using CERQual (confidence in evidence from reviews of qualitative research).

RESULTS

We developed three themes, which represent key challenges to IPP becoming embedded in placement culture: (i) thin theoretical foundations underpinned IPP, limiting understanding of the learning processes involved; (ii) implementation relied heavily on individual champions, which curtails investment and sustainability when personnel change, and (iii) students, educators and service users were unsure of the function of IPP and their respective roles, leading to uncertainty along with some negative perceptions of this placement approach.

CONCLUSIONS

In line with the 3P theoretical framework, IPP would benefit from explicit connections with educational and change management theories during presage stage IPP requires coordinated leadership and resource investment, and during product stage clear integration of interprofessional learning outcomes in curricula is advised. Addressing the identified challenges across the stages of IPP will support further development of IPP, firmly establishing this approach within placement culture. IPP can them make a significant contribution to the development of a collaborative practice-ready workforce. This in turn will enhance service user outcomes and safety.

Interprofessional clinical training in mental health improves students' readiness for interprofessional collaboration: a non-randomized intervention study

BACKGROUND

Over the past decades, the health sector in general has increasingly acknowledged the effectiveness of interprofessional clinical training in enhancing teamwork. In psychiatry, however, knowledge of the benefits of collaborative clinical training is sparse. This study aimed to investigate the impact of interprofessional training on students' readiness for interprofessional collaboration in a psychiatric ward.

METHODS

An intervention study assessed interprofessional clinical training in a training ward. Undergraduate students from the disciplines of medicine, nursing, psychotherapy, pedagogy, and social work were allocated either to an intervention group receiving interprofessional training or to a comparison group receiving conventional clinical training. Outcomes were assessed using the Readiness for Interprofessional Learning Scale (RIPLS) and the Assessment of Interprofessional Team Collaboration Scale (AITCS). Linear mixed regression was used to compare differences in mean scores postintervention, adjusted for baseline score, gender, and profession.

RESULTS

Mean postintervention scores were higher in the intervention group (n = 87) than in the comparison group (n = 108) for both scales (overall sum score). For the RIPLS, the mean difference was 2.99 (95% CI 0.82 to 5.16; p = 0.007); for the AITCS it was 8.11 (95% CI 2.92-13.30; p = 0.002). Improvement in readiness for interprofessional learning and team collaboration in the intervention group remained statistically significant after adjustment for baseline differences between the two groups.

CONCLUSION

Students' self-reported readiness for interprofessional learning and their team collaboration were improved after interprofessional clinical training. Still, further studies of both the processes and the long-term effects of undergraduate IPE in mental healthcare are needed. The study was registered March 62,017 on ClinicalTrials.gov: NCT03070977 (Retrospectively registrered).

Building a Theoretically Grounded Curricular Framework for Successful Interprofessional Education

Experts in the field of interprofessional education (IPE) have called for the use of theory in curriculum design to produce better results with measurable outcomes. While evidence of this practice is growing in the IPE literature, publications about using theoretical approaches to inform curricular design in pharmacy education is nonexistent. This paper describes the process used at the University of Washington for developing a theoretically grounded framework to anchor and guide curriculum design. Faculty charged with implementing IPE at other institutions may learn from our team's approach to co-creating an inclusive framework, developing a common philosophy, and applying appropriate theory in building a framework to guide curriculum development and IPE implementation.

Interprofessional education (IPE) in clinical practice for pre-registration nursing students: A structured literature review

OBJECTIVES

To explore the experiences of nursing students after clinical IPE activities through a review of contemporary literature then use the context of nursing programmes in Singapore to consider the transferability of the findings.

DESIGN

Structured literature review.

DATA SOURCES

A search of international qualitative literature no older than five years and published in English was conducted on CINAHL, Embase, Medline and Pubmed.

REVIEW METHODS

A systematic and structured approach was guided by Cooper's five-step approach to review the literature. The Critical Appraisal Skills Programme qualitative checklist and the Appraisal of Guidelines Research & Evaluation reporting checklist were used to critically appraise literature in this review.

RESULTS

13 papers were included for qualitative synthesis. The literature most commonly reported that students had a better understanding of professional roles, improved communication and teamwork. In contrast, the most commonly reported negative experience involved some examples of disparity within the team.

CONCLUSION

Overall findings show that positive student experiences outweigh negative ones. Nursing programmes might be able to reap similar outcomes subject to contextual and cultural differences. However, further research is recommended before IPE in clinical practice is implemented in current nursing programmes in the local setting.

Characteristics of two questionnaires used to assess interprofessional learning: psychometrics and expert panel evaluations

BACKGROUND

Interprofessional learning activities are included in many curricula but are difficult to assess. For languages that are not widely spoken such as Swedish, few validated questionnaires exist that relate to interprofessional outcomes. Therefore, the aim was to examine two such questionnaires in relation to interprofessional competence domains.

METHODS

Psychometric characteristics, such as homogeneity of items and internal consistency, were assessed for the Swedish versions of the Jefferson Scale of Attitudes Towards Physician-Nurse Collaboration (JSAPNC) and the Readiness for Interprofessional Learning Scale (RIPLS). The questionnaires were distributed directly following IPL activities. Mokken scale analysis based on Loevinger's coefficient for homogeneity and Cronbach's alpha were used to evaluate the scales. Two expert panels performed a qualitative analysis of items in relation to four internationally defined interprofessional competences.

RESULTS

In total, 88 and 84 responded to the JSAPNC and RIPLS questionnaires, respectively. Estimates of homogeneity were low for both the JSAPNC (H = 0.16) and the RIPLS (H = 0.21). Reliabilities were weak (0.62 and 0.66, respectively) for the total scales. The expert panels categorised 68% of items into similar competence domains. However, their discussion revealed ambiguous wordings and imbalances in the two questionnaires in relation to domains.

CONCLUSION

Interprofessional competence domains are defined but few validated tools exist to assess them. Examined tools relating to interprofessional learning in Swedish do not qualify for assessing overarching IPL outcomes, and summed scores from these tools should be used with caution.

Assessment of Resident Physicians' Communicator and Collaborator Competencies by Interprofessional Clinicians: A Mixed-Methods Study

Phenomenon: As we move toward competency-based medical education, greater emphasis is being placed on assessing a more comprehensive skill set, including the ability to communicate and collaborate effectively in the workplace. Nonphysician members on interprofessional (IP) teams have valuable perspectives on actual resident performance and are often not adequately engaged in the provision of feedback to residents. Based on the educational theories of collaborative evaluation and social constructivism, this research examined the ability of IP clinicians to provide feedback to residents. The aim of this study was to examine IP clinicians' perceptions of their ability to provide formative feedback, through their observations and assessments of developmental pediatric residents, compared to physician supervisors on the rotation, and to qualitatively explore potential barriers to the feedback process from their perspective.

APPROACH

This explanatory, sequential mixed-methods design study first examined which and how many of the CanMEDS Communicator and Collaborator training objectives (N = 40) were considered to be observable and assessable by IP clinicians and physicians. A comparison of the mean number of objectives that were observed and practically assessed by (a) each group (IP clinicians vs. physicians) and (b) clinical service teams during the core developmental pediatrics rotations, were examined using independent t tests. Second, a thematic qualitative analysis of focus groups was used to develop a contextual understanding of the factors that influenced this process. Data were analyzed using three levels of open coding and descriptive qualitative analysis techniques.

FINDINGS

Physicians reported they could observe (M = 33.3, SD = 5.2, 83.3%) and assess (M = 31.5, SD = 7.3, 79%) a larger number of objectives compared to the IP clinician group (M = 24.7, SD = 8.6, 61.8% and M = 20.3, SD = 10.6, 51%, respectively). There were no differences between the clinical service teams (i.e., preschool/school-age and pediatric rehabilitation). The objective that was most observable and assessable by the IP clinicians was "Demonstrates a respectful attitude towards other colleagues and members of an interprofessional team." Four themes identified by the IP clinicians provided more in-depth qualitative information: (a) assessment requires more than simple observation, (b) assumptions and indirect observation influence assessment, (c) clinic culture and structure shapes observation and assessment, and (d) specific assessment criteria are required by IP clinicians. Insights: IP clinicians have the desire and ability to provide formative feedback to residents. Formalized processes with specific evaluation criteria would facilitate meaningful feedback from IP clinicians in the assessment of residents as they journey toward competence.

Virtual Patients in a Behavioral Medicine Massive Open Online Course (MOOC): A Qualitative and Quantitative Analysis of Participants' Perceptions

OBJECTIVE

The purpose of this article is to explore learners' perceptions of using virtual patients in a behavioral medicine Massive Open Online Course (MOOCs) and thereby describe innovative ways of disseminating knowledge in health-related areas.

METHODS

A 5-week MOOC on behavioral medicine was hosted on the edX platform. The authors developed two branched virtual patients consisting of video recordings of a live standardized patient, with multiple clinical decision points and narration unfolding depending on learners' choices. Students interacted with the virtual patients to treat stress and sleep problems. Answers to the exit survey and participant comments from the discussion forum were analyzed qualitatively and quantitatively.

RESULTS

In total, 19,236 participants enrolled in the MOOC, out of which 740 received the final certificate. The virtual patients were completed by 2317 and 1640 participants respectively. Among survey respondents (n = 442), 83.1% agreed that the virtual patient exercise was helpful. The qualitative analysis resulted in themes covering what it was like to work with the virtual patient, with subthemes on learner-centered education, emotions/eustress, game comparisons, what the participants learned, what surprised them, how confident participants felt about applying interventions in practice, suggestions for improvement, and previous experiences of virtual patients.

CONCLUSIONS

Students were enthusiastic about interacting with the virtual patients as a means to apply new knowledge about behavioral medicine interventions. The most common suggestion was to incorporate more interactive cases with various levels of complexity. Further research should include patient outcomes and focus on interprofessional aspects of learning with virtual patients in a MOOC.

What makes medical students receptive to interprofessional education? Findings from an exploratory case study

Interprofessional education (IPE) continues to grow as a field internationally, and therefore has become a key activity which numerous institutions have implemented around the world. A number of learner characteristics have been suggested as being important for the success of interprofessional interventions, including prior experiences, expectations, and motivations. This study sought to explore medical student engagement with IPE and the factors that affect this. Twelve final and penultimate year students took part in two focus groups to discuss previous IPE and the factors which they felt led to successful interprofessional experiences. Thematic analysis was used to interpret the data. Students were found to be receptive to the idea of IPE, but had some reservations about its current form. Students were enthusiastic about clinically relevant IPE experiences, but were put off by generic teambuilding exercises, especially those with a poor mix of professional groups. They also reported being aware of interprofessional tensions and communication issues, which they felt might be alleviated through frequent interprofessional contact at the undergraduate level. This study suggests that medical students desire realistic, clinically relevant, interprofessional experiences, with a good mix of professionals, through which they can gain more awareness of their own role and that of other professionals.