A mixed-methods evaluation of interprofessional education in palliative care: changes in student attitudes towards health professions

This integrative review synthesizes research studies in order to explore the perceptions of allied health professionals regarding interprofessional collaboration in primary health care. A comprehensive literature search was conducted using three electronic databases and a manual search of the Journal of Interprofessional Care. The Crowe Critical Appraisal Tool was used to assess the quality of included papers. Study findings were extracted, critically examined and grouped into themes. Twelve studies conducted in six different countries met the inclusion criteria. Thematic analysis revealed five themes: (1) shared philosophy; (2) communication and clinical interaction; (3) physical environment; (4) power and hierarchy; and (5) financial considerations. This review has identified diverse key elements related to interprofessional collaboration in primary health care, as perceived by allied health professionals. Opportunity for frequent, informal communication appeared essential for interprofessional collaboration to occur. Allied health professionals working in close proximity to health practitioners from other professions had more regular interprofessional interactions than those who were geographically separated. Co-location of multiple primary health care services within the same physical space may offer increased opportunities for interprofessional collaboration. Future research should avoid reporting on allied health professionals in primary health care collectively, and isolate data to the individual professions. Direct observational methods are warranted to investigate whether allied health professionals’ perceptions of interprofessional collaboration align with their actual clinical interactions in primary health care settings.

Interprofessional education can promote healthcare professionals' competence to work in interprofessional collaboration, which is essential for the quality and safety of care. An interprofessional approach is particularly important in complex, chronic diseases like diabetes. This qualitative study evaluated changes in medical and nursing students' perceptions of interprofessional collaboration, induced by a novel interprofessional education course on diabetes care with practical elements. Data from focus-group interviews of 30 students before and after the course were analyzed by using inductive and deductive content analysis. The students’ perceptions were illustrated as Elements of Collaborative Care (e.g. Quality of professional care relationship) and Elements of Interprofessional Collaboration (e.g. Importance of communication and Valuation of collaboration). The post-course interviews added one subcategory (Need of resources) to the pre-course perceptions, and there was improvement in ten areas of self-perceived competence in performing or understanding interprofessional collaboration on diabetes care. The course improved the students' self-perceived competence and confidence in interprofessional collaboration on the care of patients with diabetes, and their understanding of interprofessional collaboration changed towards a more patient-centred and holistic perspective. The findings support further implementation of IPE with practical elements in future health professionals’ education.

A qualitative study was conducted to examine the experiences of informal caregivers of persons with dementia pertaining interprofessional collaboration with and among healthcare professionals in home care (HC), nursing homes and during home to nursing home transitions in palliative care. Semi-structured interviews were performed with bereaved informal caregivers. Data were analysed using a critical realist approach. The two main themes that emerged were: (1) Informal caregivers’ roles in interprofessional collaboration with healthcare professionals and (2) Informal caregivers’ perception of interprofessional collaboration among healthcare professionals. Informal caregivers’ roles were identified in three collaboration processes: information exchange, care process and shared decision-making. Interprofessional collaboration among healthcare professionals was more perceptible on the collaboration outcome level (e.g. being up to date with the health status of the person with dementia; acting proactive, being adequate and consistent in the care process; and giving a warm welcome) than on the collaboration processes level (e.g. communicating and being involved in team processes). Our study revealed that intrinsic and extrinsic factors and interprofessional collaboration among healthcare professionals affected informal caregivers’ collaborative roles. In summary, our study showed that informal caregivers have important roles as team members in the continuity and quality of palliative care for persons with dementia.

Increased demand for interprofessional collaboration within the educational field also increases the need for the development and evaluation of interventions to improve collaboration. In Norway, the LOG model was developed and implemented in compulsory schools to facilitate interprofessional collaboration by increasing arenas for more efficient use of existing interprofessional resources. We evaluate the effects of the model on teachers’ perceptions of interprofessional collaboration in a cluster-randomized trial, with 19 schools randomized to the experimental group and 16 schools to the control group. We use data from 5th–7th grade teachers in the 35 participating schools (N = 157) prior to randomization and one-year into the implementation. Response rates were 70% and 74%, respectively. The PINCOM-Q scale was used to analyze effects of the model on various dimensions of interprofessional collaboration. At the one-year follow-up, the LOG model demonstrates no significant effects on teachers’ perceptions of interprofessional collaboration. However, there is an indication of effect on the organizational aim dimension (ES = −0.39, CI = −0.82–0.03), but the evidence is not conclusive.

The improvement of basic cultural competency skills and the creation of a greater community-minded spirit among dental students are important parts of dental education. The purpose of our study was to assess changes in dental students' attitudes and beliefs about community service and changes in cultural competencies after participation in a two-year program of non-dental community service (Student Community Outreach Program and Education, SCOPE). During 2003-07, two identical twenty-eight-item surveys were administered to SCOPE participants/completers. In the first, students reported on their attitudes after program completion. In the second, students reported retrospectively on their attitudes prior to starting the program. One hundred twenty-six post- and pre-intervention surveys were matched and assessed for changes in student attitudes after program participation. Based on factor analysis, four distinct scales were identified: 1) community service, 2) cultural competence, 3) communication, and 4) treatment perspective. Over time, statistically significant changes (p<.05) in student attitudes and beliefs were found for scales 1 (p=.017), 2 (p=.001), and 3 (borderline significance, p=.057). Scale 4 showed no significant difference (p=.108). These scales indicate main focus areas to help guide future dentists in acquiring relevant sociocultural competencies and enabling community-minded attitudes. Overall, this study provides support for the addition of a non-dental community service-learning program into the preclinical curriculum.

Older people admitted to hospital are highly susceptible to functional decline and related complications. Care supporting their functioning is complex and requires healthcare professionals working in concert, with nurses playing a central role. Yet, little is known about nurses' perceptions of interprofessional collaboration (IPC) in care supporting functioning in acutely admitted older people. To fill this knowledge gap, we elucidate the perspectives of nurses in Ontario, Canada, on IPC in care supporting older people's functioning during a hospital stay. We employed a qualitative methodology in conjunction with a qualitative descriptive design. Thirteen focus groups were held with a purposeful, criterion-based sample of 57 acute care nurses practising in a range of acute care settings (e.g. Emergency, General Medicine, General Surgery, Intensive Care, Coronary Care). Data were thematically analysed. We identified two overarching themes: (1) IPC is improving, but nurses are excluded from decision-making and (2) nurse advocacy causes friction with other professionals. The first theme captures nurses' perception that IPC in older people's care is improving, but nurses are marginalised in interprofessional decision-making. As a result, nurses perceive that their knowledge is devalued, and their contributions to care supporting older people's functioning are undermined. The second theme underlines a tension between interprofessional team practices and patient- and family-centred care, while also demonstrating nurses' increasing willingness to act as patient and family advocates. Findings can be used to enhance IPC in care supporting the functioning of acutely hospitalised older people. To improve IPC, clinical and administrative leaders should cultivate more egalitarian team relationships that encourage nurses to contribute to decision-making and advocate on behalf of older patients and their families.

Objective: To know, through an integrative literature review, the challenges for the teaching of bioethics and palliative care (PC) in the training of health professionals at the national level. Methods: This is an integrative literature review, carried out by original and complete articles available online published in the following databases: Virtual Health Library (VHL), Online Scientific Electronic Library (SciELO) and the Journals portal of the Coordination of Improvement Higher Education Personnel (CAPES) – CAPES periodicals, published in the last five years, corresponding to the period from 2017 to 2021 and in portuguese. Results: 10 articles were included in the final study sample. two thematic categories, entitled: Category 1 – Challenges of inserting bioethics and palliative care in the process of training health professionals and Category 2 – Knowledge of undergraduates and recent graduates about palliative care at graduation. It was observed that, in Brazil, the teaching of PC is still small in the curriculum of undergraduate courses in Medicine. Generally, when offered, they are inserted as part of content in other major areas. In Nursing, the discipline with punctual progress is already observed. noting that, the lack of knowledge of the subject even in the graduation makes the practice in health harmful, hindering the professional-patient-family relationship. Final considerations: The results showed that the teaching of Palliative Care during graduation has little expression in undergraduate medical curricula, with evidence of the absence of the mandatory or optional discipline of Palliative Care and, with advancement in nursing.

INTRODUCTION The purpose of this study was to assess changes in attitudes toward interprofessional collaborative competency attainment of undergraduate dietetics, gerontology/long term care administration, and occupational therapy assistant (OTA) students as a result of participating in a problem-based simulated nursing home dining experience. METHODS A one-group quasi-experimental post-test design, with convenience sample, was used in this study. Forty-three students completed the Interprofessional Collaborative Competencies Attainment Survey (ICCAS) tool, a validated 20-item scale measuring attitudes toward interprofessional collaborative competency attainment. The ICCAS assesses six competencies: communication, collaboration, roles and responsibilities, collaborative patient/familycentered approach, conflict management/resolution and team functioning. A paired-sample t-test was conducted to evaluate the impact of the dining simulation on students’ ICCAS responses. RESUlTS A statistically significant increase was found in the ICCAS summative score from the retrospective look designated as Time 1 (M=108.95; SD=19.76) to Time 2 [M=127.65; SD=17.86, t(42)= -8.63, p<.0005]. CONClUSION The results of this study have potential implications for educators, practitioners and researchers. Careful planning during case development enhanced the realism and accuracy of the simulation. This nursing home dining simulation using problem-based case scenarios was found to be an effective method of promoting interprofessional collaborative competencies with a unique group of healthcare students. Received: 04/11/2016 Accepted: 12/14/2015 © 2016 Arvin et al. This open access article is distributed under a Creative Commons Attribution License, which allows unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. H IP & Interprofessional Education Nursing Home Dining Simulation ORIGINAL RESEARCH 2(4):eP1078 | 2 Introduction Healthcare educators in academia are challenged with meeting complex discipline-specific standards while also incorporating interprofessional skill development into their curricula. Interprofessional education (IPE) and healthcare simulation (HCS) can be used to promote collaboration and teamwork among students of multiple disciplines. Although IPE and HCS have been in existence for decades as unique fields, research exploring how these two fields overlap is relatively new (Palaganas, Epps, & Raemer, 2014). Research in this area has primarily involved medical students, nursing students, physical therapy students, and pharmacy students (Buckley, Hensman, Thomas, Dudley, Nevin, & Coleman, 2012; Efstathiou & Walker, 2014; Kyrkjebo, Brattebo, & Smith-Strom, 2006; Stephens et al., 2011) and, to date, does not include IPE nursing home environment simulations. The purpose of this study was to assess changes in IPE attitudes and competence among undergraduate dietetics, gerontology/long term care administration, and occupational therapy assistant students who participated in a problem-based simulated nursing home dining experience.

Interprofessional collaboration is necessary for handling the complex psychosocial needs of prisoners. This collaboration must be addressed to avoid high recidivism rates and the human and societal costs linked to them. Challenges are exacerbated by a linear approach to handling prisoners' problems, silo working between welfare agencies and professional boundaries between frontline workers. There are few adequate theoretical frameworks and tools to address these challenges in the prison context. The purpose of this study is to explore the perceptions that frontline staff working in Norwegian prison facilities have regarding interprofessional collaboration in providing mental health services for prisoners. This study had a non-experimental, cross-sectional design to explore perceptions of interprofessional collaboration in a prison context. Descriptive and multifactorial analyses (exploratory factor analysis and confirmatory factor analysis) were used to explore the data. The analysis showed that three factors, communication, organizational culture and domain, explained 95% of the variance. Results are discussed using relational coordination, as well as the conceptual PINCOM model, as a theoretical framework. Few studies explicitly explore collaboration between professionals in mental health and prison services despite its being a prerequisite to achieving sufficient services for prisoners. To our knowledge, this current study is one of the first in Norway to explore collaboration in a prison context by analysing quantitative data and focusing on frontline workers perception of the phenomenon.

This article focused on presenting data collection of nurses' perceptions and practices of interprofessional collaboration at Muhammadiyah hospitals in Six regions in East Java, (Surabaya, Gersik, Lamongan, Sidoarjo, Banyuwangi, and Bojonegoro) Indonesia. The survey was conducted on nurses’ perceptions and practices towards interprofessional education in hospitals. The survey was conducted using a structured questionnaire administered to 312 nurses at Muhammadiyah hospitals in East Java province which was the second largest population after West Java province and the province with the highest number of Muhammadiyah hospitals in Indonesia. The survey involved nurses working at these hospitals and was conducted from June to December 2019. The questionnaire was used for data collection consisted of 24 questions on perception of inter-professional collaboration, and 21 questions on inter-professional collaborative practices using a Likert scale measure. The data were analyzed using quantitative descriptive statistical analysis.

The lack of discipline of post-PKL students at vocational schools requires genuine efforts to maintain academic achievement and preparation for the world of work. This research aims to determine efforts to improve the discipline of vocational school students after the PKL program at SMK MUH 1 Sukoharjo—descriptive qualitative research using the Miles &amp; Huberman method. Data was obtained through non-participant interviews, direct observation, and documentation studies of students, teachers, and SMK MUH 1 Sukoharjo staff. Data analysis includes data reduction, presentation, and conclusion to understand efforts to improve student discipline after PKL. The research found that the PKL program at SMK MUH 1 Sukoharjo was a strategic step in improving student discipline. This can be seen from an increased understanding of discipline application of disciplinary values, to positive changes in students' attitudes and behavior. This positive impact is not only felt in daily life at school but also leads to a significant increase in academic achievement. The PKL program at SMK MUH 1 Sukoharjo has succeeded in creating a learning environment that supports the holistic formation of student character and discipline. In conclusion, the PKL program at SMK MUH 1 Sukoharjo has succeeded in proving its effectiveness in improving student discipline, as seen by increasing understanding of the concept of discipline, application of values, to positive changes in student attitudes and behavior, as well as positive changes in student attitudes and behavior—significant increase in academic achievement.

The pedagogic usefulness of the computer is examined by focusing on student attitudes and use of computers in a “computer-enriched” environment. Our analysis uses data from three years of a five-year longitudinal study at Wake Forest University. The results indicate that a computer-enriched environment is positively correlated with student attitudes toward computers in general, their role in teaching and learning, and their ability to facilitate communication. In addition, there were few changes in attitudes for students who did not have seamless access to the network. This study concludes that a networked institution where students have easy access can foster positive attitudes toward the use of computers in teaching and learning.

By 2030, the population of individuals living in the United States aged 65 or older is estimated to reach 71.88 million people. In turn, rehabilitation professionals will be tasked with meeting increased levels of need. One approach for promoting health and well-being is physical activity (PA) which holds potential for reducing secondary health conditions and disability. This article examined (a) student attitudes toward PA interventions for aging individuals living with functional limitations, and (b) how student attitudes toward PA interventions might change following a service learning activity. A pre-test/post-test design was utilized. Results indicated that students tended to hold favorable attitudes regarding PA as a health promoting intervention. As a class cohort, no significant changes in student attitudes were observed. However, when evaluated by major, evidence for the value of experiential learning was noted, in addition to interesting changes in the attitudes of non-rehabilitation and human services majors.

PurposeThe purpose of this paper is to report on the findings of the first stage of a project seeking to evaluate and overcome inter-professional barriers between health and social care staff within a single, co-located, integrated community team. The project seeks to answer the following questions: first, Do inter-professional barriers to integrated working exist between health and social care staff at the interface of care delivery? Second, If inter-professional barriers exist, can joint health and social care assessments help to overcome them? The paper develops the current evidence base through findings from a staff questionnaire and the initial findings of a pilot study of joint health and social care assessments aimed at overcoming inter-professional barriers to integration.Design/methodology/approachThe first stage of the project involved running an anonymous, online questionnaire with health and social care staff within a single, co-located community adult health and social care team. The questionnaire aimed to explore staffs’ perceptions of inter-professional collaboration when assessing the health and care needs of service users with a high degree of complexity of need. The second element of the study presents the initial findings of a small pilot of joint health and social care assessments. A second staff survey was used in order to provide a “before and after” comparative analysis and to demonstrate the effect of joint assessments on staffs’ perceptions of inter-professional collaboration at the interface of care delivery.FindingsHealth and social care staff value joint working as a means of improving quality of care. However, they also felt that inter-professional collaboration did not occur routinely due to organisational limitations. Staff members who participated in the pilot of joint assessments believed that this collaborative approach improved their understanding of other professional roles, was an effective means of enabling others to understand their own roles and helped to better identify the health and care needs of the most complex service users on their caseloads. Initial findings suggest that joint assessments may be a practical means of overcoming inter-professional barriers related to a lack of communication and lack of understanding of job roles.Practical implicationsThe questionnaires highlighted the need for integration strategies that are aimed at facilitating collaborative working between staff of different professions, in order to achieve the aims of integration, such as a reduction in duplication of work and hand-offs between services.Originality/valueTo date, few studies have explored either staff perceptions of collaborative working or the effectiveness of joint assessments as a means of overcoming inter-professional barriers. This paper adds new data to an important area of integration that legislators and researchers increasingly agree requires more focus. Although the findings are limited due to the small scale of the initial pilot, they provide interesting and original data that will provide insight into future workforce integration strategies.

Objective: The aim of this research was to determine the changes in medical student attitudes toward nutrition counseling after implementation of a novel curricular activity during a required third-year clerkship. Method: All third-year medical students completing their required family medicine clerkship were invited to participate in a voluntary survey composed of the Nutrition in Patient Care Survey (NIPS) and demographics before their required curricular clerkship activity consisting of two separate case-based modules focused on nutritional aspects of patient care. Students and faculty facilitators met via web platform at an assigned time to review and discuss questions. All students were invited to complete the postsurvey composed of only the NIPS. Results: Completion rate was 31% for both pre- and postsurveys. Students’ intended specialty choice did not lead to a significant difference in scores on any of the five subscales on pre-intervention surveys. Almost half (43.9%) of the students who completed the surveys reported offering nutrition-related counseling despite lack of formal training. The Physician–Patient Relationship score went from 4.29 to 4.37 (p < 0.03) and the Physician Efficacy score went from 3.18 to 3.34 (p < 0.01). The was no significant difference identified pre- versus postintervention for the Clinical Behavior scales. Conclusions: The modules used in this pilot study resulted in positive changes in student attitudes toward counseling patients about nutrition. The inclusion of required case-based modules focused on nutrition is feasible and can positively impact student attitudes regarding their efficacy in counseling patients.