Assessment of an Innovative Medication Adherence Training Exercise in an Interprofessional Training Program

Just-in-time interprofessional training: lessons from the NHS Nightingale London

BackgroundA common approach to enhance patient-centered care is training care professionals. Additional training of patients has been shown to significantly improve patient-centeredness of care. In this participatory design and evaluation study, patient education and medical education will be combined by co-creating a patient-centered and interprofessional training program, wherein patients, students and care professionals learn together to improve patient-centeredness of care.MethodsIn the design phase, scientific literature regarding interventions and effects of student-run patient education will be synthesized in a scoping review. In addition, focus group studies will be performed on the preferences of patients, students, care professionals and education professionals regarding the structure and content of the training program. Subsequently, an intervention plan of the training program will be constructed by combining these building blocks. In the evaluation phase, patients with a chronic disease, that is rheumatoid arthritis, diabetes and hypertension, and patients with an oncologic condition, that is colonic cancer and breast cancer, will learn together with medical students, nursing students and care professionals in training program cycles of three months. Process and effect evaluation will be performed using the plan-do-study-act (PDSA) method to evaluate and optimize the training program in care practice and medical education. A modified control design will be used in PDSA-cycles to ensure that students who act as control will also benefit from participating in the program.DiscussionOur participatory design and evaluation study provides an innovative approach in designing and evaluating an intervention by involving participants in all stages of the design and evaluation process. The approach is expected to enhance the effectiveness of the training program by assessing and meeting participants’ needs and preferences. Moreover, by using fast PDSA cycles and a modified control design in evaluating the training program, the training program is expected to be efficiently and rapidly implemented into and adjusted to care practice and medical education.

Social workers and other behavioral health professionals trained to provide prevention, treatment, and recovery services for opioid use disorders (OUD) remain urgently needed in the U.S. particularly in states with widespread health professional shortage areas. To help mitigate this workforce gap, faculty in social work and nursing at a public university in Alabama developed and piloted an innovative HRSA-funded interprofessional traineeship to prepare graduate-level nursing and social work students to assess and treat opioid use disorders (OUD). The yearlong traineeship included specialized coursework on evidenced-based practice in addictions, interprofessional telemedicine and simulation training, and multi-semester field practica in outpatient treatment settings. Impact of the pilot training was evaluated using a pre-experimental one group design. Baseline and post-training surveys assessed knowledge, attitudes, and skills related to OUD and interprofessional practice and perceived program impact. Significant increases were observed for trainees’ self-reported knowledge, attitudes, and skills. Moreover, at graduation students reported that the traineeship had improved their abilities to interact with underserved populations, collaborate interprofessionally, and understand ethical issues in SUD treatment as well as enhancing their professional competence, clinical problem-solving, and health workforce skills. Findings suggest that the interprofessional training program may prepare social work and nursing graduate students to effectively serve clients with OUD and help to address a critical workforce gap in medically underserved communities.

Challenges and opportunities for new medical schools in Africa.

For implementation of patient-centered treatment in interprofessional health care units, such as rehabilitation teams, external participation (interaction between patient and health care professionals) and internal participation (communication, coordination and cooperation in the interprofessional team) need to be considered. The aim of this study is to identify the preferences of patients and health care professionals concerning internal and external participation in rehabilitation clinics, in order to develop an interprofessional shared decision-making (SDM) training program for health care professionals to enhance both types of participation. Therefore, a cross-sectional mixed-methods study was implemented in four rehabilitation clinics. The study consists of two parts: focus groups with patients and a survey of experts (senior health care professionals from medicine, psychotherapy, physical therapy and nursing). More time, more respect from the health care professionals and the desire for more participation in decision-making processes were mentioned most frequently by patients (n = 36) in the focus groups. The health care professionals (n = 32) saw most deficits in internal participation, e.g. management of feedback, talking with difficult team members and moderate conflict discussion. The results of both assessments have been used to develop an interprofessional SDM training program for implementing internal and external participation in interprofessional teams in medical rehabilitation.

BackgroundTreatment for rifampicin-resistant Mycobacterium tuberculosis (RR-TB) is complex, however, shorter treatment, with newer antimicrobials are improving treatment outcomes. The South African National Department of Health (NDoH) recently accelerated the rollout of 9-month, all-oral, RR-TB short-course regimens. We sought to evaluate an inter-professional training program using pre-test and post-test performance of Professional Nurses (PNs), Advanced Practice Professional Nurses (APPNs) and Medical Officers (MOs) to inform: (a) training needs across cadres; (b) knowledge performance, by cadres; and (c) training differences in knowledge by nurse type.MethodsA 4-day didactic and case-based clinical decision support course for RR-TB regimens in South Africa (SA) was developed, reviewed and nationally accredited. Between February 2017 and July 2018, 12 training events were held. Clinicians who may initiate RR-TB treatment, specifically MOs and PN/APPNs with matched pre–post tests and demographic surveys were analyzed. Descriptive statistics are provided. Pre–post test evaluations included 25 evidence-based clinically related questions about RR-TB diagnosis, treatment, and care.ResultsParticipants (N = 842) participated in testing, and matched evaluations were received for 800 (95.0%) training participants. Demographic data were available for 793 (99.13%) participants, of whom 762 (96.1%) were MOs, or nurses, either PN or APPNs. Average correct response pre-test and post-test scores were 61.7% (range 7–24 correct responses) and 85.9% (range 12–25), respectively. Overall, 95.8% (730/762) of participants demonstrated improved knowledge. PNs improved on average 25% (6.22 points), whereas MOs improved 10% (2.89 points) with better mean test scores on both pre- and post-test (p < 0.000). APPNs performed the same as the MOs on post-test scores (p = NS).ConclusionsThe inter-professional training program in short-course RR-TB treatment improved knowledge for participants. MOs had significantly greater pre-test scores. Of the nurses, APPNs outperformed other PNs, and performed equally to MOs on post-test scores, suggesting this advanced cadre of nurses might be the most appropriate to initiate and monitor treatment in close collaboration with MOs. All cadres of nurse reported the need for additional clinical training and mentoring prior to managing such patients.

IntroductionInterprofessional healthcare teams are important actors in improving patient safety. To train these teams, an interprofessional training program (IPTP) with two interventions (eLearning and blended learning) was developed to cover key areas of patient safety using innovative adult learning methods. The aims of this study were to pilot test IPTP regarding its effectiveness and feasibility. The trial was registered with DRKS-ID: DRKS00012818.MethodsThe design of our study included both a pilot investigation of the effectiveness of the two interventions (eLearning and blended learning) and testing their feasibility (effectiveness-implementation hybrid design). For testing the effectiveness, a multi-center cluster-randomized controlled study with a three-arm design [intervention group 1 (IG1): eLearning vs. intervention group 2 (IG2)]: blended learning (eLearning plus interprofessional in-person training) vs. waiting control group (WCG) and three data collection periods (pre-intervention, 12 weeks post-intervention, and 24 weeks follow-up) was conducted in 39 hospital wards. Linear mixed models were used for the data analysis. The feasibility of IPTP was examined in 10 hospital wards (IG1) and in nine hospital wards (IG2) using questionnaires (formative evaluation) and problem-focused interviews with 10% of the participants in the two intervention groups. The collected data were analyzed in a descriptive exploratory manner.ResultsPilot testing of the effectiveness of the two interventions (eLearning and blended learning) showed no consistent differences between groups or a clear pattern in the different outcomes (safety-related behaviors in the fields of teamwork, error management, patient involvement, and subjectively perceived patient safety). Feasibility checks of the interventions showed that participants used eLearning for knowledge activation and self-reflection. However, there were many barriers to participating in eLearning, for example, lack of time or access to computers at the ward. With regard to in-person training, participants stated that the training content sensitized them to patient-safety-related issues in their everyday work, and that awareness of patient safety increased.DiscussionAlthough the interventions were judged to be feasible, no consistent effects were observed. A possible explanation is that the duration of training and the recurrence rate may have been insufficient. Another conceivable explanation would be that participants became more sensitive to patient safety-critical situations due to their knowledge acquired through the IPTP; therefore, their assessment post-intervention was more critical than before. In addition, the participants reported high pre-measurement outcomes. Future studies should examine the evidence of the intervention within a confirmatory study after adapting it based on the results obtained.

266 Background: Chemotherapy is a high-volume, high-risk clinical intervention that requires interprofessional clinical teams. With increased demand for chemotherapy, a record number of newly-approved drugs, and health system cuts to professional development, we sought to develop and deliver an evidence-based educational program for nurses and pharmacists on safe handling of hazardous drugs, management of oncology emergencies, extravasations, oral oncolytic therapy, and promoting clinical practice change. Methods: After mail and web-based recruitment activities, selected participants completed pre-workshop online modules. Live workshops included a blend of faculty-led interactive sessions and four simulations to reinforce content. Post-simulation debriefing sessions clarified concepts and identified participant action plans for clinical practice change. Attendees have access to lecture videos, handouts, resources, and a discussion board. Applying Kirkpatrick’s framework, we assessed participant confidence to meet program objectives before and after the workshop, a 27-item knowledge assessment before and after the workshop, and satisfaction with specific learning activities on a 5-point Likert scale. Results: To date, faculty have led two workshops. 266 nurses and 72 pharmacists applied and we accepted 77 (29%) and 30 (42%), respectively. Participants' change scores in confidence to meet program objectives increased from pre- to post-workshop (range 0.51-1.00). Knowledge scores increased between pre- and post- workshop (16.3 vs. 18.76, p &lt; .01). Overall satisfaction was high across all content areas (range 4.76 - 4.98). Nearly all participants (n = 104, 97.2%) reported they were extremely satisfied with the program. Conclusions: An interprofessional education program with online modules, in-person interactive sessions, and simulation activities is a promising strategy to deliver chemotherapy safety content to practicing oncology nurses and pharmacists. Future efforts include recruiting a more diverse pool of participants, and expanding the program to include advanced practice providers.

For several decades, the history of interdisciplinary education and the development of AGHE initiatives have been closely linked. The need to educate colleagues on methods and benefits of interdisciplinary/ interprofessional cooperation toward service and research of aging has never waned. In this presentation we (a) highlight how AGHE has performed as a potent incubator for progress in this area and (b) use a few examples to illustrate how notable resulting efforts have improved geriatric care. For example, early and significant infusion of federal funds for gerontology training programs supported multi-disciplinary university-based centers, the Veterans Health Administration created interprofessional geriatric training programs, foundations such as John A. Hartford and Josiah Macy founded team training and interprofessional education programs, and the Health Resources and Services Administration funded Geriatric Education Centers and Geriatric Workforce Enhancement Programs. Efforts to advance interdisciplinary/interprofessional education have been fruitful and AGHE’s role as an incubator continues to evolve.

Next to training care professionals in e.g. communication skills, training of patients is essential to enhance patient-centeredness of care. To improve patient-centered care, an interprofessional training program will be constructed, wherein patients, students and care professionals learn together. To construct the training program, a stakeholder analysis was performed. Here, we present the results of focus group interviews with patients and care professionals. Three focus group …

Finding Strengths in Our Differences: How Interprofessional Training Prepares Clinicians for Collaborative Practice (SA507)

BackgroundWhile there are many teacher training programs for health professional students, few are interprofessional, and few integrate assessment and feedback prior to participation as peer teachers. In 2021, The Student Interprofessional Facilitator Training (SIFT) program was developed to allow senior students, already trained in peer teaching, to revise, build on, and practice their newly acquired skills in an interprofessional context. The aim of this study was to explore participant perception and performance, and the contextual factors that influence student aspirations as clinical teachers.MethodsAlumni of the 2021 Peer Teacher Training program (n = 74) were invited to participate in the SIFT program. Those who participated were invited to attend individual semi-structured interviews. Thematic analysis was used to code and categorise data into themes, using Communities of Practice as a conceptual framework. Skills in interprofessional facilitation were observed, assessed and students were provided with individual feedback. Assessment data were analysed using descriptive statistics.ResultsSixteen students from six disciplines joined the SIFT program, and 13/16 (81%) completed. Students were from medicine, nursing, diagnostic radiography, medical imaging, dentistry and speech pathology. Students reported an increased recognition of teaching as a learned skill, development of clinician identity formation as educators, development of interprofessional communication skills, increased awareness of the roles of other health professions, and an increased understanding of leadership. Participants expressed a desire for additional opportunities for interprofessional networking and peer teaching. A good level of competence in facilitation skills was reached by participants.ConclusionThe SIFT program provided a sustainable framework for health professional students to develop and evidence their teaching and leadership skills in an interprofessional context. This study highlighted the important role of observation, assessment and feedback in student teacher training programs. The process of clear assessment guidelines, direct observation with feedback from supervisors provided a way to ensure quality improvement in peer teaching. The SIFT program will help to build capacity of interprofessional programs where large numbers of teachers are required for small group teaching. The next step will be to ensure a variety of opportunities within interprofessional contexts, and with face-to-face engagement.

The Relationship between Interprofessional Leadership Education and Interprofessional Practice: How Intensive Personal Leadership Education Makes a Difference

All the professions working in primary care provide placements for students. How common, or how profession-specific, are the competency requirements of the different professions for their members who supervise students on placements? If there is a significant degree of commonality in these competency requirements, how feasible would it be to develop an integrated interprofessional development and support programme for placement educators? These were the main questions addressed in this research project. The requirements for placement educators of four professions in the UK – nursing, medicine, occupational therapy and social work – were analysed and classified. Categories identified included the skills of enabling learning, knowledge of the theory and principles of learning, the ability to manage the learning environment and the ability to impart a sense of professional responsibility, as well as up-to-date knowledge on professional practice and on the relevant curricula. We concluded that only the last of these was profession-specific. The potential to use this classification for the development of an interprofessional placement educator training and support programme was explored, and the potential benefits of using this area to promote interprofessional learning were discussed. Issues that need to be considered include gaining cross professional involvement, whether service providers or universities should run programmes, whether there should be one or several programmes, and accreditation. In order to explore and take action on these issues a working group with representatives of the four professions was set up in the Primary Care Trust.

Family-professional and interprofessional collaboration have been increasingly emphasized in children's mental health since the advent of federal legislation requiring parent participation in planning services for children with disabilities and the Child and Adolescent Service System Program. However, professional training programs have been slow to incorporate attention to such collaboration. In this article we report findings from a survey of 51 university and agency-based interprofessional training programs. The purpose of the survey was to learn about interprofessional education programs that prepare professionals to work in interagency, interprofessional environments and to collaborate with families. Family member involvement in the planning, implementation, and evaluation of interprofessional training and curricular attention to family-professional collaboration were found to be present in a small number of interprofessional education training programs. These findings are presented, along with recommendations for increased attention to family-professional collaboration in professional training.