Attitudes toward Healthcare Teamwork between Osteopathic Medical Students in an Interprofessional or Intraprofessional Clinical Education Program

Abstract

INTRODUCTION Interprofessional education has attempted to positively impact and prepare students for future practice of collaboration among healthcare providers. However, few studies have assessed if short-term positive impacts on attitudes toward interprofessional collaboration can be sustained long-term. Comparing the current attitudes toward health care teams between osteopathic physicians who participated as medical students in an interprofessional clinical education program and those who participated in a similar medical student-only clinical education program, but without instruction in interprofessional education competencies, can help determine if sustained change is possible. METHODS Surveys evaluating the attitude toward interprofessional teamwork of 23 osteopathic physician students who participated in an interprofessional clinical education program and 88 osteopathic physicians who participated in a medical student-only education program between 2003 and 2007 were completed and compared. RESUlTS An independent samples t test was conducted on subscales of physicians’ attitude toward team value, team efficiency, physicians’ shared role, as well as physicians’ rating of their current proficiency level of interprofessional teamwork skills. The results revealed no statistically significant differences among respondents from the interprofessional program and respondents from the intraprofessional program. DISCUSSION Results of this study point to generally favorable attitudes toward interprofessional collaboration for both groups. It seems that regardless of pre-professional training, over time, a favorable attitude toward interprofessional collaboration is acquired. CONClUSION Future directions for research should continue to be focused on the long-term effect of interprofessional education on interprofessional practice as well as attitudes toward interprofessional teamwork and knowledge of interprofessionalism. Received: 09/09/2014 Accepted: 03/08/2015 Published: 04/08/2015 © 2015 Hackett 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 & Attitudes toward HealthcareTeamwork ORIGINAL RESEARCH 2(3):eP1072 | 2 Introduction The complex health problems of today, the high cost of healthcare, an information and technology explosion, and a trend toward preventive medicine call for more emphasis on interprofessional medical education and practice (Faresjo, 2006). Also, with multiple healthcare practitioners practicing in numerous settings, the risk of medical errors and unsafe processes is heightened. A fragmented, decentralized healthcare system along with limited attention in medical education to improving interprofessional practice may lead to costly medical errors (Institute of Medicine, 1999). In order to better prepare medical students and practitioners to provide safe, quality care in a patientcentered environment, proficiency in working as a part of interprofessional healthcare teams is now critical (Institute of Medicine, 2009). The goal of interprofessional education is to improve collaboration and cooperation between healthcare professionals. Health professions students participate in experiential activities to learn the knowledge and skills necessary for collaborative practice in interprofessional teams. Interacting with students from other health professions, they learn to value diverse perspectives, to respect the expertise of other professions, to collaborate for problem-solving, and to communicate as a team to ensure patient safety and patient-centered outcomes (Olenick, Allen, & Smego, 2010; Salfi & Solomon, 2011). Because collaboration between the professions is crucial to improving quality, safety, and access to care, common interprofessional learning experiences can help prepare future professionals for the team approach to providing care. Interprofessional education programs should specifically provide common experiences in the interprofessional competencies of ethics and responsibility for collaborative practice as well as interprofessional communication and teamwork skills (Inter-professional Education Collaborative Expert Panel, 2011). Although interprofessional education programs vary in terms of content and process, more studies are needed to assess future effects on patient care, as the programs seem to improve students’ teamwork knowledge and skills (Reeves, Goldman, Burton, & Sawatzky-Girling, 2010; Reeves, et al., 2010). Brief Literature Review As medical students involved in interprofessional educational experiences during training transition to medical practice, supportive environments for interprofessional practice may be lacking in those medical settings (Pollard, 2009). As an essential element of professional practice, interprofessional practicebased interventions and collaborative practice have the potential to lead to improved medical processes (Zwarenstein, Goldman, & Reeves, 2009) and patient safety (Manser, 2008) as role understanding and team communication may be linked to more positive patient outcomes (Suter et al., 2009). Barriers to collaboration, however, have been reported in primary and community care (Audet, Davis, & Schoenbaum, 2006; Xyrichis & Implications for Interprofessional Practice • Even if best practices are followed in interprofessional medical education programs, any positive attitudes towards interprofessional practice may not be sustained long-term. • Healthcare organizations should consider implementing sustained professional development opportunities that promote interprofessional collaboration, which may result in positive attitudes toward interprofessional collaboration over the long-term. • There is a need for healthcare organizations to monitor their policies and procedures that may serve as barriers and supports to interprofessional collaboration to ensure that favorable attitudes continue to be sustained. H IP & ISSN 2159-1253 Health & Interprofessional Practice | commons.pacificu.edu/hip 2(3):eP1072 | 3 Lowton, 2008) as well as acute care settings (Hughes & Fitzpatrick, 2007), for example. Although effectively learning to work in interprofessional teams has the potential to lead to more collaborative practice as medical professionals and possibly affect quality of patient care (Olenick, Allen, & Smego, 2010), there is currently little evidence these shortterm changes can become sustained long-term changes (Remington, Foulk, & Williams, 2006). Documentation of long-term impact of interprofessional education on medical practice is limited, although in some cases, attitudinal changes were sustained three months (Bajnok, Puddester, MacDonald, Archibald, & Kuhl, 2012) to one to two years beyond intervention (Pollard & Miers, 2008). Without continuing education, managerial follow-up, and reinforcement, though, this type of change is less likely to be sustained (Henderson, 2012). More longitudinal studies, therefore, have been advocated in regard to interprofessional education (Hansson, Foldevi, & Mattsson, 2010; Remington, Foulk, & Williams, 2006). Barriers to evaluating the effect of interprofessional education on future interprofessional practice also exist and include type of care setting, healthcare and facility policy, and patient perceptions (Henderson, 2012). The purpose of this study is to compare the current attitudes toward interprofessional teamwork of osteopathic physicians who participated in a home-visit interprofessional clinical educational program during their medical education and those who participated in an intraprofessional, medical student-only home-visit clinical education program during their medical education.