Attitudes towards Interprofessional education in the medical curriculum: a systematic review of the literature

Joana Berger-Estilita,Robert Greif,Alexander Fuchs,Markus Hahn,Hsin Chiang

doi:10.1186/s12909-020-02176-4

Abstract

BackgroundThere is agreement among educators and professional bodies that interprofessional education needs to be implemented at the pre-registration level. We performed a systematic review assessing interprofessional learning interventions, measuring attitudes towards interprofessional education and involving pre-registration medical students across all years of medical education.MethodsA systematic literature review was performed using PubMed, PsycINFO, EThOS, EMBASE, PEDro and SCOPUS. Search terms were composed of interprofession*, interprofessional education, inter professional, inter professionally, IPE, and medical student. Inclusion criteria were 1) the use of a validated scale for assessment of attitudes towards IPE, and results for more than 35 medical students; 2) peer-reviewed articles in English and German, including medical students; and 3) results for IPE interventions published after the 2011 Interprofessional Education Collaborative (IPEC) report. We identified and screened 3995 articles. After elimination of duplicates or non-relevant topics, 278 articles remained as potentially relevant for full text assessment. We used a data extraction form including study designs, training methods, participant data, assessment measures, results, and medical year of participants for each study. A planned comprehensive meta-analysis was not possible.ResultsThis systematic review included 23 articles with a pre-test-post-test design. Interventions varied in their type and topic. Duration of interventions varied from 25 min to 6 months, and interprofessional groups ranged from 2 to 25 students. Nine studies (39%) reported data from first-year medical students, five (22%) from second-year students, six (26%) from third-year students, two (9%) from fourth-year students and one (4%) from sixth-year students. There were no studies including fifth-year students. The most frequently used assessment method was the Readiness for Interprofessional Learning Scale (RIPLS) (n = 6, 26%). About half of study outcomes showed a significant increase in positive attitudes towards interprofessional education after interventions across all medical years.ConclusionsThis systematic review showed some evidence of a post-intervention change of attitudes towards IPE across different medical years studied. IPE was successfully introduced both in pre-clinical and clinical years of the medical curriculum. With respect to changes in attitudes to IPE, we could not demonstrate a difference between interventions delivered in early and later years of the curriculum.Trial registration PROSPERO registration number: CRD42020160964.

Highlights

There is agreement among educators and professional bodies that interprofessional education needs to be implemented at the pre-registration level
This systematic review showed some evidence of a post-intervention change of attitudes towards Interprofessional Education (IPE) across different medical years studied
With respect to changes in attitudes to IPE, we could not demonstrate a difference between interventions delivered in early and later years of the curriculum

Summary

Introduction

There is agreement among educators and professional bodies that interprofessional education needs to be implemented at the pre-registration level. High-quality, accessible, patient-centred care requires continuous development of interprofessional competencies [2], and IPE has repeatedly been called for, so that healthcare students can enter the workforce as effective collaborators [3,4,5]. IPE may enhance attitudes toward teamwork and collaboration, leading to improved patient care upon graduation. The optimal timing to introduce IPE and whether immersion (i.e. continuous collaborative learning) or exposure (periodic collaborative activities) should be adopted [10] are still subject to debate. Gilbert [11] suggests exposure during the early years and immersion in the graduation year Reasons for this include ensuring the optimal development of students’ professional identity before expecting them to work collaboratively with others. Current undergraduate literature shows a tendency to introduce IPE earlier, even in the first year of studies [11, 12], but the most effective timing to perform PE interventions in the medical curriculum remains to be determined

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Conclusion