Student participation in the development of interprofessional education courses: Perceptions and experiences of faculty members and the students

Medical Education Program Highlights Dell Medical School (DMS) at the University of Texas (UT), Austin, enrolled its first class in 2016. The curriculum is designed to train outstanding doctors who are also prepared as physician leaders. They should be as comfortable taking on transformational health care challenges as they are caring for patients. Every curricular component is designed to focus students on the distinct challenges of 21st-century health care and medicine and how to apply creativity in solving those challenges. Students complete a 4-year leadership curriculum and have the opportunity to individualize leadership applications during the year 3 Innovation, Leadership, and Discovery (ILD) 9-month course. The highly integrated educational program incorporates guided, self-directed learning, interprofessional education, longitudinal coursework, and a health systems science curriculum. Curriculum Curriculum description Year 1 curriculum—Essentials: The preclerkship curriculum includes courses that integrate scientific, social, and clinical knowledge for students to prepare and succeed in the clinical years of medical school. The curriculum consists of 5 integrated block courses and 3 longitudinal courses (Leadership, Interprofessional Education, and Developing Outstanding Clinical Skills) that continue throughout all 4 years. Year 2 curriculum—Delivery: There are five 8-week block clerkships, a 4-week emergency medicine clerkship, and time to complete up to 4 weeks of electives. A weekly longitudinal primary care, family, and community medicine clerkship begins in year 2 and continues through year 3. Year 3 curriculum—Growth: Students have up to 8 weeks between year 2 and the start of the ILD course to prepare and take the USMLE Step 1 examination. ILD is a 9-month course that allows students the option to complete a UT master’s degree, or a distinction in research or population health. There are shared core competencies for the ILD course, which must be met irrespective of the option chosen. Current degrees available include public health, business administration, educational psychology, health care transformation, biomedical engineering, and design in health care. Students continue their primary care clerkship with weekly preceptor half-day experiences and participate in a service-learning community project as part of their interprofessional education course. At the end of year 3, students have a weeklong clinical skills course to transition into the fourth-year clinical experiences. Year 4 curriculum—Exploration: Students are required to complete two 4-week acting internships, 4 weeks of critical care, a 2-week geriatrics/palliative care clerkship, and an intensive residency preparation experience (Milestone 1). In addition, 22 weeks of electives are required. See Supplemental Digital Appendix 1—Curriculum Schematic—at https://links.lww.com/ACADMED/A903. Assessment The DMS graduation competencies are modeled after the 6 ACGME domains, with the addition of a seventh domain specific to DMS, leadership, and innovation. There are 18 competencies and 68 measurable enabling objectives. These provide the foundation for all curricular components and student assessments. Students also complete an annual competency reflection and describe curricular and noncurricular activities and assessments that promoted those competencies in which they have experienced the most growth over the year. See Chart 1—Competency Domains, Objectives, and Assessment Methods.Chart 1: Competency Domains, Objectives, and Assessment MethodsSince the first class began in 2016, all assessments have been newly developed, implemented, and refined. The clinical performance assessment form used in the clerkship and clinical electives includes leadership, curiosity, emotional intelligence, and systems thinking as unique items, each described at 4 levels of accomplishment. The NBME Comprehensive Basic Science Examination is used as a progress test with 4 repetitions across years 1 and 2 of the curriculum. Students complete multiple OSCEs during years 1 and 2 with individual feedback provided on performance and write-ups. A multistation clinical performance examination is given in the spring of the third year as students reenter clinical medicine. Pedagogy Self-directed learning/problem-based learning (PBL): Block courses in the preclerkship curriculum include PBL, called PILLARS, for 3 to 6 hours a week with a faculty facilitator. Students discuss 1 or 2 clinical cases each Monday morning and develop a list of basic, clinical, and social science learning objectives that they will all pursue prior to the cases discussion. At the follow-up discussion, students teach each other what they have learned, assist one another in clarifying and deepening understanding, and apply the results to the patient. Simulations/standardized/simulated patients: In the 4-year Developing Outstanding Clinical Skills course, teams of 5 students work with a single clinical facilitator beginning in year 1, using role play, simulation, standardized patient exercises, real patient encounters, and OSCEs for both formative feedback and summative assessment. All of the core clerkships use simulation as a part of midpoint feedback. Emergency medicine and surgery include simulation for skill development. The transition-to-clerkship course (Milestone 0) incorporates simulation for skill development and assessment. Clinical experiences The required clerkships have identified the core conditions and clinical skills or procedures that must be completed by each medical student to pass. Each condition and clinical skill is associated with a clinical setting and level(s) of expected responsibility. The conditions/skills logs are structured to assist students and instructors in assuring a consistent clinical experience. Students’ feedback on the conditions/skills log has been very positive; students report that it forces them to look for a range of conditions and skills while they are in their clerkships, and discuss incomplete sections of the log with their residents and attending physicians. The Curriculum Committee reviews the logs across clerkships for the inclusion of essential medical conditions with attention to community needs, coverage of skills, level of responsibility, and settings. Of particular note, students complete a 2-year longitudinal clerkship in primary care, family, and community medicine at a single site to promote continuity of care, a population perspective, and consistent clinical supervision. Ascension Seton hospitals in Austin serve as the inpatient sites for the core clerkships and clinical electives. The major inpatient site is Dell Seton Medical Center at the UT. Other sites include Dell Children’s Medical Center (pediatrics), Seton Shoal Creek Hospital (psychiatry), and Seton Main Hospital (women’s health, emergency medicine). Austin’s Central Health CommunityCare is the primary ambulatory care partner. Service learning and community service DMS is committed to serving its community and has therefore embedded service learning into its required curriculum within the interprofessional courses in years 1, 3, and 4. In the year 1, Foundations of Interprofessional Collaborative Practice course, teams of medical, nursing, social work, and pharmacy students identify and explore a community health-related need and develop a public service announcement. In the year 3 course, teams plan and implement a community service learning project based on the Travis County Public Health Critical Indicators report. Medical student teams work with members of established community organizations to achieve their project aims. They develop and deliver a community project then present the results at a forum to which community stakeholders are invited. Students are also involved in volunteer community service across all years of the curriculum and can develop their own interventions or draw on the UT Austin volunteer opportunities website. Curricular Governance The Undergraduate Medical Education Curriculum (UMEC) committee, a DMS standing committee, “is responsible for the overall design, management, integration, evaluation, and enhancement of a coherent and coordinated curriculum.” The UMEC subcommittee structure was designed to foster integration across disciplines, courses, and years of the curriculum. Routine subcommittee reporting at the twice monthly UMEC meeting (Scientific Foundations, Healthcare Delivery, Curricular Innovation, Innovation, Leadership and Discovery, and Evaluation and Assessment Committees) fosters both horizontal and vertical integration. Clinical clerkships and elective education include input from the departments but are ultimately approved and financially supported centrally. See Figure 1—UMEC and subcommittees.Figure 1: UMEC and subcommittees.Education Staff Department of Medical Education The Department of Medical Education serves as the organizational locus for the planning, implementation, and evaluation of the medical education program across the continuum. The department is chaired by the executive vice dean for academics and includes faculty members who serve as the educational leadership team, consisting of an associate dean for UME, associate dean for evaluation and faculty development, associate dean for student affairs, and associate dean for graduate medical education. Assistant deans for clinical skills integration, interprofessional integration, and value-based care are also faculty members in the department and have extensive curriculum development and teaching responsibilities in their respective domains. There are also 6 full-time core faculty members who serve as course directors and teaching faculty for the scientific foundations courses in year 1. Together these faculty members provide support for all curricular components. A senior-level curriculum manager and 5 education coordinators staff various curricular components and maintain the tools that support curriculum delivery, monitoring, and management, including Canvas as the learning management system and one that serves as the curriculum database support the UME division. These UME staff also support the Curriculum Committee and its subcommittees. The evaluation and faculty development division of the department includes the associate dean and the faculty member who directs program evaluation and educational research, who are both doctoral-level educators, the director for the standardized patient program, and an education coordinator. Faculty Development and Support in Education Professional development for faculty as educators Professional development opportunities for teaching, assessment, and scholarship are widely available with programs at the school, departmental, and university levels. Faculty members can earn a DMS certificate in clinical teaching by participating in 24 hours of school and external teaching enrichment activities. The centerpiece of the certificate is a 14-hour course offered twice annually, Extraordinary Learning and Teaching in Clinical Settings. Best practices in medical education grand rounds, a medical education journal club, and an educational research-in-progress conference occur monthly. Departmental conferences, workshops, and grand rounds feature professional development topics on a regular basis. A course on leadership is available for junior faculty members, that is, coordinated with the leadership course for first-year medical students. The Department of Medical Education also supports the whole continuum of medical education through administrative support for student affairs, admissions, graduate medical education, and continuing medical education. See Figure 2—Organizational chart.Figure 2: Organizational chart.Role of teaching in promotion and tenure There are 2 faculty tracks, regular (regardless of funding source) and affiliate (volunteer). The criteria for promotion for faculty in the regular series include the opportunity to select an area of excellence in education, clinical expertise, community engagement, or research, each requiring a different type of scholarly activity. Regular faculty members are expected to continuously engage in both teaching and scholarship, while expectations for affiliate faculty are less rigorous. Peers define scholarship as the creative application of the intellect that results in development of a product that is available for assessment for quality. Furthermore, this product is made public for others to learn from or build upon. Criteria have been delineated for use in assessing products of scholarship. Scholarship may consist of traditional peer-reviewed manuscripts or new forms of dissemination such as blogs. Teaching academy The DMS Academy of Distinguished Educators recognizes the school’s most outstanding educators and educational leaders and fosters the growing community of Dell Med teachers. The academy provides peer-observation opportunities and sponsors an annual educational innovation and scholarship event with poster presentations by faculty, residents, and students. Starting in the fall of 2019, the event also serves as a celebration of faculty members and residents receiving DMS teaching awards.

ABSTRACTAs the healthcare system of the United States becomes more complex, collaboration among health professionals is becoming an essential aspect in improving the health of individuals and populations. An interprofessional education course entitled “Health Care System and Health Promotion” was developed to allow health profession students to work and learn together about issues related to healthcare delivery, health promotion, and the effect of policy issues on key stakeholders in the system. A qualitative document analysis research design was used to evaluate the effect of this interprofessional course on students’ views of the current healthcare system of the United States. Fifty-nine student articles were analysed using document analysis. Health professions represented in the sample included occupational therapy, physical therapy, athletic training, nursing, and radiation therapy, nuclear medicine technology, and magnetic resonance imaging. Eight themes were identified including: increased personal awareness, the need for a system change, concern for access, affordability of healthcare, vision for future practice role, need for quality care, the value of interprofessional collaboration (IPC), and the importance of disease prevention. The results of the study suggest that healthcare education can benefit from the integration of Interprofessional Education (IPE) courses into their curriculum especially when teaching content common to all healthcare professions such as healthcare systems and health promotion.

A Pilot Study on an Interprofessional Course Involving Pharmacy and Dental Students in a Dental Clinic

Since 2011, five educational and healthcare institutions have implemented a short interprofessional education (IPE) course to bring together undergraduates from five disciplines. To meet the logistical challenges of IPE implementation, more specifically, the large number of classrooms needed to gather students together and the need for human resources to guide learning activities, a face-to-face IPE course was redesigned into a blended (online and face-to-face collaborative learning activities) IPE course. In March 2023, 183 medical, 378 nursing, 46 radiologic technology, 69 physiotherapy, and 74 occupational therapy students participated in a one-day IPE blended course to learn interprofessional team functioning and dynamics, role clarification and responsibilities of other professions, and interprofessional communication skills. This study aimed to assess students' changes in attitudes towards IPE after being involved in a large-scale interprofessional blended learning course. A before-after study was conducted using a French translation of the validated questionnaire "University of West of England Interprofessional Questionnaire" (UWE-IP questionnaire). Students' attitudes towards interprofessional (IP) relationships and IP learning were measured before and after the course. In March 2023, two hundred fifty-six students from five professions answered two subscales of the UWE-IP questionnaire before and after the course (response rate 34%). Students' attitudes towards IP relationships improved significantly after the course. The score on this subscale (min 8; max 24) changed from 11.18 (SD 2,67) before the course to 10,38 (SD 2,55) after the course, indicating a significant improvement in attitudes towards IP relationships (p < 0,001). More specifically, students had more positive attitudes on the item "I have a good understanding of the roles of different health and social care professionals." and the item "I feel that I am respected by people from other health and social care disciplines." after the course. A positive change in students' attitudes towards IP learning was observed, but the results were not significative. A face-to-face IPE course redesigned as a blended course helped overcome existing challenges to implementing an IPE course. The results suggest a blended IPE course improves students' attitudes towards interprofessionality.

Refugee patients benefit from interdisciplinary approaches that address trauma-related migration in culturally responsive ways. This qualitative evaluation assessed the interdisciplinary trauma-based course for refugee populations. The qualitative data comes from focus groups and surveys to evaluate medical, social work, and public health students' perceptions of the interprofessional education course of refugee patient care. The evaluators analyzed qualitative data through a thematic content analysis method. Following key themes emerged from students' reflections: (1) collaboration in interdisciplinary learning, (2) role of clinical learning, (3) skills and knowledge related to refugee population care, (4) improvements for interprofessional education, and (5) strengths of the interprofessional education course. The Interprofessional Refugee Health Elective course enhanced their knowledge and competence in refugee health care. Educators, students, and the patient population will benefit from investing in interprofessional education courses that focus on specific needs and complex care management for refugee patients.

The purpose of this mixed-method longitudinal study was to understand how health professional students’ perceptions of their professional flexibility, role interdependence, and reflection on their process of working together change over time as a result of participating in an interprofessional education course. Data were collected from students enrolled in an interprofessional service-learning course each year from Fall 2014 to 2018 via online surveys at four assessment points and through qualitative reflection papers that served as course assignments. The 14-week course consisted of both didactic instruction and an experiential component whereby students conducted a service-learning activity in interprofessional teams. Quantitative findings demonstrate that students experienced a significant quadratic growth trajectory in reflection on process and a significant linear growth trajectory in professional flexibility. Students reported experiencing non-significant changes in role interdependence. Qualitative data, however, suggest student learning across all three domains. This study has implications for interprofessional educational initiatives aimed at promoting students’ interprofessional competencies.

Students’ Perspectives on Interprofessional Teamwork Before and After an Interprofessional Pain Education Course

The past decade witnessed momentum toward redesigning the U.S. health care system with the intent to improve quality of care. To achieve and sustain this change, health professions education must likewise reform to prepare future practitioners to optimize their ability to participate in the new paradigm of health care delivery. Recognizing that interprofessional education (IPE) is gaining momentum as a crucial aspect of health care professions training, this article provides an introduction to IPE programs from three different academic health centers, which were developed and implemented to train health care practitioners who provide patient-centered, collaborative care. The three participating programs are briefly described, as well as the processes and some lessons learned that were critical in the process of adopting IPE programs in their respective institutions. Critical aspects of each program are described to allow comparison of the critical building blocks for developing an IPE program. Among those building blocks, the authors present information on the planning processes of the different institutions, the competencies that each program aims to instill in the graduates, the snapshot of the three curricular models, and the assessment strategies used by each institution. The authors conclude by providing details that may provide insight for academic institutions considering implementation of IPE programs.

This was a validation study of the Norwegian version of The Interprofessional Collaborative Competency Attainment Survey (ICCAS). ICCAS consists of 20 retrospective pre- and post-questions, where respondents rate their agreement with regard to self-assessed competencies after participating in interprofessional education courses. It has been validated across various settings. The questionnaire was translated using the back-translation technique. We investigated evidence of validity regarding content, response process, and internal structure. Data were obtained from health and social care students (n = 1440, response rate 42.8%) participating in 12 different interprofessional courses in seven education institutions in Norway using a cross-sectional design. Exploratory factor analysis indicated one retracted factor for pre-scores and one retracted factor for post-scores. High McDonald’s omega values indicated good internal consistency. Item deletion did not improve the scale’s overall consistency on pre- or post-scores. We observed higher mean post-scores than pre-scores with moderate-to-large effect sizes, indicating a positive change in self-assessed interprofessional capabilities after training. Our findings indicate that the Norwegian version of ICCAS is a valid tool that may be implemented across a wide range of interprofessional education courses. Finally, our findings support earlier recommendations that ICCAS should be analyzed at an overall level to address change in interprofessional capabilities.

Teaching global interdependence to health professions students during the Anthropocene epoch: Findings from documentary analysis of an interprofessional education course

ABSTRACTNurturing student’s development of interprofessional collaboration is fundamental. Assessment-For-Learning can use reflection as one technique to support students’ growth. Thus, we investigated using reflective-writing within an interprofessional education (IPE) course using an exploratory mixed-methods design. In 2015, student-nurses, student-pharmacists, and student-physicians participated in an IPE course and completed self-assessments of student learning objectives (SLOs). In 2016, new cohorts of student-nurses, student-pharmacists, and student-physicians participated in the course and completed their self-assessments of SLOs; however, student-nurses and student-pharmacists also reflectively-wrote. Quantitatively comparing SLOs from 2015 cohorts with 2016 cohorts, we found that the effect-sizes (magnitude of difference) for those who reflectively-wrote (student-nurses and student-pharmacists) grew more than historical controls, whereas the effect-sizes remained unchanged for a control group (student-physicians) who did not reflectively-write. Qualitatively, initial and final reflective-writings were explored using content analysis. Initial reflective-writings helped students create a baseline for their final reflective-writings. In final reflective-writings, most students discussed their growth in understanding roles/responsibilities and communication, though limited growth was discussed for teams/teamwork and values/ethics. Thus, initial and final reflective-writings appeared useful within this IPE course. Initial reflective-writing further enhanced students’ self-assessed IPE improvement and recorded students’ baseline perceptions for later review, while final reflective-writings documented students’ self-actualized IPE development.

The Internet and computer technology have altered the education landscape. Online courses are offered throughout the world. Learning about the experiences of faculty members is important to guide practitioners and administrators. Using qualitative research methodology, this study investigated the experiences of faculty members teaching online courses. A convenience sampling was used to select the instructional technology faculty members to investigate their experiences in online courses. Semi-structured interviews with faculty members teaching online courses were used as the primary source to collect data about the experiences of faculty members in online courses. Results of the study showed that faculty members' interest in using technology and the amount of time available to them for online course design affected the quality of online courses. The findings of this study also indicated that design quality of online courses is affected by the interest of faculty members to use the technology and the time that they can devote to planning, designing, and developing online courses. The poor design of existing online courses, high learning expectations of individuals from these courses, and the future of online courses are the concerns of faculty members. Higher education institutions should support workshops and trainings to increase the skills and interests of non-instructional design faculty members to design and develop online courses.

To develop collaborative competencies of future health and social services professionals, the Université de Montréal (UdeM) offers interprofessional education (IPE) in partnership with patients. To meet the challenges of IPE, UdeM turned to digital tools to enable interprofessional teams of students to collaborate online and face-to-face. The collaborative flipped classroom for IPE with patient partnership is the conceptual framework for the pedagogical method used for this study. It is based on: 1) a competency framework and 2) collaborative learning concept and dimensions. The study aimed to: 1) demonstrate how interprofessional teams of students mobilize framework competencies and care approaches during online and face-to-face collaborative learning activities; and 2) analyze how students collaborate during a hybrid IPE course using a patient partnership approach. Using a qualitative methodology, the contents of the online collaborative journals (OCJs) of 12 interprofessional student teams were analyzed, along with the individual comments (n = 994) of IPE course learners collected through the Interprofessional Team Collaboration questionnaire (n = 321). The results suggest that the course under study enabled teams to collaborate online and face-to-face throughout the term, and indicate that students were better prepared to adopt a patient partnership approach.

The purpose of the articles was to describe a narrative review of literature for Concept-based eLearning, which was introduced in the predoctoral interprofessional education (IPE) curriculum to teach key transferable ideas and to consider the context of dental care in the spectrum of comprehensive patient care. The COVID -19 pandemic has further presented a disruption to the usual curriculum, and time to rethink and redesign the interprofessional education course at Harvard School of Dental Medicine (HSDM) with new pedological methods. Concept-based eLearning videos were incorporated into the interprofessional educational courses in order to advance the teaching and learning approaches. It was an attempt to provide student-focused teaching strategies which not only gave students the flexibility to learn at their own pace but also aimed at helping them increase retention and synthesize and apply knowledge. Concept videos were targeted at learning goals and were kept brief and conversational to enhance engagement. The concept-based eLearning facilitated an environment to assist students in developing awareness of interprofessional relations and communications within the health care team. Continued development and evaluation of the concept-based eLearning videos are essential in addition to faculty development efforts to support the new educational methodology.

A Pilot Interprofessional Course on Substance Use Disorders to Improve Students’ Empathy and Counseling Skills