The impact of a training programme incorporating the conceptual framework of the International Classification of Functioning (ICF) on behaviour regarding interprofessional practice in Rwandan health professionals: A cluster randomized control trial.

Abstract

BackgroundAppropriate collaboration between health professionals (HP) can reduce medical errors, enhance the spread of critical information, and assist in interpretation of health information resulting in improved patient care. The International Classification of Functioning, Disability and Health (ICF) may provide a useful conceptual framework to facilitate better interprofessional practice.PurposeTo determine whether a training programme based on the ICF framework resulted in improved interprofessional behaviour among HPs in Rwanda.MethodologyA cluster randomised control trial was used. Four district hospitals were randomly allocated to receive either a day’s training in interprofessional practice based on the ICF framework (experimental) or a short talk and a booklet on the topic (control). A total of 203 participants included medical doctors, nurses, and other HPs took part in this study. Simple random sampling was used to select the hospital records of 200 patients discharged from relevant wards at both the experimental and control hospitals at baseline and at two, four and six months after training (800 patients’ records from each group). A self-designed checklist has undergone some validation and was based on the ICF conceptual model was used to audit the quality of information included in the patients’ records. Ethical approval was obtained from the relevant authorities.ResultsThe demographic and medical profile of the patients in the two sets was equivalent. An ANOVA and post-hoc Tukey test indicated the mean number of items correctly filled in was not significant at baseline (p = 0.424) but the difference was significant (p < .001) for the post-intervention scores at two, four and six months. The control group scores did not improve over time. The improved behavior was still evident at six months although it had begun to decay.ConclusionBehaviour change as evidenced by more comprehensive recording of patient management can result from a well-structured training programme. The ICF appeared to provide a common language and facilitate HPs interaction and patient management plans.ImplicationThe ICF provided an effective conceptual framework to structure the content of the training and the audit tool. It is recommended that the framework be used to facilitate interprofessional education and practice in Rwanda and that the training approach may be applicable to other health care contexts.