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

Jean Baptiste Sagahutu,Francois Cilliers,Jeanne Kagwiza,Jennifer Jelsma

doi:10.1186/s12909-021-02537-7

Jean Baptiste Sagahutu, Francois Cilliers + Show 2 more

Open Access

https://doi.org/10.1186/s12909-021-02537-7

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Abstract

BackgroundThe first step in improving interprofessional teamwork entails training health professionals (HP) to acknowledge the role and value the contribution of each member of the team. The International Classification of Functioning, Disability and Health (ICF) has been developed by WHO to provide a common language to facilitate communication between HPs.ObjectiveTo determine whether ICF training programme would result in improved knowledge and attitudes regarding interprofessional practice within Rwandan district hospitals.Design, setting and participantsA cluster randomised, single blinded, control trial design was used to select four district hospitals. Participants included physicians, social workers, physiotherapists, nutritionists, clinical psychologists/mental health nurses.InterventionHealth professionals either received one day’s training in interprofessional practice (IPP) based on the ICF (experimental group) as a collaborative framework or a short talk on the topic (control group).Outcome measuresValidated questionnaires were used to explore changes in knowledge and attitudes. Ethical approval was obtained from the relevant authorities.ResultsThere were 103 participants in the experimental and 100 in the control group. There was no significant difference between Knowledge and Attitude scales at baseline. Post-intervention the experimental group (mean = 41.3, SD = 9.5) scored significantly higher on the knowledge scale than the control group (mean = 17.7, SD = 4.7 (t = 22.5; p < .001)). The median scores on the Attitude Scale improved in the Experimental group from 77.8 to 91.1%, whereas the median scores of the control remained approximately 80% (Adjusted Z = 10.72p < .001).ConclusionThe ICF proved to be a useful framework for structuring the training of all HPs in IPP and the training resulted in a significant improvement in knowledge and attitudes regarding IPP. As suggested by the HPs, more training and refresher courses were needed for sustainability and the training should be extended to other hospitals in Rwanda. It is thus recommended that the framework can be used in interprofessional education and practice in Rwanda and possibly in other similar countries.Trial registrationName of the registry: Pan African Clinical Trial Registry.Trial registration number:PACTR201604001185358.Date of registration: 22/04/2016.URL of trial registry record:www.pactr.org

Highlights

The first step in improving interprofessional teamwork entails training health professionals (HP) to acknowledge the role and value the contribution of each member of the team
The International Classification of Functioning (ICF) proved to be a useful framework for structuring the training of all HPs in interprofessional practice (IPP) and the training resulted in a significant improvement in knowledge and attitudes regarding IPP
As suggested by the HPs, more training and refresher courses were needed for sustainability and the training should be extended to other hospitals in Rwanda

Summary

Introduction

The first step in improving interprofessional teamwork entails training health professionals (HP) to acknowledge the role and value the contribution of each member of the team. Apart from duplication of effort, poor collaboration between health care professionals can result in medical errors, lack of critical information and inadequate interpretation of health information, all risks to a patient’s safety [12]. The Lancet Global Independent Commission identified the need for health care reform based on interprofessional and transprofessional education that breaks down professional silos while enhancing collaborative and nonhierarchical relationships in effective teams [19]. Smooth collaboration among health care providers may minimise medical errors and eventually improve patient outcomes [18]. A framework of outcome measures for effective teamwork [30], a systematic review on the effects of interdisciplinary team care interventions on general medical wards [33], and A Cluster Randomised Control Trial (CRCT) conducted by Borenstein et al [7]

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