Education Collaborative Core Competencies Research Articles

Organizational structure and resources of IPE programs in the United States: A national survey

Interprofessional education (IPE) initiatives are growing due to the Interprofessional Education Collaborative's core competencies being incorporated into health professions educations programs' accreditation criteria. This investigation examined organizational models and structures of US IPE programs using mixed methodology of quantitative survey and qualitative analysis. Responses (61% response rate from the 131 institutions surveyed) were examined to identify relationships between IPE program organizational factors. Despite marked heterogeneity in most aspects of IPE program infrastructure including administrative structure, financing, and role of the academic health center (AHC), several key relationships emerged. A centralized administrative structure was most common and was associated with dedicated resources. The majority of programs were in AHCs and this was associated with financial structure, annual budget size, program maturity, number of students participating, and references to IPE in promotion and tenure guidelines. IPE learning experiences occurred predominantly in academic settings, identifying a critical need for development of clinical IPE learning experiences. Clinical IPE learning experiences were generally not in mainstream healthcare delivery systems but filled gaps or complemented healthcare efforts for underserved populations. Qualitative analysis results supported the survey results. Continued research in IPE organizational structures is needed to determine external and internal drivers associated with program success and continued trends in the IPE field.

“We're Performing Improvisational Jazz”: Interprofessional Pediatric Palliative Care Fellowship Prepares Trainees for Team-Based Collaborative Practice

ContextInterprofessional education (IPE) prepares clinicians for collaborative practice, yet little is known about the effectiveness of postgraduate IPE. ObjectivesThis is the first study to describe educational outcomes of an interprofessional fellowship in pediatric palliative care. Objectives were to understand the experiences of postgraduate trainees in an interprofessional, clinical environment and to evaluate program effect on interprofessional competencies. MethodsIn this mixed-methodology study, we surveyed former fellows from 2002 to 2018 about their fellowship experience and perceived change in interprofessional skills. We performed qualitative semantic content analysis of fellows’ responses about learning in an interprofessional context. We compared fellows’ self-rated ability (5-point Likert scale), before and after fellowship, in 10 interprofessional competencies selected from the Interprofessional Education Collaborative's core competencies. ResultsResponse rate was 87% (41/47). Fifty-one percent of respondents were physicians, 29% were social workers, and 20% were nurse practitioners. Respondents reported significant improvement in all 10 competencies, with summed mean scores of 2.8 ± 0.6 prefellowship (“not very well prepared”) and 4.4 ± 0.4 postfellowship (“very well” to “extremely well prepared”) (t = 15.6, P< 0.0001). Effect size for each competency was greater than 1.9 (strong positive impact). The fellowship experience was characterized by dynamic educational relationships: peer relationships with interprofessional co-fellows, mentoring relationships with faculty, clinical relationships with patients and families, and collaborative relationships with the healthcare system. Benefits and challenges of IPE were associated with interprofessional roles, teamwork, patient care, and educational needs. ConclusionThis study demonstrates the feasibility and effectiveness of an interprofessional postgraduate fellowship in preparing clinicians for collaborative practice.

First-Trimester Abortion Complications: Simulation Cases for OB/GYN Residents in Sepsis and Hemorrhage

IntroductionSerious complications associated with first-trimester abortions are rare. The US mortality rate for these procedures is 0.7 per 100,000, primarily due to infection and hemorrhage. While complications are unlikely to arise during training, residents must be prepared to manage them in practice. To address this, we developed a 2-hour simulation-based abortion complication curriculum for OB/GYN resident learners.MethodsOB/GYN residents participated in three sessions: a case-based didactic reviewing institutional aspiration abortion practice and preop preparation; an in-vivo aspiration abortion hemorrhage simulation; and an interdepartmental postabortal sepsis simulation. Participants completed surveys before and after their participation that evaluated clinical knowledge, and self-rated competence in, and preparedness for, managing first-trimester abortion complications.ResultsResident learners (N = 26) represented all four classes of OB/GYN residents. Residents initially showed stronger clinical knowledge in managing postabortal hemorrhage than sepsis (90% vs. 62%, p < .001). Clinical knowledge improved following the sepsis simulation (62% to 91%, p < .001), and remained strong but unchanged after the hemorrhage simulation (90% to 87%, p = .3). Resident self-assessments of competence and preparedness were significantly improved after both the hemorrhage (p = .006) and sepsis (p = .002) simulations. Learners reported that the simulation increased their level of comfort in managing these complications in their future practice.DiscussionPostabortal hemorrhage and sepsis simulations increased OB/GYN residents' knowledge, comfort, and preparedness for managing rare complications of first-trimester abortions. In-vivo simulation and interdepartmental collaboration were novel aspects of these simulations that may facilitate increased preparedness and management skills.

Analysis of an Interprofessional Experiential Learning Program Utilizing the Case of Henrietta Lacks

An experiential interprofessional learning opportunity for university students was developed to demonstrate core competencies (CC) based on the Interprofessional Education Collaborative and to foster a deeper understanding of the interaction between literature, health care, and social justice. Faculty members in the Schools of Professional Development, Public Health, Medicine, and Social Welfare at Stony Brook University contributed to the program including use of the book, The Immortal Life of Henrietta Lacks by Rebecca Skloot (2010). The book was a springboard to combine John Dewey’s educational ideas of constructivist learning with select CC. Invitations for participation were extended to faculty and students enrolled in graduate programs in Teaching, Public Health, Medicine, Social Work, and Physician Assistant Education as well as undergraduate health science majors. The ultimate learning event was a 4-hour evening program that facilitated teamwork and collaboration among the 250 participants. The event presented information and context in multiple ways: The book inspired an innovative presentation, followed by pointed questions, discussion, problem solving and reflection. Topics explored included communication across cultures and diverse populations, privacy and patient rights, professional roles and responsibilities, and advocacy for self and others. Following the event course, instructors collected post-event reflective essays submitted by the master of public health student participants, which were analyzed using qualitative methods. This article describes the experiential learning program and the evaluation of its impact on students, with the purpose of enhancing the potential for other institutions to replicate this novel educational structure and achieve Interprofessional Education Collaborative CC.

Care Across Campus: Athletic Training, Nursing, and Occupational Therapy Student Experiences in an Interprofessional Simulation

Context: This study explored health care students' experiences after participation in an interprofessional simulation. Interprofessional education incorporates students from several health care professions in a controlled, collaborative learning environment. Athletic training students are not well represented in interprofessional education literature. Objective: This study sought to explore the attitudes of athletic training, nursing, and occupational therapy students toward other professions after their participation in an interprofessional simulation. Design: This article describes the results of the qualitative portion of a mixed-methods study. Focus group discussions related to elements of the Interprofessional Attitude Scale to explore participants' attitudes toward other professions. Researchers analyzed transcribed focus group discussions for themes. Setting: This study occurred in a private midsized Midwestern university. Patients or Other Participants: Seventy-nine students, representing athletic training, nursing, and occupational therapy, participated in the simulation; a sample of 13 of these participated in the focus groups. Intervention(s): Students in all professions cared for or observed the care of a standardized patient from the time of a spinal cord injury on the football field through an ambulance ride and subsequent emergency and inpatient care. Students collaborated and communicated with one another. Faculty conducted debriefing after the simulation and before the focus groups. Main Outcome Measure(s): Focus groups included relevant questions from the Interprofessional Attitudes Scale, and themes were identified from participants' responses. Results: Researchers identified 4 themes from the focus group discussions: collaboration, respect, knowledge of other professions, and communication. These themes also mirror elements of the Interprofessional Education Collaborative's core competencies of interprofessional collaborative practice. Conclusions: After the simulation, students expressed positive attitudes toward other professions. This study suggests that athletic training, nursing, and occupational therapy students have positive attitudes toward each other's professions after an interprofessional simulation activity.