Health Professional Programs Research Articles

Interprofessional Education for Students of Translation/Interpreting and the Health Professions

In response to the rising need for Spanish-English interpreters in the United States, there has been an increase in translation and interpreting and Spanish for the health professions courses in Spanish language programs (Martinez 2015). However, before Spanish students are exposed to a clinic or hospital context, they may have limited experience interacting with health professionals. Health professions programs encourage their faculty to develop opportunities for students from different professional fields to learn together (“interprofessional education”), but these opportunities do not frequently extend to language programs. In this essay, we present the need for an interdisciplinary approach to addressing health equity for Spanish speakers in the United States and provide practical suggestions for interprofessional education opportunities that allow students in translation and interpreting programs and the health professions to work together. To illustrate our approach to interprofessional education, we describe a patient care simulation activity for Spanish and nursing students. Through interprofessional activities addressing language and healthcare, Spanish and health professions students can gain an awareness of their role in supporting health equity for Spanish-speaking Latinos in the United States and practical experience with collaborating and addressing communication difficulties in healthcare settings.

Effects of brief training on mental health provider's knowledge of working with youth at risk of suicide in Guatemala.

Resources for mental healthcare are lacking in Guatemala, yet rates of mental illness and suicide are quite high. Mental healthcare providers often lack the knowledge needed to effectively work with young at-risk of suicide. To address this gap, we developed a training program for mental health professionals focused on increasing knowledge and understanding of engaging and working with youth at risk of suicide and present its acceptability and preliminary effectiveness. Mental health providers (N = 17) from a low SES community participated in the training, Formacion CUIDAR (Comunidades Unidos para Individuales De Alto Riesgo; CARE Training; Communities United for Individuals at High Risk). Mixed methods were used to explore outcomes including, self-reported knowledge and understanding of warning signs; risk and protective factors; effective risk assessment; and, techniques for working with at-risk youth. Findings indicate that the training was effective at increasing all targeted domains of knowledge (t = 2.46, p < .05, Cohen's d = .56). Acceptability was also rated as high. Scarcity of mental health specialists and lack of training on suicide assessment and management have resulted in inadequate resources for at-risk youth in need of mental health services in Guatemala. Results of our study demonstrate that our training is an acceptable, effective program for practicing mental health providers to address their lack of specialized training on how to work with individuals at risk of suicide. Further examination of the training in a larger RCT is required to attain more robust indictors of effectiveness and to assess long-term impact.

Working beyond disciplines in teacher teams: teachers' revelations on enablers and inhibitors.

IntroductionHealth professions education faces transitions from monodisciplinary to integrated education and from soloist teachers to interdisciplinary teacher teams. Interdisciplinary teamwork has been found complex and prone to conflict. Teachers’ perceptions of why some teams work and learn as a real interdisciplinary team and others do not are lacking in this setting. We studied the factors that teachers perceive as enabling and/or inhibiting interdisciplinary team learning.MethodsIn this exploratory, qualitative study, we conducted 17 semi-structured, vignette-guided interviews with teachers recruited from diverse disciplines in undergraduate health professions programmes at Maastricht University, the Netherlands, through maximum variation sampling. Team learning research informed data collection and template analysis.ResultsWe identified three themes representing the factors that teachers perceived to influence interdisciplinary team learning: ‘alignment/misalignment with the educational philosophy’ (regarding personal attributes, tendencies and motivation), ‘leadership practices’ (encompassing team vision, responsibility and reflection), and ‘involvement in organisational processes’ (covering organisational decision-making, support and learning opportunities). For interdisciplinary team learning in development of integrated education, teachers emphasised their personal ability to move beyond disciplinary boundaries. Shared team leadership enabled the creation of a shared vision, shared responsibility, and team reflection. Lastly, teacher involvement in educational management, peer support and learning was considered important.DiscussionTo work beyond disciplines in health professions education, teachers should take an interest in integrated education, share responsibility and work in an environment where people continuously learn from others. Organisations can facilitate this by involving teachers in decision-making processes and providing faculty development aimed to foster shared leadership and team reflection.Supplementary InformationThe online version of this article (10.1007/s40037-020-00644-7) contains supplementary material, which is available to authorized users.

Developing a Framework to Increase Access to Mental Health Services for Children With Special Needs in Ethiopia.

The availability and accessibility of Westernized mental health diagnostic processes and evidence-based treatments are limited in developing countries, such as Ethiopia (Kakuma et al., 2011; Hohenshil et al., 2013; Wondie, 2014; Zeleke et al., 2017b). Similar to other developing nations, there is (a) a lack of health care services for mental practices to build on, (b) limited services that are well-suited to the culture (Wondie, 2014; Zeleke et al., 2019), (c) limited scientific literature useful for documenting the needs of the Ethiopian public, and (d) too few mental health professional preparation programs (Zeleke et al., 2019). Whereas Western cultures generally follow the biomedical model conceptualization and treatment of disease, non-Western cultures, such as Ethiopia tend to adhere to traditional and religious views to explain the origin of mental illness (Kortmann, 1987; Jacobsson and Merdassa, 1991). Mental health symptoms may be attributed to supernatural causes or other spiritual crises, rather than a combination of biopsychosocial influences. As such, individuals seeking help with mental health symptoms in Ethiopia are mostly limited to family, friends and local community healers (Zeleke et al., 2017a, 2019). When individuals are brought to the few places providing Westernized mental health care, it is often only after exhausting other traditional and religious alternatives (Bekele et al., 2000). Even when there is a desire to seek Westernized services, socioeconomic circumstance, cultural factors (e.g., a focus on collectivism practices), negative attitudes toward mental illness, along with unfamiliarity and fear of these new practices, are noted barriers to receiving treatments. Beliefs passed down through cultural taboos go on to effect multiple generations. Not only do barriers affect individuals, but they also negatively impact the range of services for children, families and communities. With the ultimate goal of improving mental health care access for children, a full appreciation of the context is essential.

AGHE Program of Merit: Practical and Technical Application Information and Assistance

At a time in education when it is important for programs at colleges and universities to be productive in teaching, student recruitment, and income generation, the AGHE Program of Merit review process can aid in advancing gerontology and health professions programs. The AGHE Program of Merit has expanded its review. Now Colleges of Osteopathic Medicine and all Health Professions program may apply for Program of Merit status.. The POM designation provides gerontology programs and those health professions program that include geriatrics/gerontology content in the curriculum with an AGHE “stamp of approval” which can be used to verify program quality to administrators, to lobby for additional resources, to maintain a quality program, to market the program, and to recruit prospective students into the program. This session will begin with the “Why,” “What” and “How” of applying for Program of Merit and then provide time for small group consultation regarding the Program of Merit application. Preparation of the self-study document will be detailed by the experienced faculty members followed by the review process and timelines associated with application process. Free consultation available!

Nimble Gerontological Interprofessional Education During a Pandemic

To improve communication and collaboration among health professionals, interprofessional education (IPE) experiences have been offered to students through the Utah Geriatric Education Consortium (UGEC) with the support of long-term care (LTC) partners since 2017. The COVID-19 pandemic presented a unique challenge in delivering in-person IPE training. Here we describe adaptations and student outcomes with our Spring/Summer 2020 training sessions. Students (n=46) from health profession programs were recruited and enrolled in the sessions. A LTC partner helped plan two-hour remote training sessions to introduce students to current issues and health care team member roles in LTC. Moderated small group discussions regarding the 4 Ms Framework and a patient case were completed using virtual breakout rooms. A shared virtual document was used to guide discussions and record insights. Student participants (n=46) were primarily White (85%), female (70%), and enrolled in physical therapy (28%), nutrition (33%), and medicine (15%) programs. Thirty-one students completed post-course satisfaction surveys with Likert-scale and open-ended questions. Most students who completed the survey agreed or strongly agreed that the course was effective (85%) and engaging (81%), and will improve care (88%). Positive course aspects included: comprehensive information with speaker experiences and use of 4 Ms; course structure with moderated small groups; and interprofessional collaboration with common goals and multiple perspectives. Despite the challenges of COVID-19, an IPE experience was effectively delivered using video conferencing technology, community collaboration, and moderated small group discussions. The successes of this IPE delivery model will enhance engagement and accessibility of future gerontological workforce training.

Age-Friendly University Initiative Applied to Health Professions Education Programs

Opportunities for health professions (HP) education programs to make a mark in the Age Friendly University (AFU) initiative abound. Key approaches are introduced, and insights for mounting these efforts are discussed, for HP education programs based on the AFU global network initiative and the Academy for Gerontology in Higher Education (AGHE). Higher Education Institutions (HEIs) that offer HP education, have various options to establish and enhance gerontology/geriatrics competence and confidence for their students. AFU guiding principles applicable to HP education allow health gerontology faculty to be catalysts to promote and integrate the AFU guiding principles within their program’s existing curriculum. This can contribute to their institution’s readiness to apply for the AFU designation, advance the institution’s age friendliness, and/or set up the program to apply for the AGHE Program of Merit (POM) for Health Professions Programs. All prepare future HP professions providers to improve older adult health care. Part of a symposium sponsored by Directors of Aging Centers Interest Group.

AGHE Program of Merit for Health Professions Education

In 2015, the Program of Merit was expanded and adapted to implement a voluntary evaluation process for health professions programs that are choosing to integrate gerontology/geriatrics competencies in order to prepare students for working with older adults as well as their informal care partners. These programs are now eligible to apply for the Program of Merit designation. The Program of Merit for Health Professions Programs is based on the AGHE Standards and Guidelines for Gerontology/ Geriatrics in Higher Education, Sixth Edition (2015), specifically Chapters 11 and 12. This session will provide an overview of the process, review the application content, and provide technical support for interested participants.

Improving the LGBTQ2S+ cultural competency of healthcare trainees: advancing health professional education.

BackgroundLesbian, Gay, Bisexual, Trans, Queer, and Two-spirit (LGBTQ2S+) populations experience worse health outcomes compared to age-matched heterosexual and cisgender peers. Health professionals’ deficient knowledge and negative attitudes can contribute to these inequities. Healthcare trainees report insufficient LGBTQS2+ cultural competence training.MethodsIn this prospective, mixed-methods pre-post design, Atlantic Canadian health students were tested on knowledge, attitudes and self-reported behaviours towards LGBTQ2S+ populations in healthcare settings. Assessment included psychometric measurements and clinical cases involving normative and non-normative fictional patients. Participants were randomised to intervention or control groups. The intervention consisted of three training sessions lead by LGBTQ2S+ experts and elders from the community. The control group continued with usual training. Full assessment was repeated after training. We also held focus group discussions with students and faculty.ResultsThe intervention group significantly improved attitudes toward and knowledge of LGBTQ2S+ populations and changed relevant aspects of their performance in the simulated clinical situations. Focus groups identified key gaps in current local training.ConclusionsIntegrating specific training related to LGBTQ2S+ health within health professions programs is an important step toward improving these populations’ accessibility to a competent, exhaustive and nurturing healthcare. Additional research on innovative means to expand and broaden the scope of our training is warranted.

Clinical leadership development in Australian healthcare: a systematic review.

Despite clear priority and high costs of leadership capability programmes in healthcare, and significant investments into improving clinical leadership, there remains a prominent gap around evidence of effectiveness or impact on patient outcomes in Australia. We aimed to conduct a systematic review on postgraduate clinical leadership programmes to gather learnings on the processes, theoretical underpinnings, and impact of such programmes for medical and other health professionals. Our search included empirical, peer-reviewed evaluations of Australian clinical leadership development programmes published between November 2008 and March 2019 and yielded 3284 records. Four studies met criteria. Findings revealed that currently, little value is placed on formal evaluations and peer-reviewed publication including assessment of individual, organisational or system level impacts of clinical leadership development programmes, with limited evidence available on effective approaches to clinical leadership development in the Australian healthcare system.

Physiotherapy students can be educated to portray realistic patient roles in simulation: a pragmatic observational study

BackgroundSimulation-based education (SBE) has many benefits for learners, but costs can limit embedding SBE in health professional curricula. Peer simulation involves students portraying patient roles, and may reduce costs while still providing the benefits of other SBE experiences. However, the quality of the SBE may be impacted if students cannot portray authentic and realistic patient roles. The aim of this study was to investigate whether targeted education was associated with observable changes to physiotherapy students’ abilities to portray patient roles in SBE.MethodsSecond year pre-registration physiotherapy students (n = 40) participated. Students completed online and face-to-face education about SBE, patient portrayal skills, and how to portray a specific patient role. Students were video-recorded portraying patient roles in practical exams before and after the program. Three blinded independent assessors rated the overall quality of portrayals using a purpose-developed assessment instrument.ResultsTwenty-three sets of pre- and post-program videos were analysed. Correlations between assessor scores spanned 0.62 to 0.82 for analyses of interest, which justified using average assessor ratings in analysis. Statistically significant higher scores were seen for post-program assessments for overall portrayal scores (mean difference 6.5, 95%CI [1.51–11.45], p = 0.013), accuracy (mean difference 3.4, 95%CI [0.69–6.13], p = 0.016) and quality (mean difference 3.1, 95%CI [0.64–5.49], p = 0.016).ConclusionsPhysiotherapy students appear capable of playing realistic patient roles. Peer simulation can be embedded into health professional programs, and education in patient role portrayal appears to be associated with improvements in portrayal quality and realism. Given these findings, further investigation, including testing program effects in a randomised study, is warranted.

Descriptions and Reflections on the Cognitive Apprenticeship Model of Psychotherapy Training & Supervision.

This paper offers a detailed description of a Cognitive Apprenticeship Model for psychotherapy training and supervision. This form of training has been utilized in a novel psychotherapy training program developed for psychiatric trainees, enrolled in a specialized psychotherapy scholars track, embedded in an adult psychiatric residency training program. The paper offers new elaborations of the model, reflections on the apprenticeship supervision and implementation, and clinical lessons learned. The four dimensions of this model include: (1) acquisition of psychotherapy content knowledge; (2) an application of the Cognitive Apprenticeship Model of Supervision, utilizing modeling, coaching, scaffolding, articulation, reflection and exploration as essential aids in structuring a live, real-time supervisory experience; (3) sequencing of clinical psychotherapy training activities; and (4) use of situated learning and communities of practice, as important components of psychotherapy training. The article also discusses an apprentice method of psychotherapy supervision including the intake, working through, and termination phases, Barriers impeding apprenticeship supervision and implementation, and reflections on participant experiences are discussed. This approach may be valuable to others considering the development or evolution of psychotherapy training programs for psychiatrists, psychologists, social workers, or other mental health professionals.

Interprofessional education clinical placement program: a qualitative case study approach

ABSTRACT The goal of health professional education programs is to produce competent graduates, with an ability to work collaboratively as effective healthcare team members. We explored the reflections of students and clinical facilitators, in response to participation in a structured interprofessional education (IPE) clinical placement program. In our qualitative study we used an exploratory case study design. In our analysis, we highlight the benefits of interprofessional practice. Key themes identified by students included: limited opportunities to engage in IPE across their course; lack of clarity around IPE; value of IPE for students, practitioners, and patient outcomes; and need for IPE opportunities to be integrated into placements. Key themes identified by the clinical facilitators included: being reminded of the value of IPE for students and patients; preparation for IPE placements need to be embedded in curricula; coordination and communication of IPE learning activities need to be clear for staff and students; and IPE should continue as part of the broader clinical education agenda. Our findings reinforce the notion that students and clinical facilitators value the importance of IPE for student learning within the clinical placement setting. The outcomes offer valuable insights for universities and hospital and health care contexts for setting up and implementing IPE activities, and we provide recommendations for improving ongoing IPE efforts within clinical placement setting.

The Toll of Student Debt: Stress Among Health Professions Students and the Promising Role of Financial Self-Efficacy on Career Choices

Introduction. As the cost of higher education rises, the debt associated with degree attainment also increases, including that of the Doctor of Physical Therapy degree. Research suggests that a relationship between financial debt and postprofessional career aspirations may exist, and financial self-efficacy could attenuate debt-related stress. These relationships have not been studied in the health professions outside of medicine. Methods. A total of 139 participants among 6 health professions programs housed in one public, academic medical center were surveyed. Surveys administered to participants provided Likert scale data for a multiple regression analysis. Results. Eighty-one percent of students reported having a medium, large, or extreme amount of stress from the total amount of debt they are accruing. More than 70% of student responses indicated that the amount of student loan debt they expect to accumulate will influence their posttraining career selection to some extent. The regression model indicated some predictive ability of stress from student debt. Two of the covariates, self-efficacy and career selection, were statistically significant. Self-efficacy accounted for 36% of the variance explained in students' self-reported stress from debt by itself. Students' career selection and stress were strongly associated, with career selection explaining 85% of the variance explained in students' self-reported stress by itself. Discussion. Health professions students in a public academic medical center had a “medium amount” of stress, on average, from financial debt. Stress was associated with the amount of student loans students expect to accrue and their financial self-efficacy. Students also appeared to base their postprofessional career aspirations, at least in part, on the stress they experienced from financial debt. Financial self-efficacy appears to be a promising moderator for debt-related stress. Conclusion. Stress appears to be associated with higher student loan debt, but financial self-efficacy may moderate this trend. Level of Evidence. IV, Cross-sectional descriptive survey design. What Is Known About the Subject? Costs of physical therapy programs continue to rise, requiring more physical therapy students to use loans to pay for their education. Other professions, including medicine, have noted that student loan debt can cause high amounts of stress and has the potential to influence career choices. What This Study Adds to the Existing Literature? Health professions students in one academic medical center appear to base their postprofessional career aspirations, at least in part based on the stress they experience from financial debt. Financial self-efficacy appears to attenuate the amount of stress students feel from student loan debt.

Mapping mental health recovery tools developed by mental health service users and ex-users: protocol for a scoping review

IntroductionSince the emergence in 1997 of the Wellness Recovery Action Plan, a number of other tools developed by users and/or ex-users of mental health services have been published and implemented....

Web-Based Training for Nurses on Shared Decision Making and Prenatal Screening for Down Syndrome: Protocol for a Randomized Controlled Trial.

BackgroundPregnant women often find it difficult to choose from among the wide variety of available prenatal screening options. To help pregnant women and their partners make informed decisions based on their values, needs, and preferences, a decision aid and a web-based shared decision making (SDM) training program for health professionals have been developed. In Canada, nurses provide maternity care and thus can train as decision coaches for prenatal screening. However, there is a knowledge gap about the effectiveness of SDM interventions in maternity care in nursing practice.ObjectiveThis study aims to assess the impact of an SDM training program on nurses’ intentions to use a decision aid for prenatal screening and on their knowledge and to assess their overall impressions of the training.MethodsThis is a 2-arm parallel randomized trial. French-speaking nurses working with pregnant women in the province of Quebec were recruited online by a private survey firm. They were randomly allocated (1:1 ratio) to either an experimental group, which completed a web-based SDM training program that included prenatal screening, or a control group, which completed a web-based training program focusing on prenatal screening alone. The experimental intervention consisted of a 3-hour web-based training hosted on the Université Laval platform with 4 modules: (1) SDM; (2) Down syndrome prenatal screening; (3) decision aids; and (4) communication between health care professionals and the patient. For the control group, the topic of SDM in Module 1 was replaced with “Context and history of prenatal screening,” and the topic of decision aids in Module 3 was replaced with “Consent in prenatal screening.” Participants completed a self-administered sociodemographic questionnaire with close-ended questions. We also assessed the participants' (1) intention to use a decision aid in prenatal screening clinical practice, (2) knowledge, (3) satisfaction with the training, (4) acceptability, and (5) perceived usefulness of the training. The randomization was done using a predetermined sequence and included 40 nurses. Participants and researchers were blinded. Intention to use a decision aid will be assessed by a t test. Bivariate and multivariate analysis will be performed to assess knowledge and overall impressions of the training.ResultsThis study was funded in 2017 and approved by Genome Canada. Data were collected from September 2019 to late January 2020. This paper was initially submitted before data analysis began. Results are expected to be published in winter 2020.ConclusionsStudy results will inform us on the impact of an SDM training program on nurses’ intention to use and knowledge of decision aids for prenatal screening and their overall impressions of the training. Participant feedback will also inform an upgrade of the program, if needed.Trial RegistrationClinicalTrials.gov NCT04162288; https://clinicaltrials.gov/ct2/show/NCT04162288International Registered Report Identifier (IRRID)DERR1-10.2196/17878

Fostering gerontology students\u2019 competence in Interprofessional collaborative practice

BackgroundInterprofessional collaborative practice (IPCP) is increasingly recognised as being crucial for the provision of holistic care and optimising health outcomes among older adults, many with multiple complex health problems. However, little is known about the challenges of facilitating this in practice. Therefore, this study explores these issues from the perspective of different healthcare professionals and how this might inform interprofessional education curricula.MethodsSixteen different healthcare professionals working in a variety of aged care (acute, rehabilitative and community) settings were invited to participate in individual semi-structured in-depth interviews designed to: (i) explore the meaning of IPCP; (ii) explore the facilitators of and barriers to IPCP; and (iii) examine the opportunities and challenges in interprofessional gerontological education. All interviews were tape-recorded and transcribed verbatim with thematic analysis conducted by two independent researchers.ResultsThree major themes emerged from the interviews: the need for IPCP; role preparedness, scope and liability; and strategies for interprofessional education. Respondents shared a common belief that IPCP improves the quality of life of older adults in both hospital and community settings by improving person-centred coordinated care and decision making in care planning. However, respondents perceived major barriers to IPCP to be lack of knowledge about healthcare professionals’ scope of practice, lack of training in interprofessional collaboration, professional culture and stereotypes, and liability issues. Suggested approaches to overcome these barriers included innovative teaching and learning approaches, engaging students early on in the curriculum of health professional degree programmes, and enhancing collaborative effective communication in health and social care settings.ConclusionsIt is anticipated that these findings will be used to inform the development of a new interprofessional gerontological education curriculum that aims to enhance students’ competence in IPCP.

Escape the Pharmacy: An Active Learning Strategy for the Nursing Pharmacology Classroom.

Escape the Pharmacy is a fast-moving collaborative challenge for students in nursing and other health professions programs requiring coursework in pharmacology. Teams of students compete to solve a series of puzzles that reinforce knowledge of safe analgesic administration. Information regarding maximum dosing and adverse effects of opioids, nonsteroidal anti-inflammatories, and acetaminophen is included, as well as content on types of pain receptors. Recognition of opioid toxicity and symptoms of oversedation are all part of the challenge of escaping the pharmacy.

Evaluating the effects of behavior change training on the knowledge, confidence and skills of sport and exercise science students

BackgroundBehavior change interventions have the potential to have a transformative effect on the health of populations. Allied health professionals have a key role to play in delivering these interventions. However, traditionally undergraduate allied health professional programs have not had a behavior change focus. The aim of this study was to assess the effectiveness of a training program on sport and exercise science students’ knowledge, confidence and skills in the provision of behavior change support.MethodA mixed method convergent design was used to address the research question. Fifteen sport and exercise science students took part in a training program consisting of seven 90-min weekly face to face group sessions. Student satisfaction with training methods was assessed. Pre-to-post training changes in students’ confidence and knowledge in the provision of behavior change support was evaluated. Delivery of behavior change support was assessed by an audio recorded role-play rated by an expert using the Health Care Climate Questionnaire, and an adapted version of the Communication Evaluation in Rehabilitation Tool. Students also completed a reflective assignment.ResultsStudents were satisfied with the training. There were increases in students’ confidence and knowledge of certain behavior change components post-training but not behavior change techniques. Students delivered behavior change support in a broadly needs supportive manner. The reflective assignment showed that students found particular behavior change strategies difficult to implement.ConclusionIt is feasible to train undergraduate students in particular components of behavior change support. Academic institutions should embed behavior change training into the allied health professional curriculum to ensure graduates are job ready with the knowledge, confidence and skills to support health related behavior change within the wider health system.

Key Steps to Implementing Physical Activity into Health Professional Training Programs.

Key Steps to Implementing Physical Activity into Health Professional Training Programs.