Interprofessional Research Articles

Evaluation of an interprofessional collaborative practice training module for the management of children with autism spectrum disorder

BackgroundProtocols instituted for behavioral treatment and skills training programs for the management of autism spectrum disorder (ASD) suffer from lack of collaborative approaches. The tenets of interprofessional collaborative practice (IPCP) focus on preparing a panel of health care professionals (HCPs) from different professions who can work together to enable the common goal of ensuring that children with ASD can participate in society. This study was designed to pilot this approach through an IPCP training module on ASD for care providers from multiple professions. MethodsAn interventional study with pre-post analysis began with formation of the interprofessional (IP) team, who developed an IPCP module, addressing the knowledge and skills needed for the collaborative management of neurodevelopmental issues of children with ASD. This module was delivered through an online training workshop using various teaching learning methods to the participants from seven different health professions after obtaining informed consent. Perceptions of interprofessional collaboration and competencies of IPCP were assessed using standard IP tools and reflective summaries and analyzed through a mixed-methods approach. ResultsA total of 42 HCPs from seven professions, including speech and hearing, occupational therapy, clinical psychology, physiotherapy, pediatrics, nursing, and pedodontics, participated in the study. Pre-post analysis of PINCOM-Q and Dow-IPEC data and thematic analysis revealed a significant difference in the perceptions of interprofessional collaboration and competencies’ levels of IPCP. ConclusionThis study suggests that use of IPCP principles in the training of professionals working with ASD is a promising and feasible option to develop more competent health professionals. The training enhanced the abilities of professionals to work in field of ASD as conveyed by the participants. They also expressed confidence in the knowledge of IP core competencies after the completion of the module.

Comparison of 2 Methods of Debriefing for Learning of Interprofessional Handoff Skills

Purpose: Interprofessional (IP) handoff communication is imperative for patient safety in high-risk environments. Debriefing is an essential component of the learning process of this skill. Currently, one method of debriefing has not proven more effective than another. Therefore, the purpose of this study was to compare 2 forms of debriefing (face-to-face [F2F] debriefing vs computerized personal reflection) on learning and retention of IP handoff communication. Methods: Fifty-two (n = 52) third-year doctor of physical therapy students completed IP simulated experiences, followed by debriefing. Subjects were divided into 2 groups: (a) F2F debriefing (n = 26) and (b) computerized personal reflection (n = 26). Observed IP handoff communication behaviors were measured with an assessment tool. Results: Overall IP handoff skills improved from pre- to posttest scores (P < .05). The F2F debriefing demonstrated greater improvement in the delivery of communication and content skills (P < .05) than computerized personal reflection debriefing. Conclusion: The F2F debriefing should be included in the training of current and future physical therapists.

Development of an Interprofessional Handoff Assessment for Doctor of Physical Therapy Students

Background and Purpose: Handoff communication, especially interprofessional (IPE) handoff communication, has been shown to make up a large portion of communication errors in health care. There is variability in the way professionals are trained and deliver the pertinent patient information in handoffs, which, causes confusion, makes recall difficult, and increases the incidence of medical errors. Thus, this study aimed at assessing IPE handoffs for individuals who are trained in SBAR (Situation, Background, Assessment, and Recommendation) method of IPE communication developed by TEAM STEPPS®. Method: To assess IPE handoffs for those who are trained with the SBAR method, an existing tool was modified to make it more explicit to IPE handoff communication using descriptors from SBAR. Reliability and internal consistency were evaluated using videos of IPE handoffs of doctor of physical therapy (DPT) students. Results: Spearman rank coefficients for the revised assessment domains ranged from 0.56 to 0.86, indicating a strong correlation. The communication and content domains had the highest level of correlation. The interrater reliability of the 5 raters was 0.85, indicating high reliability. Discussion and Conclusion: This assessment proved to be simple and reliable to measure IPE handoff communication skills during emergent situations between DPT students and standardized nurses. Thus, this assessment can be used to assess interprofessional handoffs, develop competencies improved teamwork, and reduce medical errors.

Building interprofessional team competence through online synchronous simulation of palliative care scenarios

Simulation-enhanced interprofessional education (Sim-IPE) is increasingly used in health professional programs to promote team competence. Sim-IPE using online technology incorporating palliative care (PC) scenarios may be an attractive option for including distance learners, overcoming clinical-site restrictions, and increasing proficiency in difficult conversations. To evaluate outcomes of Sim-IPE using a web-conferencing platform in an interprofessional (IP) PC course. Repeated measures were used to evaluate self-efficacy and competent performance in IP PC scenarios among enrolled students (N = 24) during a two-part simulation in two separate semesters. Student health professions included nursing, medicine, pharmacy, social work, occupational therapy, and physical therapy. Significant self-efficacy increases were found between Simulations 1 and 2 in both course offerings, with competent student team performance in each simulation. Distance Sim-IPE using PC scenarios are effective pedagogy for IP students to develop competence in how to engage, collaborate, and communicate among teams for patient-centered care.

2021 Year in Review: Interprofessional Education.

Interprofessional (IP) education is focused on learning about, from, and with other health care professionals in an effort to improve patient care and specifically patient safety. IP education does not diminish the importance of discipline-specific competencies but rather focuses on making the connections necessary to develop IP collaborative practice to improve the quality of health care. Research studies addressing IP education in both health profession students and health care professionals published during 2021 are reviewed. The studies explored improving attitudes toward IP education, improving communication and collaboration skills, and improving patient safety. Review of the recently published IP education literature reveals opportunities for respiratory therapy educators, researchers, managers, and clinicians to discover ways to develop IP collaborative practice to ultimately have an important impact on the outcome of the patients we serve.

Evaluation of Interprofessional Education on Effective Communication Between Pharmacy and Physician Assistant Students.

The purpose of this study was to assess the effect of Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) on student self-perceived competencies and perceptions of interprofessional (IP) communication and teamwork in a clinical case review activity. TeamSTEPPS is an evidence-based curriculum that is used to enhance and support IP healthcare communication. A repeated-measures, pretest/posttest study evaluated physician assistant students' and student pharmacists' perceptions of TeamSTEPPS. Students completed Performance Assessment for Communication and Teamwork (PACT) surveys, evaluating teamwork, knowledge, attitudes, and skills perceptions before and after a TeamSTEPPS lecture and associated activity with peer feedback. Overall, 87.4% (n = 429) completed pre- and post-PACT surveys. Apart from the Mutual Support domain (p = .898), all changes were significantly positive (p < .004), with the greatest improvements occurring in the Attitudes and Perceived Skills domains. TeamSTEPPS IP education, application, and peer feedback improved students' perceptions of multiple domains, including effective communication. Using TeamSTEPPS tools in IP formats enabled the students to safely practice and collaborate in preparation for clinical practice.

Team reflexivity and the shared mind in interprofessional learning

In interprofessional (IP) workplace education, course and project leaders need a deeper understanding of how students learn. Basically, in IP workplace learning students learn from each other, from the affected agents (patients, clients, children, youth, or elderly), from the staff, and from using multitudes of artifacts. Most of these interpersonal processes are largely tacit, and we therefor decided on elucidating their possible parts in IP learning theoretically, focusing on central interpersonal aspects of team learning processes; team reflexivity and intersubjectivity. Consequently, our study aim was to elucidate possible associations between team reflexivity and the shared mind when students in the IP team interact within each other, with the people and with the artifacts around them. In this article we investigate, elaborate, and conceptualize relevant social theories which address aspects of team reflexivity and intersubjective activities. We will then elaborate and conceptualize consequences for increased understanding IP team learning. Based on our mutual libraries, we have searched in PubMed and Google Scholar for team reflexivity, intersubjectivity, shared mind and their combinations. We came to understand reflexivity and team reflexivity as mostly tacit activities which may be regarded as being interpersonal and self-pacing. Intersubjectivity is however based on the free interaction between minds, orchestrating each other with common ideas, thoughts, attitudes, and bodily actions. Intersubjectivity is created when team members’ verbal and non-verbal activities resonate, giving a shared feeling of developing mutual and common ideas, concepts, and understanding. Team reflexivity, and intersubjectivity are necessary aspects in understanding the learning processes in IP student teams, and we have sketched some consequences for IP course design.

The Struggle is Real: Understanding Helping Behaviours in Obstetrical Teams Using Interprofessional Simulation

Interprofessional (IP) healthcare team members frequently encounter challenges that require them to seek help; yet we understand little about how team members enact such helping behaviours. Given that IP simulation mimics the complexities health care teams experience in clinical practice whilst attending to educational goals, our study seeks to explore helping behaviours in IP teams in an obstetrical simulation context.

An Educational Module to Teach Interprofessional Learner Feedback Skills for Trauma Simulation Events.

BackgroundPeer feedback, or feedback given by a learner to another learner, is an important active learning strategy. Hierarchy and stereotypes may affect interprofessional (IP) learner-to-learner feedback. The aim was to assess the efficacy of an educational module for IP learners in delivering effective feedback during trauma simulations.MethodsMultiple simulation events designed to improve teamwork and leadership skills during trauma simulations included IP learners (residents and nurses). Participants completed a pre-course educational module on IP peer feedback. The Trauma Team Competence Assessment-24 tool structured feedback. Learners completed pre/post-assessments utilizing IP Collaborative Competencies Attainment Survey (ICCAS).ResultsTwenty-five learners participated in the trauma simulations (13 general surgery and 5 emergency residents, 3 medical students, 4 nurses). The majority of learners had either not received any previous training in how to effectively deliver peer feedback (40%) or had engaged in self-directed learning only (24%). Most learners (64%) had delivered peer feedback less than ten times. Learner knowledge and confidence in delivering feedback to fellow IP learners improved after simulations. All learners felt the feedback received was useful to their daily practice (68% agree, 32% strongly agree). All participants agreed that the simulation achieved each of the ICCAS competencies.ConclusionsFormal education on IP peer feedback is rare. This pilot work demonstrates educational modules with a foundation in validated tools can be effective in improving learner knowledge and confidence in the process. Engaging in IP peer feedback may also serve to flatten hierarchies that can challenge effective interprofessional teamwork.

Interprofessional Simulation as an Educational Tool to Assess Cultural Competence Among Health Professions Students.

The concept of collaborative practice within health professions is viewed as "best practice." Poor collaboration can adversely affect patient safety. Interprofessional (IP) teamwork skills can be developed and nurtured through the health professionals' education; however, many barriers exist, which deter this from occurring. A lack of cultural diversity exposure within the healthcare setting can result in treatment disparities and place the patient at risk. One healthcare area that has gained considerable interest is the practitioners' understanding of multiculturalism and how cultural competence subsequently influences health disparities. This study examined the application of culturally complex clinical simulation scenarios that intentionally integrated IP teamwork and hypothesized that participants' understanding of cultural competence would improve. Participants were junior-level nursing, bachelor-level social work, graduate-level occupational therapy, and PharmD students (N = 180) who participated in an IP simulation exercise composed of culturally complex clinical scenarios performed by trained standardized patients designed to demonstrate underrepresented populations with diverse religious/spiritual, sexual orientation, racial/ethnic, socioeconomic, psychosocial, and geographic characteristics. Survey tools included an adapted Multicultural Awareness, Knowledge, and Skills Survey (MAKSS) and the Cultural Awareness Assessment Tool (CAAT). Descriptive statistical analyses were conducted to describe the sample population with the use of inferential statistics to analyze the MAKSS and CAAT scores using a statistical significance level of 0.05. Data were analyzed using SPSS v25 using paired t tests to compare pretest-posttest results. Results showed that there was a statistically significant increase in MAKSS and CAAT scores from presimulation to postsimulation. The findings also suggest that participation in this type of exercise may have increased self-assessment of cultural awareness and multicultural awareness, knowledge, and skills among health professions students. This study described the planning and execution of a large multiple scenario simulation event that involved 180 students spanning 5 healthcare disciplines. Findings demonstrated that the IP simulation event improved the students' self-assessment of multicultural awareness, knowledge, and skills as well as their own cultural awareness. The exploration of cultural competence and humility should be a priority for simulation-based learning.

Strategies for Incorporating Health Disparities and Cultural Competency Training into the Pharmacy Curriculum and Co-curriculum

Objective. To identify and review strategies reported in the literature for strengthening instruction about both health disparities and cultural competency (HDCC) within various portions of the Doctor of Pharmacy curriculum and co-curriculum.Findings. The classroom strategies reported in the literature for incorporating HDCC into the PharmD curriculum involved teaching a single course or series of courses in HDCC. Activities found to be effective in teaching HDCC were those that involved case-based and community engagement exercises. Recommendations for incorporating HDCC into the experiential education included preceptor development in areas of HDCC to assess student understanding of health disparities concepts, increasing student engagement with diverse patient populations, and implementation of cross-cultural communication models at clinical sites. Co-curricular and interprofessional (IPE) portions of pharmacy training were found to permit greater methodological flexibility for incorporating training in HDCC, as they often confronted fewer time or space constraints than classroom endeavors. Documented methods for teaching HDCC within co-curricular and IPE experiences included service learning, study abroad, symposia, and forums.Summary. There is a paucity of literature describing processes for incorporation of health disparities and cultural competency education and training into the PharmD program. Findings suggest that conceptual frameworks for HDCC should be used throughout the pharmacy curriculum, with learning activities mapped to relevant pharmacy education standards to ensure coverage of important practice competencies. Best practices also involve the use of contemporary tools, strategies, and resources from a cross-section of disciplines that provide opportunities for learners to correct misconceptions and biases through active situational problem-solving.

Enhancing interprofessional practice through the co-design of a holistic culturally and developmentally informed First Nations child health assessment.

This qualitative study explored staff experiences of co-designing and implementing a novel interprofessional (IP) First Nations child health assessment (the helpful check), developed in partnership with a remote North-Queensland Aboriginal CommunityControlled Health Organisation. Eleven staff across two teams (family health and allied health) were involved in co-designing and implementing the child health assessment and associated IP practices. Interviews were undertaken using a semi-structured interview template and were audio recorded and transcribed verbatim. Data were analysed using thematic analysis. Three overarching themes were developed: (1) connect teams by building strong relationships; (2) leave space for helpful check processes to evolve; and (3) integrate helpful check processes into routine practice to sustain change. Results demonstrate how the incorporation of IP practices into a remote primary healthcare setting led to perceived benefits for both the health service staff and clients.

62 The Abcde of Converting Full Patient Simulation to a Virtual Non-Technical Skills Seminar

Due to the pandemic, our undergraduate programme of Interprofessional (IPE) Full Patient Simulation (FPS) 2020–2021 was converted to a virtual human factors seminar using student case scenario footage and a Non-Technical ABCDE Approach Observational Tool (Seale et al. 2020). The IPE FPS programme involves students (n = 960) from medicine, physiotherapy, nursing (adult, child fields) and midwifery with three strands of scenarios covering acute adult, paediatric and obstetric scenarios. To provide meaningful learning without the use of face-to-face simulation, the principles of active learning and directed observation in simulation were applied to create a live online seminar. Using recorded footage of inter-professional discipline students participating in scenarios and the observational tool provided the resources for students to learn about the non-technical skills (NTS) in clinical practice.The aim of the study was to meet IPE graduate outcomes and to explore the significance of human factors in clinical practice.Prior to the online seminar, students were allocated into their scenario groups to prepare notes on the non-technical skills, with directive guidance from an observational tool using an ABCDE approach. Within the seminar, students worked collaboratively in small inter-professional groups to discuss their observations and prepare a presentation, guided by the debrief diamond structure of description, analysis and application Evaluation of findings demonstrated achievement of the key ‘take aways’ associated with live simulation and attainment of learning outcomes (

The SPEER: An interprofessional team behavior rubric to optimize geriatric clinical care

ABSTRACT Geriatric patients with complex health care needs can benefit from interprofessional (IP) care; however, a major gap in health professional education is determining how to prepare future providers for IP collaboration. Effective IP team behavior assessment tools are needed to teach, implement, and evaluate IP practice skills. After review of IP evaluation tools, the Standardized Patient Encounter Evaluation Rubric (SPEER) was created to evaluate team dynamics in IP practice sites. Independent sample t-tests between faculty and learner SPEER scores showed learners scored themselves 15 points higher than their faculty scores (p < .001). Cronbach’s α showed high internal consistency (α = 0.91). Paired t-tests found that learners identified improvements in the team’s ability to address the patient’s education needs and to allow the patients to voice their expectations. Faculty identified improvements in the teams’ ability to make recommendations. Faculty evaluations of learner teams showed improvements in raw ratings on all but two items. Qualitative data analysis for emergent themes showed learners desired team functioning feedback and how teamwork could improve to provide optimal IP care. In conclusion, the SPEER can help faculty and learners identify growth in their teams’ ability to perform key IP skills in clinical sites.

Evaluating the impact of interprofessional forums on dental medicine students' collaborative practice skill perception.

This study evaluates third-year dental medicine students' perceived competencies related to interprofessional collaborative practice (IPCP) after completing two exposure level experiences with students from other professions across a large academic health center. Two cohorts of D3 dental medicine students (2018-2019 and 2019-2020) completed the Interprofessional Collaborative Competencies Attainment Survey (ICCAS) after participating in in-person 2.5-h Interprofessional (IP) Forums in the Fall and Spring semesters. Self-reported competencies were compared between pre-and post-IP Forum ratings and between Fall and Spring. Prior to the IP Forums, dental medicine students (n=185) reported perceived skill in the interprofessional competencies to be from Good to Very Good using the ICCAS. After participation in the Fall IP Forum, students' ICCAS scores increased in all ICCAS subscales with large effect sizes. Students reported a perceived decline in these skills in the four months between Fall and Spring IP Forums and restoration of IP skill levels after participating in a second IP Forum (Spring). Participation in IP Forums has a positive impact on students' IPCP skill perception. Our data suggest that perceived skill level requires repeated IP learning experiences. If dental medicine students are expected to embrace collaborative practice to enhance patient outcomes, then dental school educators must provide opportunities for students to engage in collaborative practice experiences at all levels of their training.

Interprofessional Disaster Simulation During the COVID-19 Pandemic: Adapting to Fully Online Learning

BackgroundThis paper describes the rapid conversion of a face-to-face interprofessional (IP) disaster simulation to an online format in response to COVID-19 campus closures. MethodsThe online disaster simulation utilized internet-based tools allowing real-time collaboration between IP students. Team exercises involved disaster triage, disease outbreak investigation, and disaster response. Surveys measuring self-assessment of various IP skills and simulation learning outcomes (SLOs) were compared with responses from previous face-to-face simulations. ResultsResults indicated mean scores for IP skills were higher for online students when compared with in-person simulations, and all SLOs were met. ConclusionsThe online disaster simulation provided an effective, innovative IP educational opportunity.

Impact of interprofessional geriatric teamwork on students’ perceptions of older persons and collaborative practice

ABSTRACT Health professions programs lack sufficient exposure to geriatric education in curricula. The Seniors Assisting in Geriatric Education (SAGE) Program exposes interprofessional (IP) teams of health professions students to older adults. To determine the impact of an interprofessional geriatric educational experience on student perceptions of team collaboration and older adults. IP teams of three or four students (n = 662) representing eight disciplines from two institutions were paired with an older adult to promote person-centered care over three semesters. Students completed two online questionnaires (pre- and post-SAGE Program, ~10 min). 136 students completed both questionnaires. Three IP collaborative practice sub-competencies under the Roles & Responsibilities and Interprofessional Communication Core Competencies increased significantly from pre- to post-SAGE Program (p ≤ 0.002). Comparison of the means for attitudes toward geriatric patients revealed statistically significant improvement in one item, Compassion (p < .002). The SAGE Program had a positive impact on IP collaborative practice and attitudes toward older people in some, but not all, areas.

Understanding the roles of physical therapists on the care team: An interprofessional education experience for first-year medical students

Physical therapy (PT) and occupational therapy (OT) are essential to recovery from illness and injury, as well as maintaining and improving quality of life. As the utilization of PT and OT increases, a physician's understanding of these interprofessional colleagues' practice is critical. This study aimed to improve first-year medical students' self-rated understanding of PT and OT, and intentions to incorporate these health professions into future care plans. First-year medical students participated in a 2-h interprofessional (IP) clinical observation experience in outpatient PT. Before the experience students received a handout reviewing the respective clinical focuses of PT and OT, potential reasons for referral, trajectory of care, and an example case. During the experience, students shadowed patient sessions and discussed the principles of PT and OT and key clinical details of the patient they were observing with a provider preceptor. Experience effectiveness was evaluated via post-experience 5-point Likert scale surveys and qualitative prompts given to students and providers. The PT Clinical Observation Experience resulted in a significant increase in students' self-rated confidence in their understanding of PTs'/OTs’ roles, knowledge of when to refer a patient, and intent to incorporate PT/OT into future care plans. All providers agreed the experience helped students improve their communication skills with other interprofessional team members. This curriculum experience achieved learning objectives with no additional monetary costs or training of facilitators, making it a feasible and useful mechanism for medical schools without associated professional schools to provide IP experiences to preclinical students. Additionally, this experience addresses gaps in medical student education regarding the roles and responsibilities of PT and OT and helps build a foundation for future interprofessional collaboration. Handouts and surveys used in this study are included in this report.

Translating concepts to practice: Examining the synergy of interprofessional competencies and quality improvement

Quality improvement (QI) teams typically consist of membership from many roles and professions working together to improve care. However, despite the growing number of interprofessional (IP) teams involved in QI education and projects, carrying out successful improvement remains challenging. IP competency frameworks have been used as an enabler in practice, education and research to expand understanding of collaboration beyond team dynamics. Building on literature and practices in QI and interprofessional care (IPC), this paper identifies specific team tools and practices relevant to IP competencies. By connecting IP competencies to these practical QI tools, we examine the synergistic relationship between QI tools and IP competencies. There is an opportunity to explicitly integrate IP competencies with QI tools, education and programs to enhance IPC. Future research should include application of IP competencies across different QI team structures and sectors and the impact of integration of IP competencies in QI tools and programs.

Enhancing SLP Students' Perceptions of Older Persons and Collaborative Practice Through Geriatric Interprofessional Teamwork

Purpose To address the need for practice-ready geriatric health professionals, the Seniors Assisting in Geriatric Education (SAGE) program was developed and implemented by two partnering institutions. This study examines speech-language pathology students' perceptions of interprofessional (IP) teamwork and older persons following participation in the SAGE program. Specifically, students reflected on their IP competencies and attitudes toward older persons and overall perceptions of their SAGE experience and how this experience may impact their future practice. Method IP teams of three or four students ( n = 662) from eight disciplines and two partnering institutions participated in the SAGE program. Over three semesters, IP student teams visited a senior mentor's home, completing assignments aimed at growing skills in geriatric collaborative care. A mixed-method approach was used to examine 20 speech-language pathology students' perceptions post-SAGE. Students completed two questionnaires and provided written and verbal feedback, including retrospective pre–post comparisons. Results Moderate positive effect sizes were observed on retrospective reports examining perceptions of IP knowledge, attitudes, and skills. These reports were consistent with responses to additional questions examining values/ethics, roles and responsibilities, IP communication, and teamwork. Quantitative and qualitative measures reflected predominantly positive attitudes toward older persons, including an appreciation for older adults, increased knowledge and skills in geriatric care, and an interest in working with older persons in the future. Conclusions Speech-language pathology students participating on an IP geriatric team reported improved knowledge, attitudes, and skills in geriatric collaborative care. Additional study is needed to determine the impact of this experience on students' behaviors as future IP team members.