Interprofessional Attitudes Research Articles

The Effect of a Transdisciplinary Early Intervention Playgroup Experience on Interprofessional Student Attitudes

Abstract Date Presented 4/18/2015 Successful interprofessional collaboration is key to effective health care service delivery. This 2-yr, mixed-method study showcases the impact of the university-based Transdisciplinary Toddler Playgroup on interprofessional attitudes, communication, and understanding of involved students.

Deeper Learning through Service: Evaluation of an Interprofessional Community Service-Learning Program for Pharmacy and Medicine Students

Abstract Background This Community Service-Learning Project (CSLP) at the University of Saskatchewan is designed to help students develop patient-centred care practices in urban underserved settings. First-year medical and pharmacy students partner interprofessionally to both learn and serve, working with community-based organizations (CBOs) that primarily serve either low-income or newcomer residents of Saskatoon. Since the CSLP’s pilot year in 2005-2006, 98 first-year medical and pharmacy students have participated in the CSLP. Methods and Findings We evaluated the outcomes and processes of the CSLP since the 2006-2007 year, using mixed methods: end-of-project questionnaires; document analysis looking for key and recurrent themes; end-of-project semi-structured interviews with CBO coordinators and clients. We examined students’ experiences, including satisfaction, achievement of learning objectives, learning processes, and perceived outcomes. Students’ main learning outcomes related to client-centered approach, interprofessional attitudes and skills, and personal development. Various learnings related to program processes are reported. Conclusions Our evaluation reinforced findings from the literature on both interprofessional education and community service-learning, as well uncovering some new findings. Students described a transformative learning experience that helped them begin to develop understanding and skills to work more effectively with clients in urban underserved settings.

Interprofessional Educational Experience to Assist in Student Readiness Toward Neurorehabilitation

ABSTRACT. Occupational and physical therapy professionals are natural partners in neurorehabilitation especially in the acute stages of recovery. To enhance student-learning experiences from both disciplines, we have developed an interprofessional (IP) learning unit that was embedded in neurorehabilitation tracks of each respective program. The primary goal of this project was to examine interprofessional attitudes and perception toward interprofessional learning and practice. A total of 117 occupational therapy (53) and physical therapy (64) students completed an IP case-based learning module with the goal of developing an IP care plan typically seen in neurorehabilitation. Using a sequential explanatory mixed methods design, we collected data pre- and postintervention using the Readiness for Interprofessional Learning Survey (RIPLS). We also utilized a postintervention questionnaire and focus groups intended to solicit information regarding IP competencies. At pretest, students had high ratings on the RIPLS that led to minimal changes at posttest (p = .157). However, common threads from the questionnaire and focus groups showed positive effects on student learning and attitudes toward interprofessionalism. Students reported positive experiences with the IP module. An IP case-based educational module has the potential to facilitate professional development and readiness for future IP practice. Students from different disciplines appreciate the value of IP education (IPE) in reinforcing their professional identity and understanding the professional contributions of others. Our findings are consistent with literature on best practices for IPE.

The Relationship between Interprofessional Leadership Education and Interprofessional Practice: How Intensive Personal Leadership Education Makes a Difference

The Relationship between Interprofessional Leadership Education and Interprofessional Practice: How Intensive Personal Leadership Education Makes a Difference

Assessment of Student Interprofessional Education (IPE) Training for Team-Based Geriatric Home Care: Does IPE Training Change Students’ Knowledge and Attitudes?

Our study assesses changes in students’ knowledge and attitudes after participation in an interprofessional, team-based, geriatric home training program. Second-year medical, physician assistant, occupational therapy, social work, and physical therapy students; third-year pharmacy students; and fourth-year dental students were led by interprofessional faculty teams. Student participants were assessed before and after the curriculum using an interprofessional attitudes learning scale. Significant differences and positive data trends were noted at year-end. Our study suggests that early implementation, assessment, and standardization of years of student training is needed for optimal interprofessional geriatric learning. Additionally, alternative student assessment tools should be considered for future studies.

Interprofessional Experiences and Attitudes Toward Interprofessional Health Care Teams Among Health Sciences Students

This study examined how the interprofessional experience, including education and practice, affects graduate health science students’ attitudes toward interprofessional practice in health care teams. Data were collected from 227 graduate students, using the Attitudes toward Health Care Teams (ATHCT) scale. Both social work and other health science students had positive attitudes toward interprofessional collaboration with regard to its ability to improve the quality of a patient’s care. The results from hierarchical linear regression analyses demonstrated that female students, older students, and students with longer interprofessional practice experiences had more positive attitudes toward interprofessional collaboration in health care teams. Based on these results, implications for interprofessional education are discussed.

The development of clinical reasoning and interprofessional behaviors: service-learning at a student-run free clinic

This article examines the benefits of a student run free clinic (SRFC) as a service learning experience for students in medicine, pharmacy, occupational therapy, physical therapy and physician assistant programs. We hypothesized that students who participate in an interprofessional service learning course and volunteer at a SRFC would demonstrate significant increases in perceptions and attitudes for working in interprofessional health care teams and clinical reasoning skills compared to students who did not participate. Three assessments were administered to an experimental and control group of pre-clinical students from medical, occupational therapy, physical therapy, pharmacy and physician assistant programs before and after participation in an interprofessional service-learning course and volunteering at the SRFC. The tools were the Interdisciplinary Education Perception Scale (IEPS), Readiness for Interprofessional Learning Scale (RIPLS) and the Self-Assessment of Clinical Reflection and Reasoning (SACRR). Students who completed the course had improvements in interprofessional perceptions and attitudes (p = 0.03) and perceptions of clinical reasoning skills when compared to the control group (p = 0.002). This study is novel as it examined students’ perceptions of interprofessional attitudes and clinical reasoning following participation in an interprofessional service-learning course and participation in a SRFC.

The student-run free clinic: an ideal site to teach interprofessional education?

Student-run free clinics (SRFCs) often include an interprofessional group of health professions students and preceptors working together toward the common goal of caring for underserved populations. Therefore, it would seem that these clinics would be an ideal place for students to participate in an interprofessional collaborative practice and for interprofessional education to occur. This article describes a prospective, observational cohort study of interprofessional attitudes and skills including communication and teamwork skills and attitudes about interprofessional learning, relationships and interactions of student volunteers in a SRFC compared to students who applied and were not accepted to the clinic and to students who never applied to the clinic. This study showed a decrease in attitudes and skills after the first year for all groups. Over the next two years, the total score on the survey for the accepted students was higher than the not accepted students. The students who were not accepted also became more similar to students who never applied. This suggests a protective effect against declining interprofessional attitudes and skills for the student volunteers in a SRFC. These findings are likely a function of the design of the clinical and educational experience in the clinic and of the length of contact the students have with other professions.

A training program designed to improve interprofessional knowledge, skills and attitudes in chronic disease settings

For over 25 years, The Arthritis Program (TAP) at Southlake Regional Health Centre has worked within a successful interprofessional model. TAP recognized the need to teach its model and developed The Arthritis Program – Interprofessional Training Program (TAP-ITP). This pilot study evaluated perceptions of 22 TAP-ITP participants related to effectiveness and satisfaction. The study employed a longitudinal survey design and data were collected at the baseline (T1), post-program (T2), and at one year (T3) by use of the following instruments: W(e)Learn Program Assessment; Interprofessional (IP) Learner and Team Contracts; Interprofessional Collaborative Competencies Attainment Survey (ICCAS); Bruyère Clinical Team Self Assessment Scale; and Attitudes Toward Health Care Teams (ATHCT). Data analysis included descriptive, non-parametric and parametric tests. Results indicated participants were very satisfied with TAP-ITP. ICCAS scores revealed statistically significant differences (Wilcoxon rank sum tests) from T1 to T2 in perceptions of IPC competencies (p < 0.05). Paired t-tests for each T1 to post (T2 and T3) scores were all significant (p < 0.05) for each Bruyère subscale and overall scores. For ATHCT, paired t-tests for each T1 to T2 were significant for Quality of Care/Process (p = 0.04) and borderline significant for Physician Centrality scale (p = 0.06). At T3, improvement in both scales was maintained. This pilot study suggests that TAP-ITP improves self-assessed scores of knowledge and skills, as well as attitudes in interprofessional care post-program and sustained at one year.

Board 391 - Research Abstract Development and Construct Validation of the Interprofessional Attitudes Scale (IPAS) for Assessing the Impact of Interprofessional Simulations (Submission #1233)

Introduction/Background Development of interprofessional competencies is essential in the training of practice-ready health professionals. Many interprofessional educational (IPE) programs use simulations to teach collaborative team skills. These IPE simulations should facilitate students meeting the recently published IPEC Core Competencies.1 However, determining whether this occurs is difficult since no validated tools currently exist to assess all four IPEC Core Competency domains. The goals of this study were to develop, validate and test a novel scale to assess interprofessional attitudes of students in the health professions. This scale was designed to incorporate the core competency domains defined in the IPEC Report and to be used in assessing the impact of IPE simulations on health professional student attitudes towards interprofessionalism. Methods An online survey containing 42 questions based in part on the Readiness for Interprofessional Learning Scale (RIPLS)2-4 and new questions based on the IPEC Core Competencies was developed and administered in 2012 to a diverse group of 1549 health professional students from the University of Utah Health Sciences (UUHS). The UUHS is an academic health center composed of four schools and colleges (Health, Medicine, Nursing, and Pharmacy), including nursing, medical, pharmacy, medical laboratory science, nutrition, occupational therapy, public health and physician assistant students. Analyses were performed to validate the assessment tool, eliminate redundant questions and cluster questions into subscales. Results The responses from the 42 item online survey tool were evaluated to assess construct validity and internal consistency reliability. A survey response rate of 45% (n=701) was obtained. After removing incomplete survey responses, a dataset consisting of 678 responses was randomly split into two datasets which were independently analyzed using exploratory factor analysis (EFA, n=342) and confirmatory factor analysis (CFA, n=336). The result of the EFA was a 27 item scale that we named the Interprofessional Attitudes Scale (IPAS). The EFA identified five subscales with Cronbach’s alpha coefficients ranging from 0.62 to 0.92 (Table 1). The CFA indicated the content of the five subscales was consistent with the EFA model. The collection of validated survey questions is being incorporated into surveys administered to students before and after IPE simulations to evaluate the impact of the simulations on interprofessional attitudes. These IPE simulations are designed to train students to work collaboratively in interprofessional teams and include students from all four schools and colleges at the UUHS at various levels of training. The Results of these on-going assessments using the IPAS will be described in more detail during the presentation. Conclusion We have created and validated an assessment tool, the IPAS, which contains items that reflect current interprofessional competencies. The IPAS is being used to assess the impact of IPE simulations on student’s attitudes towards working collaboratively in interprofessional teams.

Interprofessional education in a primary care teaching clinic: findings from a study involving pharmacy and medical students

Interprofessional education (IPE) can be hindered by the lack of infrastructure required to support it. We developed a clinical IPE experience for medical and pharmacy students built upon an existing infrastructure. We created tools to orient students to IPE and had students participate in pharmacist-led and physician-led IPE clinics. Results from the surveys indicated that after participating in the IPE experience, there were no significant changes in attitudes toward interprofessional teamwork or attitudes toward different members of the healthcare team. Students found less value in tools outlining roles and responsibilities of team members, on-line modules about the other profession, and IPE group discussion. They placed more value on the actual clinical experience. Themes derived from analysis of open-ended survey questions reflected the value that students placed on interprofessional interaction in the setting of direct patient care.

Medical students' interprofessional experiences in a rehabilitation and palliative care placement

The majority of interprofessional learning literature focuses on initiatives within pre-clinical or simulated learning environments, with a paucity of research exploring the variation in impact of exposure to nurses and other health professionals in different health care settings. This study aimed to explore the experiences and attitudes of medical students following scheduled placements in palliative and rehabilitative care units. Three focus groups were conducted by researchers independent of the clinical school, to explore the attitudes of first clinical year medical students towards, and experiences of, a clinical placement that provided the opportunity to develop interprofessional skills. Students responded differently to the expectation put upon them to initiate their own learning experiences. A number of students felt that being asked to focus on clinical skill development conflicted with the assessment demands of the medical curriculum. This, in turn, contributed to a missed opportunity for them to learn with, from and about nurses and other health professionals. The driver of assessment was seen to be more important to their training. This emphasises the importance of including an assessment of interprofessional skills if we want to ensure students achieve these skills. If medical students are not going to be assessed on interprofessional knowledge, skills and attitudes then a curriculum orientation to the value of interprofessional practice is required.

Interprofessional Education on Health Literacy: Session Development, Implementation, and Evaluation

Research has shown that nurses, physicians, and other health professionals working together improves quality and leads to better patient outcomes and satisfaction. This study focused on interprofessional education on health literacy. A small group format was used as the primary activity to encourage interprofessional communication and participation. The entire classes of 49 MU accelerated baccalaureate nursing students, who had previous degrees in other fields, and 102 MU first-year medical students participated. There were statistically significant increases on all items assessing knowledge and skill acquisition from pre-test to post-test (n=141, p≤.001). A single interprofessional session with activities focusing around a standardized patient encounter can be an effective strategy for learning about health literacy and developing positive interprofessional attitudes and behaviors.

Current Literature Summary

Evidence-based practice collectively involves research evidence, clinician expertise, and patient preference while making health care decisions. Due to health care reform legislation, there is grea...

Improving Collaborative Care in Managing Eating Disorders: A Pilot Study

The purpose of this pilot study was to evaluate the impact of a continuing interprofessional educational workshop focused on eating disorders in a rural area in Newfoundland and Labrador (NL), Canada. The pilot study helped determine if the eating disorder workshop was feasible for implementation to a broader audience. A conceptual model developed by our eating disorder team and described in the article guided this innovative program. The intensive 2-day workshop was piloted in one community with 41 health and education professionals in attendance. A key element was the focus on creating and sustaining collaborative care for eating disorders. Participants completed pre-post workshop measures of interprofessional attitudes and skills, self-reported knowledge, confidence, and intention to change practice (post questionnaire only). A 6-month follow-up survey measured self-reported practice change. There were significant positive changes in interprofessional attitudes and skills as well as knowledge and confidence in collaborative management of eating disorders. Post-workshop, 69% (n = 24/35) of participants indicated intention to change practice, and on follow-up, 7 of 10 respondents reported implementing changes in practice as a result of the workshop. Low response rate at follow-up was a limitation. Results support the impact of the workshop in improving knowledge, confidence, and attitudes toward collaboration and changing practice and the value of implementing the program province-wide.

Impact of Student-Run Clinics on Preclinical Sociocultural and Interprofessional Attitudes: A Prospective Cohort Analysis

Descriptive studies suggest student-run clinics (SRCs) positively affect preclinical students' sociocultural and interprofessional attitudes, but few studies use validated measures. In a pre-post design, first-year medical, nursing, and pharmacy students who did and did not participate in SRCs completed demographic and open-ended questions, as well as two validated surveys, the Sociocultural Attitudes in Medicine Inventory (SAMI) and Readiness for Interprofessional Learning Scale (RIPLS), at the beginning and end of the year. With 68% (n=182/267) matched surveys we found no significant differences between groups over time (SAMI p=.53, RIPLS p≥.28 for each subcategory). However, of SRC participants, 99% reported commitment to the underserved and 57% reported improved interprofessional attitudes. Students participating in SRCs perceive positive benefits, but do not score differently from those who do not. The SRC experiences may not be frequent enough to affect these measures, particularly since our students were high-scoring upon entry.

The Longitudinal Elderly Person Shadowing Program: Outcomes From an Interprofessional Senior Partner Mentoring Program

The University of Saskatchewan's Longitudinal Elderly Person Shadowing (LEPS) is an interprofessional senior mentors program (SMP) where teams of undergraduate students in their first year of medicine, pharmacy, and physiotherapy; 2nd year of nutrition; 3rd year nursing; and 4th year social work partner with community-dwelling older adults. Existing literature on SMPs provides little information on the sustainability of attitudinal changes toward older adults or changes in interprofessional attitudes. LEPS students completed Polizzi's Aging Semantic Differential and the Interdisciplinary Education Perception Scale. Perceptions of older men and women improved significantly and changes were sustained after one year. However, few changes were seen in interprofessional attitudes.

Interprofessional Education

The past decade witnessed momentum toward redesigning the U.S. health care system with the intent to improve quality of care. To achieve and sustain this change, health professions education must likewise reform to prepare future practitioners to optimize their ability to participate in the new paradigm of health care delivery. Recognizing that interprofessional education (IPE) is gaining momentum as a crucial aspect of health care professions training, this article provides an introduction to IPE programs from three different academic health centers, which were developed and implemented to train health care practitioners who provide patient-centered, collaborative care. The three participating programs are briefly described, as well as the processes and some lessons learned that were critical in the process of adopting IPE programs in their respective institutions. Critical aspects of each program are described to allow comparison of the critical building blocks for developing an IPE program. Among those building blocks, the authors present information on the planning processes of the different institutions, the competencies that each program aims to instill in the graduates, the snapshot of the three curricular models, and the assessment strategies used by each institution. The authors conclude by providing details that may provide insight for academic institutions considering implementation of IPE programs.

Improving interprofessional competence in undergraduate students using a novel blended learning approach

Interprofessional simulation interventions, especially when face-to-face, involve considerable resources and require that all participants convene in a single location at a specific time. Scheduling multiple people across different programs is an important barrier to implementing interprofessional education interventions. This study explored a novel way to overcome the challenges associated with scheduling interprofessional learning experiences through the use of simulations in a virtual environment (Web.Alive™) where learners interact as avatars. In this study, 60 recent graduates from nursing, paramedic, police, and child and youth service programs participated in a 2-day workshop designed to improve interprofessional competencies through a blend of learning environments that included virtual face-to-face experiences, traditional face-to-face experiences and online experiences. Changes in learners' interprofessional competence were assessed through three outcomes: change in interprofessional attitudes pre- to post-workshop, self-perceived changes in interprofessional competence and observer ratings of performance across three clinical simulations. Results from the study indicate that from baseline to post-intervention, there was significant improvement in learners' interprofessional competence across all outcomes, and that the blended learning environment provided an acceptable way to develop these competencies.

Impact of Interprofessional Education on Collaboration Attitudes, Skills, and Behavior Among Primary Care Professionals

Care for the frail elderly is often provided by several professionals. Collaboration between them is essential, but remains difficult to achieve. Interprofessional education (IPE) can improve this collaboration. We developed a 9-hour IPE program for primary care professionals from 7 disciplines caring for the frail elderly, and aimed to establish whether the program improved professionals' interprofessional attitudes and attitudes toward collaboration, collaboration skills, and collaborative behavior. We also evaluated learners' reactions to the program. Before-after study, using the Interprofessional Attitudes Questionnaire (IAQ, score:1 to 7); Attitudes Toward Health Care Teams Scale (ATHCTS, score: 0 to 105); and Team Skills Scale (TSS, score:17 to 85). Additionally, semistructured interviews were conducted with 10 selected participants. Participants' (N = 80) overall interprofessional attitudes improved (IAQ baseline: 5.49; follow-up: 5.67, p = 0.001); attitudes toward geriatric teams did not change (ATHCTS baseline: 69.9; follow-up: 69.1, p = 0.32). Participants' self-reported team skills improved (TSS baseline: 45.7; follow-up: 48.1, p = 0.001). In the interviews, many interviewees reported increased collaboration with professionals of other disciplines due to the program. Interviewees considered the program's interprofessional nature and attending the program with local professionals important contributing factors to the experienced improvements in collaboration. However, they also noted that not all parts of the program had met the needs of all participating disciplines, due to differences in professional background and knowledge. A brief IPE program can improve interprofessional attitudes, collaboration skills, and collaborative behavior. That such a program allows professionals to get acquainted with each other and each other's viewpoints appears to be as important as the educational content.