Interprofessional Collaborative Practice Research Articles

1248. Implementing Infection Prevention and Control with Antimicrobial Stewardship in a Tertiary Care Hospital in India: An Interprofessional Education and Collaborative Practice Approach

Abstract Background Infection Prevention & Control (IPC) along with Antimicrobial Resistance (AMR) has complex problems, it requires distinctive disciplinary efforts. There are few data concerning the facilitators and barriers in India. Interprofessional practice and education (IPE & IPP) initiatives amongst various stakeholders is one amongst them. Current approaches to IPC & AMR are fragmented and unidisciplinary, more like ''An Elephant and the Blind Men'. Hence the need of this structured study. Methods We conducted a prospective interventional study for one year with an interprofessional team. After institutional ethical committee clearance, an Antimicrobial Stewardship team was formed which devised training modules validated by Delphi technique /& ADDIE (Analyze, Design, Develop, Implement & Evaluate) approach by the Infection Control Committee and external resource persons. Simulated sessions, case based discussions, patient education videos & pamphlets, online interactive classrooms, ward & laboratory rounds were instituted for all doctors, staff nurses, laboratory technicians, pharmacists, and patients. Key quality indicators for antimicrobials prescription & consumption was defined and monitored. High end antimicrobial policy was implemented. Checklists & surveillance forms were put in use. Feedback surveys and audits were conducted to assess the effectiveness of these interventions. Results We observed a statistically significant increase in compliance to hand hygiene, health care associated infections (HAI) monitoring, reporting of needle stick injury, adherence to isolation protocols, and antibiotic policy (P value< 0.001) across all units. Maximum compliance to antibiotic policy was observed in medical intensive care units, least in nephrology & neonatal intensive care. Pre-test & post-test questionnaires were used for assessment. An improvement of ∼78 % in the knowledge domain was seen after the sessions. Key quality indicators for HAIs showed statistically significant improvement (P value< 0.001). Conclusion A multimodal interprofessional approach aids the training aspect of IPC & AMSP. Such structured programs in the curriculum addresses the silent pandemic of health care associated infections and antimicrobial resistance. Disclosures All Authors: No reported disclosures

Design and Validation of a Questionnaire to Measure Interprofessional Collaborative Practice for Auditing Integrated Hospital Care: Empirical Research.

Interprofessional teamwork is the key issue of delivering integrated hospital care; however, measuring interprofessional collaboration for auditing is fragmented. In this study, a questionnaire to measure InterProfessional collaborative Practice for Integrated Hospital care (IPPIH) has been developed and validated. A four-step iterative process was conducted: (1) literature search to find suitable questionnaires; (2) semistructured stakeholder interviews (individual and in focus groups) to discuss the topics and questions (face validity), (3) pretesting the prototype of the questionnaire in two different integrated care pathways for feasibility, usability, and internal consistency, and (4) testing (content and construct validity and responsiveness) of the revised questionnaire in eight integrated care pathways; the validation and responsiveness was tested by means of exploratory factor analysis, calculation of Cronbach alpha, item analysis, and linear mixed model analysis. Based on six questionnaires and the opinion of direct stakeholders, the questionnaire IPPIH comprised 27 items. Five different domains could be distinguished: own skills, culture, coordination and collaboration, practical support, and appreciation with the Cronbach alpha varied from 0.91 to 0.48. The self-reported intensity of the collaboration within a specific care pathway significantly influenced the outcome ( P = .000). The product is a questionnaire, IPPIH, which can measure the degree of interprofessional collaborative practice in integrated hospital care pathways. The IPPIH was initially developed for quality assurance. However, the IPPIH also seems to be suitable as a self-assessment tool for directors to monitor and improve the interprofessional collaboration and the quality of their integrated care pathway.

Midwives’ experiences of providing pre-eclampsia care in a low- and middle-income country – A qualitative study

ProblemLike other low- and middle-income countries, Ghana has high maternal mortality stemming from pre-eclampsia. Ghanaian midwives are frontline service providers of emergency care in obstetric complications and have the greatest potential to maximise pre-eclampsia outcomes. Little is known about the potential barriers and challenges to midwives' capacity to provide quality care in pre-eclampsia in Ghana. Therefore, we aimed to explore and gain insights into midwives’ experiences of pre-eclampsia care including their knowledge, skills, and psychological aspects such as midwives' resilience. BackgroundThere is a rising global incidence of pre-eclampsia. Quality midwifery care in inter-professional collaborative practice is crucial to reducing pre-eclampsia-related morbidity and mortality. MethodsA qualitative descriptive exploratory study. In-depth semi-structured interviews (n = 35) were performed in 2021 and analysed by thematic analysis. FindingsThere were three main themes. 1) Competence and Confidence in care; midwives provided timely and appropriate care based on sound knowledge and skills; they explained how pre-eclampsia care was organised within a multidisciplinary context and described collaborative working amongst midwives for mutual learning and support. 2) Emotional concerns and empathy; midwives’ described fulfillment in achieving positive pre-eclampsia outcomes. In contrast, maternal loss was distressing and traumatic. 3) Call for improved care resources for pre-eclampsia; midwives recommended expansion of continuing professional development opportunities, appropriate infrastructure, resources, tailored public education, and a review of pre-service education to support their participation in pre-eclampsia care. ConclusionTo improve the quality of care in pre-eclampsia, midwives should be capacitated, systems should promptly address barriers, and prioritise midwives’ emotional well-being.

Perceptions of conflicting information about long-term medications: a qualitative in-depth interview study of patients with chronic diseases in the Swiss ambulatory care system

ObjectivePatients with multiple long-term conditions visit various healthcare professionals and are exposed to medication information from various sources causing an increased risk of patients perceiving contradictory medication information. The aims...

A85Jake’s story: Teaching interprofessional working through the delivery of a live patient multi-disciplinary team meeting

The World Health Organization (WHO) Framework for Action on Interprofessional Education and Collaborative Practice (2010), states ‘Interprofessional education occurs when two or more professionals learn about, from and with each other to enable effective collaboration and improve health outcomes’ [1]. When healthcare students enter the practice workplace, they are required to work in an interprofessional team and make collaborative decisions to provide safe and effective patient care. With the increasing complexity of patient presentation, increase in life expectancy and disability years coupled with the challenges of resource and delivery within the healthcare system it is vital that practitioners have solid foundational skills in interprofessional working. To facilitate this healthcare educators are being required to think of innovative, authentic and contemptuous pedagogical tools to demonstrate interprofessional working, collaboration and interdisciplinary role awareness. To provide healthcare students with meaningful exposure to interpersonal working educators at Birmingham City University embarked on the design and delivery of a live simulated patient case conference. To promote authenticity the case conference was designed (with consent) around a living patient (Jake) with complex medical and social needs. A team of healthcare educators each took the roles of clinicians from both health, social and tertiary care service. A round table discussion was held related to Jakes’s inpatient care and decisions regarding hospital discharge. Jake has quadriplegic cerebral palsy and substantial medical, social and occupational needs. Jake’s mum is also present, demonstrating the need to have patient and carer collaboration. The session was observed live by students but also filmed and edited into an ongoing simulation learning resource with both clinical and non-clinical learning objectives. A facilitated debrief was held after the session. Feedback and anecdotal analysis of the session showed greater student engagement and understanding of the needs for interprofessional collaboration when discussing patient care and decision-making. The use of a real and living patient meant students could immerse themselves in Jake’s story and feel true empathy with his clinical case. For some students’ knowledge of interprofessional working and the roles of other disciplines proves a challenging concept to master. It is feasible and effective to utilize simulation (live and virtual) as a method of teaching hard to grasp but vital concepts of healthcare practice including interprofessional working and interdisciplinary role awareness. Authors confirm that all relevant ethical standards for research conduct and dissemination have been met. The submitting author confirms that relevant ethical approval was granted, if applicable.

The imperative of collaboration: Lived experience perspectives on team approaches in outpatient eating disorder treatment.

Across healthcare broadly, team treatment approaches range from siloed multidisciplinary treatment to synergistic Interprofessional Collaborative Practice (IPCP), with IPCP increasingly favored. In eating disorders, clinical practice guidelines endorse team outpatient treatment, and these approaches are widely used in clinical practice. However, there is limited evidence to describe attitudes toward and experiences of team approaches, including IPCP, among individuals with a lived experience. Twenty-seven participants (aged 20-51 years) with a formal eating disorder diagnosis were recruited. Each had received outpatient eating disorder treatment from a team or teams comprising a mental health professional, dietitian, and general practitioner (GP) in the past 2 years. Qualitative data were collected via semi-structured interviews and analyzed using Braun and Clarke's reflexive thematic analysis. Four themes were derived from the qualitative analysis. Themes included: (1) working together is better; (2) the linchpin of teamwork is communication; (3) teams should foster autonomy with limit-setting; and (4) systemic failures negatively affect team treatment. Participants favored highly collaborative treatment from a team including a mental health professional, dietitian, and GP at a minimum, where the team engaged in high-quality communication and fostered autonomy with limit-setting. Systemic failures negatively affecting team treatment were reported across the care continuum. Findings endorse the application of IPCP to outpatient eating disorder treatment as a strategy to improve treatment satisfaction, engagement, and outcomes. Given the paucity of evidence exploring IPCP in this field, however, the development and evaluation of interprofessional education and treatment models is a foundational necessity. Team eating disorder treatment is widely used in clinical practice, although there is limited evidence to guide interventions. This study explores attitudes toward and experiences of team outpatient eating disorder treatment among individuals with a lived experience. Understanding preferred team treatment characteristics delivers important information to improve treatment satisfaction, engagement, and outcomes for individuals receiving outpatient eating disorder treatment.

Interprofessional collaborative practices for children with speech, language and communication needs in early childhood education and care: comparing Dutch and Norwegian perspectives

ABSTRACT Interprofessional collaboration and practice (IPCP) is considered the cornerstone for effective service delivery for children with speech language and communication needs (SLCN). Following Stutsky and Spence Laschinger’s framework, we investigated IPCP-related differences between Dutch and Norwegian professionals in a cross-national comparative survey study. The personal relational skills of communication, trust and situational factor support structures were related to interprofessional collaboration in both countries. Trust was a stronger predictor for the Dutch sample than the Norwegian sample. A moderated moderation analysis revealed that the relationship between IPCP and perceived team effectiveness is moderated by trust for the Dutch professionals but not for their Norwegian colleagues. Trust may play a vital role for interprofessional teams in the Dutch context because service delivery is mainly characterised by the pull-out intervention of specialised professionals. In the integrated early intervention context of Norway, emphasis on professional communication skills seems a fruitful strategy to enhance the effectiveness of teams. Early intervention service delivery may be strengthened by structural facilitation and building networks to develop trust across professionals and organisations, which supports the development of professional competence relevant to IPCP in early intervention service delivery.

The perspectives of pharmacy student preceptors on a service-learning program in primary health care: A qualitative study

BackgroundThere are a few studies about preceptorship in primary health care settings, but they didn't assess all possible contributions of this experience, such as preceptor behavioral changes and impact on health services. ObjectiveThis study aimed to analyze the perspective of pharmacy student preceptors on a service-learning program carried out in a primary health care setting. MethodsThis was a qualitative descriptive study, with semi-structured interviews and thematic analysis. The themes were defined deductively, according to levels of Kirkpatrick's theory about the impact of educational activities. ResultsThe preceptors showed positive and negative reactions to the structure of the service-learning program, developed their knowledge, changed behaviors such as collaborative interprofessional practice, and reported improvements in the health units. ConclusionsFrom the perspective of pharmacy student preceptor preceptors, the service-learning program had an impact on all levels expected for an educational activity according to Kirkpatrick's theory: reaction, learning, behavior, and results. These findings may inform the design of service-learning programs.

Penilaian Interprofessional Collaboration pada Puskesmas dalam Upaya Penanganan Stunting di Sulawesi Barat

Stunting is one of the problems faced by Indonesia, which is a developing country. The implementation of interprofessional collaboration practices is still not carried out optimally by health workers, including nurses. This study aims to assess the implementation of Interprofessional Collaboration in handling stunting in West Sulawesi. This type of research is a quantitative research design with a descriptive analysis design with a cross sectional approach. The instrument used in this study was the Assessment of Interprofessional Team Collaboration Scale-II (AITCS-II) questionnaire. The results showed that the mean of the three indicators assessed, namely, partnership (3.97) cooperation (3.95), coordination (3.85), so that the overall assessment of the IPC (3.92) is in the category towards collaboration. Thus, it can be a concern for health service agencies to increase collaboration of health workers into good collaboration, especially in efforts to deal with stunting.

Special challenge interprofessional education – how should lecturers be trained?

To enable interprofessional collaboration in practice, it is important to practice interprofessional action during education. Teachers in interprofessional education (IPE) in Germany are insufficiently prepared for joint teaching and often lack pedagogical-didactical training. Teachers who have been who have been used to working uniprofessionally up to now are expected to be able to teach competently across professions. This overlooks the fact that the admission requirements for teaching at the various institutions such as technical colleges, universities of applied sciences and universities are different. In addition, interprofessional teaching is characterized by a special feature: it should be carried out in team teaching. This poses the challenge for the teachers not only to prepare for the teaching in terms of content, but also to get involved with another teaching person. This study asks what interprofessional faculty need to feel well prepared to teach together and focuses on three professions: human medicine, nursing, and physiotherapy. For this purpose, 15 experts were interviewed, five from each of the three professions. The interview material was analyzed according to the structuring qualitative content analysis by Kuckartz, where categories were created to answer the research question. As a result, the analysis showed that three levels are important for the interviewees: the personal prerequisites that contribute to the success of IPE as well as good preparation on a structural and content-related level. Based on this, a concept for further education for interprofessional teachers will be developed.

Using the modified Delphi technique to develop a framework for interprofessional education during international electives in health professions training institutions in Sub-Saharan Africa.

International electives provide a learning platform where interprofessional education and collaborative practice (IPECP) skills can be cultivated. However, hardly any frameworks to guide the implementation of interprofessional education (IPE) during international electives, especially in the context of low-income settings have been published. To address this gap, this study used the modified Delphi approach to develop an IPE framework guide for international electives to be used by health professions training institutions in Sub-Saharan Africa. A rapid literature review and a study among students and faculty in four African health professional training institutions were done to inform the process. This was followed by the modified Delphi technique that used three Delphi rounds with a panel of eight experts to build consensus on the final framework for IPE during international electives. The level of consensus was set at ≥70% on each of the statements in all rounds. Out of the 52 statements in round 1 (n = 37, 71%) reached consensus while (n = 15, 29%) of the statements did not reach consensus and were discussed in round 2. Round 2 led to 42 statements to be utilized for round 3. In round 3, all statements (42) reached a consensus and an IPE framework to guide the implementation of international electives was developed. The framework consists of three sections. Section one highlights the various IPECP competencies to be gained by learners in the areas of teamwork, interprofessional communication, roles and responsibilities of interprofessional collaborative practice, values and ethics of interprofessional collaboration, and reflection and evaluation of oneself and the team. Section two gives guidance on the structuring of the IPE international electives in health professional training institutions. This includes subsections on operational/institutional needs, acculturation considerations, teaching strategies, assessment strategies, mode of delivery, and public health considerations. Section three consists of the various practical guides and approaches that health professional training institutions could use according to what works best in their setting. The modified Delphi technique was an adequate approach to aid the development of an IPE framework to guide implementation during international electives in various health professional training institutions.

An exploration of faculty perspectives towards interprofessional education and collaborative practice during international electives in health professions training institutions in Africa

Background Faculty perspectives are key drivers of learning during international electives (IEs). However, in Africa, there is limited literature on these perspectives on interprofessional education and collaborative practice (IPECP) during IEs. Therefore, this study explored faculty perspectives toward IPECP within an international elective context from selected African institutions. Methods This was an exploratory qualitative study. The study participants included faculty from four health professional training universities in Africa. Thematic analysis was used to analyze the data. Common codes were identified and grouped to create subthemes and major themes. Results Four themes were identified: (i) The importance of IPECP during IEs, (ii) Approaches to IPECP during IEs, (iii) Perceived key barriers, and (iv) Perceived institutional support for IPECP during IEs. Most of the participants perceived IEs as a platform that can be used to cultivate IPECP with a multicultural perspective while promoting cross-border partnerships to advance health care. Suggested teaching approaches included case studies, joint clinical ward rounds, and simulations, among others, with an openness to having an online, blended, or physical mode of delivery. A framework to guide the implementation of IPECP during IEs was considered important, and most participants thought that their institutions had the infrastructure to support IPECP-IEs. Conclusions Faculty reported enabling perspectives of IPECP during IEs, emphasizing the need for a framework to guide and structure implementation. IPECP-IEs were perceived as a unique platform to cultivate IPECP skills with a multicultural component.

Interprofessional Education in Health Informatics (IPEHI) for Health Sciences Programs.

Given the significant changes the healthcare system has undergone recently; information technology has become an indispensable tool. To properly train future healthcare providers, it is vital to introduce information technology courses in Health Sciences programs. The provision of healthcare services now requires teamwork, which has led to the need for interprofessional education in health sciences schools. Therefore, this study explores the necessity of introducing Interprofessional Education in Health Informatics (IPEHI) in health sciences programs. Additionally, the structure and content of the course were assessed. A mixed-method approach was employed in this study to explore the need for health informatics interprofessional education among individuals with a health-related science background and who possessed health informatics expertise through work experience or formal post-graduation education. Following a cross-sectional survey-based study, expert subjects from academia and the workplace were convened for Delphi meetings to create an IPEHI course founded on the CAHIIM competency framework. 128 questionnaires were collected from three cities in Saudi Arabia. Of all the respondents, 80% agreed that the present health sciences education should be expanded. Additionally, 74% of them agreed that the proposed IPE-HI (Interprofessional Education in Health Informatics) would enhance their knowledge and positively impact the healthcare system. During the second phase, eight experts were invited to identify seven domains, which include health information science and technology, social, behavioral and information science and technology applied to health, information science and technology, leadership, social and behavioral aspects of health, professionalism, and interprofessional collaborative practice. The results emphasize the need for introducing an IPE-HI, as previous studies have also shown that educating health professionals in health information technology is crucial. IPEHI plays a crucial role in producing competent health science graduates. Consequently, experts have developed and validated a proposed IPE-HI course.

A Modular Approach to Interprofessional Concussion Education and Assessment for Athletic Training and Nursing Students

Context Due to the complexity of concussion evaluation and management and the growing demand for interprofessional collaborative practice in health care, the need for interprofessional education (IPE) among professional health care programs has become increasingly important. Objective This IPE technique provides athletic training and nursing students with an opportunity to apply knowledge of professional roles and uses collective clinical reasoning to navigate a multifaceted case scenario with a patient who sustained a concussion. Background With the emphasis of IPE in professional health care programs, both athletic training and nursing programs accrediting bodies have adopted standards that require the implementation of IPE within the curriculum. Description of Techniques This IPE event uses a modular and scaffolding teaching approach to gradually introduce new developments into the patient case in a sequential manner to increase fidelity. Advantage(s) By using this approach, students will have the opportunity to meet the objectives for each module before moving on to the next. Additionally, students will develop professional relationships over time within the collaboration of professional groups. Conclusion(s) Use of this IPE technique affords athletic training and nursing students the opportunity to develop the professional skills required to engage in interprofessional collaborative practice and improve patient outcomes.

A Roadmap to Using Simulation-Enhanced Interprofessional Education to Incorporate Interprofessional Activities in Athletic Training Educational Programs

Context Interprofessional education and collaborative practice (IPECP) is a priority in health care. Collaborative care that includes clinicians across disciplines has been shown across health care to ensure quality patient outcomes. In athletic training, a team approach to clinical practice has been promoted for nearly a decade and continues to gain attention. Interprofessional education (IPE) is a core curricular content standard that requires programs to teach students to practice in collaboration with other health care professionals. Interprofessional education and collaborative practice necessitates students have opportunities to practice before being expected to demonstrate skills clinically. Background To effectively demonstrate IPECP, athletic trainers need exposure to and training in IPECP core competencies during education. Simulation-enhanced IPE (Sim-IPE) is one strategy to integrate these experiences. Between classroom learning and clinical practice, simulation provides an opportunity for students to apply knowledge in a realistic but low-stakes clinical environment. Objective This article will detail strategies to identify and develop Sim-IPE experiences that support achieving educational standards and prepare students for effective IPECP. Description Healthcare Simulation Standards of Best Practice™ and the Association of Standardized Patient Educators best practices were established to guide the design of quality Sim-IPE. This manuscript will provide a roadmap for these best practices, including conducting a needs assessment, coordinating event logistics, designing prebrief sessions, and selecting debrief models. Clinical Advantage(s) Students can gain valuable experience during Sim-IPE. Participation in Sim-IPE improves student understanding of the roles and responsibilities, communication techniques, and teamwork. These factors combine to achieve improved patient outcomes. Conclusion(s) Athletic training programs implementing Sim-IPE should use simulation best practices to provide quality IPECP opportunities.

Factors Influencing the Implementation of Interprofessional Collaborative Practice in Teaching Hospital Setting: A Mixed-Method Study.

Health service in the current global era requires health workers to provide qualified service, this also applies to teaching hospitals. Collaboration between several professions involved (doctors, nurses, and pharmacists) in an interprofessional collaboration system is needed in providing such service. Factors influencing interprofessional collaboration is unique to each health care center. The purpose of this study was to determine the factors that influence the implementation of interprofessional collaborative practice among health workers in Dr. Wahidin Sudirohusodo General Hospital. This is a mixed-method explanatory sequential design study, utilizing quantitative and qualitative data. Quantitative data were obtained from the Indonesian-validated Collaborative Practice Assessment Tool (CPAT) questionnaire. CPAT in Indonesian language has been validated in previous research by Findyartini, et al. in 2019 in Indonesian population. The questionnaire was internally validated with the study population with Cronbach alpha of 0.812. All health care professionals meeting the selection criteria were enrolled for the quantitative study. The questionnaire was given to 152 health professionals enrolled as research subjects, including nutritionists, nurses, doctors, pharmacists, and medical rehabilitation specialists serving in Dr. Wahidin Sudirohusodo Hospital for >3 years. Five participants with highest and lowest CPAT score from each profession were invited for FGD entitled "Exploring factors involved in interprofessional collaboration in Wahidin Sudirohusodo General Hospital" and divided into 2 groups according to the CPAT score. The score from each subscale in the questionnaire is obtained for each research subjects and the median is compared among each profession group using Kruskall-Wallis test significant to a p value of <0.05. Qualitative data as recording transcript is acquired from FGD; the transcript was then coded into several general themes by 2 of the authors and was discussed using thematic analysis using MaxQDA. Research subjects were predominantly women (121 respondents (79.6%)), 32.9% were nurses, and most of the healthcare professional (81 subjects (55.1%)) have been working for >10 years. Among profession groups (Doctors, Pharmacists, Medical Rehabilitation Specialists, Nutritionists, and Nurses), difference in score distribution (p<0.05) was found in relationships among team members (40 vs 39 vs 39.5 vs 36 vs 42, p<0.001), barriers to team collaboration (10 vs 18.5 vs 14 vs 18 vs 10, p<0.001), and leadership (20 vs 20 vs 23 vs 20 vs 20, p 0.045). From the FGD, factors influencing interpersonal collaborative practice are leadership factors, system/rule factors, and personal factors. This research showed that personal, system/organizational and leadership factors influence the implementation of interprofessional collaboration. In this study, there is a different perception regarding relationships among team members, barriers to team collaboration, and leadership among profession group.

Healthcare workers’ understanding of interprofessional education and collaborative practice in regional health settings: A survey study

Introduction: Interprofessional education and collaborative practice can enhance outcomes for patients and families. Facilitating collaborative practice at the point of care requires skilled healthcare workers who understand relevant terminology and concepts. However, gaps persist in the understanding and facilitation of interprofessional education and collaborative practice in some health settings. This survey study investigated healthcare workers’ perceived knowledge and understanding of interprofessional education and collaborative practice. Methods: A bespoke online survey was administered to healthcare workers from two regional health services in Queensland, Australia. Data were subject to descriptive and inferential analyses. Results: Data were available from 235 healthcare workers. Multiple regression analysis revealed that claiming to understand the difference between different models of service delivery, the ability to explain interprofessional education to a colleague and being an allied health practitioner were statistically significant predictors of a high knowledge of interprofessional practice score. Very few respondents were trained in this area (6%, n = 14), and those trained reported higher confidence in facilitating interprofessional education and collaborative practice at the point of care. Conclusion: This study has highlighted the gaps in healthcare workers’ perceived knowledge and understanding of interprofessional education and collaborative practice. Healthcare workers need targeted professional development opportunities to develop the skills, knowledge and attitudes necessary for practising in interprofessional teams. They also need opportunities to facilitate it with students and others. Improving interprofessional and collaborative practice within teams will ultimately improve healthcare outcomes of patients serviced by healthcare workers.

A Case Study of Organizational and Curricular Attributes for Interprofessional Education: A Model for Sustainable Curriculum Delivery

Background: In health and social care (HASC) professional education, interprofessional competencies are optimally developed by engaging in interprofessional education (IPE) activities that are delivered sustainably along a continuum. Ultimately, active engagement in IPE is meant to prepare future practitioners for interprofessional collaborative practice (IPCP), which leads to improved patient/client and community-oriented outcomes. Methods and Findings: This qualitative case study explores how four Canadian post-secondary institutions deliver IPE within their HASC professional education programmatic structures. Data were collected from institutional websites, publicly available IPE relevant records and documents, and interviews with coordinators and faculty/facilitators of IPE curriculum. Data were inductively analyzed to generate relevant themes, followed by a deductive analysis guided by the five accreditation standards domains identified in the Accreditation of Interprofessional Health Education (AIPHE) projects. Analyses of the data resulted in five attributes: 1) central administrative unit, 2) longitudinal and integrative program, 3) theoretically informed curriculum design, 4) student-centred pedagogy, and 5) patient/client-oriented approach. Conclusions: Using these attributes and guided by AIPHE’s accreditation standards domains, an organizational-curricular model for sustainable IPE is proposed, through which we assert that IPE reinforced through these organizational and curricular supports reflects successful programming, leading to patient/client-oriented outcomes.

Development of individual competencies and team performance in interprofessional ward rounds: results of a study with multimodal observations at the Heidelberg Interprofessional Training Ward.

Interprofessional training wards (IPTW) aim to improve undergraduates' interprofessional collaborative practice of care. Little is known about the effects of the different team tasks on IPTW as measured by external assessment. In Heidelberg, Germany, four nursing and four medical undergraduates (= one cohort) care for up to six patients undergoing general surgery during a four-week placement. They learn both professionally and interprofessionally, working largely on their own responsibility under the supervision of the medical and nursing learning facilitators. Interprofessional ward rounds are a central component of developing individual competencies and team performance. The aim of this study was to evaluate individual competencies and team performance shown in ward rounds. Observations took place in four cohorts of four nursing and four medical undergraduates each. Undergraduates in one cohort were divided into two teams, which rotated in morning and afternoon shifts. Team 1 was on morning shift during the first (t0) and third (t1) weeks of the IPTW placement, and Team 2 was on morning shift during the second (t0) and fourth (t1) weeks. Within each team, a tandem of one nursing and one medical undergraduate cared for a patient room with three patients. Ward round observations took place with each team and tandem at t0 and t1 using the IP-VITA instrument for individual competencies (16 items) and team performance (11 items). Four hypotheses were formulated for statistical testing with linear mixed models and correlations. A total of 16 nursing and medical undergraduates each were included. There were significant changes in mean values between t0 and t1 in individual competencies (Hypothesis 1). They were statistically significant for all three sum scores: "Roles and Responsibilities", Patient-Centeredness", and "Leadership". In terms of team performance (Hypothesis 2), there was a statistically significant change in mean values in the sum score "Roles and Responsibilities" and positive trends in the sum scores "Patient-Centeredness" and "Decision-Making/Collaborative Clinical Reasoning". Analysis of differences in the development of individual competencies in the groups of nursing and medical undergraduates (Hypothesis 3) showed more significant differences in the mean values of the two groups in t0 than in t1. There were significant correlations between individual competencies and team performance at both t0 and t1 (Hypothesis 4). The study has limitations due to the small sample and some sources of bias related to the external assessment by means of observation. Nevertheless, this study offers insights into interprofessional tasks on the IPTW from an external assessment. Results from quantitative and qualitative analysis of learners self-assessment are confirmed in terms of roles and responsibilities and patient-centeredness. It has been observed that medical undergraduates acquired and applied skills in collaborative clinic reasoning and decision-making, whereas nursing undergraduates acquired leadership skills. Within the study sample, only a small group of tandems remained constant over time. In team performance, the group of constant tandems tended to perform better than the group of random tandems. The aim of IPTW should be to prepare healthcare team members for the challenge of changing teams. Therefore, implications for IPTW implementation could be to develop learning support approaches that allow medical and nursing undergraduates to bring interprofessional competencies to team performance, independent of the tandem partner or team.

Experiences of faculty and students regarding a locally developed framework for implementing interprofessional education during international electives in Sub-Saharan Africa

BackgroundGiven that there are hardly any comprehensive frameworks to guide institutions on approaches to use as they implement interprofessional education and collaborative practice during international electives, we developed and piloted a framework to address this gap. The purpose of this study, therefore, was to explore the experiences of faculty and students regarding the use of the developed interprofessional education and collaborative practice framework during international electives.MethodsThis was an exploratory qualitative study. The study participants included faculty and students from four health training universities in Africa who participated in the pilot of international electives guided by the framework developed. Deductive thematic analysis was used to analyze the data. The codes were categorized as per the major themes.ResultsThe major themes regarding the framework included (1) The Strengths, (2) Weaknesses, (3) Opportunities, and (4) Threats. All participants perceived the framework as useful and appropriate to enable the acquisition of interprofessional education and collaborative practice skills objectives set. The framework’s duration of the elective was seen as a weakness with the need for an increment in the duration. The opportunities the framework presented included: acting as a starting point to structure and implement interprofessional education across various training institutions in Africa, advancing research, and networking opportunities to share the best practices. The main threat included siloed training where the current training curriculum of the students does not have opportunities that allow the students to study with, from, and about each other.ConclusionsThe framework developed to guide the implementation of interprofessional education and collaborative practice during international electives is feasible and enabled students to achieve the interprofessional education and collaborative practice objectives set while appreciating the transcultural similarities and differences in another country.