Interprofessional Collaborative Practice Competencies Research Articles

Howard University College of Medicine.

Howard University College of Medicine.

Interprofessional education during the COVID-19 pandemic: finding the good in a bad situation

ABSTRACT COVID-19 restrictions necessitated wholescale conversion of curricula to online learning environments globally. We used a mixed-methods study design to evaluate the conversion of a large foundational interprofessional course, at our university, to an asynchronous online learning environment. A survey was used to gauge if students learned interprofessionally and about interprofessional collaborative practice (IPCP). A COVID-19 discussion board was used to assess learner knowledge of their own and other health professions and value for IPCP. Survey results indicated students perceived the online session as effective as it would have been in person. The COVID-19 discussion board presented evidence that students met all Interprofessional Education Collaborative core competencies for IPCP, shared knowledge of their and other health professions, and expressed the value and essentiality of IPCP. Findings support social context as a main requisite for interprofessional education, and within the context of the COVID-19 pandemic, students were able to heighten their connection to the global interprofessional community. Circumstances surrounding COVID-19 highlight the need for increasing IPCP education. One unforeseen positive that has emerged in spite of this global catastrophe is enhanced student awareness of IPCP and interprofessional comradery as evidenced through student discussions in this course.

Integrating a Pharmacy Student into a Marriage and Family Therapy Counseling Course: A Pilot.

Interprofessional educational experiences are a requirement in pharmacy and counseling curricula. However, scheduling conflicts between professional programs and lack of administrative support create barriers for students who want to take a course in another healthcare program. This pilot enabled a pharmacy student to participate in a counseling course for 8 weeks. The course "Integrated Healthcare" is a 3-credit required core-course in the Master of Arts in marriage and family therapy (MFT) program. It explores the connection between emotional, psychological and physical health, covering information on behavior change, psychopharmacology, and common ways in which mood and anxiety manifest in the body. Class activities were matched to pharmacy interprofessional standards, in addition to Interprofessional Collaborative Practice competencies (IPEC). All IPEC core competencies were achieved during this course. One pharmacy student and 18 counseling students helped one another understand the importance of their different roles in patient care. The course also established relationships between pharmacy and counseling faculty, paving the way for more interprofessional class experiences. This pilot integrating pharmacy and counseling students in a course demonstrates that administrative barriers can be overcome and collaborative learning benefit is achieved for everyone involved.

An interprofessional education workshop focusing on pain management and prescription opioid abuse

Abstract Interprofessional education (IPE) provides an opportunity to explore health professionals' contributions to pain management and to develop students' competencies in interprofessional (IP) collaborative practice. The purpose of this IPE workshop was to measure students' knowledge gains and changes in perceptions of core competencies for IP collaborative practice. The objectives for the workshop were that students would be able to: 1) Identify roles of healthcare team members in pain management, 2) Describe means of effective communication with the pain management healthcare team members, 3) Describe two pharmacological and two non-pharmacological interventions for pain management to decrease the use of opioids and 4) Reflect on the core competencies for IP collaborative practice. This IPE workshop on pain management and opioid abuse included a keynote speaker, an interprofessional panel and a patient case study. This format provided a comprehensive learning experience in a reasonable amount of time and was logistically feasible for health care professional students at one university.Demographic questions and the Interprofessional Attitudes Scale (IPAS) post-workshop surveys. The IPAS was modified to decrease response bias by removing the five subscale headings and reordering the questions. The post-survey also had three questions to measure achievement of workshop objectives. Scores for the core competencies of Teamwork, Roles and Responsibilities and Community- Centeredness demonstrated statistically significant increases. Post-survey analysis revealed a statistically significant difference by gender (females higher than males) on Teamwork, Roles and Responsibilities. Following the workshop students and faculty participants were emailed an online evaluation. The participants were asked to rate the effectiveness of the workshop: 1) components (keynote speaker, panel discussion and case study), 2) in helping participants to develop competence in IPE, and 3) as a learning experience. The effectiveness of the workshop in all three of these areas was rated as good to excellent by a majority of respondents. This IPE workshop format was effective and could be replicated to develop healthcare professional students’ knowledge of interprofessional pain management and to develop the core competencies of collaborative practice.

Online clinical learning for interprofessional collaborative primary care practice in a refugee Community-Centered Health Home

Abstract Background Interprofessional education (IPE) and interprofessional collaborative practice (IPCP) have the potential to decrease health disparities and lower health costs for vulnerable populations. An across-site and across-system federally funded IPCP project developed, implemented, and evaluated a model of IPE, targeting future and practicing health care professionals, preparing them to meet the health needs of local refugees and bridge currently siloed healthcare delivery systems. Purpose One project goal was to evaluate the effectiveness of two online clinical learning modules for staff and students about IPCP competencies and refugee culture and health. Method Two online pre-/post-surveys were used to evaluate participants’ IPCP competencies and collaboration levels and one pre-/post-survey was used to evaluate understanding of refugee culture and health. Discussion Participants’ knowledge about refugee culture and health improved significantly. Overall IPCP competencies and collaboration levels showed positive trends. Conclusions These online clinical learning modules were effective for staff and students.

Implementing Appearance-Care Research for Breast Cancer Patient into Routine Clinical Practice

Aims: Research the process of organizational change to understand how interventions such as appearance care can be integrated into daily practice. Background: Typical treatment of breast cancer is surgery, often followed by chemotherapy. Associated aesthetic ramifications, including hair loss, frequently cause patient distress. Methods: We conducted face-to-face semi-structured hour-long recorded interviews with three nurses. We then analyzed the developmental process according to the core competencies for interprofessional collaborative practice using the thematic content analysis. Results: Nurses worked with interdisciplinary team members with mutual respect and shared values such as concern for patients’ quality of life. Nurses used knowledge of appearance-related side effects combined with beautician-provided coping skills. Intervention involved responsible communication with other health professionals and patients in a team approach. Nurses promoted the developmental process and became program facilitators. Conclusion: This group-intervention program, facilitated by nurses, was integrated into daily practice. Implications for nursing management: Research partnerships between academics, clinical nurses, nurse managers, and beauticians can improve the integration of interventions in routine practice and increase awareness of patients’ needs.

The interprofessional dedicated education unit: Design, implementation and evaluation of an innovative model for fostering interprofessional collaborative practice

Abstract Clinically-based interprofessional education offers students an opportunity to witness and experience how interprofessional competencies are translated into practice. In 2011, Massachusetts General Hospital (MGH) and the MGH Institute of Health Professions (IHP) established the first interprofessional dedicated education unit (IPDEU) in the United States, adapting the dedicated education unit model used in nurse education. On the IPDEU, interprofessional groups of IHP students spent a half-day per week across a semester working on both clinical and interprofessional competencies under the guidance of IPDEU staff nurses and therapists who served as clinical instructors. Though student evaluations were consistently favorable, the program strained resources while being able to accommodate only a limited number of students. After three years, MGH and IHP charged a steering committee with re-envisioning a cost-effective instructional model of IPE in acute care, capable of supporting more students. This redesigned experience, introduced in 2015 and continuing today, provides students with a facilitated observational experience focused exclusively on competencies for interprofessional collaborative practice. Scheduled in interprofessional dyads, students spend one half-day on an IPDEU with a nurse interprofessional practice instructor (IPI) and a second half-day with an IPI from speech-language pathology, physical therapy, or occupational therapy. Instructors use active observation techniques to help students recognize interprofessional collaboration and its underlying competencies as they encounter it during their typical care-delivery day, with each session ending in a group debriefing. In evaluations, students indicate that the experience reinforces interprofessional competencies, highlighting the importance of the IPI role and debriefings. In this article, we describe the IPDEU's evolution, share results, offer evidence of the model's scalability and sustainability, and discuss factors contributing to its success in overcoming barriers to clinically-based IPE.

Including Communication in the Nursing Classroom: A Content Analysis of Communication Competence and Interprofessional Communication in Nursing Fundamentals Textbooks

ABSTRACT The American Association of Colleges of Nursing identifies communication as one the four core competencies for interprofessional collaborative practice and teaches communication to nursing students across the United States. The purpose of this study was to examine how communication is presented in nursing fundamentals textbooks. Grounded in communication in the disciplines (CID) framework, communication was primarily presented using the interactive model, with an emphasis on nonverbal and affective communication. All the communication competencies were covered in the textbooks, with active listening featured prominently and feedback and appropriate language choice covered least. Communication competence was also featured in the textbooks, with an emphasis on knowledge. Skills was limited to multiple choice questions and motivation was absent from the textbooks. The findings offer insight and recommendations for how to better prepare nursing students for communication interactions.

Evaluation of an interprofessional active learning session on acute pain and opioid use disorder using the interprofessional collaborative competency attainment scale

ABSTRACTPain is complex and best managed using an interprofessional approach. A complicating factor is the high prevalence of co-existing opioid use disorder (OUD). Interprofessional education (IPE) may be an important strategy for transforming pain and OUD care. The objective of this study was to evaluate the impact of an interactive, case-based IPE session related to acute pain management in persons with OUD on pre-licensure health science students’ perceived achievement of core competencies for interprofessional collaborative practice. Students completed a self-assessment of competency before and after the IPE session, using the Interprofessional Collaborative Competency Attainment Scale. Paired samples t-tests determined differences between pre- and post-session assessments and Cohen’s d effect sizes evaluated the magnitude of change. Learners (n = 160) included students from pharmacy (30.9%), social work (21.9%), dentistry (16.3%), nursing (14.4%), medicine (9.4%), and other professional schools (7.4%). Learners showed significant improvement in perceived competency for all items (all p ≤ 0.002). Using a Collaborative Patient-Centered Approach and Team Functioning demonstrated the greatest overall improvement (Cohen’s d > 0. 80). Findings suggest that an interactive IPE session is associated with perceived achievement of core interprofessional competencies for acute pain management in persons with OUD.

Patient safety - Development, implementation and evaluation of an interprofessional teaching concept.

Objective: Patient safety has high priority in health care. Since successful interprofessional collaboration is essential for patient safety, the topic should ideally be addressed interprofessionally in the curricula. The aim of the project was the development and implementation of an interprofessional teaching concept "patient safety" for medical students and students of health professions at the Medical Faculty Heidelberg.Methodology: The learning objectives were formulated on the basis of the “Patient Safety Learning Objective Catalog” (“Lernzielkatalog Patientensicherheit”) of the Society for Medical Education (Gesellschaft für Medizinische Ausbildung, GMA) and on the basis of the American Interprofessional Competence Profile “Core Competencies for Interprofessional Collaborative Practice”. Two courses were designed for interprofessional groups of approximately 15 participants. The learning content was designed interactively through the development of the project, its application and critical discussion of error reporting systems and security checklists as well as role-plays and video material. The evaluation was carried out by means of descriptive analysis of a structured course evaluation system, which was developed for this study. Results: 28 students took part in the courses. 82% of the students considered the topic "patient safety" to be relevant. In 82% of the cases, the participants rated the interprofessional aspect of the course as valuable. Overall, 73% of students whished for more interprofessional education.Conclusion: The results of the evaluation show that the teaching concept is well accepted by the students and encourage the implementation of further interprofessional courses with a thematic relevance.

Debriefing Interprofessionally: A Tool for Recognition and Reflection.

As the health care environment increases in complexity and patient acuity rises, health profession graduates need to be prepared to work collaboratively to improve patient outcomes. The interprofessional debriefing tool (Debriefing Interprofessionally: Recognition & Reflection) presented in this article allows any simulation to be transformed into an interprofessional learning opportunity. The debriefing tool frames questions for both uniprofessional and multiprofessional simulation and is aligned with the Core Competencies for Interprofessional Collaborative Practice and with Quality and Safety Education for Nurses.

Interprofessional Collaborative Practice in the Medical Intensive Care Unit: a Survey of Caregivers' Perspectives.

Research on caregivers, defined as designated family members or support persons, in the medical intensive care unit (MICU) has primarily focused on their emotional needs and experiences, thus leaving a gap in knowledge related to their perceptions of team dynamics. To examine caregivers' perceptions of team interactions and competencies for interprofessional collaborative practice (IPCP) and overall satisfaction with the MICU team. The Support Person Jefferson Teamwork Observation Guide (JTOG)™ was administered to a convenience sample of caregivers in the MICU at a large urban academic medical center between May 2016 and December 2016. One hundred sixty-one JTOG surveys were completed. Caregivers agreed on the importance of healthcare professionals working together as a team to provide patient care (3.97 out of 4.0 on Likert response scale where 1 is "Not at all important" and 4 is 'Extremely important") and were satisfied with the MICU team (3.74 out of 4.0), positively evaluating the four core competencies for IPCP (3.55 for values/ethics, 3.58 for interprofessional communication, 3.61 for roles/responsibilities, and 3.64 for teams/teamwork) and the patient/family-centeredness sub-competency (3.58 out of 4.0). There was a strong positive correlation between caregivers' Global JTOG scores and overall satisfaction with the MICU team (r = 0.596, p < 0.01). Caregivers' comments about factors that affected their experience focused on aspects of interprofessional communication and patient/family-centeredness. Findings underscore the importance of interprofessional communication and providing patient/family-centered care. Assessing caregivers' perceptions of IPCP can provide a critical lens into team functioning and, thus, be used to identify teams' strengths as well as opportunities for improvement.

Professional Counseling's Alignment with the Core Competencies for Interprofessional Collaborative Practice

Previous findings show that there is a misconception of the counseling profession and a lack of awareness of their role in interprofessional collaboration; which may lead to underutilization of counselors for team based care. As an example, in 2009 six professional health related associations developed core competencies for interprofessional collaborative practice and counseling associations were not involved in the development. This manuscript introduces the profession of counseling to others in medical health professions in hopes that similarities will bridge the gap between knowledge and future collaborative practice. The manuscript shows how the profession aligns with the core competencies for interprofessional collaborative practice (CCIPC), ethical codes, accreditation bodies, and existing counseling literature. It concludes with implications for practice, system level support, and policy.

Interprofessional Collaborative Practice and School Nursing: A Model for Improved Health Outcomes

Effective communication, teamwork, and interprofessional collaboration, or teams of health and non-health professionals working together, are critical to improving the patient experience of care; improving population health; and reducing healthcare costs (i.e., the Triple Aim). In 2016, the Interprofessional Education Collaborative (IPEC) Expert Panel updated its Core Competencies for Interprofessional Collaborative Practice. As health professionals who collaborate with an extensive network of health and non-health professionals, school nurses embody the aims of interprofessional collaboration (IPC). This article briefly reviews the background of interprofessional collaboration and describes ways that school nurse practice aligns with IPC core competencies to incorporate interprofessional collaboration. We discuss successes, such as case management and care coordination, and include challenges to IPC in the school setting. In conclusion, through case management and collaborative care, school nurse expertise in effective IPC fosters knowledge through which core competencies can be strengthened, with benefits for both patients and other healthcare providers.

Social work and interprofessional education: integration, intersectionality, and institutional leadership

Over the last decade healthcare policies and practices in the US have placed significant emphasis on healthcare integration, mental health parity, and implementation of team-based practice models to improve quality, safety, and affordability of service. With these incentives in mind, schools of social work have joined with national and international health education organizations to reduce disciplinary silos and increase shared learning opportunities across professions and programs. The social work profession has long supported collaborative practice however, students are rarely paired with others in the classroom or intentionally taught about counterparts’ roles and expertise. Social work leaders are also responsible for addressing the intersectionality between collaborative competencies and sociocultural factors. The 2015 EPAS and 2016 Core Competencies for Interprofessional Collaborative Practice create multi-level opportunities for social work educators to provide Interprofessional Education (IPE) innovation and leadership across common curricula and educational settings. The authors examine historic challenges to integrating IPE in social work curricula, provide three examples of IPE/social work initiatives in higher education, describe the intersectionality of the EPAS and the IPEC competencies, and identify institutional benefits associated with the integration of IPE in schools of social work culture and curriculum.

Development and validation of a tool to assess self-efficacy for competence in interprofessional collaborative practice

ABSTRACTAlthough interprofessional education and collaborative practice have gained increasing attention over the past five decades, development of rigorous tools to assess related competencies is still in infancy. The purpose of this study was to develop an instrument to evaluate health professions students’ self-efficacy in interprofessional collaborative competency and to assess the instrument’s psychometric properties. We developed a new instrument based on the Interprofessional Education Collaborative’s (IPEC) Core Competencies for Interprofessional Collaborative Practice. In a cross-sectional study design, 660 students from 11 health programmes at an urban university in the Midwest USA completed the Interprofessional Education Collaborative Competency Self Efficacy Tool (IPECC-SET). Rasch analysis evaluated the following: (1) functioning of the instrument; (2) fit of items within each subscale to a unidimensional construct; (3) person-response validity; (4) person-separation reliability; and (5) differential item functioning in relation to gender and ethnicity. After removing seven items with suboptimal fit, each subscale demonstrated high internal validity. Two items demonstrated differential item functioning (DIF) for “Gender” and none for “Race/Ethnicity.” Our findings provide early evidence of IPECC-SET as a valid measure of self-efficacy for interprofessional competence for health professions students. Additional research is warranted to establish external validity of the new instrument by conducting studies across institutions.

Developing Clinical Faculty Understanding of Interprofessional Education: An Inter-institutional, Interprofessional Approach

Introduction: The call for increasing interprofessional education requires institutional support for educators in the clinical environment. Innovative ideas, such as partnering with multiple universities and programs to facilitate an interprofessional workshop, have the opportunity to reach a broader group of clinical educators. The purpose of this study was to examine the attitude of healthcare professionals towards interprofessional learning, familiarity with concepts of interprofessional teaching, and interprofessional practice, and to examine the influence of an interprofessional faculty development workshop on participant familiarity with concepts of interprofessional teaching and learning. Methods: The occupational therapy, physical therapy, and physician assistant programs from two universities collaborated to implement an all-day inter-institutional, interprofessional clinical faculty development workshop. Community clinical educators who participated in the event were surveyed pre- and post-workshop to examine their attitude, readiness, and knowledge of interprofessional learning and teaching. Using the revised version of the Readiness of Interprofessional Learning Scale, the following subscales were measured and analyzed: 1) Teamwork and Collaboration, 2) Negative Professional Identity, 3) Positive Professional Identity, and 4) Roles and Responsibilities. Results: Forty-three participants representing six different healthcare professions completed pre- and post-course surveys. Forty-four percent reported participating in interprofessional education. Overall, the attendees reported the value of the workshop as a 4.6 on a 5.0 point Likert scale, with 5.0 being the highest rating. Self-reported familiarity of the fundamental concepts of interprofessional teaching, interprofessional practice, and interprofessional education improved up to 32% following participation in the workshop. The highest increase in familiarity was in the area of knowledge of interprofessional practice and education. Participants reported high levels of agreement about the value of teamwork, collaboration, and positive professional identity. Conclusion: Integrating the Core Competencies for Interprofessional Collaborative Practice into educational programs and clinical practice can facilitate improved understanding of professional roles and improved collaborative practice.

Integrating Geropsychiatric Nursing and Interprofessional Collaborative Practice Competencies Into Adult-Gerontology Clinical Nurse Specialist Education.

Specific changes to the national clinical nurse specialist (CNS) certification are necessitating a move away the psychiatric/mental health (P/MH) CNS population focus. However, a rapidly increasing older adult population with P/MH comorbidities such as depression and anxiety means that the adult-gerontology CNS (AGCNS) will likely be coordinating much of the complex care needs of this vulnerable population. Therefore, strategies are needed to ensure AGCNSs are competent in advanced practice P/MH nursing. In addition, at this critical time in the redesign of healthcare, the Institute of Medicine has made interprofessional practice center stage for healthcare professional education. Therefore, the purpose of this manuscript is to propose aligning the current AGCNS population-focused competencies with the CNS geropsychiatric nursing competency enhancements and interprofessional collaborative practice education competencies. Examples of the proposed alignment and educational application strategies are presented. When AGCNS educational curricula encompass P/MH nursing at an advanced level from an interprofessional perspective, future AGCNSs will continue to be positioned to make significant contributions to the design of care systems and monitor and trend important outcomes, while ensuring safe and efficient, high-quality healthcare for older adults with P/MH comorbidities.

Refinement of the IPEC Competency Self-Assessment survey: Results from a multi-institutional study

ABSTRACTEffective interprofessional practice requires interprofessional education that facilitates learners’ achievement of competency in the interprofessional domains. Unfortunately, educators currently have a limited number of tools to identify the level of competency of their learners. Previous investigations by some of the authors described the initial characteristics of a tool based on the Competencies for Interprofessional Collaborative Practice. Building on this work, this study describes a multi-institutional, three-part study refining this tool. The series of studies further established the validity, reliability, and usability of the assessment tool. Based on the data derived from this study, we created a shorter, more easily utilised version of the tool that retains previous psychometric strengths. This article describes a tool that consists of two domains, one linked to interprofessional interaction and one linked to interprofessional values. It is believed that this assessment tool may help educators define competence in interprofessional practice and guide assessment of both programmes and learners.

Together we stand, divided we fall: Interprofessional collaborative practice competencies from Malaysian medical professionals' perspectives

Abstract Objective As the demands on the health care system are increasing, there are more calls to embed interprofessional education (IPE) into health professionals' curriculum. However, the outcomes for the curriculum are still being defined, and there is limited information about IPE in medical contexts to guide educators. This study aims to explore medical professionalism from the perspective of Malaysian medical professionals and specifically the interprofessional collaborative practice (ICP) competencies that are expected from physicians in Malaysian medical contexts. Methods We conducted focus-group discussions with medical doctors in Malaysia to capture the participants' experiences and views on medical professionalism and ICP. We then conducted a thematic analysis of the transcripts. The data were managed by Atlas.Ti software. Results As many as 22 academician and non-academician medical doctors participated in this study. From the focus-group discussions, eight themes emerged to describe medical professionalism in Malaysia. These themes can be categorized into common, complementary and collaborative competencies. We found that collaborative competencies in Malaysia include ‘leadership and interprofessional skills’ and ‘patient primacy’. Conclusion This study provided a preliminary description of medical professionalism and collaborative competencies expected in Malaysia. The findings of this study provide a skeleton for further studies about effective teaching strategies and assessment tools that are used to impart IPE.