Interprofessional Curriculum Research Articles

Pioneering and Interprofessional Pediatric Dentistry Programs Aimed at Reducing Oral Health Disparities.

Early Childhood Caries (ECC) is the most chronic childhood disease and more predominant in low-income and underserved children. Although easily transmitted, ECC is entirely preventable. Dr. Ramos-Gomez and his team at the University of California, Los Angeles put together an interprofessional curriculum where both medical and dental knowledge and practice is integrated to prepare dentists and primary care providers to more cost effectively address ECC and thereby reduce disparities in oral health. The curriculum, known as the Strategic Partnership for Interprofessional Collaborative Education in Pediatric Dentistry (SPICE-PD), consists of nine evidence-based training modules: applied statistics and research, community partners, interprofessional education/training, quality improvement, policy and advocacy, disease management/risk assessment, ethics/professionalism, cultural competency and children with special heath-care needs. SPICE aims to prepare pediatric dental residents and primary care providers to provide preventive, culturally competent, and minimally invasive oral care for underserved, low income, and special needs children. Additionally, the Infant Oral Care Program (IOCP), located at a local community health clinic, provides culturally sensitive preventive oral health care for children aged 0–5 years. The medical–dental integration model utilized at IOCP helps reduce oral health disparities by providing a systems-based and cost-effective approach to combat the burden of ECC. To track the progress of SPICE, a comprehensive evaluation framework has been designed, which aligns goals and objectives with program activities, desired outcomes, and measured indicators.

Stimulated Hyposalivary Flow Rates in Healthcare Students in an Interprofessional Awareness Educational Program Curriculum

Purpose. Hyposalivation influences quality of life and medication compliance. However, oral health knowledge (in general) and knowledge about hyposalivation (in particular) are often lacking in nondental healthcare professional’s curricula. Additionally, hyposalivation has not been adequately studied in young adults. The purpose for this study is twofold: to use an interprofessional educational curriculum to increase nondental healthcare students’ knowledge about oral health and salivary testing and determine whether hyposalivation is different between sexes in young adults.Method. First-year medical and pharmacy students (N=178) learned the process of saliva collection and provided samples in an interprofessional program.Results. There were 14.4% of participants with hyposalivation; 72.0% were female. Males had higher flow rates (P=0.005). There failed to be a significant difference between the sexes with frank hyposalivation. There failed to be a significant difference in hyposalivation and medication use/nonuse.Conclusions. Hyposalivation is a biomedical, public health concern. However, in this young population, there was no significant difference between sexes or in medication use/nonuse. Through participation in the program, the students learned about salivary flow rates and the need for collaboration among professionals to prevent negative impacts of hyposalivation and oral health.

The Foundations of interprofessional curriculum. Finding the right epistemology and learning theory for the task.

This article was migrated. The article was marked as recommended. Introduction: Health professional education programs are currently focusing on interprofessional training. This can highlight differences between our professions in our learning theories and training assumptions. A standardized approach to picking a deliberate perspective from which to design specific interprofessional curricula may be useful. Discourses: This paper presents one such approach. It is based on a 3 X 3 matrix developed by interprofessional faculty over seven years of team-based clinical training. To use this matrix, a deliberate epistemology (e.g., reductionist, constructivist, or complexity) and a learning theory (competency-based education, clinical reasoning, and situated learning) are chosen based on the goals of training, the context, and the developmental stage of the learners. Application: Each element in the matrix then provides a focused set of considerations for designing and assessing interprofessional curriculum. In addition, this matrix provides a framework for incorporating other epistemologies and learning theories. Conclusions: As professionals, we have been enculturated to see health education from a single perspective. A wider, structured approach to adopting learning assumptions and theories may better match the interprofessional training tasks we are being asked to design.

Interprofessional Competency Toolkit for Internationally Educated Health Professionals: Evaluation and Pilot Testing.

Internationally Educated Health Professionals (IEHPs) constitute a major health care workforce in Canada. Interprofessional education is particularly important for IEHPs to integrate into the Canadian health care system. We designed an online interprofessional education curriculum for IEHPs. The curriculum is designed to cover the six interprofessional competency domains defined in the Canadian Interprofessional Health Collaborative National Interprofessional Competency Framework. In this article, we are presenting findings from the pilot testing of the curriculum with a cohort of IEHPs and educators. We conducted surveys and interviews with IEHPs and educators from four provinces (British Columbia, Alberta, Saskatchewan, and Manitoba). We aimed to include seven healthcare professionals: licensed practical nurses, registered nurses, registered psychiatric nurses, pharmacists, physicians, occupational therapists, and physical therapists. We also used a pre- post- self-assessment tool and a set of reflective questions to measure the effectiveness of the curriculum. Thirty IEHPs and five educators reviewed the online curriculum and participated in this evaluation. Postintervention confidence scores for all items under the role clarification and patient-centered care domains increased significantly (P = <0.01) after module completion. The scores also increased for most questions in team functioning, collaborative leadership, and communication domains. The postassessment scores increased for only half of the questions in conflict management domains. Participants agreed with the appropriateness of the content in terms of language, scenarios, and cultural aspects covered in the online curriculum on interprofessional education. The content of the curriculum improved IEHPs' understanding of interprofessional collaboration in Canada. The interprofessional curriculum is a creative and useful resource to improve collaborative practice among internationally educated health professionals in Canada.

The Impact of Hidden Curriculum in Wilderness-Based Educational Events on Interprofessional Competencies: A Mixed-Method Study

Background: The purpose of this study was to determine if interprofessional skills, attitudes, and behaviours could be learned during an austere medicine educational activity where interprofessionalism remained within the informal and hidden curriculum.Methods and Findings: We used a mixed-methods approach to examine the potential acquisition of interprofessional competencies during wilderness medicine educational events. Thirty-four participants, over two events, completed interprofessional learner contracts, audio diary entries between patient scenarios, and the Interprofessional Collaborative Competency Attainment Survey (ICCAS) using a retrospective pre-test/post-test design. Audio diary entries showed the reflection that took place between scenarios during the orienteering portion of the event and the adjustments toward interprofessionalism that took place. Both the survey and audio diaries confirmed that participants perceived an improvement of their interprofessional competencies after the WildER Med event.Conclusions: The outcomes confirm that interprofessional competencies can be developed during a learning event such as WildER Med, where the interprofessional curriculum is hidden. Austere medicine, which is at the base of this learning event, represents an opportunity for the further understanding and exploration of interprofessional education.

Analysing the cognitive rigor of interprofessional curriculum using the Depth of Knowledge framework

ABSTRACTInterprofessional collaborative practice is widely documented as a strategy to improve quality of healthcare. To develop collaborative practitioners, educators need interprofessional curricula with proper cognitive demand and methods of delivery and assessment. The University of the Western Cape in South Africa incorporated an Interprofessional Core Courses Curriculum for all undergraduate students enrolled in the health sciences faculty. The objective of this study was to analyse the curriculum content to determine its cognitive rigor. Cognitive rigor can be measured by the quantitative content analysis method using the Depth of Knowledge (DOK) framework. This approach tests whether the rigor of instructional activities and assessments is aligned with learning outcomes. The curriculum content evaluated in this study found that assessment activities were less demanding than instructional activities and infrequently aligned with learning outcomes. This approach may be useful to other educators seeking to evaluate and plan interprofessional curriculum.

Teaching health-care trainees empathy and homelessness IQ through service learning, reflective practice, and altruistic attribution.

This article describes a novel inter-professional curriculum designed to address the needs of homeless patients in a Midwestern region of the United States which has high rates of poverty. The curriculum is intended for healthcare trainees coming from undergraduate pre-medical programs, nursing, pharmacy, social work, clinical psychology, medical school and post-graduate medical training in family medicine, medicine-pediatrics, and psychiatry. The clinical component is specifically designed to reach destitute patients and the curriculum is structured to reverse commonly held myths about homelessness among the trainees, thereby improving their Homelessness Information Quotient, the ability to more fully understand homelessness. Participants across all disciplines and specialties have shown greater empathy and helper behavior as determined by qualitative measures. Learners have also developed a greater understanding of health-care systems allowing them to more consistently address social determinants of health identified by the authors as their Disparity Information Quotient. This article outlines the process of initiating a homeless service program, a curriculum for addressing common myths about homelessness and the effective use of narrative methods, relational connections, and reflective practice to enable trainees to process their experience and decrease burnout by focusing on the value of altruism and finding meaning in their work.

Interprofessional Education themes in a Clinical Laboratory Sciences Curriculum

The purpose of this exploratory case study was to explore and describe how clinical laboratory science students at a tertiary university hospital perceive and conceptualize interprofessional education (IPE) through exposure to IPE in clinical preceptorship and service learning experiences. Participants included five clinical laboratory science students. The data collection and analysis process included multiple interviews, student clinical preceptorship journals, student service learning journals, and a researcher9s journal. The constant comparison method was used throughout the study as themes and patterns emerged from the raw data and were discovered.1 Findings indicated that participants believed that IPE helped reduce professional hierarchy, promoted equality and respect and maximized interprofessional collaboration between the health professions. Themes that supported IPE were comprised of: hierarchal environment, mutual respect, forming and maintaining an identity, and sharing content knowledge. The results from this study reveal how an interprofessional curriculum can unite clinical laboratory science students with other health professions students early in their formative years to address the inefficiencies and ineffectiveness of a disjointed health care team that negatively affects health care in the United States today. ABBREVIATIONS:WHO – World Health Organization, CLS – Clinical Laboratory Science, IPE – Interprofessional Education

Translating interprofessional theory to interprofessional practice.

Although interprofessional collaborative activities for health professions students have demonstrated increased knowledge of professional roles, interprofessional attitudes and confidence, and team skills; traditional professional role patterns and lack of professional role understanding are still prevalent among health professions students and may continue into professional practice. Between 1 and 10years after they completed their undergraduate studies, practicing community/public health education professionals and registered nurses who participated in an interprofessional patient home-visiting curriculum as undergraduates were surveyed. Most reported current positive attitudes and perceived collaborative abilities regarding interprofessional collaboration. On their perceived interprofessional collaborative abilities, however, community/public health education participants scored significantly higher (t(143)=-2.53, p=0.01) than registered nurse participants. Although it is difficult to generalize the findings from this study to other interprofessional curriculum models, it seems that this curriculum that concentrated on teamwork behaviors and abilities may have contributed to participants' positive translation of interprofessional theory to interprofessional practice.

The Pain Interprofessional Curriculum Design Model.

Although the University of Toronto Centre for the Study of Pain has successfully implemented an Interfaculty Pain Curriculum since 2002, we have never formalized the process in a design model. Therefore, our primary aim was to develop a model that provided an overview of dynamic, interrelated elements that have been important in our experience. A secondary purpose was to use the model to frame an interactive workshop for attendees interested in developing their own pain curricula. The faculties from Dentistry, Medicine, Nursing, Occupational Therapy, Pharmacy, and Physical Therapy met to develop the model components. Discussion focused on patient-centered pain assessment and management in an interprofessional context, with pain content being based on the International Association for the Study of Pain-Interprofessional Pain Curriculum domains and related core pain competencies. Profession-specific requirements were also considered, including regulatory/course requirements, level of students involved, type of course delivery, and pedagogic strategies. The resulting Pain Interprofessional Curriculum Design Model includes components that are dynamic, competency-based, collaborative, and interrelated. Key questions important to developing curricular components guide the process. The Model framed two design workshops with very positive responses from international and national attendees. The Pain Interprofessional Curriculum Design Model is based on established pain curricula and related competencies that are relevant to all health science students at the prelicensure (entry-to-practice) level. The model has been developed from our experience, and the components resonated with workshop attendees from other regions. This Model provides a basis for future interventions in curriculum design and evaluation.

The Impact of an Interprofessional Oral Health Curriculum on Trainees.

Despite the prevalence of oral disease, the subject of oral health historically has been absent from medical education. We have developed an interprofessional curriculum in collaboration with our school of dentistry to teach oral health in the primary care setting to physician assistant (PA) students. The goal was to create and assess the impact of a curricular model that would be adaptable to various academic settings. A blend of classroom, clinical skills lab, observations in the dental clinic, and observed structured clinical examinations was used to teach oral health to first-year (didactic year) PA students. The objectives were created in collaboration between the medical and dental faculties and included topics on general oral health, oral cancer, geriatrics, pediatrics, and fluoride varnish. A total of 12 hours of instructional time was delivered to 23 students over 3 semesters from 2014 to 2015. Pretesting and posttesting demonstrated long-term knowledge retention that was 14% better than baseline at 8 months (P < .001). Student surveys demonstrated that satisfaction levels were high and that the students felt better prepared and motivated to incorporate oral health into their practice of medicine. Analyses of students' write-ups of the history and the physical examination demonstrated that the students incorporated oral health concepts. A significant impact on trainees can occur after a short, focused amount of instructional time in oral health. Students demonstrate enthusiasm and begin using oral health skills early on. A focused interprofessional oral health curriculum can likely be successfully integrated into various academic settings with a positive effect on learning and improved patient care.

Interprofessional Medical-Legal Education of Medical Students: Assessing the Benefits for Addressing Social Determinants of Health.

Screening tools exist to help identify patient issues related to social determinants of health (SDH), but solutions to many of these problems remain elusive to health care providers as they require legal solutions. Interprofessional medical-legal education is essential to optimizing health care delivery. In 2011, the authors implemented a four-session didactic interprofessional curriculum on medical-legal practice for third-year medical students at Morehouse School of Medicine. This program, also attended by law students, focused on interprofessional collaboration to address client/patient SDH issues and health-harming legal needs. In 2011-2014, the medical students participated in pre- and postintervention surveys designed to determine their awareness of SDH's impact on health as well as their attitudes toward screening for SDH issues and incorporating resources, including a legal resource, to address them. Mean ratings were compared between pre- and postintervention respondent cohorts using independent-sample t tests. Of the 222 medical students who participated in the program, 102 (46%) completed the preintervention survey and 100 (45%) completed the postintervention survey. Postintervention survey results indicated that students self-reported an increased likelihood to screen patients for SDH issues and an increased likelihood to refer patients to a legal resource (P < .001). Incorporating interprofessional medical-legal education into undergraduate medical education may result in an increased likelihood to screen patients for SDH and to refer patients with legal needs to a legal resource. In the future, an additional evaluation to assess the curriculum's long-term impact will be administered prior to graduation.

Interprofessional Education in Palliative Care: A Report from the Trenches (TH364)

•Describe three strategies for overcoming common challenges when developing interprofessional educational opportunities in palliative care.•Develop an evaluation plan for IPE.•List educational strategies and resources available for IPE. The recent IOM reports, Dying in America and Measuring the Impact of Interprofessional Education on Collaborative Practice and Patient Outcomes, challenge educational institutions to prepare clinicians who are competent in communication and collaboration across disciplines, particularly in palliative care. Such training mandates interprofessional education (IPE) experiences, yet many efforts are thwarted by the multiple obstacles and lack of resources for developing and implementing IPE. It is unusual for university-based palliative care IPE curriculum to be developed from the ground up by multiple disciplines with equal representation. In this session, faculty from three universities with successful IPE programs will share lessons learned as they (1) successfully developed and integrated interprofessional curriculum and activities into their programs; (2) built curriculum with equal interdisciplinary representation; (3) aligned the curriculum with the core competencies established by the Interprofessional Education Collaborative (values & ethics, roles & responsibilities, communication, and teamwork and team-based care) and (4) leveled and involved learners from different disciplines and academic levels. This session will address both opportunities and challenges that were encountered, including: assessing institutional readiness, early planning for IPE, creating and maintaining an interprofessional faculty team, educational strategies and resources for curricular development, logistical solutions, recruitment of appropriate learners from palliative care disciplines, and evaluation methods and tools. Attendees will be linked to online resources and organizations which provide materials and support IPE initiatives. Presenters will share examples of successful efforts through lecture, video and experiential activities.

An Interprofessional Curriculum on Antimicrobial Stewardship Improves Knowledge and Attitudes Toward Appropriate Antimicrobial Use and Collaboration.

BackgroundInappropriate antimicrobial use can threaten patient safety and is the focus of collaborative physician and pharmacist antimicrobial stewardship teams. However, antimicrobial stewardship is not comprehensively taught in medical or pharmacy school curricula. Addressing this deficiency can teach an important concept as well as model interprofessional healthcare.MethodsWe created an antimicrobial stewardship curriculum consisting of an online learning module and workshop session that combined medical and pharmacy students, with faculty from both professions. Learners worked through interactive, branched-logic clinical cases relating to appropriate antimicrobial use. We surveyed participants before and after the curriculum using validated questions to assess knowledge and attitudes regarding antimicrobial stewardship and interprofessional collaboration. Results were analyzed using paired χ2 and t tests and mixed-effects logistic regression.ResultsAnalysis was performed with the 745 students (425 medical students, 320 pharmacy students) who completed both pre- and postcurriculum surveys over 3 years. After completing the curriculum, significantly more students perceived that they were able to describe the role of each profession in appropriate antimicrobial use (34% vs 82%, P < .001), communicate in a manner that engaged the interprofessional team (75% vs 94%, P < .001), and describe collaborative approaches to appropriate antimicrobial use (49% vs 92%, P < .001). Student favorability ratings were high for the online learning module (85%) and small group workshop (93%).ConclusionsA curriculum on antimicrobial stewardship consisting of independent learning and an interprofessional workshop significantly increased knowledge and attitudes towards collaborative antimicrobial stewardship among preclinical medical and pharmacy students.

Diversity and internationalisation in interprofessional education

Abstract This position paper considers the perspectives regarding introducing diversity and internationalisation to the interprofessional education (IPE) curriculum. While this step may seem to be an onerous task in the challenging area of delivering quality IPE, the author seeks to demonstrate that the diversification of topics, disciplines and geographical locations can provide valuable student learning. By challenging the notion that IPE focusses on health-related topics alone and by broadening students' education, attributes can be developed that enhance employability and address global issues for a skilled workforce capable of delivering complex care. The paper highlights interprofessional educational initiatives developed by the author that includes the introduction of such topics as arts and humanities and public protection, as well as diversification of such disciplines as hospitality management, graphic design and the police. The international initiatives included collaborations between students and staff from Scotland, Japan and Australia. The importance of promoting diversity in the interprofessional curriculum for health and social care students concurs with the strategies from the World Health Organisation's global workforce alliance and professional bodies, such as the Higher Education Academy (UK). This paper encourages educators to engage with these strategies to acquire international perspectives on professional disciplines, thereby enabling students and faculty to develop a deeper understanding of other countries and cultures. IPE educators can develop curricula to include such initiatives and ensure that tomorrow's workforce has the necessary knowledge and skills to become global professionals. By adopting these transferable initiatives, educators can develop similar interventions appropriate for different cultural contexts.

Interprofessional collaboration strategies: A hematology unit case study

Interprofessional collaboration is essential to improve patient outcomes in hematology units. We report on the case of a patient with severe aplastic anemia who died after a fall in a hematology unit and explore the events of the case within the context of interprofessional collaboration. Several strategies were taken into consideration suggested by the Interprofessional Education Collaborative Expert Panel. A regular team meeting is helpful for gaining information about patients. Multidisciplinary education can enhance cooperation among medical team members and the use of an interprofessional curriculum at university level is recommended. Team building, interprofessional education, and clinical practice may facilitate health care providers to reach a collaborative level of clinical practice in a more considerate manner, to meet the demands of high quality health care.

A Community Needs Assessment for the Development of an Interprofessional Palliative Care Training Curriculum.

There is a known shortage of trained palliative care professionals, and an even greater shortage of professionals who have been trained through interprofessional curricula. As part of an institutional Palliative Care Training Center grant, a core team of interprofessional palliative care academic faculty and staff completed a state-wide palliative care educational assessment to determine the needs for an interprofessional palliative care training program. The purpose of this article is to describe the process and results of our community needs assessment of interprofessional palliative care educational needs in Washington state. We approached the needs assessment through a cross-sectional descriptive design by using mixed-method inquiry. Each phase incorporated a variety of settings and subjects. The assessment incorporated multiple phases with diverse methodological approaches: a preparatory phase-identifying key informants; Phase I-key informant interviews; Phase II-survey; and Phase III-steering committee endorsement. The multiple phases of the needs assessment helped create a conceptual framework for the Palliative Care Training Center and developed an interprofessional palliative care curriculum. The input from key informants at multiple phases also allowed us to define priority needs and to refine an interprofessional palliative care curriculum. This curriculum will provide an interprofessional palliative care educational program that crosses disciplinary boundaries to integrate knowledge that is beneficial for all palliative care clinicians. The input from a range of palliative care clinicians and professionals at every phase of the needs assessment was critical for creating an interprofessional palliative care curriculum.

Simulation for Operational Readiness in a New Freestanding Emergency Department: Strategy and Tactics.

Summary StatementSimulation in multiple contexts over the course of a 10-week period served as a core learning strategy to orient experienced clinicians before opening a large new urban freestanding emergency department. To ensure technical and procedural skills of all team members, who would provide care without on-site recourse to specialty backup, we designed a comprehensive interprofessional curriculum to verify and regularize a wide range of competencies and best practices for all clinicians. Formulated under the rubric of systems integration, simulation activities aimed to instill a shared culture of patient safety among the entire cohort of 43 experienced emergency physicians, physician assistants, nurses, and patient technicians, most newly hired to the health system, who had never before worked together. Methods throughout the preoperational term included predominantly hands-on skills review, high-fidelity simulation, and simulation with standardized patients. We also used simulation during instruction in disaster preparedness, sexual assault forensics, and community outreach. Our program culminated with 2 days of in-situ simulation deployed in simultaneous and overlapping timeframes to challenge system response capabilities, resilience, and flexibility; this work revealed latent safety threats, lapses in communication, issues of intake procedure and patient flow, and the persistence of inapt or inapplicable mental models in responding to clinical emergencies.

Mapping current health professional curricula: Identifying common topics for an integrated interprofessional education curriculum

Abstract Background Student response to the development of interprofessional competencies is enhanced when embedded in curricular content that appears to be relevant to their program and future practice. Purpose This paper will address the outcomes of a curriculum mapping project across eleven health professions at one university to determine potential common content for collaborative longitudinal learning. Method Course outlines, a curriculum map and a program accreditation outline were reviewed to identify topics, course objectives, year and semester taught, time allotted and method of assessment. Topics were analyzed and categorized to determine common themes. Discussion Ethics, communication with patients/clients and teams, collaboration, and quality and safety are among the common themes identified. Although these topics are currently taught in uniprofessional programs, they would have enhanced relevancy in an inteprofessional context. Conclusions Universities choosing topics for inteprofessional curricula can use themes identified as a reference point to explore further in their context.

Evoking a reciprocity of caring: Integration of humanities-based content into an interprofessional education immersion course for advanced practice nursing and health professions students

Along with calls to train nurse practitioners to be full partners in healthcare and lead interprofessional collaborative practice teams, there have been calls to enhance health professions education to develop transformative learning experiences, teach the ability to critically observe patients and capture their narrative experience of health, and assist students to become more empathic and communicate more clearly. In a Health Resources and Services Administration-funded advanced nursing education project that included advanced practice nursing, dentistry, pharmacy and social work students, several humanities-based learning strategies were infused into an interprofessional curriculum that was paired with interprofessional collaborative practice at an urban, primary care clinic serving underserved patients with multiple chronic conditions. The current study explored students’ reactions to the humanities-based interprofessional education curriculum using qualitative data from focus groups and reflective journal entries regarding student perceptions of their interprofessional collaborative practice experience in the clinical setting focused on the interprofessional education core competencies. Four major themes were identified that relate to the humanities-based curriculum. Student participants gained confidence in their abilities as health providers, improved their methods of communication and focus with patients, learned how to negotiate ethical situations in support of patient-centeredness, and grew as members of interprofessional collaborative practice teams. Thus, the inclusion of the humanities into nursing and interprofessional education and practice can assist with strengthening presence, promoting moral imagination, and evoking a reciprocity of caring that can lead to improved patient care and outcomes.